Search results for: international patient safety goals

Authors: Amina Aquil, Abdeljalil El Got

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Background: Sleep quality is one of the most important indicators related to the quality of life of patients suffering from cancer. Many factors could affect this quality of sleep and then be considered as associated predictors. Methods: The aim of this study was to assess the prevalence of sleep disorders and the associated factors with impaired sleep quality in Moroccan women with gynecological cancer. A cross-sectional study was carried out within the oncology department of the Ibn Rochd University Hospital, Casablanca, on Moroccan women who had undergone radical surgery for gynecological cancer (n=100). Translated and validated Arabic versions of the following international scales were used: Pittsburgh sleep quality index (PSQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg's self-esteem scale (RSES), and Body image scale (BIS). Results: 78% of participants were considered poor sleepers. Most of the patients exhibited very poor subjective quality, low sleep latency, a short period of sleep, and a low rate of usual sleep efficiency. The vast majority of these patients were in poor shape during the day and did not use sleep medication. Waking up in the middle of the night or early in the morning and getting up to use the bathroom were the main reasons for poor sleep quality. PSQI scores were positively correlated with anxiety, depression, body image dissatisfaction, and lower self-esteem (p < 0.001). Conclusion: Sleep quality and its predictors require a systematic evaluation and adequate management to prevent sleep disturbances and mental distress as well as to improve the quality of life of these patients.

Keywords: body image, gynecological cancer, self esteem, sleep quality

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Authors: Maryam Firouzmandi, Moosa Miri

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Smile is considered to be one of the most effective methods of influencing people. Increasing numbers of patients are requesting cosmetic dental procedures to achieve the perfect smile. Based on the patient’s age, oral and facial characteristics, and the dentist’s expertise, different concepts of treatment would be available. Orthodontics is the most conservative and the ideal treatment alternative for crowded anterior teeth; however, it may be rejected by patients due to occupational limitations of time, physical discomfort including pain and functional limitations, psychological discomfort, and appearance during treatment. In addition, orthodontic treatment will not resolve deficits of contour and color of the anterior teeth. In consequence, patients may demand restorative techniques to resolve their anterior mal-alignment instead, often called "instant orthodontics". Following its introduction, however, adhesive dentistry has suffered at times from overuse. Creating short-term attractive smiles at the expense of long-term dental health and optimal tooth biomechanics by using cosmetic techniques should not be considered an ethical approach. The objective of this narrative review was to investigate the literature for guidelines with regard to decision making and treatment planning for anterior tooth mal-alignment. In this regard, indications of orthodontic, restorative, combination of both treatments, and adjunctive periodontal surgery were discussed in clinical cases to achieve a proportional smile. Restorative modalities would include disking, cosmetic contouring, veneers, and crowns and were compared with limited or comprehensive orthodontic options. A rapid review was also presented on pros and cons of snap on smile to mask malalignments. Diagnostic tools such as mock up, wax up, and digital smile design were also considered to achieve more conservative and functional treatments with respect to biologic factors.

Keywords: crowding, misalignment, veneer, crown, orthodontics

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Authors: Jean-michel Sahut, Lubica Hikkerova, Wissal Ben Arfi

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The Internet of Things (IoT) emerged over the last few decades in many fields. Healthcare can significantly benefit from IoT. This study aims to examine factors influencing the adoption of IoT in eHealth. To do so, an innovative framework has been developed which applies both the Technology Acceptance Model (TAM) and the United Theory of Acceptance and Use of Technology (UTAUT) model and builds on them by analyzing trust and perceived-risk dimensions to predict intention to use IoT in eHealth. In terms of methodology, a Partial Least Approach Structural Equation Modelling was carried out on a sample of 267 French users. The findings of this research support the significant positive effect of constructs set out in the TAM (perceived ease of use) on predicting behavioral intention by adding the effects identified for UTAUT variables. This research also demonstrates how perceived risk and trust are significant factors for models examining behavioral intentions to use IoT. Perceived risk enhanced by the trust has a significant effect on patients’ behavioral intentions. Moreover, the results highlight the key role of prescription as a moderator of IoT adoption in eHealth. Depending on whether an individual has a prescription to use connected devices or not, ease of use has a stronger impact on adoption, while trust has a negative impact on adoption for users without a prescription. In accordance with the empirical results, several practical implications can be proposed. All connected devices applied in a medical context should be divided into groups according to their functionality: whether they are essential for the patient’s health and whether they require a prescription or not. Devices used with a prescription are easily accepted because the intention to use them is moderated by the medical trust (discussed above). For users without a prescription, ease of use is a more significant factor than for users who have a prescription. This suggests that currently, connected e-Health devices and online healthcare systems have to take this factor into account to better meet the needs and expectations of end-users.

Keywords: internet of things, Healthcare, trust, consumer acceptance

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Authors: Mohammad Zainie Bin Hassan

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Background: Erectile dysfunction (ED) is a complication commonly seen among men with diabetes which can be assessed based upon International Index of Erectile Function (IIEF-5) questionnaire. Creatinine level is a blood test that indicates kidney functionality. Object: To evaluate the association between ED, determined by the IIEF-5scores and Creatinine level in diabetic men attending Temerloh Health Clinic, Pahang, Malaysia.Hence, to identify raising Creatinine level related with ED or not. Methods: All married diabetic patients will be investigated face to face after consented for answering the IIEF-5 questionnaire. Creatinine level will be taken by using standard method.Patients with no sexual partner, refuse to answer the questionnaire, cancer, stroke, heart disease and language barrier will be excluded.Data obtained from IIEF-5 score and Creatinine level will be analyzed by using Pearson correlation. All statistical value determined by p=0.05. ED will be categorized accordingly to IIEF-5 scores: no ED (22-25), mild (17-21), moderate (12-16), severe (8-11) and very severe (1-7). Results: A total of 450 patients were investigated with 385 patients were included (85.6% respondant rate) and 65 patients were excluded in this study with age range from 29 to 85 years old. 7% had no ED, 28% mild ED, 34% moderate ED, 16% severe ED and 15% had very severe ED. There was a significant negative correlation between Creatinine level and IIEF-5 scores (r=-0.218, p <0.001). This result implicated that poor kidney function which indicated by high Creatinine level associated significantly with erectile dysfunction. 93% had ED with a different range of severity which triggers for appropriate aggressive ED management among diabetics. Conclusion: The high level of Creatinine is associated with erectile dysfunction among diabetics in Temerloh Health Clinic.

