Search results for: levels of care

Authors: Van Truong Pham

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Background: Self-management was described as a potential strategy for blood pressure control in patients with hypertension. However, the effects of self-management interventions on blood pressure, self-efficacy, medication adherence, and body mass index (BMI) in older adults with hypertension have not been systematically evaluated. We evaluated the effects of self-management interventions on systolic blood pressure (SBP) and diastolic blood pressure (DBP), self-efficacy, medication adherence, and BMI in hypertensive older adults. Methods: We followed the recommended guidelines of preferred reporting items for systematic reviews and meta-analyses. Searches in electronic databases including CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, Web of Science, and other sources were performed to include all relevant studies up to April 2019. Studies selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized intervention effects as Hedges' g values and 95% confidence intervals (CI) using a random-effects model. Data were analyzed using Comprehensive Meta-Analysis software 2.0. Results: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self-management interventions significantly improved blood pressure control, self-efficacy, medication adherence, whereas the effect of self-management on BMI was not significant in older adult patients with hypertension. The following Hedges' g (effect size) values were obtained: SBP, -0.34 (95% CI, -0.51 to -0.17, p < 0.001); DBP, -0.18 (95% CI, -0.30 to -0.05, p < 0.001); self-efficacy, 0.93 (95%CI, 0.50 to 1.36, p < 0.001); medication adherence, 1.72 (95%CI, 0.44 to 3.00, p=0.008); and BMI, -0.57 (95%CI, -1.62 to 0.48, p = 0.286). Conclusions: Self-management interventions significantly improved blood pressure control, self-efficacy, and medication adherence. However, the effects of self-management on obesity control were not supported by the evidence. Healthcare providers should implement self-management interventions to strengthen patients' role in managing their health care.

Keywords: self-management, meta-analysis, blood pressure control, self-efficacy, medication adherence, body mass index

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Authors: Pi-Hsia Hung

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The development of mathematical competency has individual benefits as well as benefits to the wider society. Children who begin school behind their peers in their understanding of number, counting, and simple arithmetic are at high risk of staying behind throughout their schooling. The development of effective strategies for improving the educational trajectory of these individuals will be contingent on identifying areas of early quantitative knowledge that influence later mathematics achievement. A computer-based quantity assessment was developed in this study to investigate the characteristics of 2nd and 3rd grade slow learners in quantity. The concept of quantification involves understanding measurements, counts, magnitudes, units, indicators, relative size, and numerical trends and patterns. Fifty-five tasks of quantitative reasoning—such as number sense, mental calculation, estimation and assessment of reasonableness of results—are included as quantity problem solving. Thus, quantity is defined in this study as applying knowledge of number and number operations in a wide variety of authentic settings. Around 1000 students were tested and categorized into 4 different performance levels. Students’ quantity ability correlated higher with their school math grade than other subjects. Around 20% students are below basic level. The intervention design implications of the preliminary item map constructed are discussed.

Keywords: mathematics assessment, mathematical cognition, quantity, number sense, validity

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Authors: Zakieh Rostamzadeh , Nariman Sepehrvand-Zahra Shirmohamadi

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Background: Cytomegalovirus (CMV) infection is one of the most common infectious problems following kidney transplantation. In this study, we are aimed to investigate the CMV infection in the setting of renal transplant recipients in Urmia-Iran, using both ELISA and polymerase chain reaction (PCR) methods. Methods: Ninety-six renal transplant recipients were selected randomly and enrolled in a cross-sectional study. Blood sampling was done via venipuncture, and all sera were investigated for anti-CMV IgM, and the seropositive cases in association with 14 randomly selected seronegative cases were investigated with PCR assay. Results: Thirty-three patients (34.3%) were seropositive for anti-CMV IgM, 3 patients (3.1%) were in borderline range, and 60 patients (62.5%) were seronegative. By considering the patients with borderline anti-CMV IgM levels as seropositive, 37.5% were seropositive for anti-CMV IgM. Among 36 seropositive cases, the CMV infection was confirmed in 19 (52.7%) of them using PCR. Age (P = 0.40), educational status (P = 0.77), history of pre-transplantation dialysis (0.52), history of blood transfusion (P = 0.52), and immunosuppressive regimen were not statistically different among recipients with positive versus negative CMV PCR study results. Conclusion: The seroprevalence of CMV infection was demonstrated to be high in renal transplant recipients of Urmia-Iran. The rate was higher compared to several previous reports in the literature. ELISA method has an appropriate sensitivity to screen the recipients for CMV infection but considering its relatively low specificity, the seropositive cases are better to be confirmed by further PCR study.

Keywords: cytomegalovirus, renal transplantation, ELISA, IgM, PCR

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Authors: Marta Skwarecka, Patrycja Bloch, Rafal Walkusz, Oliwia Urbanowicz, Grzegorz Zielinski, Sabina Zoledowska, Dawid Nidzworski

