Search results for: poor outcome of delayed breast cancer treatment

Authors: Vahid Mazloum, Mansour Sahebozamani, Amirhossein Barati, Nouzar Nakhaee, Pouya Rabiei

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Non-specific chronic low back pain (NSCLBP) is a common condition with no exact diagnosis and mechanism for its occurrence. Recently, different therapeutic exercises have taken into account to manage NSCLBP. So, the aim of this study has mainly been placed on comparing the effects of Pilates and Mackenzie exercises on quality of life (QOL) lumbar spine position sense (LSPS) in patients with NSCLBP. In this randomized clinical trial, 47 patients with NSCLBP were voluntarily divided into three groups of Pilates (n=16) (with mean age 37.1 ± 9.5 years, height 168.9 ± 7.4 cm, body mass 76.1 ± 5.9 k), McKenzie (n=15) (with mean age 42.7 ± 8.1 years, height 165.7 ± 6.8, body mass 74.1 ± 4.8 kg) and control (n=16) (with mean age 39.3 ± 9.8 years, height 168.1 ± 8.1 cm, body mass 74.2 ± 5.8 kg). Primary outcome included QOL and secondary was LSPS. Both variables were assessed by the WHOQOL-BREF questionnaires and electrogoniameter, respectively. The measurements were performed at baseline, following a 6-week intervention, and after a 4-week follow-up. The ANCOVA test at P < 0.05 was administrated to analyze the collected data using SPSS software. There was a statistically significant difference between experimental groups and the control group to improve QOL. But, no difference was seen regarding the effects of two exercises on LSPS (p < 0.05). Both Pilates and Mackenzie exercises demonstrated improvement in QOL after 6-week intervention and a 4-week follow-up while none of them considerably affected LSPS. Further studies are required to establish a supporting evidence for the effectiveness of two exercises on NSCLBP.

Keywords: pilates, Mackenzie, preconception, low back pain, physical health

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Authors: Drutika Upadhyay

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Rape is one of the most heinous crimes committed against the body of a woman violating her privacy and dignity. The Right to Privacy and the Right to Live with Dignity constitute the very essence of the Right to Life and Personal Liberty, a Fundamental Right guaranteed under Article 21 of the Indian Constitution. The study is conducted with the primary objective of analyzing the efficacy of rape laws in India. The study begins by explaining the origin, meaning, and kinds of rape recognised under Indian jurisprudence. Further, it explains various statutory and penal provisions relating to rape and the loopholes in such provisions. It focuses on the procedure followed during investigation and trial and also aims at developing an understanding of the rights of the victim and the sentence in cases of rape. The study also throws some light upon the amendments made to the criminal law and the recommendations of the Law Commission of India to meet the demands of the changing criminal justice delivery system. The outcome of the study suggests that the laws relating to rape have proved to be a major failure owing to the lack of proper implementation. Also, the lack of education among the masses leads to gender biasness, which is the ultimate cause for the commission of such crime. At last, the author concludes that the present criminal law system of the country contains various lacunae that need to be filled in so as to make the criminal justice system more stringent. Further, the scope of the definition of ‘rape’ needs to be widened in order to include such other acts of non-consensual and sexual nature that are currently not included in the definition. The author has adopted a non-doctrinal and analytical approach and relied upon the secondary sources of data for the purpose of the study. The scope of the study is limited to the crime committed against women.

Keywords: amendment, criminal law, fundamental right, personal liberty, privacy, rape

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Authors: Nagwa Mourad Abdelazeem, Marwa El-hussieny

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Multicomponent reactions (MCRs), one-pot reactions form products from more than two different starting compounds. (MCRs) are ideal reaction systems leading to high structural diversity and molecular complexity through a single transformation. (MCRs) have a lot of advantage such as higher yield, less waste generation, use of readily available starting materials and high atom. (MCRs) provide a rapid process for efficient synthesis of key structures in discovery of drug on the other hand silica sulfuric acid (SSA) has been used as an efficient heterogeneous catalyst for many organic transformations. (SSA) is low cost, ease of preparation, catalyst recycling, and ease of handling, so in this article we used 2-(thiophen-2-yl)-1H-indole, N-substituted anilines and aldehyde in the presence of silica sulfuric acid (SSA) as a catalyst in water as solvent at room temperature to prepare 3,3'-(phenylmethylene)bis(2-(thiophen-2-yl)-1H-indole) and N-methyl-4-(phenyl(2-(thiophen-2-yl)-1H-indol-3-yl)methyl)aniline derivatives Via one-pot reaction. Compound 2-(thiophen-2-yl)-1H-indole belongs to the ubiquitous class of indoles which enjoy broad synthetic, biological and industrial applications ]. Cancer is considered the first or second most common reason of death all through the world. So the synthesized compounds will be tested as anticancer. We expected the synthesized compounds will give good results comparison to the reference drug.

Keywords: aldehydes, aza-friedel-crafts reaction, indole, multicomponent reaction

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Authors: Henry Wilde, Thiravat Hemachudha

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Human rabies deaths are underreported worldwide at 55,000 annual cases; more than of dengue and Japanese encephalitis. Almost half are children. A recent study from the Philippines of nearly 2,000 rabies deaths revealed that none of had received incomplete or no post exposure prophylaxis. Coming from a canine rabies endemic country, this is not unique. There are two major barriers to reducing human rabies deaths: 1) the large number of unvaccinated dogs and 2) post-exposure prophylaxis (PEP) that is not available, incomplete, not affordable, or not within reach for bite victims travel means. Only the first barrier, inadequate vaccination of dogs, is now being seriously addressed. It is also often not done effectively or sustainably. Rabies PEP has evolved as a complex, prolonged process, usually delegated to centers in larger cities. It is virtually unavailable in villages or small communities where most dog bites occur, victims are poor and usually unable to travel a long distance multiple times to receive PEP. Reseacrh that led to better understanding of the pathophysiology of rabies and immune responses to potent vaccines and immunoglobulin have allowed shortening and making PEP more evidence based. This knowledge needs to be adopted and applied so that PEP can be rendered safely and affordably where needed the most: by village health care workers who have long performed more complex services after appropriate training. Recent research makes this an important and long neglected goal that is now within our means to implement.

