Search results for: end of life care

Authors: Raif Parlakkaya, Mustafa Nihat Demirci, Mehmet Nuri Salur

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Environmental pollution has detrimental effects on the quality of our life and its scope has reached such an extent that measures are being taken both at the national and international levels to reduce, prevent and mitigate its impact on social, economic and political spheres. Therefore, awareness of environmental problems has been increasing among stakeholders and accordingly among companies. It is seen that corporate reporting is expanding beyond environmental performance. Primary purpose of publishing an environmental report is to provide specific audiences with useful, meaningful information. This paper is intended to analyze the extent and qualification of environmental disclosures of Turkish publicly quoted firms and see how it varies from one sector to another. The data for the study were collected from annual activity reports of companies, listed on the corporate governance index (BIST-XKURY) of Istanbul Stock Exchange. Content analysis was the research methodology used to measure the extent of environmental disclosure. Accordingly, 2015 annual activity reports of companies that carry out business in some particular fields were acquired from Capital Market Board, websites of Public Disclosure Platform and companies’ own websites. These reports were categorized into five main aspects: Environmental policies, environmental management systems, environmental protection and conservation activities, environmental awareness and information on environmental lawsuits. Subsequently, each component was divided into several variables related to what each firm is supposed to disclose about environmental information. In this context, the nature and scope of the information disclosed on each item were assessed according to five different ways (N.I: No Information; G.E.: General Explanations; Q.E.: Qualitative Detailed Explanations; N.E.: Quantitative (numerical) Detailed Explanations; Q.&N.E.: Both Qualitative and Quantitative Explanations).

Keywords: environmental accounting, disclosure, corporate governance, content analysis

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Authors: Ali Aydin, Mert Sudagidan, Aysen Coban, Alparslan Kadir Devrim

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Pseudomonas spp. (specifically, P. fluorescens and P. fragi) are considered the principal spoilage microorganisms of refrigerated poultry meats. The higher the level psychrophilic spoilage Pseudomonas spp. on carcasses at the end of processing lead to decrease the shelf life of the refrigerated product. The aim of the study was the identification of psychrophilic Pseudomonas spp. having proteolytic and lipolytic activities from poultry meats by 16S rRNA and rpoB gene sequencing, investigation of protease and lipase related genes and determination of proteolytic activity of Pseudomonas spp. In the of isolation procedure, collected chicken meat samples from local markets and slaughterhouses were homogenized and the lysates were incubated on Standard method agar and Skim Milk agar for selection of proteolytic bacteria and tributyrin agar for selection of lipolytic bacteria at +4 °C for 7 days. After detection of proteolytic and lipolytic colonies, the isolates were firstly analyzed by biochemical tests such as Gram staining, catalase and oxidase tests. DNA gene sequencing analysis and comparison with GenBank revealed that 126 strong enzyme Pseudomonas spp. were identified as predominantly P. fluorescens (n=55), P. fragi (n=42), Pseudomonas spp. (n=24), P. cedrina (n=2), P. poae (n=1), P. koreensis (n=1), and P. gessardi (n=1). Additionally, protease related aprX gene was screened in the strains and it was detected in 69/126 strains, whereas, lipase related lipA gene was found in 9 Pseudomonas strains. Protease activity was determined using commercially available protease assay kit and 5 strains showed high protease activity. The results showed that psychrophilic Pseudomonas strains were present in chicken meat samples and they can produce important levels of proteases and lipases for food spoilage to decrease food quality and safety.

Keywords: Pseudomonas, chicken meat, protease, lipase

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Authors: Fatemeh Abbasi, Sahand Daneshvar

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Productivity is one of the essential goals of companies to improve performance, which as a strategy-oriented method, determines the basis of the company's economic growth. The history of productivity goes back centuries, but most researchers defined productivity as the relationship between a product and the factors used in production in the early twentieth century. Productivity as the optimal use of available resources means that "more output using less input" can increase companies' economic growth and prosperity capacity. Also, having a quality life based on economic progress depends on productivity growth in that society. Therefore, productivity is a national priority for any developed country. There are several methods for calculating productivity growth measurements that can be divided into parametric and non-parametric methods. Parametric methods rely on the existence of a function in their hypotheses, while non-parametric methods do not require a function based on empirical evidence. One of the most popular non-parametric methods is Data Envelopment Analysis (DEA), which measures changes in productivity over time. The DEA evaluates the productivity of decision-making units (DMUs) based on mathematical models. This method uses multiple inputs and outputs to compare the productivity of similar DMUs such as banks, government agencies, companies, airports, Etc. Non-parametric methods are themselves divided into the frontier and non frontier approaches. The Malmquist productivity index (MPI) proposed by Caves, Christensen, and Diewert (1982), the Hicks–Moorsteen productivity index (HMPI) proposed by Bjurek (1996), or the Luenberger productivity indicator (LPI) proposed by Chambers (2002) are powerful tools for measuring productivity changes over time. This study will compare the Malmquist, Hicks–Moorsteen, and Luenberger indices theoretically and empirically based on DEA models and review their strengths and weaknesses.

Keywords: data envelopment analysis, Hicks–Moorsteen productivity index, Leuenberger productivity indicator, malmquist productivity index

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Authors: Mohammadreza Salek Faramarzi, Touraj Taghikhany

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In this paper, seismic fragility assessment of a recently developed hybrid structural system, known as the strongback system (SBS) is investigated. In this system, to mitigate the occurrence of the soft-story mechanism and improve the distribution of story drifts over the height of the structure, an elastic vertical truss is formed. The strengthened members of the braced span are designed to remain substantially elastic during levels of excitation where soft-story mechanisms are likely to occur and impose a nearly uniform story drift distribution. Due to the distinctive characteristics of near-field ground motions, it seems to be necessary to study the effect of these records on seismic performance of the SBS. To this end, a set of 56 near-field ground motion records suggested by FEMA P695 methodology is used. For fragility assessment, nonlinear dynamic analyses are carried out in OpenSEES based on the recommended procedure in HAZUS technical manual. Four damage states including slight, moderate, extensive, and complete damage (collapse) are considered. To evaluate each damage state, inter-story drift ratio and floor acceleration are implemented as engineering demand parameters. Further, to extend the evaluation of the collapse state of the system, a different collapse criterion suggested in FEMA P695 is applied. It is concluded that SBS can significantly increase the collapse capacity and consequently decrease the collapse risk of the structure during its life time. Comparing the observing mean annual frequency (MAF) of exceedance of each damage state against the allowable values presented in performance-based design methods, it is found that using the elastic vertical truss, improves the structural response effectively.

