Search results for: middle income group

Authors: Carla S. C. da Silva, Cristiano Coelho, Junio Souza

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The universe of luxury has charmed and seduced consumers for centuries. Since the middle ages, their symbols are displayed as objects of power and status, arousing desire and provoking social covetousness. In this way, the counterfeit market is growing every day, offering a group of consumers the opportunity to enter into a distinct social position, where the beautiful and shiny brand logo signals an inclusion passport to everything this group wants. This work sought to investigate how the context and the social environment can influence consumers to choose products of symbolic brands even if they are not legitimate and how this behavior is accepted in society. The study proposed: a) to evaluate the measures of knowledge and quality of a set of marks presented in the manipulation of two contexts (luxury x academic) between buyers and non-buyers of forgeries, both for original products and their correspondence with counterfeit products; b) measure the effect of layout on the verbal responses of buyers and non-buyers in relation to their assessment of the behavior of buyers of counterfeits. The present study, in addition to measuring the level of knowledge and quality attributed to each brand investigated, also verified the willingness of consumers to pay for a falsified good of the brands of predilection compared to the original study. This data can serve as a parameter for luxury brand managers in their counterfeit coping strategies. The investigation into the frequency of purchase has shown that those who buy counterfeit goods do so regularly, and there is a propensity to repeat the purchase. It was noted that a significant majority of buyers of counterfeits are prone to invest in illegality to meet their expectations of being in line with the standards of their interest groups.

Keywords: luxury, consumers, counterfeits, context, behaviorism

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Authors: Ihsan Al-Abboodi, Tahsin Toma-Sabbagh

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Laboratory tests have been carried out to investigate the response of 2x2 pile group subjected to triangular soil movement. The pile group was instrumented with displacement and tilting devices at the pile cap and strain gauges on two piles of the group. In this paper, results from four model tests were presented to study the effects of axial loads and soil density on the lateral behavior of piles. The responses in terms of bending moment, shear force, soil pressure, deflection, and rotation of piles were compared. Test results indicate that increasing the soil strength could increase the measured moment, shear, soil pressure, and pile deformations. Most importantly, adding loads to the pile cap induces additional moment to the head of front-pile row unlike the back-pile row which was influenced insignificantly.

Keywords: pile group, passive piles, lateral soil movement, soil density, axial loads

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Authors: Ki Hwa Lee, Eunsu Kang, Jae Hong Park

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Background: Interventional neuroradiology (INR) has been a rapidly growing and evolving neurosurgical part during the past few decades. Sevoflurane and propofol are both suitable anesthetics for INR procedure. Monitoring of depth of anesthesia is being used very widely. SEDLine™ monitor, a 4-channel processed EEG monitor, uses a proprietary algorithm to analyze the raw EEG signal and displays the Patient State Index (PSI) values. There are only a fewer studies examining the PSI in the neuro-anesthesia. We aimed to investigate the difference of PSI values and hemodynamic variables between sevoflurane and propofol anesthesia during INR procedure. Methods: We reviewed the medical records of patients who scheduled to undergo embolization of non-ruptured intracranial aneurysm by a single operator from May 2013 to December 2014, retrospectively. Sixty-five patients were categorized into two groups; sevoflurane (n = 33) vs propofol (n = 32) group. The PSI values, hemodynamic variables, and the use of hemodynamic drugs were analyzed. Results: Significant differences were seen between PSI values obtained during different perioperative stages in both two groups (P < 0.0001). The PSI values of propofol group were lower than that of sevoflurane group during INR procedure (P < 0.01). The patients in propofol group had more prolonged time of extubation and more phenylephrine requirement than sevoflurane group (p < 0.05). Anti-hypertensive drug was more administered to the patients during extubation in sevoflurane group (p < 0.05). Conclusions: The PSI can detect depth of anesthesia and changes of concentration of anesthetics during INR procedure. Extubation was faster in sevoflurane group, but smooth recovery was shown in propofol group.

Keywords: interventional neuroradiology, patient state index, propofol, sevoflurane

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Authors: Memnun Seven, Mine Bahar, Aygül Akyüz, Hatice Erdoğan

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Background: The workplace has been deemed a suitable location for educating many women at once about cancer screening. Objective: To determine how group education about early diagnostic methods for breast and cervical cancer affects women’s behavior and readiness to receive mammography and Pap smears. Methods: This semi-interventional study was conducted at a textile factory in Istanbul, Turkey. Female workers (n = 125) were included in the study. A participant identification form and knowledge evaluation form developed for this study, along with the trans-theoretical model, were used to collect data. A 45-min interactive group education was given to the participants. Results: Upon contacting participants 3 months after group education, 15.4% (n = 11) stated that they had since received a mammogram and 9.8% (n = 7) a Pap smear. As suggested by the trans-theoretical model, group education increased participants’ readiness to receive cancer screening, along with their knowledge of breast and cervical cancer. Conclusions: Group education positively impacted women’s knowledge of cancer and their readiness to receive mammography and Pap smears. Group education can therefore potentially create awareness of cancer screening tests among women and improve their readiness to receive such tests.

Keywords: cancer screening, educational intervention, participation, women

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Authors: K. Subermaniam, Q. H. M. Saad, S. N. A. Bakhtiar, J. A. Hamid, F. Z .J. Sidek, F. Othman

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Objective: To investigate the effects of virgin coconut oil (VCO) on histomorphometric changes in the aorta and heart of thermoxidized palm oil-fed rats. Methods: Thirty two male Sprague-Dawley rats were divided into four groups: control group fed with normal diet; 5 times heated palm oil-fed group (5HPO) fortified with 15% w/w of 5HPO; VCO group supplemented with 1.42 ml/kg of VCO; and 5HPO + VCO group. The treatment lasted for four months. Upon sacrifice, aortic and heart tissues were processed for light microscopic studies. Results: Light microscopic studies showed thickened intima and media of the aorta in two out of eight rats in the 5HPO group only, while the rest of the rats did not show any thickening of either the intima or media of the aorta. Intima media area (IMA) in the VCO, 5HPO and 5HPO+VCO was significantly increased compared to the control group. Circumferential wall tension (CWT) and tensile stress (TS) in the aorta of 5HPO showed significant increase compared to the other groups. Cardiomyofibre width in 5HPO group showed significant increase in size compared to the control, VCO and 5HPO+VCO groups. Cardiomyofibre nuclear size in the 5HPO group decreased in size significantly compared to the control, VCO and 5HPO+VCO groups. Conclusion: VCO supplementation at a dose of 1.42 ml/kg showed protectives effect on the aorta and heart of thermoxidized palm oil fed rats.

