Search results for: pain relief

Authors: Gurlal Singh, Rupinder Singh

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The possible role of the engine brake is to convert a power-producing engine into a power-absorbing retarding mechanism. In this braking system, exhaust gas (EG) from the internal combustion (IC) engines is used to operate air brake in the automobiles. Airbrake is most used braking system in vehicles. In the proposed model, instead of air brake, EG is used to operate the brake lever and stored in a specially designed tank. This pressure of EG is used to operate the pneumatic cylinder and brake lever. Filters used to remove the impurities from the EG, then it is allowed to store in the tank. Pressure relief valve is used to achieve a specific pressure in the tank and helps to avoid further damage to the tank as well as in an engine. The petrol engine is used in the proposed EG braking system. The petrol engine is chosen initially because it produces less impurity in the exhaust than diesel engines. Moreover, exhaust brake system (EBS) for the Diesel engines is composed of gate valve, pneumatic cylinder and exhaust brake valve with the on-off solenoid. Exhaust brake valve which is core component of EBS should have characteristics such as high reliability and long life. In a diesel engine, there is butterfly valve in exhaust manifold connected with solenoid switch which is used to on and off the butterfly valve. When butterfly valve closed partially, then the pressure starts built up inside the exhaust manifold and cylinder that actually resist the movement of piston leads to crankshaft getting stops resulting stopping of the flywheel. It creates breaking effect in a diesel engine. The exhaust brake is a supplementary breaking system to the service brake. It is noted that exhaust brake increased 2-3 fold the life of service brake may be due to the creation of negative torque which retards the speed of the engine. More study may also be warranted for the best suitable design of exhaust brake in a diesel engine.

Keywords: exhaust gas, automobiles, solenoid, airbrake

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Authors: Tristan R. Fraser, Christopher D. Steadman, Christopher J. Boos

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Myopericarditis is an inflammation syndrome characterised by clinical diagnostic criteria for pericarditis, such as chest pain, combined with evidence of myocardial involvement, such as elevation of biomarkers of myocardial damage, e.g., troponins. It can rarely be a complication of therapeutics used for dysregulated immune-mediated diseases such as inflammatory bowel disease (IBD), for example, mesalazine. The infrequency of mesalazine-induced myopericarditis adds to the challenge in its recognition. Rapid diagnosis and the early introduction of treatment are crucial. This case report follows a 24-year-old professional footballer with a past medical history of ulcerative colitis, recently started on mesalazine for disease control. Three weeks after mesalazine was initiated, he was admitted with fever, shortness of breath, and chest pain worse whilst supine and on deep inspiration, as well as elevated venous blood cardiac troponin T level (cTnT, 288ng/L; normal: <13ng/L). Myocarditis was confirmed on initial inpatient cardiac MRI, revealing the presence of florid myocarditis with preserved left ventricular systolic function and an ejection fraction of 67%. This was a longitudinal case study following the progress of a single individual with myopericarditis over four acute hospital admissions over nine weeks, with admissions ranging from two to five days. Parameters examined included clinical signs and symptoms, serum troponin, transthoracic echocardiogram, and cardiac MRI. Serial measurements of cardiac function, including cardiac MRI and transthoracic echocardiogram, showed progressive deterioration of cardiac function whilst mesalazine was continued. Prior to cessation of mesalazine, transthoracic echocardiography revealed a small global pericardial effusion of < 1cm and worsening left ventricular systolic function with an ejection fraction of 45%. After recognition of mesalazine as a potential cause and consequent cessation of the drug, symptoms resolved, with cardiac MRI performed as an outpatient showing resolution of myocardial oedema. The patient plans to make a return to competitive sport. Patients suffering from myopericarditis are advised to refrain from competitive sport for at least six months in order to reduce the risk of cardiac remodelling and sudden cardiac death. Additional considerations must be taken in individuals for whom competitive sport is an essential component of their livelihood, such as professional athletes. Myopericarditis is an uncommon, however potentially serious medical condition with a wide variety of aetiologies, including viral, autoimmune, and drug-related causes. Management is mainly supportive and relies on prompt recognition and removal of the aetiological process. Mesalazine-induced myopericarditis is a rare condition; as such increasing awareness of mesalazine as a precipitant of myopericarditis is vital for optimising the management of these patients.

Keywords: myopericarditis, mesalazine, inflammatory bowel disease, professional athlete

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Authors: Osagiede Efosa Kelvin

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The Ebola virus disease (EVD); also Ebola hemorrhagic fever, is a disease of humans and other primates caused by Ebola viruses. Signs and symptoms typically start between two days and three weeks after contracting the virus as a fever, sore throat, muscle pain, and headaches. Then, vomiting, diarrhoea and rash usually follow, along with decreased function of the liver and kidneys. At this time, some people begin to bleed both internally and externally. The first death in Nigeria was reported on 25 July 2014: a Liberian-American with Ebola flew from Liberia to Nigeria and died in Lagos soon after arrival. As part of the effort to contain the disease, possible contacts were monitored –353 in Lagos and 451 in Port Harcourt On 22 September, the World Health Organisation reported a total of 20 cases, including eight deaths. The WHO's representative in Nigeria officially declared Nigeria Ebola-free on 20 October after no new active cases were reported in the follow-up contact. This paper looks at the Ebola Virus in general and the measures taken by Nigeria to combat its spread.

