Search results for: normal walking
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3123

Search results for: normal walking

2043 Lack of Physical Activity In Schools: Study Carried Out on School-aged Adolescents

Authors: Bencharif Meriem, Sersar Ibrahim, Djaafri Zineb

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Introduction and purpose of the study: Education plays a fundamental role in the lives of young people, but what about their physical well-being as they spend long hours sitting at school? School inactivity is a problem that deserves particular attention because it can have significant repercussions on the health and development of students. The aim of this study was to describe and evaluate the physical activity of students in different practices in class, at recess and in the canteen. Material and methods: A physical activity diary and an anthropometric measurement sheet (weight, height) were provided to 123 school-aged adolescents. The measurements were carried out according to international recommendations. The statistical tests were carried out with the R software. 3.2.4. The significance threshold retained was 0.05. Results and Statistical Analysis: One hundred and twenty-three students agreed to participate in the study. Their average age was 16.5±1.60 years. Overweight was present in 8.13% and obesity in 4.06%. For the practice of physical activity, during physical education and sports classes, all students played sports with an average of 1.94±1.00 hours/week, of which 74.00% sweated or were out of breath during these hours of physical activity. It was also noted that boys practiced sports more than girls (p<0.0001). Each day, on average, students spent 39.78±37.85 min walking or running during recess. On the other hand, they spent, on average 4.25±2.65 hours sitting per day in class, at recess, in the canteen, etc., without counting the time spent in front of a screen. The increasing use of screens has become a major concern for parents and educators. On average, students spent approximately 42.90±38.41 min per day using screens in class, at recess, in the canteen and at home. (computer, tablet, telephone, video games, etc.) and therefore to a prolonged sedentary lifestyle. On average, students sat for more than 1.5 hours without moving for at least 2 minutes in a row approximately 1.72±0.71 times per day. Conclusion: These students spent many hours sitting at school. This prolonged inactivity can have negative consequences on their health, including problems with posture and cardiovascular health. It is crucial that schools, educators and parents collaborate to promote more active learning environments where students can move more and thus contribute to their overall well-being. It's time to rethink how we approach education and student health to give them a healthier, more active future.

Keywords: physical acivity, sedentarity, adolescents, school

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2042 The Market Structure Simulation of Heterogenous Firms

Authors: Arunas Burinskas, Manuela Tvaronavičienė

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Although the new trade theories, unlike the theories of an industrial organisation, see the structure of the market and competition between enterprises through their heterogeneity according to various parameters, they do not pay any particular attention to the analysis of the market structure and its development. In this article, although we relied mainly on models developed by the scholars of new trade theory, we proposed a different approach. In our simulation model, we model market demand according to normal distribution function, while on the supply side (as it is in the new trade theory models), productivity is modeled with the Pareto distribution function. The results of the simulation show that companies with higher productivity (lower marginal costs) do not pass on all the benefits of such economies to buyers. However, even with higher marginal costs, firms can choose to offer higher value-added goods to stay in the market. In general, the structure of the market is formed quickly enough and depends on the skills available to firms.

Keywords: market, structure, simulation, heterogenous firms

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2041 A Smartphone-Based Real-Time Activity Recognition and Fall Detection System

Authors: Manutchanok Jongprasithporn, Rawiphorn Srivilai, Paweena Pongsopha

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Fall is the most serious accident leading to increased unintentional injuries and mortality. Falls are not only the cause of suffering and functional impairments to the individuals, but also the cause of increasing medical cost and days away from work. The early detection of falls could be an advantage to reduce fall-related injuries and consequences of falls. Smartphones, embedded accelerometer, have become a common device in everyday life due to decreasing technology cost. This paper explores a physical activity monitoring and fall detection application in smartphones which is a non-invasive biomedical device to determine physical activities and fall event. The combination of application and sensors could perform as a biomedical sensor to monitor physical activities and recognize a fall. We have chosen Android-based smartphone in this study since android operating system is an open-source and no cost. Moreover, android phone users become a majority of Thai’s smartphone users. We developed Thai 3 Axis (TH3AX) as a physical activities and fall detection application which included command, manual, results in Thai language. The smartphone was attached to right hip of 10 young, healthy adult subjects (5 males, 5 females; aged< 35y) to collect accelerometer and gyroscope data during performing physical activities (e.g., walking, running, sitting, and lying down) and falling to determine threshold for each activity. Dependent variables are including accelerometer data (acceleration, peak acceleration, average resultant acceleration, and time between peak acceleration). A repeated measures ANOVA was performed to test whether there are any differences between DVs’ means. Statistical analyses were considered significant at p<0.05. After finding threshold, the results were used as training data for a predictive model of activity recognition. In the future, accuracies of activity recognition will be performed to assess the overall performance of the classifier. Moreover, to help improve the quality of life, our system will be implemented with patients and elderly people who need intensive care in hospitals and nursing homes in Thailand.

Keywords: activity recognition, accelerometer, fall, gyroscope, smartphone

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2040 Impacts of International Training Program in Pedagogy in Higher Education in the United States on Visiting Scholars in China

Authors: Yuliang Liu, Thomas Lavallee, Mary Weishaar, Gretchen Fricke, Huaibo Xin

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The longitudinal study was designed to investigate the impacts of the International Training Program in Pedagogy (ITPP) at a midwestern institution in the United States on the visiting scholars from China from 2012-18. The study used the survey research method and involved 48 visiting scholars from Northwest Normal University in China in those eight ITPP cohorts. The results of both quantitative and qualitative data were critically examined and indicated both types of data sources revealed similar findings. It was found that the ITPP has significantly affected all scholars' instruction in China. International implications resulted from the study.

Keywords: international training program in pedagogy, visiting scholars, survey research method, International implications

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2039 Walking in a Weather rather than a Climate: Critique on the Meta-Narrative of Buddhism in Early India

Authors: Yongjun Kim

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Since the agreement on the historicity of historical Buddha in eastern India, the beginning, heyday and decline of Buddhism in Early India have been discussed in urbanization, commercialism and state formation context, in short, Weberian socio-politico frame. Recent Scholarship, notably in archaeology and anthropology, has proposed ‘re-materialization of Buddhism in Early India’ based on what Buddhist had actually done rather than what they should do according to canonical teachings or philosophies. But its historical narrations still remain with a domain of socio-politico meta-narrative which tends to unjustifiably dismiss the naturally existing heterogeneity and often chaotic dynamic of diverse agencies, landscape perceptions, localized traditions, etc. An author will argue the multiplicity of theoretical standpoints for the reconstruction on the Buddhism in Early India. For this, at first, the diverse agencies, localized traditions, landscape patterns of Buddhist communities and monasteries in Trans-Himalayan regions; focusing Zanskar Valley and Spiti Valley in India will be illustrated based on an author’s field work. And then an author will discuss this anthropological landscape analysis is better appropriated with textual and archaeological evidences on the tension between urban monastic and forest Buddhism, the phenomena of sacred landscape, cemetery, garden, natural cave along with socio-economic landscape, the demographic heterogeneity in Early India. Finally, it will be attempted to compare between anthropological landscape of present Trans-Himalayan and archaeological one of ancient Western India. The study of Buddhism in Early India has hardly been discussed through multivalent theoretical archaeology and anthropology of religion, thus traditional and recent scholarship have produced historical meta-narrative though heterogeneous among them. The multidisciplinary approaches of textual critics, archaeology and anthropology will surely help to deconstruct the grand and all-encompassing historical description on Buddhism in Early India and then to reconstruct the localized, behavioral and multivalent narratives. This paper expects to highlight the importance of lesser-studied Buddhist archaeological sites and the dynamic views on religious landscape in Early India with a help of critical anthropology of religion.

