Search results for: minimal invasive

Authors: Jui-Hung Hung, Ching-Liang Hsieh, Yi-Wen Lin

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Modern medicine highly emphasizes the importance of palliative treatment. The inception of palliative and hospice care recently developed into the concept of caring for the patients’ and families’ physical, psychological and spiritual problems. There are several benefits related to palliative care such as reducing medical expenses, decreasing patients’ suffer, and supporting patient go through the finale of the life. Nowadays, in Taiwan, over 60-70% terminal cancer patients were covered in hospice care, and the coverage rate increased annually. Acupuncture is a well-known therapy used more than thousand years to relieve symptoms of cancer patient. Many reports showed that, even in the Western society, many reputable medical centers can provide Acupuncture therapy for patients. Accordingly, using Acupuncture for cancer patient care is a global trend. There are increased evidences indicate that Acupuncture can relieve the symptoms for cancer patients including pain, reduce the dosage of anesthetic, improve the cancer-related fatigue, relieve the chemotherapy-related nausea and vomiting, ease anxiety mood and even improving the quality of life. Furthermore, some trials show that Acupuncture may help relieve xerostomia, hot flash, sleep disorders, and some GI discomfort and so on. Acupuncture therapy has many advantages for clinical use with effective, low-cost, minimal side effect, suitable for cancer patients and even for elderly population. Especially in nowadays, there are more diversified challenges in modern medicine, all of them will make the higher medical budget. We suggest that Acupuncture will be one of methods for palliative care for cancer patients.

Keywords: Acupuncture, cancer, integrative medicine, palliative care

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Authors: Shokouh Momeni, Mohammad Reza Salamat, Ali Asghar Rastegari

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Background: Osteoporosis is the most prevalent metabolic bone disease in postmenopausal women associated with reduced bone mass and increased bone fracture. Measuring bone density in the lumbar spine and hip is a reliable measure of bone mass and can therefore specify the risk of fracture. Dual-energy X-ray absorptiometry(DXA) is an accurate non-invasive system measuring the bone density, with low margin of error and no complications. The present study aimed to investigate the relationship between biochemical parameters with bone density in postmenopausal women. Materials and methods: This cross-sectional study was conducted on 87 postmenopausal women referred to osteoporosis centers in Isfahan. Bone density was measured in the spine and hip area using DXA system. Serum levels of calcium, phosphorus, alkaline phosphatase and magnesium were measured by autoanalyzer and serum levels of vitamin D were measured by high-performance liquid chromatography(HPLC). Results: The mean parameters of calcium, phosphorus, alkaline phosphatase, vitamin D and magnesium did not show a significant difference between the two groups(P-value>0.05). In the control group, the relationship between alkaline phosphatase and BMC and BA in the spine was significant with a correlation coefficient of -0.402 and 0.258, respectively(P-value<0.05) and BMD and T-score in the femoral neck area showed a direct and significant relationship with phosphorus(Correlation=0.368; P-value=0.038). There was a significant relationship between the Z-score with calcium(Correlation=0.358; P-value=0.044). Conclusion: There was no significant relationship between the values ​​of calcium, phosphorus, alkaline phosphatase, vitamin D and magnesium parameters and bone density (spine and hip) in postmenopaus

Keywords: osteoporosis, menopause, bone mineral density, vitamin d, calcium, magnesium, alkaline phosphatase, phosphorus

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Authors: Tia Morosin, Marie Shella De Robles

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Rectocele may be associated with symptoms of both obstructed defecation and faecal incontinence. Currently, numerous operative techniques exist to treat patients with rectocele; however, no single technique has emerged as the optimal approach in patients with post-partum faecal incontinence. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele for patients presenting with faecal incontinence as the predominant symptom. Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon. All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range 21 to 90 years). The median operating time and length of hospital stay were 2 hours and 7 days, respectively. Two patients developed urinary retention post-operatively, which required temporary bladder catheterization. One patient had wound dehiscence, which was managed by absorbent dressing applied by the patient and her carer. There was no operative mortality. In all patients with rectocele, there was a concomitant anal sphincter disruption. All patients had satisfactory improvement with regard to faecal incontinence on follow-up. This study suggests this method provides excellent anatomic and physiologic results with minimal morbidity. However, because none of the patients gained full continence postoperatively, pelvic floor rehabilitation might be also needed to achieve better sphincter function in patients with incontinence.

Keywords: anal sphincter defect, faecal incontinence, rectocele, transperineal repair

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Authors: Jean-Paul Kapuya Bulaba Nyembwe, John Omomoluwa Ogundiran, Manuel Carlos Gameiro da Silva

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Indoor environmental quality (IEQ) remains a global concern because it impacts people's comfort, health, performance, and general well-being. People spend a significant amount of time in buildings or while commuting, hence ensuring the minimal risk in indoor spaces by ensuring suitable IEQ. IEQ studies are limited regarding developing sub-Saharan countries, whereas there is also a huge risk and concern for the current population and geometric growth as many cities in the region will become mega-cities by 2040 (World Bank report). The absence of suitable IEQ regulations and energy poverty are reasons to assess the IEQ gaps for increased awareness of sustainable interventions to minimize the associated risk. This study evaluates the gaps and potential hazards that exist in the IEQ of sub-Saharan countries using empirical studies of hospital occupants and BRT bus passengers and drivers. The Surveys were conducted in 3 cities of the Democratic Republic of Congo and Lagos metropolis of Nigeria. The results suggest that gaps exist in IEQ for these regions. The gaps indicate existential risk to people’s health, comfort, and well-being. The inferential conclusions are that there is a need for further scientific studies, improvement in IEQ conditions, and ensuring suitable regulations for developing sub-Saharan countries.