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Upper respiratory tract infections are one of the most common reasons for visiting a general doctor. Streptococci are the most common bacterial etiological factors in these infections. There are many different types of Streptococci and infections vary in severity from mild throat infections to pneumonia. For example, S. pyogenes mainly contributes to acute pharyngitis, palatine tonsils and scarlet fever, whereas S. Streptococcus pneumoniae is responsible for several invasive diseases like sepsis, meningitis or pneumonia with high mortality and dangerous complications. There are only a few diagnostic tests designed for detection Streptococci from the infected throat of patients. However, they are mostly based on lateral flow techniques, and they are not used as a standard due to their low sensitivity. The diagnostic standard is to culture patients throat swab on semi selective media in order to multiply pure etiological agent of infection and subsequently to perform antibiogram, which takes several days from the patients visit in the clinic. Therefore, the aim of our studies is to develop and implement to the market a Point of Care device for the rapid identification of Streptococcus pyogenes and Streptococcus pneumoniae with simultaneous identification of antibiotic resistance genes. In the course of our research, we successfully selected genes for to-species identification of Streptococci and genes encoding antibiotic resistance proteins. We have developed a reaction to amplify these genes, which allows detecting the presence of S. pyogenes or S. pneumoniae followed by testing their resistance to erythromycin, chloramphenicol and tetracycline. What is more, the detection of β-lactamase-encoding genes that could protect Streptococci against antibiotics from the ampicillin group, which are widely used in the treatment of this type of infection is also developed. The test is carried out directly from the patients' swab, and the results are available after 20 to 30 minutes after sample subjection, which could be performed during the medical visit.

Keywords: antibiotic resistance, Streptococci, respiratory infections, diagnostic test

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Authors: Klaudia Tomala, Elzbieta Grochowska-Niedworok, Katarzyna Brukalo, Marek Kardas, Beata Calyniuk, Renata Polaniak

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Background. Nutrition plays an important role in the psychophysical growth of children and has effects on their health. Providing children with the appropriate supply of macro- and micro-nutrients requires dietary diversity across every food group. Meals in kindergartens should provide 70-75% of their daily food requirement. Aim. The aim of this study was to determine the vitamin content in the food rations of children attending kindergarten in the wider aspect of nutritional status. Material and Methods. Kindergarten menus from the spring and autumn seasons of 2015 were analyzed. In these meals, fat content and levels of water-soluble vitamins were estimated. The vitamin content was evaluated using the diet calculator “Aliant”. Statistical analysis was done in MS Office Excel 2007. Results. Vitamin content in the analyzed menus in many cases is too high with reference to dietary intake, with only vitamin D intake being insufficient. Vitamin E intake was closest to the dietary reference intake. Conclusion. The results show that vitamin intake is usually too high, and menus should, therefore, be modified. Also, nutrition education among kindergarten staff is needed. The identified errors in the composition of meals will affect the nutritional status of children and their proper composition in the body.

Keywords: children, nutrition status, vitamins, preschool

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Authors: Ime R. Udotong, Justina I. R. Udotong, Ofonime U. M. John

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Ibeno, Nigeria hosts the operational base of Mobil Producing Nigeria Unlimited (MPNU), a subsidiary of ExxonMobil and the current highest oil and condensate producer in Nigeria. Besides MPNU, other oil companies operate onshore, on the continental shelf and deep offshore of the Atlantic Ocean in Ibeno, Nigeria. This study was designed to delineate oil polluted sites in Ibeno, Nigeria using geophysical methods of electrical resistivity (ER) and ground penetrating radar (GPR). Results obtained revealed that there have been hydrocarbon contaminations of this environment by past crude oil spills as observed from high resistivity values and GPR profiles which clearly show the distribution, thickness and lateral extent of hydrocarbon contamination as represented on the radargram reflector tones. Contaminations were of varying degrees, ranging from slight to high, indicating levels of substantial attenuation of crude oil contamination over time. Moreover, the display of relatively lower resistivities of locations outside the impacted areas compared to resistivity values within the impacted areas and the 3-D Cartesian images of oil contaminant plume depicted by red, light brown and magenta for high, low and very low oil impacted areas, respectively confirmed significant recent pollution of the study area with crude oil.

Keywords: electrical resistivity, geophysical investigations, ground penetrating radar, oil-polluted sites

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Authors: Pibool Waijittragum

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The purpose of this research is to analyze the marketing strategies of Thai Halal products which related to the way of life for Thai Muslims. The expected benefit is the marketing strategy for brand building process for Halal products in Thailand. 4 elements of marketing strategies which necessary for the brand identity creation is the research framework: Consists of Attributes, Benefits, Values and Personality. The research methodology was applied using qualitative and quantitative; 19 marketing experts with dynamic roles in Thai consumer products were interviewed. In addition, a field survey of 122 Thai Muslims selected from 175 Muslim communities in Bangkok was studied. Data analysis will be according to 5 categories of Thai Halal product: 1) Meat 2) Vegetable and Fruits 3) Instant foods and Garnishing ingredient 4) Beverages, desserts and snacks 5) Hygienic daily products; such as soap, shampoo and body lotion. The results will explain some suitable representation in the marketing strategies of Thai Halal products as are: 1) Benefit; the characteristics of the product with its benefit. Consumers will purchase this product with the reason of; it is beneficial nutrients product, there are no toxic or chemical residues. Fresh and clean materials 2) Attribute; the exterior images that attract to consumer. Consumers will purchase this product with the reason of; there is a standard proof mark, food and drug secure proof mark and Halal products mark. Packaging and its materials should be draw attention. Use an attractive graphic. Use outstanding images of product, material or ingredients. 3) Value; the value of products that affect to consumers perception; it is healthy products. Accumulate quality of life. It is a product of expertise, manufacturing of research result. Consumers are important. It’s sincere, honest and reliable to all. 4) Personality; reflection of consumers thought. The personality feedback to them after they were consumes this product; they are health care persons. They are the rational person, moral person, justice person and thoughtful person like a progressive thinking.

