Search results for: patients care

Authors: Vivian Correa

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Hypothesis There are typical patterns - phenotypes - of sleep behaviors by age and biological sex groups of parasomnia patients where wearable devices could avoid injuries. Materials and methods We analyzed public video records on sleep-related behaviors likely representing parasomnias, looking for phenotypes in different groups. We searched public internet databases using the keywords “sleepwalking”, “sleep eating,” “sleep sex”, and “aggression in sleep” in six languages. Poor-quality vide-records and those showing apparently faked sleep behaviors were excluded. We classified the videos into estimated sex and age (children, adults, elderly) groups; scored the activity types by a self-made scoring scale; and applied binary logistic regression for analyzing the association between sleep behaviors versus the groups by STATA package providing 95% confidence interval and the probability of statistical significance. Results 224 videos (102 women) were analyzed. The odds of sleepwalking and related dangerous behaviors were lower in the elderly than in adults (P<0.025). Females performed complex risky behaviors during sleepwalking more often than males (P<0.012). Elderly people presented emotional behaviors less frequently than adults (P<0.004), and females showed them twice often as males. Elderly males had 40-fold odds compared to adults and children to perform aggressive movements and 70-fold odds of complex movements in the bed compared to adults. Conclusion Unlike other groups, the high chances of adults being sleepwalkers and elderly males performing intense and violent movements in bed showed us the importance of developing wearable parasomnia devices to prevent injuries.

Keywords: parasomnia, wearable devices, sleepwalking, RBD

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Authors: Niragira Donatien

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The progress of technology creates new expectations for patients. The world of deafness is no exception. In recent years, there have been considerable advances in the field of technologies aimed at assisting failing hearing. According to the usual medical vocabulary, hearing aids are actually orthotics. They do not replace an organ but compensate for a functional impairment. The amplifier hearing amplification is useful for a large number of people with hearing loss. Hearing aids restore speech audibility. However, their benefits vary depending on the quality of residual hearing. The hearing aid is not a "cure" for deafness. It cannot correct all affected hearing abilities. It should be considered as an aid to communicate who the best candidates for hearing aids are. The urge to judge from the audiogram alone should be resisted here, as audiometry only indicates the ability to detect non-verbal sounds. To prevent hearing aids from ending up in the drawer, it is important to ensure that the patient's disability situations justify the use of this type of orthosis. If the problems of receptive pre-fitting counselling are crucial, the person with hearing loss must be informed of the advantages and disadvantages of amplification in his or her case. Their expectations must be realistic. They also need to be aware that the adaptation process requires a good deal of patience and perseverance. They should be informed about the various models and types of hearing aids, including all the aesthetic, functional, and financial considerations. If the person's motivation "survives" pre-fitting counselling, we are in the presence of a good candidate for amplification. In addition to its relevance, hearing aids raise other questions: Should one or both ears be fitted? In short, all these questions show that the results found in this study significantly improve the quality of audibility in the patient, from where this technology must be made accessible everywhere in the world. So we want to progress with the technology.

Keywords: audiology, influence, hearing, madicaly, treatable

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Authors: Sabika Khalid, Endale Fantahun Tadesse

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Unlike other professional sectors, a great deal of studies has addressed the overwhelming gender disparity phenomena in the early childhood education (ECE) workforce, which is acknowledged for the dominance of women over men teachers. The irony of ECE being a gendered working environment is not only observed in societies that are ruled by gender roles but also in Western countries that claim to margin the gender gap in several professions. The participation of male teachers in ECE across most countries ranged from 1% to 3% of the total preschool or kindergarten teachers. When it comes to a dynamic Chinese society tempered with a deep-rooted tradition and cultural ideology, the ECE has no less place for males, and males have a low place for ECE. According to the Ministry of Education of China (2020), there are over 5 million kindergarten teachers and staff members, while only 2.3% are accounted for male teachers. The traditional gender-based discourse asserts that giving care and guidance for young children related to nurturing ‘mothering’ labels the profession in ECE as women’s work derived from originated from their ‘naturality.’ Although a large volume of evidence sheds light on the cause for low male teachers, the perception of parents, female teachers working with male teachers, and the experience of male teachers working in ECE, less is known and understood before being a teacher. Hence, this study argues that the promotion of the involvement of male teachers in light of their masculinity identity asset in the children's learning environment is comprehended to understand the construction of male student teachers' (preservice) professional identity during early childhood teacher training that allows obtaining substantial evidence that provides a feasible and robust implication in the preparation of competent and professional male preschool teachers that understand, cherish, and bring harmony in Chinese ECE through professionalism socialization with the stakeholders. This study intended to reveal male ECE preservice teachers’ knowledge of their professional identity, i.e., how they perceive themselves as a teacher and what factors agents these perceptions towards their professional identity.

Keywords: male teachers, Early Childhood Education (ECE), self-identity, perception of stakeholders

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Authors: O. H. Gebril, N. A. Meguid

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Background: Iron had been a focus of interest recently as a main exaggerating factor for oxidative stresses in the central nervous system and a link to various neurological disorders is suspected. Many studies with various techniques showed evidence of disturbed iron-related proteins in the cell in human and animal models of neurodegenerative disorders. Also, linkage to significant pathological changes had been evidenced e.g. apoptosis and cell signaling. On the other hand, the role of iron in neurodevelopmental disorders is still unclear. With increasing prevalence of autism worldwide, some changes in iron parameters and its stores were documented in many studies. This study includes Haemochromatosis HFE gene polymorphisms (p.H63D and p.C282Y) and ferroportin gene (SLC40A1) Q248H polymorphism in autism and control children. Materials and Methods: Whole genome DNA was extracted; p.H63D and p.C282Y genotyping was studied using specific sequence amplification followed by restriction enzyme digestion on a sample of autism patients (25 cases) and twenty controls. Results: The p.H63D is seen more than the C282Y among both autism and control samples, with no significant association of p.H63D or p.C282Y polymorphism and autism was revealed. Also, no association with Q248H polymorphism was evidenced. Conclusion: The study results do not prove the role of cellular iron genes polymorphisms as risk factors for neurodevelopmental disorders, and in turn highlights the specificity of cellular iron related pathways in neurodegeneration. These results demand further gene expression studies to elucidate the main pathophysiological pathways that are disturbed in autism and other neurodevelopmental disorders.

