Search results for: cross and portion

Authors: Anthony Khawaja, Jacques Prioux, Ghassan Maalouf, Rawad El Hage

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The regular practice of physical activities characterized by significant mechanical stresses stimulates bone formation and improves bone mineral density (BMD) in the most solicited sites. The purpose of this study was to explore the relationships between maximum power and bone variables in a group of young adult men. Identification of new determinants of BMD, bone mineral content (BMC) and hip geometric indices in young adult men, would allow screening and early management of future cases of osteopenia and osteoporosis. Fifty-three young adult men (18 – 35yr) voluntarily participated in this study. Weight and height were measured, and body mass index was calculated. Body composition, BMC and BMD were determined for each individual by Dual-energy X-ray absorptiometry (DXA; GE Healthcare, Madison, WI) at whole body (WB), lumbar spine (L1-L4), total hip (TH), and femoral neck (FN). FN cross-sectional area (CSA), strength index (SI), buckling ratio (BR), FN section modulus (Z), cross-sectional moment of inertia (CSMI) and L1-L4 TBS were also evaluated by DXA. The vertical jump was evaluated using a field test (sargent test). Two main parameters were retained: vertical jump performance (cm) and power (w). The subjects performed three jumps with 2 minutes of recovery between jumps. The highest vertical jump was selected. Maximum power (P max, in watts) was calculated. Maximum power was positively correlated to WB BMD (r = 0.41; p < 0.01), WB BMC (r = 0.65; p < 0.001), L1-L4 BMC (r = 0.54; p < 0.001), FN BMC (r = 0.35; p < 0.01), TH BMC (r = 0.50; p < 0.001), CSMI (r = 0.50; p < 0.001), CSA (r = 0.33; p < 0.05). Vertical jump was positively correlated to WB BMC (r = 0.31; p < 0.05), L1-L4 BMC (r = 0.40; p < 0.01), CSMI (r = 0.29; p < 0.05). The current study suggests that maximum power is a positive determinant of BMD, BMC and hip geometric indices in young adult men. In addition, it shows also that maximum power is a stronger positive determinant of bone variables than vertical jump in this population. Implementing strategies to increase maximum power in young adult men may be useful for preventing osteoporotic fractures later in life.

Keywords: bone variables, maximum power, osteopenia, osteoporosis, vertical jump, young adult men

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Authors: Margaret Elaine J. Villamayor, Lobert A. Padua, Neil S. Bacaltos, Virgilio P. Bañez

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Significance: This study aimed to determine the prevalence of Hepatobiliary Tuberculosis (HBTB) with biliary obstruction and to compare the outcomes of ERCP versus PTBD in these patients. Methodology: This is a cross-sectional study involving patients from PGH who underwent biliary drainage from HBTB from January 2009 to June 2014. HBTB was defined as having evidence of TB (culture, smear, PCR, histology) or clinical diagnosis with the triad of jaundice, fever, and calcifications on imaging with other causes of jaundice excluded. The primary outcome was successful drainage and secondary outcomes were mean hospital stay and complications. Simple logistic regression was used to identify factors associated with success of drainage, z-test for two proportions to compare outcomes of ERCP versus PTBD and t-test to compare mean hospital stay post-procedure. Results: There were 441 patients who underwent ERCP and PTBD, 19 fulfilled the inclusion criteria. 11 underwent ERCP while 8 had PTBD. There were more successful cases in PTBD versus ERCP but this was not statistically significant (p-value 0.3615). Factors such as age, gender, location and nature of obstruction, vices, coexisting pulmonary or other extrapulmonary TB and presence of portal hypertension did not affect success rates in these patients. The PTBD group had longer mean hospital stay but this was not significant (p-value 0.1880). There were no complications reported in both groups. Conclusion: HBTB comprises 4.3% of the patients undergoing biliary drainage in PGH. Both ERCP and PTBD are equally safe and effective in the management of biliary obstruction from HBTB.

Keywords: cross-sectional, hepatobiliary tuberculosis, obstructive jaundice, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage

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Authors: Rohin Rameswarapu, Sameer Valsangkar

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Background: Globally, musculoskeletal disorders are the largest single cause of work-related illnesses accounting for over 33% of all newly reported occupational illnesses. Risk factors for MSD need to be delineated to suggest means for amelioration. Material and methods: In this current cross-sectional study, the prevalence of MSDs among workers in an electrical company assembly line, the socio-demographic and job characteristics associated with MSD were obtained through a semi-structured questionnaire. A quantitative assessment of the physical risk factors through the Rapid Upper Limb Assessment (RULA) tool, and measurement of psychosocial risk factors through a Likert scale was obtained. Statistical analysis was conducted using Epi-info software and descriptive and inferential statistics including chi-square and unpaired t test were obtained. Results: A total of 263 workers consented and participated in the study. Among these workers, 200 (76%) suffered from MSD. Most of the workers were aged between 18–27 years and majority of the workers were women with 198 (75.2%) of the 263 workers being women. A chi square test was significant for association between male gender and MSD with a P value of 0.007. Among the MSD positive group, 4 (2%) had a grand score of 5, 10 (5%) had a grand score of 6 and 186 (93%) had a grand score of 7 on RULA. There were significant differences between the non-MSD and MSD group on five out of the seven psychosocial domains, namely job demand, job monotony, co-worker support, decision control and family and environment domains. Discussion: The current cross-sectional study demonstrates a high prevalence of MSD among assembly line works with inherent physical and psychosocial risk factors and recommends that not only physical risk factors, addressing psychosocial risk factors through proper ergonomic means is also essential to the well-being of the employee.

