Search results for: golden proportion

Authors: Azin Zargham, Gholamreza Rouhi, Allahyar Geramy

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One of the most prevalent types of alveolar bone loss is horizontal bone loss (HBL) in which the bone height around teeth is reduced homogenously. In the presence of HBL the magnitudes of forces during orthodontic treatment should be altered according to the degree of HBL, in a way that without further bone loss, desired tooth movement can be obtained. In order to investigate the appropriate orthodontic force system in the presence of HBL, a three-dimensional numerical model capable of the simulation of orthodontic tooth movement was developed. The main goal of this research was to evaluate the effect of different degrees of HBL on a long-term orthodontic tooth movement. Moreover, the effect of different force magnitudes on orthodontic tooth movement in the presence of HBL was studied. Five three-dimensional finite element models of a maxillary lateral incisor with 0 mm, 1.5 mm, 3 mm, 4.5 mm and 6 mm of HBL were constructed. The long-term orthodontic tooth tipping movements were attained during a 4-weeks period in an iterative process through the external remodeling of the alveolar bone based on strains in periodontal ligament as the bone remodeling mechanical stimulus. To obtain long-term orthodontic tooth movement in each iteration, first the strains in periodontal ligament under a 1-N tipping force were calculated using finite element analysis. Then, bone remodeling and the subsequent tooth movement were computed in a post-processing software using a custom written program. Incisal edge, cervical, and apical area displacement in the models with different alveolar bone heights (0, 1.5, 3, 4.5, 6 mm bone loss) in response to a 1-N tipping force were calculated. Maximum tooth displacement was found to be 2.65 mm at the top of the crown of the model with a 6 mm bone loss. Minimum tooth displacement was 0.45 mm at the cervical level of the model with a normal bone support. Tooth tipping degrees of models in response to different tipping force magnitudes were also calculated for models with different degrees of HBL. Degrees of tipping tooth movement increased as force level was increased. This increase was more prominent in the models with smaller degrees of HBL. By using finite element method and bone remodeling theories, this study indicated that in the presence of HBL, under the same load, long-term orthodontic tooth movement will increase. The simulation also revealed that even though tooth movement increases with increasing the force, this increase was only prominent in the models with smaller degrees of HBL, and tooth models with greater degrees of HBL will be less affected by the magnitude of an orthodontic force. Based on our results, the applied force magnitude must be reduced in proportion of degree of HBL.

Keywords: bone remodeling, finite element method, horizontal bone loss, orthodontic tooth movement.

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Authors: Sadhana Deshmukh

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Objective: Men represent only a fraction of the medical aesthetic practice. They are increasingly becoming more cosmetically-inclined. The primary objective is to harmonize facial proportion by prioritizing and focusing on forehead nose, cheek and chin complex. Introduction: Despite tremendous variability, diverse population of the Indian subcontinent, the male skull is unique in its overall larger size, and shape. Men tend to have a large forehead with prominent supraorbital ridges, wide glabella, square orbit, and a prominent protruding mandible. Men have increased skeletal muscle mass, with less facial subcutaneous fat. Facial aesthetics is evolving rapidly. Commonly published canons of facial proportions usually represent feminine standards and are not applicable to males. Strict adherence to these norms is therefore not necessary to obtain satisfying results in male patients. Materials and Methods: Male patients age group 30-60 years have been enrolled. Botulinum toxin and hyaluronic acid fillers were used to update consensus recommendations for facial rejuvenation using these two types of products alone and in combination. Results: There are specific recommendations by facial area, focusing on relaxing musculature, restoring volume, recontouring using toxin and dermal fillers alone and in combination. For upper face, though botulinum toxin remains the cornerstone of treatment, temples and forehead fillers are recommended for optimal results. In Mid face, these fillers are placed more laterally to maintain the masculine look. Botulinum toxin and fillers in combination can improve outcomes in the lower face. Chin augmentation remains the center point for lower face. Conclusions: Males are more likely to have shorter doctor visits, less likely to ask questions, have a lower attention to bodily changes. The physician must patiently gauge male patients’ aging and cosmetic goals. Clinicians can also benefit from ongoing guidance on products, tailoring treatments, treating multiple facial areas, and using combinations of products. An appreciation that rejuvenation is 3-dimensional process involving muscle control, volume restoration and recontouring helps.

Keywords: male aesthetics, botulinum toxin, hyaluronic acid dermal fillers, Asian patients

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Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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Authors: Jayanta Bora, Sukhvinder Kaur, Ashok Agarwal, Sangeeta Kaul

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Background: It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility and literacy for effective human immunodeficiency virus (HIV) prevention. This paper examines the association between vulnerability and behavioural outcomes among FSWs in Thane district, Maharashtra under USAID PHFI-PIPPSE project. Methods: Data were used from the Behavioural Tracking Survey, a cross-sectional behavioural study conducted in 2015 with 503 FSWs randomly selected from 12 TI-NGOs which were functioning and providing services to FSWs in Thane district prior to April 2014 in Thane district of Maharashtra. We have created the “vulnerability index”, a composite index of literacy, factors of dependence (alternative livelihood options, current debt), and aspects of sex work (mobility and duration in sex work) as a dependent variable. The key independent measures used were program exposure to intervention, service uptake, self-confidence, and self-identity. Bi-variate and multivariate logistic regressions were used to examine the study objectives. Results: A higher proportion of FSWs who were in the age-group 18–25 years from brothel/street /home/ lodge-based were categorized as highly vulnerable to HIV risk as compared to bar-based sex worker (74.1% versus 59.8%, P,0.002); regression analysis highlighted lower odds of vulnerability among FSWs who were aware of services and visited NGO clinic for medical check-up and counselling for STI [AOR= 0.092, 95% CI 0.018-0.460; P,0.004], However, lower odds of vulnerability on confident in supporting fellow sex worker in crisis [AOR= 0.601, 95% CI 0.476-0.758; P, 0.000] and were able to turn away clients when they refused to use a condom during sex [AOR= 0.524, 95% CI 0.342-0.802; P, 0.003]. Conclusion: The results highlight that FSWs associated with TIs and getting services are less vulnerable and highly empowered. As a result of behavioural change communication and other services provided by TIs, FSWs were able to successfully negotiate about condom use with their clients and manage solidarity in the crisis situation for fellow FSWs. Therefore, it is evident from study paper that TI prevention programs may transform the lives of masses considerably and may open a window of opportunity to infuse the information and awareness about HIV risk.

Keywords: female sex worker, HIV prevention, HIV service uptake, vulnerability

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Authors: Javad Saeidaskari, Mohammad Hassan Baziar

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Soil structures have been frequently damaged during piping, earthquake and other types of failures. As far as adverse circumstances were developed subsequent to piping or other similar failure types, hydraulic parameters of soil such as hydraulic conductivity should be considered. As a result, acquiring an approach to diminish soil permeability is inevitable. There are many ground improvement methods to reduce seepage, which are classified under soil treatment and stabilization methods. Recently, one of the soil improvement methods is known as nanogeotechnology. This study aims to investigate the influence of Cloisite 30B nanoclay on permeability of compacted clayey sand soils. The samples are prepared by mixing two soil types, including Kaolin clay and Firouzkooh sand, in 1:9 and 1:5 clay:sand (by mass) proportions. In experimental procedure, initially, the optimum water content and maximum dry unit weight of each samples were obtained for compaction. Then, series of permeability tests were conducted by triaxial apparatus on prepared specimens with identical relative density of 95% of maximum dry density and water content of 1% wet of optimum for different weight percentages of nanoclay (1% to 4%). Therefore, in this paper, the effect of time on treated specimen was appraised, as well as two approaches of manual mixing and ball milling were compared to reveal the importance of dispersion issue. The results show that adding nanoclay up to 3%, as its optimum content, causes notable reduction in permeability (1.60e-03 to 5.51e-05 cm/s and 3.32e-04 to 8.44e-07 cm/s in samples with 1:9 and 1:5 mixture proportions, respectively). The hydraulic conductivity of treated clayey sand (1:5 mixture proportion with 3% nanoclay) decreases gradually from 8.44e-07 to 3.00e-07 cm/s within 90 days and then tends to be consistent. The influence of mixing method on permeability results shows that the utilization of ball mill mixing effectively leads to lower values than those of manual mixing, in other words, by adding 3% nanoclay, hydraulic conductivity of specimen declines from 8.44e-07 to 2.00e-07 cm/s. In order to evaluate the interaction between soil particles and, to ensure proper dispersion of nanoparticles through clayey sand mixture, they were magnified by means of scanning electron microscope (SEM). In conclusion, the nanoclay particles in vicinity of moisture can cause soil stabilization to prevent water penetration, which eventually result in lower usage of clay and operation costs.