Keywords: health hazards, hospitals indoor environmental quality, indoor spaces, occupants, sub-Saharan countries, vehicles

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Authors: Zohreh Didar Yaser, Zanganeh Asadabadi

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The aim of this work is to open up the structure of lemon peel (Citrus × latifolia) with mild pretreatments. The effects of autoclave, microwave and ultrasonic with or without acid addition were investigated on the amount of glucose, soluble and insoluble lignin, furfural, yeast viability and bioethanol. The finding showed that autoclave- acid impregnated sample, has the highest glucose release from lignocellulose materials (14.61 and 14.95 g/l for solvent exposed and untreated sample, respectively) whereas at control sample glucose content was at its minimal level. Pretreatments cause decrease on soluble and insoluble lignin and the highest decrease cause by autoclave following with microwave and ultrasonic pretreatments (p≤5%). Moderate increase on furfural was seen at pretreated samples than control ones. Also, the most yeast viability and bioethanol content was belong to autoclave samples especially acid- impregnated ones (40.33%). Comparison between solvent treated and untreated samples indicated that significant difference was between two tested groups (p≤1%) in terms of lignin, furfural, cell viability and ethanol content but glucose didn’t show significant difference. It imply that solvent extraction don’t influences on glucose release from lignocellulose material of lemon peel but cause enhancement of yeast viability and bioethanol production.

Keywords: Bioethanol, Lemon peel, Pretreatments, Solvent Extraction

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Authors: Szu-Kai Hsu, Po-Ching Lin

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As more and more multi-core processors emerge, traditional sequential programming paradigm no longer suffice. Yet only few modern dynamic programming languages can leverage such advantage. Ruby, for example, despite its wide adoption, only includes threads as a simple parallel primitive. The global virtual machine lock of official Ruby runtime makes it impossible to exploit full parallelism. Though various alternative Ruby implementations do eliminate the global virtual machine lock, they only provide developers dated locking mechanism for data synchronization. However, traditional locking mechanism error-prone by nature. Software Transactional Memory is one of the promising alternatives among others. This paper introduces a new virtual machine: GobiesVM to provide a native software transactional memory based solution for dynamic programming languages to exploit parallelism. We also proposed a simplified variation of Transactional Locking II algorithm. The empirical results of our experiments show that support of STM at virtual machine level enables developers to write straightforward code without compromising parallelism or sacrificing thread safety. Existing source code only requires minimal or even none modi cation, which allows developers to easily switch their legacy codebase to a parallel environment. The performance evaluations of GobiesVM also indicate the difference between sequential and parallel execution is significant.

Keywords: global interpreter lock, ruby, software transactional memory, virtual machine

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Authors: Gangacharyulu Dasaroju, Sumeet Sharma, Sanjay Singh

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Heat pipe is characterised as superconductor of heat because of its excellent heat removal ability. The operation of several engineering system results in generation of heat. This may cause several overheating problems and lead to failure of the systems. To overcome this problem and to achieve desired rate of heat dissipation, there is need to study the performance of heat pipe with annular fins under free convection at different inclinations. This study demonstrates the effect of different mass flow rate of hot fluid into evaporator section on the condenser side heat transfer coefficient with annular fins under natural convection at different inclinations. In this study annular fins are used for the experimental work having dimensions of length of fin, thickness of fin and spacing of fin as 10 mm, 1 mm and 6 mm, respectively. The main aim of present study is to discover at what inclination angles the maximum heat transfer coefficient shall be achieved. The heat transfer coefficient on the external surface of heat pipe condenser section is determined by experimental method and then predicted by empirical correlations. The results obtained from experimental and Churchill and Chu relation for laminar are in fair agreement with not more than 22% deviation. It is elucidated the maximum heat transfer coefficient of 31.2 W/(m²-K) at 25˚ tilt angle and minimal condenser heat transfer coefficient of 26.4 W/(m²-K) is seen at 45˚ tilt angle and 200 ml/min mass flow rate. Inclination angle also affects the thermal performance of heat pipe. Beyond 25^o inclination, heat transport rate starts to decrease.