Keywords: Ebola virus, hemorrhagic fever, Nigeria, outbreak

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Authors: Anthony S. Machi, Joseph Minardi

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We present a case report of left atrial myxoma diagnosed by bedside transesophageal (TEE) ultrasound. Left atrial myxoma is the most common benign cardiac tumor and can obstruct blood flow and cause valvular insufficiency. Common symptoms consist of dyspnea, pulmonary edema and other features of left heart failure in addition to thrombus release in the form of tumor fragments. The availability of bedside ultrasound equipment is essential for the quick diagnosis and treatment of various emergency conditions including cardiac neoplasms. A 48-year-old Caucasian female with a four-year history of an untreated renal mass and anemia presented to the ED with two months of sharp, intermittent, bilateral flank pain radiating into the abdomen. She also reported intermittent vomiting and constipation along with generalized body aches, night sweats, and 100-pound weight loss over last year. She had a CT in 2013 showing a 3 cm left renal mass and a second CT in April 2016 showing a 3.8 cm left renal mass along with a past medical history of diverticulosis, chronic bronchitis, dyspnea on exertion, uncontrolled hypertension, and hyperlipidemia. Her maternal family history is positive for breast cancer, hypertension, and Type II Diabetes. Her paternal family history is positive for stroke. She was a current everyday smoker with an 11 pack/year history. Alcohol and drug use were denied. Physical exam was notable for a Grade II/IV systolic murmur at the right upper sternal border, dyspnea on exertion without angina, and a tender left lower quadrant. Her vitals and labs were notable for a blood pressure of 144/96, heart rate of 96 beats per minute, pulse oximetry of 96%, hemoglobin of 7.6 g/dL, hypokalemia, hypochloremia, and multiple other abnormalities. Physicians ordered a CT to evaluate her flank pain which revealed a 7.2 x 8.9 x 10.5 cm mixed cystic/solid mass in the lower pole of the left kidney and a filling defect in the left atrium. Bedside TEE was ordered to follow up on the filling defect. TEE reported an ejection fraction of 60-65% and visualized a mobile 6 x 3 cm mass in the left atrium attached to the interatrial septum extending into the mitral valve. Cardiothoracic Surgery and Urology were consulted and confirmed a diagnosis of left atrial myxoma and clear cell renal cell carcinoma. The patient returned a week later due to worsening nausea and vomiting and underwent emergent nephrectomy, lymph node dissection, and colostomy due to a necrotic colon. Her condition declined over the next four months due to lung and brain metastases, infections, and other complications until she passed away.

Keywords: bedside ultrasound, echocardiography, emergency medicine, left atrial myxoma

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Authors: Christine Li, Amanda Robertson

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Epidermal inclusion cysts occur when epidermal cells are implanted in the dermis following trauma, or surgery. They are a rare cause of an umbilical mass, with very few cases previously reported following abdominal surgery. These lesions can present with a range of symptoms, including palpable mass, pain, redness, or discharge. This paper reports a case of an umbilical epidermal inclusion cyst in a 52-year-old female presenting with a six-week history of a painful, red umbilical lump on a background of two previous diagnostic laparoscopies. Abdominal computed tomography (CT) scans revealed non-specific soft tissue thickening in the umbilical region. This was successfully treated with complete excision of the lesion. Umbilical lumps are a common presentation but can represent a diagnostic challenge. The differential diagnosis should include an epidermal inclusion cyst, particularly in a patient who has had previous abdominal surgery, including laparoscopic surgery.

Keywords: epidermal inclusion cyst, laparoscopy, umbilical mass, umbilicus

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Authors: M. Rezki, A. Belaidi

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This paper deals with a method of learning to solve a real problem in biomedical engineering from a technical study of muscle fatigue. Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles (viewpoint: anatomical and physiological). EMG is used as a diagnostics tool for identifying neuromuscular diseases, assessing low-back pain and muscle fatigue in general. In order to study the EMG signal for detecting fatigue in a muscle, we have taken a real problem which touches the tramway conductor the handle bar. For the study, we have used a typical autonomous platform in order to get signals at real time. In our case study, we were confronted with complex problem to do our experiments in a tram. This type of problem is recurring among students. To teach our students the method to solve this kind of problem, we built a similar system. Through this study, we realized a lot of objectives such as making the equipment for simulation, the study of detection of muscle fatigue and especially how to manage a study of biomedical looking.

Keywords: EMG, health platform, conductor’s tram, muscle fatigue

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Authors: Lay Poh Tan, Chor Yong Tay, Haiyang Yu

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Micro-contact printing is a form of soft lithography that uses the relief patterns on a master polydimethylsiloxane (PDMS) stamp to form patterns of self-assembled monolayers (SAMs) of ink on the surface of a substrate through conformal contact technique. Here, we adopt this method to print proteins of different dimensions on our biodegradable polymer substrates. We started off with printing 20-500 μm scale lanes of fibronectin to engineer the shape of bone marrow derived human mesenchymal stem cell (hMSCs). After 8 hours of culture, the hMSCs adopted elongated shapes, and upon analysis of the gene expressions, genes commonly associated with myogenesis (GATA-4, MyoD1, cTnT and β-MHC) and neurogenesis (NeuroD, Nestin, GFAP, and MAP2) were up-regulated but gene expression associated to osteogenesis (ALPL, RUNX2, and SPARC) were either down modulated or remained at the nominal level. This is the first evidence that cellular morphology control via micropatterning could be used to modulate stem cell fate without external biochemical stimuli. We further our studies to modulate the focal adhesion (FA) instead of the macro shape of cells. Micro-contact printed islands of different smaller dimensions were investigated. We successfully regulated the FAs into dense FAs and elongated FAs by micropatterning. Additionally, the combined effects of hard (40.4 kPa), and intermediate (10.6 kPa) PA gel and FAs patterning on hMSCs differentiation were studied. Results showed that FA and matrix compliance plays an important role in hMSCs differentiation, and there is a cross-talk between different physical stimulants and the significance of these stimuli can only be realized if they are combined at the optimum level.