Keywords: iron, neurodevelopmental, oxidative stress, haemohromatosis, ferroportin, genes

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Authors: Antonios Paraskevas, Michael Madas

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For a university to maintain its international competitiveness in education, it is essential to recruit qualitative academic staff as it constitutes its most valuable asset. This selection demonstrates a significant role in achieving strategic objectives, particularly by emphasizing a firm commitment to the exceptional student experience and innovative teaching and learning practices of high quality. In this vein, the appropriate selection of academic staff establishes a very important factor of competitiveness, efficiency and reputation of an academic institute. Within this framework, our work demonstrates a comprehensive methodological concept that emphasizes the multi-criteria nature of the problem and how decision-makers could utilize our approach in order to proceed to the appropriate judgment. The conceptual framework introduced in this paper is built upon a hybrid neutrosophic method based on the Neutrosophic Analytical Hierarchy Process (N-AHP), which uses the theory of neutrosophy sets and is considered suitable in terms of a significant degree of ambiguity and indeterminacy observed in the decision-making process. To this end, our framework extends the N-AHP by incorporating the Neutrosophic Delphi Method (N-DM). By applying the N-DM, we can take into consideration the importance of each decision-maker and their preferences per evaluation criterion. To the best of our knowledge, the proposed model is the first which applies the Neutrosophic Delphi Method in the selection of academic staff. As a case study, it was decided to use our method for a real problem of academic personnel selection, having as the main goal to enhance the algorithm proposed in previous scholars’ work, and thus taking care of the inherent ineffectiveness which becomes apparent in traditional multi-criteria decision-making methods when dealing with situations alike. As a further result, we prove that our method demonstrates greater applicability and reliability when compared to other decision models.

Keywords: multi-criteria decision making methods, analytical hierarchy process, delphi method, personnel recruitment, neutrosophic set theory

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Authors: Namratha Pai, K. Vasantharaj, K. Haribabu

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Our Team is developing an innovative cost effective biological technique to desulfurize crude oil. ’Sulphur’ is found to be present in crude oil samples from .05% - 13.95% and its elimination by industrial methods is expensive currently. Materials required :- Alicyclobacillus acidoterrestrius, potato dextrose agar, oxygen, Pyragallol and inert gas(nitrogen). Method adapted and proposed:- 1) Growth of bacteria studied, energy needs. 2) Compatibility with crude-oil. 3) Reaction rate of bacteria studied and optimized. 4) Reaction development by computer simulation. 5) Simulated work tested by building the reactor. The method being developed requires the use of bacteria Alicyclobacillus acidoterrestrius - an acidothermophilic heterotrophic, soil dwelling aerobic, Sulfur bacteria. The bacteria are fed to crude oil in a unique manner. Its coated onto potato dextrose agar beads, cultured for 24 hours (growth time coincides with time when it begins reacting) and fed into the reactor. The beads are to be replenished with O2 by passing them through a jacket around the reactor which has O2 supply. The O2 can’t be supplied directly as crude oil is inflammable, hence the process. Beads are made to move around based on the concept of fluidized bed reactor. By controlling the velocity of inert gas pumped , the beads are made to settle down when exhausted of O2. It is recycled through the jacket where O2 is re-fed and beads which were inside the ring substitute the exhausted ones. Crude-oil is maintained between 1 atm-270 M Pa pressure and 45°C treated with tartaric acid (Ph reason for bacteria growth) for optimum output. Bacteria being of oxidising type react with Sulphur in crude-oil and liberate out SO4^2- and no gas. SO4^2- is absorbed into H2O. NaOH is fed once reaction is complete and beads separated. Crude-oil is thus separated of SO4^2-, thereby Sulphur, tartaric acid and other acids which are separated out. Bio-corrosion is taken care of by internal wall painting (phenolepoxy paints). Earlier methods used included use of Pseudomonas and Rhodococcus species. They were found to be inefficient, time and energy consuming and reduce the fuel value as they fed on skeleton.

Keywords: alicyclobacillus acidoterrestrius, potato dextrose agar, fluidized bed reactor principle, reaction time for bacteria, compatibility with crude oil

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Authors: Ghufran Ahmed, Muhammad Osama Siddiqui, Shahbaz Siddiqui, Rauf Ahmad Shams Malick, Faisal Khan, Mubashir Khan

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In this paper, a machine learning-based approach for early prediction of diseases in cows is proposed. Different ML algos are applied to extract useful patterns from the available dataset. Technology has changed today’s world in every aspect of life. Similarly, advanced technologies have been developed in livestock and dairy farming to monitor dairy cows in various aspects. Dairy cattle monitoring is crucial as it plays a significant role in milk production around the globe. Moreover, it has become necessary for farmers to adopt the latest early prediction technologies as the food demand is increasing with population growth. This highlight the importance of state-ofthe-art technologies in analyzing how important technology is in analyzing dairy cows’ activities. It is not easy to predict the activities of a large number of cows on the farm, so, the system has made it very convenient for the farmers., as it provides all the solutions under one roof. The cattle industry’s productivity is boosted as the early diagnosis of any disease on a cattle farm is detected and hence it is treated early. It is done on behalf of the machine learning output received. The learning models are already set which interpret the data collected in a centralized system. Basically, we will run different algorithms on behalf of the data set received to analyze milk quality, and track cows’ health, location, and safety. This deep learning algorithm draws patterns from the data, which makes it easier for farmers to study any animal’s behavioral changes. With the emergence of machine learning algorithms and the Internet of Things, accurate tracking of animals is possible as the rate of error is minimized. As a result, milk productivity is increased. IoT with ML capability has given a new phase to the cattle farming industry by increasing the yield in the most cost-effective and time-saving manner.

