Search results for: cancer risk assessment

Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

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Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, Antibiotic misuse, Iraq, Prescribing

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Authors: Hadjer Chellia

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In the light of the recent global pandemic, different issues in educational research seem to invite careful considerations. Following this perspective, this study sets out to question the concept of classroom management in an EFL higher education context during Covid-19. In order to gain an in-depth understanding of their experiences, 6 EFL teachers from different Algerian universities took part in semi-structured interviews. The main emerging themes revealed that EFL teachers have different pedagogical practices in relation to classroom management during the global crisis than those of normal times. In relation to flexible education theory, the teachers’ experiences suggest flexible classroom management during Covid-19; flexibility in the teaching methods, approach and design, flexibility in time, flexibility in space and pace (speed), flexibility in assessment modes and flexibility in coping with students’ well-being. The flexibility awareness helps them to develop readiness towards the future, mainly in terms of maintaining an appropriate pedagogy to face the future crisis. In terms of theoretical concepts, working on classroom management under unusual circumstances in relation to flexible education helped come out with the concept of flexible classroom management (FCM) and virtual classroom management (VCM). It is then important for educators and researchers to rethink different pedagogical concepts and mind a careful application in the case of unusual times.

Keywords: Covid-19, EFL educators, flexible classroom management, flexible education, virtual classroom management

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Authors: Amirul Al-Ashraf Abdullah, Hema Ramachandran, Iszatty Ismail

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Oleochemical industry in Malaysia has been diversifying significantly due to the abundant supply of both palm and kernel oils as raw materials as well as the high demand for downstream products such as fatty acids, fatty alcohols and glycerine. However, environmental awareness is growing rapidly in Malaysia because oleochemical industry is one of the palm-oil based industries that possess risk to the environment. Glycerine pitch is one of the scheduled wastes generated from the fatty acid plants in Malaysia and its discharge may cause a serious environmental problem. Therefore, it is imperative to find alternative applications for this waste glycerine. Consequently, the aim of this research is to explore the application of glycerine pitch as direct fermentation substrate in the biosynthesis of poly(3-hydroxybutyrate-co-4-hydroxybutyrate) [P(3HB-co-4HB)] copolymer, aiming to contribute toward the sustainable production of biopolymer in the world. Utilization of glycerine pitch (10 g/l) together with 1,4-butanediol (5 g/l) had resulted in the achievement of 40 mol% 4HB monomer with the highest PHA concentration of 2.91 g/l. Synthesis of yellow pigment which exhibited antimicrobial properties occurred simultaneously with the production of P(3HB-co-4HB) through the use of glycerine pitch as renewable carbon resource. Utilization of glycerine pitch in the biosynthesis of P(3HB-co-4HB) will not only contribute to reducing society’s dependence on non-renewable resources but also will promote the development of cost efficiency microbial fermentation towards biosustainability and green technology.

Keywords: biopolymer, glycerine pitch, natural pigment, P(3HB-co-4HB)

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Authors: Ibrahim R. Elomari, Fin O'Flaherty, Ibrahim R. Elomari, Paul Lambert

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Cathodic protection (CP) is a technique commonly used to arrest corrosion of steel in infrastructure. However, it is not generally used on high strength, pre-stressed tendons due to the risk of hydrogen generation, leading to possible embrittlement. This paper investigates its use in such circumstances where the applied protection potential is varied to determine if CP can be safely employed on pre-stressed tendons. Plain steel tendons measuring 5.4 mm diameter were pre-stressed in timber moulds and embedded in sand/cement mortar, formulated to represent gunite. Two levels of pre-stressing were investigated (400MPa and 1200MPa). Pre-corrosion of 0% (control), 3% and 6% target loss of cross-sectional area was applied to replicate service conditions. Impressed current cathodic protection (ICCP) was then applied to the tendons at two levels of potential to identify any effect on strength. Instant-off values up to -950mV were used for normal protection with values of -1100mV or more negative to achieve overprotection. Following the ICCP phase, the tendons were removed from the mortar, cleaned and weighed to confirm actual percentage of corrosion. Tensile tests were then conducted on the tendons. The preliminary results show the influence of normal levels and overprotection of CP on the ultimate strength of the tendons.

Keywords: pre-stressed concrete, corrosion, cathodic protection, hydrogen embrittlement

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Authors: Iulia Crisan

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Objective: The present study investigates the cross-cultural validity of three North-American performance validity indicators (PVTs) by comparing base rates of failure (BRF) in Romanian and Canadian disability applicants. Methods: Three PVTs (Test of Memory Malingering Trial 1 [TOMM-1], Rey Fifteen Item Test free recall [Rey-15 FR], and Rey FR+Recognition [Rey COMB]) were administered to a heterogeneous Romanian clinical sample (N Ro =54) and a similar Canadian sample (N Can = 52). Patients were referred for assessment to determine the severity of their cognitive deficits. Results: We compared the BRF in both samples at various cutoffs. BRF on TOMM-1 at ≤ 43 was similar (Ro = 33.3% vs. Can = 40.4%); at ≤40, Ro = 22.2% vs. Can = 25.0%. Likewise, comparable BRF were observed on Rey-15 FR at ≤ 8 (Ro = 7.4% vs. Can = 11.5%) and ≤ 11 (Ro = 27.8% vs. Can = 23.1%). However, the Romanian sample produced significantly higher failure rates on the Rey COMB at variable cutoffs (p <.05), possibly because Romanian patients were significantly older than the Canadian sample. Conclusion: Our findings offer proof of concept for the cross-cultural validity of the TOMM and Rey-15 FR. At the same time, they serve as a reminder that the generalizability of PVT cutoffs to different populations should not be assumed but verified empirically. Employing the TOMM as a criterion measure for newly developed PVTs is discussed.