Keywords: rabies, post-exposure prophylaxis, availability, immunoglobulin

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Authors: Amrei Voelkner, Nils Peters, Thomas Mannheim

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The worldwide exponential growth of the population and the simultaneous increasing food production requires the strategic realization of sustainable and improved cultivation systems to ensure the fertility of arable land and to guarantee the food supply for the whole world. To fulfill this target, large quantities of fertilizers have to be applied to the field, but the long-term environmental impacts remain uncertain. Thus, a combined system would be necessary to increase the nutrient availability for plants while reducing nutrient losses (e.g. NO3- by leaching) to the environment. To enhance the nutrient efficiency, polymer coated fertilizer with a controlled release behavior have been developed. This kind of fertilizer ensures a delayed release of nutrients to synchronize the nutrient supply with the demand of different crops. In the last decades, research focused primarily on semi-permeable polyurethane coatings, which remain in the soil for a long period after the complete solvation of the fertilizer core. Within the implementation of the new European Regulation Directive the replacement of non-degradable synthetic polymers by degradable coatings is necessary. It was, therefore, the objective of this study to develop a total biodegradable polymer (to CO2 and H2O) coating according to ISO 17556 and to compare the retarding effect of the biodegradable coatings with commercially available non-degradable products. To investigate the effect of ten selected coated urea fertilizer on the yield of annual ryegrass and maize, the fresh and dry mass, the percentage of total nitrogen and main nutrients were analyzed in greenhouse experiments in sixfold replications using near-infrared spectroscopy. For the experiments, a homogenized and air-dried loamy sand (Cambic Luvisol) was equipped with a basic fertilization of P, K, Mg and S. To investigate the effect of nitrogen level increase, three levels (80%, 100%, 120%) were established, whereas the impact of CRF granules was determined using a N-level of 100%. Additionally, leaching of NO3- from pots planted with annual ryegrass was examined to evaluate the retention capacity of urea by the polymer coating. For this, leachate from Kick-Brauckmann-Pots was collected daily and analyzed for total nitrogen, NO3- and NH4+ in twofold repetition once a week using near-infrared spectroscopy. We summarize from the results that the coated fertilizer have a clear impact on the yield of annual ryegrass and maize. Compared to the control, an increase of fresh and dry mass could be recognized. Partially, the non-degradable coatings showed a retarding effect for a longer period, which was however reflected by a lower fresh and dry mass. It was ascertained that the percentage of leached-out nitrate could be reduced markedly. As a conclusion, it could be pointed out that the impact of coated fertilizer of all polymer types might contribute to a reduction of negative environmental impacts in addition to their fertilizing effect.

Keywords: biodegradable polymers, coating, enhanced efficiency fertilizers, nitrate leaching

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Authors: Mohammad Najmol Haque, Takeshi Maki, Jun Sasaki

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Headed stud shear connections are widely used in the junction or embedded zone of hybrid girder to achieve whole composite action with continuity that can sustain steel-concrete interfacial tensile and shear forces. In Japan, Japan Road Association (JRA) specifications are used for hybrid girder design that utilizes very low level of stud capacity than those of American Institute of Steel Construction (AISC) specifications, Japan Society of Civil Engineers (JSCE) specifications and EURO code. As low design shear strength is considered in design of connections, the time dependent shear behavior due to sustained external loading is not considered, even not fully studied. In this study, a finite element approach was used to evaluate the time dependent shear behavior for headed studs used as connections at the junction. This study clarified, how the sustained loading distinctively impacted on changing the interfacial shear of connections with time which was sensitive to lodging history, positions of flanges, neighboring studs, position of prestress bar and reinforcing bar, concrete strength, etc. and also identified a shear influence area. Stud strength was also confirmed through pushout tests. The outcome obtained from the study may provide an important basis and reference data in designing connections of hybrid girders with enhanced stud capacity with due consideration of their long-term shear behavior.

Keywords: finite element, hybrid girder, shear connections, sustained loading, time dependent behavior

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Authors: Zhang Shuqi, Liu Dan

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For the problems in intelligent network anomaly traffic detection models, such as low detection accuracy caused by the lack of training samples, poor effect with small sample attack detection, a classification model enhancement method, F-ACGAN(Flow Auxiliary Classifier Generative Adversarial Network) which introduces generative adversarial network and adversarial training, is proposed to solve these problems. Generating adversarial data with category labels could enhance the training effect and improve classification accuracy and model robustness. FACGAN consists of three steps: feature preprocess, which includes data type conversion, dimensionality reduction and normalization, etc.; A generative adversarial network model with feature learning ability is designed, and the sample generation effect of the model is improved through adversarial iterations between generator and discriminator. The adversarial disturbance factor of the gradient direction of the classification model is added to improve the diversity and antagonism of generated data and to promote the model to learn from adversarial classification features. The experiment of constructing a classification model with the UNSW-NB15 dataset shows that with the enhancement of FACGAN on the basic model, the classification accuracy has improved by 8.09%, and the score of F1 has improved by 6.94%.

Keywords: data imbalance, GAN, ACGAN, anomaly detection, adversarial training, data augmentation

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Authors: Luiz Ernani Meira Jr., Antônio Prates Caldeira, Gilson Gabriel Viana Veloso, Jackson Andrade

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Background: In Brazil, primary health care (PHC) system has developed with multidisciplinary teams in facilities located in peripheral areas, as the entrance doors for all patients. So, professionals must be prepared to deal with patients with simple and complex problems. Objective: To evaluate the knowledge and the skills of physicians and nurses of PHC on cardiorespiratory arrest (CRA) and cardiopulmonary resuscitation (CPR) before and after training in Basic Life Support. Methods: This is a before-and-after study developed in a Simulation Laboratory in Montes Claros, Brazil. We included physicians and nurses randomly chosen from PHC services. Written tests on CRA and CPR were carried out and performances in a CPR simulation were evaluated, based on the American Heart Association recommendations. Training practices were performed using special manikins. Statistical analysis included Wilcoxon’s test to compare before and after scores. Results: Thirty-two professionals were included. Only 38% had previous courses and updates on emergency care. Most of professionals showed poor skills to attend to CRA in a simulated situation. Subjects showed an increased in knowledge and skills about CPR after training (p-value=0.003). Conclusion: Primary health care professionals must be continuously trained to assist urgencies and emergencies, like CRA.

