Search results for: clinical assessment

Authors: Usman Tunde Saadu, Adedayo Adesokan, Raseed Adewale Hamsat

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This study examined the influence of procrastination on the academic achievement of students in tertiary institutions in Kwara State, Nigeria. Descriptive survey was adopted for this study and the total number of 300 respondents participated in the study. Stratified and simple random sampling techniques were used to select 3 institutions and 30 departments respectively. Systematic sampling technique was used to select 10 final year students in each department. Two instruments were used to obtain data from the respondents. Procrastination Assessment Scale adapted from Solomon and Rothblum (1984) and a proforma designed by researchers to obtain students CGPA in 2013/2014 academic session. The reliability score of 0.80 was obtained for the instrument using split half method. One research question and one hypothesis were postulated for this study. Percentage was employed to answer research question while research hypothesis was tested with t-test statistical analysis at 0.05 level of significant. The findings of this study revealed that most of final year students in tertiary institutions in Kwara State procrastinated because 82.3% engaged in procrastination while 17.7% did not procrastinate. Also, the study revealed that there was a significant difference between the academic achievement of tertiary institution students who procrastinate and those who did not procrastinate (cal. t-value =2.634 < critical t-value = 1.960). Students who did not engage in act of procrastinate achieved better academically than students who engage in procrastination. Based on the findings of this study, the following recommendations were made; procrastination as a concept, should be taught at the various institutions so that students will understand what the concept is all about. Guidance and counsellor and educational psychologists should be employed at various institutions to handle students who procrastinate so that appropriate methods will be recommended so solve the problem.

Keywords: academic, achievement, procrastination, institution

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Authors: Chun-Hao Lai, Yu-Fang Huang, Pei-Wei Wang, Meng-Han Lin, Mei-Lien Chen

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Nonylphenol (NP) is a degradation product of nonylphenol ethoxylates (NPEOs). It is a well-known endocrine disruptor which may cause estrogenic effects. The growing fetus and infants are more vulnerable to exposure to NP than adults. It is important to know the levels and influences of prenatal exposure to NP. The aims of this study were (1) to determine the levels of prenatal exposure among Taiwanese, (2) to evaluate the potential risk for the infants who were breastfed and exposed to NP through the milk. (3) To investigate the correlation between birth outcomes and prenatal exposure to NP. We analyzed thirty one pairs of maternal urines, placentas, first month’ breast milk by high-performance liquid chromatography coupling with fluorescence detector. The questionnaire included socio- demographics, lifestyle, delivery method, dietary and work history. Information about the birth outcomes were obtained from medical records. The daily intake of NP from breast milk was calculated using deterministic and probabilistic risk assessment methods. The geometric means and geometric standard deviation of NP levels in placenta, and breast milk in the first month were 31.2 (1.8) ng/g, 17.2 (1.6) ng/g, respectively. The medium of daily intake NP in breast milk was 1.33 μg/kg-bw/day in the first month. We found negative association between NP levels of placenta and birth height. And we observed negative correlation between maternal urine NP levels and birth weight. In this study, we could provide the NP exposure profile among Taiwan pregnant women and the daily intake of NP in Taiwan infants. Prenatal exposure to higher levels of NP may increase the risk of lower birth weight and shorter birth height.

Keywords: nonylphenol, mother, fetus, placenta, breast milk, urine

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Authors: Omer Altaf, Liam Wotherspoon, Rolando Orense

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The Wairau Plains are located in the north-east of the South Island of New Zealand in the region of Marlborough. The region is cut by many active crustal faults such as the Wairau, Awatere, and Clarence faults, which give rise to frequent seismic events. This paper presents the preliminary results of the overall project in which liquefaction-induced ground damage maps are developed in the Wairau Plains based on the Ministry of Business, Innovation and Employment NZ guidance. A suite of maps has been developed in relation to the level of details that was available to inform the liquefaction hazard mapping. Maps at the coarsest level of detail make use of regional geologic information, applying semi-quantitative criteria based on geological age, design peak ground accelerations and depth to the water table. The next level of detail incorporates higher resolution surface geomorphologic characteristics to better delineate potentially liquefiable and non-liquefiable deposits across the region. The most detailed assessment utilised CPT sounding data to develop ground damage response curves for areas across the region and provide a finer level of categorisation of liquefaction vulnerability. Linking these with design level earthquakes defined through NZGS guidelines will enable detailed classification to be carried out at CPT investigation locations, from very low through to high liquefaction vulnerability. To update classifications to these detailed levels, CPT investigations in geomorphic regions are grouped together to provide an indication of the representative performance of the soils in these areas making use of the geomorphic mapping outlined above.

Keywords: hazard, liquefaction, mapping, seismicity

Procedia PDF Downloads 118

Authors: Noori Shafiqullah

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Millions of people reside downstream of river basins that heavily rely on snowmelt originating from the Hindu Kush (HK) region. Snowmelt plays a critical role as a primary water source in these areas. This study aimed to evaluate snowfall and snowmelt characteristics in the HK region across altitudes ranging from 2019m to 4533m. To achieve this, the study employed a combination of remote sensing techniques and the Snow Model (SM) to analyze the spatial and temporal distribution of Snow Water Equivalent (SWE). By integrating the simulated Snow-cover Area (SCA) with data from the Moderate Resolution Imaging Spectroradiometer (MODIS), the study optimized the Precipitation Gradient (PG), snowfall assessment, and the degree-day factor (DDF) for snowmelt distribution. Ground observed data from various elevations were used to calculate a temperature lapse rate of -7.0 (°C km-1). Consequently, the DDF value was determined as 3 (mm °C-1 d-1) for altitudes below 3000m and 3 to 4 (mm °C-1 d-1) for higher altitudes above 3000m. Moreover, the distribution of precipitation varies with elevation, with the PG being 0.001 (m-1) at lower elevations below 4000m and 0 (m-1) at higher elevations above 4000m. This study successfully utilized the SM to assess SCA and SWE by incorporating the two optimized parameters. The analysis of simulated SCA and MODIS data yielded coefficient determinations of R2, resulting in values of 0.95 and 0.97 for the years 2014-2015, 2015-2016, and 2016-2017, respectively. These results demonstrate that the SM is a valuable tool for managing water resources in mountainous watersheds such as the HK, where data scarcity poses a challenge."