Keywords: nanoclay, cloisite 30b, clayey sand, hydraulic conductivity

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Authors: Mohammed Seid, Aklilu Azazh, Fikre Enquselassie, Engida Yisma

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Background: Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people. More than a million people die each year on the world’s roads, and the risk of dying as a result of a road traffic injury is highest in the Africa. Methods: A prospective hospital-based study was undertaken to assess injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia. A structured pre-tested questionnaire was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Results: A total of 230 road traffic accident victims were studied. The majority of the study subjects were men 165 (71.7%) and the male/female ratio was 2.6:1. The victims’ ages ranged from 14 to 80 years with the mean and standard deviations of 32.15 and ± 14.38 years respectively. Daily laborers (95 (41.3%)) and students (28 (12.2%)) were the majority of road traffic accident victims. Long-distance travelling Minibus (16.5%) was responsible for the majority of road traffic crash followed by followed by Taxi (14.8%) and pedestrians (62.6%) accounted for the majority of road traffic accident. Head (50.4%) and musculoskeletal (extremities) (47.0%) were the most common body region injured. Fractures (78.0%) and open wounds (56.5%) were the most common type of injuries sustained. Treatment of fracture was the most common procedure performed in 57.7 % of the victims. The overall length of hospital stay (LOS) ranged from 1 day to 61 days with mean (± standard deviation) of 7.12 ± 10.5 days and the mortality rate was 7.4 %. A significant higher proportion of victims aged 14-55 years were had less likelihood of death compared to those victims aged more than 55 years of age [Adjusted OR = 0.1 (95% CI: 0.01, 0.82)]. Conclusions: This study showed diverse injury characteristics and high morbidity and mortality among the victims attending Adult Emergency Department of Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia. The findings reflect that road traffic accident is a major public health problem. Urgent road traffic accident preventive measures and prompt treatment of the victims are warranted in order to reduce morbidity and mortality among the victims.

Keywords: road traffic accident, injury characteristics, outcome, Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia

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Authors: Vidya Yadav

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India’s youth bulge is now sharpest at the critical 15-24 age group, even as its youngest, and oldest age groups begin to narrow. As the ‘single year, age data’ for the 2011 Census releases the data on the number of people at each year of age in the population. The data shows that India’s working age population (15-64 years) is now 63.4 percent of the total, as against just short of 60 percent in 2001. The numbers also show that the ‘dependency ratio’ the ratio of children (0-14) and the elderly (65 above) to those in the working age has shrunk further to 0.55. “Even as the western world is in ageing situation, these new numbers show that India’s population is still very young”. As the fertility falls faster in urban areas, rural India is younger than urban India; while 51.73 percent of rural Indians are under the age of 24 and 45.9 percent of urban Indians are under 24. The percentage of the population under the age of 24 has dropped, but many demographers say that it should not be interpreted as a sign of the youth bulge is shrinking. Rather it is because of “declining fertility, the number of infants and children reduces first, and this is what we see with the number of under age 24. Indeed the figure shows that the proportion of children in the 0-4 and 5-9 age groups has fallen in 2011 compared to 2001. For the first time, the percentage of children in the 10-14 age group has also fallen, as the effect of families reducing the number of children they have begins to be felt. The present paper key issue is to examine that “whether this growing youth bulge has the right skills for the workforce or not”. The study seeks to examine the youth population structure and employment distribution among them in India during 2001-2011 in different industrial category. It also tries to analyze the workforce participation rate as main and marginal workers both for male and female workers in rural and urban India by utilizing an abundant source of census data from 2001-2011. Result shows that an unconscionable number of adolescents are working when they should study. In rural areas, large numbers of youths are working as an agricultural labourer. Study shows that most of the youths working are in the 15-19 age groups. In fact, this is the age of entry into higher education, but due to economic compulsion forces them to take up jobs, killing their dreams of higher skills or education. Youths are primarily engaged in low paying irregular jobs which are clearly revealed by census data on marginal workers. That is those who get work for less than six months in a year. Large proportions of youths are involved in the cultivation and household industries works.

Keywords: main, marginal, youth, work

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Authors: Kamrun Nahar Koly, Saimul Islam

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Overweight and obesity is increasing at an alarming rate and a leading risk factor for morbidity throughout the world. In a country like Bangladesh where under nutrition and overweight both co-exist at the same time, but this issue has been underexplored as expected. The aim of the present study was to assess the knowledge, attitudes and identify the barriers of the physicians regarding overweight and obesity management on an urban hospital of Dhaka city in Bangladesh. A simple cross sectional study was conducted at two selected government and two private hospital to assess the knowledge, attitude and common barriers regarding overweight and obesity management among healthcare professionals. One hundred and fifty five physicians were surveyed. A standard questionnaire was constructed in local language and interview was administrated. Among the 155 physicians, majority 53 (34.20%) were working on SMC, 36 (23.20%) from DMC, 33 (21.30%) were based on SSMC and the rest 33 (21.30%) were from HFRCMH. Mean age of the study physicians were 31.88±5.92. Majority of the physicians 80 (51.60%) were not able to answer the correct prevalence of obesity but also a substantial number of them 75(48.40%) could mark the right answer. Among the physicians 150 (96.77%) reported BMI as a diagnostic index for overweight and obesity, where as 43 (27.74%) waist circumference, 30 (19.35%) waist hip ratio and 26 (16.77%) marked mid-arm circumference. A substantial proportion 71 (46.70%) of the physicians thought that they do not have much to do controlling weight problem in Bangladesh context though it has been opposed by 42 (27.60%) of the physicians and 39(25.70%) was neutral to comment. The majority of them 147 (96.1%) thought that a family based education program would be beneficial followed by 145 (94.8%) physicians mentioned about raising awareness among mothers as she is the primary caregiver. The idea of a school based education program will also help to early intervene referred by 142 (92.8%) of the physicians. Community based education program was also appreciated by 136 (89.5%) of the physicians. About 74 (47.7%) of them think that the patients still lack in motivation to maintain their weight properly at the same time too many patients to deal with can be a barrier as well assumed by 73 (47.1%) of them. Lack of national policy or management guideline can act as an obstacle told by 60 (38.7%) of the physicians. The relationship of practicing as a part of the general examination and chronic disease management was statistically significant (p<0.05) with physician occupational status. As besides, perceived barriers like lack of parents support, lack of a national policy was statistically significant (p<0.05) with physician occupational status. For the young physician, more training programme will be needed to transform their knowledge and attitude into practice. However, several important barriers interface for the physician treatment efforts and need to address.

Keywords: obesity management, physician, awareness, barriers, Bangladesh

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Authors: V. P. Ramani, K. P. Patel, S. B. Patel

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It is necessary to dispose of generated industrial wastes in the proper way to overcome the further pollution for a safe environment. Waste can be used in agriculture for good quality higher food production. In order to evaluate the effect and rate of processed industrial biomass on yield, contents, uptake and soil status in maize, a field experiment was conducted during 2009 - 2011 at Anand on loamy sand soil for two years. The treatments of different levels of NPK i.e. 100% RD, 75% RD and 50% RD were kept to study the possibility of reduction in fertilizer application with the use of processed biomass (BM) in different proportion with FYM. (Where, RD= Recommended dose, FYM= Farm Yard Manure, BM= Processed Biomass.) The significantly highest grain yield of maize was recorded under the treatment of 75% NPK + BM application @ 10t ha-1. The higher (10t ha-1) and lower (5t ha-1) application rate of BM with full dose of NPK was found beneficial being at par with the treatment 75% NPK along with BM application @ 10t ha-1. There is saving of 25% recommended dose of NPK when combined with BM application @ 10.0t ha-1 or 50% saving of organics when applied with full dose (100%) of NPK. The highest straw yield (7734 kg ha-1) of maize on pooled basis was observed under the treatment of recommended dose of NPK along with FYM application at 7.5t ha-1 coupled with BM application at 2.5t ha-1. It was also observed that highest straw yield was at par under all the treatments except control and application of 100% recommended dose of NPK coupled with BM application at 7.5t ha-1. The Fe content of maize straw were found altered significantly due to different treatments on pooled basis and it was noticed that biomass application at 7.5t ha-1 along with recommended dose of NPK showed significant enhancement in Fe content of straw over other treatments. Among heavy metals, Co, Pb and Cr contents of grain were found significantly altered due to application of different treatments variably during the pooled. While, Ni content of maize grain was not altered significantly due to application of different organics. However, at higher rate of BM application i.e. of 10t ha-1, there was slight increase in heavy metal content of grain/ straw as well as DTPA heavy metals in soil; although the increase was not alarming Thus, the overall results indicated that the application of BM at 5t ha-1 along with full dose of NPK is beneficial to get higher yield of maize without affecting soil / plant health adversely. It also indicated that the 5t BM ha-1 could be utilized in place of 10t FYM ha-1 where FYM availability is scarce. The 10t BM ha-1 helps to reduce a load of chemical fertilizer up to 25 percent in agriculture. The lower use of agro-chemicals always favors safe environment. However, the continuous use of biomass needs periodical monitoring to check any buildup of heavy metals in soil/ plant over the years.