Keywords: primary health care, professional training, cardiopulmonary resuscitation, cardiorespiratory, emergency

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Authors: Hasan Bulent Kantarci

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This paper examine how Zakat provide a fair income redistribution and struggle with poverty. To provide a fair income redistribution and struggle with poverty take place among the fundamental tasks of all countries. Each country seeks a solution for this problem according to their political, economical and administrative styles through applying various economic and financial policies. The same situation gets handled via zakat association in the Islam. Nowadays, we observe different versions of zakat in developed countries. The applications such as negative income tax denote merely a difference from the zakat being applied almost the same way under changed names. But the minimum values to donate the zakat (e.g. 85 gr. gold and 40 animals) get altered and various amounts are put into practice. It might be named as negative income tax instead of zakat, nonetheless, these applications are based on the Holy Koran and the hadith released 1400 years ago. Besides, considering the savage and slavery in the world at those times, we might easily recognize the true value of the zakat applied the first time then in Islamic system. Through zakat is enabled an income transfer by the government so that the poor could reach the minimum level of life standard. To whom the zakat would be donated was not left to people’s heart and encouraged to determine according to objective criteria. Since the zakat is obligatory, the transfer do not get forward by hand but via the government and get distributed, which requires a vast government organization. Through applying the zakat as it must be would achieve to reduce the poverty mostly and ensuring the fair income redistribution.

Keywords: Islamic finance, zakat, income redistribution, circle of poverty, negatif income tax

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Authors: Gulnaz Khan, Meha F. Aftab, Munazza Murtaza, Rizwana S. Waraich

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Advanced glycation end products (AGEs) precursor and its abnormal accumulation cause damage to various tissues and organs. AGEs have pathogenic implication in several diseases including diabetes. Existing AGEs inhibitors are not in clinical use, and there is a need for development of novel inhibitors. The present investigation aimed at identifying the novel AGEs inhibitors and assessing their mechanism of action for treating insulin resistance in mice model of diabetes. Novel derivatives of benzylidene of indan-1,3-dione were synthesized. The compounds were selected to study their action mechanism in improving insulin resistance, in vitro, in human hepatocytes and murine adipocytes and then, in vivo, in mice genetic model of diabetes (db/db). Mice were treated with novel derivatives of benzylidene of indane 1,3-dione. AGEs mediated ROS production was measured by dihydroethidium fluorescence assay. AGEs level in the serum of treated mice was observed by ELISA. Gene expression of receptor for AGEs (RAGE), PPAR-gamma, TNF-alpha and GLUT-4 was evaluated by RT-PCR. Glucose uptake was measured by fluorescent method. Microscopy was used to analyze glycogen synthesis in muscle. Among several derivatives of benzylidene of indan-1,3-dione, IDD-24, demonstrated highest inhibition of AGESs. IDD-24 significantly reduced AGEs formation and expression of receptor for advanced glycation end products (RAGE) in fat, liver of db/db mice. Suppression of AGEs mediated ROS production was also observed in hepatocytes and fat cell, after treatment with IDD-24. Glycogen synthesis was increased in muscle tissue of mice treated with IDD-24. In adipocytes, IDD-24 prevented AGEs induced reduced glucose uptake. Mice treated with IDD-24 exhibited increased glucose tolerance, serum adiponectin levels and decreased insulin resistance. The result of present study suggested that IDD-24 can be a possible treatment target to address glycotoxins induced insulin resistance.

Keywords: advance glycation end product, hyperglycemia, indan-1, 3-dione, insulin resistance

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Authors: Mrunal Phatak, Suvarna Raut

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Introduction: Thyroid hormone is important for the normal function of the auditory system. Hearing impairment can occur insidiously in subclinical hypothyroidism. The present study was undertaken with the aims of evaluating audiological tests like tuning fork tests, pure tone audiometry, brainstem evoked auditory potentials (BAEPs), and auditory reaction time (ART) in hypothyroid women and in age and sex matched controls so as to evaluate the effect of thyroid hormone on hearing. The objective of the study was to investigate hearing status by the audiological profile in hypothyroidism (group 1) and healthy controls ( group 2) to compare the audiological profile between these groups and find the correlation of levels of TSH, T3, and T4 with the above parameters. Material and methods: A total sample size of 124 women in the age group of 30 to 50 years was recruited and divided into the Cases group comprising of 62 newly diagnosed hypothyroid women and the Control group having 62 women with normal thyroid profile. Otoscopic examination, tuning fork tests, Pure tone audiometry tests (PTA). Brain Stem Auditory Evoked Potential (BAEP) and Auditory Reaction Time (ART) were done in both ears, i.e. total 248 ears of all subjects. Results: By BAEPs, hearing impairment was detected in total 64 ears (51.61%). A significant increase was seen in Wave V latency, IPL I-V, and IPL III-V, and the decrease was seen in the amplitude of Wave I and V in both the ears in cases. Positive correlation of Wave V latency of Right and Left ears is seen with TSH levels (p < 0.001) and a negative correlation with T3 (>0.05) and with T4 (p < 0.01). Negative correlation of wave V amplitude of Right and Left ears is seen with TSH levels (p < 0.001), and a significant positive correlation is seen with T3 and T4. Pure tone audiometry parameters showed hearing impairment of conductive (31.29%), sensorineural (36.29%), as well as the mixed type (15.32%). Hearing loss was mild in 65.32% of ears and moderate in 17.74% of ears. Pure tone averages (PTA) were significantly increased in cases than in controls in both the ears. Significant positive correlation of PTA of Right and Left ears is seen with TSH levels (p<0.05). Negative correlation with T3 and T4 is seen. A significant increase in HF ART and LF ART is seen in cases as compared to controls. Positive correlation of ART of high frequency and low frequency is seen with TSH levels and a negative correlation with T3 and T4 (p > 0.05). Conclusion: The abnormal BAEPs in hypothyroid women suggest an impaired central auditory pathway. BAEP abnormalities are indicative of a nonspecific injury in the bulbo-ponto-mesencephalic centres. The results of auditory investigations suggest a causal relationship between hypothyroidism and hearing loss. The site of lesion in the auditory pathway is probably at several levels, namely, in the middle ear and at cochlear and retrocochlear sites. Prolonged ART also suggests the impairment in central processing mechanisms. The results of the present study conclude that the probable reason for hearing impairment in hypothyroidism may be delayed impulse conduction in acoustic nerve up to the level of the midbrain (IPL I-V, III-V), particularly inferior colliculus (wave V). There is also impairment in central processing mechanisms, as shown by prolonged ART.

