Search results for: patients outcomes

Authors: Vitor Rafael Regiani, Carlos Henrique Viesi Do Nascimento Filho, Patricia Matos Biselli-Chicote, Claudia Aparecida Rainho, Luiz Sergio Raposo, José Victor Maniglia, Eny Maria Goloni-Bertollo, Erika Cristina Pavarino

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Promoter hypermethylation of tumor-related genes has been associated with prognosis in early-stage head-and-neck cancers, providing strong evidence that these hypermethylated genes are valuable biomarkers for prognostic evaluation. Hence, we selected the MGMT and RASSF1A genes to examine the methylation status in head and neck squamous cell carcinomas (HNSCC) samples matched with non-tumor tissues (tumor-surrounding tissues or peripheral blood samples). DNA methylation analysis was based on Methylation-Sensitive High Resolution Melting, and the methylation status was correlated with clinic-pathological characteristics of the patients. RASSF1A and MGMT promoter methylation was detected in 43.24% (16/37) and in 44.44% (16/36) of the tumors, respectively. RASSF1A and MGMT methylation was significantly more frequent in tumor tissue than non-tumor tissues, as well as, simultaneous methylation of RASSF1A and MGMT also was higher in tumor tissue than non-tumor tissues. In relation to anatomic site, larynx cancer presented significant methylation of MGMT gene compared to tumor-surrounding tissue. The frequency of RASSF1A and MGMT promoter methylated was higher in tumor tissues in relation to peripheral blood from the same patient. No association was found between methylation and the variables analyzed, including gender, age, smoking or alcohol drinking habits. Clinic-pathological characteristics also showed no association in the presence of methylation. The Kaplan–Meier's method showed no association of methylation and both disease-free and overall survival. In conclusion, the presence of epigenetic abnormalities in normal-appearing tissue corroborates the hypothesis of the ‘field cancerization', or it can reflect preneoplastic and/or preinvasive. Moreover, MGMT methylation may serve as an important laryngeal cancer biomarker because it showed significant difference between laryngeal cancer and surrounding tumor tissues.

Keywords: head and neck cancer, DNA methylation, MGMT promoter methylation, RASSF1A promoter methylation

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Authors: Islam Nowisser, Noha Farag, Mohamed El Azizi

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Helicobacter pylori is a highly important human pathogen which inhabits about 50% of the population worldwide. Infection with this bacteria is very hard to treat, with high probability of recurrence. H. pylori causes severe gastric diseases, including peptic ulcer, gastritis, and gastric cancer, which has been linked to chronic inflammation. The infection has been reported to be associated with high levels of pro-inflammatory cytokines, especially IL-1β and TNF-α. The aim of the current study is to investigate the molecular mechanisms by which H. pylori activates NLRP3 inflammasome and its contribution to Il-1 β production in an innate cellular model. H. pylori PMSS1 and G27 standard strains, as well as the PMSS1 isogenic mutant strain PMSS1ΔVacA and G27ΔVacA, G27ΔCagA in addition to clinical isolates obtained from biopsy samples from the antrum and corpus mucosa of chronic gastritis patients, were used to establish infection in RAW-264.7 macrophages. The production levels of TNF-α and IL-1β was assessed using ELISA. Since expression of these cytokines is often regulated by the transcription factor complex, nuclear factor-kB (NF-kB), the activation of NF-κB in H. pylori infected cells was also evaluated by luciferase assay. Genomic DNA was extracted from bacterial cultures of H. pylori clinical isolates as well as the standard strains and their corresponding mutants, where they were evaluated for the cagA pathogenicity island and vacA expression. The correlation between these findings and expression of the cagA Pathogenicity Island and vacA in the bacteria was also investigated. The results showed IL-1β, and TNF-α production significantly increased in raw macrophages following H. pylori infection. The cagA+ and vacA+ H. pylori strains induced significant production of IL-1β compared to cagA- and vacA- strains. The activation pattern of NF-κB was correlated in the isolates to their cagA and vacA expression profiles. A similar finding could not be confirmed for TNF-α production. Our study shows the ability of H. pylori to activate NF-kB and induce significant IL-1β production as a possible mechanism for the augmented inflammatory response seen in subjects infected with cagA+ and vacA+ H. pylori strains that would lead to the progression to more severe form of the disease.

Keywords: Helicobacter pylori, IL-1β, inflammatory cytokines, nuclear factor KB, TNF-α

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Authors: Antonio Lopez-Villegas, Rafael Bautista-Mesa, Emilio Robles-Musso, Daniel Catalan-Matamoros, Cesar Leal-Costa

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Objectives: The purpose of this trial was to evaluate the burden borne by and the costs to informal caregivers of users with telemonitoring of pacemakers. Methods: This is a controlled, non-randomised clinical trial, with data collected from informal caregivers, five years after implantation of pacemakers. The Spanish version of the Survey on Disabilities, Personal Autonomy, and Dependency Situations was used to get information on clinical and social characteristics, levels of professionalism, duration and types of care, difficulties in providing care, health status, economic and job aspects, impact on the family or leisure due to informal caregiving for patients with pacemakers. Results: After five years of follow-up, 55 users with pacemakers finished the study. Of which, 50 were helped by a caregiver, 18 were included in the telemonitoring group (TM) and 32 in the conventional follow-up group (HM). Overall, females represented 96.0% of the informal caregivers (88.89% in TM and 100.0% in HM group). The mean ages were 63.17 ± 15.92 and 63.13 ± 14.56 years, respectively (p = 0.83) in the groups. The majority (88.0%) of the caregivers declared that they had to provide their services between 6 and 7 days per week (83.33% in TM group versus 90.63% in HM group), without significant differences between both groups. The costs related to care provided by the informal caregivers were 47.04% higher in the conventional follow-up group than in the TM group. Conclusions: The results of this trial confirm that there were no significant differences between the informal caregivers regarding to baseline characteristics, workload and time worked in both groups of follow-up. The costs incurred by the informal caregivers providing care for users with pacemakers included in telemonitoring group are significantly lower than those in the conventional follow-up group. Trial registration: ClinicalTrials.gov NCT02234245. Funding: The PONIENTE study, has been funded by the General Secretariat for Research, Development and Innovation, Regional Government of Andalusia (Spain), project reference number PI/0256/2017, under the research call 'Development and Innovation Projects in the Field of Biomedicine and Health Sciences', 2017.

Keywords: costs, disease burden, informal caregiving, pacemaker follow-up, remote monitoring, telemedicine

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Authors: Yassir Adam Shuaib, Stefan Niemann, Eltahir Awad Khalil, Ulrich Schaible, Lothar Heinz Wieler, Mohammed Ahmed Bakhiet, Abbashar Osman Mohammed, Mohamed Abdelsalam Abdalla, Elvira Richter

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Tuberculosis (TB) is a chronic bacterial disease of humans and animals and it is characterized by the progressive development of specific granulomatous tubercle lesions in affected tissues. In a six-month study, from June to November 2014, a total of 2,304 carcasses of cattle, camel, sheep, and goats slaughtered at East and West Gaash slaughterhouses, Kassala, were investigated during postmortem, in parallel, 101 sputum samples from TB suspected patients at Kassala and El-Gadarif Teaching Hospitals were collected in order to investigate tuberculosis in animals and humans. Only 0.1% carcasses were found with suspected TB lesions in the liver and lung and peritoneal cavity of two sheep and no tuberculous lesions were found in the carcasses of cattle, goats or camels. All samples, tissue lesions and sputum, were decontaminated by the NALC-NaOH method and cultured for mycobacterial growth at the NRZ for Mycobacteria, Research Center Borstel, Germany. Genotyping and molecular characterization of the grown strains were done by line probe assay (GenoType CM and MTBC) and 16S rDNA, rpoB gene, and ITS sequencing, spoligotyping, MIRU-VNTR typing and next generation sequencing (NGS). Culture of the specimens revealed growth of organisms from 81.6% of all samples. Mycobacterium tuberculosis (76.2%), M. intracellulare (14.2%), mixed infection with M. tuberculosis and M. intracellulare (6.0%) and mixed infection with M. tuberculosis and M. fortuitum and with M. intracellulare and unknown species (1.2%) were detected in the sputum samples and unknown species (1.2%) were detected in the samples of one of the animals tissues. From the 69 M. tuberculosis strains, 25 (36.2%) were showing either mono-drug-resistant or multi-drug-resistant or poly-drug-resistant but none was extensively drug-resistant. In conclusion, the prevalence of TB in animals was very low while in humans M. tuberculosis-Delhi/CAS lineage was responsible for most cases and there was an evidence of MDR transmission and acquisition.