Keywords: alternate use of industrial waste, heavy metals, maize, processed industrial biomass

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Authors: Madhvi Bhayani

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Introduction: Due to the rapid pace of urbanization, the urban health issues have become one of the significant threats to future development in India. It also poses serious repercussions on the citizen’s health. As urbanization in India is increasing at an unprecedented rate and it has generated the urban health crisis among the city dwellers especially the urban poor. The increasing proportion of the urban poor and vulnerable to the health indicators worse than the rural counterparts, they face social and financial barriers in accessing healthcare services and these conditions make human health at risk. The Local as well as the State and National governments are alike tackling with the challenges of urbanization as it has become very essential for the government to provide the basic necessities and better infrastructure that make life in cities safe and healthy. Thus, the paper argues that if no major realistic steps are taken with immediate effect, the citizens will face a huge burden of health hazards. Aim: This paper attempts to analyze the current infrastructure, government planning, and its future policy, it also discusses the challenges and outcomes of urbanization on health and its impact on it and it will also predict the future trend with regard to disease burden in the urban areas. Methods: The paper analyzes on the basis of the secondary data by taking into consideration the connection between the Rapid Urbanization and Public Health Challenges, health and health care system and its services delivery to the citizens especially to the urban poor. Extensive analyses of government census reports, health information and policy, the government health-related schemes, urban development and based on the past trends, the future status of urban infrastructure and health outcomes are predicted. The social-economic and political dimensions are also taken into consideration from regional, national and global perspectives, which are incorporated in the paper to make realistic predictions for the future. Findings and Conclusion: The findings of the paper show that India suffers a lot due to the double burden of rapidly increasing in diseases and also growing health inequalities and disparities in health outcomes. Existing tools of governance of urban health are falling short to provide the better health care services. They need to strengthen the collaboration and communication among the state, national and local governments and also with the non-governmental partners. Based on the findings the policy implications are then described and areas for future research are defined.

Keywords: health care, urbanization, urban health, service delivery

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Authors: Grace Fangmin Tan, Elaine Yiling Tay, Elizabeth Huiwen Tham, Andrea Wei Ching Yeo

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Background: While accidental poisonings in children may seem unavoidable, knowledge of circumstances surrounding such incidents and identification of risk factors is important in the development of secondary prevention strategies. Some risk factors include age of the child, lack of adequate supervision and improper storage of substances. The aim of this study is to assess risk factors and circumstances influencing outcomes in these children. Methodology: A retrospective medical record review of all accidental poisoning cases presenting to the Children’s Emergency at National University Hospital (NUH), Singapore between January 2014 and December 2015 was conducted. Information on demographics, poisoning circumstances and clinical outcomes were collected. Results: Ninety-nine of a total of 186 poisoning cases were accidental ingestions, with a mean age of 4.7 (range 0.4 to 18.3 years). The gender distribution is rather equal with 52(52.5%) females and 47(47.5%) males. Seventy-nine (79.8%) were self-administered by the child and in 20 cases (20.2%), the substance was administered erroneously by caregivers 12/20 (60.0%) of whom were given the wrong drug dose while 8/20 (40.0%) were given the wrong substance. Self-administration was associated with presentation to the ED within 12 hours (p=0.027, OR 6.65, 95% CI 1.24-35.72). Notably, 94.9% of the cases involved substances kept within reach of the child. Sixty-nine (82.1%) had the substance kept in the original container, 3(3.6%) in food containers, 8(9.5%) in other containers and 4(4.8%) without a container. Of the 50 cases with information on labelling, 40/50(80.0%) were accurately labelled, 2/50 (4.0%) wrongly labelled, and 8/50 (16.0%) were unlabelled. Implicated substances included personal care products (11.1%), household cleaning products (3.0%), and different classes of drugs such as paracetamol (22.2%), antihistamines (17.2%) and sympathomimetics (8.1%). Children < 3 years of age were 4.8 times more likely to be poisoned by household substances than children >3 years of age (p=0.009, 95% CI 1.48-15.77). Prehospital interventions were more likely to have been done in poisoning with household substances (p=0.005, OR 6.12 95% CI 1.73-21.68). Fifty-nine (59.6%) were asymptomatic, 34 (34.3%) had a Poisoning Severity Score (PSS) grade of 1 (minor) and 6 (6.1%) grade 2 (moderate). Older children were 9.3 times more likely to be symptomatic (p<0.001, 95% CI 3.15-27.25). Thirty (32%) required admission. Conclusion: A significant proportion of accidental poisoning cases were due to medication administration errors by caregivers, which should be preventable. Risk factors for accidental poisoning included lack of adequate caregiver supervision, improper labelling and young age of the child. There is an urgent need to improve caregiver counselling during medication dispensing as well as to educate caregivers on basic child safety measures in the home to prevent future accidental poisonings.

Keywords: accidental, caregiver, paediatrics, poisoning

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Authors: Karthik Chamari, Vasudha Rudraraju, Gaurav Chaudhari

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Background: Mantle cell lymphoma (MCL) is one of the mature B cell non-Hodgkin lymphomas (NHL). The course of MCL is moderately aggressive and variable, and it has median overall survival of 8 to 10 years. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, was approved by the United States (US) Food and Drug Administration in November of 2013 for the treatment of MCL patients who have received at least one prior therapy. In this study, we aimed to evaluate whether there has been a change in survival and patterns of second primary malignancies (SPMs) among the MCL population in the US after ibrutinib approval. Methods: Using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER)-18, we conducted a retrospective study with patients diagnosed with MCL (ICD-0-3 code 9673/3) between 2007 and 2018. We divided patients into two six-year cohorts, pre-ibrutinib approval (2007-2012) and post-ibrutinib approval (2013-2018), and compared relative survival rates (RSRs) and standardized incidence ratios (SIRs) of SPMs between cohorts. Results: We included 9,257 patients diagnosed with MCL between 2007 and 2018 in the SEER-18 survival and SIR registries. Of these, 4,205 (45%) patients were included in the pre-ibrutinib cohort, and 5052 (55%) patients were included in the post-ibrutinib cohort. The median follow-up duration for the pre-ibrutinib cohort was 54 months (range 0 to 143 months), and the post-ibrutinib cohort was 20 months (range 0 to 71 months). There was a significant difference in the five-year RSRs between pre-ibrutinib and post-ibrutinib cohorts (57.5% vs. 62.6%, p < 0.005). Out of the 9,257 patients diagnosed with MCL, 920 developed SPMs. A higher proportion of SPMs occurred in the post-ibrutinib cohort (63%) when compared with the pre-ibrutinib cohort (37%). Non-hematological malignancies comprised most of all SPMs. A higher incidence of non-hematological malignancies occurred in the post-ibrutinib cohort (SIR 1.42, 95% CI 1.29 to 1.56) when compared with the pre-ibrutinib cohort (SIR 1.14, 95% CI 1 to 1.3). There was a statistically significant increase in the incidence of cancers of the respiratory tract (SIR 1.77, 95% CI 1.43 to 2.18), urinary tract (SIR 1.61, 95% CI 1.23 to 2.06) when compared with other non-hematological malignancies in post-ibrutinib cohort. Conclusions: Our study results suggest the relative survival rates have increased since the approval of ibrutinib for mantle cell lymphoma patients. Additionally, for some unclear reasons, the incidence of SPM’s (non-hematological malignancies), mainly cancers of the respiratory tract, urinary tract, have increased in the six years following the approval of ibrutinib. Further studies should be conducted to determine the cause of these findings.