Keywords: micro-contact printing, polymer substrate, cell-material interaction, stem cell differentiation

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Authors: Rezaei Hachesu Peyman, Oliyaee Azadeh, Salahzadeh Zahra, Alizadeh Somayyeh, Safaei Naser

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Coronary Artery Disease (CAD) is one major cause of disability in adults and one main cause of death in developed. In this study, data mining techniques including Decision Trees, Artificial neural networks (ANNs), and Support Vector Machine (SVM) analyze CAD data. Data of 4948 patients who had suffered from heart diseases were included in the analysis. CAD is the target variable, and 24 inputs or predictor variables are used for the classification. The performance of these techniques is compared in terms of sensitivity, specificity, and accuracy. The most significant factor influencing CAD is chest pain. Elderly males (age > 53) have a high probability to be diagnosed with CAD. SVM algorithm is the most useful way for evaluation and prediction of CAD patients as compared to non-CAD ones. Application of data mining techniques in analyzing coronary artery diseases is a good method for investigating the existing relationships between variables.

Keywords: classification, coronary artery disease, data-mining, knowledge discovery, extract

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Authors: Chandra Shekhar Majumder, Shamsul Haque, Khondaker Anower Hossain, Rafiqul Islam

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Introduction: Ocular helminths are parasites that infect the eye or its adnexa. They can be either motile worms or sessile worms that form cysts. These parasites require two hosts for their life cycle, a definite host (usually a human) and an intermediate host (usually an insect). While there have been reports of ocular helminths infecting various structures of the eye, including the anterior chamber and subconjunctival space, there is no previous record of such a case involving the lens. Research Aim: The aim of this case report is to present a rare case of ocular helminth infection in the lens and to contribute to the understanding of this unusual site of infection. Methodology: This study is a case report, presenting the details and findings of an 80-year-old retired policeman who presented with severe pain, redness, and vision loss in the left eye. The examination revealed the presence of a thread-like helminth in the lens. The data for this case report were collected through clinical examination and medical records of the patient. The findings were described and presented in a descriptive manner. No statistical analysis was conducted. Case report: An 80-year-old retired policeman attended the OPD, Faridpur Medical College Hospital with the complaints of severe pain, redness and gross dimness of vision of the left eye for 5 days. He had a history of diabetes mellitus and hypertension for 3 years. On examination, L/E visual acuity was PL only, moderate ciliary congestion, KP 2+, cells 2+ and posterior synechia from 5 to 7 O’clock position was found. Lens was opaque. A thread like helminth was found under the anterior of the lens. The worm was moving and changing its position during examination. On examination of R/E, visual acuity was 6/36 unaided, 6/18 with pinhole. There was lental opacity. Slit-lamp and fundus examination were within normal limit. Patient was admitted in Faridpur Medical College Hospital. Diabetes mellitus was controlled with insulin. ICCE with PI was done on the same day of admission under depomedrol coverage. The helminth was recovered from the lens. It was thread like, about 5 to 6 mm in length, 1 mm in width and pinkish in colour. The patient followed up after 7 days, VA was HM, mild ciliary congestion, few KPs and cells were present. Media was hazy due to vitreous opacity. The worm was sent to the department of Parasitology, NIPSOM, Dhaka for identification. Theoretical Importance: This case report contributes to the existing literature on ocular helminth infections by reporting a unique case involving the lens. It highlights the need for further research to understand the mechanism of entry of helminths in the lens. Conclusion: To the best of our knowledge, this is the first reported case of ocular helminth infection in the lens. The presence of the helminth in the lens raises interesting questions regarding its pathogenesis and entry mechanism. Further study and research are needed to explore these aspects. Ophthalmologists and parasitologists should be aware of the possibility of ocular helminth infections in unusual sites like the lens.

Keywords: helminth, lens, ocular, unusual

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Authors: Bryce R. Jolley, Michael Uchic

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This study presents initial results toward the correlative characterization of inherent defects of Ti-6Al-4V additive manufacture (AM). X-Ray Computed Tomography (CT) defect data are compared and correlated with microscopic photographs obtained via automated serial sectioning. The metal AM specimen was manufactured out of Ti-6Al-4V virgin powder to specified dimensions. A post-contour was applied during the fabrication process with a speed of 1050 mm/s, power of 260 W, and a width of 140 µm. The specimen was stress relief heat-treated at 16°F for 3 hours. Microfocus CT imaging was accomplished on the specimen within a predetermined region of the build. Microfocus CT imaging was conducted with parameters optimized for Ti-6Al-4V additive manufacture. After CT imaging, a modified RoboMet. 3D version 2 was employed for serial sectioning and optical microscopy characterization of the same predetermined region. Automated montage capture with sub-micron resolution, bright-field reflection, 12-bit monochrome optical images were performed in an automated fashion. These optical images were post-processed to produce 2D and 3D data sets. This processing included thresholding and segmentation to improve visualization of defect features. The defects observed from optical imaging were compared and correlated with the defects observed from CT imaging over the same predetermined region of the specimen. Quantitative results of area fraction and equivalent pore diameters obtained via each method are presented for this correlation. It is shown that Microfocus CT imaging does not capture all inherent defects within this Ti-6Al-4V AM sample. Best practices for this correlative effort are also presented as well as the future direction of research resultant from this current study.