Keywords: animal, human, slaughterhouse, Sudan, tuberculosis

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Authors: Juliane Spaak

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A life-cycle assessment was performed, looking at seven retrofit projects in New Zealand using LCAQuickV3.5. The study found that retrofits save up to 80% of embodied carbon emissions for the structural elements compared to a new building. In other words, it is only a 20% carbon investment to transform and extend a building’s life. In addition, the systems were evaluated by looking at environmental impacts over the design life of these buildings and resilience using FEMA P58 and PACT software. With the increasing interest in Zero Carbon targets, significant changes in the building and construction sector are required. Emissions for buildings arise from both embodied carbon and operations. Based on the significant advancements in building energy technology, the focus is moving more toward embodied carbon, a large portion of which is associated with the structure. Since older buildings make up most of the real estate stock of our cities around the world, their reuse through structural retrofit and wider refurbishment plays an important role in extending the life of a building’s embodied carbon. New Zealand’s building owners and engineers have learned a lot about seismic issues following a decade of significant earthquakes. Recent earthquakes have brought to light the necessity to move away from constructing code-minimum structures that are designed for life safety but are frequently ‘disposable’ after a moderate earthquake event, especially in relation to a structure’s ability to minimize damage. This means weaker buildings sit as ‘carbon liabilities’, with considerably more carbon likely to be expended remediating damage after a shake. Renovating and retrofitting older assets plays a big part in reducing the carbon profile of the buildings sector, as breathing new life into a building’s structure is vastly more sustainable than the highest quality ‘green’ new builds, which are inherently more carbon-intensive. The demolition of viable older buildings (often including heritage buildings) is increasingly at odds with society’s desire for a lower carbon economy. Bringing seismic resilience and carbon best practice together in decision-making can open the door to commercially attractive outcomes, with retrofits that include structural and sustainability upgrades transforming the asset’s revenue generation. Across the global real estate market, tenants are increasingly demanding the buildings they occupy be resilient and aligned with their own climate targets. The relationship between seismic performance and ‘sustainable design’ has yet to fully mature, yet in a wider context is of profound consequence. A whole-of-life carbon perspective on a building means designing for the likely natural hazards within the asset’s expected lifespan, be that earthquake, storms, damage, bushfires, fires, and so on, ¬with financial mitigation (e.g., insurance) part, but not all, of the picture.

Keywords: retrofit, sustainability, earthquake, reuse, carbon, resilient

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Authors: Eva Masson, Andrea Kübler

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Anxiety disorders (AD) are the most prevalent psychological disorders. However, far from most affected individuals are diagnosed and receive treatment. This gap is probably due to the diagnosis criteria, relying on symptoms (according to the DSM-5 definition) with no objective biomarker. Approach-avoidance conflict tasks are one common approach to simulate such disorders in a lab setting, with most of the paradigms focusing on the relationships between behavior and neurophysiology. Approach-avoidance conflict tasks typically place participants in a situation where they have to make a decision that leads to both positive and negative outcomes, thereby sending conflicting signals that trigger the Behavioral Inhibition System (BIS). Furthermore, behavioral validation of such paradigms adds credibility to the tasks – with overt conflict behavior, it is safer to assume that the task actually induced a conflict. Some of those tasks have linked asymmetrical frontal brain activity to induced conflicts and the BIS. However, there is currently no consensus for the direction of the frontal activation. The authors present here a modified version of the T-Maze paradigm, a motivational conflict desktop task, in which behavior is recorded simultaneously to the recording of high-density EEG (HD-EEG). Methods: In this within-subject design, HD-EEG and behavior of 35 healthy participants was recorded. EEG data was collected with a 128 channels sponge-based system. The motivational conflict desktop task consisted of three blocks of repeated trials. Each block was designed to record a slightly different behavioral pattern, to increase the chances of eliciting conflict. This variety of behavioral patterns was however similar enough to allow comparison of the number of trials categorized as ‘overt conflict’ between the blocks. Results: Overt conflict behavior was exhibited in all blocks, but always for under 10% of the trials, in average, in each block. However, changing the order of the paradigms successfully introduced a ‘reset’ of the conflict process, therefore providing more trials for analysis. As for the EEG correlates, the authors expect a different pattern for trials categorized as conflict, compared to the other ones. More specifically, we expect an elevated alpha frequency power in the left frontal electrodes at around 200ms post-cueing, compared to the right one (relative higher right frontal activity), followed by an inversion around 600ms later. Conclusion: With this comprehensive approach of a psychological mechanism, new evidence would be brought to the frontal asymmetry discussion, and its relationship with the BIS. Furthermore, with the present task focusing on a very particular type of motivational approach-avoidance conflict, it would open the door to further variations of the paradigm to introduce different kinds of conflicts involved in AD. Even though its application as a potential biomarker sounds difficult, because of the individual reliability of both the task and peak frequency in the alpha range, we hope to open the discussion for task robustness for neuromodulation and neurofeedback future applications.

Keywords: anxiety, approach-avoidance conflict, behavioral inhibition system, EEG

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Authors: Y. Zheng, M. Busi, A. F. Pedersen, M. A. Beltran, C. Gundlach

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X-ray phase contrast imaging has shown to yield a better contrast compared to conventional attenuation X-ray imaging, especially for soft tissues in the medical imaging energy range. This can potentially lead to better diagnosis for patients. However, phase contrast imaging has mainly been performed using highly brilliant Synchrotron radiation, as it requires high coherence X-rays. Many research teams have demonstrated that it is also feasible using a laboratory source, bringing it one step closer to clinical use. Nevertheless, the requirement of fine gratings and high precision stepping motors when using a laboratory source prevents it from being widely used. Recently, a random phase object has been proposed as an analyzer. This method requires a much less robust experimental setup. However, previous studies were done using a particular X-ray source (liquid-metal jet micro-focus source) or high precision motors for stepping. We have been working on a much simpler setup with just small modification of a commercial bench-top micro-CT (computed tomography) scanner, by introducing a piece of sandpaper as the phase analyzer in front of the X-ray source. However, it needs a suitable algorithm for speckle tracking and 3D reconstructions. The precision and sensitivity of speckle tracking algorithm determine the resolution of the system, while the 3D reconstruction algorithm will affect the minimum number of projections required, thus limiting the temporal resolution. As phase contrast imaging methods usually require much longer exposure time than traditional absorption based X-ray imaging technologies, a dynamic phase contrast micro-CT with a high temporal resolution is particularly challenging. Different reconstruction methods, including neural network based techniques, will be evaluated in this project to increase the temporal resolution of the phase contrast micro-CT. A Monte Carlo ray tracing simulation (McXtrace) was used to generate a large dataset to train the neural network, in order to address the issue that neural networks require large amount of training data to get high-quality reconstructions.