Keywords: marketing strategies, product identity, branding, Thai Halal products

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Authors: A. D. Tayal

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The energy industry is undergoing significant disruption. This research outlines that, whilst challenging; this disruption is also an emerging opportunity for electricity utilities. One such opportunity is leveraging the developments in data analytics and machine learning. As the uptake of renewable energy technologies and complimentary control systems increases, electricity grids will likely transform towards dense microgrids with high penetration of renewable generation sources, rich in network and customer data, and linked through intelligent, wireless communications. Data digitisation and analytics have already impacted numerous industries, and its influence on the energy sector is growing, as computational capabilities increase to manage big data, and as machines develop algorithms to solve the energy challenges of the future. The objective of this paper is to address how far the uptake of renewable technologies can go given the constraints of existing grid infrastructure and provides a qualitative assessment of how higher levels of renewable energy penetration can be facilitated by incorporating even broader technological advances in the fields of data analytics and machine learning. Western Australia is used as a contextualised case study, given its abundance and diverse renewable resources (solar, wind, biomass, and wave) and isolated networks, making a high penetration of renewables a feasible target for policy makers over coming decades.

Keywords: data, innovation, renewable, solar

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Authors: Sameer Masood, Lucas Chartier

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Head injuries are a commonly encountered presentation in emergency departments (ED) and the Choosing Wisely Canada (CWC) campaign was released in June 2015 in an attempt to decrease imaging utilization for patients with minor head injuries. The impact of the CWC campaign on imaging utilization for head injuries has not been explored in the ED setting. In our study, we describe the characteristics of patients with head injuries presenting to a tertiary care academic ED and the impact of the CWC campaign on CT head utilization. This retrospective cohort study used linked databases from the province of Ontario, Canada to assess emergency department visits with a primary diagnosis of head injury made between June 1, 2014 and Aug 31, 2016 at the University Health Network in Toronto, Canada. We examined the number of visits during the study period, the proportion of patients that had a CT head performed before and after the release of the CWC campaign, as well as mode of arrival, and disposition. There were 4,322 qualifying visits at our site during the study period. The median presenting age was 44.12 years (IQR 27.83,67.45), the median GCS was 15 (IQR 15,15) and the majority of patients presenting had intermediate acuity (CTAS 3). Overall, 43.17% of patients arrived via ambulance, 49.24 % of patients received a CT head and 10.46% of patients were admitted. Compared to patients presenting before the CWC campaign release, there was no significant difference in the rate of CT heads after the CWC (50.41% vs 47.68%, P = 0.07). There were also no significant differences between the two groups in mode of arrival (ambulance vs ambulatory) (42.94% vs 43.48%, P = 0.72) or admission rates (9.85% vs 11.26%, P = 0.15). However, more patients belonged to the high acuity groups (CTAS 1 or 2) in the post CWC campaign release group (12.98% vs 8.11% P <0.001). Visits for head injuries make up a significant proportion of total ED visits and approximately half of these patients receive CT imaging in the ED. The CWC campaign did not seem to impact imaging utilization for head injuries in the 14 months following its launch. Further efforts, including local quality improvement initiatives, are likely needed to increase adherence to its recommendation and reduce imaging utilization for head injuries.

Keywords: choosing wisely, emergency department, head injury, quality improvement

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Authors: Andreas Kornmaaler Hansen, Carlos Gomez Cubero, Elizabeth Jochum

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The use of the arts in therapy and rehabilitation is well established, and there is growing recognition of the value of the arts for improving health and well-being across diverse populations. Combining arts with socially assistive robots is a relatively under-explored research area. This paper presents the results of a feasibility study conducted within an existing arts and health program to scope the possibility of combining visual arts with socially assistive robots to promote mental health and well-being. Using a participatory research design with participant-led perspectives, we present the results of our feasibility study with a collaborative drawing robot among an adult population with mild to severe mental illness. We identify key methodological challenges and advantages of working with participatory and human-centered approaches. Based on the results of three pilot workshops with participants and lay health workers, we outline suggestions for authentic engagement with real stakeholders toward the development of socially assistive robots in community health contexts. Working closely with a patient population at all levels of the research process is key for developing tools and interventions that center patient experience and priorities while minimizing the risks of alienating patients and communities.

Keywords: arts and health, visual art, health promotion, mental health, collaborative robots, creativity, socially assistive robots

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Authors: Silvija Šiljeg, Ante Šiljeg, Branko Cavrić

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Housing is considered as a basic human need and important component of the quality of life (QoL) in urban areas worldwide. In contemporary housing studies, the concept of the quality of housing (QoH) is considered as a multi-dimensional and multi-disciplinary field. It emphasizes connection between various aspects of the QoL which could be measured by quantitative and qualitative indicators at different spatial levels (e.g. local, city, metropolitan, regional). The main goal of this paper is to examine the QoH and compare results of quantitative analysis with the clutter land use categories derived for selected local communities in Croatian Coastal City of Zadar. The qualitative housing analysis based on the four housing indicators (out of total 24 QoL indicators) has provided identification of the three Zadar’s local communities with the highest estimated QoH ranking. Furthermore, by using GIS overlay techniques, the QoH was merged with the urban environment analysis and introduction of spatial metrics based on the three categories: the element, class and environment as a whole. In terms of semantic-content analysis, the research has also generated a set of indexes suitable for evaluation of “housing state of affairs” and future decision making aiming at improvement of the QoH in selected local communities.