Keywords: heat pipe, annular fins, natural convection, condenser heat transfer coefficient, tilt angle

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Authors: Kumari Bandana Bhatt, Navin Bhatt

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Background: Orphans and vulnerable children (OVC) are high risk of physical, mental, sexual and emotional abuse and face social stigma and discrimination which significantly increase the risk of mental and behavioral disorders such as anxiety, depression or emotional problems even they stay in well run child care homes. The objective of this study was to estimate the prevalence of depression and determine the determinants among OVC in child care homes in Nepal. Methods: An institutional-based analytical cross-sectional study was conducted in twenty orphanages of five districts of Nepal. Six hundred two children were recruited into the study. After the informed consent form obtaining, the guardian and assent were interviewed by a semi-structured questionnaire and Beck Depression Inventory-II (BDI-II). Logistic regression was used for detecting the association between variables at the significant level of =0.05. Results: The study revealed that 33.20% of OVC had depression. Among them 66.80% of children experienced minimal depression, 17.40% had mild depression, 11.30% had moderate depression 4.50% had severe depression. Sex, alcohol drinking, congenital problem, social support and bully were the main variables associated with depression among OVC of the child care homes in Nepal. Conclusion: Prevalence of depression was high among the orphans and vulnerable children living in child care homes especially among the female children in Nepal. Therefore, early identification and instituting of preventive measures of depression are essential to reduce this problem in this special group of children living in child care homes.

Keywords: Mental health, Depression, Orphans and vulnerable children, child care homes

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Authors: Sinwook Park, Gilad Yossifon

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The presence of a floating electrode array located within the depletion layer formed due to concentration-polarization (CP) across a microchannel-membrane device, produces not only induced-charge electro-osmosis (ICEO) vortex and but also a bipolar current resulting from faradaic reactions. It has been shown that there exists an optimal SiO2 layer thickness of ~50nm which is sufficient to suppress bipolar currents (at least up to 5V applied voltage) but still enables ICEO vortices that stir the depletion layer, thereby affecting its I-V response. This effect is pronounced beyond the limiting current where the existence of the depletion layer results in increased local electric field due to decreased solution conductivity. This comprehensive study of the interaction of embedded electrodes with the induced CP in microchannel-perm selective medium systems, allows one to choose the thickness of the thin dielectric coating to either enhance the mixing as a means to control the diffuse layer, or suppress it, for example, in the case where electrodes are intended for local measurements of the solution conductivity with minimal invasion. In addition, the use of alternating-current electro-osmosis by activating electrodes results in further enhancement of the fluid stirring and opens new routes for on-demand spatiotemporal control of the CP length. In addition, the use of embedded heaters within the depletion layer generates electro-thermal vortices that in turn also control the CP length.

Keywords: AC electrokinetics, microchannel, concentration-polarization, bipolar current

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Authors: A. Iaaly, O. Jadayel, R. Jadayel

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This paper explores the effectiveness of approaches used for the implementation of technology within central governments specifically Geographic Information Systems (GIS). It examines the extent to which various strategies to GIS implementation and its roll out to users within an organization is crucial for its long term assimilation. Depending on the contextual requirements, various implementation strategies exist spanning from the most revolutionary to the most evolutionary, which have an influence on the success of GIS projects and the realization of resulting business benefits within the central governments. This research compares between two strategies of GIS implementation within the Lebanese Municipalities. The first strategy is the “Technological Approach” which is focused on technology acquisition, overlaid on existing governmental frameworks. This approach gives minimal attention to capability building and the long term sustainability of the implemented program. The second strategy, referred to as the “Ecological Approach”, is naturally oriented to the function of the organization. This approach stresses on fostering the evolution of the program and on building the human capabilities. The Union of the Joumeh Municipalities will be presented as a case study under the “Ecological Approach” and the role of the GIS Center at the University of Balamand will be highlighted. Thus, this research contributes to the development of knowledge on technology implementation and the vital role of academia in the specific context of the Lebanese public sector so that this experience may pave the way for further applications.

Keywords: ecological approach GIS, low income countries, technological approach

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Authors: Amanda Madden

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The purpose of this research was to identify students understanding of well-being and perceptions of the effective components of school-based well-being programs they have participated in during their time in secondary school. With one in four adolescents suffering from some form of mental health disorder, which has the potential to directly impact their academic ability, schools have moved towards a more holistic approach to education, resulting in the growth of school-based well-being programs. There is limited research on the effectiveness of school-based well-being programs, with fewer studies examining students’ perspectives on their well-being. A mixed-method design was utilized, framed by a social constructivist methodology. Quantitative data was collected through a researcher-developed self-report survey, and qualitative data were collected through one-on-one interviews and a semi-structured focus group undertaken with Year 12 students from three independent co-educational schools in Western Australia. Preliminary findings indicate that participants have experienced a minimal impact, either positively or negatively, on their well-being from school-based well-being programs. The data detailed that adolescents consider happiness, positive attitude, good physical health, balance, emotional fulfillment and confidence components of well-being. The findings also highlighted sports, positive family relationships, positive friendships, and pets positively enhanced well-being. This research suggests that researchers and educational leaders should consider students’ understanding of well-being in the development of school-based well-being assessments and interventions. Students are the recipients of school-based well-being programs and are best placed to inform what they will and will not respond to in the determination of appropriate well-being content.