Keywords: analogy by living traditions, Buddhism in Early India, landscape analysis, meta-narrative

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2038 Dynamic-cognition of Strategic Mineral Commodities; An Empirical Assessment

Authors: Carlos Tapia Cortez, Serkan Saydam, Jeff Coulton, Claude Sammut

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Strategic mineral commodities (SMC) both energetic and metals have long been fundamental for human beings. There is a strong and long-run relation between the mineral resources industry and society's evolution, with the provision of primary raw materials, becoming one of the most significant drivers of economic growth. Due to mineral resources’ relevance for the entire economy and society, an understanding of the SMC market behaviour to simulate price fluctuations has become crucial for governments and firms. For any human activity, SMC price fluctuations are affected by economic, geopolitical, environmental, technological and psychological issues, where cognition has a major role. Cognition is defined as the capacity to store information in memory, processing and decision making for problem-solving or human adaptation. Thus, it has a significant role in those systems that exhibit dynamic equilibrium through time, such as economic growth. Cognition allows not only understanding past behaviours and trends in SCM markets but also supports future expectations of demand/supply levels and prices, although speculations are unavoidable. Technological developments may also be defined as a cognitive system. Since the Industrial Revolution, technological developments have had a significant influence on SMC production costs and prices, likewise allowing co-integration between commodities and market locations. It suggests a close relation between structural breaks, technology and prices evolution. SCM prices forecasting have been commonly addressed by econometrics and Gaussian-probabilistic models. Econometrics models may incorporate the relationship between variables; however, they are statics that leads to an incomplete approach of prices evolution through time. Gaussian-probabilistic models may evolve through time; however, price fluctuations are addressed by the assumption of random behaviour and normal distribution which seems to be far from the real behaviour of both market and prices. Random fluctuation ignores the evolution of market events and the technical and temporal relation between variables, giving the illusion of controlled future events. Normal distribution underestimates price fluctuations by using restricted ranges, curtailing decisions making into a pre-established space. A proper understanding of SMC's price dynamics taking into account the historical-cognitive relation between economic, technological and psychological factors over time is fundamental in attempting to simulate prices. The aim of this paper is to discuss the SMC market cognition hypothesis and empirically demonstrate its dynamic-cognitive capacity. Three of the largest and traded SMC's: oil, copper and gold, will be assessed to examine the economic, technological and psychological cognition respectively.

Keywords: commodity price simulation, commodity price uncertainties, dynamic-cognition, dynamic systems

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2037 Nanotechnology-Based Treatment of Klebsiella pneumoniae Infections

Authors: Lucian Mocan, Teodora Mocan, Matea Cristian, Cornel Iancu

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We present method of nanoparticle enhanced laser thermal ablation of Klebsiella pneumoniae infections, using gold nanoparticles combined with a specific growth factor and demonstrate its selective therapeutic efficacy. Ab (antibody solution) bound to GNPs (gold nanoparticles) was administered in vitro and determined the specific delivery of the nano-bioconjugate into the microorganism. The extent of necrosis was considerable following laser therapy, and at the same time, normal cells were not seriously affected. The selective photothermal ablation of the infected tissue was obtained after the selective accumulation of Ab bound to GNPs into bacteria following perfusion. These results may represent a major step in antibiotherapy treatment using nanolocalized thermal ablation by laser heating.

Keywords: gold nanoparticles, Klebsiella pneumoniae, nanoparticle functionalization, laser irradiation, antibody

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2036 Gender Differences in the Impact and Subjective Interpretation of Childhood Sexual Abuse Survivors

Authors: T. Borja-Alvarez, V. Jiménez-Borja, M. Jiménez Borja, C. J. Jiménez-Mosquera

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Research on child sexual abuse has predominantly focused on female survivors. This has resulted in less research looking at the particular context in which this abuse takes place for boys and the impact this abuse may have on male survivors. The aim of this study is to examine the sex and age of the perpetrators of child sexual abuse and explore gender differences in the impact along with the subjective interpretation that survivors attribute to these experiences. The data for this study was obtained from Ecuadorian university students (M = 230, F = 293) who reported sexual abuse using the ISPCAN Child Abuse Screening Tool Retrospective version (ICAST-R). Participants completed Horowitz's Impact of Event Scale (IES) and were also requested to choose among neutral, positive, and negative adjectives to describe these experiences. The results indicate that in the case of males, perpetrators were both males (adults =27%, peers =20%, relatives =10.3%, cousins =7.4%) and young females (girlfriends or ex-girlfriends =25.6%, neighborhood =20.7%, school =16.7%, cousins =15.3%, strangers =12.8%). In contrast, almost all females reported that adult males were the perpetrators (relatives =29.6%, neighborhood =11.9%, strangers =19.9%, family friends =9.7%). Regarding the impact of these events, significant gender differences emerged. More females (50%) than males (20%) presented symptoms of post-traumatic stress disorder (PTSD). Gender differences also surfaced in the way survivors interpret their experiences. Almost half of the male participants selected the word “consensual” followed by the words “normal”, “helped me to mature”, “shameful”, “confusing”, and “traumatic”. In contrast, almost all females chose the word “non-consensual” followed by the words “shameful”, “traumatic”, “scary”, and “confusing”. In conclusion, the findings of this study suggest that young females and adult males were the most common perpetrators of sexually abused boys whereas adult males were the most common perpetrators of sexually abused girls. The impact and the subjective interpretation of these experiences were more negative for girls than for boys. The factors that account for the gender differences in the impact and the interpretation of these experiences need further exploration. It is likely that the cultural expectations of sexual behaviors for boys and girls in Latin American societies may partially explain the differential impact in the way these childhood sexual abuse experiences are interpreted in adulthood. In Ecuador, as is the case in other Latin American countries, the machismo culture not only accepts but encourages early sexual behaviors in boys and negatively judges premature sexual behavior in females. The result of these different sexual expectations may be that sexually abused boys may re-define these experiences as “consensual” and “normal” in adulthood, even though these were not consensual at the time of occurrence. Future studies are needed to more deeply understand the different contexts of sexual abuse for boys and girls in order to analyze the long-term impact of these experiences.