Keywords: mantle cell lymphoma, Ibrutinib, relative survival analysis, secondary primary cancers

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Authors: Kangana Sengar, Sanjay Deb, Ramesh Dawar

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Introduction: Ki-67 can be a useful marker in determining proliferative activity in patients with multiple myeloma (MM). However, using Ki-67 alone results in the erroneous inclusion of non-myeloma cells leading to false high counts. We have used Dual IHC (immunohistochemistry) staining with Ki-67 and CD138 to enhance specificity in assessing proliferative activity of bone marrow plasma cells. Aims and objectives: To estimate the proportion of proliferating (Ki-67 expressing) plasma cells in patients with MM and correlation of Ki-67 with other known prognostic parameters. Materials and Methods: Fifty FFPE (formalin fixed paraffin embedded) blocks of trephine biopsies of cases diagnosed as MM from 2010 to 2015 are subjected to H & E staining and Dual IHC staining for CD 138 and Ki-67. H & E staining is done to evaluate various histological parameters like percentage of plasma cells, pattern of infiltration (nodular, interstitial, mixed and diffuse), routine parameters of marrow cellularity and hematopoiesis. Clinical data is collected from patient records from Medical Record Department. Each of CD138 expressing cells (cytoplasmic, red) are scored as proliferating plasma cells (containing a brown Ki¬67 nucleus) or non¬proliferating plasma cells (containing a blue, counter-stained, Ki-¬67 negative nucleus). Ki-67 is measured as percentage positivity with a maximum score of hundred percent and lowest of zero percent. The intensity of staining is not relevant. Results: Statistically significant correlation of Ki-67 in D-S Stage (Durie & Salmon Stage) I vs. III (p=0.026) and ISS (International Staging System) Stage I vs. III (p=0.019), β2m (p=0.029) and percentage of plasma cells (p < 0.001) is seen. No statistically significant correlation is seen between Ki-67 and hemoglobin, platelet count, total leukocyte count, total protein, albumin, S. calcium, S. creatinine, S. LDH, blood urea and pattern of infiltration. Conclusion: Ki-67 index correlated with other known prognostic parameters. However, it is not determined routinely in patients with MM due to little information available regarding its relevance and paucity of studies done to correlate with other known prognostic factors in MM patients. To the best of our knowledge, this is the first study in India using Dual IHC staining for Ki-67 and CD138 in MM patients. Routine determination of Ki-67 will help to identify patients who may benefit with more aggressive therapy. Recommendation: In this study follow up of patients is not included, and the sample size is small. Studying with larger sample size and long follow up is advocated to prognosticate Ki-67 as a marker of survival in patients with multiple myeloma.

Keywords: bone marrow, dual IHC, Ki-67, multiple myeloma

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Authors: Davood Vatankhah, Reza Mokhtari Malekabadi, Mohsen Saghaei

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Function of urban transportation systems depends on the existence of the required infrastructures, appropriate placement of different components, and the cooperation of these components with each other. Establishing various neighboring parking spaces in city neighborhood in order to prevent long-term and inappropriate parking of cars in the allies is one of the most effective operations in reducing the crowding and density of the neighborhoods. Every place with a certain application attracts a number of daily travels which happen throughout the city. A large percentage of the people visiting these places go to these travels by their own cars; therefore, they need a space to park their cars. The amount of this need depends on the usage function and travel demand of the place. The study aims at investigating the spatial distribution of the public parking spaces, determining the effective factors in locating, and their combination in GIS environment in Khomeinishahr of Isfahan city. Ultimately, the study intends to create an appropriate pattern for locating parking spaces, determining the request for parking spaces of the traffic areas, choosing the proper places for providing the required public parking spaces, and also proposing new spots in order to promote quality and quantity aspects of the city in terms of enjoying public parking spaces. Regarding the method, the study is based on applied purpose and regarding nature, it is analytic-descriptive. The population of the study includes people of the center of Khomeinishahr which is located on Northwest of Isfahan having about 5000 hectares of geographic area and the population of 241318 people are in the center of Komeinishahr. In order to determine the sample size, Cochran formula was used and according to the population of 26483 people of the studied area, 231 questionnaires were used. Data analysis was carried out by usage of SPSS software and after estimating the required space for parking spaces, initially, the effective criteria in locating the public parking spaces are weighted by the usage of Analytic Hierarchical Process in the Arc GIS software. Then, appropriate places for establishing parking spaces were determined by fuzzy method of Order Weighted Average (OWA). The results indicated that locating of parking spaces in Khomeinishahr have not been carried out appropriately and per capita of the parking spaces is not desirable in relation to the population and request; therefore, in addition to the present parking lots, 1434 parking lots are needed in the area of the study for each day; therefore, there is not a logical proportion between parking request and the number of parking lots in Khomeinishahr.

Keywords: GIS, locating, parking, khomeinishahr

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Authors: S. Z. A. Zaidi, A. Crosky

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Biocomposites is a field that has gained much scientific attention due to the current substantial consumption of non-renewable resources and the environmentally harmful disposal methods required for traditional polymer composites. Research on natural fiber reinforced polyhydroxyalkanoates (PHAs) has gained considerable momentum over the past decade. There is little work on PHAs reinforced with unidirectional (UD) natural fibers and little work on using epoxidized natural rubber (ENR) as a toughening agent for PHA-based biocomposites. In this work, we prepared polyhydroxybutyrate-co-valerate (PHBV) biocomposites reinforced with UD 30 wt.% flax fibers and evaluated the use of ENR with 50% epoxidation (ENR50) as a toughening agent for PHBV biocomposites. Quasi-unidirectional flax/PHBV composites were prepared by hand layup, powder impregnation followed by compression molding.  Toughening agents – polybutylene adiphate-co-terephthalate (PBAT) and ENR50 – were cryogenically ground into powder and mechanically mixed with main matrix PHBV to maintain the powder impregnation process. The tensile, flexural and impact properties of the biocomposites were measured and morphology of the composites examined using optical microscopy (OM) and scanning electron microscopy (SEM). The UD biocomposites showed exceptionally high mechanical properties as compared to the results obtained previously where only short fibers have been used. The improved tensile and flexural properties were attributed to the continuous nature of the fiber reinforcement and the increased proportion of fibers in the loading direction. The improved impact properties were attributed to a larger surface area for fiber-matrix debonding and for subsequent sliding and fiber pull-out mechanisms to act on, allowing more energy to be absorbed. Coating cryogenically ground ENR50 particles with PHBV powder successfully inhibits the self-healing nature of ENR-50, preventing particles from coalescing and overcoming problems in mechanical mixing, compounding and molding. Cryogenic grinding, followed by powder impregnation and subsequent compression molding is an effective route to the production of high-mechanical-property biocomposites based on renewable resources for high-obsolescence applications such as plastic casings for consumer electronics.