Keywords: improved MODIS, experiment, snow water equivalent, snowmelt

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Authors: Alireza Nikbakht Shahbazi

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There are various factors that affect climate changes; drought is one of those factors. Investigation of efficient methods for estimating climate change impacts on drought should be assumed. The aim of this paper is to investigate climate change impacts on drought in Karoon3 watershed located south-western Iran in the future periods. The atmospheric general circulation models (GCM) data under Intergovernmental Panel on Climate Change (IPCC) scenarios should be used for this purpose. In this study, watershed drought under climate change impacts will be simulated in future periods (2011 to 2099). Standard precipitation index (SPI) as a drought index was selected and calculated using mean monthly precipitation data in Karoon3 watershed. SPI was calculated in 6, 12 and 24 months periods. Statistical analysis on daily precipitation and minimum and maximum daily temperature was performed. LRAS-WG5 was used to determine the feasibility of future period's meteorological data production. Model calibration and verification was performed for the base year (1980-2007). Meteorological data simulation for future periods under General Circulation Models and climate change IPCC scenarios was performed and then the drought status using SPI under climate change effects analyzed. Results showed that differences between monthly maximum and minimum temperature will decrease under climate change and spring precipitation shall increase while summer and autumn rainfall shall decrease. The precipitation occurs mainly between January and May in future periods and summer or autumn precipitation decline and lead up to short term drought in the study region. Normal and wet SPI category is more frequent in B1 and A2 emissions scenarios than A1B.

Keywords: climate change impact, drought severity, drought frequency, Karoon3 watershed

Procedia PDF Downloads 220

Authors: Marjan Moradi Fard, Hossein Rassi, Masoud Houshmand

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Aim: Breast cancer is one of the most common cancers affecting the morbidity and mortality of Iranian women. This disease is a result of collective alterations of oncogenes and tumor suppressor genes. Studies have produced conflicting results concerning the role of p53 codon 72 polymorphism (G>C) and miR-146a rs2910164 polymorphism (G>C) on the risk of several cancers; therefore, a research was performed to estimate the association between the p53 codon 72 polymorphism and miR-146a rs2910164 polymorphism in breast cancer. Methods and Materials: A total of 45 archival breast cancer samples from khatam hospital and 40 healthy samples were collected. Verification of each cancer reported in a relative was sought through the pathology reports of the hospital records. Then, DNA extracted from all samples by standard methods and p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes were analyzed using multiplex PCR. The tubules, mitotic activity, necrosis, polymorphism and grade of breast cancer were staged by Nottingham histological grading and immunohistochemical staining of the sections from the paraffin wax embedded tissues for the expression of ER, PR and p53 was carried out using a standard method. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Successful DNA extraction was assessed by PCR amplification of b-actin gene (99 bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of breast cancer in the study population. In this study, we established that tumors of p53 GG genotype and miR-146a rs2910164 CC genotype exhibited higher mitotic activity, higher polymorphism, lower necrosis, lower tubules, higher ER- and PR-negatives and lower TP53-positives than the other genotypes. Conclusion: The present study provided preliminary evidence that a p53 GG genotype may effect breast cancer risk in the study population, interacting synergistically with miR-146a rs2910164 CC genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with clinical parameters can serve as major risk factors in the early identification of breast cancers.

Keywords: breast cancer, p53 codon 72 polymorphism, miR-146a rs2910164 polymorphism, genotypes

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Authors: Ali panahi-Kosar Khosravi

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Earthquake resilience is one of the most important theoretical and practical concepts in crisis management. Over the past few decades, the rapid growth of urban areas and developing lower urban areas (especially in developing countries) have made them more vulnerable to human and natural crises. Therefore, the resilience of urban communities, especially low-income and unhealthy neighborhoods, is of particular importance. The present study seeks to assess and evaluate the resilience of neighborhoods in the center of district 6 of Tabriz in terms of awareness, knowledge and personal skills, social and psychological capital, managerial-institutional, and the ability to return to appropriate and sustainable conditions. The research method in this research is descriptive-analytical. The authors used library and survey methods to collect information and a questionnaire to assess resilience. The statistical population of this study is the total households living in the four neighborhoods of Shanb Ghazan, Khatib, Gharamalek, and Abuzar alley. Three hundred eighty-four families from four neighborhoods were selected based on the Cochran formula using a simple random sampling method. A one-sample t-test, simple linear regression, and structural equations were used to test the research hypotheses. Findings showed that only two social and psychological awareness and capital indicators in district 6 of Tabriz had a favorable and approved status. Therefore, considering the multidimensional concept of resilience, district 6 of Tabriz is in an unfavorable resilience situation. Also, the findings based on the analysis of variance indicated no significant difference between the neighborhoods of district 6 in terms of resilience, and most neighborhoods are in an unfavorable situation.

Keywords: resilience, statistical analysis, earthquake, district 6 of tabriz

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Authors: Ramandeep Kaur M. Malhi, Prashant K. Srivastava, G.Sandhya Kiran

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Quantitative estimates of foliar biochemicals, namely chlorophyll content (CC), serve as key information for the assessment of plant productivity, stress, and the availability of nutrients. This also plays a critical role in predicting the dynamic response of any vegetation to altering climate conditions. The advent of hyperspectral data with an enhanced number of available wavelengths has increased the possibility of acquiring improved information on CC. Retrieval of CC is extensively carried through well known spectral indices derived from hyperspectral data. In the present study, an attempt is made to develop hyperspectral indices by identifying optimum bands for CC estimation in Butea monosperma (Lam.) Taub growing in forests of Shoolpaneshwar Wildlife Sanctuary, Narmada district, Gujarat State, India. 196 narrow bands of EO-1 Hyperion images were screened, and the best optimum wavelength from blue, green, red, and near infrared (NIR) regions were identified based on the coefficient of determination (R²) between band reflectance and laboratory estimated CC. The identified optimum wavelengths were then employed for developing 12 hyperspectral indices. These spectral index values and CC values were then correlated to investigate the relation between laboratory measured CC and spectral indices. Band 15 of blue range and Band 22 of green range, Band 40 of the red region, and Band 79 of NIR region were found to be optimum bands for estimating CC. The optimum band based combinations on hyperspectral data proved to be the most effective indices for quantifying Butea CC with NDVI and TVI identified as the best (R² > 0.7, p < 0.01). The study demonstrated the significance of band characterization in the development of the best hyperspectral indices for the chlorophyll estimation, which can aid in monitoring the vitality of forests.