Keywords: performance validity indicators, cross-cultural validity, failure base rates, clinical samples, cognitive dysfunction, TOMM-1, Rey-15, Rey COMB

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Authors: Nantakrit Yodpijit, Teppakorn Sittiwanchai

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The number of older adults is rising rapidly. The world’s population becomes aging. Falls is one of common and major health problems in the elderly. Falls may lead to acute and chronic injuries and deaths. The fall-prone individuals are at greater risk for decreased quality of life, lowered productivity and poverty, social problems, and additional health problems. A number of studies on falls prevention using fall detection system have been conducted. Many available technologies for fall detection system are laboratory-based and can incur substantial costs for falls prevention. The utilization of alternative technologies can potentially reduce costs. This paper presents the new design and development of a wearable-based fall detection system using an Accelerometer and Gyroscope as motion sensors for the detection of body orientation and movement. Algorithms are developed to differentiate between Activities of Daily Living (ADL) and falls by comparing Threshold-based values with Artificial Neural Networks (ANN). Results indicate the possibility of using the new threshold-based method with neural network algorithm to reduce the number of false positive (false alarm) and improve the accuracy of fall detection system.

Keywords: aging, algorithm, artificial neural networks (ANN), fall detection system, motion sensorsthreshold

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Authors: Lormaine Anne Branzuela, Elysa Largo, Julie Marisol Pagalilauan, Neil Concibido, Monet Concepcion Detras

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Energy is a necessity both for the people and the country. The demand for energy is continually increasing, but the supply is not doing the same. The reopening of the Bataan Nuclear Power Plant (BNPP) in the Philippines has been circulating in the media for the current time. The general public has been hesitant in accepting the inclusion of nuclear energy in the Philippine energy mix due to perceived unsafe conditions of the plant. This study evaluated the possible operations of a nuclear power plant, which is of the same type as the BNPP, considering the safety of the workers, the public, and the environment using a Process Hazard Analysis (PHA) method. What-If Technique was utilized to identify the hazards and consequences on the operations of the plant, together with the level of risk it entails. Through the brainstorming sessions of the PHA team, it was found that the most critical system on the plant is the primary system. Possible leakages on pipes and equipment due to weakened seals and welds and blockages on coolant path due to fouling were the most common scenarios identified, which further caused the most critical scenario – radioactive leak through sump contamination, nuclear meltdown, and equipment damage and explosion which could result to multiple injuries and fatalities, and environmental impacts.

Keywords: process safety management, process hazard analysis, what-If technique, nuclear power plant

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Authors: Bel G Raggad

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An e-Learning setting is a distributed computing environment where information resources can be connected to any public network. Public networks are very unsecure which can compromise the reliability of an e-Learning environment. This study is only concerned with the intrusion detection aspect of e-Learning security and how incident responses are planned. The literature reported great advances in intrusion detection system (ids) but neglected to study an important ids weakness: suspected events are detected but an intrusion is not determined because it is not defined in ids databases. We propose an incident response generator (DIRG) that produces incident responses when the working ids system suspects an event that does not correspond to a known intrusion. Data involved in intrusion detection when ample uncertainty is present is often not suitable to formal statistical models including Bayesian. We instead adopt Dempster and Shafer theory to process intrusion data for the unknown event. The DIRG engine transforms data into a belief structure using incident scenarios deduced by the security administrator. Belief values associated with various incident scenarios are then derived and evaluated to choose the most appropriate scenario for which an automatic incident response is generated. This article provides a numerical example demonstrating the working of the DIRG system.

Keywords: decision support system, distributed computing, e-Learning security, incident response, intrusion detection, security risk, statefull inspection

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Authors: Herawati Tri Siswati, Nurhidayat Ana Sıdık Fatimah

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The Indonesia Basic Health Research, 2013 showed that prevalence of stunting of 6–12 children years old was 35,6%, wasting was 12,2% and obesiy was 9,2%. The Indonesian Goverment have School Health Program, held in coordination, plans, directing and responsible, developing and implement health student. However, it's implementation still under expected, while Indonesian Ministry of Health has initiated the School Health Program acceleration. This aimed is to know the influencing of training to knowledge and skill of elementary school teacher about measurement and assesment nutrirional status children. The research is quasy experimental with pre-post design, in Sleman disctrict, Yogyakarta province, Indonesia, 2015. Subject was all of elementary school teacher’s who responsible in School Health Program in Gamping sub-district, Sleman, Yogyakarta, i.e. 32 persons. The independent variable is training, while the dependent variable are teacher’s klowledge and skill on measurement and assesment nutrirional status children. The data was analized by t-test. The result showed that the knowledge score before training is 31,6±9,7 and after 56,4±12,6, with an increase 24,8±15,7, and p=0.00. The skill score before training is 46,6±11,1 and after 61,7±13, with an increase 15,2±14,2, p = 0.00. Training can increase the teacher’s klowledge and skill on measurement and assesment nutrirional status.

