Search results for: secondary osteoarthritis on the knee

Authors: Haritha Saranga

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Service quality has become an important driver of competition in manufacturing industries of late, as many products are being sold in conjunction with service offerings. With increase in computational power and data capture capabilities, it has become possible to analyze and estimate various aspects of service quality at the granular level and determine their impact on business performance. In the current study context, dealer level, model-wise warranty data from one of the top two-wheeler manufacturers in India is used to estimate service quality of individual dealers and its impact on warranty related costs and sales performance. We collected primary data on warranty costs, number of complaints, monthly sales, type of quality upgrades, etc. from the two-wheeler automaker. In addition, we gathered secondary data on various regions in India, such as petrol and diesel prices, geographic and climatic conditions of various regions where the dealers are located, to control for customer usage patterns. We analyze this primary and secondary data with the help of a variety of analytics tools such as Auto-Regressive Integrated Moving Average (ARIMA), Seasonal ARIMA and ARIMAX. Study results, after controlling for a variety of factors, such as size, age, region of the dealership, and customer usage pattern, show that service quality does influence sales of the products in a significant manner. A more nuanced analysis reveals the dynamics between product quality and service quality, and how their interaction affects sales performance in the Indian two-wheeler industry context. We also provide various managerial insights using descriptive analytics and build a model that can provide sales projections using a variety of forecasting techniques.

Keywords: service quality, product quality, automobile industry, business analytics, auto-regressive integrated moving average

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Authors: Danny Barash

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Riboswitches are RNA genetic control elements that were originally discovered in bacteria and provide a unique mechanism of gene regulation. They work without the participation of proteins and are believed to represent ancient regulatory systems in the evolutionary timescale. One of the biggest challenges in riboswitch research is that many are found in prokaryotes but only a small percentage of known riboswitches have been found in certain eukaryotic organisms. The few examples of eukaryotic riboswitches were identified using sequence-based bioinformatics search methods that include some slight structural considerations. These pattern-matching methods were the first ones to be applied for the purpose of riboswitch detection and they can also be programmed very efficiently using a data structure called affix arrays, making them suitable for genome-wide searches of riboswitch patterns. However, they are limited by their ability to detect harder to find riboswitches that deviate from the known patterns. Several methods have been developed since then to tackle this problem. The most commonly used by practitioners is Infernal that relies on Hidden Markov Models (HMMs) and Covariance Models (CMs). Profile Hidden Markov Models were also carried out in the pHMM Riboswitch Scanner web application, independently from Infernal. Other computational approaches that have been developed include RMDetect by the use of 3D structural modules and RNAbor that utilizes Boltzmann probability of structural neighbors. We have tried to incorporate more sophisticated secondary structure considerations based on RNA folding prediction using several strategies. The first idea was to utilize window-based methods in conjunction with folding predictions by energy minimization. The moving window approach is heavily geared towards secondary structure consideration relative to sequence that is treated as a constraint. However, the method cannot be used genome-wide due to its high cost because each folding prediction by energy minimization in the moving window is computationally expensive, enabling to scan only at the vicinity of genes of interest. The second idea was to remedy the inefficiency of the previous approach by constructing a pipeline that consists of inverse RNA folding considering RNA secondary structure, followed by a BLAST search that is sequence-based and highly efficient. This approach, which relies on inverse RNA folding in general and our own in-house fragment-based inverse RNA folding program called RNAfbinv in particular, shows capability to find attractive candidates that are missed by Infernal and other standard methods being used for riboswitch detection. We demonstrate attractive candidates found by both the moving-window approach and the inverse RNA folding approach performed together with BLAST. We conclude that structure-based methods like the two strategies outlined above hold considerable promise in detecting riboswitches and other conserved RNAs of functional importance in a variety of organisms.

Keywords: riboswitches, RNA folding prediction, RNA structure, structure-based methods

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Authors: Gloria Pinilla, Jose Manuel Baena, Patricia Gálvez-Martín, Juan Antonio Marchad

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Cartilage is a dense connective tissue with limited self-repair properties. Currently, the therapeutic use of autologous or allogenic chondrocytes makes up an alternative therapy to the pharmacological treatment. The design of a bioprinted 3D cartilage with chondrocytes and biodegradable biomaterials offers a new therapeutic alternative able of bridging the limitations of current therapies in the field. We have developed an enhanced printing processes-Injection Volume Filling (IVF) to increase the viability and survival of the cells when working with high-temperature thermoplastics without the limitation of the scaffold geometry in contact with cells. We have demonstrated the viability of the printing process using chondrocytes for cartilage regeneration. This development will accelerate the clinical uptake of the technology and overcomes the current limitation when using thermoplastics as scaffolds. An alginate-based hydrogel combined with human chondrocytes (isolated from osteoarthritis patients) was formulated as bioink-A and the polylactic acid as bioink-B. The bioprinting process was carried out with the REGEMAT V1 bioprinter (Regemat 3D, Granada-Spain) through a IVF. The printing capacity of the bioprinting plus the viability and cell proliferation of bioprinted chondrociytes was evaluated after five weeks by confocal microscopy and Alamar Blue Assay (Biorad). Results showed that the IVF process does not decrease the cell viability of the chondrocytes during the printing process as the cells do not have contact with the thermoplastic at elevated temperatures. The viability and cellular proliferation of the bioprinted artificial 3D cartilage increased after 5 weeks. In conclusion, this study demonstrates the potential use of Regemat V1 for 3D bioprinting of cartilage and the viability of bioprinted chondrocytes in the scaffolds for application in regenerative medicine.