Keywords: band, characterization, chlorophyll, hyperspectral, indices

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Authors: Ashraf Mohammadzadeh, Ahmad Shah Farhat, Azin Vaezi, Aradokht Vaezi

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Background & Aim: Preterm infants born at less than 34 weeks postconceptional age are not as neurologically mature as their term counterparts and thus have difficulty coordinating sucking, swallowing and breathing. As a result, they are traditionally gavage fed until they are able to oral feed successfully. The aim of study was to evaluate comparative effect of orogastric and breast feeding on oxygen saturation in very low birth weight infant (<1500gm). Patients and Methods: In this clinical trial all babies admitted in the Neonatal Research Center of Imamreza Hospital, Mashhad during a 4 months period were elected. Criteria for entrance to study included birth weight ≤ 1500 grams, exclusive breastfeeding, having no special problem after 48 hours, receivinge only routine care and intake of milk was 100cc/kg/day. Each neonate received two rounds of orogastric and breast feeding in the morning and in the afternoon, during which mean oxygen saturation was measured by pulse-oxymetry. During the study the heart rate and temperature of the neonates were monitored, and in case of hypothermia, bradycardia(less than 100 per minute) or apnea the feeding was discontinued and the study was repeated the following day. Data analysis was carried out using SPSS. Results: Fifty neonates were studied. The average birth weight was 1267.20±165.42 grams and average gestational age was 31.81±1.92 and female/male ratio was 1.2. There was no significant statistical difference in arterial oxygen saturation in orogastric and breast feeding in the morning and in the afternoon. (p=0.16 in the morning and p=0.6 in the afternoon). There was no complication of apnea, hypothermia or bradycardia. Conclusion: There was no significant statistical difference between the two methods in arterial oxygen saturation. It seems that oral feeding (which is a natural route) and skin contact between the mother and neonate causes a strong emotional bonding between the two and brings about better social adaptation for the neonate. Also shorter period of stay in hospital is more preferred, and breast feeding should be started at the earliest possible time after birth.

Keywords: Very low birth weight (V.L.B.W), O2 Saturation, Breast Feeding, Tube Feeding

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Authors: Chibuzo Okoye Daniels, Gillian Glegg, Lynda Rodwell

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The continuously growing quantity of very slow degrading litter deliberately discarded into the coastal waters around Lagos as marine debris is obvious. What is not known is how to tackle this problem to reduce its prevalence and impact on the environment, economy and community. To identify ways of tackling the marine debris problem two case study areas (Ikoyi and Victoria Islands of Lagos State) were used to assess the root causes, the threat posed by marine debris in the coastal waters around Lagos and the efficacy of current instruments, programmes and initiatives that address marine debris in the study areas. The following methods were used: (1) Self-completed questionnaires for households and businesses within the study areas; (2) Semi-structured interviews with key stakeholders; (3) Observational studies of waste management from collection to disposal and waste management facilities for waste originating from land and maritime sources; (4) Beach surveys and marine debris surveys on shorelines and ports; and (5) Fishing for marine debris. Results of this study identified the following root causes: (1) Indiscriminate human activities and behaviors, and lack of awareness on the part of the main stakeholders and the public of the potential consequences of their actions; (2) Poor solid waste management practices; (3) Lack of strict legal frameworks addressing waste and marine debris problem; and (4) Disposal of non-degradable wastes into domestic sewer system and open streets drains. To effectively tackle marine debris problem in the study areas, adequate, appropriate and cost effective solutions to the above mentioned root causes needs to be identified and effectively transferred for implementation in the study areas.

Keywords: marine debris problem, Lagos state, litter, coastal waters

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Authors: Khanh To Duc, Monica Chiogna, Gianfranco Adimari

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With three diagnostic categories, assessment of the performance of diagnostic tests is achieved by the analysis of the receiver operating characteristic (ROC) surface, which generalizes the ROC curve for binary diagnostic outcomes. The volume under the ROC surface (VUS) is a summary index usually employed for measuring the overall diagnostic accuracy. When the true disease status can be exactly assessed by means of a gold standard (GS) test, unbiased nonparametric estimators of the ROC surface and VUS are easily obtained. In practice, unfortunately, disease status verification via the GS test could be unavailable for all study subjects, due to the expensiveness or invasiveness of the GS test. Thus, often only a subset of patients undergoes disease verification. Statistical evaluations of diagnostic accuracy based only on data from subjects with verified disease status are typically biased. This bias is known as verification bias. Here, we consider the problem of correcting for verification bias when continuous diagnostic tests for three-class disease status are considered. We assume that selection for disease verification does not depend on disease status, given test results and other observed covariates, i.e., we assume that the true disease status, when missing, is missing at random. Under this assumption, we discuss several solutions for ROC surface analysis based on imputation and re-weighting methods. In particular, verification bias-corrected estimators of the ROC surface and of VUS are proposed, namely, full imputation, mean score imputation, inverse probability weighting and semiparametric efficient estimators. Consistency and asymptotic normality of the proposed estimators are established, and their finite sample behavior is investigated by means of Monte Carlo simulation studies. Two illustrations using real datasets are also given.