Keywords: natural fibers, natural rubber, polyhydroxyalkanoates, unidirectional

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Authors: Xu Feifei

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The prevalence of COVID-19 currently is the biggest challenge to improving people's quality of life. Its impact on the health-related quality of life (HRQoL) is highly uncertain and has not been summarized so far. The aim of the present systematic review was to assess and provide an up-to-date analysis of the impact of the COVID-19 pandemic on the HRQoL of participants who have been infected, have not been infected but isolated, frontline, with different diseases, and the general population. Therefore, an electronic search of the literature in PubMed databases was performed from 2019 to July 2022 (without date restriction). PRISMA guideline methodology was employed, and data regarding the HRQoL were extracted from eligible studies. Articles were included if they met the following inclusion criteria: (a) reports on the data collection of the health state utility values (HSUVs) related to COVID-19 from 2019 to 2021; (b) English language and peer-reviewed journals; and (c) original HSUV data; (d) using EQ-5D tool to quantify the HRQoL. To identify studies that reported the effects on COVID-19, data on the proportion of overall HSUVs of participants who had the outcome were collected and analyzed using a one-group meta-analysis. As a result, thirty-two studies fulfilled the inclusion criteria and, therefore, were included in the systematic review. A total of 45295 participants and provided 219 means of HSUVs during COVID-19 were included in this systematic review. The range of utility is from 0.224 to 1. The study included participants from Europe (n=16), North America (n=4), Asia (n=10), South America (n=1), and Africa (n=1). Twelve articles showed that the HRQoL of the participants who have been infected with COVID-19 (range of overall HSUVs from 0.6125 to 0.863). Two studies reported the population of frontline workers (the range of overall HSUVs from 0.82 to 0.93). Seven of the articles researched the participants who had not been infected with COVID-19 but suffered from morbidities during the pandemic (range of overall HSUVs from 0.5 to 0.96). Thirteen studies showed that the HRQoL of the respondents who have not been infected with COVID-19 and without any morbidities (range of overall HSUVs from 0.64 to 0.964). Moreover, eighteen articles reported the outcomes of overall HSUVs during the COVID-19 pandemic in different population groups. The estimate of overall HSUVs of direct COVID-19 experience population (n=1333) was 0.751 (95% CI 0.670 - 0.832, I2 = 98.64%); the estimate of frontline population (n=610) was 0.906 ((95% CI 0.854 – 0.957, I2 = 98.61%); participants with different disease (n=132) were 0.768 (95% CI 0.515 - 1.021, I2= 99.26%); general population without infection history (n=29,892) was 0.825 (95% CI 0.766 - 0.885, I2 =99.69%). Conclusively, taking into account these results, this systematic review might confirm that COVID-19 has a negative impact on the HRQoL of the infected population and illness population. It provides practical value for cost-effectiveness model analysis of health states related to COVID-19.

Keywords: COVID-19, health-related quality of life, meta-analysis, systematic review, utility value

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Authors: Nicolaas Unland, John Webb

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The acidification and mobilisation of metals during the oxidation of acid sulfate soils exposed during lake bed drying is an increasingly common phenomenon under climate scenarios with reduced rainfall. In order to assess the risk of generating high concentrations of acidity and dissolved metals, chromium suite analysis are fundamental, but sometimes limited in characterising the potential risks they pose. This study combines such fundamental test work, along with incubation tests and 1D modelling to investigate the risks associated with the drying of Third Reedy Lake in South East Australia. Core samples were collected from a variable depth of 0.5 m below the lake bed, at 19 locations across the lake’s footprint, using a boat platform. Samples were subjected to a chromium suite of analysis, including titratable actual acidity, chromium reducible sulfur and acid neutralising capacity. Concentrations of reduced sulfur up to 0.08 %S and net acidities up to 0.15 %S indicate that acid sulfate soils have formed on the lake bed during permanent inundation over the last century. A further sub-set of samples were prepared in 7 columns and subject to accelerated heating, drying and wetting over a period of 64 days in laboratory. Results from the incubation trial indicate that while pyrite oxidation proceeded, minimal change to soil pH or the acidity of leachate occurred, suggesting that the internal buffering capacity of lake bed sediments was sufficient to neutralise a large proportion of the acidity produced. A 1D mass balance model was developed to assess potential changes in lake water quality during drying based on the results of chromium suite and incubation tests. Results from the above test work and modelling suggest that acid sulfate soils pose a moderate to low risk to the Third Reedy Lake system. Further, the risks can be effectively managed during the initial stages of lake drying via flushing with available mildly alkaline water. The study finds that while test work such as chromium suite analysis are fundamental in characterizing acid sulfate soil environments, they can the overestimate risks associated with the soils. Subsequent incubation test work may more accurately characterise such soils and lead to better-informed management strategies.

Keywords: acid sulfate soil, incubation, management, model, risk

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Authors: I. Poot-Ocejo, H. Silva-Poot, J. C. Cruz, A. Yeladaqui-Tello

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Mexico has remarkable archaeological remains mainly in the Maya area, which are critical to the preservation of our cultural heritage, so the authorities have an interest in preserving and restoring these vestiges of the most original way, by employing techniques traditional, which has advantages such as compatibility, durability, strength, uniformity and chemical composition. Recent studies have confirmed the addition of natural resins extracted from the bark of trees, of which Brosium alicastrum (Ramon) has been the most evaluated, besides being one of the most abundant species in the vicinity of the archaeological sites, like that Manilkara Zapota (Chicozapote). Therefore, the objective is to determine if these resins are capable of being employed in archaeological restoration. This study shows the results of the chemical composition and physical-mechanical behavior of mortar mixtures eight made with commercial lime and off by hand, calcium sand, resins added with Brosium alicastrum (Ramon) and Manilkara zapota (Chicozapote), where determined and quantified properties and chemical composition of the resins by X-Ray Fluorescence (XRF), the pH of the material was determined, indicating that both resins are acidic (3.78 and 4.02), and the addition rate maximum was obtained from resins in water by means of ultrasonic baths pulses, being in the case of 10% Manilkara zapota, because it contains up to 40% rubber and for 40% alicastrum Brosium contain less rubber. Through quantitative methodology, the compressive strength 96 specimens of 5 cm x 5 cm x 5 cm of mortar binding, 72 with partial substitution of water mixed with natural resins in proportions 5 to 10% in the case was evaluated of Manilkara Zapota, for Brosium alicastrum 20 and 40%, and 12 artificial resin and 12 without additive (mortars witnesses). 24 specimens likewise glued brick with mortar, for testing shear adhesion was found where, then the microstructure more conducive additions was determined by SEM analysis were prepared sweep. The test results indicate that the addition Manilkara zapota resin in the proportion of 10% 1.5% increase in compressive strength and 1% with respect to adhesion, compared to the control without addition mortar; In the case of Brosium alicastrum results show that compressive strengths and adhesion were insignificant compared to those made with registered by Manilkara zapota mixtures. Mortars containing the natural resins have improvements in physical properties and increase the mechanical strength and adhesion, compared to those who do not, in addition to the components are chemically compatible, therefore have considered that can be employed in Archaeological restoration.

Keywords: lime, mortar, natural resins, Manilkara zapota mixtures, Brosium alicastrum

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Authors: Zhaoxu Lu, Yufeng Ma, Linying Gao, Li Wang, Mei Qiang

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Mercury (Hg) is a well-recognized environmental pollutant known by its toxicity of development and neurotoxicity, which may result in adverse health outcomes. However, the mechanisms underlying the teratogenic effects of Hg are not well understood. Imprinting genes are emerging regulators for fetal development subject to environmental pollutants impacts. In this study, we examined the association between paternal preconception Hg exposures and the alteration of DNA methylation of imprinting genes in human sperm DNA. A total of 618 men aged from 22 to 59 was recruited from the Reproductive Medicine Clinic of Maternal and Child Care Service Center and the Urologic Surgery Clinic of Shanxi Academy of Medical Sciences during April 2015 and March 2016. Demographic information was collected using questionnaires. Urinary Hg concentrations were measured using a fully-automatic double-channel hydride generation atomic fluorescence spectrometer. And methylation status in the DMRs of imprinting genes H19, Meg3 and Peg3 of sperm DNA were examined by bisulfite pyrosequencing in 243 participants. Spearman’s rank and multivariate regression analysis were used for correlation analysis between sperm DNA methylation status of imprinting genes and urinary Hg levels. The median concentration of Hg for participants overall was 9.09μg/l (IQR: 5.54 - 12.52μg/l; range = 0 - 71.35μg/l); no significant difference was found in median concentrations of Hg among various demographic groups (p > 0.05). The proportion of samples that a beyond intoxication criterion (10μg/l) for urinary Hg was 42.6%. Spearman’s rank correlation analysis indicates a negative correlation between urinary Hg concentrations and average DNA methylation levels in the DMRs of imprinted genes H19 (rs=﹣0.330, p = 0.000). However, there was no such a correlation found in genes of Peg3 and Meg3. Further, we analyzed of correlation between methylation level at each CpG site of H19 and Hg level, the results showed that three out of 7 CpG sites on H19 DMR, namely CpG2 (rs =﹣0.138, p = 0.031), CpG4 (rs =﹣0.369, p = 0.000) and CpG6 (rs=﹣0.228, p = 0.000), demonstrated a significant negative correlation between methylation levels and the levels of urinary Hg. After adjusting age, smoking, drinking, intake of aquatic products and education by multivariate regression analysis, the results have shown a similar correlation. In summary, mercury nonoccupational environmental exposure in reproductive-aged men associated with altered DNA methylation outcomes at DMR of imprinting gene H19 in sperm, implicating the susceptibility of the developing sperm for environmental insults.