Keywords: deafness, pure tone audiometry, brain stem auditory evoked potential, hyopothyroidism

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Authors: A. G. Margaryan

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Ability of adaptation of the organism is considered as an important component of health in maintaining relative dynamic constancy of the hemostasis and functioning of all organs and systems. Among the various forms of adaptation (individual, species and mental), social adaptation of the organism has a particular role. The aim of this study was to evaluate the subjective perception of social factors, social welfare and the level of adaptability of Armenian physicians. The survey involved 2,167 physicians (592 men and 1,575 women). According to the survey, most physicians (75.1%) were married. It was found that 88.6% of respondents had harmonious family relationships, 7.6% of respondents – tense relationships, and 1.0% – marginal relationships. The results showed that the average monthly salary with all premium payments amounted to 88 263.6±5.0 drams, and 16.7% of physicians heavily relied on the material support of parents or other relatives. Low material welfare was also confirmed by the analysis of the living conditions. Analysis of the results showed that the degree of subjective perception of social factors of different specialties averaged 11.3±3.1 points, which corresponds to satisfactory results (a very good result – 4.0 points). The degree of social adaptation of physicians on average makes 4.13±1.9 points, which corresponds to poor results (allowable less than 3.0 points). The distribution of the results of social adaptation severity revealed that the majority of physicians (58.6%) showed low social adaptation, average social adaptation is observed in 22.4% of the physicians and high adaptation – in only 17.4% of physicians. In conclusions, the findings of this study suggest that the degree of social adaptation of currently practicing physicians is low.

Keywords: physician's health, social adaptation, social factor, social health

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Authors: Yiquan Liao, Quanhong Jiang

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Since terahertz was observed by German scientists, we have obtained terahertz through different generation technologies of broadband and narrowband. Then, with the development of semiconductor and other technologies, the imaging technology of terahertz has become increasingly perfect. From the earliest application of nondestructive testing in aviation to the present application of information transmission and human safety detection, the role of terahertz will shine in various fields. The weapons produced by terahertz were epoch-making, which is a crushing deterrent against technologically backward countries. At the same time, terahertz technology in the fields of imaging, medical and livelihood, communication and communication are for the well-being of the country and the people.

Keywords: terahertz, imaging, communication, medical treatment

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Authors: Ratna Farida Soenarto, Anas Alatas, Made Ryan Kharmayani

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Background: Conventional ultrafiltration (CUF) system was shown to be helpful in reducing anti-inflammatory mediators for patients who underwent open heart surgery. Additionally, modified ultrafiltration (MUF) has been shown to reduce anti-inflammatory mediators further while reducing interstitial fluid volume at the same time. However, there has been minimal data concerning the efficacy of combining both ultrafiltration methods. This study aims to compare inflammation marker, vascular resistance, and cardiac index on CUF+MUF patients with CUF only patients undergoing open heart surgery. Method: This is a single blind randomized controlled trial on patients undergoing open heart surgery between June 2021 - October 2021 in CiptoMangunkusumo National Referral Hospital and Jakarta Heart Hospital. Patients wererandomized using block randomization into modified ultrafiltration following conventional ultrafiltration (CUF+MUF) and conventional ultrafiltration (CUF) only. Outcome assessed in this study were 24-hoursinterleukin-6 levels, systemic vascular resistance (SVR), pulmonary vascular resistance (PVR), and cardiac index. Results: A total of 38patients were included (19 CUF+MUF and 19 CUF subjects). There was no difference in postoperative IL-6 level between groups (p > 0.05).No difference in PVR was observed between groups.Higher difference in SVR was observed in CUF+MUF group (-646 vs. -261dyn/s/cm-5, p < 0.05). Higher cardiac index was observed on CUF+MUF group (0.93 vs. 0.48, p < 0.05). Conclusion: Patients undergoing open heart surgery with modified ultrafiltration following conventional ultrafiltration had similar systemic inflammatory response and better cardiac response than those having conventional ultrafiltration.

Keywords: open-heart, CUF, MUF, SVR, PVR, IL-6

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Authors: Randa M. T. Mohamed

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Spices have long been used as traditional ingredients in the kitchen for seasoning, coloring, aromatic and food preservative properties. Besides, spices are equally used for therapeutic purposes. The objective of this study was to survey and document the medicinal properties of spices commonly used in the Sudanese kitchen for different food preparations. Also, extracts from reported spices were screened for the presence of secondary metabolites as well as their antioxidant and beta-lactamase inhibitory properties. This study was conducted in the Rekabbya Quartier in Omdurman, Khartoum State, Sudan. Information was collected by carrying out semi-structured interviews. All informants (30) in the present study were women. Spices were purchased from Attareen shop in Omdurman. Essential oils from spices were extracted by hydrodistillation and ethanolic extracts by maceration. Phytochemical screening was performed by thin layer chromatography (TLC). The antioxidant capacity of essential oils and ethanolic extracts was investigated through TLC bioautography. Beta lactamase inhibitory activity was performed by the acidimetric test. Ethnobotany study showed that a total of 16 spices were found to treat 36 ailments belonging to 10 categories. The most frequently claimed medicinal uses were for the digestive system diseases treated by 14 spices and respiratory system diseases treated by 8 spices. Gynaecological problems were treated by 4 spices. Dermatological diseases were cured by 5 spices while infections caused by tapeworms and other microbes causing dysentery were treated by 3 spices. 4 spices were used to treat bad breath, bleeding gum and toothache. Headache, eyes infection, cardiac stimulation and epilepsy were treated by one spice each. Other health problem like fatigue and loss of appetite and low breast milk production were treated by 1, 3 and 2 spices respectively. The majority (69%, 11/16) of spices were exported from different countries like India, China, Indonesia, Ethiopia, Egypt and Nigeria while 31% (5/16) was cultivated in Sudan. Essential oils of all spices were rich in terpenes while ethanolic extracts contained variable classes of secondary metabolites. Both essential oils and ethanolic extracts of all spices exerted considerable antioxidant activity. Only one extract, Syzygium aromaticum, possessed beta lactamase inhibitory activity. In conclusion, this study could contribute in conserving information on traditional medicinal uses of spices in Sudan. Also, the results demonstrated the potential of some of these spices to exert beneficial antimicrobial and antioxidant effect. Detailed phytochemical and biological assays of these spices are recommended.