Keywords: training, school health program, nutritional status, children.

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Authors: Mohammed Abdullah Alshahrani

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The research focuses on investigating the use of partial least squares (PLS) methodology for addressing challenges associated with high-dimensional correlated data. Recent technological advancements have led to experiments producing data characterized by a large number of variables compared to observations, with substantial inter-variable correlations. Such data patterns are common in chemometrics, where near-infrared (NIR) spectrometer calibrations record chemical absorbance levels across hundreds of wavelengths, and in genomics, where thousands of genomic regions' copy number alterations (CNA) are recorded from cancer patients. PLS serves as a widely used method for analyzing high-dimensional data, functioning as a regression tool in chemometrics and a classification method in genomics. It handles data complexity by creating latent variables (components) from original variables. However, applying PLS can present challenges. The study investigates key areas to address these challenges, including unifying interpretations across three main PLS algorithms and exploring unusual negative shrinkage factors encountered during model fitting. The research presents an alternative approach to addressing the interpretation challenge of predictor weights associated with PLS. Sparse estimation of predictor weights is employed using a penalty function combining a lasso penalty for sparsity and a Cauchy distribution-based penalty to account for variable dependencies. The results demonstrate sparse and grouped weight estimates, aiding interpretation and prediction tasks in genomic data analysis. High-dimensional data scenarios, where predictors outnumber observations, are common in regression analysis applications. Ordinary least squares regression (OLS), the standard method, performs inadequately with high-dimensional and highly correlated data. Copy number alterations (CNA) in key genes have been linked to disease phenotypes, highlighting the importance of accurate classification of gene expression data in bioinformatics and biology using regularized methods like PLS for regression and classification.

Keywords: partial least square regression, genetics data, negative filter factors, high dimensional data, high correlated data

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Authors: Maria Brás

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The main purpose of the presentation is to identify the impacts and appropriate measures to prevent potential attacks, or minimize the risk of an attack in tourist destination. Terrorism has been growing in the shadow of unpredictability, however, is possible to minimize the danger of a terrorist attack by doing the: (1) recognition; (2); evaluation; (3) avoidance; (4) threat reduction. The vulnerability of tourism industry to terrorism is an undeniable fact, and terrorists know it. They use this advantage attacking tourists for very specific reasons, such as the: (1) international coverage by the media, “if it bleeds it leads” ; (2) chances of getting different nationalities at the same place and time; (3) possibility of destroyed the economy of a destination, or destinations (“terrorism contamination effect”), through the reduction of tourist demand; (4) psychological, and social disruption based on fear of negative consequences. Security incidents, such as terrorism, include different preventive measures that can be conducted in partnership with: tourism industry (hotels, airports, tourist attractions, among others); central government; public and/or private sector; local community; and media. The recovery strategies must be based on the dissemination of positive information to the media; in creating new marketing strategies that emphasize the social and cultural values of the destination; encourage domestic tourism; get government, or state, financial support.

Keywords: terrorism, tourism, safety, security, impacts, prevention, recovery

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Authors: S. H. Atef, N. H. Mahmoud, S. Abdrahman, A. Fattoh

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Background: The aim of the study is to assess the diagnostic value of fibrotest and hyaluronic acid in discriminate between insignificant and significant fibrosis. Also, to find out if these parameters could replace liver biopsy which is currently used for selection of chronic hepatitis C patients eligible for antiviral therapy. Study design: This study was conducted on 52 patients with HCV RNA detected by polymerase chain reaction (PCR) who had undergone liver biopsy and attending the internal medicine clinic at Ain Shams University Hospital. Liver fibrosis was evaluated according to the METAVIR scoring system on a scale of F0 to F4. Biochemical markers assessed were: alpha-2 macroglobulin (α2-MG), apolipoprotein A1 (Apo-A1), haptoglobin, gamma-glutamyl transferase (GGT), total bilirubin (TB) and hyaluronic acid (HA). The fibrotest score was computed after adjusting for age and gender. Predictive values and ROC curves were used to assess the accuracy of fibrotest and HA results. Results: For fibrotest, the observed area under curve for the discrimination between minimal or no fibrosis (F0-F1) and significant fibrosis (F2-F4) was 0.6736 for cutoff value 0.19 with sensitivity of 84.2% and specificity of 85.7%. For HA, the sensitivity was 89.5% and specificity was 85.7% and area under curve was 0.540 at the best cutoff value 71 mg/dL. Multi-use of both parameters, HA at 71 mg/dL with fibrotest score at 0.22 give a sensitivity 89.5%, specificity 100 and efficacy 92.3% (AUC 0.895). Conclusion: The use of both fibrotest score and HA could be as alternative to biopsy in most patients with chronic hepaitis C putting in consideration some limitations of the proposed markers in evaluating liver fibrosis.