Keywords: housing, quality, indicators, indexes, urban environment, GIS, element, class

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Authors: Ramanish Ravishankar, Azar Hussain, Mahmoud Loubani, Mubarak Chaudhry

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Background and Aims: Currently, there are no strict guidelines in cardiopulmonary bypass temperature management in cardiac surgery not involving the aortic arch. This study aims to compare patient outcomes undergoing mild hypothermia and normothermia. The aim of this study was to compare patient outcomes between mild hypothermia and normothermia undergoing on-pump cardiac surgery not involving the aortic arch. Methods: This was a retrospective cohort study from January 2015 until May 2023. Patients who underwent cardiac surgery with cardiopulmonary bypass temperatures ≥32oC were included and stratified into mild hypothermia (32oC – 35oC) and normothermia (>35oC) cohorts. Propensity matching was applied through the nearest neighbour method (1:1) using the risk factors detailed in the EuroScore using RStudio. The primary outcome was mortality. Secondary outcomes included post-op stay, intensive care unit readmission, re-admission, stroke, and renal complications. Patients who had major aortic surgery and off-pump operations were excluded. Results: Each cohort had 1675 patients. There was a significant increase in overall mortality with the mild hypothermia cohort (3.59% vs. 2.32%; p=0.04912). There was also a greater stroke incidence (2.09% vs. 1.13%; p=0.0396) and transient ischaemic attack (TIA) risk (3.1% vs. 1.49%; p=0.0027). There was no significant difference in renal complications (9.13% vs. 7.88%; p=0.2155). Conclusions: Patient’s who underwent mild hypothermia during cardiopulmonary bypass have a significantly greater mortality, stroke, and transient ischaemic attack incidence. Mild hypothermia does not appear to provide any benefit over normothermia and does not appear to provide any neuroprotective benefits. This shows different results to that of other major studies; further trials and studies need to be conducted to reach a consensus.

Keywords: cardiac surgery, therapeutic hypothermia, neuroprotection, cardiopulmonary bypass

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Authors: Waleed M. Al-Othman, Hamid Bayati, Abdullah Al-Shahrani, Haitham Al-Jabr

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Pearlite bands commonly form parallel to the surface of the hot rolled steel and have significant influence on the properties of the steel. This study investigated the correlation between segregation pattern of Mn, Si, C and formation of the pearlite bands in hot rolled Gr 60 steel plate. Microstructural study indicated formation of a distinguished thick band at centerline of the plate with number of parallel bands through thickness of the steel plate. The thickness, frequency, and continuity of the bands are reduced from mid-thickness toward external surface of the steel plate. Analysis showed a noticeable increase of C, Si and Mn levels within the bands. Such alloying segregation takes place during metal solidification. EDS analysis verified presence of particles rich in Ti, Nb, Mn, C, N, within the bands. Texture analysis by Electron Backscatter Detector (EBSD) indicated the grains size/misorientation can noticeably change within the bands. Effect of banding on through-thickness properties of the steel was examined by carrying out microhardness, toughness and tensile tests. Results suggest the Mn and C contents are changed in sinusoidal pattern through thickness of the hot rolled plate and pearlite bands are formed at the peaks of this sinusoidal segregation pattern. Changes in grain size/misorientation, formation of highly alloyed particles, and pearlite within these bands, facilitate crack formation along boundaries of these bands.

Keywords: pearlite band, alloying segregation, hot rolling, Ti, Nb, N, C

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Authors: P. V. Pramila , V. Mahesh

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Pulmonary Function Tests are important non-invasive diagnostic tests to assess respiratory impairments and provides quantifiable measures of lung function. Spirometry is the most frequently used measure of lung function and plays an essential role in the diagnosis and management of pulmonary diseases. However, the test requires considerable patient effort and cooperation, markedly related to the age of patients esulting in incomplete data sets. This paper presents, a nonlinear model built using Multivariate adaptive regression splines and Random forest regression model to predict the missing spirometric features. Random forest based feature selection is used to enhance both the generalization capability and the model interpretability. In the present study, flow-volume data are recorded for N= 198 subjects. The ranked order of feature importance index calculated by the random forests model shows that the spirometric features FVC, FEF 25, PEF,FEF 25-75, FEF50, and the demographic parameter height are the important descriptors. A comparison of performance assessment of both models prove that, the prediction ability of MARS with the `top two ranked features namely the FVC and FEF 25 is higher, yielding a model fit of R2= 0.96 and R2= 0.99 for normal and abnormal subjects. The Root Mean Square Error analysis of the RF model and the MARS model also shows that the latter is capable of predicting the missing values of FEV1 with a notably lower error value of 0.0191 (normal subjects) and 0.0106 (abnormal subjects). It is concluded that combining feature selection with a prediction model provides a minimum subset of predominant features to train the model, yielding better prediction performance. This analysis can assist clinicians with a intelligence support system in the medical diagnosis and improvement of clinical care.

Keywords: FEV, multivariate adaptive regression splines pulmonary function test, random forest

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Authors: Sdiqeh Jalali, M. R. Khazdair

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Liver X receptors (LXR) have an essential role in the regulation of cholesterol metabolism, and their activation increase ABCG5 and ABCG8 genes expression for the improvement of cholesterol excretion from the body during reverse cholesterol transport (RCT). The aim of this study was to investigate the effects of high-intensity interval (HIT) and low intensity continuous (LIT) trainings on gene expression of these substances after a high-fat diet in Wistar rats. Materials and Methods: Fifteen male Wistar rats were divided into 3 groups: control group (n = 5), HIT exercise group (n = 5) and LIT exercise group (n = 5). All groups used a high-fat diet for 13 weeks, and the HIT and LIT groups performed the specific training program. The expression of LXRβ, ABCG5, and ABCG8 genes was measured after the training period. Findings: Data analysis showed significantly higher levels of LXRβ, ABCG5, and ABCG8 gene expression in HIT and LIT groups compared to the control group (P ≤ 0.05). Conclusion: HIT and LIT trainings after a high-fat diet have beneficial effects on RCT that prevent heart attack. Also, HIT training may have a greater effect on cholesterol excretion during the reverse cholesterol transport mechanism than LIT.

