Search results for: post-concussion symptoms scale

Authors: Yuan-Hong Ho, Chiung-Ju Huang

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This article presents a monitoring indicators system that predicts whether a local government in Taiwan is heading for fiscal distress and identifies a suitable fiscal policy that would allow the local government to achieve fiscal balance in the long run. This system is relevant to stockholders’ interest, simple for national audit bodies to use, and provides an early warning of fiscal distress that allows preventative action to be taken.

Keywords: fiscal health, fiscal distress, monitoring signals, 10-point scale

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Authors: M. Arunachalam, M. Pandey

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Nacre, a biological material that forms the inner-layer of sea shells can achieve high toughness and strength by way of staggered arrangement of strong tablets with soft and weak organic interface. Under applied loads the tablets slide over the adjacent tablets, thus generating inelastic deformation and toughness on macroscopic scale. A two dimensional finite element based homogenization methodology is adopted for obtaining the effective material properties of Nacre using a representative volume element (RVE) at finite deformations. In this work, the material behaviour for tablet and interface are assumed to be Isotropic elastic and Isotropic elastic-perfectly plastic with strain softening respectively. Numerical experiments such as uniaxial tension test along X, Y directions and simple shear test are performed on the RVE with uniform displacement and periodic constraints applied at the RVE boundaries to obtain the anisotropic homogenized response and maximum local stresses within each constituents of Nacre. Homogenized material model is then tested for macroscopic structure under three point bending condition and the results obtained are comparable with the results obtained for detailed microstructure based structure, thus homogenization provides a bridge between macroscopic scale and microscopic scale and homogenized material properties obtained from microstructural (RVE) analysis could be used in large scale structural analysis.

Keywords: finite element, homogenization, inelastic deformation, staggered arrangement

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Authors: M. Priscila Ramos, Omar O. Chisari, Juan Pablo Vila Martínez

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Current literature about trade liberalization of environmental goods and services (EGS) raises doubts about the extent of the triple win-win situation for trade, development and the environment. However, much of this literature does not consider the possibility that this agreement carries technological transmissions, either through trade or foreign direct investment. This paper presents a computable general equilibrium model calibrated for Argentina, where there are alternative technologies (one dirty and one clean according to carbon emissions) to produce the same goods. In this context, the trade liberalization of EGS allows to increase GDP, trade, reduce unemployment and improve the households welfare. However, the capital mobility appears as the key assumption to jointly reach the environmental target, when the positive scale effect generated by the increase in trade is offset by the change in the composition of production (composition and technical effects by the use of the clean alternative technology) and of consumption (composition effect by substitution of relatively lesspolluting imported goods).

Keywords: CGE modeling, CO2 emissions, composition effect, scale effect, technique effect, trade liberalization of EGS

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Authors: Yun-Ru Tsai, Jo-Hui Lin

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The cultural interactions between tourists and destination communities have received increased attention. Tourists play an important role in constructing a rewarding intercultural experience and cultural understanding. Cultural literacy is the ability for tourists to negotiate different cultures, this research aimed to develop a measurement of Tourist Cultural Literacy (TCL), the result provides a theoretical framework to assess how tourists interact with different cultural destinations. A pilot qualitative research was conducted in order to generate the initial items. In this study, the procedure of developing the TCL scale was divided into two parts. First, an exploratory factor analysis was conducted, a 25-item TCL scale was developed and six factors were identified: cultural sensitivity, appreciation of the culture, respect for the culture, knowledge of the culture, participate in the culture, and empathy for the culture. Second, confirmatory factor analyses and structural equation modeling were employed, the six-factor model was verified, and was proven to have good fit, reliability, convergent validity, discriminant validity, and criterion-related validity. The study provides managerial implications for tourist management and education, the popularization of TCL might increase the respect and understanding between tourists and local societies as well as decrease the cultural shocks and negative social-cultural impacts derived from tourism activities, thereby reducing the maintenance cost of management and allowing tourists to obtain a better cultural experience. Future research suggestions are also provided.

Keywords: cultural literacy, cultural tourism, scale development, tourism contact

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Authors: Sneha Samal, Iva Petrikova, Bohdana Marvalova

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Influence of grain size, shape and grain boundary diffusion at high temperature oxidation of pure metal is investigated as the function of microstructure evolution in this article. The oxidized scale depends on the geometrical parameter of the metal-scale system and grain shape, size, diffusion through boundary layers and influence of the contamination. The creation of the inner layer and the morphological structure develops from the internal stress generated during the growth of the scale. The oxidation rate depends on the cation and anion mobile transport of the metal in the inward and outward direction of the diffusion layer. Oxidation rate decreases with decreasing the grain size of the pure metal, whereas zinc deviates from this principle. A strong correlation between the surface roughness evolution, grain size, crystalline properties and oxidation mechanism of the oxidized metal was established.