Keywords: fibrotest, liver fibrosis, HCV RNA, biochemical markers

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Authors: Nonlapun Meenil, Pisitpong Intarapong, Thitima Wongsheree, Pranchalee Samanpiboon

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In Thailand, once pineapples are harvested, they must be classified into two classes based on their sweetness: sweet and unsweet. This paper has studied and developed the assessment of internal quality of pineapples using a low-cost compact spectroscopy sensor according to the Spectroscopy approach and Neural Network (NN). During the experiments, Batavia pineapples were utilized, generating 100 samples. The extracted pineapple juice of each sample was used to determine the Soluble Solid Content (SSC) labeling into sweet and unsweet classes. In terms of experimental equipment, the sensor cover was specifically designed to install the sensor and light source to read the reflectance at a five mm depth from pineapple flesh. By using a spectroscopy sensor, data on visible and near-infrared reflectance (Vis-NIR) were collected. The NN was used to classify the pineapple classes. Before the classification step, the preprocessing methods, which are Class balancing, Data shuffling, and Standardization were applied. The 510 nm and 900 nm reflectance values of the middle parts of pineapples were used as features of the NN. With the Sequential model and Relu activation function, 100% accuracy of the training set and 76.67% accuracy of the test set were achieved. According to the abovementioned information, using a low-cost compact spectroscopy sensor has achieved favorable results in classifying the sweetness of the two classes of pineapples.

Keywords: neural network, pineapple, soluble solid content, spectroscopy

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Authors: Ifigeneia V. Mavragani, Zacharenia Nikitaki, George Kalantzis, George Iliakis, Alexandros G. Georgakilas

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Complex DNA damage consisting of a combination of DNA lesions, such as Double Strand Breaks (DSBs) and non-DSB base lesions occurring in a small volume is considered as one of the most important biological endpoints regarding ionizing radiation (IR) exposure. Strong theoretical (Monte Carlo simulations) and experimental evidence suggests an increment of the complexity of DNA damage and therefore repair resistance with increasing linear energy transfer (LET). Experimental detection of complex (clustered) DNA damage is often associated with technical deficiencies limiting its measurement, especially in cellular or tissue systems. Our groups have recently made significant improvements towards the identification of key parameters relating to the efficient detection of complex DSBs and non-DSBs in human cellular systems exposed to IR of varying quality (γ-, X-rays 0.3-1 keV/μm, α-particles 116 keV/μm and 36Ar ions 270 keV/μm). The induction and processing of DSB and non-DSB-oxidative clusters were measured using adaptations of immunofluorescence (γH2AX or 53PB1 foci staining as DSB probes and human repair enzymes OGG1 or APE1 as probes for oxidized purines and abasic sites respectively). In the current study, Relative Biological Effectiveness (RBE) values for DSB and non-DSB induction have been measured in different human normal (FEP18-11-T1) and cancerous cell lines (MCF7, HepG2, A549, MO59K/J). The experimental results are compared to simulation data obtained using a validated microdosimetric fast Monte Carlo DNA Damage Simulation code (MCDS). Moreover, this simulation approach is implemented in two realistic clinical cases, i.e. prostate cancer treatment using X-rays generated by a linear accelerator and a pediatric osteosarcoma case using a 200.6 MeV proton pencil beam. RBE values for complex DNA damage induction are calculated for the tumor areas. These results reveal a disparity between theory and experiment and underline the necessity for implementing highly precise and more efficient experimental and simulation approaches.

Keywords: complex DNA damage, DNA damage simulation, protons, radiotherapy

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Authors: Hussain Darraj

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Background: Healthcare workers, especially nurses, are subjected to a great risk of psychological stress, mostly moral distress. Therefore, it is crucial to address moral distress in nurses. Objectives: The aim of this study is to study the extent of moral distress among hospital nurses in Jazan. Methods: This study used a cross-sectional study design, which included 419 nurses from Jazan hospitals. A questionnaire was used to measure moral distress and its related factors. Results: The average total score for moral distress among the study participants is 134.14, with a standard deviation of 53.94. Moreover, the current study findings indicate that those over the age of 35 years who work as nurse managers, working in critical departments, have the intention to leave a position, have received ethical training or workshops, have provided care for COVID-19 cases, or work in a department with staff shortages are associated with the experience of higher-level moral stress. Conclusion: Nurses are recommended to be provided with ongoing education and resources in order to reduce moral distress and create a positive work atmosphere for nurses. Moreover, the current study sheds light on the importance of organizational support to provide enough resources and staffing in order to reduce moral distress among nurses. Further research is needed to focus on other health professionals and moral distress. Moreover, future studies are also required to explore the strategies to reduce moral distress levels among nurses.

Keywords: moral distress, Jazan, nurses, hospital

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Authors: Adem Rama, Rabiha Seboussi, Mahmoud Muhamadin, Sultan Alzarooni, Fatima Mohamed, Khuloud Al Ali

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To assess public health hazards associated with the occurrence of Antibiotics and AFM1 residues in UHT milk, a survey was carried out in Sharjah, UAE. In the present study, a total of 42 UHT milk samples analyzed were from different commercial brands manufactured in industrial dairy units in the UAE and from foreign producers. Milk samples were collected for four months (January to April 2020). The occurrence and concentration range of Antibiotics (Streptomycin and Gentamycin) and AFM1 in the samples were investigated by applying the ELISA method. According to the methodology used in this study, in total, 2 (5%) out of 42(95%) samples tested positive on the presence of AFM1. While, 1(2.4%) out of 41(97.6%) positive samples were found to contain Streptomycin and Gentamycin, respectively. The positive incidence of AFM1 in the UHT milk samples ranged from 58.8 to 1074 µg/L, for Streptomycin from up to 1004 µg/L, and Gentamycin up to 6909 µg/L. There were no positive samples found in locally produced UHT milk. AFM1 and antibiotic levels in positive samples UHT milk samples exceeded the maximum tolerable limits as set by the European Union - EC guidelines/standards. These levels in the samples show a presence of contaminants that might constitute a human health risk in Sharjah. The results of this study imply that more emphasis should be given to the routine inspection of milk and dairy products in the Sharjah region.