Keywords: correlation, creatinine level, erectile dysfunction, ED, diabetes

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Authors: Minh-Phuong Ngoc Bui, Abdennour Abbas

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Microbial spoilage of food/drug has been a constant nuisance and an unavoidable problem throughout history that affects food/drug quality and safety in a variety of ways. A simple and rapid test of fungi and bacteria in food/drugs and environmental clinical samples is essential for proper management of contamination. A number of different techniques have been developed for detection and enumeration of foodborne microorganism including plate counting, enzyme-linked immunosorbent assay (ELISA), polymer chain reaction (PCR), nucleic acid sensor, electrical and microscopy methods. However, the significant drawbacks of these techniques are highly demand of operation skills and the time and cost involved. In this report, we introduce a rapid method for detection of bacteria and fungi in food/drug products using a specific interaction between a reducing agent (tris(2-carboxylethyl)phosphine (TCEP)) and the microbial surface proteins. The chemical reaction was transferred to a transduction system using gold nanoplates-enhanced chemiluminescence. We have optimized our nanoplates synthetic conditions, characterized the chemiluminescence parameters and optimized conditions for the microbial assay. The new detection method was applied for rapid detection of bacteria (E.coli sp. and Lactobacillus sp.) and fungi (Mucor sp.), with limit of detection as low as single digit cells per mL within 10 min using a portable luminometer. We expect our simple and rapid detection method to be a powerful alternative to the conventional plate counting and immunoassay methods for rapid screening of microorganisms in food/drug products.

Keywords: microorganism testing, gold nanoplates, chemiluminescence, reducing agents, luminol

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Authors: Alex Kiselyov, Suehyun Cho, Darrell Harrington; Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Michael Shpigelmacher

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Despite the most aggressive surgical and adjuvant therapeutic strategies, treatment of both pediatric and adult brainstem tumors remains problematic. Novel strategies, including targeted biologics, immunotherapy, and specialized delivery systems such as convection-enhanced delivery (CED), have been proposed. While some of these novel treatments are entering phase I trials, the field is still in need of treatment(s) that exhibits dramatically enhanced potency with optimal therapeutic ratio. Bionaut Labs has developed a modular microrobotic platform for performing localized delivery of diverse therapeutics in vivo. Our biocompatible particles (Bionauts™) are externally propelled and visualized in real-time. Bionauts™ are specifically designed to enhance the effect of radiation therapy via anatomically precise delivery of a radiosensitizing agent, as exemplified by temozolomide (TMZ) and Avastin™ to the brainstem gliomas of diverse origin. The treatment protocol is designed to furnish a better therapeutic outcome due to the localized (vs systemic) delivery of the drug to the neoplastic lesion(s) for use as a synergistic combination of radiation and radiosensitizing agent. In addition, the procedure is minimally invasive and is expected to be appropriate for both adult and pediatric patients. Current progress, including platform optimization, selection of the lead radiosensitizer as well as in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of porcine and ovine models, will be discussed.

Keywords: Bionaut, brainstem, glioma, local delivery, micro-robot, radiosensitizer

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Authors: Catarina Isabel Ramos Pereira, Jorge Machado, Begona Alonso Criado, Maria João Santos

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Introduction: Gait disorders are one of the symptoms that have severe implications on the quality of life in Parkinson's disease (PD). Currently, there is no therapy to reverse or treat this condition. None of the drugs used in conventional medical treatment is entirely efficient, and all have a high incidence of side effects. Acupuncture treatment is believed to improve motor ability, but there is still little scientific evidence in individuals with PD. Aim: The aim of the study is to investigate the acute effect of acupuncture on gait parameters in Parkinson's disease. Methods: This is a randomized and controlled crossover study. The same individual patient was part of both the experimental (real acupuncture) and control group (false acupuncture/sham), and the sequence was randomized. Gait parameters were measured at two different moments, before and after treatment, using four force platforms as well as the collection of 3D markers positions taken by 11 cameras. Images were quantitatively analyzed using Qualisys Track Manager software that let us extract data related to the quality of gait and balance. Seven patients with the diagnosis of Parkinson's disease were included in the study. Results: Statistically significant differences were found in gait speed (p = 0.016), gait cadence (p = 0.006), support base width (p = 0.0001), medio-lateral oscillation (p = 0.017), left-right step length (p = 0.0002), and stride length: right-right (p = 0.0000) and left-left (p = 0.0018), time of left support phase (p = 0.029), right support phase (p = 0.025) and double support phase (p = 0.015), between the initial and final moments for the experimental group. Differences in right-left stride length were found for both groups. Conclusion: Our results show that acupuncture could enhance gait in Parkinson's disease patients. Deep research involving a larger number of volunteers should be accomplished to validate these encouraging findings.

Keywords: acupuncture, traditional Chinese medicine, Parkinson's disease, gait

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Authors: Alessio Giovannelli, Claudia Cocozza, Enrico Marchi, Valerio Giorgio Muzzini, Eleftherios Touloupakis, Raffaella Margherita Zampieri

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In Mediterranean countries, forest fires are recurrent events that need to be considered as a central component of regional and global forest management strategies and biodiversity restoration programmes. The response of tree function to fire damage can vary widely, also taking into account species, season, age of the tree, etc. Trees that survive fire may have different levels of physiological functionality, which may result in reduced growth or increased susceptibility to delayed mortality. An approach to assessing irreversible physiological injury in trees could help to inform management decisions at burned sites for biodiversity restoration, environmental safety and understanding of ecosystem functional adaptations. Physiological proxies for latent tree mortality, such as cambial cell death, reduced or absent starch and soluble sugar content in C sinks, and ethanol accumulation in the phloem, are considered proxies for cell death. However, their determination requires time-consuming laboratory protocols, making the approach unfeasible as a practical option in the field, but recent findings have shown that biosensors could be usefully applied to overcome these limitations. The study will focus on the development of amperometric biosensors capable of detecting a few target molecules in the phloem and xylem (such as ethanol and glucose) that have recently been identified as proxies for latent tree mortality. The results of a specific experiment on a stand of Pinus pinaster subjected to prescribed fire are reported.