Keywords: high temperature oxidation, pure metals, grain size, shape and grain boundary

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Authors: Mahshid Rezaei, Zahra Tajari, Zahra Esmaeily, Atefeh Eyvazkhani, Shahrzad Daei, Marjan Mansouri Dara, Mohaddesh Rezaei, Abolghassem Djazayeri, Ahmadreza Dorosti Motlagh

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Background: Musculoskeletal pain is one of the most prevalent symptoms in elderly age. Nutrition and diet are considered important underlying factors that could affect chronic musculoskeletal pain. The purpose of this study was to identify the relationship between empirical dietary inflammatory patterns (EDII) and musculoskeletal pain. Method: In this cross-sectional study, 213 elderly individuals were selected from several health centers. The usual dietary intake was evaluated by a valid and reliable 147-items food frequency questionnaire (FFQ). To measure the intensity of pain, Visual Analogue Scale (VAS) was used. Multiple Linear Regression was applied to assess the association between EDII and musculoskeletal pain. Results: The results of multiple linear regression analysis indicate that a higher EDII score was associated with higher musculoskeletal pain (β= 0.21: 95% CI: 0.24-1.87: P= 0.003). These results stayed significant even after adjusting for covariates such as sex, marital status, height, family number, sleep, BMI, physical activity duration, waist circumference, protector, and medication use (β= 0.16: 95% CI: 0.11-1.04: P= 0.02). Conclusion: Study findings indicated that higher inflammation of diet might have a direct association with musculoskeletal pains in elderlies. However, further investigations are required to confirm these findings.

Keywords: musculoskeletal pain, empirical dietary inflammatory pattern, elderlies, dietary pattern

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Authors: Oren Shtayermman

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The current investigation expended on research among parents caring for a child who is diagnosed with an autism spectrum disorder (ASD). An online web survey was used to collect data from 253 parents caring for a child with a diagnosis of ASD. Both parents reported on elevated levels of parental stress associated with caring for the child on the spectrum. In addition, lower levels of marital satisfaction were found in both parents. About 13% of the parents in the sample met the diagnostic criteria for Major Depressive Disorder and About 15% of the parents met the diagnostic criteria for Generalized Anxiety Disorder. Although the majority of the sample was females (94%) significant differences were found between males and females in relation to meeting the diagnostic criteria for Major Depressive Disorder and for Generalized Anxiety Disorder. Higher levels of stress were associated with higher number of Generalized Anxiety Disorder symptoms and higher number of Major Depressive Disorder symptoms. Findings from this study indicate how vulnerable parents and especially females are in relation to caring to a child diagnosed with ASD. Educational Objectives: At the conclusion of the paper, the readers should be able to: -Identify levels of stress and marital satisfaction among parents caring for a child diagnosed with autism spectrum disorder, -Recognize the impact of stress on the development of mental health issues, -Name the two most common mood and anxiety related disorders associated with caring for a child diagnosed with an autism spectrum disorder.

Keywords: autism, stress, parents, children

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Authors: Maryam Kiani, Abdul Basit Kiani

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At larger scales, the performance of cementitious materials is impacted by processes occurring at the nanometer scale. These materials boast intricate hierarchical structures with random features that span from the nanometer to millimeter scale. It is fascinating to observe how the nanoscale processes influence the overall behavior and characteristics of these materials. By delving into and manipulating these processes, scientists and engineers can unlock the potential to create more durable and sustainable infrastructure and construction materials. It's like unraveling a hidden tapestry of secrets that hold the key to building stronger and more resilient structures. The present work employs simulations as the computational modeling methodology to predict mechanical properties for carbon/silica based cementitious materials at the molecular/nano scale level. Studies focused on understanding the effect of higher mechanical properties of cementitious materials with carbon silica nanoparticles via Material Studio materials modeling.

Keywords: nanomaterials, SiO₂, carbon black, mechanical properties

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Authors: Nazmul Haque, Syeda Tasnuva Maria

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Sheehan's Syndrome (SS), also known as postpartum hypopituitarism, is a rare but potentially serious condition resulting from ischemic necrosis of the pituitary gland, often occurring during or after childbirth. This syndrome is characterized by hypopituitarism, leading to deficiencies in various hormones produced by the pituitary gland. The primary cause is typically severe postpartum hemorrhage, leading to inadequate blood supply and subsequent necrosis of the pituitary tissue. This chronic hypopituitarism sometimes plays the role of premature atherosclerosis, which may lead to cardiovascular disease. This abstract provides a comprehensive overview of Sheehan's Syndrome with ischaemic heart disease, encompassing its pathophysiology, clinical manifestations, and current management strategies. The disorder presents a wide spectrum of symptoms, including chest pain, fatigue, amenorrhea, lactation failure, hypothyroidism, and adrenal insufficiency. Timely diagnosis is crucial, as delayed recognition can lead to complications and long-term health consequences. We herein report a patient complaining of chronic fatigue symptoms, aggressiveness, chest pain, and breathlessness with repeated LOC that were diagnosed with SS with IHD. The patient was treated with antiplatelet, antianginal, steroids, and hormone replacement with marked improvement in his overall condition.

Keywords: ischaemic heart disease, Sheehan's syndrome, post-partum haemorrhage, pituitary gland

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Authors: Tri Harianto, Lawalenna Samang, St. Hijraini Nur, Arwin

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Recently, a port development is constructed in Makassar city, South Sulawesi Province, Indonesia. Makassar city is located in lowland area that dominated by soft marine clay deposit. A two kilometers causeway construction was built which is situated on the soft clay layer. In order to investigate the behavior of causeway embankment, a full-scale test was conducted of high embankment built on a soft clay deposit. The embankment with 3,5 m high was supported by two types of reinforcement such as raft and raft-aggregate column foundation. Since the ground was undergoing consolidation due to the preload, the raft and raft-aggregate column foundations were monitored in order to analyze the vertical ground movement by inducing the settlement of the foundation. In this study, two types of foundation (raft and raft-aggregate column) were tested to observe the effectiveness of raft-aggregate column compare to raft foundation in reducing the settlement. The settlement monitored during the construction stage by using the settlement plates, which is located in the center and toe of the embankment. Measurements were taken every day for each embankment construction stage (4 months). In addition, an analytical calculation was conducted in this study to compare the full-scale test result. The result shows that the raft-aggregate column foundation significantly reduces the settlement by 30% compared to the raft foundation. A raft-aggregate column foundation also reduced the time period of each loading stage. The Good agreement of analytical calculation compared to the full-scale test result also found in this study.