Keywords: wellbeing, school based wellbeing, adolescents, wellbeing interventions

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Authors: Andrea Treviño Gavito, Diego Klabjan, Sanjiv J. Shah

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Echocardiograms serve as pivotal resources for clinicians in diagnosing cardiac conditions, offering non-invasive insights into a heart’s structure and function. When echocardiographic studies are conducted, no standardized labeling of the acquired views is performed. Employing machine learning algorithms for automated echocardiogram view detection has emerged as a promising solution to enhance efficiency in echocardiogram use for diagnosis. However, existing approaches predominantly rely on supervised learning, necessitating labor-intensive expert labeling. In this paper, we introduce a fully unsupervised echocardiographic view detection framework that leverages convolutional autoencoders to obtain lower dimensional representations and the K-means algorithm for clustering them into view-related groups. Our approach focuses on discriminative patches from echocardiographic frames. Additionally, we propose a trainable inverse average layer to optimize decoding of average operations. By integrating both public and proprietary datasets, we obtain a marked improvement in model performance when compared to utilizing a proprietary dataset alone. Our experiments show boosts of 15.5% in accuracy and 9.0% in the F-1 score for frame-based clustering, and 25.9% in accuracy and 19.8% in the F-1 score for view-based clustering. Our research highlights the potential of unsupervised learning methodologies and the utilization of open-sourced data in addressing the complexities of echocardiogram interpretation, paving the way for more accurate and efficient cardiac diagnoses.

Keywords: artificial intelligence, echocardiographic view detection, echocardiography, machine learning, self-supervised representation learning, unsupervised learning

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Authors: Emma K. Sales

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Durian is the flagship fruit of Mindanao and there is an abundance of several cultivars with many confusing identities/ names. The project was conducted to develop procedure for reliable and rapid detection and sorting of durian planting materials. Moreover, it is also aimed to establish specific genetic or DNA markers for routine testing and authentication of durian cultivars in question. The project developed molecular procedures for routine testing. SSR primers were also screened and identified for their utility in discriminating durian cultivars collected. Results of the study showed the following accomplishments; 1. Twenty (29) SSR primers were selected and identified based on their ability to discriminate durian cultivars, 2. Optimized and established standard procedure for identification and authentication of Durian cultivars 3. Genetic profile of durian is now available at Biotech Unit. Our results demonstrate the relevance of using molecular techniques in evaluating and identifying durian clones. The most polymorphic primers tested in this study could be useful tools for detecting variation even at the early stage of the plant especially for commercial purposes. The process developed combines the efficiency of the microsatellites development process with the optimization of non-radioactive detection process resulting in a user-friendly protocol that can be performed in two (2) weeks and easily incorporated into laboratories about to start microsatellite development projects. This can be of great importance to extend microsatellite analyses to other crop species where minimal genetic information is currently available. With this, the University can now be a service laboratory for routine testing and authentication of durian clones.

Keywords: DNA, SSR analysis, genotype, genetic diversity, cultivars

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Authors: Ayda Khosravanihaghighi, Pramod Koshy, Bill Walsh, Vedran Lovric, Charles Christopher Sorrell

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There is an increasing demand for orthopedic implants owing to the increasing numbers of the aging population. Titanium alloy (Ti6Al4V) is a common material used for orthopedic implants owing to its advantageous properties in terms of good corrosion resistance, minimal elastic modulus mismatch with bone, bio-inertness, and high mechanical strength. However, it is important to improve the bioactivity and osseointegration of the titanium alloy and this can be achieved by coating the implant surface with suitable ceramic materials. In the present work, pure and doped-ceria (CeO₂) coatings were deposited by spin coating on the titanium alloy surface in order to enhance the biological interactions between the surface of the implant and the surrounding tissue. In order to examine the bone-binding ability of an implant, simulated body fluid (SBF) tests were conducted in order to assess the capability of apatite layer formation on the surface and thus predict in vivo bone bioactivity. Characterization was done using scanning electron microscopy (SEM) and X-ray diffraction (XRD) analyses to determine the extent of apatite formation. Preliminary tests showed that the CeO₂ coatings were biocompatible and that the extent of apatite formation and its characteristics can be enhanced by doping with suitable metal ions.

Keywords: apatite layer, biocompatibility, ceria, orthopaedic implant, SBF, spin coater, Ti-implant