Keywords: aorta, heart, histomorphometric changes, thermoxidized palm oil, virgin coconut oil

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Authors: Uliana N. Tumanova, Sergey M. Voevodin, Veronica A. Sinitsyna, Alexandr I. Shchegolev

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An important part of forensic and autopsy research in perinatology is the answer to the question of life and stillbirth. Postmortem magnetic resonance imaging (MRI) is an objective non-invasive research method that allows to store data for a long time and not to exhume the body to clarify the diagnosis. The purpose of the research is to study the possibilities of a postmortem MRI to determine the stillbirth and death of a newborn who had spontaneous breathing and died on the first day after birth. MRI and morphological data of a study of 23 stillborn bodies, prenatally dead at a gestational age of 22-39 weeks (Group I) and the bodies of 16 newborns who died from 2 to 24 hours after birth (Group II) were compared. Before the autopsy, postmortem MRI was performed on the Siemens Magnetom Verio 3T device in the supine position of the body. The control group for MRI studies consisted of 7 live newborns without lung disease (Group III). On T2WI in the sagittal projection was measured MR-signal intensity (SI) in the lung tissue (L) and shoulder muscle (M). During the autopsy, a pulmonary swimming test was evaluated, and macro- and microscopic studies were performed. According to the postmortem MRI, the highest values of mean SI of the lung (430 ± 27.99) and of the muscle (405.5 ± 38.62) on T2WI were detected in group I and exceeded the corresponding value of group II by 2.7 times. The lowest values were found in the control group - 77.9 ± 12.34 and 119.7 ± 6.3, respectively. In the group II, the lung SI was 1.6 times higher than the muscle SI, whereas in the group I and in the control group, the muscle SI was 2.1 times and 1.8 times larger than the lung. On the basis of clinical and morphological data, we calculated the formula for determining the breathing index (BI) during postmortem MRI: BI = SIL x SIM / 100. The mean value of BI in the group I (1801.14 ± 241.6) (values ranged from 756 to 3744) significantly higher than the corresponding average value of BI in the group II (455.89 ± 137.32, p < 0.05) (305-638.4). In the control group, the mean BI value was 91.75 ± 13.3 (values ranged from 53 to 154). The BI with the results of pulmonary swimming tests and microscopic examination of the lungs were compared. The boundary value of BI for the differential diagnosis of stillborn and newborn death was 700. Using the postmortem MRI allows to differentiate the stillborn with the death of the breathing newborn.

Keywords: lung, newborn, postmortem MRI, stillborn

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Authors: Baqir Khawari

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This study critically examines the influence of remittances on household poverty and income inequality in Mazar-i-Sharif, Balkh Province, Afghanistan, utilizing robust OLS and Logit models with a rigorous multi-random sampling method. The empirical findings reveal that a 1% increase in per capita international remittances is associated with a substantial 0.071% and 0.059% rise in per capita income during the fiscal years 2019/20 and 2020/21, respectively. Furthermore, this increase significantly mitigates the per capita depth of poverty by 0.0272% and 0.025% and the severity of poverty by 0.0149% and 0.0145% over the same periods. Notably, the impact of international remittances on poverty alleviation surpasses that of internal remittances. In addressing income inequality, the analysis demonstrates that remittances contribute to a reduction in the Gini coefficient by 2% in 2019/20 and 7% in 2020/21, underscoring their pivotal role in promoting equitable economic distribution. However, the COVID-19 pandemic has posed significant challenges, diminishing remittance flows and, consequently, their positive effects on household welfare. The logistic regression results further corroborate these findings, indicating that increased per capita remittances, both international and internal, markedly decrease the likelihood of households falling below the poverty line. Specifically, a 1% rise in per capita external remittances reduces this likelihood by 4.5% in 2019/20 and by 3.7% in 2020/21, while internal remittances decrease it by 3% and 2.4%, respectively. The study also explores the demographic determinants of poverty. Larger household sizes and older household heads correlate positively with poverty, whereas higher education levels among household heads and members, and a greater proportion of male members, correlate negatively with poverty incidence and severity. Female-headed households are disproportionately affected by poverty, exacerbated by socio-cultural restrictions. Despite these adversities, the data suggest that remittances are a crucial instrument for poverty alleviation and income inequality reduction in Afghanistan. The findings advocate for policy interventions aimed at enhancing formal remittance channels, promoting education, and empowering women. Effective governance and sustained international assistance are essential to harness the full potential of remittances in combating poverty and inequality. This study highlights the need for strategic, multifaceted approaches to foster sustainable economic development in Afghanistan’s challenging socio-political context.

Keywords: migration, remittances, poverty, inequality, COVID-19, Afghanistan

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Authors: Mohammad Rahman, Guy Burton, Megan Mathias