Keywords: full-scale, preloading, raft-aggregate column, soft clay

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Authors: Libing Zhu, Waichung Chen, Kwaicing Lo, Lei Li

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Background: Tian Jiu Therapy (a medicinal vesiculation therapy according to traditional Chinese medicine theory) in San Fu Days (the three hottest days in a year is calculated by the Chinese ancient calendar) is widely used by patients with chronic asthma in China although from modern medicine perspective there is insufficient evidence of its effectiveness and safety issues. We investigated the efficacy and safety of Tian Jiu Therapy compared with placebo in patients with chronic asthma. Methods: Patients with chronic asthma were randomly assigned to Tian Jiu treatment group (n=165), placebo control group (n=158). Registered Chinese Medicine practitioners, in Orthopedics-Traumatology, Acupuncture, and Tui-na Clinical Centre for Teaching and Research, School of Chinese Medicine, The University of Hong Kong, administered Tian Jiu Therapy and placebo treatment in 3 times over 2 months. Patients completed questionnaires and lung function test before treatment and after treatment, 3, 6, 9, and 11 months, respectively. The primary outcome was the no of asthma-related sub-healthy symptoms and the percentage of patients with twenty-three symptoms. Results: 451 patients were recruited totally, 111 patients refused or did not participate according the appointment time and 17 did not meet the inclusion criteria. Consequently, 323 of eligible patients were enrolled. There was nothing difference between Tian Jiu Therapy group and placebo control group at the end of all treatments neither primary nor secondary outcomes. While Tian Jiu Therapy as compared with placebo significantly reduced the percentage of participants who are susceptible waken up by asthma symptoms from 27% to 14% at 2nd follow-up (P < 0.05). Similarly, Tian Jiu Therapy significantly reduced the proportion of participants who had the symptom of running nose and sneezing before onset from 18% to 8% at 2nd follow-up (P < 0.05). Additionally, Tian Jiu Therapy significantly reduced the level of asthma, the proportion of participants who don’t need to processed during asthma attack increased from 6% to 15% at 1st follow-up and 0% to 7% at 3rd follow-up (P < 0.05). Improvements also occurred with Tian Jiu Therapy group, it reduced the proportion of participants who were spontaneously sweating at 3rd follow up and diarrhea after intake of oily food at 4th follow-up (P < 0.05). Conclusion: When added to a regimen of foundational therapy for chronic asthma participants, Tian Jiu Therapy further reduced the need for medications to control asthma, improved the quality of participants’ life, and significantly reduced the level of asthma. What is more, this benefit seems to have an accumulative effect over time was in accordance with the TCM theory of 'winter disease is being cured in summer'.

Keywords: asthma, Tian Jiu Therapy, San Fu Days, triaditional Chinese medicine, clinical trial

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Authors: Bharti Arora, Michael Chen, Steven Lun

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Plasmacytoid urothelial carcinoma (PUC) of the bladder is a rare and aggressive subtype of urothelial carcinoma that usually presents at an advanced clinical stage, has a predilection for early metastatic potential and is associated with poor prognosis. The first reported case of PUC was in 1991 and approximately 100 cases were reported in the literature worldwide. We present a case of a 43 year old female presenting with a 3-month history of urgency and frequency. Failing medical management of her urinary symptoms with anticholinergic medication, she underwent a diagnostic cystoscopy which revealed an erythematous and indurated bladder. Bladder biopsies of these regions revealed plasmacytoid urothelial carcinoma. Pre-operative staging scans were clear of any metastatic disease and the patient subsequently underwent a radical cystectomy and pelvic clearance with the formation of ileal conduit for urinary diversion. Histology confirmed plasmacytoid urothelial carcinoma with involvement of right upper vagina and focally positive margins in soft tissue at right and left sides of bladder. She received adjuvant chemotherapy but passed away within a year from disease progression. PUC can present atypically and our case highlights the role of cystoscopy in patients with persistent urinary symptoms. By reviewing the literature on PUC, we aim to raise awareness and improve understanding of this rare bladder cancer subtype amongst urologists.

Keywords: urology, bladder cancer, plasmacytoid urothelial cancer, literature review

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Authors: C. Pallis

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Induced-Gravity inflation is a model of chaotic inflation where the inflaton is identified with a Higgs-like modulus whose the vacuum expectation value controls the gravitational strength. Thanks to a strong enough coupling between the inflaton and the Ricci scalar curvature, inflation is attained even for subplanckian values of the inflaton with the corresponding effective theory being valid up to the Planck scale. In its simplest realization, induced-gravity inflation is based on a quatric potential and a quadratic non-minimal coupling and the inflationary observables turn out to be in agreement with the Planck data. Its supersymmetrization can be formulated within no-scale Supergravity employing two gauge singlet chiral superfields and applying a continuous $R$ and a discrete Zn symmetry to the proposed superpotential and Kahler potential. Modifying slightly the non-minimal coupling to Gravity, the model can account for the recent results of BICEP2. These modifications can be also accommodated beyond the no-scale SUGRA considering the fourth order term of the Kahler potential which mixes the inflaton with the accompanying non-inflaton field and small deviations from the prefactor $-3$ encountered in the adopted Kahler potential.