Keywords: abuse, child, gender differences, sexual

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2035 Modelling Rainfall-Induced Shallow Landslides in the Northern New South Wales

Authors: S. Ravindran, Y.Liu, I. Gratchev, D.Jeng

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Rainfall-induced shallow landslides are more common in the northern New South Wales (NSW), Australia. From 2009 to 2017, around 105 rainfall-induced landslides occurred along the road corridors and caused temporary road closures in the northern NSW. Rainfall causing shallow landslides has different distributions of rainfall varying from uniform, normal, decreasing to increasing rainfall intensity. The duration of rainfall varied from one day to 18 days according to historical data. The objective of this research is to analyse slope instability of some of the sites in the northern NSW by varying cumulative rainfall using SLOPE/W and SEEP/W and compare with field data of rainfall causing shallow landslides. The rainfall data and topographical data from public authorities and soil data obtained from laboratory tests will be used for this modelling. There is a likelihood of shallow landslides if the cumulative rainfall is between 100 mm to 400 mm in accordance with field data.

Keywords: landslides, modelling, rainfall, suction

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2034 A Case Report on the Multidisciplinary Approach on Rectal Adenocarcinoma in Pregnancy

Authors: Maria Cristina B. Cabanag, Elijinese Marie S. Culangen

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Pregnancy is a period in a woman's life wherein the body may undergo different physiological changes. These changes can be attributed to the interplay of hormones in the body but can mask a more sinister type of disease such as malignancy on rare occasions. Colorectal cancer (CRC) in pregnancy is an epidemiologically rare disease worldwide. To our knowledge, no available studies were reported in the Philippines at the time of this writing, posing a dilemma for its appropriate diagnosis and management. Signs and symptoms of colorectal malignancy may camouflage a normal pregnancy and, when overlooked, impedes an appropriate approach. This case of a 38-year-old elderly primigravid who presented with hematochezia on her 25th week of gestation. She was diagnosed with rectal adenocarcinoma later in pregnancy which warranted a predicament regarding her appropriate care and management. This paper explores the repertoire of the different diagnostic and treatment approaches to colorectal cancer in the second trimester of pregnancy, with the least possible maternal and fetal hazards.

Keywords: cancer in pregnancy, chemotherapy in pregnancy, colorectal cancer, hematochezia in pregnancy

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2033 A New Approach for PE100 Characterization; An in-Reactor HDPE Alloy with Semi Hard and Soft Segments

Authors: Sasan Talebnezhad, Parviz Hamidia

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GPC and RMS analysis showed no distinct difference between PE 100 On, Off, and Reference grade. But FTIR spectra and multiple endothermic peaks obtained from SSA analysis, attributed to heterogeneity of ethylene sequence length, lamellar thickness and also the non-uniformity of short chain branching, showed sharp discrepancy and proposed a blend structure of high-density polyethylenes in PE 100 grade. Catalysis along with process parameters dictates poly blend PE 100 structure. This in-reactor blend is a mixture of compatible co-crystallized phases with different crystalinity, forming a physical semi hard and soft segment network responsible for improved impact properties in PE 100 pipe grade. We propose a new approach for PE100 evaluation that is more efficient than normal microstructure characterization.

Keywords: HDPE, pipe grade, in-reactor blend, hard and soft segments

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2032 Effect of Fault Depth on Near-Fault Peak Ground Velocity

Authors: Yanyan Yu, Haiping Ding, Pengjun Chen, Yiou Sun

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Fault depth is an important parameter to be determined in ground motion simulation, and peak ground velocity (PGV) demonstrates good application prospect. Using numerical simulation method, the variations of distribution and peak value of near-fault PGV with different fault depth were studied in detail, and the reason of some phenomena were discussed. The simulation results show that the distribution characteristics of PGV of fault-parallel (FP) component and fault-normal (FN) component are distinctly different; the value of PGV FN component is much larger than that of FP component. With the increase of fault depth, the distribution region of the FN component strong PGV moves forward along the rupture direction, while the strong PGV zone of FP component becomes gradually far away from the fault trace along the direction perpendicular to the strike. However, no matter FN component or FP component, the strong PGV distribution area and its value are both quickly reduced with increased fault depth. The results above suggest that the fault depth have significant effect on both FN component and FP component of near-fault PGV.

Keywords: fault depth, near-fault, PGV, numerical simulation

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2031 Impact of Preoperative Physiotherapy Care in Total Hip Arthroplasty in Slovakia and Austria

Authors: Peter Kutis, Vladimir Littva

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Nowadays, it is necessary to ensure that this reduction in costs is not at the expense of the quality of health care and future medical success. In general, physiotherapy for total hip joint arthroplasty is considered to be a routine matter that deals mainly with mobility training, increased muscular strength, and basic day-to-day activities such as bed-to-chair transition, standing, and walking. Within the KEGA project no. 003KU-4-2021, we decided to investigate preoperative physiotherapy care in Slovakia and Austria in total hip arthroplasty patients to shortened overall recovery. Research Sample and Methods: The sample comprised 498 respondents –patients who were indicated to total hip arthroplasty on the territory of Slovakia and Austria. There were 130 women in Slovakia and 135 women in Austria. The numbers of men were 120 in Slovakia and 113 men in Austria. The age of respondents was between 40 and 85 years of age. As a method of our research, we chose a non-standardized questionnaire, which consisted of three parts. The first part for the initial examination of the patient contained the identification of the patient according to the assigned number and subsequently 19 questions conditioned by the physical examination and evaluation of the patients. The second part of our questionnaire was completed after the patient's hospitalization and contained 10 questions that were conditioned by the patient's examination. The last third part for the overall assessment of the patient's state of health consisted of 12 questions conditioned by the patient's examination. This part was performed at the last meeting with the patient at the end of the treatment. All data were statistically processed by SPSS 25. Results: All data were evaluated at a significance level of p = 0.05. From the comparison of patients who underwent preoperative preparation, we can clearly state that the total duration of treatment is significantly shorter. A t-test of two mean values with uneven variance was used to verify the validity of the assumption. The total duration of treatment in patients with preoperative preparation was on average 92,635 days and without preoperative preparation was on average 135,884 days (t-Stat = 44,52784, t Critical one-tail = 1,648187415, t Critical two-tail = 1,965157). Conclusion: The results obtained during the research show the importance of adequate preoperative physiotherapeutic preparation of the patient. The results of total hip joint arthroplasty studies showed a significant reduction in a hospital stay as well as shortened total treatment time.