Keywords: IoT, machine learning, health care, dairy cows

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Authors: Ghadeer M Alkusayer, Adelicia Yu, Pamela Orr

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Study objective: To report a case of postpartum pulmonary cryptococcal infection (CCI) in an otherwise healthy 35-year-old woman. Additionally, the cases of pulmonary cryptococcal infections either in the antepartum or the postpartum period with pregnancy outcomes, were systematically reviwed. Methods: A systematic search of Cochrane Library, MEDLINE, and EMBASE was conducted for peer-reviewed studies without date restrictions, published in English and relating to CCI during pregnancy or postpartum period. Conference press, editorials, opinion pieces and letters were excluded. Two authors independently screened citations and full-text articles, extracted data and assessed study quality. Given the heterogeneity of study designs, a narrative synthesis was conducted. Results: The search identified 128 references, of which 22 case reports and series met the inclusion criteria. This is a total of 29 women (including the current case) . The mean age of the women was 28.3 ± 12.3 years. Nine (31.03%) presented and were diagnosed in the postpartum period. Two (6.90%) of the patients were reported as immunocompromised with HIV. Four maternal deaths (13.79%) were found in this case series with one (4.3%) patient with severe neurological deficits. Four (17.4%) infant deaths were reported. Women primary presentation varied with chest pain 13 (44.82%), headache 10 (35.70%), dyspnea 19 (65.51%), or fever 12 (41.38%). Three studies reported placental pathology positive for C. neoformans. Conclusion: This case of pulmonary cryptococcal infection in the postpartum period is an important addition to the literature of this rare infection in pregnancy. The patient is not immunocompromised. The patient was successfully treated with 4 months of Fluconazole 400 mg and continued to breastfeed the healthy baby.

Keywords: pulmonary cryptococcus, pregnancy, cryptococci , postpartum

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Authors: Kushal Patel, Manasa Dittakavi, Cyrus Falsafi, Gretchen Lovett

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Rural America has seen a surge in opioid addiction rates and overdose deaths in recent years, becoming a significant public health crisis. This may be due to a variety of factors, such as lack of access to healthcare or other economic and social factors that can contribute to addiction such as poverty, unemployment, and social isolation. As the opioid epidemic has disproportionately affected rural communities, pregnant women in these areas may be highly susceptible and face additional difficulties in facing the appropriate care they need. Opioid use disorder has many negative effects on prenatal infants. These include changes in their microbiome, mental health, neurodevelopment and cognition. These can affect how the child performs in various activities in life and how they interact with others. It has been demonstrated that using cognitive behavioral therapy improves not just pain-related results but also mobility, quality of life, disability, and mood outcomes. This indicates that cognitive behavioral therapy (CBT) may be a useful therapeutic strategy for enhancing general health and wellbeing in people with opioid use problems. In terms of treating psychiatric diseases, CBT carries fewer dangers than opioids. One study that illustrates the potential for CBT to promote a reduction in opioid use disorder used self-reported drug use patterns 6 months prior to and during their pregnancy. At the beginning of the study, participants reported an average of 3.78 drug or alcohol use days in the previous 28 days, which decreased to 1.63 days after treatment. The study also found a decrease in depression scores, as measured by IDS scores, from 23.9 to 17.1 at the end of treatment. These and other results show that CBT can have meaningful impacts on pregnant women in Rural America who struggle with an opioid use disorder. This project has been approved by the West Virginia School of Osteopathic Medicine- Office of Research and Sponsored Programs and deemed non-research scholarly work.

Keywords: appalachia, CBT, opiods, pregnancy

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Authors: Asavasereerat K., Teacharsripaitoon T., Tungyingyong P., Charupongrat S., Noppiboon S. Hochareon L., Kitsuban P.

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Third generation of vaccines is based on gene therapy where DNA is introduced into patients. The antigenic or therapeutic proteins encoded from transgenes DNA triggers an immune-response to counteract various diseases. Moreover, DNA vaccine offers the customization of its ability on protection and treatment with high stability. The production of DNA vaccines become of interest. According to USFDA guidance for industry, the recommended limits for impurities from host cell are lower than 1%, and the active conformation homogeneity supercoiled DNA, is more than 80%. Thus, the purification strategy using two-steps chromatography has been established and verified for its robustness. Herein, pVax1/lacZ, a pre-approved USFDA DNA vaccine backbone, was used and transformed into E. coli strain DH5α. Three purification process parameters including sample-loading flow rate, the salt concentration in washing and eluting buffer, were studied and the experiment was designed using response surface method with central composite face-centered (CCF) as a model. The designed range of selected parameters was 10% variation from the optimized set point as a safety factor. The purity in the percentage of supercoiled conformation obtained from each chromatography step, AIEX and HIC, were analyzed by HPLC. The response data were used to establish regression model and statistically analyzed followed by Monte Carlo simulation using SAS JMP. The results on the purity of the product obtained from AIEX and HIC are between 89.4 to 92.5% and 88.3 to 100.0%, respectively. Monte Carlo simulation showed that the pVAX1/lacZ purification process is robust with confidence intervals of 0.90 in range of 90.18-91.00% and 95.88-100.00%, for AIEX and HIC respectively.

Keywords: AIEX, DNA vaccine, HIC, puification, response surface method, robustness

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Authors: Evmorfia Koukia, Polyxeni Mangoulia

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Workshops tend to be a vivid and productive way as an in vivo teaching method. Due to the pandemic, COVID-19 university courses were conducted through the internet. Method It was tried for the first time to integrate online art therapy workshops in a core course named “Special Themes of Mental Health Nursing” in a MSc Program in Mental Health. The duration of the course is 3-hours per week for 11 weeks in a single semester. The course has a main instructor, a professor of psychiatric nursing experienced in arts therapies workshops and visiting art therapists. All art therapists were given a certain topic to cover. Students were encouraged to keep a logbook that was evaluated at the end of the semester and was submitted as a part of the examination process of the course. An interview of 10 minutes was conducted with each student at the end of the course from an independent investigator (an assistant professor) Participants The students (sample) of the program were: nurses, psychologists, and social workers Results: All students who participated in the courses found that the learning process was vivid, encouraging participation and self-motivation, and there were no main differences from in vivo learning. The students identified their personal needs, and they felt a personal connection with the learning experience. The result of the personalized learning was that students discovered their strengths and weaknesses and developed skills like critical thinking. All students admitted that the workshops were the optimal way for them to comprehend the courses’ content, their capability to become therapists, as well as their obstacles and weaknesses while working with patients in mental health. Conclusion: There were no important differences between the views of students in online and in vivo teaching method of the workshops. The result has shown that workshops in mental health can contribute equally in the learning experience.