Keywords: imputation, missing at random, inverse probability weighting, ROC surface analysis

Procedia PDF Downloads 398

Authors: C. Salis, D. Zedda, M. F. Wilson

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The IDEA project was conceived for teachers who are interested in enhancing their capacity to effectively implement the use of specific technologies in their teaching practice. Participating teachers are coached and supported as they explore technologies applied to the educational context. They access tools such as the technological platform developed by our team. Among the platform functionalities, teachers access an instructional systems design (ISD) tool (learning designer) that was adapted to the needs of our project. The tool is accessible from computers or mobile devices and used in association with other technologies to create new, meaningful learning environments. The objective of an instructional systems design is to guarantee the quality and effectiveness of education and to enhance learning. This goal involves both teachers who want to become more efficient in transferring knowledge or skills and students as the final recipient of their teaching. The use of Blooms’s taxonomy enables teachers to classify the learning objectives into levels of complexity and specificity, thus making it possible to highlight the kind of knowledge teachers would like their students to reach. The fact that the instructional design features can be visualized through the IDEA platform is a guarantee for those who are looking for specific educational materials to be used in their lessons. Despite the benefits offered, a number of teachers are reluctant to use ISD because the preparatory work of having to thoroughly analyze the teaching/learning objectives, the planning of learning material, assessment activities, etc., is long and felt to be time-consuming. This drawback is minimized using a learning designer, as the tool facilitates to reuse of the didactic contents having a clear view of the processes of analysis, planning, and production of educational or testing materials uploaded on our platform. In this paper, we shall present the feedback of the teachers who used our tool in their didactic.

Keywords: educational benefits, educational quality, educational technology, ISD tool

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Authors: A. Hira Masood, B. Umer Hameed, C. Ezza Nasir

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Contemporary studies support the strong co-relation between psychology and design. This study elaborates how different psychological personality test can help a fashion designer to judge the needs of their clients with respect to have products which will satisfy the client's request concerning costumised clothing. This study will also help the designer to improve the lacking in the personality and will enable him to put his effort in required areas for grooming the customer, control and direct organization regarding quality maintenance. The use of psychology test to support the choice of certain design strategies that how the right clothing can make client a better intellectual with enhanced self-esteem and confidence. Different projective personality test are being used to suggest to evaluate personality traits. The Rorschach Inkblot Test is projective mental comprising of 10 ink-blots synonymous with the clinical brain research. Lüsher Color Diagnostics measures a person’s psycho physical state, his or her ability to withstand stress to perform and communicate. HTP is a projective responsibility test measuring self-perception, attitudes. The TAT test intend to evaluate a person’s patterns of thoughts, attitudes, observation, capacity and emotional response to this ambiguous test materials. No doubt designers are already crucially redesigning the individuals by their attires, but to expose the behavioral mechanism of the customer, designers should be able to recognize the hidden complexity behind his client by using the above mentioned methods. The study positively finds the design and psychology need to become substantially contacted in order to create a new regime of norms to groom a personality under the concentration and services of a fashion designer in terms of clothing, This interactive activity altimately upgrade design team to help customers to find the suited way to satisfy their needs and wishes, offer client relible relationship and quality management services, and to become more disereable.

Keywords: projective personality tests, customized clothing, Rorschach Inkblot test, TAT, HTP, Lüsher color diagnostics, quality management services

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Authors: Nibal Al-Batsh, Issam A. Al-Khatib, Subha Ghannam

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Yatta is a town in the Governorate of Hebron, located 9 km south of Hebron City in the West Bank. The town houses over 100,000 people, 49% of which are females; a population that doubles every 15 years. Yatta has been connected to a water network since 1974 serving nearly 85% of the households. The water network is old and inadequate to meet the needs of the population. The water supply made available to the area is also very limited, estimated to be around 20 l/c/d. Residents are thus forced to rely on water vendors which supply water with a lower quality compared to municipal water while being 400% more expensive. As a cheaper and more reliable alternative, rainwater harvesting is a common practice in the area, with the majority of the households owning at least one cistern. Rainwater harvesting is of great socioeconomic importance in areas where water sources are scarce or polluted. In this research, the quality of harvested rainwater used for drinking and domestic purposes in the Yatta area was assessed throughout a year. A total of 100 samples, were collected from (cisterns) with an average capacity of 69 m3, which are adjacent to cement-roof catchment areas with an average area of 145 m2. Samples were analyzed for a number of parameters including: pH, alkalinity, hardness, turbidity, Total Dissolved Solids (TDS), NO3, NH4, chloride and salinity. Biological and microbiological contents such as Total Coliforms (TCC) and Fecal Coliforms (FC) bacteria were also tested. Results showed that most of the rainwater samples were within WHO and EPA guidelines set for chemical parameters. The research also addressed the impact of different socioeconomic attributes on rainwater harvesting through questionnaire that was pre-tested before the actual statically sample is collected.

Keywords: rainwater, harvesting, water quality, socio-economic aspects

Procedia PDF Downloads 235

Authors: Isabel Lopez-Oliva, Akshay Paropkari, Shweta Saraswat, Stefan Serban, Paola de Pablo, Karim Raza, Andrew Filer, Iain Chapple, Thomas Dietrich, Melissa Grant, Purnima Kumar

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Objective: We aimed to explicate the role of the subgingival microbiome in the causal link between rheumatoid arthritis (RA) and periodontitis (PD). Methods: Subjects with/without RA and with/without PD were randomized for treatment with scaling and root planing (SRP) or oral hygiene instructions. Subgingival biofilm, gingival crevicular fluid, and serum were collected at baseline and at 3- and 6-months post-operatively. Correlations were generated between 72 million 16S rDNA sequences, immuno-inflammatory mediators, circulating antibodies to oral microbial antigens, serum inflammatory molecules, and clinical metrics of RA. The dynamics of inter-microbial and host-microbial interactions were modeled using differential network analysis. Results: RA superseded periodontitis as a determinant of microbial composition, and DAS28 score superseded the severity of periodontitis as a driver of microbial assemblages (p=0.001, ANOSIM). RA subjects evidenced higher serum anti-PPAD (p=0.0013), anti-Pg-enolase (p=0.0031), anti-RPP3, anti- Pg-OMP and anti- Pi-OMP (p=0.001) antibodies than non-RA controls (with and without periodontitis). Following SRP, bacterial networks anchored by IL-1b, IL-4, IL-6, IL-10, IL-13, MIP-1b, and PDGF-b underwent ≥5-fold higher rewiring; and serum antibodies to microbial antigens decreased significantly. Conclusions: Our data suggest a circular relationship between RA and PD, beginning with an RA-influenced dysbiosis within the healthy subgingival microbiome that leads to exaggerated local inflammation in periodontitis and circulating antibodies to periodontal pathogens and positive correlation between severity of periodontitis and RA activity. Periodontal therapy restores host-microbial homeostasis, reduces local inflammation, and decreases circulating microbial antigens. Our data highlights the importance of integrating periodontal care into the management of RA patients.