Keywords: liver X receptor, atherosclerosis, interval training, endurance training

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Authors: Aragorn Joaquin Pineda Dela Cruz

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Road traffic congestion is continually deteriorating in Hong Kong. The largest contributing factor is the increase in vehicle fleet size, resulting in higher competition over the utilisation of road space. This study proposes a project that can process closed-circuit television images and videos to provide real-time traffic detection and prediction capabilities. Specifically, a deep-learning model involving computer vision techniques for video and image-based vehicle counting, then a separate model to detect and predict traffic congestion levels based on said data. State-of-the-art object detection models such as You Only Look Once and Faster Region-based Convolutional Neural Networks are tested and compared on closed-circuit television data from various major roads in Hong Kong. It is then used for training in long short-term memory networks to be able to predict traffic conditions in the near future, in an effort to provide more precise and quicker overviews of current and future traffic conditions relative to current solutions such as navigation apps.

Keywords: intelligent transportation system, vehicle detection, traffic analysis, deep learning, machine learning, computer vision, traffic prediction

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Authors: Soudeh Tabashi, Soudabeh Fazeli Dehkordy, Masood Movahedi, Nasrin Behniafard

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Introduction: Food allergy has increased in three last decades. Since wheat is one of the major constituents of daily meal in many regions throughout the world, wheat allergy is one of the most important allergies ranking among the 8 most common types of food allergies. Our information about epidemiology and etiology of food allergies are limited. Therefore, in this study we sought to evaluate the symptoms and laboratory findings in children with wheat allergy. Materials and methods: There were 23 patients aged up to 18 with the diagnosis of IgE mediated wheat allergy that were included enrolled in this study. Using a questionnaire .we collected their information and organized them into 4 groups categories of: demographic data identification, signs and symptoms, comorbidities, and laboratory data. Then patients were followed up for 6 month and their lab data were compared together. Results: Most of the patients (82%) presented the symptoms of wheat allergy in the first year of their life. The skin and the respiratory system were the most commonly involved organs with an incidence of 86% and 78% respectively. Most of the patients with wheat allergy were also sensitive to the other type of foods and their sensitivity to egg were most common type (47%). in 57% of patients, IgE levels were decreased during the 6 month follow-up period. Conclusion: We do not have enough information about data on epidemiology and response to therapy of wheat allergy and to best of our knowledge no study has addressed this issue in Iran so far. This study is the first source of information about IgE mediated wheat allergy in Iran and It can provide an opening for future studies about wheat allergy and its treatments.

Keywords: wheat allergy, food allergy, IgE, food allergy

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Authors: Jared Cheves, Amanda DeChent, Joyce Pan

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Total knee replacements (TKAs) are one of the most common but painful surgical procedures performed in the United States. Currently, the gold standard for postoperative pain management is the utilization of opioids. However, in the wake of the opioid epidemic, the healthcare system is attempting to reduce opioid consumption by trialing innovative opioid sparing analgesic techniques such as continuous peripheral nerve blocks (CPNB) and continuous periarticular infiltration (CPAI). The alleviation of pain, particularly during the first 72 hours postoperatively, is of utmost importance due to its association with delayed recovery, impaired rehabilitation, immunosuppression, the development of chronic pain, the development of rebound pain, and decreased patient satisfaction. While both CPNB and CPAI are being used today, there is limited evidence comparing the two to the current standard of care or to each other. An extensive literature review was performed to explore the safety profiles and effectiveness of CPNB and CPAI in reducing reported pain scores and decreasing opioid consumption. The literature revealed the usage of CPNB contributed to lower pain scores and decreased opioid use when compared to opioid-only control groups. Additionally, CPAI did not improve pain scores or decrease opioid consumption when combined with a multimodal analgesic (MMA) regimen. When comparing CPNB and CPAI to each other, neither unanimously lowered pain scores to a greater degree, but the literature indicates that CPNB decreased opioid consumption more than CPAI. More research is needed to further cement the efficacy of CPNB and CPAI as standard components of MMA in TKA procedures. In addition, future research can also focus on novel catheter-free applications to reduce the complications of continuous catheter analgesics.

Keywords: total knee arthroplasty, continuous peripheral nerve blocks, continuous periarticular infiltration, opioid, multimodal analgesia

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Authors: Vesna Karapetkovska Hristova, M. Ayaz Ahmad, Julijana Tomovska, Biljana Bogdanova Popov, Blagojce Najdovski

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The average total concentrations of heavy metals; (cadmium [Cd], copper [Cu], nickel [Ni], lead [Pb], and zinc [Zn]) were analyzed in soil and vegetables samples collected from the different region of Macedonia during the years 2010-2012. Basic soil properties such as pH, organic matter and clay content were also included in the study. The average concentrations of Cd, Cu, Ni, Pb, Zn in the A horizon (0-30 cm) of agricultural soils were as follows, respectively: 0.25, 5.3, 6.9, 15.2, 26.3 mg kg-1 of soil. We have found that neural networking model can be considered as a tool for prediction and spatial analysis of the processes controlling the metal transfer within the soil-and vegetables. The predictive ability of such models is well over 80% as compared to 20% for typical regression models. A radial basic function network reflects good predicting accuracy and correlation coefficients between soil properties and metal content in vegetables much better than the back-propagation method. Neural Networking / soft computing can support the decision-making processes at different levels, including agro ecology, to improve crop management based on monitoring data and risk assessment of metal transfer from soils to vegetables.