Keywords: mental health, workshops, students, nursing

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Authors: L. Sun, T. Hargreaves, Z. Ahmad

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Newly-qualified Foundation Year 1 doctors in the United Kingdom are frequently expected to perform practical skills involving the upper limb in clinical practice (for example, venipuncture, cannulation, and blood gas sampling). However, a move towards systems-based undergraduate medical education in the United Kingdom often precludes or limits dedicated time to anatomy teaching with cadavers or prosections, favouring only applied anatomy in the context of pathology. The authors hypothesised that detailed anatomical knowledge may consequently be adversely affected, particularly with respect to long-term retention. A simple picture quiz and accompanying questionnaire testing the identification of 7 upper limb surface landmarks was distributed to a total of 98 final year medical students from two universities - one with a systems-based curriculum, and one with a dedicated longitudinal dissection-based anatomy module in the first year of study. Students with access to dissection and prosection-based anatomy teaching performed more strongly, with a significantly higher rate of correct identification of all but one of the landmarks. Furthermore, it was notable that none of the students who had previously undertaken a systems-based course scored full marks, compared with 20% of those who had participated in the more dedicated anatomy course. This data suggests that a traditional, dissection-based approach to undergraduate anatomy teaching is superior to modern system-based curricula, in terms of aiding long-term retention of anatomical knowledge pertinent to newly-qualified doctors. The authors express concern that this deficit in proficiency could be detrimental to patient care in clinical practice, and propose that, where dissection-led anatomy teaching is not available, further anatomy revision modules are implemented throughout undergraduate education to aid knowledge retention and support clinical excellence.

Keywords: dissection, education, surface anatomy, upper limb

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Authors: Ignatius Madu

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The study aims at assessing the environmental and socioeconomic determinants of climate change resilience in rural Nigeria. This is necessary because researches and development efforts on building climate change resilience of rural areas in developing countries are usually made without the knowledge of the impacts of the inherent rural characteristics that determine resilient capacities of the households. This has, in many cases, led to costly mistakes, delayed responses, inaccurate outcomes, and other difficulties. Consequently, this assessment becomes crucial not only to policymakers and people living in risk-prone environments in rural areas but also to fill the research gap. To achieve the aim, secondary data were obtained from the Annual Abstract of Statistics 2017, LSMS-Integrated Surveys on Agriculture and General Household Survey Panel 2015/2016, and National Agriculture Sample Survey (NASS), 2010/2011.Resilience was calculated by weighting and adding the adaptive, absorptive and anticipatory measures of households variables aggregated at state levels and then regressed against rural environmental and socioeconomic characteristics influencing it. From the regression, the coefficients of the variables were used to compute the impacts of the variables using the Stochastic Regression of Impacts on Population, Affluence and Technology (STIRPAT) Model. The results showed that the northern States are generally low in resilient indices and are impacted less by the development indicators. The major determining factors are percentage of non-poor, environmental protection, road transport development, landholding, agricultural input, population density, dependency ratio (inverse), household asserts, education and maternal care. The paper concludes that any effort to a successful resilient building in rural areas of the country should first address these key factors that enhance rural development and wellbeing since it is better to take action before shocks take place.

Keywords: climate change resilience; spatial impacts; STIRPAT model; Nigeria

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Authors: Anja Kurz, Marc Flynn, Tobias Good, Marco Caversaccio, Martin Kompis

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Bone Anchored Hearing Implants (BAHI) are routinely used in patients with conductive or mixed hearing loss, e.g. if conventional air conduction hearing aids cannot be used. New sound processors and new fitting software now allow the adjustment of parameters such as loudness compression ratios or maximum power output separately. Today it is unclear, how the choice of these parameters influences aided speech understanding in BAHI users. In this prospective experimental study, the effect of varying the compression ratio and lowering the maximum power output in a BAHI were investigated. Twelve experienced adult subjects with a mixed hearing loss participated in this study. Four different compression ratios (1.0; 1.3; 1.6; 2.0) were tested along with two different maximum power output settings, resulting in a total of eight different programs. Each participant tested each program during two weeks. A blinded Latin square design was used to minimize bias. For each of the eight programs, speech understanding in quiet and in noise was assessed. For speech in quiet, the Freiburg number test and the Freiburg monosyllabic word test at 50, 65, and 80 dB SPL were used. For speech in noise, the Oldenburg sentence test was administered. Speech understanding in quiet and in noise was improved significantly in the aided condition in any program, when compared to the unaided condition. However, no significant differences were found between any of the eight programs. In contrast, on a subjective level there was a significant preference for medium compression ratios of 1.3 to 1.6 and higher maximum power output.

Keywords: Bone Anchored Hearing Implant, baha, compression, maximum power output, speech understanding

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Authors: Jing Chen, Jun-E Liu, Peng Yue

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Objective: The objective of this study was to develop a psychological adjustment and adaptation status scale for breast cancer survivors, and to examine the reliability and validity of the scale. Method: 37 breast cancer survivors were recruited in qualitative research; a five-subject theoretical framework and an item pool of 150 items of the scale were derived from the interview data. In order to evaluate and select items and reach a preliminary validity and reliability for the original scale, the suggestions of study group members, experts and breast cancer survivors were taken, and statistical methods were used step by step in a sample of 457 breast cancer survivors. Results: An original 24-item scale was developed. The five dimensions “domestic affections”, “interpersonal relationship”, “attitude of life”, “health awareness”, “self-control/self-efficacy” explained 58.053% of the total variance. The content validity was assessed by experts, the CVI was 0.92. The construct validity was examined in a sample of 264 breast cancer survivors. The fitting indexes of confirmatory factor analysis (CFA) showed good fitting of the five dimensions model. The criterion-related validity of the total scale with PTGI was satisfactory (r=0.564, p<0.001). The internal consistency reliability and test-retest reliability were tested. Cronbach’s alpha value (0.911) showed a good internal consistency reliability, and the intraclass correlation coefficient (ICC=0.925, p<0.001) showed a satisfactory test-retest reliability. Conclusions: The scale was brief and easy to understand, was suitable for breast cancer patients whose physical strength and energy were limited.