Keywords: enzymes, glucose, ethanol, prescribed fires

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Authors: Adam Jenkins

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The Maritime RobotX Challenge provides a platform for postgraduate students conducting research in autonomous robotic systems to participate in an international competition. Although targeted to postgraduate students, the problem domain lends itself to a wide range of different levels of student expertise. In 2022, undergraduate Information Technology students from the University of South Australia undertook the challenge, utilizing a System of the Systems approach to the project's architecture. Each student group produced an independent solution to an identified task, which was then implemented on a Single Board Computer (SBC). A Central Control System then engaged each solution when appropriate, allowing the encapsulated SBC systems to manage each task as it was encountered. This approach facilitated collaboration among the multiple independent student teams over an 18-month period, and the fundamental system-agnostic architecture allowed for both the variance in student solutions and the limitations caused by the global electronics shortage. By adopting this approach, Information Technology teams were able to work independently yet produce an effective solution, leveraging their expertise to develop and construct an autonomous catamaran capable of meeting the competition's demanding requirements while producing a high level of engagement. The System of Systems approach is recommended to other universities interested in competing at this level and engaging students in a real-world problem.

Keywords: case study, robotics, education, programming, system of systems, multi-disciplinary collaboration

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Authors: M. N. Khajavi, S. Nasiri, E. Farokhi, M. R. Bavir

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Alcohol fuels are renewable, have low pollution and have high octane number; therefore, they are important as fuel in internal combustion engines. Percentage detection of these alcoholic fuels with gasoline is a complicated, time consuming, and expensive process. Nowadays, these processes are done in equipped laboratories, based on international standards. The aim of this research is to determine percentage detection of different fuels based on vibration analysis of engine block signals. By doing, so considerable saving in time and cost can be achieved. Five different fuels consisted of pure gasoline (G) as base fuel and combination of this fuel with different percent of ethanol and methanol are prepared. For example, volumetric combination of pure gasoline with 10 percent ethanol is called E10. By this convention, we made M10 (10% methanol plus 90% pure gasoline), E30 (30% ethanol plus 70% pure gasoline), and M30 (30% Methanol plus 70% pure gasoline) were prepared. To simulate real working condition for this experiment, the vehicle was mounted on a chassis dynamometer and run under 1900 rpm and 30 KW load. To measure the engine block vibration, a three axis accelerometer was mounted between cylinder 2 and 3. After acquisition of vibration signal, eight time feature of these signals were used as inputs to an Adaptive Neuro Fuzzy Inference System (ANFIS). The designed ANFIS was trained for classifying these five different fuels. The results show suitable classification ability of the designed ANFIS network with 96.3 percent of correct classification.

Keywords: internal combustion engine, vibration signal, fuel composition, classification, ANFIS

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Authors: Bahram Khan, Anderson Rocha Ramos, Rui R. Paulo, Fernando J. Velez

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With the growing demand for a new blend of applications, the users dependency on the internet is increasing day by day. Mobile internet users are giving more attention to their own experiences, especially in terms of communication reliability, high data rates and service stability on move. This increase in the demand is causing saturation of existing radio frequency bands. To address these challenges, researchers are investigating the best approaches, Carrier Aggregation (CA) is one of the newest innovations, which seems to fulfill the demands of the future spectrum, also CA is one the most important feature for Long Term Evolution - Advanced (LTE-Advanced). For this purpose to get the upcoming International Mobile Telecommunication Advanced (IMT-Advanced) mobile requirements (1 Gb/s peak data rate), the CA scheme is presented by 3GPP, which would sustain a high data rate using widespread frequency bandwidth up to 100 MHz. Technical issues such as aggregation structure, its implementations, deployment scenarios, control signal techniques, and challenges for CA technique in LTE-Advanced, with consideration of backward compatibility, are highlighted in this paper. Also, performance evaluation in macro-cellular scenarios through a simulation approach is presented, which shows the benefits of applying CA, low-complexity multi-band schedulers in service quality, system capacity enhancement and concluded that enhanced multi-band scheduler is less complex than the general multi-band scheduler, which performs better for a cell radius longer than 1800 m (and a PLR threshold of 2%).

Keywords: component carrier, carrier aggregation, LTE-advanced, scheduling

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Authors: Nuha Alamro

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Besides achieving of weight loss, Bariatric surgery (BS) shown metabolic improvement including reduction of cardiovascular disease, insulin resistance and diabetes. This study aimed to measure BS effects on Framingham Risk Score (FRS) and metabolic syndrome (MetS) among patients who underwent BS. Additionally, to determine the effect of BS on TSH among euthyroid obese patients. A Retrospective follow-up study was conducted in King Abdullah Medical City. A total of 160 participants who underwent BS and completed one year of follow ups. Medical history, biochemical, anthropometric, and hormonal parameters were evaluated at baseline and 3-12 months after BS. International Diabetes Federation (IDF) criteria were used to diagnose MetS pre and postoperative. The mean age of participants was 41.9 ± 10.6 with Body Mass Index (BMI) of 48.8 ± 7.3. After 3 months, Systolic, Diastolic blood pressure (SBP, DBP), glycated haemoglobin (HBA1C), Low-density lipoprotein (LDL), cholesterol, triglycerides and Thyroid stimulating hormone (TSH) were significantly decrease (P < 0.001). Significant decrease was seen in Mets, BMI, FRS, SBP, DBP, HBA1C, LDL, triglycerides, cholesterol, liver enzyme, with significant increase in high-density lipoprotein (HDL) level 12 months post-op (P < 0.001). After 1 year, the prevalence of MetS, DM, HTN, FRS were significantly decrease from 72.5%, 43.1%, 78.1%, 11.4 to 16.3%, 9.4%, 22.5% and 5.4, respectively. Besides achieving substantial weight loss, MetS resolution was linked to improvement in cardiovascular risk profile.