Keywords: epigenetics, genomic imprinting gene, DNA methylation, mercury, transgenerational effects, sperm

Procedia PDF Downloads 249

Authors: K. Thiel, P. Patrikainen, C. Nagy, D. Fitzpatrick, E.-M. Aro, P. Kallio

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Photosynthetic cyanobacteria have been recognized as potential future biotechnological hosts for the direct conversion of CO₂ into chemicals of interest using sunlight as the solar energy source. However, in order to develop commercially viable systems, the flux of electrons from the photosynthetic light reactions towards specified target chemicals must be significantly improved. The objective of the study was to investigate whether the autotrophic production efficiency of specified end-metabolites can be improved in engineered cyanobacterial cells by rescuing excited electrons that are normally lost to molecular oxygen due to the cyanobacterial flavodiiron protein Flv1/3. Natively Flv1/3 dissipates excess electrons in the photosynthetic electron transfer chain by directing them to molecular oxygen in Mehler-like reaction to protect photosystem I. To evaluate the effect of flavodiiron inactivation on autotrophic production efficiency in the cyanobacterial host Synechocystis sp. PCC 6803 (Synechocystis), sucrose was selected as the quantitative reporter and a representative of a potential end-product of interest. The concept is based on the native property of Synechocystis to produce sucrose as an intracellular osmoprotectant when exposed to high external ion concentrations, in combination with the introduction of a heterologous sucrose permease (CscB from Escherichia coli), which transports the sucrose out from the cell. In addition, cell growth, photosynthetic gas fluxes using membrane inlet mass spectrometry and endogenous storage compounds were analysed to illustrate the consequent effects of flv deletion on pathway flux distributions. The results indicate that a significant proportion of the electrons can be lost to molecular oxygen via Flv1/3 even when the cells are grown under high CO₂ and that the inactivation of flavodiiron activity can enhance the photosynthetic electron flux towards optionally available sinks. The flux distribution is dependent on the light conditions and the genetic context of the Δflv mutants, and favors the production of either sucrose or one of the two storage compounds, glycogen or polyhydroxybutyrate. As a conclusion, elimination of the native Flv1/3 reaction and concomitant introduction of an engineered product pathway as an alternative sink for excited electrons could enhance the photosynthetic electron flux towards the target endproduct without compromising the fitness of the host.

Keywords: cyanobacterial engineering, flavodiiron proteins, redirecting electron flux, sucrose

Procedia PDF Downloads 117

Authors: Pin Yu Chen, Puay Chuan Lee, Yu Jen Loo, Ju Xia Zhang, Deborah Teo, Jack Wei Chieh Tan, Biauw Chi Ong

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Background: Synchronous communication, such as telephone calls, remains the standard communication method between nurses and other healthcare professionals in Singapore public hospitals despite advances in asynchronous technological platforms, such as instant messaging. Although miscommunication is one of the most common causes of lapses in patient care, there is a scarcity of research characterizing baseline inter-professional healthcare communications in a hospital setting due to logistic difficulties. Objective: This study aims to characterize the frequency and patterns of communication behaviours among healthcare professionals. Methods: The one-week observational study was conducted on Monday through Sunday at the nursing station of a cardiovascular medicine and cardiothoracic surgery inpatient ward at the National Heart Centre Singapore. Subjects were shadowed by two physicians for sixteen hours or consecutive morning and afternoon nursing shifts. Communications were logged and characterized by type, duration, caller, and recipient. Results: A total of 1,023 communication events involving the attempted use of the common telephones at the nursing station were logged over a period of one week, corresponding to a frequency of one event every 5.45 minutes (SD 6.98, range 0-56 minutes). Nurses initiated the highest proportion of outbound calls (38.7%) via the nursing station common phone. A total of 179 face-to-face communications (17.5%), 362 inbound calls (35.39%), 481 outbound calls (47.02%), and 1 emergency alert (0.10%) were captured. Average response time for task-oriented communications was 159 minutes (SD 387.6, range 86-231). Approximately 1 in 3 communications captured aimed to clarify patient-related information. The total duration of time spent on synchronous communication events over one week, calculated from total inbound and outbound calls, was estimated to be a total of 7 hours. Conclusion: The results of our study showed that there is a significant amount of time spent on inter-professional healthcare communications via synchronous channels. Integration of patient-related information and use of asynchronous communication channels may help to reduce the redundancy of communications and clarifications. Future studies should explore the use of asynchronous mobile platforms to address the inefficiencies observed in healthcare communications.

Keywords: healthcare communication, healthcare management, nursing, qualitative observational study

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Authors: Daniel Nigusse Tollosa, Erica James, Alexis Hurre, Meredith Tavener

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Introduction: Lifestyle behaviours such as healthy diet, regular physical activity and maintaining a healthy weight are essential for cancer survivors to improve the quality of life and longevity. However, there is no study that synthesis cancer survivor’s adherence to healthy lifestyle recommendations. The purpose of this review was to collate existing data on the prevalence of adherence to healthy behaviours and produce the pooled estimate among adult cancer survivors. Method: Multiple databases (Embase, Medline, Scopus, Web of Science and Google Scholar) were searched for relevant articles published since 2007, reporting cancer survivors adherence to more than two lifestyle behaviours based on the WCRF/AICR recommendations. The pooled prevalence of adherence to single and multiple behaviours (operationalized as adherence to more than 75% (3/4) of health behaviours included in a particular study) was calculated using a random effects model. Subgroup analysis adherence to multiple behaviours was undertaken corresponding to the mean survival years and year of publication. Results: A total of 3322 articles were generated through our search strategies. Of these, 51 studies matched our inclusion criteria, which presenting data from 2,620,586 adult cancer survivors. The highest prevalence of adherence was observed for smoking (pooled estimate: 87%, 95% CI: 85%, 88%) and alcohol intake (pooled estimate 83%, 95% CI: 81%, 86%), and the lowest was for fiber intake (pooled estimate: 31%, 95% CI: 21%, 40%). Thirteen studies were reported the proportion of cancer survivors (all used a simple summative index method) to multiple healthy behaviours, whereby the prevalence of adherence was ranged from 7% to 40% (pooled estimate 23%, 95% CI: 17% to 30%). Subgroup analysis suggest that short-term survivors ( < 5 years survival time) had relatively a better adherence to multiple behaviours (pooled estimate: 31%, 95% CI: 27%, 35%) than long-term ( > 5 years survival time) cancer survivors (pooled estimate: 25%, 95% CI: 14%, 36%). Pooling of estimates according to the year of publication (since 2007) also suggests an increasing trend of adherence to multiple behaviours over time. Conclusion: Overall, the adherence to multiple lifestyle behaviors was poor (not satisfactory), and relatively, it is a major concern for long-term than the short-term cancer survivor. Cancer survivors need to obey with healthy lifestyle recommendations related to physical activity, fruit and vegetable, fiber, red/processed meat and sodium intake.

Keywords: adherence, lifestyle behaviours, cancer survivors, WCRF/AICR

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Authors: Emiliano Matta

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Passive resonant vibration absorbers are among the most widely used dynamic control systems in civil engineering. They typically consist in a single-degree-of-freedom mechanical appendage of the main structure, tuned to one structural target mode through frequency and damping optimization. One classical scheme is the pendulum absorber, whose mass is constrained to move along a curved trajectory and is damped by viscous dashpots. Even though the principle is well known, the search for improved arrangements is still under way. In recent years this investigation inspired a type of bidirectional pendulum absorber (BPA), consisting of a mass constrained to move along an optimal three-dimensional (3D) concave surface. For such a BPA, the surface principal curvatures are designed to ensure a bidirectional tuning of the absorber to both principal modes of the main structure, while damping is produced either by horizontal viscous dashpots or by vertical friction dashpots, connecting the BPA to the main structure. In this paper, a variant of BPA is proposed, where damping originates from the variable tangential friction force which develops between the pendulum mass and the 3D surface as a result of a spatially-varying friction coefficient pattern. Namely, a friction coefficient is proposed that varies along the pendulum surface in proportion to the modulus of the 3D surface gradient. With such an assumption, the dissipative model of the absorber can be proven to be nonlinear homogeneous in the small displacement domain. The resulting homogeneous BPA (HBPA) has a fundamental advantage over conventional friction-type absorbers, because its equivalent damping ratio results independent on the amplitude of oscillations, and therefore its optimal performance does not depend on the excitation level. On the other hand, the HBPA is more compact than viscously damped BPAs because it does not need the installation of dampers. This paper presents the analytical model of the HBPA and an optimal methodology for its design. Numerical simulations of single- and multi-story building structures under wind and earthquake loads are presented to compare the HBPA with classical viscously damped BPAs. It is shown that the HBPA is a promising alternative to existing BPA types and that homogeneous tangential friction is an effective means to realize systems provided with amplitude-independent damping.