Keywords: spices, ethnobotany, phytoconstituents, antioxidant, beta lactamase inhibition

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Authors: Keiko Naito, Y. Nakashima, S. Yamauchi, Y. Kunitani, Y. Ishigami, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

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Background: A presence of severe acidemia, defined as pH < 7.2, is common during endotracheal intubation for critically ill patients in the emergency department (ED). Severe acidemia is widely recognized as a predisposing factor for intubation failure. However, it is unclear that acidemic condition itself actually makes endotracheal intubation more difficult. We aimed to evaluate if a presence of severe acidemia before intubation is associated with the lower first attempt intubation success rate in the ED. Methods: This is a retrospective observational cohort study in the ED of an urban hospital in Japan. The collected data included patient demographics, such as age, sex, and body mass index, presence of one or more factors of modified LEMON criteria for predicting difficult intubation, reasons for intubation, blood gas levels, airway equipment, intubation by emergency physician or not, and the use of the rapid sequence intubation technique. Those with any of the following were excluded from the analysis: (1) no blood gas drawn before intubation, (2) cardiopulmonary arrest, and (3) under 18 years of age. The primary outcome was the first attempt intubation success rates between a severe acidemic patients (SA) group and a non-severe acidemic patients (NA) group. Logistic regression analysis was used to test the first attempt success rates for intubations between those two groups. Results: Over 5 years, a total of 486 intubations were performed; 105 in the SA group and 381 in the NA group. The univariate analysis showed that the first attempt intubation success rate was lower in the SA group than in the NA group (71.4% vs 83.5%, p < 0.01). The multivariate logistic regression analysis identified that severe acidemia was significantly associated with the first attempt intubation failure (OR 1.9, 95% CI 1.03-3.68, p = 0.04). Conclusions: A presence of severe acidemia before endotracheal intubation lowers the first attempt intubation success rate in the ED.

Keywords: acidemia, airway management, endotracheal intubation, first-attempt intubation success rate

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Authors: Benjamas Penboon, Zachary Zimmer, Aree Jampaklay

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Cambodia is a country where labor migration has been consistently high. Coupled with advancing labor opportunities in urban areas, a function partly of globalization, this is resulting in massive migration out of rural areas. This is particularly true in Cambodia where there are high migration and a very large proportion of adult children living some distant from their parents. This paper explores characteristics associated with migrant providing support to parents in rural Cambodia. With reference to perspectives of family altruism and solidarity, this analysis particularly focusses on how a series of variables representing family integration and residential location associates with intergenerational monetary and instrumental support from migrants. The study hypothesizes that migrants are more likely to provide support when parents are in need, and there are no alternative means of support. Data come from The Rural Household Survey (N=3,713), part of the 2011 Cambodian Rural Urban Migration Project (CRUMP). Multilevel multinomial models indicate international migrants are likely to give money, while internal migrants are likely to provide both money and instrumental support, especially when migrants have no sibling and their parent in poor health status. In addition, employed migrants are two times providing monetary compared to those unemployed. Findings elucidate the decision to which and why support occurs more often when no other source of support exists and also depends on the ability to provide of migrants themselves.

Keywords: migration, left-behind parent, intergenerational relations, support, rural, Cambodia

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Authors: Zainuddin Abuhamid Muhammad Ghozali, Andrew Whitworth

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Islamic boarding school or pesantren is a distinctive education institution in Indonesia focusing on religious teachings. Its stance in restricting access to the internet raises a question about its students’ development of digital literacy. Inspired by Luckin’s ecology of resource model, this study aims to map out the digital literacy situation of the institution based on the availability of learning resources, such as digital facilities, digital accessibility, and digital competence. This study was carried out through a survey method involving 50 teachers from pesantrens across the nation. The result shows that pesantrens have provided students with digital facilities at a moderate level, yet the accessibility to using them is still limited. They also incorporated digital competencies into their curriculum, with an emphasis on digital ethics. The study also identifies different patterns of pesantrens’ behavior based on types and educational levels, where certain school types and educational levels tend to give a stricter policy compared to others or vice versa. The restriction of digital resources in pesantren indicated that they had done a filtration process to design their learning environment. The filtration was mainly motivated by sociocultural factors, where they drew concern for the negative impact of the internet. Notably, this restriction also contributes to students’ poor development of digital literacy.

Keywords: digital literacy, ecology of resources, Indonesia, Islamic boarding school

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Authors: Repaul Kanji, Rajat Agrawal

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In this era where issues like climate change and disasters are the topics of discussion at national and international forums, it is very often that humanity questions the causative role of corporates in such events. It is beyond any doubt that rapid industrialisation and development has taken a toll in the form of climate change and even disasters, in some case. Thus, demanding to fulfill a corporate's responsibilities in the form of rescue and relief in times of disaster, rehabilitation and even mitigation and preparedness to adapt to the oncoming changes is obvious. But how can the responsibilities of the corporates be channelised to ensure all this, i.e., develop a resilient society? More than that, which factors, when emphasised upon, can lead to the holistic development of the society. To answer this query, an extensive literature review was done to identify several enablers like legislations of a nation, the role of brand and reputation, ease of doing Corporate Social Responsibility, mission and vision of an organisation, religion and culture, etc. as a tool for building disaster resilience. A questionnaire survey, interviews with experts and academicians followed by interpretive structural modelling (ISM) were used to construct a multi-hierarchy model depicting the contextual relationship among the identified enablers. The study revealed that culture and religion are the most powerful driver, which affects other enablers either directly or indirectly. Taking cognisance of the fact that an idea of separation between religion and workplace (business) resides subconsciously within the society, the study tries to interpret the outcome of the ISM through the lenses of past researches (The Integrating Box) and explores how it can be leveraged to build a resilient society.