Keywords: IDA, near-fault, probabilistic performance assessment, seismic fragility, strongback system, uncertainty

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Authors: Jarmila Bernasovska, Pavel Ružbarský, Ivan Bernasovsky, Regina Lohajová Behulová

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The paper presents the results of the application of molecular genetics methods in sport research, with special emphasis on the most advanced methods and trends in diagnosing of motoric predispositions for the sake of identifying talented children. Genetic tests differ in principle from the traditional motoric tests, because the DNA of an individual does not change during life. Genetics is important in determining the capacity of an individual and for professional sport level. Genetic information can be used for individual genetic predispositions in early childhood. The phenotypes are influenced by a combination of genetic and environmental factors. The aim of the presented study was to examine physical condition, coordination skills, motoric docility and to determine the frequency of ACTN3 (R577X) gene in Romany children from Eastern Slovakia and compared their motoric performance with non-Romany children. This paper is not looking just for a performance, but also its association to genetic predispositions in relation to ACTN3 gene and its R577X polymorphism. Genotype data were obtained from 175 Romany children from 6 to 15 years old and 218 non-Romany children at the same age from Eastern Slovakia. Biological material for genetic analyses comprised samples of buccal swabs. Genotypes were determined using Real Time High resolution melting PCR method (Rotor Gene 6000 Corbett and LightCycler 480 Roche). Romany children of analyzed group legged to non-Romany children at the same age in all the compared tests. The % distribution of R and X alleles in children was different from controls. The frequency of XX genotype was 11,45% which is comparable to a frequency of an Indian population. Data were analysed with the ANOVA statistical programme and parametric and nonparametric tests. This work was supported by grants APVV-0716-10, ITMS 26220120023 and ITMS 26220120041.

Keywords: ACTN3 gene, R577X polymorphism, Romany children, sport performance, Slovakia

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Authors: Neha Singh, Shristi Singh

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Accidents involving motor vehicles are more likely to cause serious injuries and fatalities. It also has a host of other perpetual issues, such as the regular loss of life and goods in accidents. To solve these issues, appropriate measures must be implemented, such as establishing an autonomous incident detection system that makes use of machine learning and artificial intelligence. In order to reduce traffic accidents, this article examines the overview of artificial intelligence and machine learning in autonomous event detection systems. The paper explores the major issues, prospective solutions, and use of artificial intelligence and machine learning in road transportation systems for minimising traffic accidents. There is a lot of discussion on additional, fresh, and developing approaches that less frequent accidents in the transportation industry. The study structured the following subtopics specifically: traffic management using machine learning and artificial intelligence and an incident detector with these two technologies. The internet of vehicles and vehicle ad hoc networks, as well as the use of wireless communication technologies like 5G wireless networks and the use of machine learning and artificial intelligence for the planning of road transportation systems, are elaborated. In addition, safety is the primary concern of road transportation. Route optimization, cargo volume forecasting, predictive fleet maintenance, real-time vehicle tracking, and traffic management, according to the review's key conclusions, are essential for ensuring the safety of road transportation networks. In addition to highlighting research trends, unanswered problems, and key research conclusions, the study also discusses the difficulties in applying artificial intelligence to road transport systems. Planning and managing the road transportation system might use the work as a resource.

Keywords: artificial intelligence, machine learning, incident detector, road transport systems, traffic management, automatic incident detection, deep learning

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Authors: Ying Chuan Wang, Zhang Tao

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The aim of this article intends to explore the differences of well-being of employees in casino hotels before and after the Chinese government began to fight corruption. This researcher also attempted to find out the relationship between work pressure and well-being of employees in gambling workplaces before and after the Chinese government crackdowns the corruption. The category of well-being including life well-being, workplace well-being, and psychological well-being was included for analyzing well-being of employees in gaming workplaces. In addition, the psychological pressure classification was applied into this study and the Job Content Questionnaire (JCQ) would be adopted on investigating employees’ work pressure in terms of decision latitude, psychological demands, and workplace support. This study is a quantitative approach research and was conducted in March 2017. A purposive sampling was used in this study. A total of valid 339 responses were collected and the participants were casino hotel employees. The findings showed that decision latitude was significantly different prior to and after Chinese government crackdowns on corruption. Moreover, workplace support was strongly significantly related to employees’ well-being before Chinese government crackdowns. Decision latitude was strongly significantly related to employees’ well-being after Chinese government crackdowns. The findings suggest that employees’ work pressure affects their well being. In particular, because of workplace supports, it may alleviate employees’ work pressure and affect their perceptions of well-being but only prior to fighting the crackdowns. Importantly, decision latitude has become an essential factor affecting their well-being after the crackdown. It is finally hoped that the findings of this study provide suggestion to the managerial levels of hospitality industries. It is important to enhance employees’ decision latitude. Offering training courses to equip employees’ skills could be a possible way to reduce work pressure. In addition, establishing career path for the employees to pursuit is essential for their self-development and the improvement of well being. This would be crucial for casino hotels’ sustainable development and strengthening their competitiveness.

Keywords: well-being, work pressure, Casino hotels’ employees, gaming workplace

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Authors: Fernanda Rodriguez

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Breast cancer is pervasive among women, and an increasing number of women are opting for a mastectomy: a medical operation in which one or both breasts are removed with the intention of treating or averting breast cancer. However, there is an emerging population of cancer survivors in European nations that, rather than attempting to reconstruct their breasts to resemble as much as possible ‘normal’ breasts, have turned to dress their scars with decorative tattoos. At a practical level, this study hopes to improve the support systems of these women by possibly providing professionals in the medical field, tattoo artists, and family members of cancer survivors with a deeper understanding of their motivations and decision-making processes for choosing an alternative restorative route - such as decorative tattoos - after their mastectomy. At an intellectual level, however, this study aims to narrow a gap in the academic field concerning the relationship between mastectomies and alternative methods of healing, such as decorative tattoos, as well as to broaden the understanding regarding meaning-making and the ‘normal’ feminine body. Thus, by means of semi-structured interviews and a phenomenological standpoint, this research set itself the goal to understand why do women who have undergone a mastectomy choose to dress their scars with decorative tattoos instead of attempting to regain ‘normalcy’ through breast reconstruction or 3D areola tattoos? The results obtained from the interviews with fifteen women showed that the disillusionment with one part of the other of breast restoration techniques had led these women to find an alternative form of healing that allows them not only to close a painful chapter of their life but also to regain control over their bodies after a period of time in which agency was taking away from them. Decorative post-mastectomy tattoos allow these women to grant their bodies with new meanings and produce their own interpretation of their feminine body and identity.

Keywords: alternative femininity, decorative mastectomy tattoos, gender embodiment, social stigmatization

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Authors: E. Mattio

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The aim of this project is to study the Chinese presence in Ethiopia, following the path of the last salt caravans from Danakil to Tigray region. Official estimates of the number of Chinese in Africa vary widely; on the continent, there are increasingly diverse groups of Chinese migrants in terms of language, dialect, class, education, and employment. Based on this and on a very general state of the art, it was decided to increase the studies on this phenomenon, documenting the extraction of salt and following the sellers in the north of the country. The project is unique and allows you to admire a landscape that will soon change, due to the construction of infrastructure that is changing the dynamics of movement and sales. To carry out this study, interdisciplinary investigation methods were integrated, such as landscape archeology, historiographic research, participatory anthropology, geopolitics, and cultural anthropology and ethnology. There are two main objectives of the research. The first was an analysis of risk perceptions to predict what will happen to these populations and how the territory will be modified, trying to monitor the growth of infrastructure in the country and the effects it will have on the population. Thanks to the use of GIS, some roads created by Chinese companies that worked in the area have been georeferenced. The second point was to document the life and rituals of Ethiopian populations, in order not to lose the aspects of uniqueness that risk being lost. The local interviews have garnered impressions and criticisms from the local population to understand whether the Chinese presence is perceived as a threat or a solution. Among the most exclusive interviews, there are those made to Afar leaders in the Logya area and some Coptic representatives in the Wukro area. To make this project even more unique, the Coptic rituals of Gennà and Timkat have been documented, unique expressions of a millennial tradition. The aim was to understand whether the Maoist presence began to influence the religious rites and forms of belief present in the country.