Keywords: amplitude-independent damping, homogeneous friction, pendulum nonlinear dynamics, structural control, vibration resonant absorbers

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Authors: Elena Listo, Miguel Marchamalo

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This research studies the soil properties located in the watershed of Jabillo River in the Guanacaste province, Costa Rica. The soils are classified as Alfisols (T. Haplustalfs), in the flatter parts with grazing as Fluventic Haplustalfs or as a consequence of bad drainage as F. Epiaqualfs. The objective of this project is to define the status of the soil, to use remote sensing as a tool for analyzing the evolution of land use and determining the water balance of the watershed in order to improve the efficiency of the water collecting systems. Soil samples were analyzed from trial pits taken from secondary forests, degraded pastures, mature teak plantation, and regrowth -Tectona grandis L. F.- species developed favorably in the area. Furthermore, to complete the study, infiltration measurements were taken with an artificial rainfall simulator, as well as studies of soil compaction with a penetrometer, in points strategically selected from the different land uses. Regarding remote sensing, nearly 40 data samples were collected per plot of land. The source of radiation is reflected sunlight from the beam and the underside of leaves, bare soil, streams, roads and logs, and soil samples. Infiltration reached high levels. The majority of data came from the secondary forest and mature planting due to a high proportion of organic matter, relatively low bulk density, and high hydraulic conductivity. Teak regrowth had a low rate of infiltration because the studies made regarding the soil compaction showed a partial compaction over 50 cm. The secondary forest presented a compaction layer from 15 cm to 30 cm deep, and the degraded pasture, as a result of grazing, in the first 15 cm. In this area, the alfisols soils have high content of iron oxides, a fact that causes a higher reflectivity close to the infrared region of the electromagnetic spectrum (around 700mm), as a result of clay texture. Specifically in the teak plantation where the reflectivity reaches values of 90 %, this is due to the high content of clay in relation to others. In conclusion, the protective function of secondary forests is reaffirmed with regards to erosion and high rate of infiltration. In humid climates and permeable soils, the decrease of runoff is less, however, the percolation increases. The remote sensing indicates that being clay soils, they retain moisture in a better way and it means a low reflectivity despite being fine texture.

Keywords: alfisols, Costa Rica, infiltration, remote sensing

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Authors: Mary Ann L. Halliday, Zoengpari Gohain

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The stigma associated with HIV-AIDS negatively affect mental health and ability to effectively manage the disease. While the number of People living with HIV/AIDS (PLHIV) has been increasing day by day in Mizoram (a small north-eastern state in India), research on HIV/AIDS stigma has so far been limited. Despite the potential significance of Internalized HIV Stigma (IHS) in the lives of PLHIV, there has been very limited research in this area. It was therefore, felt necessary to explore the internalized HIV stigma, mental health, coping and perceived social support of PLHIV in Aizawl District, Mizoram. The present study was designed with the objectives to determine the degree of IHS, to study the relationship between the socio-demographic characteristics and level of IHS, to highlight the mental health status, coping strategies and perceived social support of PLHIV and to elucidate the relationship between these psychosocial variables. In order to achieve the objectives of the study, six hypotheses were formulated and statistical analyses conducted accordingly. The sample consisted of 300 PLWHA from Aizawl District, 150 males and 150 females, of the age group 20 to 70 years. Two- way classification of “Gender” (male and female) and three-way classification of “Level of IHS” (High IHS, Moderate IHS, Low IHS) on the dependent variables was employed, to elucidate the relationship between Internalized HIV Stigma, mental health, coping and perceived social support of PLHIV. The overall analysis revealed moderate level of IHS (67.3%) among PLHIV in Aizawl District, with a small proportion of subjects reporting high level of IHS. IHS was found to be significantly different on the basis of disclosure status, with the disclosure status of PLHIV accounting for 9% variability in IHS.  Results also revealed more or less good mental health among the participants, which was assessed by minimal depression (50.3%) and minimal anxiety (45%), with females with high IHS scoring significantly higher in both depression and anxiety (p<.01). Examination of the coping strategies of PLHIV found that the most frequently used coping styles were Acceptance (91%), Religion (84.3%), Planning (74.7%), Active Coping (66%) and Emotional Support (52.7%). High perception of perceived social support (48%) was found in the present study. Correlation analysis revealed significant positive relationships between IHS and depression as well as anxiety (p<.01), thus revealing that IHS negatively affects the mental health of PLHIV. Results however revealed that this effect may be lessened by the use of various coping strategies by PLHIV as well as their perception of social support.

Keywords: Aizawl, anxiety, depression, internalized HIV stigma, HIV/AIDS, mental health, mizoram, perceived social support

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Authors: Mansir Abubakar, Hazlina Hamdan, Norwati Mustapha, Teh Noranis Mohd Aris

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In order to build a matching pattern for each class correspondences of ontology, it is required to specify a set of attribute correspondences across two corresponding classes by clustering. Clustering reduces the size of potential attribute correspondences considered in the matching activity, which will significantly reduce the computation workload; otherwise, all attributes of a class should be compared with all attributes of the corresponding class. Most existing ontology matching approaches lack scalable attributes discovery methods, such as cluster-based attribute searching. This problem makes ontology matching activity computationally expensive. It is therefore vital in ontology matching to design a scalable element or attribute correspondence discovery method that would reduce the size of potential elements correspondences during mapping thereby reduce the computational workload in a matching process as a whole. The objective of this work is 1) to design a clustering method for discovering similar attributes correspondences and relationships between ontologies, 2) to discover element correspondences by classifying elements of each class based on element’s value features using K-medoids clustering technique. Discovering attribute correspondence is highly required for comparing instances when matching two ontologies. During the matching process, any two instances across two different data sets should be compared to their attribute values, so that they can be regarded to be the same or not. Intuitively, any two instances that come from classes across which there is a class correspondence are likely to be identical to each other. Besides, any two instances that hold more similar attribute values are more likely to be matched than the ones with less similar attribute values. Most of the time, similar attribute values exist in the two instances across which there is an attribute correspondence. This work will present how to classify attributes of each class with K-medoids clustering, then, clustered groups to be mapped by their statistical value features. We will also show how to map attributes of a clustered group to attributes of the mapped clustered group, generating a set of potential attribute correspondences that would be applied to generate a matching pattern. The K-medoids clustering phase would largely reduce the number of attribute pairs that are not corresponding for comparing instances as only the coverage probability of attributes pairs that reaches 100% and attributes above the specified threshold can be considered as potential attributes for a matching. Using clustering will reduce the size of potential elements correspondences to be considered during mapping activity, which will in turn reduce the computational workload significantly. Otherwise, all element of the class in source ontology have to be compared with all elements of the corresponding classes in target ontology. K-medoids can ably cluster attributes of each class, so that a proportion of attribute pairs that are not corresponding would not be considered when constructing the matching pattern.

Keywords: attribute correspondence, clustering, computational workload, k-medoids clustering, ontology matching

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Authors: Begum Rokeya, Rahelee Zinnat, Fatema Jebunnesa, Israt Ara Hossain, A. Rahman

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Background and Aims: Arsenic in drinking water is a global environmental health problem, and the exposure may increase dyslipidemia and cerebrovascular diseases mortalities, most likely through causing atherosclerosis. However, the mechanism of lipid metabolism, atherosclerosis formation, arsenic exposure and impact in pregnancy is still unclear. Recent epidemiological evidences indicate close association between inorganic arsenic exposure via drinking water and Dyslipidemia. However, the exact mechanism of this arsenic-mediated increase in atherosclerosis risk factors remains enigmatic. We explore the association of the effect of arsenic on serum lipid profile in pregnant subjects. Methods: A total 200 pregnant mother screened in this study from arsenic exposed area. Our study group included 100 exposed subjects were cases and 100 Non exposed healthy pregnant were controls requited by a cross-sectional study. Clinical and anthropometric measurements were done by standard techniques. Lipidemic status was assessed by enzymatic endpoint method. Urinary As was measured by inductively coupled plasma-mass spectrometry and adjusted with specific gravity and Arsenic exposure was assessed by the level of urinary arsenic level > 100 μg/L was categorized as arsenic exposed and < 100 μg/L were categorized as non-exposed. Multivariate logistic regression and Student’s t - test was used for statistical analysis. Results: Systolic and diastolic blood pressure both were significantly higher in the Arsenic exposed pregnant subjects compared to the Non-exposed group (p<0.001). Arsenic exposed subjects had 2 times higher chance of developing hypertensive pregnancy (Odds Ratio 2.2). In parallel to the findings in Ar exposed subjects showed significantly higher proportion of triglyceride and total cholesterol and low density of lipo protein when compare to non- arsenic exposed pregnant subjects. Significant correlation of urinary arsenic level was also found with SBP, DBP, TG, T chol and serum LDL-Cholesterol. On multivariate logistic regression showed urinary arsenic had a positive association with DBP, SBP, Triglyceride and LDL-c. Conclusion: In conclusion, arsenic exposure may induce dyslipidemia like atherosclerosis through modifying reverse cholesterol transport in cholesterol metabolism. For decreasing atherosclerosis related mortality associated with arsenic, preventing exposure from environmental sources in early life is an important element.