Keywords: additive manufacture, automated serial sectioning, computed tomography, nondestructive evaluation

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Authors: Samitharathana R. Wadigala

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The peace will not be established until the self-consciousness would reveal in the human beings. In this nuclear age, the establishment of a lasting peace on the earth represents the primary condition for the preservation of human civilization and survival of human beings. Nothing perhaps is so important and indispensable as the achievement and maintenance of peace in the modern world today. Peace in today’s world implies much more than the mere absence of war and violence. In the interdependent world of today the United Nations needs to be representative of the modern world and democratic in its functioning because it came into existence to save the generations from the scourge of war and conflict. Buddhism is the religion of peaceful co-existence and philosophy of enlightenment. Violence and conflict from the perspective of the Buddhist theory of interdependent origination (Paṭiccasamuppāda) are same with everything else in the world a product of causes and conditions. Buddhism is totally compatible with the congenial and peaceful global order. The canonical literature, doctrines, and philosophy of Buddhism are the best suited for inter-faith dialogue, harmony, and universal peace. Even today Buddhism can resurrect the universal brotherhood, peaceful co-existence and harmonious surroundings in the comity of nations. With its increasing vitality in regions around the world, many people today turn to Buddhism for relief and guidance at the time when peace seems to be a deferred dream more than ever. From a Buddhist point of view the roots of all unwholesome actions (Conflict) i. e. greed, hatred and delusion are viewed as the root cause of all human conflicts. Conflict often emanates from attachment to material things: pleasures, property, territory, wealth, economic dominance or political superiority. Buddhism has some particularly rich resources for deployment in dissolving conflict. Buddhism addresses the Buddhist perspective on the causes of conflict and ways to resolve conflict to realize world peace. The world has enough to satisfy every body’s needs but not every body’s greed.

Keywords: Buddhism, conflict-violence, peace, self-consciousness

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Authors: Renata Kurpiewska-Korbut

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Making an assumption that the use and sharing of data generated in humanitarian action constitute a core function of humanitarian organizations, the paper analyzes the position of the largest Polish humanitarian non-governmental organizations in the humanitarian data ecosystem in Ukraine and their approach to non-personal and personal data management since February of 2022. Both expert interviews and document analysis of non-profit organizations providing a direct response in the Ukrainian crisis context, i.e., the Polish Humanitarian Action, Caritas, Polish Medical Mission, Polish Red Cross, and the Polish Center for International Aid and the applicability of theoretical perspective of contingency theory – with its central point that the context or specific set of conditions determining the way of behavior and the choice of methods of action – help to examine the significance of data complexity and adaptive approach to data management by relief organizations in the humanitarian supply chain network. The purpose of this study is to determine how the existence of well-established and accurate internal procedures and good practices of using and sharing data (including safeguards for sensitive data) by the surveyed organizations with comparable human and technological capabilities are implemented and adjusted to Ukrainian humanitarian settings and data infrastructure. The study also poses a fundamental question of whether this crisis experience will have a determining effect on their future performance. The obtained finding indicate that Polish humanitarian organizations in Ukraine, which have their own unique code of conduct and effective managerial data practices determined by contingencies, have limited influence on improving the situational awareness of other assistance providers in the data ecosystem despite their attempts to undertake interagency work in the area of data sharing.

Keywords: humanitarian data ecosystem, humanitarian data management, polish NGOs, Ukraine

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Authors: K. P. Farsana

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Each and every community has its own way of understanding on health and illness; it varies from culture to culture. According to the Mappila Muslims of Malappuram, the state of pain, distress, and misery is understood as an affliction to their health. They believe that most of the afflictions are due to the Jinn/ Shaitanic Possession. So they prefer religious healers than the other systems of medicine for their treatments. Thangals are the endogamous community in Kerala, of Yemeni heritage who claim direct descent from the Prophet Mohammed’s family. Because of their sacrosanct status, many Thangals works as religious healers in Northern Kerala. Using the case of one Thangal healer as the illustration of the many religious healers in Kerala who engage in the healing practices, it is intended, in this paper to illustrate the patterns of afflictions among Mappila Muslims of Malappuram. Based on the analysis of this Thangal’s healing practice in the local context of Northern Kerala, the researcher further discusses the modes of treatment which they are providing to care seekers.

Keywords: affliction, religious healing, faith, Mappila Muslims, Jinn/Shaitanic possession

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Authors: Deepak Mohan, Sushma Sharma

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Diclofenac sodium, a member of the acetic acid family of non-steroidal anti-inflammatory drugs, is used to retard inflammation, arthritis pain and ankylosing spondylitis. The drug is known to cause severe injury in different tissues due to formation of reactive oxygen species. The present study is focused on the effect of different doses of diclofenac (4 mg/kg/body weight and 14 mg/kg/body weight on histoarchitecture of the liver from 7-28 days of the investigation. Diclofenac administration resulted in distorted hepatic degeneration and formation of wide areas in the form of sinusoidal gaps. Hepatic fibrosis noticed in different stages of investigation could be attributed to chronic inflammation and reactive oxygen species which results in deposition of extracellular matrix proteins. The abrupt degenerative changes observed during later stages of the experiment showed maximum damage to the liver, and there was enlargement of sinusoidal gaps accompanied by maximum necrosis in the tissues.

Keywords: arthritis, diclofenac, histoarchitecture, sinusoidal

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Authors: Chariya Laohavich

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Background: Some limitations and complications have been found associated with commercial mouthpiece in bronchoscopic procedure. Therefore, we invented the Rama-chest mouthpiece from plastic normal saline bottle. Objective: The aim of this study was to compare user satisfaction in Rama-chest mouthpiece with the commercial mouthpiece. Methods: A prospective randomized controlled trial between commercial mouthpiece and Rama-chest mouthpiece was conducted on patients who were underwent bronchoscopy and required mouthpiece insertion from May to June 2014. The questionnaire about satisfaction was completed by the bronchoscopists, assistant nurses, and patients. Results: Thirty procedures in both groups were investigated. Mean satisfaction scores filled by the bronchoscopists and assistant nurses were not different between both groups. However, higher satisfaction score filled by the patients was found in Rama-chest mouthpiece than the comparator (p=0.011). Complications such as abrasion, pain, and itching were observed in commercial mouthpiece but not found in Rama-chest mouthpiece. Conclusion: We have introduced Rama-chest mouthpiece and proved its usefulness comparable to the commercial mouthpiece.