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Strategic management as an organizational practice was adopted by the public sector in the New Public Management (NPM) era that began in most parts of the world in the 1980s. Strategy as a new public management concept was subscribed by governments in both developed and developing world, as they were persuaded that clearly defined vision, mission and goals, as well as programs and projects - aligned with the goals - could potentially help achieve government vision at the national level and organizational goals at the service-delivery level. The advocates for strategic management in the public sector saw an inherent link between strategy and performance, claiming that the implementation of organizational strategy has an effect on the overall performance of an organization. Arguably, many government entities that have failed in enhancing team and individual performance had poorly-designed strategy or weak strategy implementation. Another key argument about low-level performance is linked with lack of strategic sense-making and orientation by middle managers in particular. Scholars maintain that employees at all levels need to understand strategic management plan in order to facilitate its implementation. Therefore, involving employees (particularly the middle managers) from the beginning potentially helps an organization avoid the drop in performance, and on the contrary would increase their commitment. The United Arab Emirates (UAE) is well known for adopting public sector reform strategies and tools since the 1990s. This observation is contextually pertinent in the case of the Government of Dubai, which has provided a Strategy Execution Guide to all of its entities to achieve high level strategic success in service delivery. The Dubai public sector also adopts road maps for e-Government, Smart Dubai, Expo 2020, investment, environment, education, health and other sectors. Evidently, some of these strategies are bringing tangible (e.g. Smart Dubai transformation) results in a transformational manner. However, the amount of academic research and literature on the strategy process vis-à-vis staff performance in the Government of Dubai is limited. In this backdrop, this study examines how individual performance of public sector employees in Dubai is linked with their sense-making, engagement and orientation with strategy development and implementation processes. Based on a theoretical framework, this study will undertake a sample-based questionnaire survey amongst middle managers in Dubai public sector to (a) measure the level of engagement of middle managers in strategy development and implementation processes as perceived by them; (b) observe the organizational landscape in which role expectations are placed on middle managers; and (c) examine the impact of employee engagement in strategy development process and the conditions for role expectations on individual performance. The paper is expected to provide new insights on the interface between strategic sense-making and performance in order to contribute a better understanding of the current culture/practices of staff engagement in strategic management in the public sector of Dubai.

Keywords: employee performance, government of Dubai, middle managers, strategic sense-making

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Authors: Yusef Karimi, Masoomeh Esmaeily, Razgar Mohammadi

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Following the events of September 11th, one of the most important concerns of governments, politicians and, researchers has been to answer the question that why does an ordinary person become fundamentalism? One of the major controversies in past researches was about as to whether a fundamentalist person is normal or abnormal. In this regard, the purpose of this research is to investigate whether a Salafi-jihadi individual is normal or abnormal. The participants included 6 Jihadi Salafism individuals who were living in the Middle East and had been purposefully selected. This research is a qualitative study which examines these people′s retrospective experience of their lives. The data were collected through collaborative observation and interview. This continued till data saturation. Unlike the introduced concepts of fundamentalist personality in the previous studies such as self-fascination, aggression, paranoid personality and psychopathic, participants in this study had no abnormal symptoms of mental disorders. Hence, in the context of recognizing the fundamentalist personality, we must seek other personality and positional variables.

Keywords: abnormal, fundamentalism, normal, personality, Salafi

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Authors: Zhibin Lei, Minghui Yang

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Ningwu-Jingle basin is a structural syncline which has undergone a complex tectono-thermal history since Cretaceous. It stretches along the strike of the northern Lvliang Mountains which are the most important mountains in the middle and west of North China Craton. The Mesozoic units make up of the core of Ningwu-Jingle Basin, with pre-Mesozoic units making up of its flanks. The available low-temperature thermochronology implies that Ningwu-Jingle Basin has experienced two stages of uplifting: 94±7Ma to 111±8Ma (Albian to Cenomanian) and 62±4 to 75±5Ma (Danian to Maastrichtian). In order to constrain its tectono-thermal history in the Cenozoic, both apatite (U-Th-Sm)/He and fission track dating analysis are applied on 3 Middle Jurassic and 3 Upper Triassic sandstone samples. The central fission track ages range from 74.4±8.8Ma to 66.0±8.0Ma (Campanian to Maastrichtian) which matches well with previous data. The central He ages range from 20.1±1.2Ma to 49.1±3.0Ma (Ypresian to Burdigalian). Inverse thermal modeling is established based on both apatite fission track data and (U-Th-Sm)/He data. The thermal history obtained reveals that all 6 sandstone samples cross the high-temperature limit of fission track partial annealing zone by the uppermost Cretaceous and that of He partial retention zone by the uppermost Eocene to the early Oligocene. The result indicates that the middle and west of North China Craton is not stable in the Cenozoic.

Keywords: apatite fission track thermochronology, apatite (u–th)/he thermochronology, Ningwu-Jingle basin, North China craton, tectono-thermal history

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Authors: Xu Heng

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Since the financial crisis of 2008 and the resulting Great Recession, the number of China’s unemployed college graduate reached over 500 thousand in 2011. Following the severe situation of college graduate employment, there has been growing public concern about college graduates, especially those with the less-privileged background, and their working and living condition in metropolises. Previous studies indicate that well-educated urban migrants with less-privileged background tend to obtain temporary occupation with less financial income and lower social status. Those vulnerable young migrants are described as ‘Ant Tribe’ by some scholars. However, since the implementation of a new urbanization project, together with the relaxed Hukou system and the acceleration of socio-economic development in middle/small cities, some researchers described well-educated urban migrant’s situation and the prospect of upward social mobility in urban areas in an overly optimistic light. In order to shed more lights on the underlying tensions encountered by China’s well-educated urban migrants in their upward social mobility pursuit, this research mainly focuses on 10 well-educated urban migrants’ life trajectories between their university-to-work transition and their current situation. All selected well-educated urban migrants are young adults with rural background who have already received higher education qualification from first-tier universities of Wuhan City (capital of Hubei Province). Drawing on the in-depth interviews with 10 participants and Inspired by Lahire’s Theory of Plural Actor, this study yields the following preliminary findings; 1) For those migrants who move to super-mega cities (i.e., Beijing, Shenzhen, Guangzhou) or stay in Wuhan after college graduation, their inadequacies of economic and social capital are the structural factors which negatively influence their living condition and further shape their plan for career development. The incompatibility between the sub-fields of urban life and the disposition, which generated from their early socialization, is the main cause for marginalized position in the metropolises. 2) For those migrants who move back to middle/small cities located in their hometown regions, the inconsistency between the disposition, which generated from college life, and the organizational habitus of the workplace is the main cause for their sense of ‘fish out of water’, even though they have obtained the stable occupation of local government or state-owned enterprise. On the whole, this research illuminates how the underlying the structural forces shape well-educated urban migrants’ life trajectories and hinder their upward social mobility under the context of new urbanization project.