Keywords: musculoskeletal disorders, India, occupational health, Rapid Upper Limb Assessment (RULA)

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Authors: T. Garba, Y. Y. Babanyara, K. G. Ilellah, M. A. Modibbo, T. O. Quddus, M. J. Sani

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After the United Nation Convention on Desertification (UNCD) in 1977 which was preceded by extensive, regional, and local studies, and consultations with numerous scientists, decision-makers, and relevant institutions. Global Plan of Action to Combat Desertification (PACD) was formulated, endorsed by member Countries. The role of implementing PACD was vested with Governments of countries affected by desertification. The Federal Government of Nigeria as a signatory and World Bank funded and implement afforestation project aimed at combating desertification between 1988 and 1999. This research, therefore, applied remote sensing techniques to assess the effectiveness of the project. To achieve that a small portion of about 143,609 hectares was curved out from the project area. Normalized Difference of the Vegetative Index (NDVI) and Land Use Land Cover were derived from Landsat TM 1986, Landsat ETM 1999 and Nigeria Sat 1, 2007 of the project area. The findings show that there was an increase in cultivated area due to the project from 1986 through 1999 and 2007. This is further buttressed by the three NDVI imageries due to their high positive pixel value from 0.04 in 1986 to 0.22 in 1999 and to 0.32 in 2007 These signifies the gradual physical development of Afforestation project in the area. In addition, it was also verified by histograms of changes in vegetation which indicated an increased vegetative cover from 60,192 in 1986, to 102,476 in 1999 and then to 88,343 in 2007. The study concluded that Remote Sensing approach has actually confirmed that the project was indeed successful and effective.

Keywords: afforestation, desertification, landsat, vegetative index, remote sensing

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Authors: Uche A. Nnawulezi

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Over the past decades, the acquisition and utilization of nuclear energy have remained a standout amongst the most intractable issues which past world leaders have unsuccessfully endeavored to grapple with. This study analyzes the present advancement and enactment on the acquisition and utilization of nuclear energy in contemporary international law. It seeks to address international co-operations in the field of nuclear energy by looking at what nuclear energy is all about and how it came into being. It also seeks to address concerns expressed by a few researchers on the position of nuclear law in the most extensive domain of the law by looking at the authoritative procedure for nuclear law, system of arrangements and traditions. This study also agrees in favour of treaty on non-proliferation of nuclear weapons based on human right and humanitarian principles that are not duly moral, but also legal ones. Specifically, the past development activities on nuclear weapon and the practical system of the nuclear energy institute will be inspected. The study noted among others, former president Obama's remark on nuclear energy and Pakistan nuclear policies and its attendant outcomes. Essentially, we depended on documentary evidence and henceforth scooped a great part of the data from secondary sources. The study emphatically advocates for the adoption of absolute liability principles and setting up of a viability trust fund, all of which will help in sustaining global peace where global best practices in acquisition and use of nuclear energy will be widely accepted in the contemporary international law. Essentially, the fundamental proposals made in this paper if completely adopted, might go far in fortifying the present advancement and enactment on the application and utilization of nuclear energy and accordingly, addressing a portion of the intractable issues under international law.

Keywords: nuclear energy, international law, acquisition, development

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Authors: Hesamaddin Khoshnoodi, Ahmad Rahbar Ranji

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Corrosion in steel structures is one of the most important issues that should be considered in designing and constructing. Corrosion reduces the cross section and load capacity of element and leads to costly damage of structures. In this paper, the corrosion has been modeled for moment stresses. Moreover, the steel beam has been modeled using ABAQUS advanced finite element software. The conclusions of this study demonstrated that the displacement of the analyzed composite steel girder bridge might increase.

Keywords: Abaqus, Corrosion, deformation, Steel Beam

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Authors: Fabio T. Costa, Sergio E. Moya, Marcelo H. Sousa

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Nanocomposites designed by embedding magnetic nanoparticles into a polymeric matrix stand out as ideal magnetic-hybrid and magneto-responsive materials as sorbents for removal of pollutants in environmental applications. Covalent coupling is often desired for the immobilization of species on these nanocomposites, in order to keep them permanently bounded, not desorbing or leaching over time. Moreover, unwanted adsorbates can be separated by successive washes/magnetic separations, and it is also possible to recover the adsorbate covalently bound to the nanocomposite surface through detaching/cleavage protocols. Thus, in this work, we describe the preparation and characterization of highly-magnetizable chloromethylated polystyrene-based nanocomposite beads for selective covalent coupling in environmental applications. For synthesis optimization, acid resistant core-shelled maghemite (γ-Fe₂O₃) nanoparticles were coated with oleate molecules and directly incorporated into the organic medium during a suspension polymerization process. Moreover, the cross-linking agent ethylene glycol dimethacrylate (EGDMA) was utilized for co-polymerization with the 4-vinyl benzyl chloride (VBC) to increase the resistance of microbeads against leaching. After characterizing samples with XRD, ICP-OES, TGA, optical, SEM and TEM microscopes, a magnetic composite consisting of ~500 nm-sized cross-linked polymeric microspheres embedding ~8 nm γ-Fe₂O₃ nanoparticles was verified. This nanocomposite showed large room temperature magnetization (~24 emu/g) due to the high content in maghemite (~45 wt%) and resistance against leaching even in acidic media. Moreover, the presence of superficial chloromethyl groups, probed by FTIR and XPS spectroscopies and confirmed by an amination test can selectively adsorb molecules through the covalent coupling and be used in molecular separations as shown for the selective removal of 4-aminobenzoic acid from a mixture with benzoic acid.

Keywords: nanocomposite, magnetic nanoparticle, covalent separation, pollutant removal

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Authors: Lucy Patricia Onundo, Wilfred Njoroge Mwema

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The tidal power potential available for electricity generation from Mombasa and Lamu sites in Kenya will be examined. Several African countries in the Western Indian Ocean endure insufficiencies in the power sector, including both generation and distribution. One important step towards increasing energy security and availability is to intensify the use of renewable energy sources. The access to cost-efficient hydropower is low in Mombasa and Lamu hence Ocean energy will play an important role. Global-Level resource assessments and oceanographic literature and data have been compiled in an analysis between technology-specific requirements for ocean energy technologies (salinity, tide, tidal current, wave, Ocean thermal energy conversion, wind and solar) and the physical resources in Lamu and Mombasa. The potential for tide and tidal current power is more restricted but may be of interest at some locations. The theoretical maximum power produced over a tidal cycle is determined by the product of the forcing tide and the undisturbed volumetric flow-rate. The extraction of the maximum power reduces the flow-rate, but a significant portion of the maximum power can be extracted with little change to the tidal dynamics. Two-dimensional finite-element, numerical simulations designed and developed agree with the theory. Temporal variations in resource intensity, as well as the differences between small-scale and large-scale applications, are considered.