Keywords: bariatric surgery, cardiovascular disease, metabolic syndrome, thyroid stimulating hormone

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Authors: Ho-Dae Chong, Jong-Kil Kim

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Collaborative research has become more prevalent and important across disciplines because it stimulates innovation and interaction between scholars. Seeing as existing studies relatively disregarded the institutional conditions triggering collaborative research, this work aims to analyze the changing trend in collaborative work patterns among Korean social scientists. The focus of this research is the performance of social scientists who received research grants through the government’s Social Science Korea (SSK) program. Using quantitative statistical methods, collaborative research patterns in a total of 2,354 papers published under the umbrella of the SSK program in peer-reviewed scholarly journals from 2013 to 2016 were examined to identify changing trends and triggering factors in collaborative research. A notable finding is that the share of collaborative research is overwhelmingly higher than that of individual research. In particular, levels of collaborative research surpassed 70%, increasing much quicker compared to other research done in the social sciences. Additionally, the most common composition of collaborative research was for two or three researchers to conduct joint research as coauthors, and this proportion has also increased steadily. Finally, a strong association between international journals and co-authorship patterns was found for the papers published by SSK program researchers from 2013 to 2016. The SSK program can be seen as the driving force behind collaboration between social scientists. Its emphasis on competition through a merit-based financial support system along with a rigorous evaluation process seems to have influenced researchers to cooperate with those who have similar research interests.

Keywords: coauthorship, collaboration, competition, cooperation, Social Science Korea, policy

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Authors: H. Shamoradifar, B. Teimuri, P. Parvaresh, S. Mohammadi

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One of the main characteristics of Heavy Water Moderated Reactors is their high production of plutonium. This article demonstrates the possibility of reduction of plutonium and other actinides in Heavy Water Research Reactor. Among the many ways for reducing plutonium production in a heavy water reactor, in this research, changing the fuel from natural Uranium fuel to Thorium-Uranium mixed fuel was focused. The main fissile nucleus in Thorium-Uranium fuels is U-233 which would be produced after neutron absorption by Th-232, so the Thorium-Uranium fuels have some known advantages compared to the Uranium fuels. Due to this fact, four Thorium-Uranium fuels with different compositions ratios were chosen in our simulations; a) 10% UO₂-90% THO₂ (enriched= 20%); b) 15% UO₂-85% THO₂ (enriched= 10%); c) 30% UO₂-70% THO₂ (enriched= 5%); d) 35% UO₂-65% THO₂ (enriched= 3.7%). The natural Uranium Oxide (UO₂) is considered as the reference fuel, in other words all of the calculated data are compared with the related data from Uranium fuel. Neutronic parameters were calculated and used as the comparison parameters. All calculations were performed by Monte Carol (MCNPX2.6) steady state reaction rate calculation linked to a deterministic depletion calculation (CINDER90). The obtained computational data showed that Thorium-Uranium fuels with four different fissile compositions ratios can satisfy the safety and operating requirements for Heavy Water Research Reactor. Furthermore, Thorium-Uranium fuels have a very good proliferation resistance and consume less fissile material than uranium fuels at the same reactor operation time. Using mixed Thorium-Uranium fuels reduced the long-lived α emitter, high radiotoxic wastes and the radio toxicity level of spent fuel.

Keywords: Heavy Water Reactor, Burn up, Minor Actinides, Neutronic Calculation

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Authors: Funmilola Ajani, I. A. Ayodele, O.A. Filade

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Tourism has direct, indirect and induced impacts on economic development and the industry is one of the most crucial tradable sectors in the world. The study was therefore carried out to assess the potentials of ecotourism to nature conservation and its contributions to the improvement of the livelihood of Oke- Ila Orangun community. One hundred and fifty residents were chosen by stratified random sampling as respondents. Respondents awareness of ecotourism was assessed using an 8-point scale while respondents acceptance of ecotourism was assessed using a 14-point scale. Contributions to improvement of livelihood of residents and perceived constraints identified by residents to the development of the water fall and socio-economic variables among others were also obtained. Also, in-depth interview was conducted with the king of Ayikunnugba. The data was analyzed using descriptive statistics such as frequency count, mean and percentages. Correlation analysis was used to determine whether or not a relationship exists between two variables at 0.05 level of significance. Perception of respondents based on the awareness of ecotourism and contributions to livelihood development was high (78.3%). A significant relationship exists between acceptance of ecotourism and its contributions to peoples’ livelihood. Also, relationship between constraints encountered by respondents and its contributions to peoples livelihood is highly significant(r =0.546; P =0.00). Majority (71.3%) of the respondents believed that the development of the area will not lead to environmental pollution. Public- Private- Partnership (PPP) is therefore recommended so as to enable the recreation site to meet international standard in terms of development and management.

Keywords: Ayikunnugba water fall, ecotourism constraints, nature conservation, awareness

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Authors: Vandana T. Gawande, Kailash G. Bothara, Chandani O. Satija

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The present research work was aimed to determine stability of cefprozil monohydrate (CEFZ) as per various stress degradation conditions recommended by International Conference on Harmonization (ICH) guideline Q1A (R2). Forced degradation studies were carried out for hydrolytic, oxidative, photolytic and thermal stress conditions. The drug was found susceptible for degradation under all stress conditions. Separation was carried out by using High Performance Thin Layer Chromatographic System (HPTLC). Aluminum plates pre-coated with silica gel 60F254 were used as the stationary phase. The mobile phase consisted of ethyl acetate: acetone: methanol: water: glacial acetic acid (7.5:2.5:2.5:1.5:0.5v/v). Densitometric analysis was carried out at 280 nm. The system was found to give compact spot for cefprozil monohydrate (0.45 Rf). The linear regression analysis data showed good linear relationship in the concentration range 200-5.000 ng/band for cefprozil monohydrate. Percent recovery for the drug was found to be in the range of 98.78-101.24. Method was found to be reproducible with % relative standard deviation (%RSD) for intra- and inter-day precision to be < 1.5% over the said concentration range. The method was validated for precision, accuracy, specificity and robustness. The method has been successfully applied in the analysis of drug in tablet dosage form. Three unknown degradation products formed under various stress conditions were isolated by preparative HPTLC and characterized by mass spectroscopic studies.