Keywords: mouthpiece, bronchoscopist, bronchology, pulmonology and respiratory diseases

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Authors: Kong Wing Man

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The purpose of this paper is to review the waste generation and management in different parts of the world. It is undeniable that waste generation and management has become an alarming environmental issue. Solid waste generation links inextricably to the degree of industrialization and economic development. Urbanization increases with the economic wealth of the countries. As the income of people and standard of living enhances, so does their consumption of goods and services, leading to a corresponding increase in waste generation. Based on the latest statistics from What A Waste Report published by World Bank (2012), it is estimated that the current global Municipal Solid Waste (MSW) generation levels are about 1.3 billion tonnes per year (1.2 kg per capita per day). By 2050, it is projected that the waste generation will be doubled. Although many waste collection practices have been implemented in various countries, the amount of waste generation keeps increasing. An integrated solid waste management is needed in order to reduce the continuous significant increase in waste generation rates. Although many countries have introduced and implemented the 3Rs strategy and landfill, however, these are only the ways to diverse waste, but cannot reduce the volume. Instead, the advanced thermal treatment technology, incineration, can reduce up to 90% volume of disposed waste prior to dispose at landfills is discussed. Sweden and Tokyo were chosen as case studies, which provide an overview of the municipal solid waste management system. With the condition of escalating amount of wastes generated, it is crucial to build incinerators to relief pressing needs of landfill. Two solutions are proposed to minimize waste generation, including one incineration in one city and several small incinerators in different cities. While taking into consideration of a sustainable model and the perspectives of all stakeholders, building several incinerators at different cities and different sizes would be the best option to reduce waste. Overall, the solution to the global solid waste management should be a holistic approach with the involvement of both government and citizens.

Keywords: Incineration, Municipal Solid Waste, Thermal Treatment, Waste generation

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Authors: Charlotte Lülf

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Migration flows, resulting from war, climate change or economic crisis cannot be tackled by single states but need to be addressed as a transnational and international responsibility. The traditional architecture surrounding the work of the UNHCR and the 1951 Convention, however, is not equipped to deal with these challenges. Widely excluded from legal protection are people not individually persecuted for the statutory criteria, people that flee from the indiscriminate effects of an armed conflict as well as people fleeing natural disasters. With the lack of explicit legal protection and the political reluctance of nation states worldwide to extend their commitment in new asylum laws, the judiciary must be put in focus: it plays a unique role in interpreting and potentially expanding the application of existing regulations. This paper as part of an ongoing Ph.D. Project deals with the current and partly contradicting approaches to the protection of war- and climate refugees. Changing jurisprudential practice of national and regional courts will be assessed, as will be their dialogue to interpret the international obligations of human rights law, migration laws, and asylum laws in an interacting world. In recent judgments refoulment to an armed conflict as well as countries without adequate disaster relief or health care was argued as violating fundamental human and asylum law rights and therefore prohibited – even for applicants without refugee status: The first step towards access to subsidiary protection could herewith be established. Can one observe similar developments in other parts of the world? This paper will evaluate the role of the judiciary to define, redefine and potentially expand protection for people seeking refuge from armed conflicts and natural disasters.

Keywords: human rights law, asylum-seekers, displacement, migration

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Authors: Mara J. Richman, Zsolt Unoka, Robert Dudas, Zsolt Demetrovics

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Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and effective liability. Of this domain, ruminative behaviors have been considered a core feature of emotion dysregulation difficulties. Taking this into consideration, a meta-analysis was performed to assess how BPD symptoms correlate with rumination, while also considering clinical moderator variables such as comorbidity, GAF score, and type of BPD symptom and demographic moderator variables such as age, gender, and education level. Analysis of correlation across rumination domains for the entire sample revealed a medium overall correlation. When assessing types of rumination, the largest correlation was among pain rumination followed by anger, depressive, and anxious rumination. Furthermore, affective instability had the strongest correlation with increased rumination, followed by unstable relationships, identity disturbance, and self-harm/ impulsivity, respectively. Demographic variables showed no significance. Clinical implications are considered and further therapeutic interventions are discussed in the context of rumination.

Keywords: borderline personality disorder, meta-analysis, rumination, symptoms

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Authors: Soumeya Krimat, Tahar Dob, Aicha Kesouri, Ahmed Nouasri, Hafidha Metidji

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Lavandula antineae Maire is an endemic medicinal plant of Algeria which is traditionally used for the treatment of chills, bruises, oedema and rheumatism. The objective of this study is to evaluate the anti-inflammatory of hydromethanolic aerial parts extract of Lavandula antineae for the first time using carrageenan-paw edema and croton oil-ear odema models. The plant extract, at the dose of 200 mg/kg, showed a significant anti-inflammatory activity (P˂0.05) in the carrageenan induced edema test in mice, showing 80.74% reduction in the paw thikness comparable to that produced by the standard drug aspirin 83.44% at 4h. When it was applied topically at a dosage of 1 and 2 mg per ear, the percent edema reduction in treated mice was 29.45% and 74.76%, respectively. These results demonstrate that Lavandula antineae Maire extract possess remarkable anti-inflammatory activity, supporting the folkloric usage of the plant to treat various inflammatory and pain diseases.