Keywords: corporate social responsibility, interpretive structural modelling, disaster resilience and risk reduction, the integration box (TIB)

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Authors: Ruwan Gunawardane

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This paper attempts to emphasize the benefits of conducting an intensive course in English for university entrants. In the Sri Lankan university context, an intensive course in English is usually conducted amidst various obstacles. In the 1970s and 1980s, undergraduates had intensive programmes in English for two to three months. Towards the end of the 1990s, a programme called General English Language Training (GELT) was conducted for the new students, and it was done outside universities before they entered their respective universities. Later it was not conducted, and that also resulted in students’ poor performance in English at university. However, having understood its importance, an eight week long intensive course in English was conducted for the new intake of the Faculty of Science, University of Ruhuna. As the findings show, the students heavily benefited from the programme. More importantly, they had the opportunity to refresh their knowledge of English gained at school and private institutions while gaining new knowledge. Another advantage was that they had plenty of time to enjoy learning English since the learners had adequate opportunities to carry out communicative tasks and the course was not exam-oriented, which reduced their fear of making mistakes in English considerably. The data was collected through an open-ended questionnaire given to 60 students, and their oral feedback was also taken into consideration. In addition, a focus group interview with 6 teachers was also conducted to get an idea about their experience and perception. The data were qualitatively analyzed. The findings suggest that an intensive programme in English undoubtedly lays a good foundation for the students’ academic career at university.

Keywords: intensive course, English, teachers, undergraduates, experience, perception

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Authors: Alireza Hassanshahi, Xanthe Strudwick, Zlatko Kopecki, Allison J Cowin

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Studies have shown that Flightless (Flii) is elevated in human wounds, including burns, and reducing the level of Flii is a promising approach for improving wound repair and reducing scar formation. The most effective approach has been to neutralise Flii activity using localized, intradermal application of function blocking monoclonal antibodies. However, large surface area burns are difficult to treat by intradermal injection of therapeutics, so the aim of this study was to investigate if a systemic injection of a monoclonal antibody against Flii could improve healing in mice following burn injury. Flii neutralizing antibodies (FnAbs) were labelled with Alxa-Fluor-680 for biodistribution studies and the healing effects of systemically administered FnAbs to mice with burn injuries. A partial thickness, 7% (70mm2) total body surface area scald burn injury was created on the dorsal surface of mice (n=10/group), and 100µL of Alexa-Flour-680-labeled FnAbs were injected into the intraperitoneal cavity (IP) at time of injury. The burns were imaged on days 0, 1, 2, 3, 4, and 7 using IVIS Lumina S5 Imaging System, and healing was assessed macroscopically, histologically, and using immunohistochemistry. Fluorescent radiance efficiency measurements showed that IP injected Alexa-Fluor-680-FnAbs localized at the site of burn injury from day 1, remaining there for the whole 7-day study. The burns treated with FnAbs showed a reduction in macroscopic wound area and an increased rate of epithelialization compared to controls. Immunohistochemistry for NIMP-R14 showed a reduction in the inflammatory infiltrate, while CD31/VEGF staining showed improved angiogenesis post-systemic FnAb treatment. These results suggest that systemically administered FnAbs are active within the burn site and can improve healing outcomes. The clinical application of systemically injected Flii monoclonal antibodies could therefore be a potential approach for promoting the healing of large surface area burns immediately after injury.

Keywords: biodistribution, burn, flightless, systemic, fnAbs

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Authors: Lauren McGillivray, Michelle Torok, Alison Calear

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Suicide is the leading cause of death for Australians aged 15-24 years, with rates increasing over the past decade. As young people can be particularly vulnerable to mental health problems and suicidal behavior, they are an essential and obvious target for suicide prevention efforts. This study investigates the effectiveness of the universal mental health promotion and suicide prevention program, Youth Aware of Mental Health (YAM), to reduce suicidal ideation and attempts and increase help-seeking in young people. This trial took place in Australian schools across four regions in New South Wales that form part of LifeSpan, a larger multilevel suicide prevention research trial. The YAM program was delivered to Year 9 students in up to 78 schools over two years (from January 2017 to December 2019). All schools were invited to participate in YAM's evaluation, which included completing a student questionnaire at three time-points: baseline, 3-month post-intervention, and 6-month follow-up. The primary outcome is suicidal ideation severity. Secondary outcomes are new reports of suicide attempts, stigma towards suicide, knowledge about suicide, help-seeking intentions and behaviors, and depressive symptoms. Results from pre-post and follow-up data will be presented. These research findings are promising and will contribute to the evidence-based for YAM and suicide prevention programs in Australian schools. These findings are also expected to promote YAM's value and sustainability to be more widely delivered in Australian secondary schools.

Keywords: adolescent mental health, suicidal ideation, suicide prevention, universal program

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Authors: Syed Toqueer Akhter, Muhammad Muzaffar Abbas

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Conflicts in Pakistan are a result of a configuration of factors, which are directly related to the system of the state, the unstable regional setting, and the geo-strategic location of Pakistan at large. This paper examines the impact of regional conflict onto the socio-political sustainability of Pakistan. The magnitude of the spillover from a conflicted region is similar in size of the equivalent increase in domestic conflict. Pakistan has gone at war three times with India; the border with India is named as the tensest borderlines of the world. Disagreements with India and lack of dispute settlement mechanisms have negatively effected the peace in the region, influx of illegal weapons and refugees from Afghanistan as an outcome of 9/11 incidence, have exasperated the criticality of levels of internal conflict in Pakistan. Our empirical findings are based on the data collected on regional conflict levels, regional trade, global trade, comparative defence capabilities of the region in contrast to Pakistan and the government regime (Autocratic, Democratic) over 1972-2007. It has been proposed in this paper that the intent of domestic conflict is associated with the conflict in the region, regional trade, global trade and the government regime of Pakistan. The estimated model (OLS) implies that domestic conflict is effected positively and significantly with long term impact of conflict in the region. Also, if defence capabilities of the region are better than that of Pakistan it effects domestic conflict positively and significantly. Conflict in neighbouring countries are found as a source of domestic conflict in Pakistan, whereas the regional trade as well as type of government regimes in Pakistan lowered the intensity of domestic conflict significantly, while globalized trade imply risk of domestic conflict to be reduced but not significantly.