Keywords: cartilage regeneration, bioprinting, bioink, scaffold, chondrocyte

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Authors: Precious Roselyn Obuobi

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Background: In Ghana, water-borne diseases remain a public health concern due to its impact. While marine pollution has been linked to outbreak of diseases especially in communities along the coast, associated risks such as oil spillage, marine debris, erosion, improper waste disposal and management practices persist. Objective: The study seeks to investigate sanitation practices that contribute to marine pollution in Prampram and the prevalence of selected water-borne diseases (diarrhea and typhoid fever). Method: This study used a descriptive cross-sectional design, employing the mix-method (qualitative and quantitative) approach. Twenty-two (22) participants were selected and semistructured questionnaire were administered to them. Additionally, interviews were conducted to collect more information. Further, an observation check-list was used to aid the data collection process. Secondary data comprising information on water-borne diseases in the district was acquired from the district health directorate to determine the prevalence of selected water-borne diseases in the community. Data Analysis: The qualitative data was analyzed using NVIVO® software by adapting the six steps thematic analysis by Braun and Clarke whiles STATA® version 16 was used to analyze the secondary data collected from the district health directorate. A descriptive statistic employed using mean, standard deviation, frequencies and proportions were used to summarize the results. Results: The results showed that open defecation and indiscriminate waste disposal were the main practices contributing to marine pollution in Prampram and its effect on public health. Conclusion: These findings have implications on public health and the environment, thus effort needs to be stepped up in educating the community on best sanitation practices.

Keywords: environment, sanitation, marine pollution, water-borne diseases

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Authors: Courtney Manthey-Pierce, Anna Warrener

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Polycystic ovarian syndrome (PCOS) is the most common endocrine disruptive disorder in females. PCOS is primarily characterized by polycystic ovaries, anovulation, hirsutism, insulin resistance, and hyperandrogenism. Despite negative reproductive consequences for females from anovulation and endocrine dysfunction, genes associated with the pathogenesis of PCOS are highly hereditable (h2 = 0.72). An evolutionary mismatch occurs when a trait that evolved in one environment has become maladaptive in another environment. The idea that PCOS is an evolutionary mismatch disease has been promoted by several researchers. Each trait of the resulting PCOS phenotype should be investigated individually in order to demonstrate an evolutionary mismatch. Hyperandrogenism is often regarded as the main characteristic of PCOS Hyperandrogenism may have aided with conception in older females, increased bone mineral density, and supported prolonged breastfeeding in nutritionally distressed populations. Because of the high prevalence of PCOS in the modern world, approximately 6%, it is often argued that PCOS emerged in an ancestral population prior to the migration out of Africa approximately 200,000 years ago. This environment would be characterized by sporadic periods of nutrition deficit and resource hardships as the climate began changing. Presently, modern society is characterized by obesity and sedentary lifestyles. The prevalence of obesity renders hyperandrogenism PCOS useless as there are no periods of nutritional distress requiring androgens for increased reproductive rates. In an ancestral environment, hyperandrogenism would likely lead to sporadic anovulation and mild secondary symptoms, however high levels of androgens in a modern environment led to prolonged if not permanent infertility and excessive secondary problems. Thus, hyperandrogenism related to PCOS appears to meet evolutionary mismatch criteria. Seen in this light, PCOS may be effectively treated as a probably evolutionary mismatch.

Keywords: evolutionary mismatch, heritability, hyperandrogenism, mismatch disorder

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Authors: Elizabeta Sivevska, Sunchica Petrovska, Vaska Antevska, Lidija Todorovska, Sanja Manchevska, Beti Dejanova, Ivanka Karagjozova, Jasmina Pluncevic Gligoroska

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Introduction: Body composition plays an important role in the selection of young soccer players and it is associated with their successful performance. The most commonly used model of body composition divides the body into two compartments: fat components and fat-free mass (muscular and bone components). The aims of the study were to determine the body composition parameters of young male soccer players and to show the differences in age groups. Material and methods: A sample of 52 young male soccer players, with an age span from 9 to 14 years were divided into two groups according to the age (group 1 aged 9 to 12 years and group 2 aged 12 to 14 years). Anthropometric measurements were taken according to the method of Mateigka. The following measurements were made: body weight, body height, circumferences (arm, forearm, thigh and calf), diameters (elbow, knee, wrist, ankle) and skinfold thickness (biceps, triceps, thigh, leg, chest, abdomen). The measurements were used in Mateigka’s equations. Results: Body mass components were analyzed as absolute values (in kilograms) and as percentage values: the muscular component (MC kg and MC%), the bone component (BCkg and BC%) and the body fat (BFkg and BF%). The group up to 12 years showed the following mean values of the analyzed parameters: MM=21.5kg; MM%=46.3%; BC=8.1kg; BC%=19.1%; BF= 6.3kg; BF%= 15.7%. The second group aged 12-14 year had mean values of body composition parameters as follows: MM=25.6 kg; MM%=48.2%; BC = 11.4 kg; BC%=21.6%; BF= 8.5 kg; BF%= 14. 7%. Conclusions: The young soccer players aged 12 up to 14 years who are in the pre-pubertal phase of growth and development had higher bone component (p<0.05) compared to younger players. There is no significant difference in muscular and fat body component between the two groups of young soccer players.

Keywords: body composition, young soccer players, body fat, fat-free mass

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Authors: Ahmed Stifi, Sascha Gentes

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The German nuclear industry, while implementing the German policy, believes that the journey towards the green-field, namely phasing out of nuclear energy, should be achieved through green techniques. The most important techniques required for the wide range of decommissioning activities are decontamination techniques, cutting techniques, radioactivity measuring techniques, remote control techniques, techniques for worker and environmental protection and techniques for treating, preconditioning and conditioning nuclear waste. Many decontamination techniques are used for removing contamination from metal, concrete or other surfaces like the scales inside pipes. As the pipeline system is one of the important components of nuclear power plants, the process of decontamination in tubing is of more significance. The development of energy sectors like oil sector, gas sector and nuclear sector, since the middle of 20th century, increased the pipeline industry and the research in the decontamination of tubing in each sector is found to serve each other. The extraction of natural products and material through the pipeline can result in scale formation. These scales can be radioactively contaminated through an accumulation process especially in the petrochemical industry when oil and gas are extracted from the underground reservoir. The radioactivity measured in these scales can be significantly high and pose a great threat to people and the environment. At present, the decontamination process involves using high pressure water jets with or without abrasive material and this technology produces a high amount of secondary waste. In order to overcome it, the research team within Karlsruhe Institute of Technology developed a new sustainable method to carry out the decontamination of tubing without producing any secondary waste. This method is based on vibration technique which removes scales and also does not require any auxiliary materials. The outcome of the research project proves that the vibration technique used for decontamination of tubing is environmental friendly in other words a sustainable technique.