Keywords: lavandula antineae maire, medicinal plant, anti-inflammatory activity, carrageenan-paw edema, croton oil-ear edema

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Authors: S. P. Bansal, Mukesh Kumar Sharma, Ankit Prabhakar

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Luhri Hydroelectric Project Stage-I (210 MW) is a run of the river type development with a dam toe surface powerhouse (122m long, 50.50m wide, and 65.50m high) on the right bank of river Satluj in Himachal Pradesh, India. The project is located in the inner lesser Himalaya between Dhauladhar Range in the south and higher Himalaya in the north in the seismically active region. At the project, the location river is confined within narrow V-shaped valleys with little or no flat areas close to the river bed. Nearly 120m high cut slopes behind the powerhouse are proposed from the powerhouse foundation level of 795m to ± 915m to accommodate the surface powerhouse. The stability of 120m high cut slopes is a prime concern for the reason of risk involved. The slopes behind the powerhouse will be excavated in mainly in augen gneiss, fresh to weathered in nature, and biotite rich at places. The foliation joints are favorable and dipping inside the hill. Two valleys dipping steeper joints will be encountered on the slopes, which can cause instability during excavation. Geological exploration plays a vital role in designing and optimization of cut slopes. SWEDGE software has been used to analyze the geometry and stability of surface wedges in cut slopes. The slopes behind powerhouse have been analyzed in three zones for stability analysis by providing a break in the continuity of cut slopes, which shall provide quite substantial relief for slope stabilization measure. Pseudo static analysis has been carried out for the stabilization of wedges. The results indicate that many large wedges are forming, which have a factor of safety less than 1. The stability measures (support system, bench width, slopes) have been planned so that no wedge failure may occur in the future.

Keywords: cut slopes, geotechnical investigations, Himalayan geology, surface powerhouse, wedge failure

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Authors: Shruti Govindarajan

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In-utero gene editing with CRISPR-Cas9 opens up new possibilities for treating genetic disorders during pregnancy while still in mother’s womb. By targeting genetic mutations in the early stages of fetal development, this approach could potentially prevent severe conditions—like cystic fibrosis, sickle cell anemia, and muscular dystrophy—from causing harm. CRISPR-Cas9, which allows precise DNA edits, could be delivered into fetal cells through vectors such as adeno-associated viruses (AAVs) or nanoparticles, correcting disease-causing mutations and possibly offering lifelong relief from these disorders. For families facing severe genetic diagnoses, in-utero gene editing could provide a transformative option. However, technical challenges remain, including ensuring that gene editing only targets the intended cells and verifying long-term safety. Ethical considerations are also at the forefront of this technology. The editing of a fetus's genes brings up difficult questions about consent, especially since these genetic changes will affect the child’s entire life without their input. There's also concern over possible unintended side effects, or changes passed down to future generations. Moreover, if used beyond therapeutic purposes, this technology could be misused for ‘enhancements,’ like selecting for certain physical or cognitive traits, raising concerns about inequality and social pressures. In this way, in-utero gene editing brings both exciting potential and complex moral questions. As research progresses, addressing these scientific and ethical concerns will be key to ensuring that this technology is used responsibly, prioritizing safety, fairness, and a focus on alleviating genetic disease. A cautious and inclusive approach, along with clear regulations, will be essential to realizing the benefits of in-utero gene editing while protecting against unintended consequences.

Keywords: in-utero gene editing, CRISPR, bioethics, genetic disorder

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Authors: Lucile Rapin, Cynthia El Hage, Rihab Gamaoun, Maria-Fernanda Arboleda, Erin Prosk

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Introduction: Sante Cannabis (SC), a Canadian group of clinics dedicated to medical cannabis, based in Montreal and in the province of Quebec, has served more than 8000 patients seeking cannabis-based treatment over the past five years. As randomized clinical trials with natural medical cannabis are scarce, real-world evidence offers the opportunity to fill research gaps between scientific evidence and clinical practice. Data on the use of medical cannabis products from SC patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to report information on the profiles of both patients and prescribed medical cannabis products at SC clinics, and to assess the safety of medical cannabis among Canadian patients. Methods: This is an observational retrospective study of 1342 adult patients who were authorized with medical cannabis products between October 2017 and September 2019. Information regarding demographic characteristics, therapeutic indications for medical cannabis use, patterns in dosing and dosage form of medical cannabis and adverse effects over one-year follow-up (initial and 4 follow-up (FUP) visits) were collected. Results: 59% of SC patients were female, with a mean age of 56.7 (SD= 15.6, range= (19-97)). Cannabis products were authorized mainly for patients with a diagnosis of chronic pain (68.8% of patients), cancer (6.7%), neurological disorders (5.6%), and mood disorders (5.4 %). At initial visit, a large majority (70%) of patients were authorized exclusively medical cannabis products, 27% were authorized a combination of pharmaceutical cannabinoids and medical cannabis and 3% were prescribed only pharmaceutical cannabinoids. This pattern was recurrent over the one-year follow-up. Overall, oil was the preferred formulation (average over visits 72.5%) followed by a combination of oil and dry (average 19%), other routes of administration accounted for less than 4%. Patients were predominantly prescribed products with a balanced THC:CBD ratio (59%-75% across visits). 28% of patients reported at least one adverse effect (AE) at the 3-month follow-up visit and 12% at the six-month FUP visit. 84.8% of total AEs were mild and transient. No serious AE was reported. Overall, the most common side effects reported were dizziness (11.95% of total AEs), drowsiness (11.4%), dry mouth (5.5%), nausea (4.8%), headaches (4.6%), cough (4.4%), anxiety (4.1%) and euphoria (3.5%). Other adverse effects accounted for less than 3% of total AE. Conclusion: Our results confirm that the primary area of clinical use for medical cannabis is in pain management. Patients in this cohort are largely utilizing plant-based cannabis oil products with a balanced ratio of THC:CBD. Reported adverse effects were mild and included dizziness and drowsiness. This real-world data confirms the tolerable safety profile of medical cannabis and suggests medical indications not yet validated in controlled clinical trials. Such data offers an important opportunity for the investigation of the long-term effects of cannabinoid exposure in real-life conditions. Real-world evidence can be used to direct clinical trial research efforts on specific indications and dosing patterns for product development.