Keywords: cefprozil monohydrate, degradation products, HPTLC, stress study, stability indicating method

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Authors: Mohamed Abdel-Hamid, Olfat Gamil Shaker, Doha El-Sayed Ellakwa, Eman Fathy Abdel-Maksoud

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Introduction: Despite advances in the knowledge of the molecular virology of hepatitis C virus (HCV), the mechanisms of hepatocellular injury in HCV infection are not completely understood. Hepatitis C viral infection (HCV) influences the susceptibility to apoptosis. This could lead to insufficient antiviral immune response and persistent viral infection. Aim of this study: was to examine whether BCL-2 gene polymorphism at codon 43 (+127G/A or Ala43Thr) has an impact on development of hepatocellular carcinoma caused by chronic hepatitis C Egyptian patients. Subjects and Methods: The study included three groups; group 1: composing of 30 patients with hepatocellular carcinoma (HCC), group 2 composing of 30 patients with HCV, group 3 composing of 30 healthy subjects matching the same age and socioeconomic status were taken as a control group. Gene polymorphism of BCL2 (Ala43Thr) were evaluated by PCR-RFLP technique and measured for all patients and controls. Results: The summed 43Thr genotype was more frequent and statistically significant in HCC patients as compared to control group. This genotype of BCL2 gene may inhibit the programmed cell death which leads to disturbance in tissue and cells homeostasis and reduction in immune regulation. This result leads to viral replication and HCV persistence. Moreover, virus produces variety of mechanisms to block genes participated in apoptosis. This mechanism proves that HCV patients who have 43Thr genotype are more susceptible to HCC. Conclusion: The data suggest for the first time that the BCL2 polymorphism is associated with the susceptibility to HCC in Egyptian populations and might be used as molecular markers for evaluating HCC risk. This study clearly demonstrated that Chronic HCV exhibit a deregulation of apoptosis with the disease progression. This provides an insight into the pathogenesis of chronic HCV infection, and may contribute to the therapy.

Keywords: BCL2 gene, Hepatitis C Virus, Hepatocellular carcinoma, sensitivity, specificity, apoptosis

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Authors: Sara Bilal, Abdi Omar Shuriye, Raihan Othman

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Numerical Methods is a course that can be conducted using workshops and group discussion. This study has been implemented on undergraduate students of level two at the Faculty of Engineering, International Islamic University Malaysia. The Numerical Method course has been delivered to two Sections 1 and 2 with 44 and 22 students in each section, respectively. Systematic steps have been followed to apply the student centered learning approach in teaching Numerical Method course. Initially, the instructor has chosen the topic which was Euler’s Method to solve Ordinary Differential Equations (ODE) to be learned. The students were then divided into groups with five members in each group. Initial instructions have been given to the group members to prepare their subtopics before meeting members from other groups to discuss the subtopics in an expert group inside the classroom. For the time assigned for the classroom discussion, the setting of the classroom was rearranged to accommodate the student centered learning approach. Teacher strength was by monitoring the process of learning inside and outside the class. The students have been assessed during the migrating to the expert groups, recording of a video explanation outside the classroom and during the final examination. Euler’s Method to solve the ODE was set as part of Question 3(b) in the final exam. It is observed that none of the students from both sections obtained a zero grade in Q3(b), compared to Q3(a) and Q3(c). Also, for Section 1(44 students), 29 students obtained the full mark of 7/7, while only 10 obtained 7/7 for Q3(a) and no students obtained 6/6 for Q3(c). Finally, we can recommend that the Numerical Method course be moved toward more student-centered Learning classrooms where the students will be engaged in group discussion rather than having a teacher one man show.

Keywords: teacher centered learning, student centered learning, mathematic, numerical methods

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Authors: Jahangir Ahmad Rather, Emad A. Khudaish, Ahsanulhaq Qurashi, Palanisamy Kannan

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Chemical modification and assembling of fullerenes are fundamentally important for the application of fullerenes as functional molecules and in molecular devices and organic electronic devices. We have synthesized fullerene nanorods C60NRs conjugate via liquid-liquid interface and the synthesized C60NRs was characterized by FTIR spectroscopy, field emission electron microscopy (FESEM) and X-ray diffraction techniques. The C60NRs were immobilized on glassy carbon electrode via surface bound diazonium salts as an impact strategy. This method involves electrografting of p–nitrophenyl to give GCE–Ph–NO2 and then the terminal nitro-group was chemically reduced to GCE–Ph–NH2 in a presence of sodium borohydride/gold–polyaniline nanocomposite (NaBH4/Au–PANI). The Au–PANI composite was synthesized and characterized by FTIR, UV-vis, SEM and EDX techniques. The C60NRs were immobilized on GCE–Ph–NH2 via amination reaction which involves N-H addition across a π-bond on [60] fullerene. The immobilized C60NRs/GCE was subjected to electrochemical reduction in 1.0 M KOH to yield ERC60NRs/GCE sensor. The developed sensor shows high electrocatalytic activity for the detection of ethylparaben (EP) over a concentration range from 0.01 to 0.52 µM with a detection limit (LOD) 3.8 nM. The amount of EP present in the nourishing repair cream (OlAY®) was determined by standard addition method at the developed ERC60NRs/GCE sensor. The total concentration of EP was found to be 0.011 µM (0.1%) and is within the permissible limit of 0.19 % EP in cosmetics according to the European scientific committee (SCCS) on consumer safety on 22 March 2011 (SCCS/1348/11).