Keywords: milk, contaminant residues, ELISA, public health, Sharjah

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Authors: N. S. Kubanza, D. Simatele, D. K. Das

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The purpose of this paper is to understand the urban environmental problems in Kinshasa and the consequences of these for the poor. This paper particularly examines the concept of environmental injustice in solid waste management in Kinshasa, the capital of the Democratic Republic of Congo (DRC). The urban low-income communities in Kinshasa face multiple consequences of poor solid waste management associated with unhealthy living conditions. These situations stemmed from overcrowding, poor sanitary, accumulation of solid waste, resulting in the prevalence of water and air borne diseases. Using a mix of reviewed archival records, scholarly literature, a semi-structured interview conducted with the local community members and qualitative surveys among stakeholders; it was found that solid waste management challenge in Kinshasa is not only an environmental and health risk issues, but also, a problem that generates socio-spatial disparities in the distribution of the solid waste burden. It is argued in the paper that the urban poor areas in Kinshasa are often hardest affected by irregularities of waste collection. They lack sanitary storage capacities and have undermined organizational capacity for collective action within solid waste management. In view of these observations, this paper explores mechanisms and stakeholders’ engagement necessary to lessen environmental injustice in solid waste management (SWM) in Kinshasa.

Keywords: environmental justice, solid waste management, urban environmental problems, urban poor

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Authors: Michael Josef Schwerer

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Background: The identification of unknown victims from mass disasters, violent crimes, or terrorist attacks is frequently facilitated through information from missing persons lists, portrait photos, old or recent pictures showing unique characteristics of a person such as scars or tattoos, or simply reference samples from blood relatives for DNA analysis. In contrast, the identification or at least the characterization of an unknown perpetrator from criminal or terrorist actions remains challenging, particularly in the absence of material or data for comparison, such as fingerprints, which had been previously stored in criminal records. In scenarios that result in high levels of destruction of the perpetrator’s corpse, for instance, blast or fire events, the chance for a positive identification using standard techniques is further impaired. Objectives: This study shows the forensic genetic procedures in the Legal Medicine Service of the German Air Force for the identification of unknown individuals, including such cases in which reference samples are not available. Scenarios requiring such efforts predominantly involve aircraft crash investigations, which are routinely carried out by the German Air Force Centre of Aerospace Medicine as one of the Institution’s essential missions. Further, casework by military police or military intelligence is supported based on administrative cooperation. In the talk, data from study projects, as well as examples from real casework, will be demonstrated and discussed with the audience. Methods: Forensic genetic identification in our laboratories involves the analysis of Short Tandem Repeats and Single Nucleotide Polymorphisms in nuclear DNA along with mitochondrial DNA haplotyping. Extended DNA analysis involves phenotypic markers for skin, hair, and eye color together with the investigation of a person’s biogeographic ancestry. Assessment of the biological age of an individual employs CpG-island methylation analysis using bisulfite-converted DNA. Forensic Investigative Genealogy assessment allows the detection of an unknown person’s blood relatives in reference databases. Technically, end-point-PCR, real-time PCR, capillary electrophoresis, pyrosequencing as well as next generation sequencing using flow-cell-based and chip-based systems are used. Results and Discussion: Optimization of DNA extraction from various sources, including difficult matrixes like formalin-fixed, paraffin-embedded tissues, degraded specimens from decomposed bodies or from decedents exposed to blast or fire events, provides soil for successful PCR amplification and subsequent genetic profiling. For cases with extremely low yields of extracted DNA, whole genome preamplification protocols are successfully used, particularly regarding genetic phenotyping. Improved primer design for CpG-methylation analysis, together with validated sampling strategies for the analyzed substrates from, e.g., lymphocyte-rich organs, allows successful biological age estimation even in bodies with highly degraded tissue material. Conclusions: Successful identification of unknown individuals or at least their phenotypic characterization using pigmentation markers together with age-informative methylation profiles, possibly supplemented by family tree search employing Forensic Investigative Genealogy, can be provided in specialized laboratories. However, standard laboratory procedures must be adapted to work with difficult and highly degraded sample materials.

Keywords: identification, forensic genetics, phenotypic markers, CPG methylation, biological age estimation, forensic investigative genealogy

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Authors: Mercy Marimirofa, Farai Machinga, Alfred Zvoushe, Tsitsidzaishe Musvosvi