Keywords: THA, physiotherapy, recovery, preoperative physiotherapy care

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2030 Evaluation of Ocular Changes in Hypertensive Disorders of Pregnancy

Authors: Rajender Singh, Nidhi Sharma, Aastha Chauhan, Meenakshi Barsaul, Jyoti Deswal, Chetan Chhikara

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Introduction: Pre-eclampsia and eclampsia are hypertensive disorders of pregnancy with multisystem involvement and are common causes of morbidity and mortality in obstetrics. It is believed that changes in retinal arterioles may indicate similar changes in the placenta. Therefore, this study was undertaken to evaluate the ocular manifestations in cases of pre-eclampsia and eclampsia and to deduce any association between the retinal changes and blood pressure, the severity of disease, gravidity, proteinuria, and other lab parameters so that a better approach could be devised to ensure maternal and fetal well-being. Materials and Methods: This was a hospital-based cross-sectional study conducted over a period of one year, from April 2021 to May 2022. 350 admitted patients with diagnosed pre-eclampsia, eclampsia, and pre-eclampsia superimposed on chronic hypertension were included in the study. A pre-structured proforma was used. After taking consent and ocular history, a bedside examination to record visual acuity, pupillary size, corneal curvature, field of vision, and intraocular pressure was done. Dilated fundus examination was done with a direct and indirect ophthalmoscope. Age, parity, BP, proteinuria, platelet count, liver and kidney function tests were noted down. The patients with positive findings only were followed up after 72 hours and 6 weeks of termination of pregnancy. Results: The mean age of patients was 26.18±4.33 years (range 18-39 years).157 (44.9%) were primigravida while 193(55.1%) were multigravida.53 (15.1%) patients had eclampsia, 128(36.5%) had mild pre-eclampsia,128(36.5%) had severe pre-eclampsia and 41(11.7%) had chronic hypertension with superimposed pre-eclampsia. Retinal changes were found in 208 patients (59.42%), and grade I changes were the most common. 82(23.14%) patients had grade I changes, 75 (21.4%) had grade II changes, 41(11.71%) had grade III changes, and 11(3.14%) had serous retinal detachment/grade IV changes. 36 patients had unaided visual acuity <6/9, of these 17 had refractive error and 19(5.4%) had varying degrees of retinal changes. 3(0.85%) out of 350 patients had an abnormal field of vision in both eyes. All 3 of them had eclampsia and bilateral exudative retinal detachment. At day 4, retinopathy in 10 patients resolved, and 3 patients had improvement in visual acuity. At 6 weeks, retinopathy in all the patients resolved spontaneously except persistence of grade II changes in 23 patients with chronic hypertension with superimposed pre-eclampsia, while visual acuity and field of vision returned to normal in all patients. Pupillary size, intraocular pressure, and corneal curvature were found to be within normal limits at all times of examination. There was a statistically significant positive association between retinal changes and mean arterial pressure. The study showed a positive correlation between fundus findings and severity of disease (p value<0.05) and mean arterial pressure (p value<0.005). Primigravida had more retinal changes than multigravida patients. A significant association was found between fundus changes and thrombocytopenia and deranged liver and kidney function tests (p value<0.005). Conclusion: As the severity of pre-eclampsia and eclampsia increases, the incidence of retinopathy also increases, and it affects visual acuity and visual fields of the patients. Thus, timely ocular examination should be done in all such cases to prevent complications.

Keywords: eclampsia, hypertensive, ocular, pre-eclampsia

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2029 The Mechanical Properties of a Small-Size Seismic Isolation Rubber Bearing for Bridges

Authors: Yi F. Wu, Ai Q. Li, Hao Wang

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Taking a novel type of bridge bearings with the diameter being 100mm as an example, the theoretical analysis, the experimental research as well as the numerical simulation of the bearing were conducted. Since the normal compression-shear machines cannot be applied to the small-size bearing, an improved device to test the properties of the bearing was proposed and fabricated. Besides, the simulation of the bearing was conducted on the basis of the explicit finite element software ANSYS/LS-DYNA, and some parameters of the bearing are modified in the finite element model to effectively reduce the computation cost. Results show that all the research methods are capable of revealing the fundamental properties of the small-size bearings, and a combined use of these methods can better catch both the integral properties and the inner detailed mechanical behaviors of the bearing.

Keywords: ANSYS/LS-DYNA, compression shear, contact analysis, explicit algorithm, small-size

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2028 Dys-Regulation of Immune and Inflammatory Response in in vitro Fertilization Implantation Failure Patients under Ovarian Stimulation

Authors: Amruta D. S. Pathare, Indira Hinduja, Kusum Zaveri

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Implantation failure (IF) even after the good-quality embryo transfer (ET) in the physiologically normal endometrium is the main obstacle in in vitro fertilization (IVF). Various microarray studies have been performed worldwide to elucidate the genes requisite for endometrial receptivity. These studies have included the population based on different phases of menstrual cycle during natural cycle and stimulated cycle in normal fertile women. Additionally, the literature is also available in recurrent implantation failure patients versus oocyte donors in natural cycle. However, for the first time, we aim to study the genomics of endometrial receptivity in IF patients under controlled ovarian stimulation (COS) during which ET is generally practised in IVF. Endometrial gene expression profiling in IF patients (n=10) and oocyte donors (n=8) were compared during window of implantation under COS by whole genome microarray (using Illumina platform). Enrichment analysis of microarray data was performed to determine dys-regulated biological functions and pathways using Database for Annotation, Visualization and Integrated Discovery, v6.8 (DAVID). The enrichment mapping was performed with the help of Cytoscape software. Microarray results were validated by real-time PCR. Localization of genes related to immune response (Progestagen-Associated Endometrial Protein (PAEP), Leukaemia Inhibitory Factor (LIF), Interleukin-6 Signal Transducer (IL6ST) was detected by immunohistochemistry. The study revealed 418 genes downregulated and 519 genes upregulated in IF patients compared to healthy fertile controls. The gene ontology, pathway analysis and enrichment mapping revealed significant downregulation in activation and regulation of immune and inflammation response in IF patients under COS. The lower expression of Progestagen Associated Endometrial Protein (PAEP), Leukemia Inhibitory Factor (LIF) and Interleukin 6 Signal Transducer (IL6ST) in cases compared to controls by real time and immunohistochemistry suggests the functional importance of these genes. The study was proved useful to uncover the probable reason of implantation failure being imbalance of immune and inflammatory regulation in our group of subjects. Based on the present study findings, a panel of significant dysregulated genes related to immune and inflammatory pathways needs to be further substantiated in larger cohort in natural as well as stimulated cycle. Upon which these genes could be screened in IF patients during window of implantation (WOI) before going for embryo transfer or any other immunological treatment. This would help to estimate the regulation of specific immune response during WOI in a patient. The appropriate treatment of either activation of immune response or suppression of immune response can be then attempted in IF patients to enhance the receptivity of endometrium.