Keywords: life trajectory, social mobility, urbanization, well-educated urban migrant

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Authors: Jamel Boukhatem, Semia Rachid, Marmar Nasr

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Considering the differences between oil- and non-oil-producing countries, this paper aims to evaluate the impact of financial development (FD) and institutional quality (IQ) on CO2 emissions in 15 MENA (Middle East and North Africa) countries over the period 1996-2018 using the Panel ARDL approach. We found evidence to support an unconditional long run effect of FD on environmental conditions (EC), with quite significant differences between the two groups of countries. While FD leads to environmental degradation (ED) in non-oil-producing countries, it helps protect the environment in oil-producing ones. Regarding the effects of IQ on EC, they are not significant in both short- and long run for non-oil-producing countries, but they are significant for oil-producing ones only in the long run. In the short run, IQ indicators haven’t significant effects on EC for the two groups of countries.

Keywords: financial development, institutional quality, environmental conditions, Panel ARDL

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Authors: Naser B. Almari, Salem S. Alghamdi, Muhammad Afzal, Mohamed Helmy El Shal

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Wheat landraces are a rich genetic resource for boosting agronomic qualities in breeding programs while also providing diversity and unique adaptation to local environmental conditions. These genotypes have grown increasingly important in the face of recent climate change challenges. This research aimed to look at the genetic diversity of Saudi Durum wheat landraces using morpho-phenological and molecular data. The principal components analysis (PCA) analysis recorded 78.47 % variance and 1.064 eigenvalues for the first six PCs of the total, respectively. The significant characters contributed more to the diversity are the length of owns at the tip relative to the length of the ear, culm: glaucosity of the neck, flag leaf: glaucosity of the sheath, flag leaf: anthocyanin coloration of auricles, plant: frequency of plants with recurved flag leaves, ear: length, and ear: shape in profile in the PC1. The significant wheat genotypes contributed more in the PC1 (8, 14, 497, 650, 569, 590, 594, 598, 600, 601, and 604). The cluster analysis recorded an 85.42 cophenetic correlation among the 22 wheat genotypes and grouped the genotypes into two main groups. Group, I contain 8 genotypes, however, the 2nd group contains 12 wheat genotypes, while two genotypes (13 and 497) are standing alone in the dendrogram and unable to make a group with any one of the genotypes. The second group was subdivided into two subgroups. The genotypes (14, 602, and 600) were present in the second sub-group. The genotypes were grouped into two main groups. The first group contains 17 genotypes, while the second group contains 3 (8, 977, and 594) wheat genotypes. The genotype (602) was standing alone and unable to make a group with any wheat genotype. The genotypes 650 and 13 also stand alone in the first group. Using the Mantel test, the data recorded a significant (R2 = 0.0006) correlation (phenotypic and genetic) among 22 wheat durum genotypes.

Keywords: durum wheat, PCA, cluster analysis, SRAP, genetic diversity

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Authors: Sheila R. Pai, Rekha D. Kini, Amrutha Mary

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Objective: To assess and compare the cardiac autonomic activity after mental stress among the wards of normal and hypertensive parents. Methods: The study included 67 subjects, 30 of them had a parental history of hypertension and rest 37 had normotensive parents. Subjects were divided into control group (wards of normotensive parents) and Study group (wards of hypertensive parents). The height, weight were noted, and Body Mass Index (BMI) was also calculated. The mental stress test was carried out. Blood pressure (BP) and electro cardiogram (ECG) was recorded during normal breathing and after mental stress test. Heart rate variability (HRV) analysis was done by time domain method HRV was recorded and analyzed by the time-domain method. Analysis of HRV in the time-domain was done using the software version 1.1 AIIMS, New Delhi. The data obtained was analyzed using student’s t-test followed by Mann-Whitney U-test and P < 0.05 was considered significant. Results: There was no significant difference in systolic blood pressure and diastolic blood pressure (DBP) between study group and control group following mental stress. In the time domain analysis, the mean value of pNN50 and RMSSD of the study group was not significantly different from the control group after the mental stress test. Conclusion: The study thus concluded that there was no significant difference in HRV between study group and control group following mental stress.

Keywords: heart rate variability, time domain analysis, mental stress, hypertensive

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Authors: A. Keshavarz, Z. Roosta

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In this paper, propagation of cos-Gaussian beam in strongly nonlocal nonlinear media has been stimulated by using paraxial group transformation. At first, cos-Gaussian beam, nonlocal nonlinear media, critical power, transfer matrix, and paraxial group transformation are introduced. Then, the propagation of the cos-Gaussian beam in strongly nonlocal nonlinear media is simulated. Results show that beam propagation has periodic structure during self-focusing effect in this case. However, this simple method can be used for investigation of propagation of kinds of beams in ABCD optical media.

Keywords: paraxial group transformation, nonlocal nonlinear media, cos-Gaussian beam, ABCD law

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Authors: Ju-Chun Chien

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Rapid aging and depopulation could lead to serious problems, including workforce shortages and health expenditure costs. The current and predicted future LTC workforce shortages could be a real threat to Taiwan’s society. By means of comparison of data from 144 nursing aide trainees and 727 general public, the main purpose of the present study was to determine whether there were any notable differences between the two groups toward engaging in LTC services. Moreover, this study focused on recognizing the attributes of the general public who had the willingness to take LTC jobs but continue to ride the fence. A self-developed questionnaire was designed based on Ajzen’s Theory of Planned Behavior model. After conducting exploratory factor analysis (EFA) and reliability analysis, the questionnaire was a reliable and valid instrument for both nursing aide trainees and the general public. The main results were as follows: Firstly, nearly 70% of nursing aide trainees showed interest in LTC jobs. Most of them were middle-aged female (M = 46.85, SD = 9.31), had a high school diploma or lower, had unrelated work experience in healthcare, and were mostly unemployed. The most common reason for attending the LTC training program was to gain skills in a particular field. The second most common reason was to obtain the license. The third and fourth reasons were to be interested in caring for people and to increase income. The three major reasons that might push them to leave LTC jobs were physical exhaustion, payment is bad, and being looked down on. Secondly, the variables that best-predicted nursing aide trainees’ intention to engage in LTC services were having personal willingness, perceived behavior control, with high school diploma or lower, and supported from family and friends. Finally, only 11.80% of the general public reported having interest in LTC jobs (the disapproval rating was 50% for the general public). In comparison to nursing aide trainees who showed interest in LTC settings, 64.8% of the new workforce for LTC among the general public was male and had an associate degree, 54.8% had relevant healthcare experience, 67.1% was currently employed, and they were younger (M = 32.19, SD = 13.19) and unmarried (66.3%). Furthermore, the most commonly reason for the new workforce to engage in LTC jobs were to gain skills in a particular field. The second priority was to be interested in caring for people. The third and fourth most reasons were to give back to society and to increase income, respectively. The top five most commonly reasons for the new workforce to quitting LTC jobs were listed as follows: physical exhaustion, being looked down on, excessive working hours, payment is bad, and excessive job stress.