Keywords: China, Ethiopia, GIS, risk perceptions

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Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

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Obesity is associated with significant personal impacts on health and has a substantial economic burden on payers due to increased healthcare use. A contemporary estimate of the healthcare costs associated with obesity at the population level are lacking. This evidence may provide further rationale for weight management strategies. Methods: Adults who underwent a medical procedure between 2012 and 2019 in Alberta, Canada were categorized into the investigational cohort (had body mass index [BMI]-defined class 2 or 3 obesity based on a procedure-associated code) and the control cohort (did not have the BMI procedure-associated code); those who had bariatric surgery were excluded. Characteristics were presented and healthcare costs ($CDN) determined over a 1-year observation period (2019/2020). Logistic regression and a generalized linear model with log link and gamma distribution were used to assess total healthcare costs (comprised of hospitalizations, emergency department visits, ambulatory care visits, physician visits, and outpatient prescription drugs); potential confounders included age, sex, region of residence, and whether the medical procedure was performed within 6-months before the observation period in the partial adjustment, and also the type of procedure performed, socioeconomic status, Charlson Comorbidity Index (CCI), and seven obesity-related health conditions in the full adjustment. Cost ratios and estimated cost differences with 95% confidence intervals (CI) were reported; incremental cost differences within the adjusted models represent referent cases. Results: The investigational cohort (n=220,190) was older (mean age: 53 standard deviation [SD]±17 vs 50 SD±17 years), had more females (71% vs 57%), lived in rural areas to a greater extent (20% vs 14%), experienced a higher overall burden of disease (CCI: 0.6 SD±1.3 vs 0.3 SD±0.9), and were less socioeconomically well-off (material/social deprivation was lower [14%/14%] in the most well-off quintile vs 20%/19%) compared with controls (n=1,955,548). Unadjusted total healthcare costs were estimated to be 1.77-times (95% CI: 1.76, 1.78) higher in the investigational versus control cohort; each healthcare resource contributed to the higher cost ratio. After adjusting for potential confounders, the total healthcare cost ratio decreased, but remained higher in the investigational versus control cohort (partial adjustment: 1.57 [95% CI: 1.57, 1.58]; full adjustment: 1.21 [95% CI: 1.20, 1.21]); each healthcare resource contributed to the higher cost ratio. Among urban-dwelling 50-year old females who previously had non-operative procedures, no procedures performed within 6-months before the observation period, a social deprivation index score of 3, a CCI score of 0.32, and no history of select obesity-related health conditions, the predicted cost difference between those living with and without obesity was $386 (95% CI: $376, $397). Conclusions: If these findings hold for the Canadian population, one would expect an estimated additional $3.0 billion per year in healthcare costs nationally related to BMI-defined obesity (based on an adult obesity rate of 26% and an estimated annual incremental cost of $386 [21%]); incremental costs are higher when obesity-related health conditions are not adjusted for. Results of this study provide additional rationale for investment in interventions that are effective in preventing and treating obesity and its complications.

Keywords: administrative data, body mass index-defined obesity, healthcare cost, real world evidence

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Authors: Neslihan Sahin Celik, Ali Eraslan

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Mathematical model and modeling are one of the topics that have been intensively discussed in recent years. In line with the results of the PISA studies, researchers in many countries have begun to question how much students in school-education system are prepared to solve the real-world problems they encounter in their future professional lives. As a result, many mathematics educators have begun to emphasize the importance of new skills and understanding such as constructing, Hypothesizing, Describing, manipulating, predicting, working together for complex and multifaceted problems for success in beyond the school. When students increasingly face this kind of situations in their daily life, it is important to make sure that students have enough experience to work together and interpret mathematical situations that enable them to think in different ways and share their ideas with their peers. Thus, model eliciting activities are one of main tools that help students to gain experiences and the new skills required. This research study was carried on the town center of a big city located in the Black Sea region in Turkey. The participants were eighth-grade students in a middle school. After a six-week preliminary study, three students in an eighth-grade classroom were selected using criterion sampling technique and placed in a focus group. The focus group of three students was videotaped as they worked on a model eliciting activity, the Summer Job Problem. The conversation of the group was transcribed, examined with students’ written work and then qualitatively analyzed through the lens of Blum’s (1996) modeling processing cycle. The study results showed that eighth grade students can successfully work with the model eliciting, develop a model based on the two parameters and review the whole process. On the other hand, they had difficulties to relate parameters to each other and take all parameters into account to establish the model.

Keywords: middle school, modeling, mathematical modeling, summer job problem

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Authors: Charalabos Antonatos, Mariza Panoutsopoulou, Georgios K. Georgakilas, Evangelos Evangelou, Yiannis Vasilopoulos