Keywords: micro-ct, neural networks, reconstruction, speckle-based x-ray phase contrast

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Authors: G. Yanay-Ventura, H. Desivilya Syna, K. Michael

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Social businesses are based on the idea that an enterprise can be established for the sake of profit and, at the same time, with the aim of fulfilling social goals. Yet, the question of how these goals can be integrated in practice to derive parallel benefit in both realms still needs to be examined. Particularly notable in this context is the ‘governance challenge’ of social businesses, meaning the danger of the mission drifts from the social goal in the pursuit of good business. This study is based on an evaluation study of a social business that operates as a restaurant providing professional training to at-risk youth. The evaluation was based on the collection of a variety of data through interviews with stakeholders in the enterprise (directors and managers, business partners, social partners, and position holders in the restaurant and the social enterprise), a focus group consisting of the youth receiving the professional training, observations of the restaurant’s operation, and analysis of the social enterprise’s primary documents. The evaluation highlighted significant strengths of the social enterprise, including reaching relatively fast business sustainability, effective management of the restaurant, stable employment of the restaurant staff, and effective management of the social project. The social enterprise and business management have both enjoyed positive evaluations from a variety of stakeholders. Clearly, the restaurant was deemed by all a promising young business. However, the social project suffered from a 90% dropout rate among the youth entering its ranks, extreme monthly fluctuation in the number of youths participating, and a distinct minority of the youth who have succeeded in completing their training period. Possible explanations of the high dropout rate included the small number of cooks, which impeded the effectiveness of the training process and the provision of advanced cooking skills; lack of clarity regarding the essence and the elements of training; and lack of a meaningful peer group for the youth engaged in the program. Paradoxically, despite the stakeholders’ great appreciation for the social enterprise, the challenge of governability was also formidable, revealing a tangible risk of mission drift in the reduction of the social enterprise’s target population and a breach of the commitment made to the youth with regard to practical training. The risk of mission drifts emerged as a hidden and evasive issue for the stakeholders, who revealed a deep appreciation for the management and the outcomes of the social enterprise. The challenge of integration, therefore, requires an in-depth examination of how to maintain a successful business without hindering the achievement of the social goal. The study concludes that clear conceptualization of the training process and its aims, increased cooks’ participation in the social project, and novel conceptions with regard to the evaluation of success could serve to benefit the youth and impede mission drift.

Keywords: evaluation study, management, mission drift, social business

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Authors: Mustafa Gulsen, Nihan Pekyavas, Emine Atıcı

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Purpose: The aim of this study is to investigate the effects of Kinesio taping on postural stability and in young soccer players. Subjects and Methods: 62 volunteered soccer players from Cayyolu Sports Club were included in our study. Permissions were also taken from the club directors about the inclusion of their players to our study. Soccer players between the age of 12 and 16 were included in our study. Players that had previous injury on lower extremities were excluded from the study. Players were randomly divided into two groups: Kinesio taping (KT) (n=31), and control group (n = 31). KT application including gastrocnemius and quadriceps femoris muscle facilitation techniques were applied to the first group. A rest time for 45 minutes was given in order to see the best effectiveness of the tape. The second group was set as the control group and no application was made. All participants were assessed before the application and 45 minutes later. In order to provide the double-blind design of the study, an experienced physiotherapist has done the assessments and another experienced physiotherapist has done the taping. The patients were randomly assigned to one of the two groups using an online random allocation software program. Postural stability was assessed by using Tetrax Interactive Balance System. Thermographic assessment was done by using FLIR E5 (FLIR Systems AB, Sweden) thermal camera in order to see which muscles have the most thermal activity while maintaining postural stability. Results: Statistically significant differences were found in all assessment parameters in both Kinesio Taping and control groups (all p<0.05) except thermal imaging of dominant gastrocnemius muscle results (p=0.668) (Table 1). In comparison of the two groups, statistically significant differences were found in all parameters (all p<0.05). Conclusion: In this study, we investigated the effects of Kinesio taping on postural stability in young soccer players and found that KT application on Quadriceps and Gastrocnemius muscles may have decreased the risk of falling more than the control group. According to thermal imaging assessments, both Quadriceps and Gastrocnemius muscles may be active in maintaining postural stability but in KT group, the temperature of these muscles are higher which leads us to think that they are more activated.

Keywords: Kinesio taping, fall risk, muscle temperature, postural stability

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Authors: Antonio J. Melendez-Martinez

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Beyond their role as natural colorants, some carotenoids are provitamins A and may be involved in health-promoting biological actions and contribute to reducing the risk of developing non-communicable diseases, including several types of cancer, cardiovascular disease, eye conditions, skin disorders or metabolic disorders. Given the versatility of carotenoids, the COST-funded European network to advance carotenoid research and applications in agro-food and health (EUROCAROTEN) is aimed at promoting health through the diet and increasing well-being by means. Stakeholders from 38 countries participate in this network, and one of its main objectives is to promote research on little-studied carotenoids. In this contribution, recent advances of our research group and collaborators in the study of two such understudied carotenoids, namely phytoene and phytofluene, the colorless carotenoids, are outlined. The study of these carotenoids is important as they have been largely neglected despite they are present in our diets, fluids, and tissues, and evidence is accumulating that they may be involved in health-promoting actions. More specifically, studies on their levels in diverse tomato and orange varieties were carried out as well as on their potential bioavailability from different dietary sources. Furthermore, the potential effect of these carotenoids on an animal model subjected to oxidative stress was evaluated. The tomatoes were grown in research greenhouses, and some of them were subjected to regulated deficit irrigation, a sustainable agronomic practice. The citrus samples were obtained from an experimental field. The levels of carotenoids were assessed using HPLC according to routine methodologies followed in our lab. Regarding the potential bioavailability (bioaccessibility) studies, different products containing colorless carotenoids, like fruits, juices, were subjected to simulated in vitro digestions, and their incorporation into mixed micelles was assessed. The effect of the carotenoids on oxidative stress was evaluated on the Caenorhabditis elegans model. For that purpose, the worms were subjected to oxidative stress by means of a hydrogen peroxide challenge. In relation to the presence of colorless carotenoids in tomatoes and orange varieties, it was observed that they are widespread in such products and that there are mutants with very high quantities of them, for instance, the Cara Cara or Pinalate mutant oranges. The studies on their bioaccessibility revealed that, in general, phytoene and phytofluene are more bioaccessible than other common dietary carotenoids, probably due to their distinctive chemical structure. About the in vivo antioxidant capacity of phytoene and phytofluene, it was observed that they both exerted antioxidant effects at certain doses. In conclusion, evidence on the importance of phytoene and phytofluene as dietary easily bioavailable and antioxidant carotenoids has been obtained in recent studies from our group, which can be important shortly to innovate in health-promotion through the development of functional foods and related products.

Keywords: carotenoids, health, functional foods, nutrition, phytoene, phytofluene

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Authors: Subham Ghosh, Banani Basu, Marami Das

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Background: The development of compact, low-power antenna sensors has resulted in hardware restructuring, allowing for wireless ubiquitous sensing. The antenna sensors can create wireless body-area networks (WBAN) by linking various wireless nodes across the human body. WBAN and IoT applications, such as remote health and fitness monitoring and rehabilitation, are becoming increasingly important. In particular, Parkinson’s disease (PD), a common neurodegenerative disorder, presents clinical features that can be easily misdiagnosed. As a mobility disease, it may greatly benefit from the antenna’s nearfield approach with a variety of activities that can use WBAN and IoT technologies to increase diagnosis accuracy and patient monitoring. Methodology: This study investigates the feasibility of leveraging a single patch antenna mounted (using cloth) on the wrist dorsal to differentiate actual Parkinson's disease (PD) from false PD using a small hardware platform. The semi-flexible antenna operates at the 2.4 GHz ISM band and collects reflection coefficient (Γ) data from patients performing five exercises designed for the classification of PD and other disorders such as essential tremor (ET) or those physiological disorders caused by anxiety or stress. The obtained data is normalized and converted into 2-D representations using the Gabor wavelet transform (GWT). Data augmentation is then used to expand the dataset size. A lightweight deep-learning (DL) model is developed to run on the GPU-enabled NVIDIA Jetson Nano platform. The DL model processes the 2-D images for feature extraction and classification. Findings: The DL model was trained and tested on both the original and augmented datasets, thus doubling the dataset size. To ensure robustness, a 5-fold stratified cross-validation (5-FSCV) method was used. The proposed framework, utilizing a DL model with 1.356 million parameters on the NVIDIA Jetson Nano, achieved optimal performance in terms of accuracy of 88.64%, F1-score of 88.54, and recall of 90.46%, with a latency of 33 seconds per epoch.