Keywords: long-term care services, nursing aide trainees, Taiwanese people, theory of planned behavior

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Authors: Taurino S. R. Neto, Epitácio D. S. Neto, Flávio Signorelli, Gustavo G. M. Balbi, Alex H. Higashi, Mário Luiz R. Monteiro, Eloisa Bonfá, Danieli C. O. Andrade, Leandro C. Zacharias

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Purpose: To perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with primary antiphospholipid syndrome (PAPS) without ocular complaints and to compare them with healthy individuals. Methods: A complete structural and functional ophthalmological evaluation using OCTA and microperimetry (MP) exam in patients with PAPS, followed at a tertiary rheumatology outpatient clinic, was performed. All ophthalmologic manifestations were recorded and then statistical analysis was performed for comparative purposes; p <0.05 was considered statistically significant. Results: 104 eyes of 52 subjects (26 patients with PAPS without ocular complaints and 26 healthy individuals) were included. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. Thrombotic PAPS was the main clinical criteria manifestation (100%); 65.4% had venous and 34.6% had arterial thrombosis. Obstetrical criteria were present in 34.6% of all thrombotic PAPS patients. Lupus anticoagulant was present in all patients. 19.2% of PAPS patients presented ophthalmologic findings against none of the healthy individuals. The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen-like deposits (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (1 patient, 1 eye). Systemic hypertension and hyperlipidaemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together. In the quantitative OCTA evaluation, we found significant differences between PAPS patients and controls in both the superficial vascular complex (SVC) and deep vascular complex (DVC) in the high-speed protocol, as well as in the SVC in the high-resolution protocol. In the analysis of the foveal avascular zone (FAZ) parameters, the PAPS group had a larger area of FAZ in the DVC using the high-speed method compared to the control group (p=0.047). In the quantitative analysis of the MP, the PAPS group had lower central (p=0.041) and global (p<0.001) retinal sensitivity compared to the control group, as well as in the sector analysis, with the exception of the inferior sector. In the quantitative evaluation of fixation stability, there was a trend towards worse stability in the PAPS subgroup with PAMM in both studied methods. Conclusions: PAMM was observed in 11.5% of PAPS patients with no previous ocular complaints. Systemic hypertension concomitant with hyperlipidemia was the most commonly associated risk factor for PAMM in patients with PAPS. PAPS patients present lower vascular density and retinal sensitivity compared to the control group, even in patients without PAMM.

Keywords: antiphospholipid syndrome, optical coherence angio tomography, optical coherence tomography, retina

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Authors: Srinivasa Rao Gadde

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In this article, we considered a group acceptance sampling plans for exponentiated half logistic distribution when the life-test is truncated at a pre-specified time. It is assumed that the index parameter of the exponentiated half logistic distribution is known. The design parameters such as the number of groups and the acceptance number are obtained by satisfying the producer’s and consumer’s risks at the specified quality levels in terms of medians and 10th percentiles under the assumption that the termination time and the number of items in each group are pre-fixed. Finally, an example is given to illustration the methodology.

Keywords: group acceptance sampling plan, operating characteristic, consumer and producer’s risks, truncated life-test

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Authors: Chansheng He, Lanhui Zhang, Baoqing Zhang

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Spatial heterogeneity of landscape significantly affects watershed hydrological processes, particularly in high elevation and cold mountainous watersheds such as the inland river (terminal lake) basins in Northwest China, where the upper reach mountainous areas are the main source of streamflow for the downstream agricultural oases and desert ecosystems. Thus, it is essential to take into account spatial variations of hydrological processes in streamflow allocation at the watershed scale. This paper adapts the Distributed Large Basin Runoff Model (DLBRM) to the Heihe River Watershed, the second largest inland river with a drainage area of about 128,000 km2 in Northwest China, for understanding the transfer and partitioning mechanism among the glacier and snowmelt, surface runoff, evapotranspiration, and groundwater recharge among the upper, middle, and lower reaches in the study area. Results indicate that the upper reach Qilian Mountain area is the main source of streamflow for the middle reach agricultural oasis and downstream desert areas. Large withdrawals for agricultural irrigation in the middle reach had significantly depleted river flow for the lower reach desert ecosystems. Innovative conservation and enforcement programs need to be undertaken to ensure the successful implementation of water allocation plan of delivering 0.95 x 109 m3 of water downstream annually by the State Council in the Heihe River Watershed.

Keywords: DLBRM, Northwestern China, spatial variation, water allocation

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Authors: Basma Hussein Abdelaziz Hassan, Kareem Kamel, Philobater Bahgat Adly Awad, Karim Fahmy