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The extended tissue damage and severe clinical outcomes of autoimmune diseases, accompanied by the high annual costs to the overall health care system, highlight the need for an efficient therapy. Increasing knowledge over the pathophysiology of specific chronic inflammatory diseases, namely Psoriasis (PsO), Inflammatory Bowel Diseases (IBD) consisting of Crohn’s disease (CD) and Ulcerative colitis (UC), and Rheumatoid Arthritis (RA), has provided insights into the underlying mechanisms that lead to the maintenance of the inflammation, such as Tumor Necrosis Factor alpha (TNF-α). Hence, the anti-TNFα biological agents pose as an ideal therapeutic approach. Despite the efficacy of anti-TNFα agents, several clinical trials have shown that 20-40% of patients do not respond to treatment. Nowadays, high-throughput technologies have been recruited in order to elucidate the complex interactions in multifactorial phenotypes, with the most ubiquitous ones referring to transcriptome quantification analyses. In this context, a random effects meta-analysis of available gene expression cDNA microarray datasets was performed between responders and non-responders to anti-TNFα therapy in patients with IBD, PsO, and RA. Publicly available datasets were systematically searched from inception to 10th of November 2020 and selected for further analysis if they assessed the response to anti-TNFα therapy with clinical score indexes from inflamed biopsies. Specifically, 4 IBD (79 responders/72 non-responders), 3 PsO (40 responders/11 non-responders) and 2 RA (16 responders/6 non-responders) datasetswere selected. After the separate pre-processing of each dataset, 4 separate meta-analyses were conducted; three disease-specific and a single combined meta-analysis on the disease-specific results. The MetaVolcano R package (v.1.8.0) was utilized for a random-effects meta-analysis through theRestricted Maximum Likelihood (RELM) method. The top 1% of the most consistently perturbed genes in the included datasets was highlighted through the TopConfects approach while maintaining a 5% False Discovery Rate (FDR). Genes were considered as Differentialy Expressed (DEGs) as those with P ≤ 0.05, |log2(FC)| ≥ log2(1.25) and perturbed in at least 75% of the included datasets. Over-representation analysis was performed using Gene Ontology and Reactome Pathways for both up- and down-regulated genes in all 4 performed meta-analyses. Protein-Protein interaction networks were also incorporated in the subsequentanalyses with STRING v11.5 and Cytoscape v3.9. Disease-specific meta-analyses detected multiple distinct pro-inflammatory and immune-related down-regulated genes for each disease, such asNFKBIA, IL36, and IRAK1, respectively. Pathway analyses revealed unique and shared pathways between each disease, such as Neutrophil Degranulation and Signaling by Interleukins. The combined meta-analysis unveiled 436 DEGs, 86 out of which were up- and 350 down-regulated, confirming the aforementioned shared pathways and genes, as well as uncovering genes that participate in anti-inflammatory pathways, namely IL-10 signaling. The identification of key biological pathways and regulatory elements is imperative for the accurate prediction of the patient’s response to biological drugs. Meta-analysis of such gene expression data could aid the challenging approach to unravel the complex interactions implicated in the response to anti-TNFα therapy in patients with PsO, IBD, and RA, as well as distinguish gene clusters and pathways that are altered through this heterogeneous phenotype.

Keywords: anti-TNFα, autoimmune, meta-analysis, microarrays

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Authors: Chia-Pei Chen, Yu-Ju Chen, Yu-Juei Hsu

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The prevalence and incidence of end-stage renal disease in Taiwan ranks the highest in the world. According to the statistical survey of the Ministry of Health and Welfare in 2019, kidney disease is the ninth leading cause of death in Taiwan. It leads to autonomic dysfunction, inflammatory response and symptom distress, and further increases the damage to the structure and function of the kidneys, leading to increased demand for renal replacement therapy and risks of cardiovascular disease, which also has medical costs for the society. If we can intervene in a feasible manual to effectively regulate the autonomic nerve function of CKD patients, reduce the inflammatory response and symptom distress. To prolong the progression of the disease, it will be the main goal of caring for CKD patients. This study aims to test the effect of heart rate variability biofeedback (HRVBF) on improving autonomic nerve function (Heart Rate Variability, HRV), inflammatory response (Interleukin-6 [IL-6], C reaction protein [CRP] ), symptom distress (Piper fatigue scale, Pittsburgh Sleep Quality Index [PSQI], and Beck Depression Inventory-II [BDI-II] ) in patients with chronic kidney disease. This study was experimental research, with a convenience sampling. Participants were recruited from the nephrology clinic at a medical center in northern Taiwan. With signed informed consent, participants were randomly assigned to the HRVBF or control group by using the Excel BINOMDIST function. The HRVBF group received four weekly hospital-based HRVBF training, and 8 weeks of home-based self-practice was done with StressEraser. The control group received usual care. We followed all participants for 3 months, in which we repeatedly measured their autonomic nerve function (HRV), inflammatory response (IL-6, CRP), and symptom distress (Piper fatigue scale, PSQI, and BDI-II) on their first day of study participation (baselines), 1 month, and 3 months after the intervention to test the effects of HRVBF. The results were analyzed by SPSS version 23.0 statistical software. The data of demographics, HRV, IL-6, CRP, Piper fatigue scale, PSQI, and BDI-II were analyzed by descriptive statistics. To test for differences between and within groups in all outcome variables, it was used by paired sample t-test, independent sample t-test, Wilcoxon Signed-Rank test and Mann-Whitney U test. Results: Thirty-four patients with chronic kidney disease were enrolled, but three of them were lost to follow-up. The remaining 31 patients completed the study, including 15 in the HRVBF group and 16 in the control group. The characteristics of the two groups were not significantly different. The four-week hospital-based HRVBF training combined with eight-week home-based self-practice can effectively enhance the parasympathetic nerve performance for patients with chronic kidney disease, which may against the disease-related parasympathetic nerve inhibition. In the inflammatory response, IL-6 and CRP in the HRVBF group could not achieve significant improvement when compared with the control group. Self-reported fatigue and depression significantly decreased in the HRVBF group, but they still failed to achieve a significant difference between the two groups. HRVBF has no significant effect on improving the sleep quality for CKD patients.

Keywords: heart rate variability biofeedback, autonomic nerve function, inflammatory response, symptom distress, chronic kidney disease

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Authors: Saraswati Kerketta

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Tea industry is one of the oldest organised sector of India. It employs roughly 1.5 million people directly. Since the last decade Indian tea industry, especially in the northern region is experiencing worst crisis in the post-independence period. Due to many reason the prices of tea show steady decline. The workers are paid one of the lowest wage in tea industry in the world (1.5$ a day) below the UN's $2 a day for extreme poverty. The workers rely on addition benefits from plantation which includes food, housing and medical facilities. These have been effective means of enslavement of generations of labourers by the owners. There is hardly any change in the tea estates where the owners determine the fate of workers. When the tea garden is abandoned or is closed all the facilities disappear immediately. The workers are the descendants of tribes from central India also known as 'tea tribes'. Alienated from their native place, the geographical and social isolation compounded their vulnerability of these people. The economy of the region being totally dependent on tea has resulted in absolute unemployment for the workers of these tea gardens. With no other livelihood and no land to grow food, thousands of workers faced hunger and starvation. The Plantation Labour Act which ensures the decent working and living condition is violated continuously. The labours are forced to migrate and are also exposed to the risk of human trafficking. Those who are left behind suffers from starvation, malnutrition and disease. The condition in the sick tea plantation is no better. Wage are not paid regularly, subsidised food, fuel are also not supplied properly. Health care facilities are in very bad shape. Objectives: • To study the socio-cultural and demographic characteristics of the tea garden labourers in the study area. • To examine the social situation of workers in sick estates in dooars region. • To assess the magnitude of deprivation the impact of economic crisis on abandoned and closed tea estates in the region. Data Base: The study is based on data collected from field survey. Methods: Quantative: Cross-Tabulation, Regression analysis. Qualitative: Household Survey, Focussed Group Discussion, In-depth interview of key informants. Findings: Purchasing power parity has declined since in last three decades. There has been many fold increase in migration. Males migrates long distance towards central and west and south India. Females and children migrates both long and short distance. No one has reported to migrate back to the place of origin of their ancestors. Migrant males work mostly as construction labourers and as factory workers whereas females and children work as domestic help and construction labourers. In about 37 cases either they haven't contacted their families in last six months or are not traceable. The families with single earning members are more likely to migrate. Burden of disease and the duration of sickness, abandonment and closure of plantation are closely related. Death tolls are likely to rise 1.5 times in sick tea gardens and three times in closed tea estates. Sixty percent of the people are malnourished in the sick tea gardens and more than eighty five per cent in abandoned and sick tea gardens.