Keywords: sustainable technologies, decontamination, pipeline, nuclear industry

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Authors: Sina Moradi, Sanly Liu, Christopher W. K. Chow, John Van Leeuwen, David Cook, Mary Drikas, Soha Habibi, Rose Amal

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In recent years, chloramine has been widely used for both primary and secondary disinfection. However, a major concern with the use of chloramine as a secondary disinfectant is the decay of chloramine and nitrification occurrence. The management of chloramine decay and the prevention of nitrification are critical for water utilities managing chloraminated drinking water distribution systems. The detection and monitoring of nitrification episodes is usually carried out through measuring certain water quality parameters, which are commonly referred to as indicators of nitrification. The approach taken in this study was to collect water samples from different sites throughout a drinking water distribution systems, Tailem Bend – Keith (TBK) in South Australia, and analyse the samples by high performance size exclusion chromatography (HPSEC). We investigated potential association between the water qualities from HPSEC analysis with chloramine decay and/or nitrification occurrence. MATLAB 8.4 was used for data processing of HPSEC data and chloramine decay. An increase in the absorbance signal of HPSEC profiles at λ=230 nm between apparent molecular weights of 200 to 1000 Da was observed at sampling sites that experienced rapid chloramine decay and nitrification while its absorbance signal of HPSEC profiles at λ=254 nm decreased. An increase in absorbance at λ=230 nm and AMW < 500 Da was detected for Raukkan CT (R.C.T), a location that experienced nitrification and had significantly lower chloramine residual (<0.1 mg/L). This increase in absorbance was not detected in other sites that did not experience nitrification. Moreover, the UV absorbance at 254 nm of the HPSEC spectra was lower at R.C.T. than other sites. In this study, a chloramine residual index (C.R.I) was introduced as a new indicator of chloramine decay and nitrification occurrence, and is defined based on the ratio of area underneath the HPSEC spectra at two different wavelengths of 230 and 254 nm. The C.R.I index is able to indicate DS sites that experienced nitrification and rapid chloramine loss. This index could be useful for water treatment and distribution system managers to know if nitrification is occurring at a specific location in water distribution systems.

Keywords: nitrification, HPSEC, chloramine decay, chloramine residual index

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Authors: Anish Desai, Reshmi Pillai, Nilesh Mahajan, Hitesh Chopra, Vishal Mahajan, Ajay Grover, Ashish Kohli

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Surgical Site Infection (SSI) is hospital acquired infection of growing concern. This study presents the efficacy and cost-effectiveness of triclosan-coated suture, in reducing the burden of SSI in India. Methodology: A systematic literature search was conducted for economic burden (1998-2018) of SSI and efficacy of triclosan-coated sutures (TCS) vs. non-coated sutures (NCS) (2000-2018). PubMed Medline and EMBASE indexed articles were searched using Mesh terms or Emtree. Decision tree analysis was used to calculate, the cost difference between TCS and NCS at private and public hospitals, respectively for 7 surgical procedures. Results: The SSI range from low to high for Caesarean section (C-section), Laparoscopic hysterectomy (L-hysterectomy), Open Hernia (O-Hernia), Laparoscopic Cholecystectomy (L-Cholecystectomy), Coronary artery bypass graft (CABG), Total knee replacement (TKR), and Mastectomy were (3.77 to 24.2%), (2.28 to 11.7%), (1.75 to 60%), (1.71 to 25.58%), (1.6 to 18.86%), (1.74 to 12.5%), and (5.56 to 25%), respectively. The incremental cost (%) of TCS ranged 0.1%-0.01% in private and from 0.9%-0.09% at public hospitals across all surgical procedures. Cost savings at median efficacy & SSI risk was 6.52%, 5.07 %, 11.39%, 9.63%, 3.62%, 2.71%, 9.41% for C-section, L-hysterectomy, O-Hernia, L-Cholecystectomy, CABG, TKR, and Mastectomy in private and 8.79%, 4.99%, 12.67%, 10.58%, 3.32%, 2.35%, 11.83% in public hospital, respectively. Efficacy of TCS and SSI incidence in a particular surgical procedure were important determinants of cost savings using one-way sensitivity analysis. Conclusion: TCS suture led to cost savings across all 7 surgeries in both private and public hospitals in India.

Keywords: cost Savings, non-coated sutures, surgical site infection, triclosan-coated sutures

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Authors: Tambe Daniel Atem

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Background: Clinical Research is an organized research on human beings intended to provide adequate information on the drug use as a therapeutic agent on its safety and efficacy. The significance of the study is to educate the global health and life science graduates in Clinical Research in depth to perform better as it involves testing drugs on human beings. Objectives: to provide an overall understanding of the scientific approach to the evaluation of new and existing medical interventions and to apply ethical and regulatory principles appropriate to any individual research. Methodology: It is based on – Primary data analysis and Secondary data analysis. Primary data analysis: means the collection of data from journals, the internet, and other online sources. Secondary data analysis: a survey was conducted with a questionnaire to interview the Clinical Research Professionals to understand the need of training to perform clinical trials globally. The questionnaire consisted details of the professionals working with the expertise. It also included the areas of clinical research which needed intense training before entering into hardcore clinical research domain. Results: The Clinical Trials market worldwide worth over USD 26 billion and the industry has employed an estimated 2,10,000 people in the US and over 70,000 in the U.K, and they form one-third of the total research and development staff. There are more than 2,50,000 vacant positions globally with salary variations in the regions for a Clinical Research Coordinator. R&D cost on new drug development is estimated at US$ 70-85 billion. The cost of doing clinical trials for a new drug is US$ 200-250 million. Due to an increase trained Clinical Research Professionals India has emerged as a global hub for clinical research. The Global Clinical Trial outsourcing opportunity in India in the pharmaceutical industry increased to more than $2 billion in 2014 due to increased outsourcing from U.S and Europe to India. Conclusion: Assessment of training need is recommended for newer Clinical Research Professionals and trial sites, especially prior the conduct of larger confirmatory clinical trials.