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Background: Laparoscopic adjustable gastric band was one of the most applied and common bariatric procedures in the last 8 years. However; the failure rate was very high, reaching approximately 60% of the patients not achieving the desired weight loss. Most patients sought another revisional surgery. In which, we compared two of the most common weight loss surgeries performed nowadays: the laparoscopic sleeve gastrectomy and laparoscopic one- anastomosis gastric bypass. Objective: To compare the weight loss and postoperative outcomes among patients undergoing conversion laparoscopic one-anastomosis gastric bypass (cOAGB) and laparoscopic sleeve gastrectomy (cSG) after a failed laparoscopic adjustable gastric band (LAGB). Patients and Methods: A prospective cohort study was conducted from June 2020 to June 2022 at a single medical center, which included 77 patients undergoing single-stage conversion to (cOAGB) vs (cSG). Patients were reassessed for weight loss, comorbidities remission, and post-operative complications at 6, 12, and 18 months. Results: There were 77 patients with failed LAGB in our study. Group (I) was 43 patients who underwent cOAGB and Group (II) was 34 patients who underwent cSG. The mean age of the cOAGB group was 38.58. While in the cSG group, the mean age was 39.47 (p=0.389). Of the 77 patients, 10 (12.99%) were males and 67 (87.01%) were females. Regarding Body mass index (BMI), in the cOAGB group the mean BMI was 41.06 and in the cSG group the mean BMI was 40.5 (p=0.042). The two groups were compared postoperative in relation to EBWL%, BMI, and the co-morbidities remission within 18 months follow-up. The BMI was calculated post-operative at three visits. After 6 months of follow-up, the mean BMI in the cOAGB group was 34.34, and the cSG group was 35.47 (p=0.229). In 12-month follow-up, the mean BMI in the cOAGB group was 32.69 and the cSG group was 33.79 (p=0.2). Finally, the mean BMI after 18 months of follow-up in the cOAGB group was 30.02, and in the cSG group was 31.79 (p=0.001). Both groups had no statistically significant values at 6 and 12 months follow-up with p-values of 0.229, and 0.2 respectively. However, patients who underwent cOAGB after 18 months of follow-up achieved lower BMI than those who underwent cSG with a statistically significant p-value of 0.005. Regarding EBWL% there was a statistically significant difference between the two groups. After 6 months of follow-up, the mean EBWL% in the cOAGB group was 35.9% and the cSG group was 33.14%. In the 12-month follow-up, the EBWL % mean in the cOAGB group was 52.35 and the cSG group was 48.76 (p=0.045). Finally, the mean EBWL % after 18 months of follow-up in the cOAGB group was 62.06 ±8.68 and in the cSG group was 55.58 ±10.87 (p=0.005). Regarding comorbidities remission; Diabetes mellitus remission was found in 22 (88%) patients in the cOAGB group and 10 (71.4%) patients in the cSG group with (p= 0.225). Hypertension remission was found in 20 (80%) patients in the cOAGB group and 14 (82.4%) patients in the cSG group with (p=1). In addition, dyslipidemia remission was found in 27(87%) patients in cOAGB group and 17(70%) patients in the cSG group with (p=0.18). Finally, GERD remission was found in about 15 (88.2%) patients in the cOAGB group and 6 (60%) patients in the cSG group with (p=0.47). There are no statistically significant differences between the two groups in the post-operative data outcomes. Conclusion: This study suggests that the conversion of LAGB to either cOAGB or cSG could be feasibly performed in a single-stage operation. cOAGB had a significant difference as regards the weight loss results than cSG among the mid-term follow-up. However, there is no significant difference in the postoperative complications and the resolution of the co-morbidities. Therefore, cOAGB could provide a reliable alternative but needs to be substantiated in future long-term studies.

Keywords: laparoscopic, gastric banding, one-anastomosis gastric bypass, Sleeve gastrectomy, revisional surgery, weight loss

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Authors: Michaela Wang

Abstract:

Since British established colonial settlements across the East Coast, Native Americans have suffered stark socio economic disparities in comparison to their neighboring communities. This paper employs the 1990, 2000, and 2010 United States Decennial Census to assess whether and to what extent the casino economy helped to close this socioeconomic gap between the Mohegan tribe and its surrounding community. These three Decennial Censuses cover two decades, from six years prior to the erection of Mohegan Sun casino to 14 years afterwards, including the Great Recession 2007-2009. Income, employment, education and housing parameters are selected as socio economic indicators. The profitable advent of the Mohegan Sun in 1996 dramatically improved the socio economic status of the Mohegan Tribe between 1990 and 2000. In fact, for most of these indicators––poverty, median household income, employment, home ownership, and car ownership––disparities shifted; tribal socioeconomic parameters improved from well below the level of New London County in 1990, to the same level or above the county rates in 2000. However, economic downturn in 2007-2009 Great Recession impacted Mohegan people remarkably. By 2010, disparities for household income, employment, home ownership, and car ownership returned. The casino bridged socio economic inequalities, but at the face of economic crises, the mono-product economy grew vulnerable.

Keywords: socio economic, indigenous, native American, disparity

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Authors: N. Haj Salem, M. Belhadj, S. Ben Jomâa, R. Dhouieb, S. Saadi, M. A. Mesrati, A. Chadly

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Introduction: The hyoid bone is considered as one of many bones used to identify a missed person. There is a specificity of each population group in human identifications. Objective: To analyze the relationship between age, sex and metric parameters of hyoid bone in Tunisian population sample, using CT-scan. Materials and Methods: A prospective study was conducted in the Department of Forensic Medicine of FattoumaBourguiba Hospital of Monastir-Tunisia during 4 years. A total of 240 samples of hyoid bone were studied. The age of cases ranged from 18 days to 81 years. The specimens were collected only from the deceased of known age. Once dried, each hyoid bone was scanned using CT scan. For each specimen, 10 measurements were taken using a computer program. The measurements consisted of 6 lengths and 4 widths. A regression analysis was used to estimate the relationship between age, sex, and different measurements. For age estimation, a multiple logistic regression was carried out for samples ≤ 35 years. For sex determination, ROC curve was performed. Discriminant value finally retained was based on the best specificity with the best sensitivity. Results: The correlation between real age and estimated age was good (r²=0.72) for samples aged 35 years or less. The unstandardised canonical function equation was estimated using three variables: maximum length of the right greater cornua, length from the middle of the left joint space to the middle of the right joint space and perpendicular length from the centre point of a line between the distal ends of the right and left greater cornua to the centre point of the anterior view of the body of the hyoid bone. For sex determination, the ROC curve analysis reveals that the area under curve was at 81.8%. Discriminant value was 0.451 with a specificity of 73% and sensibility of 79%. The equation function was estimated based on two variables: maximum length of the greater cornua and maximum length of the hyoid bone. Conclusion: The findings of the current study suggest that metric analysis of the hyoid bone may predict the age ≤ 35 years. Sex estimation seems to be more reliable. Further studies dealing with the fusion of the hyoid bone and the current study could help to achieve more accurate age estimation rates.