Keywords: endometrial receptivity, immune and inflammatory response, gene expression microarray, window of implantation

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2027 Bone Mineralization in Children with Wilson’s Disease

Authors: Shiamaa Eltantawy, Gihan Sobhy, Alif Alaam

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Wilson disease, or hepatolenticular degeneration, is an autosomal recessive disease that results in excess copper buildup in the body. It primarily affects the liver and basal ganglia of the brain, but it can affect other organ systems. Musculoskeletal abnormalities, including premature osteoarthritis, skeletal deformity, and pathological bone fractures, can occasionally be found in WD patients with a hepatic or neurologic type. The aim was to assess the prevalence of osteoporosis and osteopenia in Wilson’s disease patients. This case-control study was conducted on ninety children recruited from the inpatient ward and outpatient clinic of the Paediatric Hepatology, Gastroenterology, and Nutrition department of the National Liver Institute at Menofia University, aged from 1 to 18 years. Males were 49, and females were 41. Children were divided into three groups: (Group I) consisted of thirty patients with WD; (Group II) consisted of thirty patients with chronic liver disease other than WD; (Group III) consisted of thirty age- and sex-matched healthy The exclusion criteria were patients with hyperparathyroidism, hyperthyroidism, renal failure, Cushing's syndrome, and patients on certain drugs such as chemotherapy, anticonvulsants, or steroids. All patients were subjected to the following: 1- Full history-taking and clinical examination. 2-Laboratory investigations: (FBC,ALT,AST,serum albumin, total protein, total serum bilirubin,direct bilirubin,alkaline phosphatase, prothrombin time, serum critine,parathyroid hormone, serum calcium, serum phosphrus). 3-Bone mineral density (BMD, gm/cm2) values were measured by dual-energy X-ray absorptiometry (DEXA). The results revealed that there was a highly statistically significant difference between the three groups regarding the DEXA scan, and there was no statistically significant difference between groups I and II, but the WD group had the lowest bone mineral density. The WD group had a large number of cases of osteopenia and osteoporosis, but there was no statistically significant difference with the group II mean, while a high statistically significant difference was found when compared to group III. In the WD group, there were 20 patients with osteopenia, 4 patients with osteoporosis, and 6 patients who were normal. The percentages were 66.7%, 13.3%, and 20%, respectively. Therefore, the largest number of cases in the WD group had osteopenia. There was no statistically significant difference found between WD patients on different treatment regimens regarding DEXA scan results (Z-Score). There was no statistically significant difference found between patients in the WD group (normal, osteopenic, or osteoporotic) regarding phosphorus (mg/dL), but there was a highly statistically significant difference found between them regarding ionised Ca (mmol/L). Therefore, there was a decrease in bone mineral density when the Ca level was decreased. In summary, Wilson disease is associated with bone demineralization. The largest number of cases in the WD group in our study had osteopenia (66.7%). Different treatment regimens (zinc monotherapy, Artamin, and zinc) as well as different laboratory parameters have no effect on bone mineralization in WD cases. Decreased ionised Ca is associated with low BMD in WD patients. Children with WD should be investigated for BMD.

Keywords: wilson disease, Bone mineral density, liver disease, osteoporosis

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2026 Atypical Clinical Presentation of Wallenberg Syndrome from Acute Right Lateral Medullary Infarct in a-37-year-old Female

Authors: Sweta Das

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This case report highlights the atypical clinical manifestation of ipsilateral head, neck, shoulder, and eye pain with erythema and edema of right eyelid and conjunctiva, along with typical presentation of right sided Horner’s syndrome in a 37-year-old female, who was correctly diagnosed with Wallenberg syndrome due to collaborative effort from optometry, primary care, emergency, and neurology specialties in medicine. Horner’s syndrome is present in 75% of patients with Wallenberg syndrome. Given that patients with Wallenberg syndrome often first present to the Emergency Department with a vast variety of non-specific symptoms, and a normal MRI, a delayed diagnosis is common. Therefore, a collaborative effort between emergency department, optometry, primary care, and neurology is essential in correctly diagnosing Wallenberg’s syndrome in a timely manner.

Keywords: horner's syndrome, stroke, wallenberg syndrome, lateropulsion of eyes

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2025 Wetting Induced Collapse Behavior of Loosely Compacted Kaolin Soil: A Microstructural Study

Authors: Dhanesh Sing Das, Bharat Tadikonda Venkata

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Collapsible soils undergo significant volume reduction upon wetting under the pre-existing mechanically applied normal stress (inundation pressure). These soils exhibit a very high strength in air-dried conditions and can carry up to a considerable magnitude of normal stress without undergoing significant volume change. The soil strength is, however, lost upon saturation and results in a sudden collapse of the soil structure under the existing mechanical stress condition. The intrusion of water into the dry deposits of such soil causes ground subsidence leading to damages in the overlying buildings/structures. A study on the wetting-induced volume change behavior of collapsible soils is essential in dealing with the ground subsidence problems in various geotechnical engineering practices. The collapse of loosely compacted Kaolin soil upon wetting under various inundation pressures has been reported in recent studies. The collapse in the Kaolin soil is attributed to the alteration in the soil particle-particle association (fabric) resulting due to the changes in the various inter-particle (microscale) forces induced by the water saturation. The inundation pressure plays a significant role in the fabric evolution during the wetting process, thus controls the collapse potential of the compacted soil. A microstructural study is useful to understand the collapse mechanisms at various pore-fabric levels under different inundation pressure. Kaolin soil compacted to a dry density of 1.25 g/cc was used in this work to study the wetting-induced volume change behavior under different inundation pressures in the range of 10-1600 kPa. The compacted specimen of Kaolin soil exhibited a consistent collapse under all the studied inundation pressure. The collapse potential was observed to be increasing with an increase in the inundation pressure up to a maximum value of 13.85% under 800 kPa and then decreased to 11.7% under 1600 kPa. Microstructural analysis was carried out based on the fabric images and the pore size distributions (PSDs) obtained from FESEM analysis and mercury intrusion porosimetry (MIP), respectively. The PSDs and the soil fabric images of ‘as-compacted’ specimen and post-collapse specimen under 400 kPa were analyzed to understand the changes in the soil fabric and pores due to wetting. The pore size density curve for the post-collapse specimen was found to be on the finer side with respect to the ‘as-compacted’ specimen, indicating the reduction of the larger pores during the collapse. The inter-aggregate pores in the range of 0.1-0.5μm were identified as the major contributing pore size classes to the macroscopic volume change. Wetting under an inundation pressure results in the reduction of these pore sizes and lead to an increase in the finer pore sizes. The magnitude of inundation pressure influences the amount of reduction of these pores during the wetting process. The collapse potential was directly related to the degree of reduction in the pore volume contributed by these pore sizes.