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Authors: Iveta Bryjova

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Recording of viscoelastic strain-vs-time curves with the aid of the suction method and a follow-up analysis, resulting into evaluation of standard viscoelastic parameters, is a significant technique for non-invasive contact diagnostics of mechanical properties of skin and assessment of its conditions, particularly in acute burns, hypertrophic scarring (the most common complication of burn trauma) and reconstructive surgery. For elimination of the skin thickness contribution, usable viscoelastic parameters deduced from the strain-vs-time curves are restricted to the relative ones (i.e. those expressed as a ratio of two dimensional parameters), like grosselasticity, net-elasticity, biological elasticity or Qu’s area parameters, in literature and practice conventionally referred to as R2, R5, R6, R7, Q1, Q2, and Q3. With the exception of parameters R2 and Q1, the remaining ones substantially depend on the position of inflection point separating the elastic linear and viscoelastic segments of the strain-vs-time curve. The standard algorithm implemented in commercially available devices relies heavily on the experimental fact that the inflection time comes about 0.1 sec after the suction switch-on/off, which depreciates credibility of parameters thus obtained. Although the Qu’s US 7,556,605 patent suggests a method of improving the precision of the inflection determination, there is still room for nonnegligible improving. In this contribution, a novel method of inflection point determination utilizing the advantageous properties of the Savitzky–Golay filtering is presented. The method allows computation of derivatives of smoothed strain-vs-time curve, more exact location of inflection and consequently more reliable values of aforementioned viscoelastic parameters. An improved applicability of the five inflection-dependent relative viscoelastic parameters is demonstrated by recasting a former study under the new method, and by comparing its results with those provided by the methods that have been used so far.

Keywords: Savitzky–Golay filter, scarring, skin, viscoelasticity

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Authors: Mokoena Oratilwe Penwell, Seeletse Solly Matshonisa

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The demand for quality products is a vital factor determining the success of a producing company, and the reality of this demand influences customer satisfaction. In Sefako Makgatho Health Sciences University (SMU), concerns over the quality of food being sold have been raised by mostly students and staff who are primary consumers of food being sold by the cafeteria. Suspicions of food poisoning and the occurrence of diarrhea-related to food from the cafeteria, amongst others, have been raised. However, minimal measures have been taken to resolve the issue of food quality. New service providers have been appointed, and still, the same trends are being observed, the quality of food seems to depreciate continuously. This paper uses multi-attribute failure mode analysis (MAFMA) for failure detection and minimization on the machines used for food production by SMU catering company before being sold to both staff, and students so as to improve production plant reliability, and performance. Analytical Hierarchy Process (AHP) will be used for the severity ranking of the weight criterions and development of the hierarchical structure for the cafeteria company. Amongst other potential issues detected, maintenance of the machines and equipment used for food preparations was of concern. Also, the staff lacked sufficient hospitality skills, supervision, and management in the cafeteria needed greater attention to mitigate some of the failures occurring in the food production plant.

Keywords: MAFMA, food quality, maintenance, supervision

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Authors: Meghamala Nugehally

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This paper hypothesises and draws inferences on the impact of minimalism in dance education on the development of artistic and aesthetic sensibilities in individuals in the age group of 5-18 yrs of age. This research and conclusions are within the context of Indian Classical Dance, which is based on Indian theories of aesthetics drawn from the Natyashastra, an ancient treatise on Indian dance and drama. The research employs training methods handed down through a strict one-on-one teacher-student tradition known as the Guru-Shishya Parampara. Aesthetic principles used are defined, and basic theories from the Natyashastra are explained to provide background for the research design. The paper also discusses dance curriculum design and training methodology design within the context of these aesthetic theories. The scope of the research is limited to two genres of Indian classical forms: Bharatanatyam and Odissi. A brief description of these dance forms is given as background and dance aesthetics specific to these forms are described. The research design includes individual case studies of subjects studied, independent predetermined attributes for observations and a qualitative scoring methodology devised for the purpose of the study. The study describes the training techniques used and contrasts minimal solo training techniques with the more elaborate group training techniques. Study groups were divided and the basis for the division are discussed. Study observations are recorded and presented as evidences. The results inform the conclusion and set the stage for further research in this area.

Keywords: dance aesthetics, dance education, Indian classical dance, minimalism

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Authors: Kuan-Wei Chen, Chien-Wei Chen, Tai-Ling Chang, Nan-Cheng Chen, Ching-Lin Hsieh, Gong-Hong Lin

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Background and Purposes: Deficits in sustained attention are common in patients with schizophrenia. Such impairment can limit patients to effectively execute daily activities and affect the efficacy of rehabilitation. The aims of this study were to examine the test-retest agreement, random measurement error, and practice effect of the Continuous Performance Test-Identical Pairs (CPT-IP) (a commonly used sustained attention test) in patients with schizophrenia. The results can provide empirical evidence for clinicians and researchers to apply a sustained attention test with sound psychometric properties in schizophrenia patients. Methods: We recruited patients with chronic schizophrenia to be assessed twice with 1 week interval using CPT-IP. The intra-class correlation coefficient (ICC) was used to examine the test-retest agreement. The percentage of minimal detectable change (MDC%) was used to examine the random measurement error. Moreover, the standardized response mean (SRM) was used to examine the practice effect. Results: A total of 56 patients participated in this study. Our results showed that the ICC was 0.82, MDC% was 47.4%, and SRMs were 0.36 for the CPT-IP. Conclusion: Our results indicate that CPT-IP has acceptable test-retests agreement, substantial random measurement error, and small practice effect in patients with schizophrenia. Therefore, to avoid overestimating patients’ changes in sustained attention, we suggest that clinicians interpret the change scores of CPT-IP conservatively in their routine repeated assessments.