Keywords: rheumatoid arthritis, periodontal, subgingival, DNA sequence analysis, oral microbiome

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Authors: A. E. Buyken, D. J. Mela, P. Dussort, I. T. Johnson, I. A. Macdonald, A. Piekarz, J. D. Stowell, F. Brouns

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Recently a number of renewed dietary guidelines have been published by various health authorities. The aim of the present work was 1) to review the processes (systematic approach/review, inclusion of public consultation) and methodological approaches used to identify and select the underpinning evidence base for the established recommendations for total carbohydrate (CHO), fiber and sugar consumption, and 2) examine how differences in the methods and processes applied may have influenced the final recommendations. A search of WHO, US, Canada, Australia and European sources identified 13 authoritative dietary guidelines with the desired detailed information. Each of these guidelines was evaluated for its scientific basis (types and grading of the evidence) and the processes by which the guidelines were developed Based on the data retrieved the following conclusions can be drawn: 1) Generally, a relatively high total CHO and fiber intake and limited intake of sugars (added or free) is recommended. 2) Even where recommendations are quite similar, the specific, justifications for quantitative/qualitative recommendations differ across authorities. 3) Differences appear to be due to inconsistencies in underlying definitions of CHO exposure and in the concurrent appraisal of CHO-providing foods and nutrients as well the choice and number of health outcomes selected for the evidence appraisal. 4) Differences in the selected articles, time frames or data aggregation method appeared to be of rather minor influence. From this assessment, the main recommendations are for: 1) more explicit quantitative justifications for numerical guidelines and communication of uncertainty; and 2) greater international harmonization, particularly with regard to underlying definitions of exposures and range of relevant nutrition-related outcomes.

Keywords: carbohydrates, dietary fibres, dietary guidelines, recommendations, sugars

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Authors: Giancarlo La Marca, Engy Shokry, Fabio Villanelli

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Epilepsy is one of the most common neurological disorders, with an estimated prevalence of 50 million people worldwide. Twenty five percent of the epilepsy population is represented in children under the age of 15 years. For antiepileptic drugs (AED), there is a poor correlation between plasma concentration and dose especially in children. This was attributed to greater pharmacokinetic variability than adults. Hence, therapeutic drug monitoring (TDM) is recommended in controlling toxicity while drug exposure is maintained. Carbamazepine (CBZ) is a first-line AED and the drug of first choice in trigeminal neuralgia. CBZ is metabolised in the liver into carbamazepine-10,11-epoxide (CBZE), its major metabolite which is equipotent. This develops the need for an assay able to monitor the levels of both CBZ and CBZE. The aim of the present study was to develop and validate a LC-MS/MS method for simultaneous quantification of CBZ and CBZE in dried blood spots (DBS). DBS technique overcomes many logistical problems, ethical issues and technical challenges faced by classical plasma sampling. LC-MS/MS has been regarded as superior technique over immunoassays and HPLC/UV methods owing to its better specificity and sensitivity, lack of interference or matrix effects. Our method combines advantages of DBS technique and LC-MS/MS in clinical practice. The extraction process was done using methanol-water-formic acid (80:20:0.1, v/v/v). The chromatographic elution was achieved by using a linear gradient with a mobile phase consisting of acetonitrile-water-0.1% formic acid at a flow rate of 0.50 mL/min. The method was linear over the range 1-40 mg/L and 0.25-20 mg/L for CBZ and CBZE respectively. The limit of quantification was 1.00 mg/L and 0.25 mg/L for CBZ and CBZE, respectively. Intra-day and inter-day assay precisions were found to be less than 6.5% and 11.8%. An evaluation of DBS technique was performed, including effect of extraction solvent, spot homogeneity and stability in DBS. Results from a comparison with the plasma assay are also presented. The novelty of the present work lies in being the first to quantify CBZ and its metabolite from only one 3.2 mm DBS disc finger-prick sample (3.3-3.4 µl blood) by LC-MS/MS in a 10 min. chromatographic run.

Keywords: carbamazepine, carbamazepine-10, 11-epoxide, dried blood spots, LC-MS/MS, therapeutic drug monitoring

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Authors: Richard Patrick Kabuye

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This study focuses on the addressing the enhancement of in-service training programs as a tool of transforming the existing traditional approaches of formal lectures/contact hours. This will be supported with a more versatile, robust, and remotely accessible means of mobile based e-learning, as a support tool for the traditional means. A combination of various factors in education and incorporation of the eLearning strategy proves to be a key factor in effective in-service education. Key factor needs to be factored in so as to maintain a credible co-existence of the programs, with the prevailing social, economic and political environments. Effective in-service education focuses on having immediate transformation of knowledge into practice for a good time period, active participation of attendees, enable before training planning, in training assessment and post training feedback training analysis which will yield knowledge to the trainers of the applicability of knowledge given out. All the above require a more robust approach to attain success in implementation. Incorporating mobile technology in eLearning will enable the above to be factored together in a more coherent manner, as it is evident that participants have to take time off their duties and attend to these training programs. Making it mobile, will save a lot of time since participants would be in position to follow certain modules while away from lecture rooms, get continuous program updates after completing the program, send feedback to instructors on knowledge gaps, and a wholly conclusive evaluation of the entire program on a learn as you work platform. This study will follow both qualitative and quantitative approaches in data collection, and this will be compounded incorporating a mobile eLearning application using Android.