Keywords: energy assessment, marine tidal power, renewable energy, tidal dynamics

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Authors: Mona Almanasef, Dalia Almaghaslah, Geetha Kandasamy, Rajalakshimi Vasudevan, Sadia Batool

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Background: Community pharmacists are one of the most accessible healthcare practitioners worldwide and their services are used by a large proportion of the population. Expanding the roles of community pharmacists could contribute to reducing pressure on general health practice and other areas of health services. This research aimed to evaluate the contribution of community pharmacists in the provision of public health services and to investigate the perceived barriers to the provision of these services in Saudi Arabia. Materials and Methods: This study followed a cross-sectional design using an online anonymous self-administered questionnaire. The study took place in the Asir region, Saudi Arabia, between September 2019 and February 2020. A convenience sampling strategy was used to select and recruit the study participants. The questionnaire was adapted from previous research and involved three sections: demographics, involvement in public health services and barriers to practicing public health roles. Results: The total number of respondents was 193. The proportion of respondents who reported that they were “very involved” or “involved” in each service was 61.7% for weight management, 60.6% for sexual health, 57.5% for healthy eating, 53.4% for physical activity promotion, 51.3% for dental health, 46.1% for smoking cessation, 39.4% for screening for diabetes, 35.7% for screening for hypertension, 31.1% for alcohol dependence and drug misuse counseling, 30.6% for screening for dyslipidaemia, and 21.8% for vaccination and immunization. Most of the barriers in the current research were rated as having low relevance to the provision of public health services. Conclusion: Findings in the current research suggest that community pharmacists in the Asir region have varying levels of involvement in public health roles. Further research needs to be undertaken to understand the barriers to the provision of public health services and what strategies would be beneficial for enhancing the public health role of community pharmacists in Saudi Arabia.

Keywords: community pharmacist, public health, Asir region, Saudi Arabia

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Authors: Mikiyas Adugna

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Effort estimation is among the activities carried out in software development processes. An accurate model of estimation leads to project success. The method of agile effort estimation is a complex task because of the dynamic nature of software development. Researchers are still conducting studies on agile effort estimation to enhance prediction accuracy. Due to these reasons, we investigated and proposed a model on LASSO and Elastic Net regression to enhance estimation accuracy. The proposed model has major components: preprocessing, train-test split, training with default parameters, and cross-validation. During the preprocessing phase, the entire dataset is normalized. After normalization, a train-test split is performed on the dataset, setting training at 80% and testing set to 20%. We chose two different phases for training the two algorithms (Elastic Net and LASSO) regression following the train-test-split. In the first phase, the two algorithms are trained using their default parameters and evaluated on the testing data. In the second phase, the grid search technique (the grid is used to search for tuning and select optimum parameters) and 5-fold cross-validation to get the final trained model. Finally, the final trained model is evaluated using the testing set. The experimental work is applied to the agile story point dataset of 21 software projects collected from six firms. The results show that both Elastic Net and LASSO regression outperformed the compared ones. Compared to the proposed algorithms, LASSO regression achieved better predictive performance and has acquired PRED (8%) and PRED (25%) results of 100.0, MMRE of 0.0491, MMER of 0.0551, MdMRE of 0.0593, MdMER of 0.063, and MSE of 0.0007. The result implies LASSO regression algorithm trained model is the most acceptable, and higher estimation performance exists in the literature.

Keywords: agile software development, effort estimation, elastic net regression, LASSO

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Authors: Isha Ranadive, Sonam Patel, Suresh Balakrishnan

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It has been observed that in lizards wound can be healed by either a scar free mechanism or by scarring. The animal model used to study both these healing processes was Northern House Gecko. In lizard, the tail when amputated heals by scar free mechanism which allows it to regenerate, the same is not seen when the limb is amputated. Proliferation, apoptosis, and angiogenesis are the main events which succeed an injury. We observed that proliferation of the cells beneath the wound epidermis was much higher in case of wound healing in tail. This could be because after the wound gets covered by the epithelium, it enters in to a cross-talk with the underlying mesenchyme to recruit a pool of blastemal cells which proliferate and later differentiate to form the lost part through epimorphic regeneration. This was substantiated by mRNA expression levels of various FGFs which facilitate the cross-talk and also by PCNA which is a marker for proliferation. Western blot result reaffirms the same notion. However, in case of the limb, the rate of apoptosis was more than proliferation as there are a lot of debris that needs to be removed. We came to this conclusion as we observed that p53 the apoptotic gene was highly upregulated in case of the scarred tissue. Further, we confirmed this result by checking the anti-apoptotic gene bcl2 and found it to be significantly down-regulated. As we noticed heightened proliferation in the case of scar-free wound healing in tail, angiogenesis was targeted for the study. This is because, when the cells are proliferating they require constant supply of blood and hence neo-vascularization is inevitable. It was observed that the marker of angiogenesis, VEGF, was expressed more during wound healing as compared to the resting stage of tail. Moreover, a high up-regulation was seen in KDR, a receptor of VEGF. Thus, this study reveals how proliferation, apoptosis, and angiogenesis play a key role in the scar-free as well as scarred wound healing.

Keywords: epimorphic regeneration, injury, northern house gecko, wound healing

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Authors: Christiana Frimpong, Mpundu Makasa, Lungowe Sitali, Charles Michelo

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Background: Toxoplasmosis is a neglected zoonotic disease which is prevalent among pregnant women especially in Africa. This study aimed to determine the seroprevalence and determinants of the disease among pregnant women attending the antenatal clinic at the University Teaching Hospital (UTH). Method: A cross-sectional study was employed where 411 pregnant women attending the antenatal clinic at UTH were interviewed using closed-ended questionnaires. Their blood was also tested for Toxoplasma gondii IgG and IgM antibodies using the OnSite Toxo IgG/IgM Combo Rapid Test cassettes by CTK Biotech, Inc, USA. Result: The overall seroprevalence of the infection (IgG) was 5.87%. There was no seropositive IgM result. Contact with cats showed 7.81 times the risk of contracting the infection in the pregnant women and being a farmer/being involved in construction work showed 15.5 times likelihood of contracting the infection. Socio-economic status of the pregnant women also presented an inverse relationship (showed association) with the infection graphically. However, though there were indications of the association between contact with cats, employment type as well as the socioeconomic status of the pregnant women with the infection, there was not enough evidence to suggest these factors as significant determining factors of Toxoplasma gondii infection in our study population. Conclusion: There is a low prevalence of Toxoplasma gondii infection among pregnant women in Lusaka, Zambia. Screening for the infection among pregnant women can be done once or twice during pregnancy to help protect both mother and child from the disease. Health promotion among women of child bearing age on the subject is of immense importance in order to help curb the situation. Further studies especially that of case-control and cohort studies should be carried out in the country in order to better ascertain the extent of the condition nationwide.