Keywords: cosmology, supersymmetric models, supergravity, modified gravity

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Authors: M. G. Tanga, P. B. Telefo, D. N. Tarla

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Even though the WHO, the EPA and other regulatory bodies have recognized the effects of acute pesticide poisoning little data exists on health effects after long-term low-dose exposures especially in Africa and Cameroon. The aim of this study was to evaluate the impact of pesticides on the hepatic functions of market gardeners in the Western Region of Cameroon by studying some biochemical parameters. Sixty six male market gardeners in Foumbot, Massangam, and Bantoum were interviewed on their health status, habits and pesticide use in agriculture, including the spray frequency, application method, and pesticide dosage. Thirty men with no history of pesticide exposure were recruited as control group. Thereafter, their blood samples were collected for assessment of hepatic function biomarkers (ALT, AST, and albumin). The results showed that 56 pesticides containing 25 active ingredients were currently used by market gardeners enrolled in our study and most of their symptoms (headache, fatigue, skin rashes, eye irritation, and nausea) were related to the use of these chemicals. Compared to the control subjects market gardeners’ ALT levels (32.9 ± 7.19 UL-1 vs. 82.11 ± 35.40 UL-1; P < 0.001) and, AST levels (40.63 ± 6.52 UL-1 vs. 112.11 UL-1 ± 47.15 UL-1; P < 0.001) were significantly increased. These results suggest that liver function tests can be used as biomarkers to indicate toxicity before overt clinical signs occur. The market gardeners’ chronic exposure to pesticides due to poor application measures could lead to hepatic function impairment. Further research on larger scale is needed to confirm these findings and to establish a mechanism of toxicity.

Keywords: biomarkers, liver, pesticides, occupational exposure

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Authors: Zuhair Kadhim Jahanger, S. Joseph Antony

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The available studies in the literature which dealt with the scale effects of strip footings on different sand packing systematically still remain scarce. In this research, the variation of ultimate bearing capacity and deformation pattern of soil beneath strip footings of different widths under plane-strain condition on the surface of loose, medium-dense and dense sand have been systematically studied using experimental and noninvasive methods for measuring microscopic deformations. The presented analyses are based on model scale compression test analysed using Particle Image Velocimetry (PIV) technique. Upper bound analysis of the current study shows that the maximum vertical displacement of the sand under the ultimate load increases for an increase in the width of footing, but at a decreasing rate with relative density of sand, whereas the relative vertical displacement in the sand decreases for an increase in the width of the footing. A well agreement is observed between experimental results for different footing widths and relative densities. The experimental analyses have shown that there exists pronounced scale effect for strip surface footing. The bearing capacity factors Nγ rapidly decrease up to footing widths B=0.25 m, 0.35 m, and 0.65 m for loose, medium-dense and dense sand respectively, after that there is no significant decrease in Nγ. The deformation modes of the soil as well as the ultimate bearing capacity values have been affected by the footing widths. The obtained results could be used to improve settlement calculation of the foundation interacting with granular soil.

Keywords: DPIV, granular mechanics, scale effect, upper bound analysis

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Authors: Bidisha Chatterjee, Sonal Grover, Rekha Gurung

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Postpartum dissection of the internal carotid artery is a relatively rare condition and is considered as an underlying aetiology in 5% to 25% of strokes under the age of 30 to 45 years. However, 86% of these cases recover completely and 14% have mild focal neurological symptoms. Prognosis is generally good with early intervention. The risk quoted for a repeat carotid artery dissection in subsequent pregnancies is less than 2%. 36-year Caucasian primipara presented on postnatal day one of forceps delivery with tachycardia. In the intrapartum period she had a history of prolonged rupture of membranes and developed intrapartum sepsis and was treated with antibiotics. Postpartum ECG showed septal inferior T wave inversion and a troponin level of 19. Subsequently Echocardiogram ruled out post-partum cardiomyopathy. Repeat ECG showed improvement of the previous changes and in the absence of symptoms no intervention was warranted. On day 4 post-delivery, she had developed symptoms of droopy right eyelid, pain around the right eye and itching in the right ear. On examination, she had developed right sided ptosis, unequal pupils (Rt miotic pupil). Cranial nerve examination, reflexes, sensory examination and muscle power was normal. Apart from migraine, there was no medical or family history of note. In view of Horner’s on the right, she had a CT Angiogram and subsequently MR/MRA and was diagnosed with dissection of the cervical portion of the right internal carotid artery. She was discharged on a course of Aspirin 75mg. By 6 week post-natal follow up patient had recovered significantly with occasional episodes of unequal pupils and tingling of right toes which resolved spontaneously. Cervical artery dissection, including VAD and carotid artery dissection, are rare complications of pregnancy with an estimated annual incidence of 2.6–3 per 100,000 pregnancy hospitalizations. Aetiology remains unclear though trauma during straining at labour, underlying arterial disease and preeclampsia have been implicated. Hypercoagulable state during pregnancy and puerperium could also be an important factor. 60-90% cases present with severe headache and neck pain and generally precede neurological symptoms like ipsilateral Horner’s syndrome, retroorbital pain, tinnitus and cranial nerve palsy. Although rare, the consequences of delayed diagnosis and management can lead to severe and permanent neurological deficits. Patients with a strong index of suspicion should undergo an MRI or MRA of head and neck. Antithrombotic and antiplatelet therapy forms the mainstay of therapy with selected cases needing endovascular stenting. Long term prognosis is favourable with either complete resolution or minimal deficit if treatment is prompt. Patients should be counselled about the recurrence risk and possibility of stroke in future pregnancy. Coronary artery dissection is rare and treatable but needs early diagnosis and treatment. Post-partum headache and neck pain with neurological symptoms should prompt urgent imaging followed by antithrombotic and /or antiplatelet therapy. Most cases resolve completely or with minimal sequelae.