Keywords: schizophrenia, sustained attention, CPT-IP, reliability

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Authors: Yamina Boukari, Nashiru Billa, Andrew Morris, Stephen Doughty, Kevin Shakesheff

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Poly (lactic-co-glycolic) acid (PLGA) is a synthetic polymer that can be used in bone tissue engineering with the aim of creating a scaffold in order to support the growth of cells. The formation of microspheres from this polymer is an attractive strategy that would allow for the development of an injectable system, hence avoiding invasive surgical procedures. The aim of this study was to develop a microsphere delivery system for use as an injectable scaffold in bone tissue engineering and evaluate various formulation parameters on its properties. Porous and lysozyme-containing PLGA microspheres were prepared using the double emulsion solvent evaporation method from various molecular weights (MW). Scaffolds were formed by sintering to contain 1 -3mg of lysozyme per gram of scaffold. The mechanical and physical properties of the scaffolds were assessed along with the release of lysozyme, which was used as a model protein. The MW of PLGA was found to have an influence on microsphere size during fabrication, with increased MW leading to an increased microsphere diameter. An inversely proportional relationship was displayed between PLGA MW and mechanical strength of formed scaffolds across loadings for low, intermediate and high MW respectively. Lysozyme release from both microspheres and formed scaffolds showed an initial burst release phase, with both microspheres and scaffolds fabricated using high MW PLGA showing the lowest protein release. Following the initial burst phase, the profiles for each MW followed a similar slow release over 30 days. Overall, the results of this study demonstrate that lysozyme can be successfully incorporated into porous PLGA scaffolds and released over 30 days in vitro, and that varying the MW of the PLGA can be used as a method of altering the physical properties of the resulting scaffolds.

Keywords: bone, microspheres, PLGA, tissue engineering

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Authors: Rizwan Iqbal

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Introduction: Re-TURBT has been recommended by international guidelines for patients with non-muscle invasive bladder cancer (NMIBC) who are deemed high-risk. Indications for re-TURBTs remain controversial and studies show mixed outcomes. It should be performed when the initial TURBT specimen lacks detrusor muscle, has tumor stage pT1 or G3/high-grade, or where resection is deemed incomplete. This ensures complete resection of tumors that have a high risk of recurrence as well as accurately identifying any tumors which have been upstaged. The aim of this audit was to evaluate the quality of re-TURBTs in a district general hospital. Method: Data were retrospectively collected from 31 patients who had re-TURBTs between April 2021 and September 2022. Data included baseline demographics, time from initial to re-TURBT, quality of operation note, presence of residual tumor, complications, and administration of chemotherapy within 24 hours of the initial TURBT. Data collection remains ongoing at the time of writing. Results: The mean age was 76 years old and 71.0% of patients were male. 32.3% of patients had their re-TURBT within six weeks and 32.3% had intravesical chemotherapy administered within 24 hours of the initial TURBT. 74.2% of initial TURBTs had detrusor muscle present in the specimen. 48.4% of patients had residual disease following re-TURBT. Just one patient had their pathology upstaged at re-TURBT. The use of the TURBT proforma on the operation note was variable, with 51.6% and 38.7% of surgeons using the proforma after the initial and re-TURBT. Conclusion: Re-TURBT improves bladder cancer staging and is necessary in patients who are deemed high-risk in order to identify any upstaging or recurrence of the disease.

Keywords: urology, bladder cancer, turbt, cancer

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Authors: Maha Saliba Foster

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Speech perception has been recognized as a bi-sensory process involving the auditory and visual channels. Compared to the auditory modality, the contribution of the visual signal to speech perception is not very well understood. Studying how the visual modality affects speech recognition can have pedagogical implications in second language learning, as well as clinical application in speech therapy. The current investigation explores the potential effect of speech visual cues on the perception of Arabic emphatics (AEs). The corpus consists of 36 minimal pairs each containing two contrasting consonants, an AE versus a non-emphatic (NE). Movies of four Lebanese speakers were edited to allow perceivers to have partial view of facial regions: lips only, lips-cheeks, lips-chin, lips-cheeks-chin, lips-cheeks-chin-neck. In the absence of any auditory information and relying solely on visual speech, perceivers were above chance at correctly identifying AEs or NEs across vowel contexts; moreover, the models were able to predict the probability of perceivers’ accuracy in identifying some of the COIs produced by certain speakers; additionally, results showed an overlap between the measurements selected by the computer and those selected by human perceivers. The lack of significant face effect on the perception of AEs seems to point to the lips, present in all of the videos, as the most important and often sufficient facial feature for emphasis recognition. Future investigations will aim at refining the analyses of visual cues used by perceivers by using Principal Component Analysis and including time evolution of facial feature measurements.