Keywords: determinants, pregnant women, seroprevalence, toxoplasmosis, University Teaching Hospital (UTH), Zambia

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Authors: Michelle Hartanto, Risheka Suthantirakumar

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Introduction Staff redeployment, increased numbers of acutely unwell patients requiring resuscitation decision-making conversations, visiting restrictions, and varying guidance regarding resuscitation for patients with COVID-19 disrupted clinicians’ management of resuscitation and escalation decision-making processes. While it was generally accepted that the COVID-19 pandemic disturbed numerous aspects of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process in the United Kingdom, a process which establishes a patient’s CPR status and treatment escalation plans, the impact of the pandemic on clinicians’ attitudes towards these resuscitation and decision-making conversations was unknown. This was the first study to examine the impact of the COVID-19 pandemic on clinicians’ knowledge, skills, and attitudes towards the ReSPECT process. Methods A cross-sectional survey of clinicians at one acute teaching hospital in the UK was conducted. A questionnaire with a defined five-point Likert scale was distributed and clinicians were asked to recall their pre-pandemic views on ReSPECT and report their current views at the time of survey distribution (May 2020, end of the first COVID-19 wave in the UK). Responses were received from 171 clinicians, and self-reported views before and during the pandemic were compared. Results Clinicians reported they found managing ReSPECT conversations more challenging during the pandemic, especially when conducted over the telephone with relatives, and they experienced an increase in negative emotions before, during, and after conducting ReSPECT conversations. Our findings identified that due to the pandemic there was now a need for clinicians to receive training and support in conducting resuscitation and escalation decision-making conversations over the telephone with relatives and managing these processes.

Keywords: cardiopulmonary resuscitation, COVID-19 pandemic, DNACPR discussion, education, recommended summary plan for emergency care and treatment, resuscitation order

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Authors: Ryo Shikimoto, Hidehito Niimura, Hisashi Kida, Kota Suzuki, Yukiko Miyasaka, Masaru Mimura

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Introduction: In Japan, the most aged country in the world, it is important to explore predictive factors of cognitive function among the elderly. Coping behavior relieves chronic stress and improves lifestyle, and consequently may reduce the risk of cognitive impairment. One of the most widely investigated frameworks evaluated in previous studies is approach-oriented and avoidance-oriented coping strategies. The purpose of this study is to investigate the relationship between cognitive function and coping strategies among elderly residents in urban areas of Japan. Method: This is a part of the cross-sectional Arakawa geriatric cohort study for 1,099 residents (aged 65 to 86 years; mean [SD] = 72.9 [5.2]). Participants were assessed for cognitive function using the Mini-Mental State Examination (MMSE) and diagnosed by psychiatrists in face-to-face interviews. They were then investigated for their each coping behaviors and coping strategies (approach- and avoidance-oriented coping) using stress and coping inventory. A multiple regression analysis was used to investigate the relationship between MMSE score and each coping strategy. Results: Of the 1,099 patients, the mean MMSE score of the study participants was 27.2 (SD = 2.7), and the numbers of the diagnosis of normal, mild cognitive impairment (MCI), and dementia were 815 (74.2%), 248 (22.6%), and 14 (1.3%), respectively. Approach-oriented coping score was significantly associated with MMSE score (B [partial regression coefficient] = 0.12, 95% confidence interval = 0.05 to 0.19) after adjusting for confounding factors including age, sex, and education. Avoidance-oriented coping did not show a significant association with MMSE score (B [partial regression coefficient] = -0.02, 95% confidence interval = -0.09 to 0.06). Conclusion: Approach-oriented coping was clearly associated with neurocognitive function in the Japanese population. A future longitudinal trial is warranted to investigate the protective effects of coping behavior on cognitive function.

Keywords: approach-oriented coping, cognitive impairment, coping behavior, dementia

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Authors: Goitom Molalign Takele, Tsegalem Hailemariam Ballo, Kiros Belay Gebrekidan, Birhan Gebresilassie Gebregiorgis

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Background: Emergency medical services (EMS) are services that provide out-of-hospital emergency medical care to injured or ill peoples, and transporting to definitive care. EMS is an integral part of the emergency medical system and has been associated with decreased morbidity and mortality related to emergency cases. The aim of this study was to assess the utilization, barriers, and determinants of EMS in Mekelle, Ethiopia. Methods: A community-based cross-sectional study was conducted in selected sub-cities of Mekelle. A multistage sampling method was employed to recruit study participants, and data were collected by trained data collectors using an interviewer-administered questionnaire. Multivariate logistic regression analysis was used to examine the statistical association of the determinants of EMS utilization. Results: Half (50.5%) of the respondents had experienced or witnessed an emergency incident in the past year. The common means of transportations used were Bajaj’s (39.2%) and ambulances (22.7%). Majority (88.1%) of the respondents did not knew the EMS access phone number of an ambulance. As their preferred mode of transportation in case of emergency conditions, 42.2% of the participants reported an ambulance, followed by Bajaj 33.7%. Where participants who had gynecologic emergencies were 9.4 times (AOR=9.4, 95% CI: 1.04, 85, p=0.046), and those who knew any ambulance numbers were 3.6 times (AOR=3.6, 95% CI: 1.22, 10.8, p=0.02) more likely to use ambulance services in case of emergencies. Conclusion: The ambulance utilization level in Mekelle city was low and victims of emergency conditions were being transported mainly using public transports such as Bajaj’s and taxis. Even though the perception of the public towards EMS services is favorable, lack of awareness of EMS access, and lack of integrated EMS system in the city are the barriers that may have contributed to the low utilization. Actions to improve EMS access and integrating the system are warranted to promote the services utilization.