Keywords: anthropology, age estimation, CT scan, sex determination, Tunisia

Procedia PDF Downloads 172

Authors: Jong Yeop Kim, Jong Bum Choi, Hyun Jeong Kwak, Sook Young Lee

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Background: Each supraglottic airway requires different anesthetic depth because it has a specific structure and different compressive force in the oropharyngeal cavity. We designed the study to investigate remifentanil effect-site concentration (Ce) in 50% of patients (EC50) for successful insertion of i- gel, and to compare it with that for laryngeal mask airway (LMA) insertion during propofol target-controlled infusion (TCI). Methods: Forty-one female patients were randomized to the i-gel group (n=20) or the LMA group (n=21). Anesthesia induction was performed using propofol Ce of 5 μg/ml and the predetermined remifentanil Ce, and i-gel or LMA insertion was attempted 5 min later. The remifentanil Ce was estimated by modified Dixon's up-and-down method (initial concentration: 3.0 ng/ml, step size: 0.5 ng/ml). The patient’s response to device insertion was classified as either ‘success (no movement)’ or ‘failure (movement)’. Results: Using the Dixon’s up and down method, EC50 of remifentanil Ce for i-gel (1.58 ± 0.41 ng/ml) was significantly lower than that for LMA (2.25 ± 0.55 ng/ml) (p=0.038). Using isotonic regression, EC50 (83% CI) of remifentanil in the i-gel group [1.50 (1.37-1.80) ng/ml] was statistically lower than that in the LMA group [2.00 (1.82-2.34) ng/ml]. EC95 (95% CI) of remifentanil in the i-gel group [2.38 (1.48-2.50) ng/ml] was statistically lower than that in the LMA group [3.35 (2.58-3.48) ng/ml]. Conclusion: We found that EC50 of remifentanil Ce for i-gel insertion (1.58 ng/ml) was significantly lower than that for LMA insertion (2.25 ng/ml), in female patients during propofol TCI without neuromuscular blockade.

Keywords: i-gel, laryngeal mask airway, propofol, remifentanil

Procedia PDF Downloads 386

Authors: K. P. v. R. de Silva, R. W. Senevirathna, M. M. A. J. Kumara, J. P. M. Kumarasinghe, R. L. Gunawardana, S. M. Uluwitiya, G. C. P. Jayawickrama, W. K. T. I. Madushani

Abstract:

Introduction: The limited literature supporting the utilization of mechanical bowel preparation (MBP) for patients undergoing laparoscopic anterior resection (LAR) remains a notable issue. This study was conducted to examine the clinical consequences of anastomosis in colorectal surgery with MBP compared to cases where MBP was not utilized (no-MBP) in the context of LAR. Methods: This was a retrospective comparative study conducted in the professorial surgical wards of the teaching hospital karapitiya (THK). Colorectal cancer patients(n=306) participated in the study, including 151 MBP patients and 155 no-MBP patients, where the postoperative complications and mortality rates were compared. Results: The anastomotic leakage rate was 2.6%(n=4) in the no-MBP group and 6.0%(n=9) in the MBP group (p=0.143). The postoperative paralytic ileus rate was 18.5%(n=28) and 5.8%(n=9) in the MBP group and no-MBP group, respectively, displaying a statistically significant difference (p=0.001). Wound infection, pneumonia, urinary tract infection, and cardiac complication rates also were higher in the MBP group. The overall mortality rate was 1.3%(n=3) in the no-MBP group and 2.0%(n=2) in the MBP group. Conclusions: The evidence concludes that MBP increases post-operative complications. Therefore, prophylactic MBP in LAR has not been proven to benefit patients. However, further research is necessary to understand the comparative effects of MBP versus no preparation comprehensively.

Keywords: MBP, anastomosis, LAR, paralytic ileus

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Authors: Sizhu Wang, Cuisong Tang, Lin Zhang, Guangyu Tang

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Objective: We aimed to detect the composition of bone marrow fatty acids early after ovariectomized (OVX) surgery and explore the potential mechanism. Methods: Thirty-two female Sprague-Dawley (SD) rats (12 weeks) were randomly divided into OVX group and Sham group (N=16/group), and received ovariectomy or sham surgery respectively. After 3 and 28 days, eight rats in each group were sacrificed to detect the composition of bone marrow fatty acids by gas chromatography–mass spectrometry (GC–MS) and evaluate the trabecular bone microarchitecture by micro-CT. Significant different fatty acids in the early stage of post-menopausal osteoporosis were selected by OPLS-DA and t test. Then selected fatty acids were further studied in the process of osteogenic differentiation through RT-PCR and Alizarin Red S staining. Results: An apparent sample clustering and group separation were observed between OVX group and sham group three days after surgery, which suggested the role of bone marrow fatty acids in the early stage of postmenopausal osteoporosis. Specifically, myristate, palmitoleate and arachidonate were found to play an important role in classification between OVX group and sham group. We further investigated the effect of palmitoleate and arachidonate on osteogenic differentiation and found that palmitoleate promoted the osteogenic differentiation of MC3T3-E1 cells while arachidonate inhibited this process. Conclusion: Profound bone marrow fatty acids changes have taken place in the early stage of post-menopausal osteoporosis. Bone marrow fatty acids may begin to affect osteogenic differentiation shortly after deficiency of estrogen.

Keywords: bone marrow fatty acids, GC-MS, osteoblast, osteoporosis, post-menopausal

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Authors: Jiří F. Urbánek, David Král

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Small and Middle Enterprises (SME) have a specific mission, characteristics, and behavior in global business competitive environments. They must respect policy, rules, requirements and standards in all their inherent and outer processes of supply - customer chains and networks. Paper aims and purposes are to introduce computational assistance, which enables us the using of prevailing operation system MS Office (SmartArt...) for mathematical models, using DYVELOP (Dynamic Vector Logistics of Processes) method. It is providing for SMS´s global environment the capability and profit to achieve its commitment regarding the effectiveness of the quality management system in customer requirements meeting and also the continual improvement of the organization’s and SME´s processes overall performance and efficiency, as well as its societal security via continual planning improvement. DYVELOP model´s maps - the Blazons are able mathematically - graphically express the relationships among entities, actors, and processes, including the discovering and modeling of the cycling cases and their phases. The blazons need live PowerPoint presentation for better comprehension of this paper mission – added value analysis. The crisis management of SMEs is obliged to use the cycles for successful coping of crisis situations.  Several times cycling of these cases is a necessary condition for the encompassment of the both the emergency event and the mitigation of organization´s damages. Uninterrupted and continuous cycling process is a good indicator and controlling actor of SME continuity and its sustainable development advanced possibilities.