Keywords: Arsenic Exposure, Dyslipidemia, Gestational Diabetes Mellitus, Serum lipid profile

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Authors: M. V. Shivaani, P. K. Jain, Surendra S. Yadav

Abstract:

Public Sector Undertakings (PSUs), being government-owned organizations have commitments for the economic and social wellbeing of the society; this commitment needs to be reflected in their risk-taking, decision-making and governance structures. Therefore, the primary objective of the study is to suggest measures that may lead to improvement in performance of PSUs. To achieve this objective two normative frameworks (one relating to risk levels and other relating to governance structure) are being put forth. The risk index is based on nine risks, such as, solvency risk, liquidity risk, accounting risk, etc. and each of the risks have been scored on a scale of 1 to 5. The governance index is based on eleven variables, such as, board independence, diversity, risk management committee, etc. Each of them are scored on a scale of 1 to five. The sample consists of 39 PSUs that featured in Nifty 500 index and, the study covers a 10 year period from April 1, 2005 to March, 31, 2015. Return on assets (ROA) and return on equity (ROE) have been used as proxies of firm performance. The control variables used in the model include, age of firm, growth rate of firm and size of firm. A dummy variable has also been used to factor in the effects of recession. Given the panel nature of data and possibility of endogeneity, dynamic panel data- generalized method of moments (Diff-GMM) regression has been used. It is worth noting that the corporate governance index is positively related to both ROA and ROE, indicating that with the improvement in governance structure, PSUs tend to perform better. Considering the components of CGI, it may be suggested that (i). PSUs ensure adequate representation of women on Board, (ii). appoint a Chief Risk Officer, and (iii). constitute a risk management committee. The results also indicate that there is a negative association between risk index and returns. These results not only validate the framework used to develop the risk index but also provide a yardstick to PSUs benchmark their risk-taking if they want to maximize their ROA and ROE. While constructing the CGI, certain non-compliances were observed, even in terms of mandatory requirements, such as, proportion of independent directors. Such infringements call for stringent penal provisions and better monitoring of PSUs. Further, if the Securities and Exchange Board of India (SEBI) and Ministry of Corporate Affairs (MCA) bring about such reforms in the PSUs and make mandatory the adherence to the normative frameworks put forth in the study, PSUs may have more effective and efficient decision-making, lower risks and hassle free management; all these ultimately leading to better ROA and ROE.

Keywords: PSU, risk governance, diff-GMM, firm performance, the risk index

Procedia PDF Downloads 155

Authors: Eze Chinwe Catherine, Orji Nkiru Marykate, Anyaegbunam L. C., Igbodika M.C.

Abstract:

Uterine Leiomyomata (ULs) are the most frequently occurring pelvic and gynaecologic tumors in premenopausal women, occurring globally with a prevalence of 21.4%. UL represents a major public health problem in African women; therefore, this study aimed to reveal public health impact and risk factors associated with uterine leiomyomata among women in Imo state. A convenience sample of 2965 women was studied for gynaecological cases from October 2020 to March 2021 at the selected clinics of study. Eligible women were recruited to participate in a non interventional descriptive cross-sectional study. Data on socio demographic and gynaecological characteristics, BMI, parity, age, age at menarche, knowledge, attitudes, and perception were collected using a structured questionnaire, guided interviews, anthropometrics, and haematological tests. These were analyzed using SPSS Version 23. Associations between continuous variables were analysed appropriately and tested at 95% confidence level and standard error of 5%. A total of 652(22.0%) were diagnosed having uterine Leiomyomata (UL), and the overall prevalence of UF at clinics/Diagnostic centre in Imo State was 22%. A total of 652 women (46.1%) responded. More than half of the women had a parity of zero (1623: 54.8%), 664 (22.4%) had a parity of 1-2, and 491 (16.6%) had a parity of 3-4. Majority (68.6%) indicated that they experience an irregular menstrual cycle, and a similar proportion (67%) number experience pelvic pain. Age was found as a significant associating factor of uterine fibroids in this study (p=0.046, χ2= 6.158), lowest among the women between 16 to 25 years old and highest among the women between 36 – 45 years of age. The rate of UF was found to be 62.1% on the studied women menarche age of 11 years old or less while it was approximately 18% among the women whose age at menarche were at least 14 years old. Education ((p=0.003, χ²= 13.826), residency (p=0.066, χ²= 3.372). BMI (p= 0.000, χ²=102.36) were significantly associated with the risk of UL. Some of the Clinical presentation includes anaemia, abdominal pelvic mass, and infertility. The poor positive perception was obtained on the general perception (16.7%) as well as on treatment seeking behavior (28%). The study concluded that UL had a significant impact on health related quality of life on respondents due to its relatively high prevalence and their probable impact on patient’s quality of life.UL was especially prevalent in women aged between 36 to 45 years, nulliparous women, and women of higher BMI. Community enlightenment to enhance knowledge, attitude, and perception on fibroids and risk factors necessary to ensure early diagnosis and presentation, including patient centered treatment option.

Keywords: fibroids, prevalence, risk factors, body mass index, menarche, anaemia, KAP

Procedia PDF Downloads 152

Authors: M. Weller Jones, J. Moffat, J. Taylor, J. Hartland, M. Natarajan

Abstract:

Background: Uganda’s teenage pregnancy rate remains a significant problem for female and maternal health in the country. Teenage pregnancy is linked to higher rates of maternal and neonatal mortality and morbidity, including preterm labour, obstructed labour, vesicovaginal fistulae, infections, and maternal mental health morbidity. In 2015, the National Strategy to End Child Marriage and Teenage Pregnancy was launched in Uganda. Research is needed so that the interventions in this Strategy can be effectively applied at a local level. This study at Kitovu and Villa Maria Hospitals, two local community hospitals near Masaka, Uganda, aimed to measure change in the local teenage pregnancy rate over the past 5 years; and to explore the awareness and attitudes of teenagers and healthcare professionals towards 1) teenage pregnancy and, 2) the challenges female adolescents still currently face. Method: Teenage delivery rate, type of delivery, incidence of complications in labour and neonatal and maternal outcomes were collected from the labour ward admission books, at both hospitals, for a six month time period in 2011 and 2016. At Kitovu Hospital, qualitative data regarding the experience of, and attitudes towards teenage pregnancy was collected from interviews conducted with 12 maternity staff members and with eight female teenagers, aged 16-19, who were pregnant or post-partum. Results: The proportion of total births to teenage mothers fell from 14% in 2011 to 7% in 2016 (Kitovu), but it remains higher in rural locations (19%, Villa Maria). Beliefs about exacerbating factors included: poor access to contraception; misconceptions that contraception is damaging to women’s health; failing sex education in schools; and poor awareness of national campaigns to reduce teenage pregnancy. Staff felt that the best way to tackle teenage pregnancy was to improve sex education in schools and to sensitise families to these issues. Six of the eight teenagers wanted more frequent sex education and easier, cheap access to contraception. Only one teenager saw positive consequences stating that teenage pregnancy would ‘avoid operations later in life.’ Discussion: Teenage pregnancy is a recognised problem and strategies in the Masaka region should focus on improving sex education in schools and initiating an organisation that educates and supplies free contraception to teenagers.

Keywords: adolescents, attitudes, teenage pregnancy, Uganda

Procedia PDF Downloads 173