Keywords: breast cancer survivors, rehabilitation, psychological adaption and adjustment, development of scale

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Authors: Mrinal Kanti Bhowmik, Kakali Das Jr., Barin Kumar De, Debotosh Bhattacharjee

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Breast cancer is the most common cancer and a leading cause of death for women in the 35 to 55 age group. Early detection of breast cancer can decrease the mortality rate of breast cancer. Mammography is considered as a ‘Gold Standard’ for breast cancer detection and a very popular modality, presently used for breast cancer screening and detection. The screening of digital mammograms often leads to over diagnosis and a consequence to unnecessary traumatic & painful biopsies. For that reason recent studies involving the use of thermal imaging as a screening technique have generated a growing interest especially in cases where the mammography is limited, as in young patients who have dense breast tissue. Tumor is a significant sign of breast cancer in both mammography and thermography. The tumors are complex in structure and they also exhibit a different statistical and textural features compared to the breast background tissue. Fractal geometry is a geometry which is used to describe this type of complex structure as per their main characteristic, where traditional Euclidean geometry fails. Over the last few years, fractal geometrics have been applied mostly in many medical image (1D, 2D, or 3D) analysis applications. In breast cancer detection using digital mammogram images, also it plays a significant role. Fractal is also used in thermography for early detection of the masses using the thermal texture. This paper presents an overview of the recent aspects and initiatives of fractals in breast cancer detection in both mammography and thermography. The scope of fractal geometry in automatic breast cancer detection using digital mammogram and thermogram images are analysed, which forms a foundation for further study on application of fractal geometry in medical imaging for improving the efficiency of automatic detection.

Keywords: fractal, tumor, thermography, mammography

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Authors: Thidathit Prachanukool, Chaiyaporn Yuksen, Welawat Tienpratarn, Sorravit Savatmongkorngul, Panvilai Tangkulpanich, Chetsadakon Jenpanitpong, Yuranan Phootothum, Malivan Phontabtim, Promphet Nuanprom

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Background: Ruptured appendicitis has a high morbidity and mortality and requires immediate surgery. The Alvarado Score is used as a tool to predict the risk of acute appendicitis, but there is no such score for predicting rupture. This study aimed to developed the prediction score to determine the likelihood of ruptured appendicitis in an Asian population. Methods: This study was diagnostic, retrospectively cross-sectional and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between March 2016 and March 2018. The inclusion criteria were age >15 years and an available pathology report after appendectomy. Clinical factors included gender, age>60 years, right lower quadrant pain, migratory pain, nausea and/or vomiting, diarrhea, anorexia, fever>37.3°C, rebound tenderness, guarding, white blood cell count, polymorphonuclear white blood cells (PMN)>75%, and the pain duration before presentation. The predictive model and prediction score for ruptured appendicitis was developed by multivariable logistic regression analysis. Result: During the study period, 480 patients met the inclusion criteria; of these, 77 (16%) had ruptured appendicitis. Five independent factors were predictive of rupture, age>60 years, fever>37.3°C, guarding, PMN>75%, and duration of pain>24 hours to presentation. A score > 6 increased the likelihood ratio of ruptured appendicitis by 3.88 times. Conclusion: Using the Ramathibodi Welawat Ruptured Appendicitis Score. (RAMA WeRA Score) developed in this study, a score of > 6 was associated with ruptured appendicitis.

Keywords: predictive model, risk score, ruptured appendicitis, emergency room

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Authors: Metrek Almetrek, Naser Alqahtani, Eisa Ghazwani, Mona Asiri, Mohammed Alqahtani, Magboolah Balobaid

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Background: Advocacy of potential for community coalitions to positively address social determinants of health and quality of life, little is known about the views of stakeholders involved in such efforts. This study sought to assess the provinces leaders’ perspectives about social determinants related to the Health Neighborhood Initiative (HNI), a new county effort to support community coalitions. Method and Subjects: We used a descriptive, qualitative study using personal interviews in 2022. We conducted it in the community coalition's “main cities committees” set across service planning areas that serve vulnerable groups located in the seven registered healthy cities to WHO (Abha, Tareeb, Muhayel, Balqarn, Alharajah, Alamwah, and Bisha). We conducted key informant interviews with 76 governmental, profit, non-profit, and community leaders to understand their perspectives about the HNI. As part of a larger project, this study focused on leaders’ views about social determinants of health related to the HNI. All interviews were audio-recorded and transcribed. An inductive approach to coding was used, with text segments grouped by social determinant categories. Results: Provinces leaders described multiple social determinants of health and quality of life that were relevant to the HNI community coalitions: housing and safety, community violence, economic stability, city services coordination and employment and education. Leaders discussed how social determinants were interconnected with each other and the need for efforts to address multiple social determinants simultaneously to effectively improve health and quality of life. Conclusions: Community coalitions have an opportunity to address multiple social determinants of health and quality of life to meet the social needs of vulnerable groups. Future research should examine how community coalitions, like those in the HNI, can actively engage with community members to identify needs and then deliver evidence-based care.

Keywords: social determinants, health and quality of life, vulnerable groups, qualitative research

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Authors: Suraj Muke, Vikas Mankumare, Sadhana Sathaye

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Osteoporosis is the most common metabolic bone disease which affects an estimated 25 million people worldwide, leading to 1 million fractures, 40,000 annual deaths and health costs of billions of dollars. It is estimated that about 80% of total osteoporosis patients are women, amongst which majority are above the age of 45 years. Postmenopausal osteoporosis is associated with lack of intestinal calcium absorption, increasing pro-oxidant and inflammatory mediators. Lawsonia inermis is a biennial dicotyledonous herbaceous shrub is reported to possess a high flavonoid, high phenolic and Inhibitors of osteoclastogenesis like Daphneside and Daphnorin. The present study aimed to screen osteoprotective effect of methanolic extract of Lawsonia inermis (LIM) in rat model along with its antioxidant activity. LIM shows phenolic content 146.3Milligrams of Gallic acid equivalent present per gram of extract and 19.8 Milligrams of rutin per gram of extract of Total flavonoid content with IC50 value 42.99μg/ml. bilateral ovariectomized rat model in which Healthy female wistar rats were used for screening. Treatment with LIM was carried out using graded doses of 25mg/kg, 50mg/kg and 100mg/kg for period of 28 days. The negative control group comprised of ovariectomized rats along with saline treatment for four weeks whereas sham operated rats were used as positive control.LIM showed a decrease in bone turnover by preventing loss of urinary calcium and phosphorous moreover it decreased the alkaline phosphatase levels and loss of bone density is prevented by LIM suggesting decrease in osteoclast activity.