Keywords: collapse behavior, inundation pressure, kaolin, microstructure

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2024 Evaluation of Reliability Indices Using Monte Carlo Simulation Accounting Time to Switch

Authors: Sajjad Asefi, Hossein Afrakhte

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This paper presents the evaluation of reliability indices of an electrical distribution system using Monte Carlo simulation technique accounting Time To Switch (TTS) for each section. In this paper, the distribution system has been assumed by accounting random repair time omission. For simplicity, we have assumed the reliability analysis to be based on exponential law. Each segment has a specified rate of failure (λ) and repair time (r) which will give us the mean up time and mean down time of each section in distribution system. After calculating the modified mean up time (MUT) in years, mean down time (MDT) in hours and unavailability (U) in h/year, TTS have been added to the time which the system is not available, i.e. MDT. In this paper, we have assumed the TTS to be a random variable with Log-Normal distribution.

Keywords: distribution system, Monte Carlo simulation, reliability, repair time, time to switch (TTS)

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2023 Evaluation of Interaction Between Fans and Celebrities in New Media

Authors: Mohadese Motahari

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In general, we consider the phenomenon of "fandism" or extreme fandom to be an aspect of fandom for a person, a group, or a collection, which leads to extreme support for them. So, for example, we consider a fan or a "fanatic" (which literally means a "fanatical person") to be a person who is extremely interested in a certain topic or topics and has a special passion and fascination for that issue. It may also be beyond the scope of logic and normal behavior of the society. With the expansion of the media and the advancement of technology, the phenomenon of fandom also underwent many changes and not only became more intense, but a large economy was also formed alongside it, and it is becoming more and more important every day. This economy, which emerged from the past with the formation of the first media, has now taken a different form with the development of media and social networks, as well as the change in the interaction between celebrities and audiences. Earning huge amounts of money with special methods in every social network and every media is achieved through fans and fandoms. In this article, we have studied the relationship between fans and famous people with reference to the economic debates surrounding it.

Keywords: fandism, famous people, social media, new media

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2022 Deep Learning Approach for Colorectal Cancer’s Automatic Tumor Grading on Whole Slide Images

Authors: Shenlun Chen, Leonard Wee

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Tumor grading is an essential reference for colorectal cancer (CRC) staging and survival prognostication. The widely used World Health Organization (WHO) grading system defines histological grade of CRC adenocarcinoma based on the density of glandular formation on whole slide images (WSI). Tumors are classified as well-, moderately-, poorly- or un-differentiated depending on the percentage of the tumor that is gland forming; >95%, 50-95%, 5-50% and <5%, respectively. However, manually grading WSIs is a time-consuming process and can cause observer error due to subjective judgment and unnoticed regions. Furthermore, pathologists’ grading is usually coarse while a finer and continuous differentiation grade may help to stratifying CRC patients better. In this study, a deep learning based automatic differentiation grading algorithm was developed and evaluated by survival analysis. Firstly, a gland segmentation model was developed for segmenting gland structures. Gland regions of WSIs were delineated and used for differentiation annotating. Tumor regions were annotated by experienced pathologists into high-, medium-, low-differentiation and normal tissue, which correspond to tumor with clear-, unclear-, no-gland structure and non-tumor, respectively. Then a differentiation prediction model was developed on these human annotations. Finally, all enrolled WSIs were processed by gland segmentation model and differentiation prediction model. The differentiation grade can be calculated by deep learning models’ prediction of tumor regions and tumor differentiation status according to WHO’s defines. If multiple WSIs were possessed by a patient, the highest differentiation grade was chosen. Additionally, the differentiation grade was normalized into scale between 0 to 1. The Cancer Genome Atlas, project COAD (TCGA-COAD) project was enrolled into this study. For the gland segmentation model, receiver operating characteristic (ROC) reached 0.981 and accuracy reached 0.932 in validation set. For the differentiation prediction model, ROC reached 0.983, 0.963, 0.963, 0.981 and accuracy reached 0.880, 0.923, 0.668, 0.881 for groups of low-, medium-, high-differentiation and normal tissue in validation set. Four hundred and one patients were selected after removing WSIs without gland regions and patients without follow up data. The concordance index reached to 0.609. Optimized cut off point of 51% was found by “Maxstat” method which was almost the same as WHO system’s cut off point of 50%. Both WHO system’s cut off point and optimized cut off point performed impressively in Kaplan-Meier curves and both p value of logrank test were below 0.005. In this study, gland structure of WSIs and differentiation status of tumor regions were proven to be predictable through deep leaning method. A finer and continuous differentiation grade can also be automatically calculated through above models. The differentiation grade was proven to stratify CAC patients well in survival analysis, whose optimized cut off point was almost the same as WHO tumor grading system. The tool of automatically calculating differentiation grade may show potential in field of therapy decision making and personalized treatment.

Keywords: colorectal cancer, differentiation, survival analysis, tumor grading

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2021 Artificial Intelligence Based Analysis of Magnetic Resonance Signals for the Diagnosis of Tissue Abnormalities

Authors: Kapila Warnakulasuriya, Walimuni Janaka Mendis

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In this study, an artificial intelligence-based approach is developed to diagnose abnormal tissues in human or animal bodies by analyzing magnetic resonance signals. As opposed to the conventional method of generating an image from the magnetic resonance signals, which are then evaluated by a radiologist for the diagnosis of abnormalities, in the discussed approach, the magnetic resonance signals are analyzed by an artificial intelligence algorithm without having to generate or analyze an image. The AI-based program compares magnetic resonance signals with millions of possible magnetic resonance waveforms which can be generated from various types of normal tissues. Waveforms generated by abnormal tissues are then identified, and images of the abnormal tissues are generated with the possible location of them in the body for further diagnostic tests.

Keywords: magnetic resonance, artificial intelligence, magnetic waveform analysis, abnormal tissues

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2020 AI-based Digital Healthcare Application to Assess and Reduce Fall Risks in Residents of Nursing Homes in Germany

Authors: Knol Hester, Müller Swantje, Danchenko Natalya

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Objective: Falls in older people cause an autonomy loss and result in an economic burden. LCare is an AI-based application to manage fall risks. The study's aim was to assess the effect of LCare use on patient outcomes in nursing homes in Germany. Methods: LCare identifies and monitors fall risks through a 3D-gait analysis and a digital questionnaire, resulting in tailored recommendations on fall prevention. A study was conducted with AOK Baden-Württemberg (01.09.2019- 31.05.2021) in 16 care facilities. Assessments at baseline and follow-up included: a fall risk score; falls (baseline: fall history in the past 12 months; follow-up: a fall record since the last analysis); fall-related injuries and hospitalizations; gait speed; fear of falling; psychological stress; nurses experience on app use. Results: 94 seniors were aged 65-99 years at the initial analysis (average 84±7 years); 566 mobility analyses were carried out in total. On average, the fall risk was reduced by 17.8 % as compared to the baseline (p<0.05). The risk of falling decreased across all subgroups, including a trend in dementia patients (p=0.06), constituting 43% of analyzed patients, and patients with walking aids (p<0.05), constituting 76% of analyzed patients. There was a trend (p<0.1) towards fewer falls and fall-related injuries and hospitalizations (baseline: 23 seniors who fell, 13 injury consequences, 9 hospitalizations; follow-up: 14 seniors who fell, 2 injury consequences, 0 hospitalizations). There was a 16% improvement in gait speed (p<0.05). Residents reported less fear of falling and psychological stress by 38% in both outcomes (p<0.05). 81% of nurses found LCare effective. Conclusions: In the presented study, the use of LCare app was associated with a reduction of fall risk among nursing home residents, improvement of health-related outcomes, and a trend toward reduction in injuries and hospitalizations. LCare may help to improve senior resident care and save healthcare costs.