Keywords: conflict, regional trade, socio-politcal instability

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Authors: Mateus L. O. Freitas, Flávia H. de M. Libório, Letycia L. Ricardo, Patrícia da C. Zonetti, Graciene de S. Bido

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Weeds compete with agricultural crops for resources such as light, water, and nutrients. This competition can cause significant damage to agricultural producers, and, currently, the use of agrochemicals is the most effective method for controlling these undesirable plants. Morning glory (Ipomoea grandifolia [Dammer] O'Donell) is an aggressive weed and significantly reduces agricultural productivity making harvesting difficult, especially mechanical harvesting. The biggest challenge in modern agriculture is to preserve high productivity reducing environmental damage and maintaining soil characteristics. No-till is a sustainable practice that can reduce the use of agrochemicals and environmental impacts due to the presence of plant residues in the soil, which release allelopathic compounds and reduce the incidence or alter the growth and development of crops and weeds. Sorghum (Sorghum bicolor [L.] Moench) is a forage with proven allelopathic activity, mainly for producing sorgholeone. In this context, this research aimed to evaluate the allelopathic action of sorghum fractions using hexane, dichloromethane, butanol, and ethyl acetate on the germination and initial growth of morning glory. The parameters analyzed were the percentage of germination, speed of germination, seedling length, and biomass weight (fresh and dry). The bioassays were performed in Petri dishes, kept in an incubation chamber for 7 days, at 25 °C, with a 12h photoperiod. The experimental design was completely randomized, with five replicates of each treatment. The data were evaluated by analysis of variance, and the averages between each treatment were compared using the Scott Knott test at a 5% significance level. The results indicated that the dichloromethane and ethyl acetate fractions showed bioherbicidal effects, promoting effective reductions on germination and initial growth of the morning glory. It was concluded that allelochemicals were probably extracted in these fractions. These secondary metabolites can reduce the use of agrochemicals and environmental impact, making agricultural production systems more sustainable.

Keywords: allelochemicals, secondary metabolism, sorgoleone, weeds

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Authors: Hansraj Bookun, Angela Tan, Rachel Xuan, Linheng Zhao, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos

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Introduction: Incisional wound complications in vascular surgery patients represent a significant clinical and econometric burden of morbidity and mortality. The objective of this study was to trial the feasibility of applying the Prevena negative pressure incision management system as a routine dressing in patients who had undergone arterial surgery. Conventionally, Prevena has been applied to groin incisions, but this study features applications on multiple wound sites such as the thigh or major amputation stumps. Method: This was a cross-sectional observational, single-centre case series of 12 patients who had undergone major vascular surgery. Their wounds were managed with the Prevena system being applied either intra-operatively or on the first post-operative day. Demographic and operative details were collated as well as the length of stay and complication rates. Results: There were 9 males (75%) with mean age of 66 years and the comorbid burden was as follows: ischaemic heart disease (92%), diabetes (42%), hypertension (100%), stage 4 or greater kidney impairment (17%) and current or ex-smoking (83%). The main indications were acute ischaemia (33%), claudication (25%), and gangrene (17%). There were single instances of an occluded popliteal artery aneurysm, diabetic foot infection, and rest pain. The majority of patients (50%) had hybrid operations with iliofemoral endarterectomies, patch arterioplasties, and further peripheral endovascular treatment. There were 4 complex arterial bypass operations and 2 major amputations. The mean length of stay was 17 ± 10 days, with a range of 4 to 35 days. A single complication, in the form of a lymphocoele, was encountered in the context of an iliofemoral endarterectomy and patch arterioplasty. This was managed conservatively. There were no deaths. Discussion: The Prevena wound management system shows that in conjunction with safe vascular surgery, absolute wound complication rates remain low and that it remains a valuable adjunct in the treatment of vasculopaths.

Keywords: wound care, negative pressure, vascular surgery, closed incision

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Authors: Naheed Malik, Waheed Akhtar

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An introduction to the Islamic move towards the managing human resource is a preliminary attempt to provide managers with a useful way of managing and accepting employees. This knowledge would be helpful to even non-Muslim managers. Muslim managers are required not to know only the Islamic HR but also it is expected from them to apply the Islamic approach in managing the employees. Human resource is considered the most substantial asset of organizations. Studies have recommended that successful human resource management (HRM) leads to positive attitudes and behaviors at the workplace. On the contrary, unproductive use of human resources results in negative penalty in the form of lower job satisfaction, lower commitment, or even high employee turnover and even poor workforce quality.The study examined the Impact of Islamic HR practices on job satisfaction. Islamic HR variables encompass the aspects of performance appraisal, training and development, selection and recruitment. Data was obtained via self –administered questionnaires distributed among the employees of Banks in Pakistan which are practicing Islamic Banking. The sampling method employed was purposive sampling.Based on 240 responses obtained ,the study revealed that Islamic HRM deliberates the 40per cent of the variances in Job satisfaction .All variables excluding recruitment were found to be substantially pertinent to the dependent variable. The study also meditated the implications for future studies.

Keywords: islamic HRM, job satisfaction, islamic and conventional banks, Pakistan

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Authors: Diego A. Romero Espinosa

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Thermal simulations are used to evaluate comfort and energy consumption of buildings. However, the performance of different urban forms cannot be assessed precisely if an environmental control system and user schedules are considered. The outcome of such analysis would lead to conclusions that combine the building use, operation, services, envelope, orientation and density of the urban fabric. The influence of these factors varies during the life cycle of a building. The orientation, as well as the surroundings, can be considered a constant during the lifetime of a building. The structure impacts the thermal inertia and has the largest lifespan of all the building components. On the other hand, the building envelope is the most frequent renovated component of a building since it has a great impact on energy performance and comfort. Building services have a shorter lifespan and are replaced regularly. With the purpose of addressing the performance, an urban form, a specific orientation, and density, a thermal simulation method were developed. The solar irradiation is taken into consideration depending on the outdoor temperature. Incoming irradiation at low temperatures has a positive impact increasing the indoor temperature. Consequently, overheating would be the combination of high outdoor temperature and high irradiation at the façade. On this basis, the indoor temperature is simulated for a specific orientation of the evaluated urban form. Thermal inertia and building envelope performance are considered additionally as the materiality of the building. The results of different thermal zones are summarized using the 'Degree day method' for cooling and heating. During the early phase of a design process for a project, such as Masterplan, conclusions regarding urban form, density and materiality can be drawn by means of this analysis.