Keywords: emergency medical services, utilization, Mekelle, barriers

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Authors: S. Zith Dey Babu, S. Kour, S. Verma, C. Verma, V. Pathania, A. Agrawal, V. Chaudhary, A. Manoj Puthur, R. Goyal, A. Pal, T. Danti Dey, A. Kumar, K. Wadhwa, O. Ved

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Background: Skin cancer is now is the buzzing button in the field of medical science. The cyst's pandemic is drastically calibrating the body and well-being of the global village. Methods: The extracted image of the skin tumor cannot be used in one way for diagnosis. The stored image contains anarchies like the center. This approach will locate the forepart of an extracted appearance of skin. Partitioning image models has been presented to sort out the disturbance in the picture. Results: After completing partitioning, feature extraction has been formed by using genetic algorithm and finally, classification can be performed between the trained and test data to evaluate a large scale of an image that helps the doctors for the right prediction. To bring the improvisation of the existing system, we have set our objectives with an analysis. The efficiency of the natural selection process and the enriching histogram is essential in that respect. To reduce the false-positive rate or output, GA is performed with its accuracy. Conclusions: The objective of this task is to bring improvisation of effectiveness. GA is accomplishing its task with perfection to bring down the invalid-positive rate or outcome. The paper's mergeable portion conflicts with the composition of deep learning and medical image processing, which provides superior accuracy. Proportional types of handling create the reusability without any errors.

Keywords: computer-aided system, detection, image segmentation, morphology

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Authors: Ioana Dallinger, Vincent P. Magnini

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Due to the many moving parts and high human component, mistakes and failures sometimes occur during transactions in service environments. Because a certain portion of such failures is unavoidable, many service providers constantly look for guidance regarding optimal ways by which they should manage failures and recoveries. Through the use of a scenario-based experiment, the findings of this study run counter to the empowerment approach (i.e. that frontline employees should be empowered to resolve failure situations on their own doing). Specifically, this study finds that customers’ perceptions of distributive, procedural, and interactional justice are significantly higher [p-values < .05] when a manager delivers an apology as opposed to the frontline provider. Moreover, customers’ satisfaction with the recovery and commitment to the firm are also significantly stronger [p-values < .05] when a manager apologizes. Interestingly, this study also empirically tests the effects of combined apologies of both the manager and employee and finds that the combined approach yields better results for customers’ interactional justice perceptions and for their satisfaction with recovery, but not for their distributive or procedural justice perceptions or consequent commitment to the firm. This study can serve a springboard for further research. For example, perceptions and attitudes regarding employee empowerment vary based upon country culture. Furthermore, there are likely a number of factors that can moderate the cause and effect relationship between a failure recovery and customers’ post-recovery perceptions [e.g. the severity of the failure].

Keywords: apology, empowerment, service failure recovery, service recovery

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Authors: Pedro Ferraz-Gameiro

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Introduction: The Pellegrini-Stieda lesion is the result of post-traumatic calcification and/or ossification on the medial collateral ligament (MCL) of the knee. When this calcification is accompanied by gonalgia and limitation of knee flexion, it is called Pellegrini-Stieda syndrome. The pathogenesis is probably the calcification of a post-traumatic hematoma at least three weeks after the initial trauma or secondary to repetitive microtrauma. On anteroposterior radiographs, a Pellegrini-Stieda lesion is a linear vertical ossification or calcification of the proximal portion of the MCL and usually near the medial femoral condyle. Patients with Pellegrini-Stieda syndrome present knee pain associated with loss of range of motion. The treatment is usually conservative with analgesic and anti-inflammatory drugs, either systemic or intra-articular. Physical medicine and rehabilitation techniques associated with shock wave therapy can be a way of reduction of pain/inflammation. Patients who maintain instability with significant limitation of knee mobility may require surgical excision. Methods: Research was done using PubMed central using the terms Pellegrini-Stieda syndrome. Discussion/conclusion: Medical treatment is the rule, with initial rest, anti-inflammatory, and physiotherapy. If left untreated, this ossification can potentially form a significant bone mass, which can compromise the range of motion of the knee. Physical medicine and rehabilitation techniques associated with shock wave therapy are a way of reduction of pain/inflammation.

Keywords: knee, Pellegrini-Stieda syndrome, rehabilitation, shock waves therapy

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Authors: Matthew B. Davis, Amit Kumar

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With potentially dangerous impacts of climate change on the horizon, Canada has an opportunity to take a lead role on the international stage to demonstrate how energy use intensity and greenhouse gas emission intensity may be effectively reduced. Through bottom-up modelling of Canada’s energy sector using Long-range Energy Alternative Planning (LEAP) software, it can be determined where efforts should to be concentrated to produce the most positive energy management results. By analyzing a provincially integrated Canada, one can develop strategies to minimize the country’s economic downfall while transitioning to lower-emission energy technologies. Canada’s electricity sector plays an important role in accommodating these transitionary technologies as fossil-fuel based power production is prevalent in many parts of the country and is responsible for a large portion (17%) of Canada’s greenhouse gas emissions. Current findings incorporate an in-depth model of Canada’s current energy supply and demand sectors, as well as a business-as-usual scenario up to the year 2035. This allows for in-depth analysis of energy flow from resource potential, to extraction, to fuel and electricity production, to energy end use and emissions in Canada’s residential, transportation, commercial, institutional, industrial, and agricultural sectors. Bottom-up modelling techniques such as these are useful to critically analyze and compare the various possible scenarios of implementing sustainable energy measures. This work can aid government in creating effective energy and environmental policies, as well as guide industry to what technology or process changes would be most worthwhile to pursue.