Keywords: migration, trafficking, starvation death, tea garden workers

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Authors: Ozoemelam Ikechukwu Lazarus, Nizamuddin B. Zainuddin, Abdul Kafi

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Numerous studies have been carried out on Green Logistics Management Practices (GLMPs) across the globe. The study on the practices and performance of green chain practices in Africa in particular has not gained enough scholarly attention. Again, the majority of supply chain sustainability research being conducted focus on environmental sustainability. Logistics has been a major cause of supply chain resource waste and environmental damage. Many sectors of the economy that engage in logistical operations significantly rely on vehicles, which emit pollutants into the environment. Due to urbanization and industrialization, the logistical operations of manufacturing companies represent a serious hazard to the society and human life, making the sector one of the fastest expanding in the world today. Logistics companies are faced with numerous difficulties when attempting to implement logistics practices along their supply chains. In Nigeria, manufacturing companies aspire to implement reverse logistics in response to stakeholders’ requirements to reduce negative environmental consequences. However, implementing this is impeded by a criteria framework, and necessitates the careful analysis of how such criteria interact with each other in the presence of uncertainty. This study integrates most of the green logistics management practices (GLMPs) into the Nigerian firms to improve generalizability, and credibility. It examines the effect of Green Logistics Management Practices on environmental performance, social performance, market performance, and financial performance in the logistics industries. It seeks to identify the critical success factors in order to develop a model that incorporates different factors from the perspectives of the technology, organization, human and environment to inform the adoption and use of technologies for logistics supply chain social sustainability in Nigeria. It uses exploratory research approach to collect and analyse the data.

Keywords: logistics, managemernt, suatainability, environment, operations

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Authors: Nitika Sharma, Yogesh Jain

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Introduction: An efficient Information System helps in improving the service delivery as well provides the foundation for policy and regulation of other building blocks of Health System. Health care organizations require an integrated working of its various sub-systems. An efficient EMR software boosts the teamwork amongst the various sub-systems thereby resulting in improved service delivery. Although there has been a huge impetus to EMR under the Digital India initiative, it has still not been mandated in India. It is generally implemented in huge funded public or private healthcare organizations only. Objective: The study was conducted to understand the factors that lead to the successful adoption of an affordable EMR in the low level healthcare organization. It intended to understand the design of the EMR and address the solutions to the challenges faced in adoption of the EMR. Methodology: The study was conducted in a non-profit registered Healthcare organization that has been providing healthcare facilities to more than 2500 villages including certain areas that are difficult to access. The data was collected with help of field notes, in-depth interviews and participant observation. A total of 16 participants using the EMR from different departments were enrolled via purposive sampling technique. The participants included in the study were working in the organization before the implementation of the EMR system. The study was conducted in one month period from 25 June-20 July 2018. The Ethical approval was taken from the institute along with prior approval of the participants. Data analysis: A word document of more than 4000 words was obtained after transcribing and translating the answers of respondents. It was further analyzed by focused coding, a line by line review of the transcripts, underlining words, phrases or sentences that might suggest themes to do thematic narrative analysis. Results: Based on the answers the results were thematically grouped under four headings: 1. governance of organization, 2. architecture and design of the software, 3. features of the software, 4. challenges faced in adoption and the solutions to address them. It was inferred that the successful implementation was attributed to the easy and comprehensive design of the system which has facilitated not only easy data storage and retrieval but contributes in constructing a decision support system for the staff. Portability has lead to increased acceptance by physicians. The proper division of labor, increased efficiency of staff, incorporation of auto-correction features and facilitation of task shifting has lead to increased acceptance amongst the users of various departments. Geographical inhibitions, low computer literacy and high patient load were the major challenges faced during its implementation. Despite of dual efforts made both by the architects and administrators to combat these challenges, there are still certain ongoing challenges faced by organization. Conclusion: Whenever any new technology is adopted there are certain innovators, early adopters, late adopters and laggards. The same pattern was followed in adoption of this software. He challenges were overcome with joint efforts of organization administrators and users as well. Thereby this case study provides a framework of implementing similar systems in public sector of countries that are struggling for digitizing the healthcare in presence of crunch of human and financial resources.

Keywords: EMR, healthcare technology, e-health, EHR

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Authors: Ashneel Ajay Singh, Kazumi Sakuramoto, Naoki Suzuki, Kalla Alok, Nath Paras

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Bluefin (Thunnus orientalis) tuna is one of the most economically valuable tuna species in the world. In recent years the stock has been observed to decline. It is suspected that the stock-recruitment relationship and population structure is influenced by environmental and climatic variables. This study was aimed at investigating the influence of environmental and climatic conditions on the trajectory of the different life stages of the North Pacific bluefin tuna. Exploratory analysis was performed for the North Pacific sea surface temperature (SST) and Pacific Decadal Oscillation (PDO) on the time series of the bluefin tuna cohorts (age-0, 1, 2,…,9, 10+). General Additive Modeling (GAM) was used to reconstruct the recruitment (R) trajectory. The spatial movement of the SST was also monitored from 1953 to 2012 in the distribution area of the bluefin tuna. Exploratory analysis showed significance influence of the North Pacific Sea Surface temperature (SST) and Pacific Decadal Oscillation (PDO) on the time series of the age-0 group. Other age group (1, 2,…,9, 10+) time series did not exhibit any significant correlations. PDO showed most significant relationship in the months of October to December. Although the stock-recruitment relationship is of biological significance, the recruits (age-0) showed poor correlation with the Spawning Stock Biomass (SSB). Indeed the most significant model incorporated the SSB, SST and PDO. The results show that the stock-recruitment relationship of the North Pacific bluefin tuna is multi-dimensional and cannot be adequately explained by the SSB alone. SST and PDO forcing of the population structure is of significant importance and needs to be accounted for when making harvesting plans for bluefin tuna in the North Pacific.

Keywords: pacific bluefin tuna, Thunnus orientalis, cohorts, recruitment, spawning stock biomass, sea surface temperature, pacific decadal oscillation, general additive model

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Authors: Faiqa Jalal

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The purpose of the following research paper is to discuss the differentiating meanings of culture and how popular culture has maintained a great impact on intercultural and international behavior. The following discussion leads to the notion of communicating cultural impact on behavior through advertising and sub-cultural theory in advertising. Although towards the end of the research, the complexities that develop through the above discussion, lead to the solution that ‘advertising gives meaning to the otherwise meaningless and identical objects through linking them to our basic needs’. In today’s fast paced digital world, it is difficult to define culture, literally, since its meaning tends to shift through series of different perceptions such as ‘how’ and ‘why’ it should be used. This notion can be taken towards another notion of popular culture. It is dependent on ‘attitudes, ideas, images, perspectives and other phenomena within the mainstream of a given culture’. Since popular culture is influenced by mass media, it has a way of influencing an individual’s attitude towards certain topics. For example, tattoos are a form of human decorations, that have historic significance, and a huge spectrum of meanings. Advertising is one aspect of marketing that has evolved from the time when it was ‘production oriented’, up till the time it started using different mediums to make its impact more effective. However, this impact has confused us between our needs and desires. The focus in this paper is ‘we consume to acquire a sense of social identity and status, not just for the sake of consumption’. Every culture owns different expressions, which are then used by advertisers to create its impact on the behavior of people sub-culturally and globally, as culture grows through social interaction. Advertisers furthermore play a smart role in highlighting quality of life ranging from ‘survival to well-being’. Hence, this research paper concludes by highlighting that culture is considered as a ‘basic root’ of any community that also provides solution to certain problems; however, advertisers play their part in manipulating society’s literacy and beliefs by rationalizing how relevant certain products/brands are to their beliefs.