Keywords: falls, digital healthcare, falls prevention, nursing homes, seniors, AI, digital assessment

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2019 Prognostic Significance of Nuclear factor kappa B (p65) among Breast Cancer Patients in Cape Coast Teaching Hospital

Authors: Precious Barnes, Abraham Mensah, Leonard Derkyi-Kwarteng, Benjamin Amoani, George Adjei, Ernest Adankwah, Faustina Pappoe, Kwabena Dankwah, Daniel Amoako-Sakyi, Samuel Victor Nuvor, Dorcas Obiri-Yeboah, Ewura Seidu Yahaya, Patrick Kafui Akakpo, Roland Osei Saahene

Abstract:

Context: Breast cancer is a prevalent and aggressive type of cancer among African women, with high mortality rates in Ghana. Nuclear factor kappa B (NF-kB) is a transcription factor that has been associated with tumor progression in breast cancer. However, there is a lack of published data on NF-kB in breast cancer patients in Ghana or other African countries. Research Aim: The aim of this study was to assess the prognostic significance of NF-kB (p65) expression and its association with various clinicopathological features in breast cancer patients at the Cape Coast Teaching Hospital in Ghana. Methodology: A total of 90 formalin-fixed breast cancer tissues and 15 normal breast tissues were used in this study. The expression level of NF-kB (p65) was examined using immunohistochemical techniques. Correlation analysis between NF-kB (p65) expression and clinicopathological features was performed using SPSS version 25. Findings: The study found that NF-kB (p65) was expressed in 86.7% of breast cancer tissues. There was a significant relationship between NF-kB (p65) expression and tumor grade, proliferation index (Ki67), and molecular subtype. High-level expression of NF-kB (p65) was more common in tumor grade 3 compared to grade 1, and Ki67 > 20 had higher expression of NF-kB (p65) compared to Ki67 ≤ 20. Triple-negative breast cancer patients had the highest overexpression of NF-kB (p65) compared to other molecular subtypes. There was no significant association between NF-kB (p65) expression and other clinicopathological parameters. Theoretical Importance: This study provides important insights into the expression of NF-kB (p65) in breast cancer patients in Ghana, particularly in relation to tumor grade and proliferation index. The findings suggest that NF-kB (p65) could serve as a potential biological marker for cancer stage, progression, prognosis and as a therapeutic target. Data Collection and Analysis Procedures: Formalin-fixed breast cancer tissues and normal breast tissues were collected and analyzed using immunohistochemical techniques. Correlation analysis between NF-kB (p65) expression and clinicopathological features was performed using SPSS version 25. Question Addressed: This study addressed the question of the prognostic significance of NF-kB (p65) expression and its association with clinicopathological features in breast cancer patients in Ghana. Conclusion: This study, the first of its kind in Ghana, demonstrates that NF-kB (p65) is highly expressed among breast cancer patients at the Cape Coast Teaching Hospital, especially in triple-negative breast cancer patients. The expression of NF-kB (p65) is associated with tumor grade and proliferation index. NF-kB (p65) could potentially serve as a biological marker for cancer stage, progression, prognosis, and as a therapeutic target.

Keywords: breast cancer, Ki67, NF-kB (p65), tumor grade

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2018 Association of Zinc with New Generation Cardiovascular Risk Markers in Childhood Obesity

Authors: Mustafa M. Donma, Orkide Donma

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Zinc is a vital element required for growth and development. This fact makes zinc important, particularly for children. It maintains normal cellular structure and functions. This essential element appears to have protective effects against coronary artery disease and cardiomyopathy. Higher serum zinc levels are associated with lower risk of cardiovascular diseases (CVDs). There is a significant association between low serum zinc levels and heart failure. Zinc may be a potential biomarker of cardiovascular health. High sensitive cardiac troponin T (hs-cTnT) and cardiac myosin binding protein C (cMyBP-C) are new generation markers used for prediagnosis, diagnosis, and prognosis of CVDs. The aim of this study is to determine zinc as well as new generation cardiac markers profiles in children with normal body mass index (N-BMI), obese (OB), morbid obese (MO) children, and children with metabolic syndrome (MetS) findings. The association among them will also be investigated. Four study groups were constituted. The study protocol was approved by the institutional Ethics Committee of Tekirdag Namik Kemal University. Parents of the participants filled informed consent forms to participate in the study. Group 1 is composed of 44 children with N-BMI. Group 2 and Group 3 comprised 43 OB and 45 MO children, respectively. Forty-five MO children with MetS findings were included in Group 4. World Health Organization age- and sex-adjusted BMI percentile tables were used to constitute groups. These values were 15-85, 95-99, and above 99 for N-BMI, OB, and MO, respectively. Criteria for MetS findings were determined. Routine biochemical analyses, including zinc, were performed. High sensitive-cTnT and cMyBP-C concentrations were measured by kits based on enzyme-linked immunosorbent assay principle. Appropriate statistical tests within the scope of SPSS were used for the evaluation of the study data. p<0.05 was accepted as statistically significant. Four groups were matched for age and gender. Decreased zinc concentrations were measured in Groups 2, 3, and 4 compared to Group 1. Groups did not differ from one another in terms of hs-cTnT. There were statistically significant differences between cMyBP-C levels of MetS group and N-BMI as well as OB groups. There was an increasing trend going from N-BMI group to MetS group. There were statistically significant negative correlations between zinc and hs-cTnT as well as cMyBP-C concentrations in MetS group. In conclusion, inverse correlations detected between zinc and new generation cardiac markers (hs-TnT and cMyBP-C) have pointed out that decreased levels of this physiologically essential trace element accompany increased levels of hs-cTnT as well as cMyBP-C in children with MetS. This finding emphasizes that both zinc and these new generation cardiac markers may be evaluated as biomarkers of cardiovascular health during severe childhood obesity precipitated with MetS findings and also suggested as the messengers of the future risk in the adulthood periods of children with MetS.