Keywords: energy management, LEAP, energy end-use, GHG emissions

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Authors: Khalid Abdelghany

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Additive Manufacturing (AM) is the manufacturing technology that is used to fabricate fast products direct from CAD models in very short time and with minimum operation steps. Jointly with the advancement in medical computer modeling, AM proved to be a very efficient tool to help physicians, orthopedic surgeons and dentists design and fabricate patient-tailored surgical guides, templates and customized implants from the patient’s CT / MRI images. AM jointly with computer-assisted designing/computer-assisted manufacturing (CAD/CAM) technology have enabled medical practitioners to tailor physical models in a patient-and purpose-specific fashion and helped to design and manufacture of templates, appliances and devices with a high range of accuracy using biocompatible materials. In developing countries, there are some technical and financial limitations of implementing such advanced tools as an essential portion of medical applications. CMRDI institute in Egypt has been working in the field of Medical Additive Manufacturing since 2003 and has assisted in the recovery of hundreds of poor patients using these advanced tools. This paper focuses on the surgical and dental use of 3D printing technology in Egypt as a developing country. The presented case studies have been designed and processed using the software tools and additive manufacturing machines in CMRDI through cooperative engineering and medical works. Results showed that the implementation of the additive manufacturing tools in developed countries is successful and could be economical comparing to long treatment plans.

Keywords: additive manufacturing, dental and orthopeadic stents, patient specific surgical tools, titanium implants

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Authors: Meenakshi Chaubey

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A principle proposed in the cross-cultural adaption of behavior among Indian and Tibetan societies in which there are not any great variations between their young adults on the mindset of day-to-day marriage, Marriage plays a dominant position in constructing the society, which in large part comprises underneath the domain of lifestyle. Way of life is a social behavior and norm located in human societies where an extensive range of phenomena can be transmitted thru social studying. It acts characteristic of the individual has been the diploma day-to-day which they have got cultivated a specific stage of class in arts, science, architecture. The existing studies preliminarily on young adults of each community, wherein we carried out a comparative observe of the mindset of daily marriage among Indian and Tibetan teens. Further, we studied statistics comprehensively on the mindset closer day by day the marriage between Indian adult males and Tibetan younger males. With the extension of a complete look, we considered the mindset of an everyday marriage of Indian girls and Tibetan young ladies. Studies 1 showed that there might be no sizable distinction within the attitude of the day-to-day marriage of Indian and Tibetan teenagers. It, in addition, showed that they followed each different marriage beliefs and customs. Studies 2 showed that there might be no important difference in the attitude toward the everyday marriage of Indian and Tibetan young males. It similarly showcased that day-to-day secular schooling gadget in Tibetan society complements their clinical approach and changes their point of view on distinct social issues along with marriage. Research three confirmed that there is no substantial difference in the mindset of the daily marriage of Indian and Tibetan younger females. It similarly spread out the strict authorities' recommendations that they may no longer be allowed day-to-day comply with their marriage practices, including polygamy and polyandry. Thus, the information showed that there's a shift of lifestyle from one network every day to some other community because of social every day, which affects the conduct and results of daily past cultural adaptation.

Keywords: culture, marriage, attitude, society, young adults, Indian, Tibetan

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Authors: Matthew Venunye Fianu, Jerry Fiave, Ebenezer Kye-Mensah, Dacosta Aboagye, Felix Osei-Sarpong

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Introduction: Road traffic accidents involving motorbikes are a priority public health concern in Ghana. While there are local initiatives to address this public health challenge, little is known about motor riders’ knowledge and compliance with road safety regulations (RSR) and their association with RTAs. The aim of this study was, therefore, to assess motorbike riders’ knowledge and compliance with RSRs. Methodology: Motorbike riders in Hohoe Municipality were randomly sampled in a cross-sectional study in June 2022. Data were collected from 237 riders using a questionnaire designed in Kobocollect and administered by ten research assistants. A score of 70% or less is considered low for knowledge and compliance. The data were exported into Excel and imported into STATA 17 for analysis. A chi-square test was performed to generate descriptive and inferential statistics to establish the association between independent and dependent variables. Results: All 237 respondents were male, and each of them completed the questionnaire representing a 100% response rate. Participants who had knowledge about speed limit at different segments of the road were 59(24.9%), the use of helmet were 124 (52.3%), and alcohol use were 152 (64.1%). Participants who complied with regulations on speed limits, helmet use, and alcohol use were 108 (45.6%), 179(75.5%), and 168(70.8%), respectively. Riders who had at least junior high school education were 2.43 times more likely to adhere to RSR [cOR =2.43(95%CI= 1.15-6.33) p= 0.023] than those who had less education. Similarly, riders who had high knowledge about RSR were 2.07 times more likely to comply with RSR than those who had less knowledge [AOR= -2.07 (95% CI= 0.34-0.97), p=0.038]. Conclusion: Motor riders in the Hohoe Municipality had low knowledge as well as low compliance with road safety regulations. This could be a contributor to road traffic accidents. It is therefore recommended that road safety regulatory authorities and relevant stakeholders enhance the enforcement of RSR. There should also be country-specific efforts to increase awareness among all motor riders, especially those with less than junior high school education.

Keywords: compliance, motor riders, road safety regulations, road traffic accident

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Authors: Ahmadreza Ebadati, Asaad Y. Shamseldin, Amin Ghadirian

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Seawall geometry plays a crucial role in mitigating wave impacts, though detailed exploration of its manipulation is limited. This study delves into the effects of varying cross-shore seawall geometry on the dynamics of wave impacts, with a particular focus on vertical seawalls. Inspired by foundational insights linking seawall shape to hydraulic efficiency, this investigation centres on how alterations in seawall geometry can influence wave energy dissipation and subsequent wave impacts. The study investigates the 2D interaction of regular waves with a period of 2.1s with a vertical seawall and berm featuring small-scale cross-shore protrusions and recesses. Utilising OpenFOAM® simulations and a k-ω SST turbulence model, this investigation compares results to a base case simulation, which is partially calibrated with experimental data from a flume study. The analysis evaluates various geometric modifications, specifically interchanged protrusions and recesses at different heights and orientations along the seawall. Findings suggest that specific configurations, such as interchanged protrusions and recesses, can mitigate initial impact forces, while certain arrangements may intensify subsequent impacts. Key insights include the identification of geometry configurations that can effectively reduce the force impulse of slamming waves on coastal structures and potentially decrease the frequency and cost of seawall maintenance. This research contributes to the field by advancing the understanding of how seawall geometry influences wave forces and by providing actionable insights for the design of more resilient seawall structures. Further exploration of seawall geometry variation is recommended, advocating additional case studies to optimise designs tailored to specific coastal environments.