Keywords: antenna, deep-learning, GPU-hardware, Parkinson’s disease

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Authors: Shiao-Wei Chu

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In order to enhance the ability of their graduates to compete in an increasingly globalized economy, the majority of universities in Taiwan require students to pass Freshman English in order to earn a bachelor's degree. However, many college students show low motivation in English class for several important reasons, including exam-oriented lessons, unengaging classroom activities, a lack of opportunities to use English in authentic contexts, and low levels of confidence in using English. Students’ lack of motivation in English classes is evidenced when students doze off, work on assignments from other classes, or use their phones to chat with others, play video games or watch online shows. Cooperative learning aims to address these problems by encouraging language learners to use the target language to share individual experiences, cooperatively complete tasks, and to build a supportive classroom learning community whereby students take responsibility for one another’s learning. This study includes approximately 50 student participants in a low-proficiency Freshman English class. Each week, participants will work together in groups of between 3 and 4 students to complete various in-class interactive tasks. The instructor will employ a reward system that incentivizes students to be responsible for their own as well as their group mates’ learning. The rewards will be based on points that team members earn through formal assessment scores as well as assessment of their participation in weekly in-class discussions. The instructor will record each team’s week-by-week improvement. Once a team meets or exceeds its own earlier performance, the team’s members will each receive a reward from the instructor. This cooperative learning approach aims to stimulate EFL freshmen’s learning motivation by creating a supportive, low-pressure learning environment that is meant to build learners’ self-confidence. Students will practice all four language skills; however, the present study focuses primarily on the learners’ reading comprehension. Data sources include in-class discussion notes, instructor field notes, one-on-one interviews, students’ midterm and final written reflections, and reading scores. Triangulation is used to determine themes and concerns, and an instructor-colleague analyzes the qualitative data to build interrater reliability. Findings are presented through the researcher’s detailed description. The instructor-researcher has developed this approach in the classroom over several terms, and its apparent success at motivating students inspires this research. The aims of this study are twofold: first, to examine the possible benefits of this cooperative approach in terms of students’ learning outcomes; and second, to help other educators to adapt a more cooperative approach to their classrooms.

Keywords: freshman English, cooperative language learning, EFL learners, learning motivation, zone of proximal development

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Authors: Zongyan Yang, Gagan K. Jena, Sankar B. Karanam, Noora M. A. Hokal

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Jumeirah First beach, a segment of coastline of length 1.5 km, is one of the popular public beaches in Dubai, UAE. The stability of the beach has been affected by several coastal developmental projects, including The World, Island 2 and La Mer. A comprehensive stabilization scheme comprising of two composite groynes (of lengths 90 m and 125m), modification to the northern breakwater of Jumeirah Fishing Harbour and beach re-nourishment was implemented by Dubai Municipality in 2012. However, the performance of the implemented stabilization scheme has been compromised by La Mer project (built in 2016), which modified the wave climate at the Jumeirah First beach. The objective of the coastal modelling studies is to establish design basis for further beach stabilization scheme(s). Comprehensive coastal modelling studies had been conducted to establish the nearshore wave climate, equilibrium beach orientations and stable beach plan forms. Based on the outcomes of the modeling studies, recommendation had been made to extend the composite groynes to stabilize the Jumeirah First beach. Wave transformation was performed following an interpolation approach with wave transformation matrixes derived from simulations of a possible range of wave conditions in the region. The Dubai coastal wave model is developed with MIKE21 SW. The offshore wave conditions were determined from PERGOS wave data at 4 offshore locations with consideration of the spatial variation. The lateral boundary conditions corresponding to the offshore conditions, at Dubai/Abu Dhabi and Dubai Sharjah borders, were derived with application of LitDrift 1D wave transformation module. The Dubai coastal wave model was calibrated with wave records at monitoring stations operated by Dubai Municipality. The wave transformation matrix approach was validated with nearshore wave measurement at a Dubai Municipality monitoring station in the vicinity of the Jumeirah First beach. One typical year wave time series was transformed to 7 locations in front of the beach to count for the variation of wave conditions which are affected by adjacent and offshore developments. Equilibrium beach orientations were estimated with application of LitDrift by finding the beach orientations with null annual littoral transport at the 7 selected locations. The littoral transport calculation results were compared with beach erosion/accretion quantities estimated from the beach monitoring program (twice a year including bathymetric and topographical surveys). An innovative integral method was developed to outline the stable beach plan forms from the estimated equilibrium beach orientations, with predetermined minimum beach width. The optimal lengths for the composite groyne extensions were recommended based on the stable beach plan forms.

Keywords: composite groyne, equilibrium beach orientation, stable beach plan form, wave transformation matrix

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Authors: Jeremy Bost, Matthew Brett, Jacob Flynn, Weihui Li

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One response during anaphylaxis is reduced blood pressure due to blood vessels relaxing and dilating. Epinephrine causes the blood vessels to constrict, which raises blood pressure to counteract the symptoms. When going through an allergic reaction, an Epinephrine injector is used to administer a shot of epinephrine intramuscularly. Epinephrine injectors have become an integral part of day-to-day life for people with allergies. Current Epinephrine injectors (EpiPen) are completely mechanical and have no sensors to monitor the vital signs of patients or give suggestions the optimal time for the shot. The EpiPens are also large and inconvenient to carry daily. The current price of an EpiPen is roughly 600$ for a pack of two. This makes carrying an EpiPen very expensive, especially when they need to be switched out when the epinephrine expires. This new design is in the form of a bracelet, which has the ability to inject epinephrine. The bracelet will be equipped with vital signs monitors that can aid the patient to sense the allergic reaction. The vital signs that would be of interest are blood pressure, heart rate and Electrodermal activity (EDA). The heart rate of the patient will be tracked by a photoplethysmograph (PPG) that is incorporated into the sensors. The heart rate is expected to increase during anaphylaxis. Blood pressure will be monitored through a radar sensor, which monitors the phase changes in electromagnetic waves as they reflect off of the blood vessel. EDA is under autonomic control. Allergen-induced anaphylaxis is caused by a release of chemical mediators from mast cells and basophils, thus changes the autonomic activity of the patient. So by measuring EDA, it will give the wearer an alert on how their autonomic nervous system is reacting. After the vital signs are collected, they will be sent to an application on a smartphone to be analyzed, which can then alert an emergency contact if the epinephrine injector on the bracelet is activated. Overall, this design creates a safer system by aiding the user in keeping track of their epinephrine injector, while making it easier to track their vital signs. Also, our design will be more affordable and more convenient to replace. Rather than replacing the entire product, only the needle and drug will be switched out and not the entire design.