Keywords: clinical research, clinical trials, clinical research professionals

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Authors: Charles U. Eze, Joy Johnbest Egbo

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The study investigated the effect of Context-Based Instructional Strategy (CBIS) on students’ achievement in chemistry. CBIS was used as an experimental group and expository method (EM) as a control group, sources showed that students poor achievement in chemistry is from teaching strategy adopted by the chemistry teachers. Two research questions were answered, and two null hypotheses were formulated and tested. This strategy recognizes the need for student-centered, relevance of tasks and students’ voice; it also helps students develop creative and critical learning skills. A quasi-experimental (non-equivalent, pretest, posttest control group) design was adopted for the study. The population for the study comprised all senior secondary class one (SSI) students who were offering chemistry in co-education schools in Agbani Education zone. The instrument for data collection was a self-developed Basic Chemistry Achievement Test (BCAT). Relevant data were collected from a sample of SSI chemistry students using purposive random sampling techniques from two co-education schools in Agbani Education Zone of Enugu State, Nigeria. A reliability co-efficient was obtained for the instrument using Kuder-Richardson formula 20. Mean and standard deviation scores were used to answer the research questions while two-way analysis of covariance (ANCOVA) was used to test the hypotheses. The findings showed that the experimental group taught with context-based instructional strategy (CBIS) obtained a higher mean achievement score than the control group in the post BCAT; male students had higher mean achievement scores than their female counterparts. The difference was significant. It was recommended, among others, that CBIS should be given more emphasis in the training and re-training program of secondary school chemistry teachers.

Keywords: context-based instructional strategy, expository strategy, student-centered

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Authors: Danuvasin Charoen

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The study investigates the business process and business model of GRABTAXI. The paper also discusses how the company implemented strategies to gain competitive advantages. The data is derived from the analysis of secondary data and the in-depth interviews among staffs, taxi drivers, and key customers. The findings indicated that the company’s competitive advantages come from being the first mover, emphasising on the ease of use and tangible benefits of application, and using network effect strategy.

Keywords: taxi, mobile application, innovative business model, Thailand

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Authors: Nishi Malhotra

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Art has developed as a mode of investment and saving. Art and culture of any nation is the source of foreign direct investment (FDI) generation and growth development. Several intermediaries and skill-building organizations thrive on at and culture for their earnings. Indian art market has grown to Rs. 2000 Crores. Art establishment houses access to privileged information is the main reason for arbitrariness and volatility in the market. The commercialization of art and development of the markets with refinement in the taste of the customers have led to the development of art as an investment avenue. Investors keen on investing in these products can do so, and earnings from art are taxable too, like any other capital asset. This research paper is aimed at exploring the role of art and culture as an investment avenue in India and reasons for increasing volatilities in the art market. Based on an extensive literature review and secondary research, a benchmarking study has been conducted to capture the growth of the art as an investment avenue. These studies indicate that during the financial crisis of 2008-10, the art emerged as an alternative investment avenue. The paper aims at discussing the financial engineering of various art funds and instruments. Based on secondary data available from Sotheby’s, Christies, Bonham, there is a positive correlation between strategic diversification and increasing return in the Art market. Similarly, digitization has led to disintermediation in the art markets and also helped to increase the market base. The data clearly enumerates the growing interest of the Indian investor towards art as an investment option. Much like any other broad asset class, art market too thrives on excess returns provided by diversification. Many financial intermediaries and art funds have emerged, to offer valuable investment planning advisory to a genuine investor. This paper clearly highlights the increasing returns of strategic diversification and its impact on reducing volatility in the art markets. Moreover, with coming up of e-auctions and websites, investors are able to analyse art more objectively. Digitization and commercialization of art have definitely helped in reducing volatility in world art markets.

Keywords: art, investment avenue, diversification, digitization

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Authors: Fendouli Ines, Zaafrane Nesrine, Mhamdi Hana, Knani Leila, Ghorbel Mohamed

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Introduction: Ocular infiltration of leukemia can involve orbit, uveal tract, retina and optic nerve. It may result from direct ocular infiltration by leukemic cells or indirect ocular involvement resulting from secondary hematologic changes, opportunistic infections and complications of various modalities of therapy. We here in report a case of central venous retinal occlusion associated to optic nerve infiltration as presenting signs of a relapse of acute lymphoblastic leukemia. Case Report: A twelve-year-old male -patient of acute B lymphoblastic leukemia presented with headaches and bilateral blurred vision in the left ee. Ophthalmic examination showed a visual acuity reduced to counting fingers in the right eye and no light perception in the left eye. Funduscopy revealed a voluminous disc edema surrounded by retinal haemorrhages in the right eye, and venous tortusities, papillary edema, and hemorrages suggesting central retinal venous occlusion in the LE. Swept source optical coherence tomography revealed a serous retinal detachment in the RE and .hyperreflective inner layers with macular edema in the left eye. Cerebro-orbital MRI showed bilateral thickened left optic nerve. There were no radiological signs of true papillary edema due to intracranial hypertension secondary to central nervous system involvement. Myelogram and lumbar punction demonstrated blast infiltration and confirmed ocular relapse of the leukemia. Conclusion: Ocular involvement lymphoblastic acute leukemias decreased since the introduction of a systematic prophylactic treatment of central nervous system. Periodic ophthalmic examination is necessary to allow early diagnosis and treatment.

Keywords: acute leukemia, optic nerve, infiltration, relapse

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Authors: Aminah Abdullah, Iqbal Khadaroo

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This paper investigates to what ends, how and by whom museums and art galleries in the UK are governed, and to whom they provide accounts to justify their behavior and activities. A theoretical framework is developed by drawing from the governance and accountability literature and is fleshed out by using empirical data from secondary sources. The findings show that the governance model used, informed by the new public management (NPM) philosophy, and has created tensions between the managerial and social forms of accountability. Museums and art galleries have adopted a managerial culture of getting done what gets measured.