Keywords: soft computing approach, total concentrations, heavy metals, agricultural soils

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Authors: Maria C. Proença, Marco Aniceto, Pedro N. Santos, José C. Freitas

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A methodology based on wavelets is proposed for the automatic location and delimitation of defects in limestone plates. Natural defects include dark colored spots, crystal zones trapped in the stone, areas of abnormal contrast colors, cracks or fracture lines, and fossil patterns. Although some of these may or may not be considered as defects according to the intended use of the plate, the goal is to pair each stone with a map of defects that can be overlaid on a computer display. These layers of defects constitute a database that will allow the preliminary selection of matching tiles of a particular variety, with specific dimensions, for a requirement of N square meters, to be done on a desktop computer rather than by a two-hour search in the storage park, with human operators manipulating stone plates as large as 3 m x 2 m, weighing about one ton. Accident risks and work times are reduced, with a consequent increase in productivity. The base for the algorithm is wavelet decomposition executed in two instances of the original image, to detect both hypotheses – dark and clear defects. The existence and/or size of these defects are the gauge to classify the quality grade of the stone products. The tuning of parameters that are possible in the framework of the wavelets corresponds to different levels of accuracy in the drawing of the contours and selection of the defects size, which allows for the use of the map of defects to cut a selected stone into tiles with minimum waste, according the dimension of defects allowed.

Keywords: automatic detection, defects, fracture lines, wavelets

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Authors: Nivedita Ghosh

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In his critique of Lefebvre’s view that ‘technological capacities’ are class-dependent, Francois Hetman argues that technology today is participatory, allowing the entry of individuals from different levels of social stratification. As a result, we are entering into an era of technology operators or ‘clerks’ who become the new decision-makers because of the knowledge they possess of the use of technologies. In response to Hetman’s thesis, this paper argues that knowledge of technology, while indeed providing a momentary space for decision-making, does not necessarily restructure social hierarchies. Through case studies presented from the world of Indian documentary filmmaking, this paper puts forth the view that Hetman’s clerks, despite being technologically advanced, do not break into the filmmaking hierarchical order. This remains true even for a situation where technical knowledge rests most with those in the lowest rungs of the filmmaking ladder. Instead, technological knowledge provides the space for other kinds of relationships to evolve, such as those of ‘trusting the technician’ or ‘admiration for the technician’s work’. Furthermore, what continues to define documentary filmmaking hierarchy is conceptualization capacities of the practitioners, which are influenced by a similarity in socio-cultural backgrounds and film school training accessible primarily to the filmmakers instead of the technicians. Accordingly, the paper concludes with the argument that more than ‘technological-capacities’, it is ‘conceptualization capacities’ which are class-dependent, especially when we study the field of documentary filmmaking.

Keywords: documentary filmmaking, India, technology, knowledge, hierarchy

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Authors: Stella Sten, Peter Hedström, Joakim Odqvist, Susanne Norgren

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Two functionally graded cemented carbide samples have been produced by local addition of Titanium carbide (TiC) to a pressed Tungsten carbide and Cobalt, WC-10 wt% Co, green body prior to sintering, with the aim of creating a gradient in both composition and grain size in the as-sintered component. The two samples differ only by the in-going WC particle size, where one sub-micron and one coarse WC particle size have been chosen for comparison. The produced sintered samples had a gradient, thus a non-homogenous structure. The Titanium (Ti), Cobalt (Co), and Carbon (C) concentration profiles have been investigated using SEM-EDS and WDS; in addition, the Vickers hardness profile has been measured. Moreover, the Ti concentration profile has been simulated using DICTRA software and compared with experimental results. The concentration and hardness profiles show a similar trend for both samples. Ti and C levels decrease, as expected from the area of TiC application, whereas Co increases towards the edge of the samples. The non-homogenous composition affects the number of stable phases and WC grain size evolution. The sample with finer in-going WC grain size shows a shorter gamma (γ) phase zone and a larger difference in WC grain size compared to the coarse-grained sample. Both samples show, independent of the composition, the presence of abnormally large grains.

Keywords: cemented carbide, functional gradient material, grain growth, sintering

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Authors: Sozan H. Omar, Lina L. Al-Rewaili

Abstract:

The current study aimed to measure the fifth Grade student skills of reading illustrates in physical and chemical chapter included in science textbook, as well as identity the tasks the dispersants related to designing these illustrates which obstruct the students to read them properly. The researcher applied the test instrument of open discuss questions to measure the skill of: recognizing, description, interpretation and assessment for a sample of this research consisted of (269) students who read three illustrates, and conduct an interview with sample of them (27) students to recognize the dispersants related to designing of these illustrates. The study results showed that there are poor levels in illustrated drawing reading skills: description, interpretation, and assessment. The most important dispersants which obstruct the students to read theses illustrates properly representing: Art impacts of these illustrates, there are some elements which don’t serve these illustrates. In the light of the above results, the researcher provided some recommendations such as training the students on using the images and illustrates properly in science textbooks, as well as create simple designs of illustrates and they should be free of crowded elements and impacts which don’t serve the illustrates.