Keywords: allergy, anaphylaxis, epinephrine, injector, vital signs monitor

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Authors: K. Frahtia, I. Mihoubi, S. Picot

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Leishmaniasis is a group of parasitic disease with a varied clinical expression caused by flagellate protozoa of the Leishmania genus. These diseases are transmitted to humans and animals by the sting of a vector insect, the female sandfly. Among the groups of dipteral disease vectors, Phlebotominae occupy a prime position and play a significant role in human pathology, such as leishmaniasis that affects nearly 350 million people worldwide. The vector control operation launched by health services throughout the country proves to be effective since despite the prevalence of the disease remains high especially in rural areas, leishmaniasis appears to be declining in Algeria. In this context, this study mainly concerns molecular detection of Leishmania from the vector. Furthermore, a molecular diagnosis has also been made on skin samples taken from patients in the region of Constantine, located in the North-East of Algeria. Concerning the vector, 5858 sandflies were captured, including 4360 males and 1498 females. Male specimens were identified based on their morphological. The morphological identification highlighted the presence of the Phlebotomus genus with a prevalence of 93% against 7% represented by the Sergentomyia genus. About the identified species, P. perniciosus is the most abundant with 59.4% of the male identified population followed by P. longicuspis with 24.7% of the workforce. P. perfiliewi is poorly represented by 6.7% of specimens followed by P. papatasi with 2.2% and 1.5% S. dreyfussi. Concerning skin samples, 45/79 (56.96%) collected samples were found positive by real-time PCR. This rate appears to be in sharp decline compared to previous years (alert peak of 30,227 cases in 2005). Concerning the detection of Leishmania from sandflies by RT-PCR, the results show that 3/60 PCR performed genus are positive with melting temperatures corresponding to that of the reference strain (84.1 +/- 0.4 ° C for L. infantum). This proves that the vectors were parasitized. On the other side, identification by RT-PCR species did not give any results. This could be explained by the presence of an insufficient amount of leishmanian DNA in the vector, and therefore support the hypothesis of the regression of leishmaniasis in Constantine.

Keywords: Algeria, molecular diagnostic, phlebotomus, real time PCR

Procedia PDF Downloads 272

Authors: Anna Mirczak

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Introduction: In connection with the aging of the population and the increase in the number of people with chronic illnesses, the priority objective for public health has become not only lengthening life, but also improving quality of life in older persons, as well as maintenance of their relative independence and active participation in social life. The most important determinant of a person’s quality of life is health. According to the literature, older people with chronic illness who live in rural settings are at greater risk for poor outcomes than their urban counterparts. Furthermore research characterizes the rural elderly as having a higher incidence of sickness, dysfunction, disability, restricted mobility, and acute and chronic conditions than their urban citizens. It is dictated by the overlapping certain specific socio-economic factors typical for rural areas which include: social and geography exclusion, limited access to health care centers, and low socioeconomic status. Aim of the study: The objective of this study was to recognize health status and needs of older people living in selected rural areas in Poland and evaluate the impacts of working in the farm on their health status. Material and methods: The study was performed personally, using interviews based on the structural questionnaires, during the period from March 2011 to October 2012. The group of respondents consisted 203 people aged 65 years and over living in selected rural areas in Poland. The analysis of collected research material was performed using the statistical package SPSS 19 for Windows. The level of significance for the tested the hypotheses assumed value of 0.05. Results: The mean age of participants was 75,5 years (SD=5,7) range from 65 to 94 years. Most of the interviewees had children (89.2%) and grandchildren (83.7) and lived mainly with family members (75.9%) mostly in double (46.8%) and triple (20.8%) household. The majority of respondents (71,9%) were physical working on the farm. At the time of interview, each of the respondents reported that they had been diagnosed with at least one chronic diseases by their GP. The most common were: hypertension (67,5%), osteoarthritis (44,8%), atherosclerosis (43,3%), cataract (40,4%), arrhythmia (28,6%), diabetes mellitus (19,7%) and stomach or duodenum ulcer diseases (17,2%).The number of diseases occurring of the sample was dependent on gender and age. Significant associations were observed between working on the farm and frequency of occurrence cardiovascular diseases, the gastrointestinal tract dysfunction and sensory disorders. Conclusions: The most common causes of disability among older citizens were: chronic diseases, malnutrition and complaints about access to health services (especially to cardiologist and an ophthalmologist). Health care access and health status are a particular concern in rural areas where the population is older, has lower education and income levels, and is more likely to be living in medically underserved areas than is the case in urban areas.

Keywords: ageing, health status, older people, rural

Procedia PDF Downloads 263

Authors: Hidehiro Endo, Taizo Shigemichi

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Introduction & Objectives: In 2008, the revised course of study for elementary schools was published by MEXT, and from the beginning of the academic year of 2011-2012, foreign language activities (English lessons) became mandatory for 5th and 6th graders in Japanese elementary schools. Foreign language activities are currently offered once a week for approximately 50 minutes by elementary school teachers, assistant language teachers who are native speakers of English, volunteers, among others, with the purpose of helping children become accustomed to functional English. However, the new policy has disclosed a myriad of issues in conducting foreign language activities since the majority of the current elementary school teachers has neither English teaching experience nor English proficiency. Nevertheless, converting foreign language activities into English, as a subject in Japanese elementary schools (for 5th and 6th graders) from 2020 is what MEXT currently envisages with the purpose of reforming English education in Japan. According to their new proposal, foreign language activities will be mandatory for 3rd and 4th graders from 2020. Consequently, gaining better access to English learning opportunities becomes one of the primary concerns even in early childhood education. Thus, in this project, we aim to explore some nursery schools’ attempts at providing toddlers with online English lessons via Skype. The main purpose of this project is to look deeply into what roles online English lessons in the nursery schools play in guiding nursery school children to enjoy learning the English language as well as to acquire English communication skills. Research Methods: Setting; The main research site is a nursery school located in the northern part of Japan. The nursery school has been offering a 20-minute online English lesson via Skype twice a week to 7 toddlers since September 2015. The teacher of the online English lessons is a male person who lives in the Philippines. Fieldwork & Data; We have just begun collecting data by attending the Skype English lessons. Direct observations are the principal components of the fieldwork. By closely observing how the toddlers respond to what the teacher does via Skype, we examine what components stimulate the toddlers to pay attention to the English lessons. Preliminary Findings & Expected Outcomes: Although both data collection and analysis are ongoing, we found that the online English teacher remembers the first name of each toddler and calls them by their first name via Skype, a technique that is crucial in motivating the toddlers to actively participate in the lessons. In addition, when the teacher asks the toddlers the name of a plastic object such as grapes in English, the toddlers tend to respond to the teacher in Japanese. Accordingly, the effective use of Japanese in teaching English for nursery school children need to be further examined. The anticipated results of this project are an increased recognition of the significance of creating English language learning opportunities for nursery school children and a significant contribution to the field of early childhood education.

Keywords: teaching children, English education, early childhood education, nursery school

Procedia PDF Downloads 329

Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

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Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

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Authors: Sonika Raj, Amarjeet Singh, Vijay Lakshmi Sharma

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Introduction: In 21st century, due to revolution in Information and Communication Technologies (ICTs), there has been phenomenal development in quality and quantity of knowledge in the field of medical science. So, the access to relevant information to physicians is critical to the delivery of effective healthcare services to patients. The study was conducted to assess the information needs and attitudes of the medical professionals; to determine the sources and channels of information used by them; to ascertain the current usage of ICTs and the barriers faced by them in utilization of ICTs in health information access. Methodology: This descriptive cross-sectional study was carried in 2015 on hundred medical professionals working in public and private sectors of Chandigarh. The study used both quantitative and qualitative method for data collection. A semi structured questionnaire and interview schedule was used to collect data on information seeking needs, access to ICTs and barriers to healthcare information access. Five Data analysis was done using SPSS-16 and qualitative data was analyzed using thematic approach. Results: The most preferred sources to access healthcare information were internet (85%), trainings (61%) and communication with colleagues (57%). They wanted information on new drug therapy and latest developments in respective fields. All had access to computer with but almost half assessed their computer knowledge as average and only 3% had received training regarding usage. Educational status (p=0.004), place of work (p=0.004), number of years in job (p=0.004) and sector of job (p=0.04) of doctors were found to be significantly associated with their active search for information. The major themes that emerged from in-views were need; types and sources of healthcare information; exchange of information among different levels of healthcare providers; usage of ICTs to obtain and share information; barriers to access of healthcare information and quality of health information materials and involvement in their development process Conclusion and Recommendations: The medical professionals need information in their in their due course of work. However, information needs of medical professionals were not being adequately met. There should be training of professional regarding internet skills and the course on bioinformatics should be incorporated in the curricula of medical students. The policy framework must be formulated that will encourage and promote the use of ICTs as tools for health information access and dissemination.