Keywords: seawall geometry, wave impact loads, numerical simulation, coastal engineering, wave-structure interaction

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Authors: Policarpio Jr. Joves

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Physicians in most teaching hospitals are commonly promoted into managerial roles, yet their training is mostly in clinical and scientific skills but not in leadership competencies. When they shift into roles of physician leadership, the majority hold on to their primary identity of physicians. These conflicting roles affect their identity and eventually their work. The physician leaders also face additional challenges related to academics which include incorporation of new knowledge into the existing curriculum, use of technology in the delivery of teaching, the need to train medical students outside of hospital wards, etc. The study aims to explore how physician leaders in teaching hospitals of private medical schools enact their leadership roles and how they face the challenges as physician leaders. The study setting shall be teaching hospitals of three private medical schools situated in the National Capital Region, Philippines. A multiple case study design shall be adopted in this research. Physicians shall be eligible to participate in the study if they are practicing clinicians limited to the five major clinical specialty: Internal Medicine, Pediatrics, Family Medicine, Surgery, Obstetrics and Gynecology. They must be teaching in the College of Medicine prior to their appointments as physician leaders in both medical school and teaching hospital. Semi-structured face-to-face interviews shall be utilized as a means of data collection, with open-ended questions, enabling physician leaders to present narratives about their identity, role enactment, conflicts, reaction of colleagues, and the challenges encountered in their day-to-day work as physician leaders. Interviews shall be combined with observations and review of records to gain more insights into how the physician leaders are 'doing' management. Within-case analysis shall be done initially followed by a thematic analysis across the cases, referred to as cross–case analysis or cross-case synthesis.

Keywords: academic leaders, academic managers, physician leaders, physician managers

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Authors: Terkimbi Vange, Obed Abimiku, Lateef Lekan Bello, Lucky Omoigui

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In 2014 and 2015, eight maize inbred lines resistant to Striga hermonthica (Del) Benth were crossed in 8 x 8 half diallel (Griffing method 11, model 1). The eight parent inbred lines were planted out in a Randomized Complete Block Design (RCBD) with three replications at two different Striga infested environments (Lafia and Makurdi) during the late cropping season. The objectives were to determine the combining ability of Striga resistant maize inbred lines and identify suitable inbreds for hybrids development. The lines were used to estimate general combining ability (GCA), and specific combining ability (SCA) effects for Striga related parameters such as Striga shoot counts, Striga damage rating (SDR), plant height and grain yield and other agronomic traits. The result of combined ANOVA revealed that mean squares were highly significant for all traits except Striga damage rating (SDR1) at 8WAS and Striga emergence count (STECOI) at 8WAS. Mean squares for SCA were significantly low for all traits. TZSTR190 was the highest yielding parent, and TZSTR166xTZST190 was the highest yielding hybrid (cross). Parent TZSTR166, TZEI188, TZSTR190 and TZSTR193 shows significant (p < 0.05) positive GCA effects for grain yield while the rest had negative GCA effects for grain yield. Parent TZSTR166, TZEI188, TZSTR190, and TZSTR193 could be used for initiating hybrid development. Also, TZSTR166xTZSTR190 cross was the best specific combiner followed by TZEI188xTZSTR193, TZEI80xTZSTR193, and TZSTR190xTZSTR193. TZSTR166xTZSTR190 and TZSTR190xTZSTR193 had the highest SCA effects. However, TZEI80 and TZSTR190 manifested a high positive SCA effect with TZSTR166 indicating that these two inbreds combined better with TZSTR166.

Keywords: combining ability, Striga hermonthica, resistance, grain yield

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Authors: Gbone Akou Sophie

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Lome state in Togo is considered to have the highest HIV prevalence in Togo according to NAIIS 2023, with the prevalence of 5.5%, Female Sex Workers (FSW) are one of the most vulnerable population, and they are vital in HIV programming. They have the highest HIV prevalence compared to others such as HRM, PWID and Transgender in lome State, Togo. Evidence from Integrated Biological Behavioral Surveillance Survey shows increasing burden of HIV infection from 13.7% in 20018 to 17.2% in 2020 and now 22.9% in 2021 among Female Sex Workers (FSW). This shows their HIV prevalence has been rising over time. The vulnerability status of the FSW in the riverine areas of lome is heightened because of cultural and economic issues where there is exchange of sex for commodities with cross border traders as well as limited access to HIV prevention information. Methods:A cross sectional study which recruited 120 FSW from two Riverine LGAs of Agoe and Kpehenou LGA of Lome State using both snowballing and simple random sampling technique. While semi-structured questionnaire was used as an instrument for data collection among the 120 FSW respondents. Additional information was also elicited from 10 FSW key opinion leaders and community members through in-depth interviews (IDI). Results: 44(36%) of respondents were willing to receive regular HIV care and services as well as visit for STI check-ups at any service point. However, 47(40%) were willing to receive services at private facilities alone, 10 (8%) were willing to receive services at public facilities, 6 (5%) were willing to access services in their homes rather than in the health facility. 13 (11%) were also willing to have peers assist in getting HIV testing services. Conclusion: integrated differentiated model of care for HIV services helps improve HIV services uptake among FSW community especially in the hard- to reach riverine areas which will further lead to epidemic control. Also targeted HIV information should be designed to suit the learning needs of the hard-to reach communities like the riverine areas. More peer educators should be engaged to ensure information and other HIV services reach the riverine communities.