Keywords: postpartum, dissection of internal carotid artery, magnetic resonance angiogram, magnetic resonance imaging, antiplatelet, antithrombotic

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Authors: Mohammed G. Alotaibi, Sameer Albahkaly, Salwa M. Bahkali, Abdullah M. Alghamdi, Raseel S. Alswidan, Maha Bin Shafi, Sarah Almaiman

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Introduction: Rhinitis is common in Saudi Arabia. Therefore, our study was designed to evaluate the prevalence, triggering factors, severity and progression of rhinitis during pregnancy. Methods: Prospective cross-sectional study was conducted in eight governmental and private medical centers in Riyadh, Saudi Arabia, during June and July 2014. Validated Arabic language self-administered questionnaire was used. Sample size of 260 Saudi pregnant women was calculated by Raosoft sample size calculator. Random sampling was achieved by choosing one and skipping every five patients in the clinic list. Data were coded and entered manually into spreadsheets then transferred to SPSS statistical package version 16.0 for Windows. Consent, Privacy and confidentiality of information were assured. Results: Pregnancy rhinitis was reported 31.2% (CI 25.6 - 37.2%). Symptoms arising in first trimester appeared in 79.2% of PR cases and mostly worsen. The most prevalent symptoms were nasal pruritis (67.5%), followed by sneezing (57.1%), congestion (50.6%), and post nasal drip (46.7%). The major triggering factor was dust (71.4%), followed by Tobacco/Shisha smoke (57.6%) and perfume(47%). Preexisting allergic diseases were markedly associated with developing pregnancy rhinitis. Conclusion: Rhinitis during pregnancy manifested in one third of Saudi pregnant ladies. Nasal pruritus was the most common symptom and dust was the widespread triggering factor.

Keywords: allergy, pregnancy, Rhinitis, sneezing

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Authors: Manav Sabharwal, Ruda Rai Md, Candace Parker, James Ridley

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Wheat is one of the most commonly consumed grains worldwide, which contains gluten. Nowadays, gluten intake is considered to be a trigger for GRDs, including Celiac disease (CD), a common genetic disease affecting 1% of the US population, non-celiac gluten sensitivity (NCGS) and wheat allergy. NCGS is being recognized as an acquired gluten-sensitive enteropathy that is prevalent across age, ethnic and geographic groups. The cause of this entity is not fully understood, and recent studies suggest that it is more common in participants with irritable bowel syndrome (IBS), with iron deficiency anemia, symptoms of fatigue, and has considerable overlap in symptoms with IBS and Crohn’s disease. However, these studies were lacking in availability of complete serologies, imaging tests and/or pan-endoscopy. We performed a prospective study of 745 adult patients who presented to an outpatient clinic for evaluation of chronic upper gastro-intestinal symptoms and subsequently underwent an upper endoscopic (EGD) examination as standard of care. Evaluation comprised of comprehensive celiac antibody panel, inflammatory bowel disease (IBD) serologic markers, duodenal biopsies and Small Bowel Video Capsule Endoscopy (VCE), when available. At least 6 biopsy specimens were obtained from the duodenum and proximal jejunum during EGD, and CD3+ Intraepithelial lymphocytes (IELs) and villous architecture were evaluated by a single experienced pathologist, and VCE was performed by a single experienced gastroenterologist. Of the 745 patients undergoing EGD, 12% (93/745) patients showed elevated CD3+ IELs in the duodenal biopsies. 52% (387/745) completed a comprehensive CD panel and 7.2% (28/387) were positive for at least 1 CD antibody (Tissue transglutaminase (tTG), being the most common antibody in 65% (18/28)). Of these patients, 18% (5/28) showed increased duodenal CD3+ IELs, but 0% showed villous blunting or distortion to meet criteria for CD. Surprisingly, 43% (12/28) were positive for at 1 IBD serology (ASCA, ANCA or expanded IBD panel (LabCorp)). Of these 28 patients, 29% (8/28) underwent a SB VCE, of which 100 % (8/8) showed significant jejuno-ileal mucosal lesions diagnostic for IBD. Findings of abnormal CD antibodies (7.2%, 28/387) and increased CD3+ IELs on duodenal biopsy (12%, 93/745) were observed frequently in patients with UGI symptoms undergoing EGD in an outpatient clinic. None met criteria for CD, and a high proportion (43%, 12/28) showed evidence of overlap with IBD. This suggests a potential causal link of acquired GRDs to underlying inflammation and gut mucosal barrier disruption. Further studies to investigate a role for abnormal antigen presentation of dietary gluten to gut associated lymphoid tissue as a cause are justified. This may explain a high prevalence of GRDs in the population and correlation with IBS, IBD and other gut inflammatory disorders.