Keywords: health information, ICTs, medical professionals, qualitative

Procedia PDF Downloads 349

Authors: Salima Taleb, Kafila Boulaba, Ahlem Yousfi, Nada Taleb, Difallah Basma

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Introduction: Obesity is recognized as a cardiovascular risk factor. It is associated with cardio-metabolic diseases. Its prevalence is increasing significantly in both rich and poor countries. However, there are obese people who have no metabolic disturbance. So we think obesity is not always a risk factor for an abnormal metabolic profile that increases the risk of cardiometabolic problems. However, there is no definition that allows us to identify the individual group Metabolically Healthy but Obese (MHO). Objective: The objective of this study is to evaluate the relationship between MHO and some factors associated with it. Methods: A longitudinal study is a prospective cohort study of 600 participants aged ≥18 years. Metabolic status was assessed by the following parameters: blood pressure, fasting glucose, total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. Body Mass Index (BMI) was calculated as weight (in kg) divided by height (m2), BMI = Weight/(Height)². According to the BMI value, our population was divided into four groups: underweight subjects with BMI <18.5 kg/m2, normal weight subjects with BMI = 18.5–24.9 kg/m², overweight subjects with BMI=25–29.9 kg/m², and obese subjects who have (BMI ≥ 30 kg/m²). A value of P < 0.05 was considered significant. Statistical processing was done using the SPSS 25 software. Results: During this study, 194 (32.33%) were identified as MHO among 416 (37%) obese individuals. The prevalence of the metabolically unhealthy phenotype among normal-weight individuals was (13.83%) vs. (37%) in obese individuals. Compared with metabolically healthy normal-weight individuals (10.93%), the prevalence of diabetes was (30.60%) in MHO, (20.59%) in metabolically unhealthy normal weight, and (52.29%) for metabolically unhealthy obese (p = 0.032). Blood pressure was significantly higher in MHO individuals than in metabolically healthy normal-weight individuals and in metabolically unhealthy obese than in metabolically unhealthy normal weight (P < 0.0001). Familial coronary artery disease does not appear to have an effect on the metabolic status of obese and normal-weight patients (P = 0.544). However, waist circumference appears to have an effect on the metabolic status of individuals (P < 0.0001). Conclusion: This study showed a high prevalence of metabolic profile disruption in normal-weight subjects and a high rate of overweight and/or obese people who are metabolically healthy. To understand the physiological mechanism related to these metabolic statuses, a thorough study is needed.

Keywords: metabolically health, obesity, factors associated, cardiovascular diseases

Procedia PDF Downloads 117

Authors: Njabulo Ncube, Elena Kulinskaya, Nicholas Steel, Dmitry Pshezhetskiy

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Life expectancy in the United Kingdom (UK) has been near constant since 2010, particularly for the individuals of 65 years and older. This trend has been also noted in several other countries. This slowdown in the increase of life expectancy was concurrent with the increase in the number of deaths caused by non-communicable diseases. Of particular concern is the world-wide exponential increase in the number of diabetes related deaths. Previous studies have reported increased mortality hazards among diabetics compared to non-diabetics, and on the differing effects of antidiabetic drugs on mortality hazards. This study aimed to estimate the all-cause mortality hazards and related life expectancies among type 2 diabetes (T2DM) patients in the UK using the time-variant Gompertz-Cox model with frailty. The study also aimed to understand the major causes of the change in life expectancy growth in the last decade. A total of 221 182 (30.8% T2DM, 57.6% Males) individuals aged 50 years and above, born between 1930 and 1960, inclusive, and diagnosed between 2000 and 2016, were selected from The Health Improvement Network (THIN) database of the UK primary care data and followed up to 31 December 2016. About 13.4% of participants died during the follow-up period. The overall all-cause mortality hazard ratio of T2DM compared to non-diabetic controls was 1.467 (1.381-1.558) and 1.38 (1.307-1.457) when diagnosed between 50 to 59 years and 60 to 74 years, respectively. The estimated life expectancies among T2DM individuals without further comorbidities diagnosed at the age of 60 years were 2.43 (1930-1939 birth cohort), 2.53 (1940-1949 birth cohort) and 3.28 (1950-1960 birth cohort) years less than those of non-diabetic controls. However, the 1950-1960 birth cohort had a steeper hazard function compared to the 1940-1949 birth cohort for both T2DM and non-diabetic individuals. In conclusion, mortality hazards for people with T2DM continue to be higher than for non-diabetics. The steeper mortality hazard slope for the 1950-1960 birth cohort might indicate the sub-population contributing to a slowdown in the growth of the life expectancy.

Keywords: T2DM, Gompetz-Cox model with frailty, all-cause mortality, life expectancy

Procedia PDF Downloads 119

Authors: Kyra Kannen, Sonja D. Roelen, Sebastian Schnieder, Jarek Krajewski, Steffen Holsteg, André Karger, Johanna Askeridis, Celina Slawik, Philip Mildner, Jens Piesk, Ruslan David, Holger Kürten, Benjamin Oster, Robert Malzan, Mike Ludemann

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Virtual Reality (VR) is increasingly recognized for its potential in transforming mental disorder treatment, offering advantages such as cost-effectiveness, time efficiency, accessibility, reduced stigma, and scalability. While the application of VR in the context of anxiety disorders has been extensively evaluated and demonstrated to be effective, the utilization of VR as a therapeutic treatment for depression remains under-investigated. Our goal is to pioneer immersive VR therapy modules for treating major depression, alongside a web-based system for home use. We develop a modular digital therapy platform grounded in psychodynamic therapy interventions which addresses stress reduction, exploration of social situations and relationship support, social skill training, avoidance behavior analysis, and psychoeducation. In addition, an automated depression monitoring system, based on acoustic voice analysis, is implemented in the form of a speech-based diary to track the affective state of the user and depression severity. The use of immersive VR facilitates patient immersion into complex and realistic interpersonal interactions with high emotional engagement, which may contribute to positive treatment acceptance and satisfaction. In a proof-of-concept study, 45 depressed patients were assigned to VR or web-platform modules, evaluating user experience, usability and additional metrics including depression severity, mindfulness, interpersonal problems, and treatment satisfaction. The findings provide valuable insights into the effectiveness and user-friendliness of VR and web modules for depression therapy and contribute to the refinement of more tailored digital interventions to improve mental health.

Keywords: virtual reality therapy, digital health, depression, psychotherapy

Procedia PDF Downloads 63

Authors: Lancer Scott

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Purpose: High quality clinical disaster medicine requires providers working collaboratively to care for multiple patients in chaotic environments; however, many providers lack adequate training. To address this deficit, we created a competency-based, 5-hour Emergency Preparedness Training (EPT) curriculum using didactics, small-group discussion, and kinetic learning. The goal was to evaluate the effect of a short course on improving provider knowledge, confidence and skills in disaster scenarios. Methods: Diverse groups of medical university students, health care professionals, and community members were enrolled between 2011 and 2014. The course consisted of didactic lectures, small group exercises, and two live, multi-patient mass casualty incident (MCI) scenarios. The outcome measures were based on core competencies and performance objectives developed by a curriculum task force and assessed via trained facilitator observation, pre- and post-testing, and a course evaluation. Results: 708 participants completed were trained between November 2011 and August 2014, including 49.9% physicians, 31.9% medical students, 7.2% nurses, and 11% various other healthcare professions. 100% of participants completed the pre-test and 71.9% completed the post-test, with average correct answers increasing from 39% to 60%. Following didactics, trainees met 73% and 96% of performance objectives for the two small group exercises and 68.5% and 61.1% of performance objectives for the two MCI scenarios. Average trainee self-assessment of both overall knowledge and skill with clinical disasters improved from 33/100 to 74/100 (overall knowledge) and 33/100 to 77/100 (overall skill). The course assessment was completed by 34.3% participants, of whom 91.5% highly recommended the course. Conclusion: A relatively short, intensive EPT course can improve the ability of a diverse group of disaster care providers to respond effectively to mass casualty scenarios.