Keywords: mass media, popular culture, production oriented, sub-culture

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Authors: R. Hellmuth

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The method of factory planning has changed a lot, especially when it is about planning the factory building itself. Factory planning has the task of designing products, plants, processes, organization, areas, and the building of a factory. Regular restructuring is becoming more important in order to maintain the competitiveness of a factory. Restrictions in new areas, shorter life cycles of product and production technology as well as a VUCA world (Volatility, Uncertainty, Complexity and Ambiguity) lead to more frequent restructuring measures within a factory. A digital factory model is the planning basis for rebuilding measures and becomes an indispensable tool. Furthermore, digital building models are increasingly being used in factories to support facility management and manufacturing processes. The main research question of this paper is, therefore: What kind of digital factory model is suitable for the different areas of application during the operation of a factory? First, different types of digital factory models are investigated, and their properties and usabilities for use cases are analysed. Within the scope of investigation are point cloud models, building information models, photogrammetry models, and these enriched with sensor data are examined. It is investigated which digital models allow a simple integration of sensor data and where the differences are. Subsequently, possible application areas of digital factory models are determined by means of a survey and the respective digital factory models are assigned to the application areas. Finally, an application case from maintenance is selected and implemented with the help of the appropriate digital factory model. It is shown how a completely digitalized maintenance process can be supported by a digital factory model by providing information. Among other purposes, the digital factory model is used for indoor navigation, information provision, and display of sensor data. In summary, the paper shows a structuring of digital factory models that concentrates on the geometric representation of a factory building and its technical facilities. A practical application case is shown and implemented. Thus, the systematic selection of digital factory models with the corresponding application cases is evaluated.

Keywords: building information modeling, digital factory model, factory planning, maintenance

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Authors: Cheryl Teelucksingh

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Toronto is in the midst of an urban development and infrastructure boom. Population growth and concerns about urban sprawl and carbon emissions have led to pressure on the municipal and the provincial governments to re-think urban development. Toronto’s approach to climate change mitigation and adaptation has positioning of the emerging green economy as part of the solution. However, the emerging green economy many not benefit all Torontonians in terms of jobs, improved infrastructure, and enhanced quality of life. Community benefits agreements (CBAs) are comprehensive, negotiated commitments, in which founders and builders of major infrastructure projects formally agree to work with community interest groups based in the community where the development is taking place, toward mutually beneficial environmental and labor market outcomes. When community groups are equitably represented in the process, they stand not only to benefit from the jobs created from the project itself, but also from the longer-term community benefits related to the quality of the completed work, including advocating for communities’ environmental needs. It is believed that green employment initiatives in Toronto should give greater consideration to best practices learned from community benefits agreements. Drawing on the findings of a funded qualitative study in Toronto (Canada), “The Green Gap: Toward Inclusivity in Toronto’s Green Economy” (2013-2016), this paper examines the emergent CBA in Toronto in relation to the development of a light rail transit project. Theoretical and empirical consideration will be given to the research gaps around CBAs, the role of various stakeholders, and discuss the potential for CBAs to gain traction in the Toronto’s urban development context. The narratives of various stakeholders across Toronto’s green economy will be interwoven with a discussion of the CBA model in Toronto and other jurisdictions.

Keywords: green economy in Toronto, equity, community benefits agreements, environmental justice, community sustainability

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Authors: Sanjal Gavande, Thomas Mazzuchi, Shahram Sarkani

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In a complex aerospace operational environment, identifying failures in a procedure involving multiple human-machine interactions are difficult. These failures could lead to accidents causing loss of hardware or human life. The likelihood of failure further increases if operational procedures are tested for a novel system with multiple human-machine interfaces and with no prior performance data. The existing approach in the literature of reviewing complex operational tasks in a flowchart or tabular form doesn’t provide any insight into potential system failures due to human decision-making ability. To address these challenges, this research explores an agent-based simulation approach for reliability assessment and fault detection in complex human-machine systems while utilizing a human decision-making model. The simulation will predict the emergent behavior of the system due to the interaction between humans and their decision-making capability with the varying states of the machine and vice-versa. Overall system reliability will be evaluated based on a defined set of success-criteria conditions and the number of recorded failures over an assigned limit of Monte Carlo runs. The study also aims at identifying high-likelihood failure locations for the system. The research concludes that system reliability and failures can be effectively calculated when individual human and machine agent states are clearly defined. This research is limited to the operations phase of a system lifecycle process in an aerospace environment only. Further exploration of the proposed agent-based and human decision-making model will be required to allow for a greater understanding of this topic for application outside of the operations domain.

Keywords: agent-based model, complex human-machine system, human decision-making model, system reliability assessment

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Authors: Paul J Yazaki, Michael Bouvet, John Shively

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Surgery for solid gastrointestinal (GI) cancers such as pancreatic, colorectal, and gastric adenocarcinoma remains the mainstay of curative therapy. Complete resection of the primary tumor with negative margins (R0 resection), its draining lymph nodes, and distant metastases offers the optimal surgical benefit. Real-time fluorescence guided surgery (FGS) promises to improve GI cancer outcomes and is rapidly advancing with tumor-specific antibody conjugated fluorophores that can be imaged using near infrared (NIR) technology. Carcinoembryonic Antigen (CEA) is a non-internalizing tumor antigen validated as a surface tumor marker expressed in >95% of colorectal, 80% of gastric, and 60% of pancreatic adenocarcinomas. Our humanized anti-CEA hT84.66-M5A (M5A) monoclonal antibody (mAb)was conjugated with the NHS-IRDye800CW fluorophore and shown it can rapidly and effectively NIRoptical imageorthotopically implanted human colon and pancreatic cancer in mouse models. A limitation observed is that these NIR-800 dye conjugated mAbs have a rapid clearance from the blood, leading to a narrow timeframe for FGS and requiring high doses for effective optical imaging. We developed a novel antibody-fluorophore conjugate by incorporating a PEGylated sidearm linker to shield or mask the IR800 dye’s hydrophobicity which effectively extended the agent’s blood circulation half-life leading to increased tumor sensitivity and lowered normal hepatic uptake. We hypothesized that our unique anti-CEA linked to the fluorophore, IR800 by PEGylated sidewinder, M5A-SW-IR800 will become the next generation optical imaging agent, safe, effective, and widely applicable for intraoperative image guided surgery in CEA expressing GI cancers.