Keywords: Arabic emphatics, machine learning, speech perception, visual speech perception

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Authors: A. A. Yakub, Omavudu Ikogho

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Land subdivision in most peri-urban areas of Kano metropolis is the entrenched prerogative of ‘KAFADA’ a group of informal plot partitioners who oversee the demarcation of mainly previous farmland into residential plots popularly called 'awon igiya' for those in need. With time these areas are engulfed in the milieu of the rapidly expanding urban landscape and form clusters of poorly planned settlements with tendencies to become future slums. This paper studies the practice of informal land subdivision in Kano metropolis with emphasis on the practitioners, the institutional framework, and the demand and supply scenario that sustains this trend as well as the extent of infrastructural development in these areas. Using three selected informally planned settlements as case-studies, a series of interviews and questionnaires are administered to 'KAFADA,' residents and the state land officers to generate data in these areas. Another set of data was similarly generated in three government subdivided residential layouts, and both sets analysed comparatively. The findings identify varying levels of infrastructural deficits in the informal communities compared to the planned neighbourhoods which are seen to be as a result of the absence of government participation and an informal subdivision process which did not provide for proper planning standards. This study recommends that the regulatory agencies concerned register and partner with KAFADA to ensure that minimal planning standards are maintained in future settlements.

Keywords: peri-urban, informal land markets, land subdivision, infrastructure

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Authors: Akosua Asantewaa Anane

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Social media and its networking sites have become beneficial to society. With the advent of Web 2.0, many people are becoming technologically savvy and attracted to internet-based activities. With the click of a button, users are now sharing more information on topics, events and issues than before. A new phenomenon in the Ghanaian journalism sphere is the advent of blogger and citizen journalism, some of whom have become niche authorities. Niche authorities have emerged through the habitual and persistent curation of news on specific topics, resulting in the steady growth and emergence of valuable contributions to news sharing. Minimal studies have been conducted on niche authorities and their role in social activism in Ghana. This study, anchored on Cialdini’s Six Principles of Persuasion (reciprocation, consistency, social proof, liking, authority and scarcity), explores the features of niche authorities, their areas of expertise, as well as their authoritative voices in the curation of news stories. Using qualitative content analysis, cyber ethnography and thematic analysis of purposively sampled social media posts of five niche authorities, the study interrogates how these niche authorities employ the six principles of persuasion on their platforms to spark conversations on development, social inclusion and gender-based issues in the country. The study discusses how niche authorities deploy the principles in social activism and further recommends nurturing and mentoring communication strategies to progressively guide the youth to become future niche authorities in news curation and news sharing.

Keywords: social activism, cialdini’s six principles of persuasion, news curation, niche authorities

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Authors: Eunhye Cho, Hyuk-Hoon Kim, Sieun Lee, Minjung Kathy Chae

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Introduction: I-gel is a commonly used supraglottic advanced airway device in prehospital out-of-hospital cardiac arrest (OHCA) allowing for minimal interruption of continuous chest compression. However, previous studies have shown that prehospital supraglottic airway had inferior neurologic outcomes and survival compared to no advanced prehospital airway with conventional bag mask ventilation. We hypothesize that continuous compression with i-gel as an advanced airway may cause insufficient ventilation compared to 30:2 chest compression with conventional BVM. Therefore, we investigated the ventilation efficacy of i-gel with the initial arterial blood gas analysis in OHCA patients visiting our ER. Material and Method: Demographics, arrest parameters including i-gel insertion, initial arterial blood gas analysis was retrospectively analysed for 119 transported OHCA patients that visited our ER. Linear regression was done to investigate the association with i-gel insertion and initial pCO2 as a surrogate of prehospital ventilation. Result: A total of 52 patients were analysed for the study. Of the patients who visited the ER during OHCA, 24 patients had i-gel insertion and 28 patients had BVM as airway management in the prehospital phase. Prehospital i-gel insertion was associated with the initial pCO2 level (B coefficient 29.9, SE 10.1, p<0.01) after adjusting for bystander CPR, cardiogenic cause of arrest, EMS call to arrival. Conclusion: Despite many limitations to the study, prehospital insertion of i-gel was associated with high initial pCO2 values in OHCA patients visiting our ER, possibly indicating insufficient ventilation with prehospital i-gel as an advanced airway and continuous chest compressions.

Keywords: arrest, I-gel, prehospital, ventilation

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Authors: Panagiotis Gkekas, Christos Sougles, Dionysios Kehagias, Dimitrios Tzovaras

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Cooperative intelligent transport systems (C-ITS) can greatly improve safety and efficiency in road transport by enabling communication, not only between vehicles themselves but also between vehicles and infrastructure. For that reason, traffic surveillance systems on the road are of great importance. This paper focuses on the development of an on-road unit comprising several magnetic sensors for real-time vehicle detection, movement direction, and speed measurement calculations. Magnetic sensors can feel and measure changes in the earth’s magnetic field. Vehicles are composed of many parts with ferromagnetic properties. Depending on sensors’ sensitivity, changes in the earth’s magnetic field caused by passing vehicles can be detected and analyzed in order to extract information on the properties of moving vehicles. In this paper, we present a prototype algorithm for real-time, high-accuracy, vehicle detection, and speed measurement, which can be implemented as a portable, low-cost, and non-invasive to existing infrastructure solution with the potential to replace existing high-cost implementations. The paper describes the algorithm and presents results from its preliminary lab testing in a close to real condition environment. Acknowledgments: Work presented in this paper was co-financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship, and Innovation (call RESEARCH–CREATE–INNOVATE) under contract no. Τ1EDK-03081 (project ODOS2020).