Keywords: in service, training, mobile, e- learning, model

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Authors: Brigita Mieziene, Arunas Emeljanovas, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen

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Background. Health-related physical fitness refers to the favorable health status, i.e. ability to perform daily activities with vigor, as well as capacities that are associated with a low risk for development of chronic diseases and premature death. However, in school-aged children it is constantly declining, while some aspects of fitness declined as much as 50 percent during the last two decades, which prognosticates increasingly earlier onset of health problems, decreasing the quality of life of the population and financial burden for the society. Therefore, the goal of the current study was to indicate nationally representative age- and gender-specific reference values of anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children from 6 to 10 years. Methods. The study included 3556 students in total, from 73 randomly selected schools. Ethics approval for research by the Kaunas Regional Ethics Committee (No. BE-2-42) was obtained. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues. Height and weight were measured and body mass index calculated. Smoothed centile charts were derived using the LMS method. Results. The numerical age- and gender-specific percentile values (3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile) for anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness were provided. The equivalent smoothed LMS curves were performed. The study indicated 12.5 percent of overweight and 5 percent of obese children in accordance with international gender and age specific norms of body mass index. This data could be used in clinical and educational settings in order to identify the level of individual physical fitness within its different components.

Keywords: fitness, overweight, primary school children, reference values, smoothed percentile curves

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Authors: Dianis Wulan Sari, Takeo Minematsu, Mikako Yoshida, Hiromi Sanada

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Introduction: Pruritus is diagnosed as itching without macroscopic abnormalities on skin. It is the most skin complaint of elderly people. In the present study, we conducted a dermatological study to examine the risk factors of pruritic skin and predicted how to prevent pruritus especially in the elderly population. Pruritus is caused several types of inflammation, including epidermal innate immunity based on keratinocyte responses and acquired immunity regulated by type 1 or 2 helper T (Th) cells. The triggers of pruritus differ among inflammation types, therefore we did separately assess the pruritus-associated factors of each inflammation type in an effort to contribute to the identification of intervention targets for preventing pruritus. Therefore, this study aimed to investigate the factors related with actual condition of pruritic skin by examine the skin properties. Method: This study was conducted in elderly population of Indonesian nursing home. Basic characteristics and behaviors were obtained by interview. The properties of pruritic skin were collected by examination of skin biomarker using skin blotting as novel method of non-invasive skin assessment method and examination of skin barrier function using stratum corneum hydration and skin pH. Result: The average age of participants was 74 years with independent status was 66.8%. Age (β = -0.130, p = 0.044), cumulative lifetime sun exposure (β = 0.145, p = 0.026), bathing duration (β = 0.151, p = 0.022), clothing change frequency (β = 0.135, p = 0.029), and clothing type (β = -0.139, p = 0.021) were risk factors of pruritic skin in multivariate analysis. Conclusion: Risk factors of pruritic skin in elderly population were caused by internal factors such as skin senescence and external factors such as sun exposure, hygiene care and skin care behavior.

Keywords: aging, hygiene care, pruritus, skin care, sun exposure

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Authors: Asghar Zamani, Mostafa Falahmorad

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Virtualization is established to combine and use the unique capabilities of employees to increase productivity and agility to provide services regardless of location. Adapting to fast and continuous change and getting maximum access to human resources are reasons why virtualization is happening. The distance problem is solved by information. Flexibility is the most important feature of virtualization, and information will be the main focus of virtualized companies. In this research, we used the Covid-19 opportunity window to assess the productivity of the companies that had been going through more virtualized management before the Covid-19 in comparison with those that just started planning on developing infrastructures on virtual management after the crises of pandemic occurred. The research process includes financial (profitability and customer satisfaction) and behavioral (organizational culture and reluctance to change) metrics assessment. In addition to financial and CRM KPIs, a questionnaire is devised to assess how manager and employees’ attitude has been changing towards the migration to virtualization. The sample companies and questions are selected by asking from experts in the IT industry of Iran. In this article, the conclusion is that companies open to virtualization based on accurate strategic planning or willing to pay to train their employees for virtualization before the pandemic are more agile in adapting to change and moving forward in recession. The prospective companies in this research, not only could compensate for the short period loss from the first shock of the Covid-19, but they could also foresee new needs of their customer sooner than other competitors, resulting in the need to employ new staff for executing the emerging demands. Findings were aligned with the literature review. Results can be a wake-up call for business owners especially in developing countries to be more resilient toward modern management styles instead of continuing with traditional ones.

Keywords: virtual management, virtual organization, competitive advantage, KPI, profit

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Authors: Priyanka Tiwari, Uma Devi Ranjit, Ritesh Thapa

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Background and Significance: Cerebral Palsy (CP) influences not only the child's everyday functioning but also the functioning of whole family. Application of study findings can be used in clinical or community setting to screen the parents of children with cerebral palsy in order to identify the compromised domain of stress which in turn will help to improve the interaction between parent and child with disability and thus ultimately affect the progress that a child makes in his or her therapeutic or educational programs. Objective: The objective of the study was to assess the level of stress in mothers of children with CP by adopting mixed method design. Methodology: Cross-sectional descriptive design was adopted in the quantitative design where Parental Stress Scale (PSS) was utilized to collect data from a convenient sample of 40 mothers of children with CP who were under regular follow-up by home visitor of Self-help Group for Cerebral Palsy while embedded qualitative design was used to explore the stress of mothers of CP affected children. From the parent population of quantitative sample 4 mothers were chosen for in-depth exploration, regarding their stress by means of case study method. Descriptive statistics like frequency, percentage, mean, median, standard deviation, correlation and inferential statistics like Mann-Whitney U test and Kruskal-Wallis H test were used to describe and assess relationship between variables. Findings: The mean stress experienced by mothers of children with cerebral palsy was 53.62±9.53 with 15% percent of the mothers experiencing severe stress. There was significant association between age group of mother and total stress score and negative themes of stress. Similarly, signification association was found between educational status of the mother and positive themes of stress which was convergent with the qualitative finding as well, where literate mothers had more positive view of their child's disability which could be attributed to their educational level as education provides us with a broad perspective to look at a situation. Conclusions: Still one-sixth of the mothers experienced severe stress so if we want to ensure the well-being of the children affected by cerebral palsy, then parents caring for them need to be looked after as well.