Keywords: optical imaging, anti-CEA, cancer, fluorescence-guided surgery

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Authors: Chitra Rajagopal, Indra Deo Kumar, Ruchi Joshi, Binoy Bhargavan

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Role of fighter planes in modern network centric military warfare scenarios has changed significantly in the recent past. New generation fighter planes have multirole capability of engaging both air and ground targets with high precision. Multirole aircraft undertakes missions such as Air to Air combat, Air defense, Air to Surface role (including Air interdiction, Close air support, Maritime attack, Suppression and Destruction of enemy air defense), Reconnaissance, Electronic warfare missions, etc. Designers have primarily focused on development of technologies to enhance the combat performance of the fighter planes and very little attention is given to human factor aspects of technologies. Unique physical and psychological challenges are imposed on the pilots to meet operational requirements during these missions. Newly evolved technologies have enhanced aircraft performance in terms of its speed, firepower, stealth, electronic warfare, situational awareness, and vulnerability reduction capabilities. This paper highlights the impact of emerging technologies on human factors for various military operations and missions. Technologies such as ‘cooperative knowledge-based systems’ to aid pilot’s decision making in military conflict scenarios as well as simulation technologies to enhance human performance is also studied as a part of research work. Current and emerging pilot protection technologies and systems which form part of the integrated life support systems in new generation fighter planes is discussed. System safety analysis application to quantify the human reliability in military operations is also studied.

Keywords: combat effectiveness, emerging technologies, human factors, systems safety analysis

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Authors: Mihaja Razafimbelo, Guillaume Herve-Secourgeon, Fabrice Gatuingt, Marina Bottoni, Tulio Honorio-De-Faria

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The challenge of the research is to provide engineering with a robust, semi-automatic method for calculating optimal reinforcement for massive structural elements. In the absence of such a digital post-processing tool, design office engineers make intensive use of plate modelling, for which automatic post-processing is available. Plate models in massive areas, on the other hand, produce conservative results. In addition, the theoretical foundations of automatic post-processing tools for reinforcement are those of reinforced concrete beam sections. As long as there is no suitable alternative for automatic post-processing of plates, optimal modelling and a significant improvement of the constructability of massive areas cannot be expected. A method called strut-and-tie is commonly used in civil engineering, but the result itself remains very subjective to the calculation engineer. The tool developed will facilitate the work of supporting the engineers in their choice of structure. The method implemented consists of defining a ground-structure built on the basis of the main constraints resulting from an elastic analysis of the structure and then to start an optimization of this structure according to the fully stressed design method. The first results allow to obtain a coherent return in the first network of connecting struts and ties, compared to the cases encountered in the literature. The evolution of the tool will then make it possible to adapt the obtained latticework in relation to the cracking states resulting from the loads applied during the life of the structure, cyclic or dynamic loads. In addition, with the constructability constraint, a final result of reinforcement with an orthogonal arrangement with a regulated spacing will be implemented in the tool.

Keywords: strut and tie, optimization, reinforcement, massive structure

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Authors: Linda Blümel, Bettina Bert, Jan Brosda, Heidrun Fink, Melanie Hamann

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Age-related cognitive decline can eventually lead to dementia, the most common mental illness in elderly people and an immense challenge for patients, their families and caregivers. Cholinesterase inhibitors constitute the most commonly used antidementia prescription medication. The standardized Ginkgo biloba leaf extract EGb 761® is approved for treating age-associated cognitive impairment and has been shown to improve the quality of life in patients suffering from mild dementia. A clinical trial with 96 Alzheimer´s disease patients indicated that the combined treatment with donepezil and EGb 761® had fewer side effects than donepezil alone. In an animal model of cognitive aging, we compared the effect of combined treatment with EGb 761® or donepezil monotherapy and vehicle. We compared the effect of chronic treatment (15 days of pretreatment) with donepezil (1.5 mg/kg p. o.), EGb 761® (100 mg/kg p. o.), or the combination of the two drugs, or vehicle in 18 – 20 month old male OFA rats. Learning and memory performance were assessed by Morris water maze testing, motor behavior in an open field paradigm. In addition to chronic treatment, the substances were administered orally 30 minutes before testing. Compared to the first day and to the control group, only the combination group showed a significant reduction in latency to reach the hidden platform on the second day of testing. Moreover, from the second day of testing onwards, the donepezil, the EGb 761® and the combination group required less time to reach the hidden platform compared to the first day. The control group did not reach the same latency reduction until day three. There were no effects on motor behavior. These results suggest a superiority of the combined treatment of donepezil with EGb 761® compared to monotherapy.

Keywords: age-related cognitive decline, dementia, ginkgo biloba leaf extract EGb 761®, learning and memory, old rats

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Authors: Yang Shen, Yongpan Cheng, Jinliang Xu

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The effective blade cooling is of great significance for improving the performance of turbine. The mist cooling emerges as the promising way compared with the transitional single-phase cooling. In the mist cooling, the injected droplet will evaporate rapidly, and cool down the blade surface due to the absorbed latent heat, hence the lifetime for evaporating droplet becomes critical for design of cooling passages for the blade. So far there have been extensive studies on the droplet evaporation, but usually the isothermal model is applied for most of the studies. Actually the surface cooling effect can affect the droplet evaporation greatly, it can prolong the droplet evaporation lifetime significantly. In our study, a new theoretical model for sessile droplet evaporation with surface cooling effect is built up in toroidal coordinate. Three evaporation modes are analyzed during the evaporation lifetime, include “Constant Contact Radius”(CCR) mode、“Constant Contact Angle”(CCA) mode and “stick-slip”(SS) mode. The dimensionless number E0 is introduced to indicate the strength of the evaporative cooling, it is defined based on the thermal properties of the liquid and the atmosphere. Our model can predict accurately the lifetime of evaporation by validating with available experimental data. Then the temporal variation of droplet volume, contact angle and contact radius are presented under CCR, CCA and SS mode, the following conclusions are obtained. 1) The larger the dimensionless number E0, the longer the lifetime of three evaporation cases is; 2) The droplet volume over time still follows “2/3 power law” in the CCA mode, as in the isothermal model without the cooling effect; 3) In the “SS” mode, the large transition contact angle can reduce the evaporation time in CCR mode, and increase the time in CCA mode, the overall lifetime will be increased; 4) The correction factor for predicting instantaneous volume of the droplet is derived to predict the droplet life time accurately. These findings may be of great significance to explore the dynamics and heat transfer of sessile droplet evaporation.