Keywords: antioxidant, osteoclast, osteoporosis, ovariectomized

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Authors: Wilfred Isak April, Anthony Adenyanju

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Research has proven that no other beverage has been adored and criticized at the same time as wine. It is important to reiterate that a selected grape production that results in the manufacturing of wine should be scrutinized with the greatest care. In addition, it should be laid down until optimum maturity, carefully selected for serving and ritually tasted by likeminded individuals. This paper aims to explore the entrepreneurial opportunities available through wine production in Namibia. In our daily lives, to the naked eye, consumers usually buy a bottle of wine according to affordability and what is on offer at the moment, sometimes get themselves intoxicated and also finish the bottle on the same day it has been purchased. When taking this as a comparison to those who are accustomed to grape production and wine-producing regions, it is usually a beverage purchased from the local produce cooperative, resembling a dispenser from a petrol pump at a fuel/gas station, usually taken home more than 5 liters at a particular point in time and enjoy it with a meal. It is very important to highlight that grapes are a non-climatic type of fruit, which usually occurs in clusters. Bringing it closer to context, this paper is based on the Republic of Namibia, which is a developing economy with so much potential. A qualitative research methodology will be applied with a purposive sampling technique. Moreover, in this study, a sample of 50 grape farmers will be interviewed. Data will be collected through in-depth interviews and thematic analysis was used to analyze the data. The envisaged results clearly illustrate that grape production contributes significantly not only to households but also to the larger economy. Studies of this nature are of crucial importance to Namibia since the country became a signatory of the General Agreement on Tariffs and Trade (GATT) in 1993 and has also become a subsequent member of the World Trade Organisation (WTO) subsequent to its creation after signing the Marrakech agreement in 1994. Given the latter mentioned, Namibia has made a commitment to the directives of WTO, meaning Namibian manufacturers have to compete in the global market.

Keywords: wine production, entrepreneurship, innovation, development, Namibia, internalisation, creativity

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Authors: Ana Cristina Lindsay, Sherrie Wallington, Faith Lees, Mary Greaney

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Purpose: Latino children in low-income families are at elevated risk of becoming overweight or obese. The purpose of this study was to examine low-income Latino parents’ beliefs, parenting styles and practices related to their children’s eating and physical activity behaviors while at home. Design and Methods: Qualitative study using focus group discussions with 33 low-income Latino parents of preschool children 2 to 5 years of age. Transcripts were analyzed using thematic analysis. Results: Data analyses revealed that most parents recognize the importance of healthy eating and physical activity for their children and themselves. However, daily life demands including conflicting schedules, long working hours, financial constraints, and neighborhood safety concerns, etc., impact parents’ ability to create a home environment supportive of these behaviors. Conclusions: This study provides information about how the home environment influences low-income Latino preschool children’s eating and physical activity habits. This information is useful for pediatric nurses in their health promotion and disease prevention efforts with low-income Latino families with young children, and for the development of home-based and parenting interventions to prevent and control childhood obesity among this population group. Practice Implications: Pediatric nurses can facilitate communication, provide education, and offer guidance to low-income Latino parents that support their children’s development of early healthy eating and physical activity habits, while taking into account daily life barriers faced by families. Moreover, nurses can play an important role in the integration and coordination of home-visitation to complement office-based visits and provide a continuum of care to low-income Latino families.

Keywords: home environment, Latino, obesity, parents, healthy eating, physical activity

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Authors: Sevana Daneghian, Leila Chodari, Sahar Mehranfar, Shadi Mohammadpour-Asl, Diman Mahdi

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Sarcopenia is an age-related muscle disease. Lack of antioxidant protection, and cumulative oxidative damage to skeletal muscle are recognized mechanisms. Curcumin is a hormetin as it has a stimulating effect in low doses and an inhibitory effect in high doses. The purpose of this study was to examine the effects of four weeks of curcumin supplementation in presarcopenic and sarcopenic rats, and likelihood of potential negative effects while co-exist with sarcopenia. The rats were divided into 7 groups: young sham rats, 18 months old; presarcopenic control, supplemented with 400 and 1500 mg/kg/day, 24 months old; Sarcopenia control, sarcopenia supplemented with 400 and 1500 mg/kg/day. MDA levels were significantly reduced in the low-dose pre-sarcopenic group compared to the control group. Compared to the corresponding control groups, SOD levels decreased in the groups treated with low-dose presarcopenic supplementation and increased in the high-dose sarcopenic supplemented. GPx levels increased at both doses only in the sarcopenic group compared to the control group. SIRT-1 only increased at low doses in the sarcopenic groups and PGC-1α in both pre-sarcopenia groups compared to the corresponding control. IGF-1 increased compared to the control group at both doses in the pre-sarcopenic group and at high doses in sarcopenic group. Considering the hormetic effects of curcumin, it can be argued that, curcumin supplementation has some positive effects not only at low but also at high doses in both groups. This means that the high doses of curcumin have no negative synergistic effects in addition to oxidative stress during sarcopenia and high-dose supplementation in patients already suffering from high oxidative stress due to sarcopenia is safe and could be considered hormetic.

Keywords: curcumin, hormesis, sarcopenia, muscular atrophy, PGC protein, Sirtuins

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Authors: Kimberley Kershaw, Denis Hyams-Ssekasi

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Although there is a wealth of information about refugees and Asylum seekers, Refugee job opportunities continue to be one of the most hotly contested areas and less researched within the social sciences. Refugees are a vital asset in the society due to their experiences, skills, and competences. However, society perceives them differently, and as such, their prior lived experiences are often underutilised. This research study gleans from the work conducted during the Refugee Employment Support Clinic delivered for 12 weeks within a University setting in the North West of England. The study is conducted using three perspectives, refugees, students, and researchers, allowing for identification of the challenges encountered by the refugees concerning job opportunities. Through the utilisation of the qualitative research method, the study has found that refugees experience a wide range of issues unrelated to their skills, prior experience, and education but rather due to the red tapes connected to their legal identity labelling. Refugees struggle to build reliable employment networks that appreciate and acknowledge their capabilities and talents, impacting their ability to navigate the labour market and classism. Notably, refugees are misunderstood within their new societies, and little care is taken to understand the unique struggles they face with respect to securing paid work in their industry or field of work due to their lack of experience in the UK. Unlike other European countries, it is evident that the UK has no strategic approach to enhancing the chances of paid or voluntary work for refugees. A clinic like this provided lenses for comprehending how refugees can be better supported with employment related opportunities. By creating a safe and conducive platform for honest and open discussion about employment and through collaborative approaches with local community agencies, doors were opened for social and professional networks to be built. The study concluded that there is a need for local communities and education establishments to be more aware of the prevailing challenges and in a position to support at all stages of their asylum claim in order for the perceptions of distrust and uncertainty around refugees to be minimised.