Keywords: medical cannabis, safety, real-world data, Canada

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Authors: Romi Dey

Abstract:

Introduction: One of the most important criteria for technology to sustain and grow is through it’s elaborate and intuitive design methodology and design thinking. Designing for enterprise applications that cater to Just in Time Technology is one of the most challenging and detailed processes any User Experience Designer would come across. Description: The basic principles of Design, when applied to tailor to these technologies, creates an immense challenge and that’s how a set of redefined and revised design principles that can be applied to designing any Just In Time manufacturing solution. Findings: The thorough process of understanding the end user, their existing pain points which they’ve faced in the real world, their responsibilities and expectations, the core needs and last but not the least the demands, creates havoc nurturing of the design methodologies for the Just in Time solutions. With respect to the business aspect, design and design principles play a strong role in any form of innovation. Conclusion: Innovation and knowledge about the latest technologies are the keywords in the manufacturing industry. It becomes crucial for the product development team to be precise in their understanding of the technology and being sure of end users expectation.

Keywords: design thinking, enterprise application, Just in Time, user experience design

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Authors: Cheuk Wing Lee, Kit Lun Yick, Sun Pui Ng, Joanne Yip

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Daily activities and exercise may result in large displacements of the breasts, which lead to breast pain and discomfort. Therefore, a proper bra design and fit can help to control excessive breast motion to prevent the over-stretching of the connective tissues. Nevertheless, bra fit problems, such as excessively high tension of the shoulder straps and a tight underband could have substantially negative effects on the wear comfort and health of the wearer. The purpose of this study is to, therefore, examine the effects of bra band tension on breast displacement. Usually, human wear trials are carried out, but there are inconsistencies during testing. Therefore, a soft manikin torso is used to examine breast displacement at walking speeds of 2.30 km/h and 4.08 km/h. The breast displacement itself is determined by using a VICON motion capture system. The 3D geometric changes of the underwire bra band tension and the corresponding control of breast movement are also analyzed by using a 3D handheld scanner along with Rapidform software. The results indicate that an appropriate bra band tension can help to reduce breast displacement and provide a comfortable angle for the underwire. The findings can be used by designers and bra engineers as a reference source to advance bra design and development.

Keywords: bra band, bra features, breast displacement, underwire angle

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Authors: Muhd. Barzani Gasim, Mohd. Ekhwan Toriman, Mohd. Khairul Amri Kamarudin, Azman Azid, Siti Humaira Haron, Muhammad Hafiz Md. Saad

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Malaysia is a country in Southeast Asia that constantly exposed to flooding and landslide. The disaster has caused some troubles such loss of property, loss of life and discomfort of people involved. This problem occurs as a result of climate change leading to increased stream flow rate as a result of disruption to regional hydrological cycles. The aim of the study is to determine hydrologic processes in the east coasts of Peninsular Malaysia, especially in Kelantan Basin. Parameterized to account for the spatial and temporal variability of basin characteristics and their responses to climate variability. For hydrological modeling of the basin, the Soil and Water Assessment Tool (SWAT) model such as relief, soil type, and its use, and historical daily time series of climate and river flow rates are studied. The interpretation of Landsat map/land uses will be applied in this study. The combined of SWAT and climate models, the system will be predicted an increase in future scenario climate precipitation, increase in surface runoff, increase in recharge and increase in the total water yield. As a result, this model has successfully developed the basin analysis by demonstrating analyzing hydrographs visually, good estimates of minimum and maximum flows and severe floods observed during calibration and validation periods.

Keywords: east coasts of Peninsular Malaysia, Kelantan river basin, minimum and maximum flows, severe floods, SWAT model

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Authors: Somayeh Abedian, Pirhossein Kolivand, Hamid Reza Lornejad, Amin Karampour, Ebrahim Keshavarz Safari

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For emergency and relief service providers such as pre-hospital emergencies, quick arrival at the scene of an accident or any EMS mission is one of the most important requirements of effective service delivery. Response time (the interval between the time of the call and the time of arrival on scene) is a critical factor in determining the quality of pre-hospital Emergency Medical Services (EMS). This is especially important for heart attack, stroke, or accident patients. Location-based e-services can be broadly defined as any service that provides information pertinent to the current location of an active mobile handset or precise address of landline phone call at a specific time window, regardless of the underlying delivery technology used to convey the information. According to research, one of the effective methods of meeting this goal is determining the location of the caller via the cooperation of landline and mobile phone operators in the country. The follow-up of the Communications Regulatory Authority (CRA) organization has resulted in the receipt of two separate secured electronic web services. Thus, to ensure human privacy, a secure technical architecture was required for launching the services in the pre-hospital EMS information management system. In addition, to quicken medics’ arrival at the patient's bedside, rescue vehicles should make use of an intelligent transportation system to estimate road traffic using a GPS-based mobile navigation system independent of the Internet. This paper seeks to illustrate the architecture of the practical national model used by the Iranian EMS organization.