Keywords: clinical disaster medicine, training, hospital preparedness, surge capacity, education, curriculum, research, performance, training, student, physicians, nurses, health care providers, health care

Procedia PDF Downloads 193

Authors: Hossein Rassi, Marjan Moradi Fard, Masoud Houshmand

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Background: Cervical cancer is multistep disease that is thought to result from an interaction between genetic background and environmental factors. Human papillomavirus (HPV) infection is the leading risk factor for cervical intraepithelial neoplasia (CIN) and cervical cancer. In other hand, some of p53 and miRNA polymorphism may plays an important role in carcinogenesis. This study attempts to clarify the relation of p53 genotypes and miR-146a rs2910164 polymorphism in cervical lesions. Method: Forty two archival samples with cervical lesion retired from Khatam hospital and 40 sample from healthy persons used as control group. A simple and rapid method was used to detect the simultaneous amplification of the HPV consensus L1 region and HPV-16,-18, -11, -31, 33 and -35 along with the b-globin gene as an internal control. We use Multiplex PCR for detection of P53 and miR-146a rs2910164 genotypes in our lab. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Cervix lesions were collected from 42 patients with Squamous metaplasia, cervical intraepithelial neoplasia, and cervical carcinoma. Successful DNA extraction was assessed by PCR amplification of b-actin gene (99bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of cervical lesions in the study population. In this study, we detected 13 HPV 18 from 42 cervical cancer. Conclusion: The connection between several SNP polymorphism and human virus papilloma in rare researches were seen. The reason of these differences in researches' findings can result in different kinds of races and geographic situations and also differences in life grooves in every region. The present study provided preliminary evidence that a p53 GG genotype and miR-146a rs2910164 CC genotype may effect cervical cancer risk in the study population, interacting synergistically with HPV 18 genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with HPV18 can serve as major risk factors in the early identification of cervical cancers. Furthermore, the results indicate the possibility of primary prevention of cervical cancer by vaccination against HPV18 in Iran.

Keywords: cervical cancer, HPV18, p53 codon 72 polymorphism, miR-146a rs2910164 polymorphism

Procedia PDF Downloads 457

Authors: Thaer Khaleel Swaid, Maryam Al Ahmad, Ishtiaq Ahmad

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47-year-old female, known to have a liver cyst and hemangiomas, presented to the gastroenterology clinic for chronic moderate postprandial epigastric pain, which is aggravated by food, leaning forward and relieved on lying flat. The pain was associated with nausea, vomiting, heartburn and excessive burping. She opened her bowel daily, having well-formed stools without blood or mucus. The patient denied NSAID intake, smoking or alcohol. On physical examination during the episode of pain abdomen revealed a soft, lax abdomen and mild tenderness in the epigastric region without organomegaly. Bowel sounds were audible. Her routine hematological and biochemical parameters were within normal, including CBC, Celiac serology, Lipase, Metabolic profile and H pylori stool antigen. The patient underwent an Ultrasound of the abdomen which showed multiple liver cysts, hemangioma, normal GB and biliary tree. Based on the clinical picture and to narrow our differential diagnosis, an ultrasound Doppler for the abdomen was ordered, and it showed celiac artery peak systolic velocity in expiration is 270cm/s, suggestive of median arcuate ligament syndrome. She Had computerized tomography abdomen done and showed a Narrowing of the celiac artery at the origin, likely secondary to low insertion of the median arcuate ligament. Furthermore, Gastroscopy and, later on colonoscopy were done, which was unremarkable. A laparoscopic decompression of the celiac trunk was indicated, for which the patient was referred to vascular surgery. This case confirms that Median Arcuate Ligament syndrome is an unusual diagnosis and is always challenging. Usually, patients undergo extensive workups before a final diagnosis is achieved. Our case highlights the challenge of diagnosing MALS since this entity is rare. It is a good choice to perform abdominal ultrasound with Doppler imaging on a patient with symptoms such as postprandial angina.

Keywords: Unveiling the Mystery, MALS, rare entity, Rare vascular phenomenon

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Authors: Goldie Lynn Diaz, Ma. Teresa Tricia G. Bautista, Elisabeth Engeljakob, Mary Glaze Rosal

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Introduction: Residents are expected to convey unfavorable news, discuss prognoses, and relieve suffering, and address do-not-resuscitate orders, yet some report a lack of competence in providing this type of care. Recognizing this need, Family Medicine residency programs are incorporating end-of-life care from symptom and pain control, counseling, and humanistic qualities as core proficiencies in training. Objective: This study determined the competency of Family Medicine Residents from various institutions in Metro Manila on rendering care for the dying. Materials and Methods: Trainees completed a Palliative Care Evaluation tool to assess their degree of confidence in patient and family interactions, patient management, and attitudes towards hospice care. Results: Remarkably, only a small fraction of participants were confident in performing independent management of terminal delirium and dyspnea. Fewer than 30% of residents can do the following without supervision: discuss medication effects and patient wishes after death, coping with pain, vomiting and constipation, and reacting to limited patient decision-making capacity. Half of the respondents had confidence in supporting the patient or family member when they become upset. Majority expressed confidence in many end-of-life care skills if supervision, coaching and consultation will be provided. Most trainees believed that pain medication should be given as needed to terminally ill patients. There was also uncertainty as to the most appropriate person to make end-of-life decisions. These attitudes may be influenced by personal beliefs rooted in cultural upbringing as well as by personal experiences with death in the family, which may also affect their participation and confidence in caring for the dying. Conclusion: Enhancing the quality and quantity of end-of-life care experiences during residency with sufficient supervision and role modeling may lead to knowledge and skill improvement to ensure quality of care. Fostering bedside learning opportunities during residency is an appropriate venue for teaching interventions in end-of-life care education.

Keywords: end of life care, geriatrics, palliative care, residency training skill

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Authors: Rakesh Mishra

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India’s Demography has always amazed the world because of its unprecedented outcomes in the presence of multifaceted socioeconomic and geographical characteristics. Being the first one to implement family panning in 1952, it occupies 2nd largest population of the world, with some of its state like Uttar Pradesh contributing 5th largest population to the world population surpassing Brazil. Being the one with higher in number it is more prone to the demographic disparity persisting into its territories brought upon by the inequalities in availability, accessibility and attainability of socioeconomic and various other resources. Fifth goal of Millennium Development Goal emphasis to improve maternal and child health across the world as Children’s development is very important for the overall development of society and the best way to develop national human resources is to take care of children. The target is to reduce the infant deaths by three quarters between 1990 and 2015. Child health status depends on the care and delivery by trained personnel, particularly through institutional facilities which is further associated with the status of the mother. However, delivery in institutional facilities and delivery by skilled personnel are rising slowly in India. The main objective of the present study is to measure the child health status on based on the educational and occupational background of the women in India. Study indicates that women education plays a very crucial role in deciding the health of the new born care and access to family planning, but the women autonomy indicates to have mixed results in different states of India. It is observed that rural women are 1.61 times more likely to exclusive breastfed their children compared to urban women. With respect to Hindu category, women belonging to other religious community were 21 percent less likely to exclusive breastfed their child. Taking scheduled caste as reference category, the odds of exclusive breastfeeding is found to be decreasing in comparison to other castes, and it is found to be significant among general category. Women of high education status have higher odds of using family planning methods in most of the southern states of India. By and large, girls and boys are about equally undernourished. Under nutrition is generally lower for first births than for subsequent births and consistently increases with increasing birth order for all measures of nutritional status. It is to be noted that at age 12-23 months, when many children are being weaned from breast milk, 30 percent of children are severely stunted and around 21 percent are severely underweight. So, this paper presents the evidence on the patterns of prevailing child health status in India and its states with reference to the mother socioeconomics and biological characteristics and examines trends in these, and discusses plausible explanations.