Keywords: diazonium salt reduction, ethylparaben (EP), endocrine disruptor, fullerene nanorods (C60NRs), gold–polyaniline nanocomposite (Au–PANI)

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Authors: K. Rajarajeswaran, Krishna Prasad

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Introduction: Refractory shock is a typical consequence of sepsis that does not improve with standard vasopressor therapy. A possible adjuvant therapeutic option for treating refractory shock in sepsis is methylene blue. This study looked at the effects of intravenous methylene blue plus norepinephrine given as a single bolus infusion on mortality and hemodynamic improvement in patients suffering from refractory shock. Methodology: This six-month observational prospective study was carried out at an intensive care unit, teaching hospital, and medical college. It involved 112 patients who had been diagnosed with refractory septic shock and needed vasopressor medication. Group B received injection norepinephrine 0.01 µg/kg/min infusion alone, while Group A received injection methylene blue 2 mg/kg iv single bolus (fixed dose) in addition to injection norepinephrine 0.01 µg/kg/min infusion. Both groups' noradrenaline doses were titrated to reach the desired MAP of 60–75 mm Hg. The amount of norepinephrine needed to sustain a MAP of more than 60 mm Hg was the data gathered. Serum lactate, procalcitonin level, C-reactive protein, length of stay in the intensive care unit (ICU), sequential organ failure assessment (SOFA) score, and duration of mechanical ventilation, incidence of acute kidney injury (AKI), and mortality were compared. Results: A total of 112 patients with refractory shock were included in the study. With the use of IV methylene blue, 36 (59.3%) patients showed significant improvement in MAP within 2 hours (77.12 ± 8.90 vs 74.28 ± 21.84, p = 0.005). Responders were 4.009 times more likely to have vasopressor-free time within 24 hours (19.5% vs 6.1%, p = 0.022, odds ratio 5.017, 95% confidence interval, 1.110–14.283). The serum lactate was lower, and urine output was higher in group I than in group II (p <0.05). Group I had a significantly greater reduction in SOFA score in 12 hours than group II. However, there was no significant difference in terms of mortality, length of ICU stay, ventilator free days, and incidence of AKI. In the responder group, there was a significant increase in the MAP and decrease in vasopressor requirement pre- and post-infusion of methylene blue (p < 0.05). Responder had shorter vasopressor-free days as compared with non-responder (5.44 vs 6.99, p = 0.007). Conclusion: When administered as adjuvant therapy, a single-dose bolus infusion of Methylene Blue plus Norepinephrine may aid in meeting early resuscitation goals for the management of patients with septic shock. But the patients' death rate, ICU stay duration, ventilator-free days, or incidence of AKI were unchanged.

Keywords: norepinephrine, methylene blue, shock, vasopressor

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Authors: Hamad Albadr

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With a rapid influence to sustain the needs for global trends that had arisen for the increasing complexities in health-care provision, the increasing number of health professionals at different levels, and the need to assure more equitable access to health care, the great variation in the levels of initial education for health care professional around the world had been assign bachelor's degree as the minimum point of entry to the health professions. This intent had affected all the health care professions including biomedical engineering. In Saudi Arabia, these challenges add more pressure to retain the global trends for associate degree graduates to upgrade their education to the bachelor's degree or called birding. This paper is to review the reality of biomedical technology programs that offered in Saudi Arabia by Technical Colleges or Community Colleges nationwide and the challenges that face these colleges to run such bridging program to achieve the Bachelor's degree in biomedical engineering and the official requirements by the Ministry of Higher Education and to maintain the international standards. The author will use strategic planning methodology for designing the biomedical engineering bridging of bachelor's program by reviewing the responsibilities of the biomedical engineers in hospitals through their job descriptions to determine the job assessment needs in advance to Developing a Curriculum (DACUM) through Instructional System Design (ISD) approach via five steps: Analysis, Design, Development, Implement, Evaluate (ADDIE).

Keywords: bachelor's degree bridging, biomedical engineering program, Saudi Arabia, Riyadh College of Technology

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Authors: B. B. van Schalkwyk, C. B. Schoeman, E. J. Cilliers

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High levels of urbanisation and the lingering effects of Apartheid have caused South African municipalities to experience difficulties in planning for sustainability and, more specifically, sustainable community development. Sustainable community development is needed in order to achieve more integrated and sustainable towns and cities with an improved living environment and a higher quality of life. Due to this, sustainable community development is of particular relevance to South Africa. Although policies and legislation exist at international, national and local level, there is a lack of suitable planning instruments to guide sustainable community development. Tlokwe Local Municipality is researched in this paper as study area to test and develop planning instruments for sustainable community development. A comparative assessment matrix of sustainability indicators is linked to Multi-Criteria Analysis (MCA) and applied to identify the themes and sub-themes applicable to sustainability in which intervention is required to improve the sustainability rating of the municipality. The result of the comparative sustainability assessment is that the Tlokwe Local Municipality is considered to be relatively sustainable, performing overall better than the three spheres of government against which it was measured. It is recommended that municipalities use the comparative assessment matrix method to determine its level of sustainability when developing respective sectorial plans (SDFs, ITPs, EMFs and IDPs). Areas in which there is a lack of sustainability are highlighted and can consequently be addressed through intervention strategies. The comparative assessment matrix method is a valuable planning instrument with which to achieve sustainable community development.

Keywords: sustainable community development, sustainability indicators, comparative sustainability, urbanisation, development planning, urban management

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Authors: Marie Taylor, Catriona Murphy

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The aim of this paper is to identify the factors of success in community based heritage tourism initiatives. Heritage and community are central to many tourism initiatives with heritage tourism having the potential to act as a catalyst for community development. This paper presents the findings of research that examined the relationship between heritage tourism and community development. The findings recognised that heritage tourism had economic, social and cultural benefits for a community as well as a role in strengthening concepts such as sense of identity, place, and authenticity. In addition, this paper proposes an assessment framework for sustainable community based heritage tourism to identify factors and contextual influences involved in their success or failure. In evaluating the sustainability of such initiatives, a number of issues are investigated including the continued role of stakeholders, the role of funding, the influence of collaboration and the changing role of rural development and its impact on community engagement. The research is descriptive, evaluative and explanatory research, exploring and analysing issues such as the development of community structures in community based heritage tourism. Thus, it will contribute to the development of potential tourism and community development policies and strategies at a local, national and international level. An interpretative and inductive approach is utilised, and a mixed method approach followed as it encapsulates the best of quantitative and qualitative research methods. The case studies focus on social enterprises in relation to tourism and community based tourism cooperatives as there are limited study and knowledge of these. Consequently, this research will contribute to the discourse on community based heritage tourism as an aspect of community development.