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The Government of Zimbabwe embarked on integrating family planning with Sexually Transmitted Infection (STI) and Human Immunodeficiency Virus (HIV) services in May 2020 with support from the World Health Organization (WHO). There was high HIV prevalence, incidence rates and STI infections among women attending FP clinics. Spilhaus is a specialized center of excellence clinic which offers a range of sexual reproductive health services. HIV services were limited to testing only, and clients were referred to other facilities for further management. Integration of services requires that all the services be available at one point so that clients will access them during their visit to the facility. Objectives: The study was conducted to assess the impact the one-stop-shop model has made in accessing integrated Family Planning services and sexual reproductive health services compared to the supermarket approach. It also assessed the relationship family planning services have with other sexual reproductive health services. Methods: A secondary data analysis was conducted at Spilhaus clinic in Harare using family planning registers and HIV services registers comparing years 2019 and 2021. A 2 sample t-test was used to determine the difference in clients accessing the services under the two models. A Spearman’s rank correlation was used to determine if accessing family planning services has a relationship with other sexual reproductive health services. Results: In 2019, 7,548 clients visited the Spilhaus clinic compared to 8,265 during the period January to December 2021. The median age for all clients accessing services was 32 years. An increase of 69% in the number of services accessed was recorded from 2019 to 2021. More services were accessed in 2021. There was no difference in the number of clients accessing family planning services cervical cancer, and HIV services. A difference was found in the number of clients who were offered STI screening services. There was also a relationship between accessing family planning services and STI screening services (ρ = 0.729, p-value=0.006). Conclusion: Programming towards SRH services was a great achievement, the use of an integrated approach proved to be cost-effective as it minimised the required resources for separate programs. Clients accessed important health needs at once. The integration of these services provided an opportunity to offer comprehensive information which addressed an individual’s sexual reproductive health needs.

Keywords: intergration, one stop shop, family planning, reproductive health

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Authors: Fatemehsadat Mortazavizadeh, Amin Dehghani, Majid Mirzaei, Nurulhuda Binti Mohammad Ramli, Adnan Dehghani

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Flood is Malaysia's most common and serious natural disaster. Kelantan River Basin is a tropical basin that experiences a rainy season during North-East Monsoon from November to March. It is also one of the hardest hit areas in Peninsular Malaysia during the heavy monsoon rainfall. Considering the consequences of the flood events, it is essential to develop the flood inundation map as part of the mitigation approach. In this study, the delineation of flood inundation zone in the area of Kelantan River basin using a hydrodynamic model is done by HEC-RAS, QGIS and ArcMap. The streamflow data has been generated with the weather generator based on the observation data. Then, the data is statistically analyzed with the Extreme Value (EV1) method for 2-, 5-, 25-, 50- and 100-year return periods. The minimum depth, maximum depth, mean depth, and the standard deviation of all the scenarios, including the OBS, are observed and analyzed. Based on the results, generally, the value of the data increases with the return period for all the scenarios. However, there are certain scenarios that have different results, which not all the data obtained are increasing with the return period. Besides, OBS data resulted in the middle range within Scenario 1 to Scenario 40.

Keywords: flood inundation, kelantan river basin, hydrodynamic model, extreme value analysis

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Authors: Shourav Ahmed, M. Gulam Kibria, Kais Zaman

Abstract:

Control charts graphically verify variation in quality parameters. Attribute type control charts deal with quality parameters that can only hold two states, e.g., good or bad, yes or no, etc. At present, p-control chart is most commonly used to deal with attribute type data. In construction of p-control chart using binomial distribution, the value of proportion non-conforming must be known or estimated from limited sample information. As the probability distribution of fraction non-conforming (p) is considered in hyperbinomial distribution unlike a constant value in case of binomial distribution, it reduces the risk of false detection. In this study, a statistical control chart is proposed based on hyperbinomial distribution when prior estimate of proportion non-conforming is unavailable and is estimated from limited sample information. We developed the control limits of the proposed modified p-chart using the mean and variance of hyperbinomial distribution. The proposed modified p-chart can also utilize additional sample information when they are available. The study also validates the use of modified p-chart by comparing with the result obtained using cumulative distribution function of hyperbinomial distribution. The study clearly indicates that the use of hyperbinomial distribution in construction of p-control chart yields much accurate estimate of quality parameters than using binomial distribution.

Keywords: binomial distribution, control charts, cumulative distribution function, hyper binomial distribution

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Authors: Eisa A. Alsafran, Francis T. Edum-Fotwe, Wayne E. Lord

Abstract:

The degree to which a public client actively participates in Public Private Partnership (PPP) schemes, is seen as a determinant of the success of the arrangement, and in particular, efficiency in the delivery of the assets of any infrastructure development. The asset delivery is often an early barometer for judging the overall performance of the PPP. Currently, there are no defined descriptors for the degree of such participation. The lack of defined descriptors makes the association between the degree of participation and efficiency of asset delivery, difficult to establish. This is particularly so if an optimum effect is desired. In addition, such an association is important for the strategic decision to embark on any PPP initiative. This paper presents a conceptual model of different levels of participation that characterise PPP schemes. The modelling was achieved by a systematic review of reported sources that address essential aspects and structures of PPP schemes, published from 2001 to 2015. As a precursor to the modelling, the common areas of Public Client Participation (PCP) were investigated. Equity and risk emerged as two dominant factors in the common areas of PCP, and were therefore adopted to form the foundation of the modelling. The resultant conceptual model defines the different states of combined PCP. The defined states provide a more rational basis for establishing how the degree of PCP affects the efficiency of asset delivery in PPP schemes.