Keywords: governance, accountability, UK museums and art galleries, public sector

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Authors: Yibeltal T. Bayou, Yohana S. Mashalla, Gloria Thupayagale-Tshweneagae

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Background: According to the World Health Organization, caesarean section delivery rates of more than 10-15% caesarean section deliveries in any specific geographic region in the world are not justifiable. The aim of the study was to describe the level and analyse determinants of caesarean section delivery in Addis Ababa. Methods: Data was collected in Addis Ababa using a structured questionnaire administered to 901 women aged 15-49 years through a stratified two-stage cluster sampling technique. Binary logistic regression model was employed to identify predictors of caesarean section delivery. Results: Among the 835 women who delivered their last birth at healthcare facilities, 19.2% of them gave birth by caesarean section. About 9.0% of the caesarean section births were due to mother’s request or service provider’s influence without any medical indication. The caesarean section delivery rate was much higher than the recommended rate particularly among the non-slum residents (27.2%); clients of private healthcare facilities (41.1%); currently married women (20.6%); women with secondary (22.2%) and tertiary (33.6%) level of education; and women belonging to the highest wealth quintile household (28.2%). The majority (65.8%) of the caesarean section clients were not informed about the consequences of caesarean section delivery by service providers. The logistic regression model shows that older age (30-49), secondary and above education, non-slum residence, high-risk pregnancy and receiving adequate antenatal care were significantly positively associated with caesarean section delivery. Conclusion: Despite the unreserved effort towards achieving MDG 5 through safe skilled delivery assistance among others, the high caesarean section rate beyond the recommend limit, and the finding that caesarean sections done without medical indications were also alarming. The government and city administration should take appropriate measures before the problems become setbacks in healthcare provision. Further investigations should focus on the effect of caesarean section delivery on maternal and child health outcomes in the study area.

Keywords: Addis Ababa, caesarean section, mode of delivery, slum residence

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Authors: Azadeh Rouhandeh, Chris Joslin, Zhen Qu, Yuu Ono

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The centre of rotation of the hip joint is needed for an accurate simulation of the joint performance in many applications such as pre-operative planning simulation, human gait analysis, and hip joint disorders. In human movement analysis, the hip joint center can be estimated using a functional method based on the relative motion of the femur to pelvis measured using reflective markers attached to the skin surface. The principal source of errors in estimation of hip joint centre location using functional methods is soft tissue artefacts due to the relative motion between the markers and bone. One of the main objectives in human movement analysis is the assessment of soft tissue artefact as the accuracy of functional methods depends upon it. Various studies have described the movement of soft tissue artefact invasively, such as intra-cortical pins, external fixators, percutaneous skeletal trackers, and Roentgen photogrammetry. The goal of this study is to present a non-invasive method to assess the displacements of the markers relative to the underlying bone using optical motion capture data and tissue thickness from ultrasound measurements during flexion, extension, and abduction (all with knee extended) of the hip joint. Results show that the artefact skin marker displacements are non-linear and larger in areas closer to the hip joint. Also marker displacements are dependent on the movement type and relatively larger in abduction movement. The quantification of soft tissue artefacts can be used as a basis for a correction procedure for hip joint kinematics.

Keywords: hip joint center, motion capture, soft tissue artefact, ultrasound depth measurement

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Authors: Dwi Endarti, Susi a Kristina, Rizki Noorizzati, Akbar E Nugraha, Fera Maharani, Kika a Putri, Asninda H Azizah, Sausanzahra Angganisaputri, Yunisa Yustikarini

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Cost utility analysis is the most recommended pharmacoeconomic method since it allows widely comparison of cost-effectiveness results from different interventions. The method uses outcome of quality-adjusted life year (QALY) or disability-adjusted life year (DALY). Measurement of QALY requires the data of utility dan life years gained. Utility is measured with the instrument for quality of life measurement such as EQ-5D. Recently, the EQ-5D is available in two versions which are EQ-5D-3L and EQ-5D-5L. This study aimed to compare the EQ-5D-3L and EQ-5D-5L to examine the most suitable version for Indonesian population. This study was an observational study employing cross sectional approach. Data of quality of life measured with EQ-5D-3L and EQ-5D-5L were collected from several groups of population which were respondent with chronic diseases, respondent with acute diseases, and respondent from general population (without illness) in Yogyakarta Municipality, Indonesia. Convenience samples of hypertension patients (83), diabetes mellitus patients (80), and osteoarthritis patients (47), acute respiratory tract infection (81), cephalgia (43), dyspepsia (42), and respondent from general population (293) were recruited in this study. Responses on the 3L and 5L versions of EQ-5D were compared by examining the psychometric properties including agreement, internal consistency, ceiling effect, and convergent validity. Based on psychometric properties tests of EQ-5D-3L dan EQ-5D-5L, EQ-5D-5L tended to have better psychometric properties compared to EQ-5D-3L. Future studies for health related quality of life (HRQOL) measurements for pharmacoeconomic studies in Indonesia should apply EQ-5D-5L.

Keywords: EQ-5D, Health Related Quality of Life, Indonesian Population, Psychometric Properties

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Authors: Mohammad Karam, Abdulmalik Alsaif, Abdulrahman Al-Naseem, Amrit Hayre, Abdurrahman Al Jabbouri, Ahmad Aldubaikhi, Narvair Kahlar, Salem Al-Mutairi

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Purpose: To compare the outcomes of mycophenolate mofetil (MMF) versus methotrexate (MTX) in non-infectious ocular inflammatory disease (NIOID). Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and an electronic search was conducted to identify all comparative studies of MMF versus MTX in NIOID. Treatment results and side effects were primary outcome measures. Secondary outcome measures included visual acuity and resolution of macular oedema. Fixed and random-effects models were used for the analysis. Results: Four studies enrolling 905 patients were identified. There was no significant difference between MMF and MTX groups in overall treatment success (Odds Ratio [OR] = 0.97, P = 0.96) and failure (OR = 0.86, P = 0.85) of NIOID. Although treatment success of uveitis showed no significant difference for anterior and intermediate uveitis cases (OR = 2.33, P = 0.14), MTX showed a significantly improved effect in cases involving posterior uveitis and panuveitis (OR = 0.41, P = 0.003). However, the median dose required for treatment success was lower for MTX whereas MMF was associated with a faster median time to treatment success. Further to this, MMF showed a reduced rate of side effects when compared to MTX, but MTX failed to reach statistical significance, most notably for liver enzyme elevation (OR = 0.65, P = 0.16), fatigue (OR = 0.84, P = 0.49) and headache (OR = 0.81, P = 0.37). For secondary outcomes, no significant difference was noted in visual acuity and resolution of macular edema. Conclusions: MMF is comparable to MTX in the treatment of NIOID as there was no significant difference in the outcome of treatment success and side effect profiles.