Keywords: reading illustrated drawings skills, fifth grade science, physical and chemical changes

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Authors: Getenet Shumet Birhan, Biruk Lelisa Eticha, Gizachew Tilahun Belete, Fisseha Admassu Ayele

Abstract:

Context: Glaucoma is a significant public health concern globally, being the second leading cause of blindness. This study focuses on adult glaucoma patients in Ethiopia, specifically at the University of Gondar. Research Aim: The main objective is to assess the prevalence of visual impairment and identify associated factors among adult glaucoma patients at the University of Gondar. Methodology: The study used an institution-based cross-sectional design, collecting data from 423 glaucoma patients through interviews and medical chart reviews. Descriptive statistics and logistic regression were employed for analysis. Findings: The study found a high prevalence of visual impairment (77.6%) among adult glaucoma patients, with factors such as female sex, rural residence, glaucoma type, disease stage, and duration of diagnosis significantly associated with visual impairment. Theoretical Importance: This research adds valuable insights into the prevalence and determinants of visual impairment among glaucoma patients in Ethiopia, contributing to the existing literature on eye health in low-resource settings. Data Collection: Data were collected through face-to-face interviews and medical chart reviews at the University of Gondar, utilizing a structured questionnaire. Analysis Procedures: Descriptive statistics, frequency analysis, and binary logistic regression were employed to analyze the data and identify factors associated with visual impairment in adult glaucoma patients. Question Addressed: The study sought to answer the question of the prevalence of visual impairment and its associated factors among adult glaucoma patients at the University of Gondar in Northwest Ethiopia. Conclusion: The research concludes that visual impairment is significantly high among adult glaucoma patients in this setting, with several factors playing a role in its occurrence.

Keywords: visual impairment, glaucoma, Ethiopia, Gondar

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Authors: Donna L. Roberts

Abstract:

Beyond the fundamental question of what is (and what isn’t) art, one then moves to the question of what about art, or a specific artwork, matters. If there is an agreement that something is art, the next step is to answer the obvious, ‘So what? What does it mean?’ In answering these questions, one must decide how to focus the proverbial microscope –i.e., what level of perspective is relevant as a point of view for this analysis- the artwork itself, the artist’s intention, the viewer’s interpretation, the artwork’s reflection of the larger artistic movement, the social, political, and historical context of art? One must determine what product and what contexts are meaningful when experiencing and interpreting art. Is beauty really in the eye of the beholder? Or is it more important what the creator was trying to say than what the critic or observer heard? The fact that so many artists –from Rembrandt to Van Gogh to Picasso- include among their works at least one self-portrait seems to scream their point –I matter. But, Is a piece more impactful because of the persona behind it? Or does that persona impose limits and close one’s mind to the possibilities of interpretation? In the popular art text visual culture, Richard Howells argues against a biographical focus on the artist in the analysis of art. Similarly, abstract expressionist Mark Rothko, along with several of his contemporaries of the genre, often did not title his paintings for the express purpose of not imposing a specific meaning or interpretation on the piece. And yet, he once said, ‘The people who weep before my pictures are having the same religious experience I had when I painted them,’ thus alluding to a desire for a shared connection and revelation. This research analyzes the arguments for differing levels of interpretation and points of view when considering a work of art and/or the artist who created it.

Keywords: art analysis, art interpretation, art theory, artistic perspective

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Authors: Indri Nilam Sari, Aris Subagiyo, Nindya Sari

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Malinau Regency border area is an area which is based on the RTRWN and the development priority. But, in real border area Malinau Regency placed as backyard from Indonesian area and caused development lag that is fairly large compared by town area in Malinau Regency. This research aimed to know the condition of the gap in the Malinau Regency border and its influence on the development of the border region as well as knowing the problems related to the economy development of society in the area of the border district of Malinau. Methods of analysis are used in namely descriptive analysis that represent analysis of land use and analysis of movement activities of the population, level analysis facility and infrastructure, economy analysis that represent top commodity determination analysis (LQ and Growth Share) and accessibility. The results of the study showed that the condition of the Malinau Regency border come within the gap as seen from the contributions of infrastructure repair facilities and accessibility advocates, communities, scattered seed commodities come within the borders and human resources with the condition of the most Upstream Bahau town in the backwaters of the town more. There are a few problems that cause the condition area of the border experiencing inequality, lack of human resources, poor infrastructure, lack of accessibility and low levels of security so that it brings development recommendations was the development of the flagship commodities and infrastructure as well as supporting community economic infrastructure, as well as human resources.

Keywords: border, economy, development, Malinau

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Authors: Naif Al-Jomah, Falah H Al-Mohanna, Abdelilah Aboussekhra

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Active breast cancer-associated fibroblasts (CAFs), the most influential cells in breast tumor microenvironment, express/secrete high levels of the proinvasive/metastatic interleukin-6 (IL-6). Therefore, we have tested here the effect of the IL-6 receptor (IL-6R) inhibitor tocilizumab (TCZ; Actemra) on different active breast CAFs. We have shown that TCZ potently and persistently suppresses the expression of various CAF biomarkers, namely α-SMA, SDF-1 as well as the STAT3 pathway and its downstream target AUF1. TCZ also inhibited the proliferation, migration and invasion abilities of active breast CAF cells. Additionally, TCZ repressed the ability of CAF cells in promoting epithelial-to-mesenchymal transition, and enhancing the migratory/invasive and proliferative capacities of breast cancer cells in vitro. Importantly, these findings were confirmed in orthotopic humanized breast tumors in mice. Furthermore, TCZ suppressed the expression of the pro-angiogenic factor VEGF-A and its transactivator HIF-1α in CAF cells, and consequently inhibited the angiogenic-promoting effect of active CAFs both in vitro and in orthotopic tumor xenografts. These results indicate that inhibition of the IL-6/STAT3/AUF1 pathway by TCZ can normalize active breast CAFs and suppress their paracrine pro-carcinogenic effects, which paves the way toward development of specific CAF-targeting therapy, badly needed for more efficient breast cancer treatments.