Keywords: celiac, gluten sensitive enteropathy, lymphocitic enteritis, IBS, IBD

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Authors: Kwadwo Afari Gyan

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Cities are growing at unprecedented levels. Meanwhile, governments in the Global South are already overwhelmed by this growth and are unable to provide infrastructure proactively as expected. As a result, urban residents resort to providing their own infrastructure, such as drainage systems, as part of self-built housing development. Their small-scale, incremental housing practices, which often represent the formation of dense and diverse housing types, styles, and ages, have been identified to affect the planning of drainage systems at the regional scale. Such developments reflect the varied, affordable responses as part of a collective effort to curb regional problems, specifically flooding in this case. However, while some are included in this collective action, others are excluded as they are unable to afford to be included. This phenomenon, in addition to the formation of new autonomous localities, has led to challenges in mitigating flooding and has affected resilience to climate change. Using a qualitative approach, this paper explores how the mismatch between housing development, which occurs at an individual scale, and drainage infrastructure, which is provided at a regional scale, affects a regional effort to mitigate flooding in Tema, Ghana. It seeks to explore and reveal a relationship between affordability and inclusiveness. It also explores how density and diversity influence public infrastructure provision and their connection with affordability.

Keywords: climate change, affordability, inclusivity, equity, contextualization, regionalism

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Authors: Aline Giardin

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Introduction: This review addresses the relationship between physical education and mental health and its main objective is to discuss the meanings that circulate in Psychiatric Hospitalization Units and Psychosocial Care Centers (CAPS) about the presence of physical education teachers and the practices developed by Them within these services. Material and methods: It is based on the theoretical contribution of the Psychiatric Reform and is methodologically inspired by the Bibliographic Review. Objectives: The objective of this review was to identify the main scientific evidence on the effects of physical activity on the main psychological aspects associated with mental health during the hospitalization process. Results: It was observed that physical activity has beneficial effects in the psychological, social and cognitive aspects, being thus a fundamental aspect of the lifestyle in promoting a healthy and successful treatment. In studies evaluating the effects of physical activity on mental health, the most frequently evaluated outcomes include anxiety, depression, and health-related quality of life (eg, self-esteem and self-efficacy). Evidence from epistemological studies indicates that the level of physical activity is positively associated with good mental health, when mental health is defined as good mood, general well-being and decreased symptoms. Conclusion: It is necessary to intervene and a greater interest of the professionals of physical education in the treatment with the people with mental disorders so that the negative symptoms are modified, through the aid of the physical activity, by better quality of life, physical condition, nutritional state and A healthy emotional appearance.

Keywords: health mental, physical activity, benefits, treatment

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Authors: Andrey A. Chernousov, Ben Y. B. Chan

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The thermal behavior of a large-scale, phase change material (PCM) enhanced building envelope system was studied in regard to the need for pre-fabricated construction in subtropical regions. The proposed large-scale envelope consists of a reinforced aluminum skin, insulation core, phase change material and reinforced gypsum board. The PCM impact on an energy efficiency of an enveloped room was resolved by validation of the Energy Plus numerical scheme and optimization of a smart material location in the core. The PCM location was optimized by a minimization method of a cooling energy demand. It has been shown that there is good agreement between the test and simulation results. The optimal location of the PCM layer in Hong Kong summer conditions has been then recomputed for core thicknesses of 40, 60 and 80 mm. A non-dimensional value of the optimal PCM location was obtained to be same for all the studied cases and the considered external and internal conditions.

Keywords: thermal performance, phase change material, energy efficiency, PCM optimization

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Authors: Intan Izafina Idrus, Mardina Abdullah, Alina Marie Hasbi, Asnawi Husin

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This paper presents the result of large-scale traveling ionospheric disturbance (LSTID) observation during moderate magnetic storm event on 25 October 2011 with SYM-H ~ -160 nT and Kp ~ 7 over Peninsular Malaysia at equatorial region using vertical total electron content (VTEC) from the Global Positioning System (GPS) observation measurement. The propagation of the LSTID signatures in the TEC measurements over Peninsular Malaysia was also investigated using VTEC map. The LSTID was found to propagate equator-ward during this event. The results showed that the LSTID propagated with an average phase velocity of 526.41 m/s and average periods of 140 min. The occurrence of this LSTID was also found to be the subsequent effects of substorm activities in the auroral region.

Keywords: Global Positioning System (GPS), large-scale traveling ionospheric disturbance (LSTID), moderate geomagnetic storm, vertical total electron content (VTEC)

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Authors: Il-Ho Kim, Samuel Noh, Kwame McKenzie, Cyu-Chul Choi

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Many members of immigrant minorities choose to operate microbusinesses that involve emotionally taxing interactions with customers and discriminatory exposures in the workplace. This study investigated the psychological risks of emotional demands and discrimination as well as the buffering roles of two types of job resources (job autonomy and job security) among immigrant microbusiness owners (MBOs). Data were derived from a cross-sectional survey of 550 Korean immigrant MBOs, aged 30 to 70, living in Toronto and its surrounding areas. Face-to-face interviews were conducted between March and November 2013. Results showed that emotional suppression and discrimination were positively associated with depressive symptoms. However, the direct effect of positive emotional demands was insignificant. For job resources, the beneficial effect of job security on depressive symptom was apparent, but the effect of job autonomy was trivial. Regarding the moderating effect, job security buffered the psychological harm of both emotional suppression and workplace discrimination. Although job autonomy buffered the link between discrimination and depressive symptoms, the buffering effect of job autonomy on the emotional suppression-depression link was insignificant. This study’s finding implies that emotional demands and workplace discrimination seem to be important factors in contributing to occupational psychological problems, but the psychological impact can differ according to the types of emotional demands and job resources among immigrant MBOs.