Keywords: stress, cerebral palsy, mothers, mixed method

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Authors: Naad-E-Ali Sulehria

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Pakistan and china have stepped in a new phase of strengthening fraternity as the dream of economic corridor once discerned by both countries is going to take a pragmatic shape. Pak-China economic corridor an under construction program is termed to be an emerging dynamic of 21st century that anticipates a nexus between Asian continent and Indian Ocean by extending its functions to adjoining East, South, Central and Western Asian regions. The $45.6 billion worth heavily invested megaprojects by China are meant to revive energy sector and building economic infrastructure in Pakistan. Evidently, these projects are a part of ‘southern extension’ of Silk Road economic belt which is going to draw out prominent incentives for both countries particularly bolstering China to acquire influential dominance over the regional trade and beyond. In pursuit to adhere, by these progressive plans both countries have began working on their respective assignments. This article discusses the economical development programs under China’s peripheral diplomacy regarding its region-specific-approach to accumulate trade of Persian Gulf and access the landlocked Central Asian states through Pakistan in a sublimate context to break US encirclement of Asia. Pakistan’s utmost preference to utilize its strategic channel as a trade hub to become an emerging economy and surpass its arch-rival India for strategic concerns is contemplated accordingly. The needs and feasibility of the economic gateway and the dividends it can provide in the contemporary scenario are examined carefully and analysis is drawn upon the future prospects of the Pakistan-China Economic corridor once completed.

Keywords: pak-china economic corridor (PCEC), central asian republic states (CARs), new silk road economic belt, gawadar

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Authors: Rasheed Amao Busari, Ahmed Ibrahim

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The engineering properties of giant palms are crucial for the reasonable design of the processing and handling systems. The research was conducted to investigate some engineering properties of giant palm seeds in relation to their oil potential. The ripe giant palm fruit was sourced from some parts of Zaria in Kaduna State and Ado Ekiti in Ekiti State, Nigeria. The mesocarps of the fruits collected were removed to obtain the nuts, while the collected nuts were dried under ambient conditions for several days. The actual moisture content of the nuts at the time of the experiment was determined using KT100S Moisture Meter, with moisture content ranged 17.9% to 19.15%. The physical properties determined are axial dimension, geometric mean diameter, arithmetic mean diameter, sphericity, true and bulk densities, porosity, angles of repose, and coefficients of friction. The nuts were measured using a vernier caliper for physical assessment of their sizes. The axial dimensions of 100 nuts were taken and the result shows that the size ranges from 7.30 to 9.32cm for major diameter, 7.2 to 8.9 cm for intermediate diameter, and 4.2 to 6.33 for minor diameter. The mechanical properties determined were compressive force, compressive stress, and deformation both at peak and break using Instron hydraulic universal tensile testing machine. The work also revealed that giant palm seed can be classified as an oil-bearing seed. The seed gave 18% using the solvent extraction method. The results obtained from the study will help in solving the problem of equipment design, handling, and further processing of the seeds.

Keywords: giant palm seeds, engineering properties, oil potential, moisture content, and giant palm fruit

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Authors: Christen Kutz

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Objective: The aim of this study is to review a case series of 4 high-level Olympic and Division 1 wrestlers who experienced debilitating posterior circulation ischemic strokes during or after a competitive wrestling event and to identify risk factors, etiology and outcomes of stroke in young, healthy elite wrestlers. Background: Stroke occurs in one in 10,000 people under age 64. In young adults, the most common causes of stroke are cardiac embolism, hypercoagulable state, and vasculopathy. One-third of these strokes occur in young, fit individuals. There is little published literature about ischemic strokes that occur in wrestlers. Based on the nature of wrestling, the risk of injury or dissection to neurovascular structures may be a possible theory, but very few case reports exist. Methodology: 4 wrestlers under the age of 44 with a known history of ischemic stroke participated in individual interviews either in person or virtually. Each of the wrestlers provided their demographic information, wrestling background, clinical presentation at the time of stroke, imaging results, identification of potential risk factors, acute treatment and recovery. Results: 3 white male Division 1 wrestlers (2 Lehigh University, 1 Lock Haven University) and 1 black male 2008 Olympian experienced posterior circulation strokes. Case #1 felt a “pop” while wrestling (lateral medullary infarct, possible vertebral artery dissection); Case #2 awoke with severe vertigo, sweating, and vomiting after wrestling the previous day (left cerebellar infarct, (+) protein S deficiency); Case #3 severe vertigo, ataxia, and sensation of impending doom after wrestling earlier that week (left cerebellar infarct, hypoplastic left vertebral artery (+) anti-cardiolipin antibodies). Case #4 severe dizziness, confusion (left cerebellar stroke, vertebral artery dissection, small PFO). Conclusion: 3 wrestlers were started on anti-platelet therapy, risk factors were modified, and returned to their sport. 1 wrestler was placed on anti-coagulation and retired from competition.