Keywords: Mycophenolate mofetil, methotrexate, non-infectious ocular inflammation, uveitis, scleritis

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Authors: Arzyana Sunkar, Yanto Santosa, Intan Purnamasari, Yohanna Dalimunthe

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A variety of negative allegations have criticized the Indonesian oil palm plantations as being environmentally unfriendly. One of the important allegations thus must be verified is that expansion of Indonesian oil palm plantation has increased the deforestation rate of primary tropical forest. In relation to this, a research was conducted to study the origin or history of the status and land use of 8 private oil palm plantations (with a total of 46,372.38 ha) located in Riau Province. Several methods were employed: (1) conducting analysis of overlay maps between oil palm plantation studied with the 1986 Forest Map Governance Agreement (TGHK) and the 1994 and 2014 Riau Provincial Spatial Plans(RTRWP); (2) studying the Cultivation Right on Land (HGU) documents including the Forestry Ministerial Decree on the release of forest area and (3) interpretation of lands at imagery of bands 542, covering 3 years before and after the oil palm industries operated. In addition, field cross-checked, and interviews were conducted with National Land Agency, Plantation and Forestry Office and community figures. The results indicated that as much as 1.95% of the oil palm plantations under study were converted from production forest, 30.34% from limited production forest and 67.70% from area for other usage /conversion production forest. One year prior to the establishment of the plantations, the land cover types comprised of rubber plantations (49.96%), secondary forest (35.99%), bare land (10.17%), shrubs (3.03%) and mixed dryland farming-shrubs (0.84%), whereas the land use types comprised of 35.99% forest concession areas, 14.04% migrants dryland farms, and 49.96% Cultivation Right on Land of other companies. These results indicated that most of the private oil palm plantations under study, resulted from the conversion of production forests and the previous land use were not primary forest but rubber plantations and secondary forests.

Keywords: land cover types, land use history, primary forest, private oil palm plantations

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Authors: Ozen Asut, Gulifeiya Abuduxike, Imge Begendi, Mustafa O. Canatan, Merve Colak, Gizem Ozturk, Lara Tasan, Ahmed Waraiet, Songul A. Vaizoglu, Sanda Cali

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Obesity among children and adolescents is one of the critical public health problems worldwide. Internet addiction is one of the sedentary behaviors that cause obesity due to the excessive screen time and reduced physical activities. We aimed to examine the relationships between the screen time, internet addiction and other lifestyle behaviors with obesity among high school students in the Near East College in Nicosia, Northern Cyprus. A cross-sectional study conducted among 469 secondary school students, mean age 11.95 (SD, 0.81) years. A self-administrated questionnaire was applied to assess the screen time and lifestyle behaviors. The Turkish adopted version of short-form of internet addiction test was used to assess internet addiction problems. Height and weight were measured to calculate BMI and classified based on the BMI percentiles for sex and age. Descriptive analysis, Chi-Square test, and multivariate regression analysis were done. Of all, 17.2% of the participants were overweight and obese, and 18.1% had internet addictions, while 40.7% of them reported having screen time more than two hours. After adjusting the analysis for age and sex, eating snacks while watching television (OR, 3.04; 95% CI, 1.28-7.21), self- perceived body weight (OR, 24.9; 95% CI, 9.64-64.25) and having a play station in the room (OR, 4.6; 95% CI, 1.85 - 11.42) were significantly associated with obesity. Screen time (OR, 4.68; 95% CI, 2.61-8.38; p=0.000) and having a computer in bedroom (OR, 1.7; 95% CI, 1.01- 2.87; p=0.046) were significantly associated with internet addiction, whereas parent’s compliant regarding the lengthy technology use (OR, 0.23; 95% CI, 0.11-0.46; p=0.000) was found to be a protective factor against internet addiction. Prolonged screen time, internet addiction, sedentary lifestyles, and reduced physical and social activities are interrelated, multi-dimensional factors that lead to obesity among children and adolescents. A family - school-based integrated approach should be implemented to tackle obesity problems.

Keywords: adolescents, internet addiction, lifestyle, Northern Cyprus, obesity, screen time

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Authors: Jonathan Sahu, Jill Aylott

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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: advocacy, autism, health inequalities, intellectual developmental disabilities, quality of care

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Authors: Ryan Villafuerte Lansangan

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Assessing students’ understanding in the microscopic level of an abstract subject like chemistry poses a challenge to teachers. Literature reveals that the use of representations serves as an essential avenue of measuring the extent of understanding in the discipline as an alternative to traditional assessment methods. This undertaking explored the representational competence profile of high school students from the University of Santo Tomas High School in understanding selected chemical principles and correlate this with their academic profile in chemistry based on their performance in the academic achievement examination in chemistry administered by the Center for Education Measurement (CEM). The common misconceptions of the students on the selected chemistry principles based on their representations were taken into consideration as well as the students’ views regarding their understanding of the role of chemical representations in their learning. The students’ level of representation task instrument consisting of the main lessons in chemistry with a corresponding scoring guide was prepared and utilized in the study. The study revealed that most of the students under study are unanimously rated as Level 2 (symbolic level) in terms of their representational competence in understanding the selected chemical principles through the use of chemical representations. Alternative misrepresentations were most observed on the students’ representations on chemical bonding concepts while the concept of chemical equation appeared to be the most comprehensible topic in chemistry for the students. Data implies that teachers’ representations play an important role in helping the student understand the concept in a microscopic level. Results also showed that the academic achievement in the chemistry of the students based on the standardized CEM examination has a significant association with the students’ representational competence. In addition, the students’ responses on the students’ views in chemical representations questionnaire evidently showed a good understanding of what a chemical representation or a mental model is by drawing a negative response that these tools should be an exact replica. Moreover, the students confirmed a greater appreciation that chemical representations are explanatory tools.