Keywords: asset delivery, infrastructure development, public private partnership, public client participation

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Authors: Jane N. O'Sullivan

Abstract:

Although it is widely believed that fertility decline has benefitted economic advancement, particularly in East and South-East Asian countries, the causal mechanisms for this stimulus are contested. Since the turn of this century, demographic dividend theory has been increasingly recognised, hypothesising that higher proportions of working-age people can contribute to economic expansion if conditions are met to employ them productively. Population growth rate, as a systemic condition distinct from age composition, has not been similar attention since the 1970s and has lacked methodology for quantitative assessment. This paper explores conceptual and empirical quantification of the burden of expanding physical capital to accommodate a growing population. In proof-of-concept analyses of Australia and the United Kingdom, actual expenditure on gross fixed capital formation was compiled over four decades and apportioned to maintenance/turnover or expansion to accommodate population growth, based on lifespan of capital assets and population growth rate. In both countries, capital expansion was estimated to cost 6.5-7.0% of GDP per 1% population growth rate. This opportunity cost impedes the improvement of per capita capacity needed to realise the potential of the working-age population. Economic modelling of demographic scenarios have to date omitted this channel of influence; the implications of its inclusion are discussed.

Keywords: age dependency, demographic dividend, infrastructure, population growth rate

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Authors: Mohamad Reza Mohamed Afla, Putri Haryati Ibrahim, Azila Ahmad Sarkawi

Abstract:

This study examines the standard procedure involved in terms of planning and management at selected Muslim cemeteries within the Kuala Lumpur Metropolitan Area. It focuses on sustainable design practice for the provision of burial infrastructures at public cemeteries, which emphasizes the inclusion of society, economy, and environment. The escalating issues of overcrowding, lack of space, and land shortage for full-body burial in the urbanized area of Kuala Lumpur have raised a concern to this alarming situation. There is a necessity to address these problems through the incorporation of sustainable development in the making of urban cemeteries to ensure a holistic approach. Recorded site observation of cemeteries’ area has been employed as a means of data collection and interpreted by conducting spatial analysis. The spatial analysis entails the assessment of form and function in accordance with sustainable design principles. The finding exhibits the dimensional layout of Muslim cemeteries were problematics due to the tension that exists between ritual practices and space organization set-up by the local authorities. This article concludes by providing conceptual guidelines for the purpose of Muslim cemetery development in the future.

Keywords: cemetery, metropolitan, spatial analysis, sustainable design practice

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Authors: R. Litt, A. Brown

Abstract:

Aims: We aimed to assess the efficiency of ‘Attend Anywhere’ orthodontic clinics within a district general hospital during COVID- 19. Our secondary aim was to pilot a questionnaire to assess patient satisfaction with virtual orthodontic appointments. Design: The study design is a service evaluation including pilot questionnaire. Methods: The average number of patients seen per virtual clinic and the number of patients failing to attend was compared to face-to-face clinics. The capability of virtual appointments to be successful in preventing the need for a face-to-face appointment was assessed. Patients were invited to complete a telephone pilot questionnaire focusing on patient satisfaction and accessibility. Results: There was a small increase in the number of patients failing to attend virtual appointments, with a third of the patients who did not attend failing to receive the appointment link. 81.9% of virtual clinic appointments were successful and prevented the need for a face-to-face appointment. Overall patients were very satisfied with their virtual orthodontic appointment and the majority required no assistance to access the service. Conclusions: The use of ‘Attend Anywhere’ clinics in orthodontics offers patients and clinicians an effective and efficient alternative to face-to-face appointments that patients on average find easy to use and completely satisfactory.

Keywords: clinics, COVID, orthodontics, patient satisfaction, virtual

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Authors: Iddrisu Ibrahim, Joseph Atia Ayariga, Junhuan Xu, Daniel A. Abugri, Robertson K. Boakai, Olufemi S. Ajayi

Abstract:

The recalcitrance of pathogenic bacteria indicates that millions of people who are at risk of infection arising from chronic diseases, surgery, organ transplant, diabetes, and several other debilitating diseases present an aura of potentially untreatable illness due to resistance development. Antimicrobial resistance has successfully become a global health menace, and resistances are often acquired by bacteria through health-care-related incidence (HRI) orchestrated by multi-drug resistant (MDR) and extended drug-resistant pathogens (EDRP). To understand the mechanisms S. Typhimurium uses to resist CDB, we study the abundance of LPS modification, Ergosterols, Mysristic palmitic resistance, Oleic acid resistance of susceptible and resistant S. Typhimurium. Using qPCR, we also analyzed the expression of selected genes known for enabling resistance in S. Typhimurium. We found high abundance of LPS, Ergosterols, Mysristic palmitic resistance, Oleic acid resistance of and high expression of resistant genes in S. Typhimurium compared to the susceptible strain. LPS modification, Ergosterols, Mysristic palmitic resistance, Oleic acid and genes such as Fims, integrons, blaTEM are important indicators of resistance development of S. typhimurium.