Keywords: stroke, wrestling, Olympic, posterior circulation

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Authors: Swati Bajpai, S. P. K Jena

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Background: There is dramatic increase in the prevalence and severity of overweight in adolescents, raising concerns about their psychosocial and cognitive consequences, thereby indicating the immediate need to understand the effects of increased weight on scholastic performance. Although the body of research is currently limited, available results have identified an inverse relationship between obesity and cognition in adolescents. Aim: to examine the association between increased Body Mass Index in adolescents and their neurocognitive functioning. Methods: A case –control study of 28 subjects in the age group of 11-17 years (14 Males and 14 females) was taken on the basis of main inclusion criteria (Body Mass Index). All of them were randomized to (experimental group: overweight) and (control group: normal weighted). A complete neurocognitive assessment was carried out using validated psychological scales namely, Color Progressive Matrices (to assess intelligence); Bender Visual Motor Gestalt Test (Perceptual motor functioning); PGI-Memory Scale for Children (memory functioning) and Malin’s Intelligence Scale Indian Children (verbal and performance ability). Results: statistical analysis of the results depicted that 57% of the experimental group lack in cognitive abilities, especially in general knowledge (99.1±12.0 vs. 102.8±6.7), working memory (91.5±8.4 vs. 93.1±8.7), concrete ability (82.3±11.5 vs. 92.6±1.7) and perceptual motor functioning (1.5±1.0 vs. 0.3±0.9) as compared to control group. Conclusion: Our investigations suggest that weight gain results, at least in part, from a neurological predisposition characterized by reduced executive function, and in turn obesity itself has a compounding negative impact on the brain. Though, larger sample is needed to make more affirmative claims.

Keywords: adolescents, body mass index, neurocognition, obesity

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Authors: Ayse Inel Manav, Nuray Simsek

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The number of people with dementia and the problems that are experienced by these people are increasing along with aging world population. This study was carried out to assess the effects of reminiscence therapy using internet videos on the cognitive condition and apathy levels of elderly people who had mild dementia and lived in nursing homes. This randomly controlled experimental study was conducted between 25 May-25 August 2016 in the nursing home, elderly care and rehabilitation centers in Adana and Seyhan, Turkey. A total of 32 individuals participated in this study, 16 in the experimental group and 16 in the control group. Data were collected using a personal information form developed on the basis of the published literature, the Standardized Mini Mental Test (SMMT) and the Apathy Rating Scale (ARS). The Clinical Research Ethics Committee's approval, written institutional permission, and the written consent of the participants were obtained before data collection. The individuals in the experimental group received reminiscence therapy using internet videos for 60 minutes one day a week for three months. During the same period, 25-30 minutes of unstructured interviews on subjects unrelated to reminiscence were carried out with individuals in the control group. The SMMT and ARS were administered before the applications in the experimental group and at the end of the third month. The collected data were analyzed using descriptive statistics (means, standard deviations, and frequencies) as well as Student's t-test, the Mann-Whitney U-test, and Wilcoxon's signed ranks test. In this study, the total SMMT post-test scores of the experimental group were higher than those of the control group (p = 0.001; p < 0.01). There was a difference between experimental and control groups' total SMMT post-test scores (p = 0.001; p < 0.01). The experimental group's ARS total post-test scores were higher than those of the control group (p = 0.001; p < 0.01). This study found that group reminiscence therapy using internet videos improved the cognitive functions and apathy levels of elderly individuals with mild dementia.

Keywords: apaty, cognitive testing, dementia, elderly, reminisence threapy

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Authors: G. Pelozo, N. Quaranta

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The assessment of environmental hazard and ecotoxicological potential of industrial wastes has become an issue of concern in many countries. Therefore, the aim of this work is to develop a methodology, adapting an Argentinian standard, which allows analyze the ecotoxicological effect of various metallurgical and steel wastes. Foundry sand, white mud, red mud, electric arc furnace dust, converter slag, among others, are the studied wastes. The species used to analyze the ecotoxicological effects of wastes is rye grass (Lolium Perenne). The choice of this kind lies, among other things, in its easy and rapid germination making it possible to develop the test in a few days. Moreover, since the processes involved are general for most seeds, the obtained results with this kind are representative, in general, of the effects on seeds or seedlings. Since the studied residues are solids, prior to performing the assay, an eluate is obtained by stirring for 2 hours and subsequent filtration of a solution of waste in water in a relationship of 1:4. This represents 100% of eluate from which two dilutions in water (25% and 50%) are prepared. A sample with untreated solid waste and water is also performed. The test is performed by placing two filter papers in a Petri dish that are saturated with 3.5ml of the prepared dilutions. After that 20 rye grass seeds are placed, and the Petri dishes are covered and the seeds are incubated for 120 hours at 24 °C. Reference controls are carried out by distilled water. Three replicates are performed for each concentration. Once the exposure period is finished, inhibiting elongation of the root is measured (IR). The results of this test show that all the studied wastes produce an unfavorable effect on the development of the seedlings, being the electric arc furnace dust which more affects the germination.

Keywords: ecotoxicity, industrial wastes, environmental hazard, seeds

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Authors: Ching-Yuan Chen, Lung-Kwang Pan

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Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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Authors: Siva Kumar Bathina, Sudheer Siddapureddy

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Fires accident becomes even worse when the hazardous equipment like reactors or radioactive waste packages are engulfed in fire. In this work, large-eddy numerical fire simulations are performed using fire dynamic simulator to predict the thermal behavior of such bodies engulfed in hydrocarbon pool fires. A radiatively dominated 0.3 m circular burner with n-heptane as the fuel is considered in this work. The fire numerical simulation results without anybody inside the fire are validated with the reported experimental data. The comparison is in good agreement for different flame properties like predicted mass burning rate, flame height, time-averaged center-line temperature, time-averaged center-line velocity, puffing frequency, the irradiance at the surroundings, and the radiative heat feedback to the pool surface. Cask of different sizes is simulated with SS304L material. The results are independent of the material of the cask simulated as the adiabatic surface temperature concept is employed in this study. It is observed that the mass burning rate increases with the blockage ratio (3% ≤ B ≤ 32%). However, the change in this increment is reduced at higher blockage ratios (B > 14%). This is because the radiative heat feedback to the fuel surface is not only from the flame but also from the cask volume. As B increases, the volume of the cask increases and thereby increases the radiative contribution to the fuel surface. The radiative heat feedback in the case of the cask engulfed in the fire is increased by 2.5% to 31% compared to the fire without cask.

Keywords: adiabatic surface temperature, fire accidents, fire dynamic simulator, radiative heat feedback

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