Keywords: collaboration, community-based heritage tourism, stakeholders, sustainable tourism

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Authors: Temple Probyne Abali

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Port Harcourt, Rivers State in the Niger Delta region of Nigeria is bedeviled by the phenomenon of climatechange, posing threat to food security and livelihood. This study examined a 4 decadel (1980-2020) trend of climate change as well as its socio-economic impact on food security in the region. Furthermore, to achieve sustainable food security and livelihood amidst the phenomenon, the study adopted the World Bank Assisted Third National Fadama Development Programme approach. The data source for climate change involved secondary data from Nigeria Meteorological Agency (NIMET). Consequently, the results for climate change over the 4decade period were displayed in tables, charts and maps for the expected changes. Data sources on socio-economic impact of food security and livelihood were acquired through questionnairedesign. A purposive random sampling technique was used in selecting 5 coastal communities inthe region known for viable economic potentials for agricultural development and the resultswere analyzed using Analysis of Variance (ANOVA). The Participatory Rural Appraisal (PRA) technique of the World Bank for needs assessment wasadopted in selecting 5 agricultural sub-project proposals/activities based on groups’ commoneconomic interest from a total of 1,000 farmers each drawn from the 5 communities of differentage groups including men, women, youths and the vulnerable. Based on the farmers’ sub-projectinterests, the various groups’ Strength, Weakness, Opportunities and Threats (SWOT), Problem Listing Matrix, Skill Gap Analysis as well as EIAson their sub-project proposals/activities were analyzed with substantialMonitoring and Evaluation (M & E), using the Specific, Measurable, Attribute, Reliable and Time bound (SMART)approach. Based on the findings from the PRA technique, the farmers recorded considerableincreaseinincomeofover200%withinthe5yearprojectplan(2008-2013).Thestudyrecommends capacity building and advisory services on this PRA innovation. By so doing, there would be a sustainable increase in agricultural production and assured food security in an environmental friendly manner, in line with the United Nation’s Sustainable Development Goals(SDGs).

Keywords: climate change, food security, fadama, world bank, agriculture, sdgs

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, John Beatty, Aakash Pai

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Introduction: The development of robotic surgery has accelerated centralisation to tertiary centres, where robotic radical prostatectomy (RP) is offered. The purpose of concentrating treatment in high volume specialist centres is to improve the quality of care and patient outcomes. The aim of this study was to assess the impact on clinical outcomes of centralisation for locally diagnosed patients undergoing RP. Methods: Clinical outcomes for 169 consecutive laparoscopic & open RP pre-centralisation were retrospectively compared with 50 consecutive robotic RP conducted over a similar period post-centralisation. Preoperative risk stratification and time to surgery were collected. Perioperative outcomes, including length of stay (LOS) and complications, were collated. Post-operative outcomes, including erectile dysfunction (ED), biochemical recurrence (BCR), and urinary continence, were assessed. Results: Preoperative risk stratification showed no difference between the two groups. The median time from diagnosis to treatment was similar between the two groups (pre-centralisation, 121 days, post-centralisation, 117 days). The mean length of stay (pre-centralisation, 2.1 days, post-centralisation, 1.6 days) showed no significant difference (p=0.073). Proportion of overall complications (pre-centralisation, 11.4%, post-centralisation, 8.7%) and complications, above Clavien-Dindo 2, were similar between the two groups (pre-centralisation1.2%, post-centralisation 2.2%). Post operative functional parameters, including continence and ED, were comparable. Five-year BCR free rate was 78% for the pre-centralisation group and 79% for the post centralisation group. Conclusion: For our cohort of patients, clinical outcomes have remained static during centralisation. It is imperative that centralisation is accompanied by increased capacity, streamlining of pathways, and training to ensure that improved quality of care is achieved. Our institution has newly acquired a robot, and prospectively studying this data may support the reversal of centralisation for RP surgery.

Keywords: prostate, cancer, prostatectomy, clinical

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Authors: Hanadi Khadawardi

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The current study contributes to research on foreign/second language (L2) academic reading by presenting a significant case study, which seeks to investigate specific groups of international (Arab) postgraduate students’ L2 academic reading practices in the UK educational context. In particular, the study scrutinises postgraduate students’ L2 paper-based and digital-based academic reading strategies, and their use of digital aids while engaged in L2 academic reading. To this end, the study investigates Arab readers’ attitudes toward digital L2 academic reading. The study aims to compare between paper and digital L2 academic reading strategies that the students employ and which reading formats they prefer. This study tracks Masters-level students and examines the way in which their reading strategies and attitudes change throughout their Masters programme in the UK educational context. The academic reading strategies and attitudes of five students from four different disciplines (Health Science, Psychology, Management, and Education) are investigated at two points during their one-year Masters programmes. In addition, the study investigates the same phenomenon with 15 Saudi PhD students drawn from seven different disciplines (Computer Science, Engineering, Psychology, Management, Marketing, Health Science, and Applied Linguistics) at one period of their study in the same context. The study uses think-aloud protocol, field notes, stimulated recall, and semi-structured interviews to collect data. The data is analysed qualitatively. The results of the study will explain the process of learning in terms of reading L2 paper and digital academic texts in the L2 context.

Keywords: EFL: English as a foreign language, ESL: English as a second language, L: Language

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Authors: Donghwan Lee, Gichun Cha, Jooyoung Park, Junkyeong Kim, Seunghee Park

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3D shape models of the existing structure are required for many purposes such as safety and operation management. The traditional 3D modeling methods are based on manual or semi-automatic reconstruction from close-range images. It occasions great expense and time consuming. The Terrestrial Laser Scanner (TLS) is a common survey technique to measure quickly and accurately a 3D shape model. This TLS is used to a construction site and cultural heritage management. However there are many limits to process a TLS point cloud, because the raw point cloud is massive volume data. So the capability of carrying out useful analyses is also limited with unstructured 3-D point. Thus, segmentation becomes an essential step whenever grouping of points with common attributes is required. In this paper, members segmentation algorithm was presented to separate a raw point cloud which includes only 3D coordinates. This paper presents a clustering approach based on a fuzzy method for this objective. The Fuzzy C-Means (FCM) is reviewed and used in combination with a similarity-driven cluster merging method. It is applied to the point cloud acquired with Lecia Scan Station C10/C5 at the test bed. The test-bed was a bridge which connects between 1st and 2nd engineering building in Sungkyunkwan University in Korea. It is about 32m long and 2m wide. This bridge was used as pedestrian between two buildings. The 3D point cloud of the test-bed was constructed by a measurement of the TLS. This data was divided by segmentation algorithm for each member. Experimental analyses of the results from the proposed unsupervised segmentation process are shown to be promising. It can be processed to manage configuration each member, because of the segmentation process of point cloud.