Keywords: building envelope, density, masterplanning, urban form

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Authors: Supriyo Das, Elbir Jove, Ajay Singh, Sophie Corbet, Noel Carr, Martin Deetz

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Water is a critical commodity in the healthcare and medical field. The utility of medical-grade water spans from washing surgical equipment, drug preparation to the key element of life-saving therapy such as hydrotherapy and hemodialysis for patients. A properly treated medical water reduces the bioburden load and mitigates the risk of infection, ensuring patient safety. However, any compromised condition during the production of medical-grade water can create a favorable environment for microbial growth putting patient safety at high risk. Therefore, proper upstream treatment of the medical water is essential before its application in healthcare, pharma and medical space. Reverse Osmosis (RO) is one of the most preferred treatments within healthcare industries and is recommended by all International Pharmacopeias to achieve the quality level demanded by global regulatory bodies. The RO process can remove up to 99.5% of constituents from feed water sources, eliminating bacteria, proteins and particles sizes of 100 Dalton and above. The combination of RO with other downstream water treatment technologies such as Electrodeionization and Ultrafiltration meet the quality requirements of various pharmacopeia monographs to produce highly purified water or water for injection for medical use. In the reverse osmosis process, the water from a liquid with a high concentration of dissolved solids is forced to flow through an especially engineered semi-permeable membrane to the low concentration side, resulting in high-quality grade water. However, these specially engineered RO membranes need to be sanitized either chemically or at high temperatures at regular intervals to keep the bio-burden at the minimum required level. In this paper, we talk about Dupont´s FilmTec Heat Sanitizable Reverse Osmosis membrane (HSRO) for the production of medical-grade water. An HSRO element must be pre-conditioned prior to initial use by exposure to hot water (80°C-85°C) for its stable performance and to meet the manufacturer’s specifications. Without pre-conditioning, the membrane will show variations in feed pressure operations and salt rejection. The paper will discuss the critical variables of pre-conditioning steps that can affect the overall performance of the HSRO membrane and demonstrate the data to support the need for pre-conditioning of HSRO elements. Our preliminary data suggests that there can be up to 35 % reduction in flow due to initial heat treatment, which also positively affects the increase in salt rejection. The paper will go into detail about the fundamental understanding of the performance change of HSRO after the pre-conditioning step and its effect on the quality of medical water produced. The paper will also discuss another critical point, “regular hot water sanitization” of these HSRO membranes. Regular hot water sanitization (at 80°C-85°C) is necessary to keep the membrane bioburden free; however, it can negatively impact the performance of the membrane over time. We will demonstrate several data points on hot water sanitization using FilmTec HSRO elements and challenge its robustness to produce quality medical water. The last part of this paper will discuss the construction details of the FilmTec HSRO membrane and features that make it suitable to pre-condition and sanitize at high temperatures.

Keywords: heat sanitizable reverse osmosis, HSRO, medical water, hemodialysis water, water for Injection, pre-conditioning, heat sanitization

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Authors: McKenzie S. Braley, Lesley Jessiman

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If language reveals internal psychological processing, then it is also likely that language use in autobiographical memory transcripts may be used as a window into attachment style and related personality features. The current study, therefore, examined the possible associations between attachment style, negative affectivity, social inhibition, and linguistic features extracted from autobiographical memory transcripts. Young adult participants (n = 61) filled out attachment and personality questionnaires, and orally reported a relationship-related memory. Memories were audio-recorded and later transcribed verbatim. Using a computerized linguistic extraction tool, positive affect words, negative affect words, and cognition words were extracted. Spearman’s rank correlation coefficients revealed that attachment anxiety was negatively correlated with cognition words (r2 = -0.26, p = 0.047) and that negative affectivity was negatively correlated with positive affect words (r2 = -0.32, p = 0.012). The findings suggest that attachment style and personality are associated with speech styles indicative of both emotionality and depth of processing. Because attachment styles, negative affectivity, and social inhibition are associated with poor mental health outcomes, analyses of key linguistics features in autobiographical memory narratives may provide reliable screening tools for mental wellbeing.

Keywords: attachment style, autobiographical memory, language, negative affectivity, social inhibition

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Authors: L. Petrosyan

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The problem of psychologist training remains a key priority in Armenia. During the Soviet period, the notion of a psychologist was obscure not only in Armenia but also in other Soviet republics. The breakup of the Soviet Union triggered a gradual change in this area activating the cooperation with specialists from other countries. The need for recovery from the psychological trauma caused by the 1988 earthquake pushed forward the development of practical psychology in Armenia. This phenomenon led to positive changes in perception of and interest to a psychologist profession.Armenian universities started designing special programs for psychologists’ preparation. Armenian psychologists combined their efforts in the field of training relevant specialists. During the recent years, the Bologna educational system was introduced in Armenia which led to implementation of education quality improvement programs. Nevertheless, even today the issue of psychologists’ training is not yet settled in Armenian universities. So far graduate psychologists haven’t got a clear idea of personal and professional qualities of a psychologist. Recently, as a result of educational reforms, the psychology curricula underwent changes, but so far they have not led to a desired outcome. Almost all curricula in certain specialties are aimed to form professional competencies and strengthen practical skills. A survey conducted in Armenia aimed to identify what are the ideas of young psychology specialists on the image of a psychologist. The survey respondents were 45 specialists holding bachelor’s degree as well as 30 master degree graduates, who have not been working yet. The research reveals that we need to change the approach of preparing psychology practitioners in the universities of Armenia. Such an approach to psychologist training will make it possible to train qualified specialists for enhancement of modern psychology theory and practice.

Keywords: practitioners, psychology degree, study, professional competencies

Procedia PDF Downloads 447