Keywords: refugees, employment, community, classism, education

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Authors: Andriati Nadhilah Widyarini, Ezra Margareth

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Introduction: Rhegmatogenous retinal detachment is a condition where there’s a break in the retina, which allows the vitreous to directly enter the subretinal space. Proliferative vitreoretinopathy (PVR) may develop due to this condition and can result in a new break, which could cause traction on the previously detached retina. Various methods of therapy can be done to treat this complication. Case: This case series involved 2 eyes of 2 patients who had total retinal detachment with advanced PVR. Pars plana vitrectomy was performed, and a 360-degree retinectomy procedure with perfluorocarbon liquid usage was done. This was followed by endo laser retinopexy to surround the border of retinectomy. 5000 cs silicone oil was used in 1 eye, whereas 12% of perfluoropropane gas was used in the other eye as a tamponade. These procedures were performed with meticulous attention to prevent any fluid from entering the subretinal space. Postoperative examination showed attachment of the retina and improvement of the patient’s visual acuity. Both eyes’ intraocular pressure was in the normal range. One eye developed retinal displacement, but no other complications occurred. Discussion: Rhegmatogenous retinal detachment with advanced PVR is a complex situation for vitreoretinal surgeons. PVR is characterized by the growth and migration of preretinal or subretinal membranes. PVR is the most common cause of retinal reattachment failure. A 360-degree retinectomy is an alternative surgical method to overcome this condition. Objectives of this procedure are releasing retinal traction caused by PVR, reducing the recurrence rate of PVR, and reattaching the retina to the pigment epithelial surface. Conclusion: 360-degree retinectomy provides satisfactory retinal reattachment and visual outcome improvement in rhegmatogenous retinal detachment with advanced PVR.

Keywords: RRD, retinectomy, pars plana, advanced PVR

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Authors: Murorunkwere Marie Claire

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Introduction: In Sub-Saharan Africa and specifically in Rwandan rural areas, mother-to-Child human immunodeficiency virus transmission remains a big challenge. This is mainly due to lack of awareness and ignorance among pregnant rural women, leading to neglect regular taking of prophylactic antiretroviral treatment and to persistently beliefs in traditional healers and home deliveries. This paper explores the factors associated with stagnant reduction in human immunodeficiency virus vertical transmission among pregnant rural women and provides solutions to tackle it. Methodology: The first phase of this research will be a qualitative survey was conducted to assess the knowledge, attitudes and practices towards vertical human immunodeficiency virus transmission among pregnant women in one rural district in Rwanda. The data generated from phase one of this research will be used to address the main factors revealed through community mobilization and motivation on attending required antenatal consultations and hospital deliveries, proper and regular antiretroviral treatment taking, and discouraging beliefs in traditional healers and home deliveries. Refresher training seminars will also be organized for healthcare providers qualified on conducting deliveries about current measures to maximize the reduction of chances that can lead to mother -child contamination (to avoid early rupture of membranes and to prevent any source of contamination). Results: This paper is expected to contribute in a significant reduction of the vertical human immunodeficiency virus transmission burden among pregnant rural women. Conclusion: Strong campaigns on prevention of mother- to-child human immunodeficiency virus transmission and community mobilization of pregnant rural women, and house to house education and continuous reminders as well as training seminars to health care personnel on updated measures is, key in addressing vertical human immunodeficiency virus transmission.

Keywords: attitudes transformation, community mobilisation, pregnant rural women, vertical HIV transmission

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Authors: Antonios Paraskevas, Michael Madas

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For a university to maintain its international competitiveness in education, it is essential to recruit qualitative academic staff as it constitutes its most valuable asset. This selection demonstrates a significant role in achieving strategic objectives, particularly by emphasizing a firm commitment to exceptional student experience and innovative teaching and learning practices of high quality. In this vein, the appropriate selection of academic staff establishes a very important factor of competitiveness, efficiency and reputation of an academic institute. Within this framework, our work demonstrates a comprehensive methodological concept that emphasizes on the multi-criteria nature of the problem and on how decision makers could utilize our approach in order to proceed to the appropriate judgment. The conceptual framework introduced in this paper is built upon a hybrid neutrosophic method based on the Neutrosophic Analytical Hierarchy Process (N-AHP), which uses the theory of neutrosophy sets and is considered suitable in terms of significant degree of ambiguity and indeterminacy observed in decision-making process. To this end, our framework extends the N-AHP by incorporating the Neutrosophic Delphi Method (N-DM). By applying the N-DM, we can take into consideration the importance of each decision-maker and their preferences per evaluation criterion. To the best of our knowledge, the proposed model is the first which applies Neutrosophic Delphi Method in the selection of academic staff. As a case study, it was decided to use our method to a real problem of academic personnel selection, having as main goal to enhance the algorithm proposed in previous scholars’ work, and thus taking care of the inherit ineffectiveness which becomes apparent in traditional multi-criteria decision-making methods when dealing with situations alike. As a further result, we prove that our method demonstrates greater applicability and reliability when compared to other decision models.