Keywords: antimicrobials, resistance, Cannabidiol, Salmonella, blaTEM, fimA, Lipopolysaccharide, Ergosterols

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Authors: Amina Sultan, Mohamed Ghonim, Eman Oweida, Aya Abdelaziz

Abstract:

Objective: To assess the diagnostic reliability of multi-detector CT in pre and post-operative evaluation of cochlear implant candidates. Material and Methods: The study includes 40 patients (18 males and 22 females); mean age 5.6 years. They were classified into two groups: Group A (20 patients): cochlear implant device was Nucleus-22 and Group B (20 patients): the device was MED-EL. Cochlear length (CL) and cochlear height (CH) were measured pre-operatively by 128-multidetector CT. Electrode length (EL) and insertion depth angle (α) were measured post-operatively by MDCT. Results: For Group A mean CL was 9.1 mm ± 0.4 SD; mean CH was 4.1 ± 0.3 SD; mean EL was 18 ± 2.7 SD; mean α angle was 299.05 ± 37 SD. Significant statistical correlation (P < 0.05) was found between preoperative CL and post-operative EL (r²=0.6); as well as EL and α angle (r²=0.7). Group B's mean CL was 9.1 mm ± 0.3 SD; mean CH was 4.1 ± 0.4 SD; mean EL was 27 ± 2.1 SD; mean α angle was 287.6 ± 41.7 SD. Significant statistical correlation was found between CL and EL (r²= 0.6) and α angle (r²=0.5). Also, a strong correlation was found between EL and α angle (r²=0.8). Significant statistical difference was detected between the two devices as regards to the electrode length. Conclusion: Multidetector CT is a reliable tool for preoperative planning and post-operative evaluation of the outcomes of cochlear implant operations. Cochlear length is a valuable prognostic parameter for prediction of the depth of electrode array insertion which can influence criteria of device selection.

Keywords: angle of insertion (α angle), cochlear implant (CI), cochlear length (CL), Multidetector Computed Tomography (MDCT)

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Authors: Sara Sousa, Veronique Gomes, Nélio Veiga, Maria José Correia

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Objectives: To assess the presence or absence of Streptococcus mutans, Streptococcus gordonii and Streptococcus salivarius in the oral biofilm of children in an elementary school of Viseu, Portugal, and verify the relationship between Streptococcus gordonii and Streptococcus salivarius and the absence of dental caries. Methods: A cross-sectional study was designed with a final sample of 40 children aged 6-11 years old. Oral examination was accomplished with the identification of their oral health status and oral biofilm collection. Analysis of biological samples by molecular techniques of DNA isolation and identification of three Streptococci bacteria by Polimerase Chain Reaction (PCR) was made. Results: We identified Streptococcus salivarius and Streptococcus gordoni only in the lower interincisal region. These species were also present mainly in the first permanent non-decayed molars. On the contrary, Streptococcus mutans was found mostly in decayed first permanent molars. Conclusion: This preliminary study establishes a possible association between the absence of dental caries and the presence of Streptococcus gordonii and Streptococcus salivarius. Since these two species are described as alkali producers, it is suggested that their presence somehow confers protection against caries. These results support new dental caries prevention strategies based on oral biofilm modulation by enrichment with alkalinogenic species.

Keywords: dental caries, oral biofilm, Streptococcus gordonii, Streptococcus salivarius

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Authors: Ibrahim Khalil Ibrahim, Enas Mohamed Shahine, Abeer Shawky El Hadedy, Emmanuel Kamal Aziz Saba, Ghada Salah Attia Hussein

Abstract:

Osteoarthritis (OA) is a multifactorial disease characterized by a progressive degradation of articular cartilage and is the leading cause of disability in elderly persons. IL-18 contributes to the destruction of cartilage and bone in the disease process of arthritis. The aim of the study was to investigate the role of IL-18 in primary knee OA patients. Serum level of IL-18 was assessed by enzyme-linked immunosorbent assay in 30 primary knee OA patients and compared to 20 age and gender-matched healthy volunteers as a control group. Radiographic severity of OA was assessed by Kellgren and Lawrence (KL) global scale. Pain, stiffness and functional assessment were done using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). OA patients had significantly higher serum IL-18 level than in control group (420.93 ± 345.4 versus 151.03 ± 144.16 pg/ml, P=0.001). Serum level of IL-18 was positively correlated with KL global scale (P=0.001). There were no statistically significant correlations between serum level of IL-18 and pain, stiffness, function subscales and total WOMAC index scores among the studied patients. In conclusions, IL-18 has a role in the pathogenesis of OA and it is positively correlated with the radiographic damage of OA.

Keywords: Interlukin-18, knee osteoarthritis, primary osteoarthritis, WOMAC scale

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Authors: Alaa F. A. Bakr, Sherein S. Abdelgayed, Osama. S. EL-Tawil, Adel M. Bakeer

Abstract:

Objective: This study was carried out to evaluate the cytotoxic and genotoxic effect of tartrazine in both male and female albino rats. Methodology: Forty adult male (20) and female (20) Sprague Dawley albino rats (120 - 150g) were obtained and distributed into four experimental groups; Group I; 10 untreated males, Group II; 10 untreated females, Group III; 10 treated males, and Group IV; 10 treated females. Body weight was recorded weekly, reduced glutathione (RGH), lipid peroxidation (SOD), and superoxide dismutase activity (MDA) in liver tissue were carried out, histopathological studies of brain, liver, and kidneys were performed, COMET assay was performed, all values were statistically analyzed. Results: Decrease in the activity of RGH and SOD in the treated groups were reported, but there was a more significant decrease in the female treated group. MDA was increased in treated groups with tartrazine, moreover, it was more significant in the female treated group. Multiple histological lesions were developed in brain, liver, and kidneys. COMET showed positive results. Conclusion: Our study concluded that Tartrazine has a cytotoxic and genotoxic effect on albino rats and it was more significant in females than males.

Keywords: tartrazine, cytotoxicity, genotoxicity, histopathology, albino rats

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