Keywords: blazons, computational assistance, DYVELOP method, small and middle enterprises

Procedia PDF Downloads 341

Authors: Shikha Gupta, Suneet Kathuria, Supriya Sampley, Sunil Katyal

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Opioids are being increasingly used these days as adjuvants to local anesthetics in spinal anesthesia. The aim of this prospective, randomized, double‑blind study is to compare the effects of adding sufentanil or fentanyl to low dose bupivacaine in spinal anesthesia for endoscopic urological procedures. A total of 90 elective endoscopic urological surgery patients, 40‑80 years old, received spinal anesthesia with 7.5 mg hyperbaric bupivacaine 0.5% (Group A) or by adding sufentanil 10 μg (Group B) or fentanyl 25 μg (Group C) to 5 mg hyperbaric bupivacaine 0.5%. These groups were compared in terms of the quality of spinal anesthesia as well as analgesia. Analysis of variance and Chi‑square test were used for Statistical analysis. The onset of sensory and motor blockade was significantly rapid in Group A as compared with Groups B and C. The maximum upper level of sensory block was higher in Group A patients than Groups B and C patients. Quality of analgesia was significantly better and prolonged in sufentanil group as compared with other two groups. Motor block was more intense and prolonged in Group A as compared with Groups B and C patients. Request for post‑operative analgesic was significantly delayed in Group B patients. Hence in conclusions, spinal anesthesia for endoscopic urological procedures in elderly patients using low dose bupivacaine (5 mg) combined with 10 μg sufentanil is associated with a lower incidence of hemodynamic instability, better quality and prolonged duration as compared to that by adding 25 μg fentanyl.

Keywords: adjuvants, bupivacaine, fentanyl, intrathecal, low dose spinal, sufentanil

Procedia PDF Downloads 375

Authors: Reham H. Diab, Amira A. A. Abdallah, Eman A. Embaby

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Background: The effectiveness of bracing on preventing spino-pelvic alignment deterioration in idiopathic scoliosis has been extensively studied especially in the frontal plane. Yet, there is lack of knowledge regarding the effect of soft braces on spino-pelvic alignment in the sagittal plane. Achieving harmonious sagittal plane spino-pelvic balance is critical for the preservation of physiologic posture and spinal health. Purpose: This study examined the kyphotic angle, lordotic angle and pelvic inclination in the sagittal plane and trunk imbalance in the frontal plane before and after a six-month rehabilitation period. Methods: Nineteen patients with idiopathic scoliosis participated in the study. They were divided into two groups; experimental and control. The experimental group (group I) used the SpineCor brace in addition to a rehabilitation exercise program while the control group (group II) had the exercise program only. The mean ±SD age, weight and height were 16.89±2.15 vs. 15.3±2.5 years; 59.78±6.85 vs. 62.5±8.33 Kg and 162.78±5.76 vs. 159±5.72 cm for group I vs. group II. Data were collected using for metric Π system. Results: Mixed design MANOVA showed that there were significant (p < 0.05) decreases in all the tested variables after the six-month period compared with “before” in both groups. Moreover, there was a significant decrease in the kyphotic angle in group I compared with group II after the six-month period. Interpretation and conclusion: SpineCor brace is beneficial in reducing spino-pelvic alignment deterioration in both sagittal and frontal planes.

Keywords: adolescent idiopathic scoliosis, SpineCor, spino-pelvic alignment, biomechanics

Procedia PDF Downloads 340

Authors: Rajendra Kanojia

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Femoral components with inbuilt rotation require thicker flexion resection of the lateral femoral condyle and could potential risk to damage the popliteus tendon especially in the smaller Asian knees. We prospectively evaluated 10 patients with bilateral varus osteoarthritis knee to size the cuts and their location in relation to the popliteus tendon. Two different types of implant were used on either side, one side requires resection in 3° external rotation (group A) and other side femoral component with inbuilt external roation (group B). We had popliteus tendon injury in 3 knees all from group B. Risk of damaging the popliteus tendon was found higher in group B.

Keywords: popliteaus tendon injury, TKA, orthopaedic surgery, biomechanics and clinical applications

Procedia PDF Downloads 334

Authors: Kejal Joshi Reddy, Sirimavo Nair

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Micronutrient malnutrition affects pregnant women and children extremely with reference to growth manifestations in gestation as well as after birth. Early fetal development affected by iodine and iron deficiency leads to poor life quality. Various researchers have found interesting interrelations between iron and iodine. A few studies on impact assessment of DFS supplementation during pregnancy have been reported in India. Aim To provide meaningful contribution by assessing the efficacy of DFS supplementation on iodine and iron status of pregnant women. Design An interventional study. Setting A semi government hospital of urban Vadodara. Subjects Pregnant women (n=150) enrolled during first trimester (< 12 weeks) and followed up till the end of gestation, n=75 were divided in experimental (DFS supplemented) and control (Non supplemented) group. Results Impact on iron and iodine status was assessed by Hb concentration and UIE respectively. Mean Hb improved significantly (p < 0.001) (+0.42 g/dl) in experimental group and reduced non significantly (-0.20 g/dl) in control group at the end, since DFS provided additional 93 mg of iron within 6 months. Median UIE improved non significantly (278.6 to 299.01µg/L) in experimental group and decreased significantly (p < 0.05) (376.59 to 288.66 µg/L) in control group. Conclusion DFS could improve iron and iodine status of experimental group compared to control group. It is an effective measure to control two essential micronutrient deficiencies together.

Keywords: DFS supplementation, anemia, pregnancy, iodine deficiency, iron

Procedia PDF Downloads 470