Keywords: chemical representations, representational competence, academic profile in chemistry, secondary students

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Authors: Danuvasin Charoen

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This study investigates the development of the digital economy policy in Thailand. The researcher describes the importance of digital technologies for competitiveness development of the country. In addition, the researcher analyzes the components and roadmap of the digital economy policy in Thailand. Main problems and challenges of the policy were identified. The data were gathered and analyzed from secondary sources. The finding can be used to guide the implementation of the digital economy in Thailand and other developing economies.

Keywords: digital economy, ICT in developing countries, Thailand, ICT development

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Authors: Martyna Ekiert, Andrzej Mlyniec

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Tendons are the biological structures, which primary function is to transfer force generated by muscles to the bones. Unfortunately, damages of tendons are also one of the most common injuries of the human musculoskeletal system. For the most severe cases of tendon rupture, such as the tear of calcaneus tendon or anterior cruciate ligament of the knee, a surgical procedure is the only possible way of full recovery. Tendons used as biological grafts are usually subjected to the process of deep freezing and subsequent thawing. This, in particular for multiple freezing/thawing cycles, may result in changes of tendon internal structure causing deterioration of mechanical properties of the tissue. Therefore, studies on the influence of freezing on tendons biomechanics, including internal water content in soft tissue, seems to be greatly needed. An experimental study of the influence of freezing on mechanical properties of the tendon was performed on fascicles samples dissected form bovine flexor tendons. The preparation procedure was performed with the presence of 0.9% saline solution in order to prevent an excessive tissue drying. All prepared samples were subjected to the different number of freezing/thawing cycles. For freezing part of the protocol we used -80°C temperature while for slow thawing we used fridge temperature (4°C) combined with equalizing temperatures in the standard state (25°C). After final thawing, the mechanical properties of each sample was examined using cyclic loading test. Our results may contribute for better understanding of negative effects of soft tissues freezing, resulting from abnormal thermal expansion of water. This also may help to determine the limit of freezing/thawing cycles disqualifying tissue for surgical purposes and thus help optimize tissues storage conditions.

Keywords: freezing, soft tissue, tendon, bovine fascicles

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Authors: L. Sun, O. Bloom, K. Anderson

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The medial and lateral sural artery perforator flaps (MSAP and LSAP, respectively) are two recently described flaps that are less commonly used in lower limb trauma reconstructive surgeries compared to flaps such as the anterolateral thigh (ALT) flap or the gastrocnemius flap. The LSAP flap has several theoretical benefits over the MSAP, including the ability to be sensate and being more easily manoeuvred into position as a local flap for coverage of lateral knee or leg defects. It is less commonly used in part due to a lack of documented studies of the anatomical reliability of the perforator, and an unquantified average length of the pedicle used for microsurgical anastomosis (if used as a free flap) or flap rotation (if used as a pedicled flap). It has been shown to have significantly lower donor site morbidity compared to other flaps such as the ALT, due to the decreased need for intramuscular dissection and resulting in less muscle loss at the donor site. 11 cadaveric lower limbs were dissected, with a mean of 1.6 perforators per leg, with an average pedicle length of 45mm to the sural artery and 70mm to the popliteal artery. While the majority of perforating arteries lay close to the midline (average of 19mm lateral to the midline), there were patients whose artery was significantly lateral and would have been likely injured by the initial incision during an operation. Adding to the literature base of documented LSAP dissections provides a greater understanding of the anatomical basis of these perforator flaps, and the authors hope this will establish them as a more commonly used and discussed option when managing complicated lower limb trauma requiring soft tissue reconstruction.

Keywords: cadaveric, dissection, lateral, perforator flap, sural artery, surface anatomy

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Authors: Elizaveta Startseva, Elena Notina, Irina Bykova, Valentina Ulyumdzhieva, Natallia Zhabo

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With the various existing models of intercultural communication that contain a vast number of stages for foreign language acquisition, there is a need for conscious perception of the foreign culture. Such a process is associated with the emergence of linguistic conflict with the consistent students’ desire to solve the problem of the language differences, along with cultural discrepancies. The aim of this study is to present the modern ways and methods of removing psycholinguistic conflict through skills development in professional translation and intercultural communication. The study was conducted in groups of 1-4-year students of Medical Institute and Agro-Technological Institute RUDN university. In the course of training, students got knowledge in such disciplines as basic grammar and vocabulary of the English language, phonetics, lexicology, introduction to linguistics, theory of translation, annotating and referencing media texts and texts in specialty. The students learned to present their research work, participated in the University and exit conferences with their reports and presentations. Common strategies of removing linguistic and cultural conflict can be attributed to the development of such abilities of a language personality as a commitment to communication and cooperation, the formation of cultural awareness and empathy of other cultures of the individual, realistic self-esteem, emotional stability, tolerance, etc. The process of mastering a foreign language and culture of the target language leads to a reduplication of linguistic identity, which leads to successive formation of the so-called 'secondary linguistic personality.' In our study, we tried to approach the problem comprehensively, focusing on the translation gaps for technical and non-technical language still missing such a typology which could classify all of the lacunas on the same principle. When obtaining the background knowledge, students learn to overcome the difficulties posed by the national-specific and linguistic differences of cultures in contact, i.e., to eliminate the gaps (to fill in and compensate). Compensation gaps is a means of fixing it, the initial phase of elimination, followed in some cases and some not is filling semantic voids (plenus). The concept of plenus occurs in most cases of translation gaps, for example in the transcription and transliteration of (intercultural and exoticism), the replication (reproduction of the morphemic structure of words or idioms. In all the above cases the task of the translator is to ensure an identical response of the receptors of the original and translated texts, since any statement is created with the goal of obtaining communicative effect, and hence pragmatic potential is the most important part of its contents. The practical value of our work lies in improving the methodology of teaching English for specific purposes on the basis of psycholinguistic concept of the secondary language personality.