Keywords: fuzzy c-means (FCM), point cloud, segmentation, terrestrial laser scanner (TLS)

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Authors: Eni Rahmi, Rasmi Rikmasari, Taufik Soemarsongko

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Background: One of the bad habits that requires a treatment and viewed as a risk factor of the temporomandibular disorder is bruxism. Bruxism defined as an awake and/or asleep parafunctional activities include grinding, gnashing, bracing or clenching of the teeth. In particular circumstances such as an increased frequency of episode, duration and the intensity of masseter contractions, caused phenomenon with pathological consequences, i.e., mandibular remodeling. The remodeling in mandibular angle was associated with the masseter and pterygoid medial muscles attachment which in its insertion area. The aim of this study was to compare the mandibular remodeling between bruxers and non-bruxers with ramus height, gonial angle and bigonial width as parameters, and to identify correlation among those parameters in bruxers, using panoramic radiographic. Methods: This study was conducted on 35 bruxers (10 phasic bruxism patients, 6 tonic bruxism patients, and 19 mixed bruxism patients) and 20 non-bruxers as control group. The data were obtained by using questionary, clinical examination, and radiographic measurement. Panoramic radiograph measurement was done using soft CBCT EPX Impla (E-Woo Korea). The data was analyzed by using Paired T-Test to see differences between parameters in both group and Pearson Correlation Test to evaluate correlation among parameters. Result: There was significant differences between bruxers and non-bruxers in ramus heights (p=0,04), bigonial widths (p=0,001), and gonial angles(p=0,015). The bruxers showed increased ramus heights and bigonial widths, in other hand, the gonial angles decreased. This study also found that there was highly correlation among ramus height, gonial angles, and bigonial widths. Conclusion: the bone remodeling occurred on inferior and posterior border of mandibular angle in bruxism patient, indicated by the form and size differences between bruxers (phasic bruxism, tonic bruxism, and mixed bruxism) with non-bruxers, which shown by panoramic radiograph.

Keywords: bruxism, ramus height, gonial angle, bigonial width

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Authors: Anne-Marie Dionne

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Teacher reading aloud to students is a practice that is well established in preschool and primary classrooms. Many benefits of this pedagogical activity have been highlighted in multiple studies. However, it has also been shown that teachers are not keen on choosing informational texts for their read aloud, as their selections for this venue are mainly fictional stories, mostly written in a unique narrative story-like structure. Considering that students soon have to read complex informational texts by themselves as they go from one grade to another, there is cause for concern because those who do not benefit from an early exposure to informational texts could be lacking knowledge of informational text structures that they will encounter regularly in their reading. Exposing students to informational texts could be done in different ways in classrooms. However, since read aloud appears to be such a common and efficient practice in preschool and primary grades, it is important to examine more deeply the factors taken into account by teachers when they are selecting their readings for this important teaching activity. Moreover, it seems critical to know why teachers are not inclined to choose more often informational texts when they are reading aloud to their pupils. A group of 22 preschool or primary grade teachers participated in this study. The data collection was done by a survey and an individual semi-structured interview. The survey was conducted in order to get quantitative data on the read-aloud practices of teachers. As for the interviews, they were organized around three categories of questions (exploratory, analytical, opinion) regarding the process of selecting the texts for the read-aloud sessions. A statistical analysis was conducted on the data obtained by the survey. As for the interviews, they were subjected to a content analysis aiming to classify the information collected in predetermined categories such as the reasons given to favor fictional texts over informative texts, the reasons given for avoiding informative texts for reading aloud, the perceptions of the challenges that the informative texts could bring when they are read aloud to students, and the perceived advantages that they would present if they were chosen more often for this activity. Results are showing variable factors that are guiding the teachers when they are making their selection of the texts to be read aloud. As for example, some of them are choosing solely fictional texts because of their convictions that these are more interesting for their students. They also perceive that the informational texts are not good choices because they are not suitable for pleasure reading. In that matter, results are pointing to some interesting elements. Many teachers perceive that read aloud of fictional or informational texts have different goals: fictional texts are read for pleasure and informational texts are read mostly for academic purposes. These results bring out the urgency for teachers to become aware of the numerous benefits that the reading aloud of each type of texts could bring to their students, especially the informational texts. The possible consequences of teachers’ perceptions will be discussed further in our presentation.

Keywords: fictional texts, informational texts, preschool or primary grade teachers, reading aloud

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Authors: Andriy Fedorenko

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Background Early closure of the open abdomen is a priority after damage control laparotomy to prevent retraction of fascial layers and prevent hernia formation that requires definitive repair at a later stage. This substantially reduces the complications associated with ventral hernia formation for up to a year after initial surgery. TopClosure® is an innovative method that employs stress-relaxation and mechanical creep for skin stretching. Its use enables the primary closure of large abdominal wall defects and mitigates large ventral hernia formation. Materials and Methods A 7-year-old girl presented with severe blast injury. She underwent initial laparotomy in a facility within the conflict zone and was transferred in a state of septic shock to our facility for further care. Her abdominal injuries included liver lacerations, multiple perforations of the transverse colon and ileum, and a 8x16cm oblique abdominal wall defect. Further damage control laparotomy was performed with primary suture of the colon and ileum and temporary closure of the abdomen using a Bagota bag. Twelve hours later, negative pressure wound therapy (NPWT) was applied to the abdominal wound after relook laparotomy. Five days later, TopClosure® was applied to the lower part of the wound incorporating NPWT to the upper wound. Results The patient suffered leak from the colonic suture line and required relaparotomy. TopClosure® abdominal closure was achieved after every laparotomy. Conclusion TopClosure® utilizes the viscoelastic properties of the skin achieving full closure of the abdominal wall (including the fascia and skin),eliminating the need for prolonged NPWT, skin graft, and delayed ventral hernia repair surgery.

Keywords: topclosure, abdominal wall defect, hernia, damage control

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