Keywords: immigrant microbusiness owners, emotional demands, discrimination, job resources, depression

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Authors: Liliane Clark

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Immigrating to a different country may imply having to handle many difficult exertions. There is a particular issue that has to be endured by some immigrants: the children they had to leave behind. It is a phenomenon that occurs with certain frequency. Surprisingly, despite the fact that immigration in the United States is such a large proceeding, there is not much research about the topic in America exploring the trauma of the abandonment caused by this separation and its consequences on the mental health of those children. The term “left behind children” is usually applied to children who were left behind by their parents in their original nation under the care of a noteworthy relative, frequently the grandparents, when they moved to another country. This preliminary research, which is a partial study projected for a doctoral thesis, investigated whether the trauma of abandonment experienced by ten left behind children had affected their emotional development. The Strengths and Difficulties Questionnaire (SDQ) and a brief interview were utilized to assess the information. The SDQ explored scales such as emotional symptoms, conduct problems, hyperactivity, peer problems and prosocial behavior. In this pilot study, the results indicated that all these issues had some sort of significant correlation between them. During the interviews, the participants or their parents identified a range of symptoms: anxiety disorder, eating disorders, panic attacks, psychotic-like experiences, drug use and depression. Hence, it seems that there is a connection between the trauma of abandonment suffered due to the separation and the children’s consequent symptomatic behavior. Further studies are indeed necessary to validate the initial results of this investigation.

Keywords: abandonment, parent migration, psychological problems, trauma

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Authors: Bharat Rawat, Shekhar Rajbhandari, Yadav Bhatta, Jay Prakash Jaiswal, Shivaji Bikram Silwal, Rajiv Shrestha, Shova Sunuwar

Abstract:

Introduction: The honey produced by the bees fed on Rhobdodendron species containing grayanotoxin is known as mad honey. Grayanotoxin is found in honey obtained from the nectar of Rhododendron species growing on the mountains of the Black Sea region of Turkey and also in Japan, Nepal, Brazil, parts of North America, and Europe. Although the incidence of grayanotoxin poisoning is rare, there is concern that the number of cases per year will rise with the increasing demand for organic products. Mad honey intoxication might present with mild symptoms of cardiovascular, gastrointestinal and neurological systems or might also present with a life-threatening form with AV block and cardiovascular collapse. In this article, we describe the summary of five cases, which came to our hospital with mad honey related cardiac complications. Findings: In last one year, five cases presented in the emergency department with sudden onset of Loss of consciousness, dizziness, shortness of breath. They felt difficulty after the consumption of 1-3 teaspoonful of wild honey. The honey was brought from most of the rural parts of Nepal like khotang. Some of them also came with vomiting, dizziness, and loose stool. On examination, most of them had severe bradycardia and low blood pressure. No abnormalities were detected on systemic examinations. In one patient, ECG and cardiac enzymes showed features of the acute coronary syndrome, but his treadmill test done few days later was normal. All patients were managed with inj. Atropine, I/V normal saline, and other supportive measures and discharged in a stable condition within one or two days. Conclusions: Rhododendrons is the national flower of Nepal. The specific species of rhododendron found in Nepal which contains the toxin is not known. Bees feeding on these rhododendrons are known to transfer the grayanotoxin to the honey they produce. Most symptoms are mild and resolve themselves without medical intervention. Signs and symptoms of grayanotoxin poisoning rarely last more than 24 hours and are usually not fatal. Some signs of mad honey poisoning include Bradycardia, Cardiac arrhythmia, Hypotension, Nausea and Vomiting. They respond to close monitoring and appropriate supportive treatment. Normally, patients recover completely with no residual damage to the heart or its conduction system.

Keywords: rhobdodendron, honey, grayanotoxin, bradycardia

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Authors: Camille Alexis-Garsee, Nicola Payne

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One consequence of the pandemic has been the debilitating health impact that some people experience over a longer period of time, known as long-COVID. This has been predominately researched in adults; however, there is emerging evidence on the effects of long-COVID in children. Research has indicated over half of children who contracted COVID-19 experienced persistent symptoms four months after a confirmed diagnosis. There is little research on the impact of this on children and their families. This study aimed to explore the experiences of children with long-COVID, to enable further understanding of the impacts and needs within this group. Semi-structured interviews, facilitated by children’s drawings, were conducted with 15 children (aged 9-16, 9 females). Inductive thematic analysis was used to analyze the data. The findings tell a story of loss, change and of resilience. Many children were unable to engage in normal daily activities and were unable to attend school, however, all employed self-management techniques to cope with symptoms and were positive for the future. Four main themes were identified: (1) Education challenges: although some schools tried to accommodate the child’s new limitations with provision of flexi-attendance, online classes and a reduced timetable, children struggled to keep up with their schoolwork and needed more support; (2) Disrupted relationships: children felt socially isolated; they were forced to give up co and extra-curricular activities, were no longer in contact with friendship groups and missed out on key experiences with friends and family; (3) Diverse health-related challenges: children’s symptoms affected daily functioning but were also triggers for changes in thoughts and mood; (4) Coping and resilience: children actively engaged in symptom management and were able to ‘self-pace’ and/or employ distraction activities to cope. They were also focused on living a ‘normal’ life and looked to the future with great positivity. A key challenge of the long-term effects of COVID is recognizing and treating the illness in children and the subsequent impact on multiple aspects of their lives. Even though children described feeling disconnected in many ways, their life goals were still important. A multi-faceted approach is needed for management of this illness, with a focus on helping these children successfully reintegrate into society and achieve their dreams.