Keywords: analytical hierarchy process, delphi method, multi-criteria decision maiking method, neutrosophic set theory, personnel recruitment

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Authors: Hager Elsheikh, Matthias Sendler, Juliana Glaubnitz

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In pancreatitis, an inflammatory reaction occurs in the pancreatic secretory cells due to premature activation of proteases, leading to pancreatic self-digestion and necrotic cell death of acinar cells. Acute pancreatitis in patients is characterized by a severe immune reaction that could lead to serious complications, such as organ failure or septic shock, if left untreated. Chronic pancreatitis is a recurrence of episodes of acute pancreatitis resulting in a fibro-inflammatory immune response, in which the type 2 immune response is primarily driven by AAMs in the pancreas. One of the most important signaling pathways for M2 macrophage activation is the IL-4/STAT6 pathway. Pancreatic fibrosis is induced by the hyperactivation of pancreatic stellate cells by dysregulation in the inflammatory response, leading to further damage, autodigestion and possibly necrosis of pancreatic acinar cells. The aim of this research is to investigate the effect of STAT6 knockout in disease severity and development of fibrosis wound healing in the presence of different macrophage populations, regulated by the type 2 immune response, after inducing chronic and/or acute pancreatitis in mice models via cerulean injection. We further investigate the influence of the JAK/STAT6 signaling pathway on the balance of fibrosis and regeneration in STAT6 deficient and wild-type mice. The characterization of resident and recruited macrophages will provide insight into the influence of the JAK/STAT6 signaling pathway on infiltrating cells and, ultimately, tissue fibrosis and disease severity.

Keywords: acute and chronic pancreatitis, tissue regeneration, macrophage polarization, Gastroenterology

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Authors: Zahra khaksari, Mahboobeh Mehrabi

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One of the biggest health problems in communities, suicide is now one of the top ten causes of death in the world. This study aimed to investigate the risk factors of suicide attempt in Minab city over two years. This was a descriptive and cross-sectional study. Subjects of this study were cases who admitted in Hazrat Abolfazl hospital of minab city over two years Since the beginning of 1389 to end of 1390. During this period,their cases were reviewed. To analyze data, descriptive statistics was applied. During this two-year period, 275 patients who had attempted suicide, of which 65 percent are female and most of them were 15-24 years. 60% of them were single and 70 % of rural areas. 51% of suicides in 1390 and most of the suicide attempts occurred at a rate of 37 percent in summer. and the most common way of attempting suicide was medication poisoning (74%). The suicide rate leading to death was 1.5% The chi-square test showes that there were significant relationship between suicide by gender and residence status. This means that more women are committing suicide of rural areas.based on The chi-square test there were significant relation between the gender and method, gender and the result of suicide and means that more women than men commit suicide with the use of drugs. Males were more successful suicide. who had attempted with organophosphates and hanging were more successful in suicide. The finding of the current study showed that most of the suicide victims were female ,rural deweller,14-24 years old,single, serious attention must be paid to the problems of this group. It also extends the field of education professionals and health centers, and psychological therapy that focuses specifically on this topic.

Keywords: attempt to suicide, minab, risk factors, suicide

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Authors: Bianca W. O. Silva, Adriana C. M. Andrade, Gustavo C. M. Lucena, Virna M. S. Lima

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Introduction: Basic life support (BLS) involves the immediate recognition of cardiopulmonary arrest. Each year, 359.400 and 275.000 individuals with cardiac arrest are attended in emergency departments in USA and Europe. Brazilian data shows that 200.000 cardiac arrests occur every year, and half of them out of the hospital. Medical schools around the world teach BLS in the first years of the course, but studies show that there is a decline of the knowledge as the years go by, affecting the chain of survival. The objective was to analyze the knowledge of medical students about BLS and the retention of this learning throughout the course. Methods: This study included 150 students who were at the second and third year of a medical school in Salvador, Bahia, Brazil. The instrument of data collection was a structured questionnaire composed of 20 questions based on the 2015 American Heart Association guideline. The Pearson Chi-square test was used in order to study the association between previous training, sex and semester with the degree of knowledge of the students. The Kruskal-Wallis test was used to evaluate the different yields obtained between the various semesters. The number of correct answers was described by average and quartiles. Results: Regarding the degree of knowledge, 19.6% of the female students reached the optimal classification, a better outcome than the achieved by the male participants. Of those with previous training, 33.33% were classified as good and optimal, none of the students reached the optimal classification and only 2.2% of them were classified as bad (those who did not have 52.6% of correct answers). The analysis of the degree of knowledge related to each semester revealed that the 5th semester had the highest outcome: 30.5%. However, the acquaintance presented by the semesters was generally unsatisfactory, since 50% of the students, or more, demonstrated knowledge levels classified as bad or regular. When confronting the different semesters and the achieved scores, the value of p was 0.831. Conclusion: It is important to focus on the training of medical professionals that are capable of facing emergency situations, improving the systematization of care, and thereby increasing the victims' possibility of survival.

Keywords: basic life support, cardiopulmonary ressucitacion, education, medical students

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Authors: Fiorenza Misale

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The painful phenomenon of so-called white deaths and accidents at work, unfortunately, is always current. The key is to act on the culture of security through effective measures of attitudes and behaviors that go far beyond the knowledge and the know-how. It is necessary that there is an ‘introjection’ of safety culture through the conscious involvement of all workers. The legislation on work safety identifies the main tool to promote the culture of safety at work and prevention within the workplace. In law the term education is used to distinguish itself from the information with which they will simply theoretically transmit, and from the training with which they will provide the practical skills. The new decree fact fills several gaps in previous legislation and stresses the importance of training in the workplace, that is, the main activity through which it is possible to achieve the active participation of all workers in the company’s prevention system. This system is built only through the dissemination of risk information, the circulation of information, comparison and dialogue between all actors involved that are the necessary elements for a correct transmission of the culture of worker safety. Training activity should put the focus on work experience in order to bring out all the knowledge needed to identify and assess the risks in the work place, and especially the action to eliminate or control them, integrating, when necessary, the missing knowledge. In addition to traditional training and information systems can be utilized for the purpose of training that are able to affect both one emotionally and aesthetically, team-theatre is one of them. Among the methods of company theater that can be used in work safety we have: Lesson show, theater workshop, improvised theater, forum theater, theater playback. The theater can represent a complementary approach to traditional training and give information on safety measures, demonstrating that there are more engaging outreach tools. Team-theatre allows identification with the characters, a transmission of emotions and moods and it is through the staging of a story that the individual processes new information. It’ also s a means of experiential training that allows you to work with your mind, body, emotions.The aim of one work is the use of corporate theater on the personnel working in the health sector. Through a questionnaire we are able to analyze the knowledge of occupational safety and current risks; in particular in health care which is to be administered before and after the play.

Keywords: theater, training, occupational health, safety

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