Keywords: blade cooling, droplet evaporation, lifetime, theoretical analysis

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Authors: Niloofar Mobasem, Kambiz Heidarzadeh Hanzaee

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Purpose: The study aimed to measure the customer satisfaction with service recovery through the conflict management framework, especially assessing the role of pre-existing attitudes for measuring the customer response to the service failure. Design/ methodology/ approach: The study is based on the experimental research method. The factorial designs are used in the research that measures the variables in two separate studies. In the first study, the factorial design is 3 conflict management style: cooperative, competitive, avoiding; - 3 service performance: exceed expectation, meet expectation, fail to meet expectation; and in the second study includes: - 3 conflict management style: cooperative, competitive, avoiding; - 2 service performance: exceed expectation, fail to meet expectation; - 2 pre-existing attitude: positive, negative. Finding: The results of study based on a scenario indicate that the conflict management style affected on customer satisfaction by service recovery efforts as well as the pre-existing attitudes affected the customer interpretation for service providers (conflict management style) and those who have positive pre-existing attitudes are interested to response to the cooperative approach in dealing with service failure. Research limitation/ implication: According to all researches, the study has several limitations. The nature of scenario in this study may cause to hit the reality of life. Although, the similar scenario approaches commonly are used for such researches, but the approaches are not without criticism. Practical implications: Given the importance of service recovery, companies can understand the importance of creating customer satisfaction achieved by the positive results due to the service recovery during the shortness or service failure by the mentioned companies. Originality/ value: The study highlights the importance of service failure and providing the education in relation to the service recovery.

Keywords: service recovery, pre-existing attitude, service failure, customer satisfaction

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Authors: Camilo Andrés Agudelo Vélez, Lina María Martínez Sánchez, Isabel Cristina Ortiz Trujillo, Evert Armando Jiménez Cotes, Natalia Perilla Hernández, María de los Ángeles Rodríguez Gázquez, Daniel Duque Restrepo, Felipe Hernández Restrepo, Dayana Andrea Quintero Moreno, Juan José Builes Gómez, Camilo Ruiz Mejía, Ana Lucia Arango Gómez

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Preeclampsia is a clinical complication during pregnancy with high incidence in Colombia; therefore, it is important to evaluate the influence of external conditions and medical interventions, in order to promote measures that encourage improvements in the quality of life. Objective: Determine clinical and sociodemographic variables in women with preeclampsia. Methods: This cross-sectional study enrolled 50 patients with the diagnosis of preeclampsia, from a private institution in Medellin, during 2015. We used the software SPSS ver.20 for statistical analysis. For the qualitative variables, we calculated the mean and standard deviation, while, for ordinal and nominal levels of quantitative variables, ratios were estimated. Results: The average age was 26.8±5.9 years. The predominant characteristics were socioeconomic stratum 2 (48%), students (55%), mixed race (46%) and middle school as level of education (38%). As for clinical features, 72% of the cases were mild preeclampsia, and 22% were severe forms. The most common clinical manifestations were edema (46%), headache (62%), and proteinuria (55%). As for the Gyneco-obstetric history, 8% reported previous episodes of this disease and it was the first pregnancy for 60% of the patients. Conclusions: Preeclampsia is a frequent condition in young women; on the other hand, headache and edema were the most common reasons for consultation, therefore, doctors need to be aware of these symptoms in pregnant women.

Keywords: pre-eclampsia, hypertension, pregnancy complications, pregnancy, abdominal, edema

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Authors: M. Naimi, M. B. Khaled

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The present study consisted of an applied test in meat system to assess the effectiveness of three bio agents bacteriocinproducing strains: Lm24: Lactobacillus sakei, Lm14and Lm25: Pediococcus spp. Two tests were carried out: The ex-situ test was intended for three batches added with crude bacteriocin solutions at 12.48 AU/ml for Lm25 and 8.4 AU/ml for Lm14 and Lm24. However, the in situ one consisted of four batches; three of them inoculated with one bacteriocinogenic Lm25, Lm14, Lm24, respectively. The fourth one was used in mixture: Lm14+m24 at approximately of 107 CFU/ml. The two used tests were done in the presence of the pathogen St. aureus ATCC 6538, as a test strain at 103 CFU/ml. Another batch served as a positive or a negative control was used too. The incubation was performed at 7°C. Total viable counts, staphylococci and lactic acid bacteria, at the beginning and at selected times with interval of three days were enumerated. Physicochemical determinations (except for in situ test): pH, dry mater, sugars, fat and total protein, at the beginning and at end of the experiment, were done, according to the international norms. Our results confirmed the ex situ effectiveness. Furthermore, the batches affected negatively the total microbial load over the incubation days, and showed a significant regression in staphylococcal load at day seven, for Lm14, Lm24, and Lm25 of 0.73, 2.11, and 2.4 log units. It should be noticed that, at the last day of culture, staphylococcal load was nil for the three batches. In the in situ test, the cultures displayed less inhibitory attitude and recorded a decrease in staphylococcal load, for Lm14, Lm24, Lm25, Lm14+m24 of 0.73, 0.20, 0.86, 0.032 log units. Therefore, physicochemical analysis for Lm14, Lm24, Lm25, Lm14+m24 showed an increase in pH from 5.50 to 5.77, 6.18, 5.96, 7.22, a decrease in dry mater from 7.30% to 7.05%, 6.87%, 6.32%, 6.00%.This result reflects the decrease in fat ranging from 1.53% to 1.49%, 1.07%, 0.99%, 0.87%; and total protein from 6.18% to 5.25%, 5.56%, 5.37%, 5.5%. This study suggests that the use of selected strains as Lm25 could lead to the best results and would help in preserving and extending the shelf life of lamb meat.

Keywords: biocontrol, in situ, ex situ, meat system, St. aureus, Lactobacillus sakei, Pediococcus spp.

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Authors: Mahmoud S. Zaghloul, Mohammed M. Khalaf, Wael N. Thabet, Haidy N. Asham

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Background. Hypertrophic scarring is a difficult problem for burn patients, and scar management is an essential aspect of outpatient burn therapy. Post-burn pathologic scars involve functional and aesthetic limitations that have a dramatic influence on the patient’s quality of life. The aim was to investigate the use of extracorporeal shock wave therapy (ESWT), which targets the fibroblasts in scar tissue, as an effective modality for scar treatment in burn patients. Subjects and methods: forty patients with post-burn scars were assigned randomly into two equal groups; their ages ranged from 20-45 years. The study group received ESWT and traditional physical therapy program (deep friction massage, stretching exercises). The control group received traditional physical therapy program (deep friction massage, stretching exercises). All groups received two sessions per week for six successful weeks. The data were collected before and after the same period of treatment for both groups. Evaluation procedures were carried out to measure scar thickness using ultrasonography and Vancouver Scar Scale (VSS) was completed before and after treatment. Results: Post-treatment results showed that there was a significant improvement difference in scar thickness in both groups in favor of the study group. Percentage of improvement in scar thickness in the study group was 42.55%, while it was 12.15% in the control group. There was also a significant improvement difference between results obtained using VSS in both groups in favor of the study group. Conclusion: ESWT is effective in management of pathologic post burn scars.

Keywords: extracorporeal shock wave therapy, post-burn scars, ultrasonography, Vancouver scar scale

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