Keywords: cardiac myosin binding protein-C, cardiovascular diseases, children, high sensitive cardiac troponin T, obesity

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2017 Evaluating the Baseline Chatacteristics of Static Balance in Young Adults

Authors: K. Abuzayan, H. Alabed

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The objectives of this study (baseline study, n = 20) were to implement Matlab procedures for quantifying selected static balance variables, establish baseline data of selected variables which characterize static balance activities in a population of healthy young adult males, and to examine any trial effects on these variables. The results indicated that the implementation of Matlab procedures for quantifying selected static balance variables was practical and enabled baseline data to be established for selected variables. There was no significant trial effect. Recommendations were made for suitable tests to be used in later studies. Specifically it was found that one foot-tiptoes tests either in static balance is too challenging for most participants in normal circumstances. A one foot-flat eyes open test was considered to be representative and challenging for static balance.

Keywords: static balance, base of support, baseline data, young adults

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2016 A Re-Evaluation of Green Architecture and Its Contributions to Environmental Sustainability

Authors: Po-Ching Wang

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Considering the notable effects of natural resource consumption and impacts on fragile ecosystems, reflection on contemporary sustainable design is critical. Nevertheless, the idea of ‘green’ has been misapplied and even abused, and, in fact, much damage to the environment has been done in its name. In 1996’s popular science fiction film Independence Day, an alien species, having exhausted the natural resources of one planet, moves on to another —a fairly obvious irony on contemporary human beings’ irresponsible use of the Earth’s natural resources in modern times. In fact, the human ambition to master nature and freely access the world’s resources has long been inherent in manifestos evinced by productions of the environmental design professions. Ron Herron’s Walking City, an experimental architectural piece of 1964, is one example that comes to mind here. For this design concept, the architect imagined a gigantic nomadic urban aggregate that by way of an insect-like robotic carrier would move all over the world, on land and sea, to wherever its inhabitants want. Given the contemporary crisis regarding natural resources, recently ideas pertinent to structuring a sustainable environment have been attracting much interest in architecture, a field that has been accused of significantly contributing to ecosystem degradation. Great art, such as Fallingwater building, has been regarded as nature-friendly, but its notion of ‘green’ might be inadequate in the face of the resource demands made by human populations today. This research suggests a more conservative and scrupulous attitude to attempting to modify nature for architectural settings. Designs that pursue spiritual or metaphysical interconnections through anthropocentric aesthetics are not sufficient to benefit ecosystem integrity; though high-tech energy-saving processes may contribute to a fine-scale sustainability, they may ultimately cause catastrophe in the global scale. Design with frugality is proposed in order to actively reduce environmental load. The aesthetic taste and ecological sensibility of design professions and the public alike may have to be reshaped in order to make the goals of environmental sustainability viable.

Keywords: anthropocentric aesthetic, aquarium sustainability, biosphere 2, ecological aesthetic, ecological footprint, frugal design

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2015 Compressive Strength and Capillary Water Absorption of Concrete Containing Recycled Aggregate

Authors: Yeşim Tosun, Remzi Şahin

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This paper presents results of compressive strength, capillary water absorption, and density tests conducted on concrete containing recycled aggregate (RCA) which is obtained from structural waste generated by the construction industry in Turkey. In the experiments, 0%, 15%, 30%, 45% and 60% of the normal (natural) coarse aggregate was replaced by the recycled aggregate. Maximum aggregate particle sizes were selected as 16 mm, 22,4 mm and 31,5 mm; and 0,06%, 0,13% and 0,20% of air-entraining agent (AEA) were used in mixtures. Fly ash and superplasticizer were used as a mineral and chemical admixture, respectively. The same type (CEM I 42.5) and constant dosage of cement were used in the study. Water/cement ratio was kept constant as 0.53 for all mixture. It was concluded that capillary water absorption, compressive strength, and density of concrete decreased with increasing RCA ratio. Increasing in maximum aggregate particle size and amount of AEA also affect the properties of concrete significantly.

Keywords: capillary water absorption, compressive strength, recycled concrete aggregates

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2014 Combining Patients Pain Scores Reports with Functionality Scales in Chronic Low Back Pain Patients

Authors: Ivana Knezevic, Kenneth D. Candido, N. Nick Knezevic

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Background: While pain intensity scales remain generally accepted assessment tool, and the numeric pain rating score is highly subjective, we nevertheless rely on them to make a judgment about treatment effects. Misinterpretation of pain can lead practitioners to underestimate or overestimate the patient’s medical condition. The purpose of this study was to analyze how the numeric rating pain scores given by patients with low back pain correlate with their functional activity levels. Methods: We included 100 consecutive patients with radicular low back pain (LBP) after the Institutional Review Board (IRB) approval. Pain scores, numeric rating scale (NRS) responses at rest and in the movement,Oswestry Disability Index (ODI) questionnaire answers were collected 10 times through 12 months. The ODI questionnaire is targeting a patient’s activities and physical limitations as well as a patient’s ability to manage stationary everyday duties. Statistical analysis was performed by using SPSS Software version 20. Results: The average duration of LBP was 14±22 months at the beginning of the study. All patients included in the study were between 24 and 78 years old (average 48.85±14); 56% women and 44% men. Differences between ODI and pain scores in the range from -10% to +10% were considered “normal”. Discrepancies in pain scores were graded as mild between -30% and -11% or +11% and +30%; moderate between -50% and -31% and +31% and +50% and severe if differences were more than -50% or +50%. Our data showed that pain scores at rest correlate well with ODI in 65% of patients. In 30% of patients mild discrepancies were present (negative in 21% and positive in 9%), 4% of patients had moderate and 1% severe discrepancies. “Negative discrepancy” means that patients graded their pain scores much higher than their functional ability, and most likely exaggerated their pain. “Positive discrepancy” means that patients graded their pain scores much lower than their functional ability, and most likely underrated their pain. Comparisons between ODI and pain scores during movement showed normal correlation in only 39% of patients. Mild discrepancies were present in 42% (negative in 39% and positive in 3%); moderate in 14% (all negative), and severe in 5% (all negative) of patients. A 58% unknowingly exaggerated their pain during movement. Inconsistencies were equal in male and female patients (p=0.606 and p=0.928).Our results showed that there was a negative correlation between patients’ satisfaction and the degree of reporting pain inconsistency. Furthermore, patients talking opioids showed more discrepancies in reporting pain intensity scores than did patients taking non-opioid analgesics or not taking medications for LBP (p=0.038). There was a highly statistically significant correlation between morphine equivalents doses and the level of discrepancy (p<0.0001). Conclusion: We have put emphasis on the patient education in pain evaluation as a vital step in accurate pain level reporting. We have showed a direct correlation with patients’ satisfaction. Furthermore, we must identify other parameters in defining our patients’ chronic pain conditions, such as functionality scales, quality of life questionnaires, etc., and should move away from an overly simplistic subjective rating scale.

Keywords: pain score, functionality scales, low back pain, lumbar

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