Keywords: response time, geographic location inquiry service (GLIS), location-based service (LBS), emergency medical services information system (EMSIS)

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Authors: Christina Tran, Lu Khoo, Andrea Waylen

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Introduction: The evolution of the dental consultation from paternalism to partnership has been well documented in developed Western countries. Great emphasis is now placed on the importance of empowering patients to make decisions regarding their care, obtaining informed consent, and maintaining patient privacy and confidentiality. With the majority of communication occurring non-verbally, clinicians often adopt behaviours which suggest an approachable and positive attitude. However, evidence indicates that in Asia, a paternalistic model may be favored in medicine. The power imbalance occurring in doctor-patient relationships worldwide may be exacerbated by various factors in Southeast Asia: the strong hierarchical culture, and the large education gap between doctor and patient. Further insight into this matter can be gained by observing patient-dentist communication in Cambodia. The dentist:population ratio in Cambodia is approximately 1:33,000, with rural areas remaining extremely underserviced. We have carried out an observational study of communication in a voluntary dental clinic in Cambodia with the aim of describing whether the patient-dentist relationship follows a paternalistic or patient-centred model. Method: Over a period of two weeks, two clinicians provided dental care as part of a voluntary program in two Cambodian settings: a temporary, rural clinic and a permanent clinic in Phnom Penh. The clinicians independently recorded their experiences in diaries, making observations on the verbal and non-verbal communication between patients and staff. General observations such as the clinic environment were also made. The diaries were then compared and analyzed using a thematic approach. Results: The overall themes that emerged were regarding the clinic environment, verbal communication, and non-verbal communication. Regarding the clinic environment, the rural clinic was arranged in order to easily direct patients from one dentist to another, with little emphasis on continuous patient care. There was also little consideration for patient privacy: patients were often treated in the presence of many observers, including other waiting patients. However, the permanent clinic was structured to allow greater patient privacy, with continuous patient care occurring throughout the appointment. Regarding verbal communication, there was a strongly paternalistic approach to gaining consent and giving instruction. Patients rarely asked questions regarding their treatment, with dentists doing little to encourage patient involvement. Non-verbal communication between patients and dentists was generally paternalistic, with the dentist often addressing the supine patient from above. Patients often avoided making eye-contact, which may have indicated discomfort or lack of engagement. Both adult and paediatric patients rarely raised verbal concerns regarding pain during treatment, despite displaying non-verbal signs of experiencing pain. Anxious paediatric patients were sometimes managed with physical restraint by their mothers to facilitate treatment. Conclusion: Patient-professional communication in the Cambodian dental setting was observed to be generally paternalistic in nature, although more patient-centred aspects were observed in the established, urban setting. However, it should be noted that these observations are subjective in nature, and that the patients’ actual perceptions of their communication experience were unexplored. Further observations in variety of dental settings in Cambodia are needed before any definitive conclusions can be made.

Keywords: patient-dentist communication, paternalism, patient-centered, non-verbal communication

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Authors: Nirav P. Vaghela

Abstract:

Work-related musculoskeletal symptoms (WMS) are a major health issue in many occupations all over the world. Past research on hospital workers have mainly been focused on nurses [8] and very few studies have examined musculoskeletal symptoms among doctors in various specialties. The work of surgeons can involve high levels of mental concentration and very precise movements that can be categorized as mild-to-moderate physical demands. Design: Forty-three surgeons were enrolled in this study. To investigate musculoskeletal disorder among the surgeons we had used Standardised Nordic Questionnaire, Quick Exposure Check (QEC) and Workstyle Short Form. Result: In the current study, total 43 surgeons participants out of 30 males and 13 females. Their mean age was 42.07 ± 12.35, and the mean working years of the group were 15.14years ±9.017. On the average, they worked a total of about 8.58 h (±1.967) per day. The prevalence of work related musculoskeletal symptoms among the surgeons indicating 83.70% surgeons had atleast one joint affected while 16.30% had no symptoms at all. Conclusion: The present survey study has shown high prevalence rates of neck, back and shoulder musculoskeletal symptoms in surgeons.

Keywords: repetitive stress injury, pain, occupational hazards, disability, abneetism, physical health, quality of life

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Authors: Priya Kulkarni, Soumya Koppikar, Datta Shinde, Shantanu Deshpande, Narendrakumar Wagh, Abhay Harsulkar

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Osteoarthritis (OA) is associated with multiple and overlapping aetiologies. IL-1β is produced by stressed tissue and known to aggravate disease pathologies. We selected 10 patients with elevated IL-1β in their synovial fluids (SF). We hypothesized IL-1β as nodal-point connecting different pathologies. IL-1β was higher in all meniscal tear (MT) patients perhaps as the earliest response to injury. Since MT above age of 30 leads to OA in less than 5 years, it is attributed that IL-1β modulates OA pathology. Among all bilateral OA patients, an interesting case operated for Total-Knee-Replacement revealed differential cartilage degeneration demonstrating strong association with higher IL-1β. Symptoms like acute-pain, effusion and redness were correlated with higher IL-1β and NO (Nitric-oxide). However, higher IL-1β was also found without typical-inflammation characterized by infiltration of neutrophils and macrophages. Cultured synoviocytes responded to IL-1β by releasing NO. In conclusion, IL-1β in SF acquires central position influencing different OA pathologies and aetiologies.

Keywords: IL-1β, meniscal tear, osteoarthritis, synovial fluid

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Authors: Sneha Noble, Rahul Krishnan, Uma G., D. K. Vijaykumar

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Breast-Cancer related Lymphedema is a major problem that affects many women. Lymphedema is the swelling that generally occurs in the arms or legs caused by the removal of or damage to lymph nodes as a part of cancer treatment. Treating it at the earliest possible stage is the best way to manage the condition and prevent it from leading to pain, recurrent infection, reduced mobility, and impaired function. So, this project aims to focus on the multi-modal approaches to identify the risks of Lymphedema in post-surgical oncology patients and prevent it at the earliest. The Kinect IR Sensor is utilized to capture the images of the body and after image processing techniques, the region of interest is obtained. Then, performing the voxelization method will provide volume measurements in pre-operative and post-operative periods in patients. The formation of a mathematical model will help in the comparison of values. Clinical pathological data of patients will be investigated to assess the factors responsible for the development of lymphedema and its risks.

Keywords: Kinect IR sensor, Lymphedema, voxelization, lymph nodes

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