Keywords: magnetic sensors, vehicle detection, speed measurement, traffic surveillance system

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Authors: Gorazd Karer

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When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents are one of the main tasks of the anesthesiologist. However, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. The paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a UDP-based communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of a medical device manufacturer and is implemented in Matlab-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: closed-loop control, depth of anesthesia (DoA), modeling, optical signal acquisition, patient state index (PSi), UDP communication protocol

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Authors: Marwa T. Badawy, Alaa F. Bakr, Nesrine Hegazi, Mohamed A. Farag, Ahmed Abdellatif

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Diabetes Mellitus (DM) is a chronic disease affecting a large population worldwide. Africa is rich in native medicinal plants with myriad health benefits, though less explored towards the development of specific drug therapy as in diabetes. This study aims to determine the in vivo antidiabetic potential of the well-reported and traditionally used fruits of Baobab (Adansonia digitata L.) using STZ induced diabetic model. The in-vitro cytotoxic and antioxidant properties were examined using MTT assay on L-929 fibroblast cells and DPPH antioxidant assays, respectively. The extract showed minimal cytotoxicity with an IC50 value of 105.7 µg/mL. Histopathological and immunohistochemical investigations showed the hepatoprotective and the renoprotective effects of A. digitata fruits’ extract, implying its protective effects against diabetes complications. These findings were further supported by biochemical assays, which showed that i.p., injection of a low dose (150 mg/kg) of A. digitata twice a week lowered the fasting blood glucose levels, lipid profile, hepatic and renal markers. For a comprehensive overview of extract metabolites composition, ultrahigh performance (UHPLC) analysis coupled to high-resolution tandem mass spectrometry (HRMS/MS) in synchronization with molecular networks led to the annotation of 77 metabolites, among which 50% are reported for the first time in A. digitata fruits.

Keywords: adansonia digital, diabetes mellitus, metabolomics, streptozotocin, Sprague, dawley rats

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

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Authors: Alisha Akya, Afsaneh salami

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Background and Objective: Pseudomonas aeruginosa is an opportunistic pathogen associated with nosocomial infections. One of the major concerns for the treatment of P. aeruginosa infections is its resistant to a variety of antibiotics. The purpose of this study was to assess the dissemination of p. aeruginosa isolates obtained from major hospitals in Kermanshah, west of Iran. Materials and Methods: Antibiotic susceptibility testing was performed using the minimal inhibitory concentrations. Mettalo-beta-lactamase was investigated using the double disk diffusion (DDST) test and PCR. Molecular typing was performed by pulsed-field gel electrophoresis (PFGE). Results: The 60 P. aeruginosa isolates, 30 (50%) were resistant to gentamicin, 38 (63/3%) to piperacilin, 42 (70%) to ceftazidime, and 45 (75%) to cefepime. Twenty-nine (48/3%) isolates were MBLs producer based on the DDST test. Five (8/3%) isolates were positive for VIM gene and 4 of them were from burn specimens. PFGE analysis among MBLs producers revealed 12 distinct genotype patterns. A pattern covering the highest number of strains was determined as the dominant clone. Conclusions: Our study showed that P. aeruginosa strains can be spread between patients in hospitals or acquired from different environmental sources. P. aeruginosa isolates were highly resistant to antibiotics and, therefore, the susceptibility of isolates to antibiotics should be tested before treatment. Given the clinical significance of MBLs producing isolates, identification of these organisms is essential in the hospitals in order to get a better therapeutic response and control of bacterial dissemination.

Keywords: clonal dissemination, mettalo-beta-lactamase, Pseudomonas aeruginosa, PFGE

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Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

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Dealing with emerging cases of dental malpractice with justifications that stem from the clear rules of dental ethics is a phenomenon with an increasing trend in today's dental practice. Dentists should clearly understand how far the limit of malpractice goes, with or without minimal or major consequences, for the affected patient, which can be justified as a complication of dental treatment, in support of the rules of dental ethics in the dental office. Indeed, malpractice can occur in cases of lack of professionalism, but it can also come as a consequence of anatomical and physiological limitations in the implementation of the dental protocols, predetermined and indicated by the patient in the paragraph of the treatment plan in his personal card. This study is of the review type with the aim of the latest findings published in the literature about the problem of dealing with these phenomena. The combination of keywords is done in such a way with the aim to give the necessary space for collecting the right information in the networks of publications about this field, always first from the point of view of the dentist and not from that of the lawyer or jurist. From the findings included in this article, it was noticed the diversity of approaches towards the phenomenon depends on the different countries based on the legal basis that these countries have. There is a lack of or a small number of articles that touch on this topic, and these articles are presented with a limited number of data on the same topic. Conclusions: Dental malpractice should not be hidden under the guise of various dental complications that we justify with the strict rules of ethics for patients treated in the dental chair. The individual experience of dental malpractice must be published with the aim of serving as a source of experience for future generations of dentists.

Keywords: dental ethics, malpractice, professional protocol, random deviation

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