Keywords: immunization, exclusive breastfeeding, under five mortality, binary logistic regression, ordinal regression and life table

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Authors: Aabha Chaubey, Bani Bhattacharya

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Evaluation of the quality of teaching in engineering education in India needs to be conducted on a continuous basis to achieve the best teaching quality in technical education. Quality teaching is an influential factor in technical education which impacts largely on learning outcomes of the students. Present study is not exclusively theory-driven, but it draws on various specific concepts and constructs in the domain of technical education. These include teaching and learning in higher education, teacher effectiveness, and teacher evaluation and performance management in higher education. Student Evaluation of Education Quality (SEEQ) was proposed as one of the evaluation instruments of the quality teaching in engineering education. SEEQ is one of the popular and standard instrument widely utilized all over the world and bears the validity and reliability in educational world. The present study was designed to evaluate the teaching quality through SEEQ in the context of technical education in India, including its validity and reliability based on the collected data. The multiple dimensionality of SEEQ that is present in every teaching and learning process made it quite suitable to collect the feedback of students regarding the quality of instructions and instructor. The SEEQ comprises of 9 original constructs i.e.; learning value, teacher enthusiasm, organization, group interaction, and individual rapport, breadth of coverage, assessment, assignments and overall rating of particular course and instructor with total of 33 items. In the present study, a total of 350 samples comprising first year undergraduate students from Indian Institute of Technology, Kharagpur (IIT, Kharagpur, India) were included for the evaluation of the importance of SEEQ. They belonged to four different courses of different streams of engineering studies. The above studies depicted the validity and reliability of SEEQ was based upon the collected data. This further needs Confirmatory Factor Analysis (CFA) and Analysis of Moment structure (AMOS) for various scaled instrument like SEEQ Cronbach’s alpha which are associated with SPSS for the examination of the internal consistency. The evaluation of the effectiveness of SEEQ in CFA is implemented on the basis of fit indices such as CMIN/df, CFI, GFI, AGFI and RMSEA readings. The major findings of this study showed the fitness indices such as ChiSq = 993.664,df = 390,ChiSq/df = 2.548,GFI = 0.782,AGFI = 0.736,CFI = 0.848,RMSEA = 0.062,TLI = 0.945,RMR = 0.029,PCLOSE = 0.006. The final analysis of the fit indices presented positive construct validity and stability, on the other hand a higher reliability was also depicted which indicated towards internal consistency. Thus, the study suggests the effectivity of SEEQ as the indicator of the quality evaluation instrument in teaching-learning process in engineering education in India. Therefore, it is expected that with the continuation of this research in engineering education there remains a possibility towards the betterment of the quality of the technical education in India. It is also expected that this study will provide an empirical and theoretical logic towards locating a construct or factor related to teaching, which has the greatest impact on teaching and learning process in a particular course or stream in engineering education.

Keywords: confirmatory factor analysis, engineering education, SEEQ, teaching and learning process

Procedia PDF Downloads 421

Authors: Mohammed Eltayeb Salih Elamin

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This study discusses the concept of the artificial heart using engineering concepts, of the fluid mechanics and the characteristics of the non-Newtonian fluid. For the purpose to serve heart patients and improve aspects of their lives and since the Statistics review according to world health organization (WHO) says that heart disease and blood vessels are the first cause of death in the world. Statistics shows that 30% of the death cases in the world by the heart disease, so simply we can consider it as the number one leading cause of death in the entire world is heart failure. And since the heart implantation become a very difficult and not always available, the idea of the artificial heart become very essential. So it’s important that we participate in the developing this idea by searching and finding the weakness point in the earlier designs and hoping for improving it for the best of humanity. In this study a pump was designed in order to pump blood to the human body and taking into account all the factors that allows it to replace the human heart, in order to work at the same characteristics and the efficiency of the human heart. The pump was designed on the idea of the diaphragm pump. Three models of blood obtained from the blood real characteristics and all of these models were simulated in order to study the effect of the pumping work on the fluid. After that, we study the properties of this pump by using Ansys15 software to simulate blood flow inside the pump and the amount of stress that it will go under. The 3D geometries modeling was done using SOLID WORKS and the geometries then imported to Ansys design modeler which is used during the pre-processing procedure. The solver used throughout the study is Ansys FLUENT. This is a tool used to analysis the fluid flow troubles and the general well-known term used for this branch of science is known as Computational Fluid Dynamics (CFD). Basically, Design Modeler used during the pre-processing procedure which is a crucial step before the start of the fluid flow problem. Some of the key operations are the geometry creations which specify the domain of the fluid flow problem. Next is mesh generation which means discretization of the domain to solve governing equations at each cell and later, specify the boundary zones to apply boundary conditions for the problem. Finally, the pre–processed work will be saved at the Ansys workbench for future work continuation.

Keywords: Artificial heart, computational fluid dynamic heart chamber, design, pump

Procedia PDF Downloads 459

Authors: Ian Kingsbury

Abstract:

The rapid expansion of charter schools (public schools that receive government but do not face the same regulations as traditional public schools) over the preceding two decades has raised concerns over the potential for graft and fraud. These concerns are largely justified: Incidents of financial crime and mismanagement are not unheard of, and the charter sector has become a darling of hedge fund managers. In response, several states have strengthened their charter school regulatory regimes. Imposing regulations and attempting to increase accountability seem like sensible measures, and perhaps they are necessary. However, increased regulation may come at the cost of imposing barriers to entry. Specifically, increased regulation often entails evidence for a high likelihood of fiscal solvency. That should theoretically entail access to capital in the short-term, which may systematically preclude Black or Hispanic applicants from opening charter schools. Moreover, increased regulation necessarily entails more red tape. The institutional wherewithal and the number of hours required to complete an application to open a charter school might favor those who have partnered with an education service provider, specifically a charter management organization (CMO) or education management organization (EMO). These potential barriers to entry pose a significant policy concern. Just as policymakers hope to increase the share of minority teachers and principals, they should sensibly care whether individuals who open charter schools look like the students in that school. Moreover, they might be concerned if successful applications in states with stringent regulations are overwhelmingly affiliated with education service providers. One of the original missions of charter schools was to serve as a laboratory of innovation. Approving only those applications affiliated with education service providers (and in effect establishing a parallel network of schools rather than a diverse marketplace of schools) undermines that mission. Data and methods: The analysis examines more than 2,000 charter school applications from 15 states. It compares the outcomes of applications from states with a strong regulatory environment (those with high scores) from NACSA-the National Association of Charter School Authorizers- to applications from states with a weak regulatory environment (those with a low NACSA score). If the hypothesis is correct, applicants not affiliated with an ESP are more likely to be rejected in high-regulation states compared to those affiliated with an ESP, and minority candidates not affiliated with an education service provider (ESP) are particularly likely to be rejected. Initial returns indicate that the hypothesis holds. More applications in low NASCA-scoring Arizona come from individuals not associated with an ESP, and those individuals are as likely to be accepted as those affiliated with an ESP. On the other hand, applicants in high-NACSA scoring Indiana and Ohio are more than 20 percentage points more likely to be accepted if they are affiliated with an ESP, and the effect is particularly pronounced for minority candidates. These findings should spur policymakers to consider the drawbacks of charter school accountability and consider accountability regimes that do not impose barriers to entry.

Keywords: accountability, barriers to entry, charter schools, choice

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