Keywords: angiogenesis, interleukin-6, paracrine, cancer-associated fibroblasts

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Authors: Sushma Tejwani, Shoruba Dinakaran, Kushal Kacha, K. Bhujang Shetty

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Introduction and aim: It is not unusual to find patients with glaucomatous damage and normal intraocular pressure, and to label a patient as Normal tension glaucoma (NTG) majority of clinicians depend on office Intraocular pressures (IOP) recordings; hence, the concern is that whether we are missing the late night or early morning spikes in this group of patients. Also, ischemia to the optic nerve is one of the presumed causes of damage in these patients, however demonstrating the same has been a challenge. The aim of this study was to evaluate IOP variations and patterns in a series of patients with open angles, glaucomatous discs or fields but normal office IOP, and in addition to identify ischemic factors for true NTG patients. Materials & Methods: This was an observational cross- sectional study from a tertiary care centre. The patients that underwent full day DVT from Jan 2012 to April 2014 were studied. All patients underwent IOP measurement on Goldmann applanation tonometry every 3 hours for 24 hours along with a recording of the blood pressure (BP). Further patients with normal IOP throughout the 24- hour period were evaluated with a cardiologist for echocardiography and carotid Doppler. Results: There were 47 patients and a maximum number of patients studied was in the age group of 50-70 years. A biphasic IOP peak was noted for almost all the patients. Out of the 47 patients, 2 were excluded from analysis as they were on treatment.20 patients (42%) were diagnosed on DVT to have an IOP spike and were then diagnosed as open angle glaucoma and another 25 (55%) were diagnosed to have normal tension glaucoma and were subsequently advised a carotid Doppler and a cardiologists consult. Another interesting finding was that 9 patients had a nocturnal dip in their BP and 3 were found to have carotid artery stenosis. Conclusion: A continuous 24-hour monitoring of the IOP and BP is a very useful albeit mildly cumbersome tool which provides a wealth of information in cases of glaucoma presenting with normal office pressures. It is of great value in differentiating between normal tension glaucoma patients & open angle glaucoma patients. It also helps in timely diagnosis & possible intervention due to referral to a cardiologist in cases of carotid artery stenosis.

Keywords: carotid artery disease in NTG, diurnal variation of IOP, ischemia in glaucoma, normal tension glaucoma

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Authors: Mitra Savabi-Esfahani, Fariba Taleghani, Mahnaz Noroozi, Maryam Tabatabaeian, Elsebeth Lynge

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Breast cancer is a health concern in worldwide. All women have not adequate information about breast cancer, resulting in undetected some tumors until advanced stages. Therefore awareness of people was recommended as a strategy to control that. The aim of this study was to assess the effect of an educational intervention on women's knowledge and attitude about breast cancer and screening. This study was conducted in 2016 on 191 women. All women living in one of big cities were invited to enroll in training classes. Inclusion criteria consisted women who were 20 - 69 years and not participated in any educational intervention. The lecture with group discussion was used as educational methods. Data collection tool was a structured questionnaire which filled out before and after intervention. The reliability of the questionnaire was determined by Cronbach's alpha. The data were analyzed using SPSS software. The average age was 44/4 ± 11.5 and 42.6% of the women had obtained high school. Of the 191 women, 70(36.6%) and 76(39.8%) had low and medium level of knowledge respectively and half of them, 95(50%) had medium level of attitude in before intervention. There was significant difference between mean scores of knowledge and attitude before and after the intervention by Paired T test (p < 0/001). It seems applying effective educational interventions can increase knowledge and attitude women about breast cancer particularly in community that they have insufficient levels. Moreover, the lecture method along with group discussion can be proposed as effective and conventional methods for this purpose.

Keywords: attitude, breast cancer, educational intervention, knowledge

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Authors: Kesavan Markkandan, Ha Young Park, Seung-Il Yoo, Sin-Gi Park, Junhyung Park

Abstract:

For genetic identification of crop cultivars, insertions/deletions (InDel) markers have been preferred currently because they are easy to use, PCR based, co-dominant and relatively abundant. However, new InDels need to be developed for genetic studies of new varieties due to the difference of allele frequencies in InDels among the population groups. These new varieties are evolved with low levels of genetic diversity in specific genome loci with high recombination rate. In this study, we described soybean barcode system approach based on InDel makers, each of which is specific to a variation block (VB), where the genomes split by all assumed recombination sites. Firstly, VBs in crop cultivars were mined for transferability to VB-specific InDel markers. Secondly, putative InDels in the VB regions were identified for the development of barcode system by analyzing particular cultivar’s whole genome data. Thirdly, common VB-specific InDels from all cultivars were selected by gel electrophoresis, which were converted as 2D barcode types according to comparing amplicon polymorphisms in the five cultivars to the reference cultivar. Finally, the polymorphism of the selected markers was assessed with other cultivars, and the barcode system that allows a clear distinction among those cultivars is described. The same approach can be applicable for other commercial crops. Hence, VB-based genetic identification not only minimize the molecular markers but also useful for assessing cultivars and for marker-assisted breeding in other crop species.

Keywords: variation block, polymorphism, InDel marker, genetic identification

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