Keywords: lacuna, language barrier, plenus, secondary language personality

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Authors: Pebri Nurhayati, Rozanah Ahlam Fadiyah

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In the development of the city often use rural areas that can not be separated from the change in land use that lead to the degradation of urban green space in the city fringe. In the long run, the degradation of green open space this can impact on the decline of ecological, psychological and public health. Therefore, this research aims to (1) determine the relationship between the parameters of the degradation rate of urban development with green space, (2) develop a spatial model of the impact of urban development on the degradation of green open space with remote sensing techniques and Geographical Information Systems in an integrated manner. This research is a descriptive research with data collection techniques of observation and secondary data . In the data analysis, to interpret the direction of urban development and degradation of green open space is required in 2005-2010 ASTER image with NDVI. Of interpretation will generate two maps, namely maps and map development built land degradation green open space. Secondary data related to the rate of population growth, the level of accessibility, and the main activities of each city map is processed into a population growth rate, the level of accessibility maps, and map the main activities of the town. Each map is used as a parameter to map the degradation of green space and analyzed by non-parametric statistical analysis using Crosstab thus obtained value of C (coefficient contingency). C values were then compared with the Cmaximum to determine the relationship. From this research will be obtained in the form of modeling spatial map of the City Development Impact Degradation Green Space in Urban Fringe eastern city of Yogyakarta 2005-2010. In addition, this research also generate statistical analysis of the test results of each parameter to the degradation of green open space in the Urban Fringe eastern city of Yogyakarta 2005-2010.

Keywords: spatial analysis, urban development, degradation of green space, urban fringe

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Authors: Neritan Shkodrani

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On November 26, 2019, an earthquake hit the central western part of Albania. It was assessed as Mw 6.4. Its epicenter was located offshore north western Durrës, about 7 km north of the city. In this paper, the consequences of settlements of very soft soils have been discussed for the case of a residential building, mentioned as “K Building”, which was suffering a significant tilting after the earthquake. “KBuilding” is an RC framed building having 12+1 (basement) storiesand a floor area of 21000 m2. The construction of the building was completed in 2012. “KBuilding”, located in Durres city, suffered severe non-structural damage during November 26, 2019, Durrës Earthquake sequences. During the in-site inspections immediately after the earthquake, the general condition of the buildings, the presence of observable settlements on the ground, and the crack situation in the structure were determined, and damage inspection were performed. It was significant to note that the “K Building” presented tilting that might be attributed, as it was believed at the beginning, partially to the failure of the columns of the ground floor and partially to liquefaction phenomena, but it did not collapse. At the first moment was not clear if the foundation had a bearing capacity failure or the foundation failed because of the soil liquefaction. Geotechnical soil investigations by using CPTU test were executed, and their data are usedto evaluatebearing capacity, consolidation settlement of the mat foundation, and soil liquefaction since they were believed to be the main reasons of this building tilting.Geotechnical soil investigation consist in 5 (five) Static Cone Penetration tests with pore pressure measurement (piezocone test). They reached a penetration depth of 20.0 m to 30.0 mand, clearly shown the presence of very soft and organic soils in the soil profile of the site. Geotechnical CPT based analysis of bearing capacity, consolidation, and secondary settlement are applied, and results are reported for each test. These results shown very small values of allowable bearing capacity and very high values of consolidation and secondary settlements. Liquefaction analysis based on the data of CPTU tests and the characteristics of ground shaking of the mentioned earthquake has shown the possibility of liquefaction for some layers of the considered soil profile, but the estimated vertical settlements are at a small range and clearly shown that the main reason of the building tilting was not related to the consequences of liquefaction, but was an existing settlement caused from the applied bearing pressure of this building. All the CPTU tests were carried out on August 2021, almost two years after the November 26, 2019, Durrës Earthquake and when the building itself was demolished. After removing the mat foundation on September 2021, it was possible to carry out CPTU tests even on the footprint of the existing building, which made possible to observe the effects of long time applied of foundation bearing pressure to the consolidation on the considered soil profile.

Keywords: bearing capacity, cone penetration test, consolidation settlement, secondary settlement, soil liquefaction, etc

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Authors: Afaf Manzoor, Abdul Hameed

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Children with hearing impairment face several challenges in accessing primary and secondary education in general and higher education in particular in Pakistan. A large number of these children are excluded from formal education system through segregated special institutions. The enrollment rate of these children at school level is very low and it continues decreasing as they move on the ladder of education. Negligible number of students with hearing impairment gets any chance to be enrolled at tertiary or higher education institutes. The segregated system of education at primary and secondary level makes it even more difficult to adjust in an inclusive classroom at a higher level not only for students with hearing impairment but for their teachers and peers as well. A false belief of teachers and parents about low academic profile of students with hearing impairment is one of the major challenges to overcome for their participation at higher education. This case study was conducted to document an innovative step taken by the Department of Special Education Needs, University of Management & Technology, Lahore Pakistan. The prime objective of this study was to assess the satisfaction level of students with hearing impairment in BS 4 Years and MA Special Education programs at Lahore campus. Structured interviews were of 40 students with hearing impairment to assess the satisfaction on service delivery (admission process, classroom pedagogy, content, assessment/results, access to other services centers i.e. library, cafeteria, hostel, co-curricular activities) and campus life. Their peers without disabilities were also interviewed to assess their acceptance level. The findings of the study revealed positive results about their educational as well as social inclusion in the university. The students also shared their fears at the time of admission and how fear eventually faded out with the passage of time due to the proper academic support system. The findings of the study will be shared in detail with the audience during the presentation.

Keywords: students with hearing impairment, higher education, inclusive education, marginalization

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