Keywords: female sex workers ( FSW), human immuno-deficiency virus(HIV), prevanlence, service delivery

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Authors: Shima Naderi, Abbas Abbaszadeh Shahri

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Energy resources are reachable and affordable in Iran, thus surplus access to fossil fuels besides high level of economic growth leads to serious environmental critical such as pollutants and greenhouse gases in the atmosphere, increase in average degrease and lack of water sources specially in Tehran as a capital city of Iran. As building sector consumes a huge portion of energy, taking actions towards alternative sources of energy as well as conserving non-renewable energy resources and architectural energy saving methods are the fundamental basis for achieving sustainability`s goals. This study tries to explore implantation of both high technologies and traditional issues for reduction of energy demands in buildings of Tehran and introduce some factors and instructions for achieving this purpose. Green and energy efficient buildings such as ZEBs make it possible to preserve natural resources for the next generations by reducing pollution and increasing ecosystem self-recovery. However ZEB is not widely spread in Iran because of its low economic efficiency, it is not viable for a private entrepreneur without the governmental supports. Therefore executing of Architectural Energy Efficiency can be a better option. It is necessary to experience a substructure expansion with respect to traditional residential building style. Renewable energies and passive design which are the substantial part of the history of architecture in Iran can be regenerated and employed as an essential part of designing energy efficient buildings.

Keywords: architectural energy efficiency, passive design, renewable energies, zero energy buildings

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Authors: Windy Rakhmawati, Suryani Suryani, Sri Hendrawati, Nenden Nur Asriyani Maryam

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Tuberculosis (TB) is one of the leading causes of death in the world. Fear of COVID-19 has made people reluctant to visit health facilities, leading to disruptions to childhood TB control programs, which may increase household transmission and delay diagnosis and treatment. This study aimed to describe parents' knowledge, attitudes, and health-seeking behaviour towards childhood TB during the COVID-19 pandemic. This cross-sectional study was performed on 392 parents with TB children in three provinces with the highest proportion of TB cases in Indonesia. This study was conducted from February to December 2022. The inclusion criteria of respondents were parents with a child aged 0-14 years old with TB diagnosis who live with their parents. Data were collected using the Knowledge, Attitude, and Practice (KAP) survey guidelines from the World Health Organization and analyzed descriptively, as well as Spearman’s correlation. Overall, 392 parents of children with TB had poor knowledge (51.8%) including about causes, risk factors, transmission, symptoms, treatment, and prevention, which about 52.3%, 55.1%, 61.2%, 69.6%, 100%, 59.2%, respectively. Parents' health service-seeking behaviour towards Child TB was not normally distributed (P < 0.05) with knowledge test results (.000) and Seeking Health Services (.000). Health-seeking behaviour of parents in pediatric TB care was self-medication or self-treatment (86.2%), Traditional health seeking behaviour (4.8%), and modern health seeking behaviour (8.9%). The correlation between knowledge and seeking health services (Sig= .609) means there is no correlation between knowledge about TB and parents' health-seeking behaviour. Furthermore, 60.2% of the respondents would be shocked if their child had TB. More than half of the families in this study have poor knowledge and did self-medication or self-treatment regarding health-seeking behaviour for TB disease. Therefore, health workers, especially nurses, must provide TB-related education and health promotion and emphasize the importance of early detection. Health workers can also optimize their role in caring for and providing care to patients by increasing their trust in health workers, which will impact health-seeking behaviour in the future.

Keywords: attitude, child, health seeking behaviour, knowledge, tuberculosis

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Authors: Ali Akbar Jabbari

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The present study assessed the acquisition of L3 French direct objects by Persian speakers who had already learned English as their L2. The ultimate goal of this paper is to extend the current knowledge about the CLI phenomenon in the realm of third language acquisition by examining the role of Persian and English as background languages and learners’ English level of proficiency in their performance on French direct object. To fulfill this, the assumptions of three L3 hypotheses, namely L1 Transfer, L2 Status Factor, and Cumulative Enhancement Model, were examined. The research sample was comprised of 40 undergraduate students in the fields of English language and literature and translation studies at Birjand University in Iran. According to the English proficiency level of learners revealed by the Quick Oxford English Placement test, the participants were grouped as upper intermediate and lower intermediate. A grammaticality judgment and a translation test were administered to gather the required data on learners' comprehension and production of the desired structure in French. It was demonstrated that the rate of positive transfer from previously learned languages was more potent than the rate of negative transfer. A Comparison of groups' performances revealed a significant difference between upper and lower intermediate groups in positing French direct objects correctly. However, the upper intermediate group did not significantly differ from the lower intermediate group in negative transfer. It can be said that by increasing the L2 proficiency of the learners, they could use their previous linguistic knowledge more efficiently. Although further examinations are needed, the current study contributed to a better characterization of cross-linguistic influence in third language acquisition. The findings help French teachers and learners to positively exploit the prior knowledge of Persian and English and apply it in in the multilingual context of French direct object's teaching and learning process.

Keywords: Cross-Linguistic Influence, Persian, French & English Direct Object, Third Language Acquisition, Language Transfer

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Authors: Jing Li Hong

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This study compared Michel Foucault’s thoughts and the Chan School’s thoughts on the idea of healing. Healing is not an unfamiliar idea in Buddhist thoughts. The paired concepts of illness and medicine are often used as a metaphor to describe the relationship between people and truth. Foucault investigated the topic of care of self in his later studies and dedicated a large portion of his final semester course at the Collège de France in 1984 to discuss the meaning of Socrates’s offering of a sacrifice to the god of medicine in Phaedo. Foucault indicated a key preposition in ancient philosophy, namely healing. His idea of healing also addressed the relationship between subject and truth. From this relationship, Foucault unraveled his novel study on truth, namely the technologies of the self, with an emphasis on the care of self. Whereas numerous philosophers ask obvious questions such as ‘what is truth’ and ‘how to learn about truth,’ Foucault proposed distinct questions such as ‘what is our relationship to truth’ and ‘how does our relationship with truth turn us into who we are now?’ Thus, healing in both Buddhist and Foucault’s thoughts is related to the relationship between being and truth. This study first reviews Buddhist and Foucault’s ideas of healing to explicate what is illness and what is medicine. Because Buddhist thoughts cover an extensive scope, this study focuses on the thoughts of the Chan School. The second part is a discussion on medicine (treatment), specifically what is used as the medicine for the illness in both thoughts, and how can this medicine treat the illness. This part includes a description and comparison of the use of concepts of negation in these two thought groups. Finally, the subjects that practice the technologies of the self in both groups are compared from the idea of care of self; in other words, the differences between the subjects formed by the different relationships between being and truth are analyzed.

Keywords: Chan, heterogeneous, living style, language of paradox, Michel Foucault, negation, parrhesia, the care of self

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