Keywords: children’s illness experience, COVID-19, long-COVID in children, long-COVID kids, qualitative research

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Authors: Mustafa Cam, Nedim Ongun, Ufuk Kutluana

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

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

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Authors: Meril Kate Mariano, Billy Joel Almarinez Divina Amalin, Jose Isagani Janairo

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The scale insects Aspidiotus destructor and Aspidiotus rigidus exhibit notable scale covers made of wax which provides protection against water loss and is capable to resist wetting, thus making them a desirable model for biomimetic designs. Their waxy covers enable them to infest mainly leaves of coconut trees despite the harsh wind and rain. This study aims to describe and compare the micro morphological characters on the surfaces of their scale covers consequently, how these micro structures affect their wetting properties. Scanning electron microscope was used for the surface characterization while an optical contact angle meter was employed in the wetting measurement. The scale cover of A. destructor is composed of multiple overlapping layers of wax that is arranged regularly while that of A. rigidus is composed of a uniform layer of wax with much more prominent wax ribbons irregularly arranged compared to the former. The protrusions found on the two organisms are formed by the wax ribbons that differ in arrangement with their height being A. destructor (3.57+1.29) < A. rigidus (4.23+1.22) and their density A. destructor (15+2.94) < A. rigidus (18.33+2.64). These morphological measurements could affect the contact angle (CA θ) measurement of A. destructor (102.66+9.78°) < A. rigidus (102.77 + 11.01°) wherein the assessment that the interaction of the liquid to the microstructures of the substrate is a large factor in the wetting properties of the insect scales is realized. The calculated surface free energy of A. destructor (38.47 mJ/m²) > A. rigidus (31.02 mJ/m²) shows inverse proportionality with the CA measurement. The dispersive interaction between the surface and liquid is more prevalent compared to the polar interaction for both Aspidiotus species, which was observed using the Fowkes method. The results of this study have possible applications to be a potential biomimetic design for various industries such as textiles and coatings.

Keywords: Aspidiotus spp., biomimetics, contact angle, surface characterization, wetting behavior

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Authors: Chia-Yi Wu, Jung-Chen Chang, Wen-Yu Hu, Ming-Been Lee

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In nearly all physical health conditions, suicide risk is increased compared to healthy people even after adjustment for age, gender, mental health, and substance use diagnoses. In order to highlight the importance of suicide risk assessment for the inpatients and early identification and engagement for inpatients’ mental health problems, a study was designed aiming at developing a comprehensive psychosomatic nursing engagement (PSNE) model with standardized operation procedures informing how nurses communicate, assess, and engage with the inpatients with emotional distress. The purpose of the study was to promote the gatekeeping role of clinical nurses in performing brief assessment and interventions to detect depression and anxiety symptoms among the inpatients, particularly in non-psychiatric wards. The study will be carried out in a 2000-bed university hospital in Northern Taiwan in 2019. We will select a ward for trial and develop feasible procedures and in-job training course for the nurses to offer mental health care, which will also be validated through professional consensus meeting. The significance of the study includes the following three points: (1) The study targets at an important but less-researched area of PSNE model in the cultural background of Taiwan, where hospital service is highly accessible, but mental health and suicide risk assessment are hardly provided by non-psychiatric healthcare personnel. (2) The issue of PSNE could be efficient and cost-effective in the identification of suicide risks at an early stage to prevent inpatient suicide or to reduce future suicide risk by early treatment of mental illnesses among the high-risk group of hospitalized patients who are more than three-times lethal to suicide. (3) Utilizing a brief tool with its established APP ('The Five-item Brief Symptom Rating Scale, BSRS-5'), we will invent the standardized procedure of PSNE and referral steps in collaboration with the medical teams across the study hospital. New technological tools nested within nursing assessment/intervention will concurrently be invented to facilitate better care quality. The major outcome measurements will include tools for early identification of common mental distress and suicide risks, i.e., the BSRS-5, revised BSRS-5, and the 9-item Concise Mental Health Checklist (CMHC-9). The main purpose of using the CMHC-9 in clinical suicide risk assessment is mainly to provide care and build-up therapeutic relationship with the client, so it will also be used to nursing training highlighting the skills of supportive care. Through early identification of the inpatients’ depressive symptoms or other mental health care needs such as insomnia, anxiety, or suicide risk, the majority of the nursing clinicians would be able to engage in critical interventions that alleviate the inpatients’ suffering from mental health problems, given a feasible nursing input.

Keywords: mental health care, clinical outcome improvement, clinical nurses, suicide prevention, psychosomatic nursing

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Authors: Shehret Tilvaldyev, Jorge Flores-Garay, Alfredo Villanueva, Erwin Martinez, Lazaro Rico

Abstract:

The efficiency of modern transportation is severely compromised by the prevalence of turbulent drag. The high level of turbulent skin-friction occurring, e.g., on the surface of an aircraft, automobiles or the carriage of a high-speed train, is responsible for excess fuel consumption and increased carbon emissions. The environmental, political, and economic pressure to improve fuel efficiency and reduce carbon emissions associated with transportation means that reducing turbulent skin-friction drag is a pressing engineering problem. The dynamic pressure of subsonic airflow around solid objects creates lift, but also induces drag force. This paper is presenting the results of laboratory experiments, investigating appearance and magnitude of dynamic pressure in micro scale of subsonic air flow around right cylinder and symmetrical airfoil.

Keywords: airflow, dynamic pressure, micro scale, symmetric object

Procedia PDF Downloads 362