Search results for: clinical trial development

Authors: Mohammad Mehdizadeh, Sara Miri

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In today's world, competition is one of the essential components of different markets. Therefore, in addition to economic factors, social factors can also affect the development and prosperity of businesses. In this regard, social networks are of particular importance and play a critical role in the flourishing and development of Internet businesses. The purpose of this article is to investigate the effect of different social networks in promoting digital entrepreneurship. The research method is the descriptive survey. The results show that social networks have a positive and significant impact on digital entrepreneurship development. Among the social networks studied, Instagram and Facebook have the most positive effect on digital entrepreneurship.

Keywords: entrepreneurship, Facebook, Instagram, social media

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Authors: Miklos Taliga

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In the present case study we examined the development and testing methods of systems that contain safety-critical elements in different industrial fields. Consequentially, we observed the classical object-oriented development and testing environment, as both medical technology and automobile industry approaches the development of safety critical elements that way. Subsequently, we examined model-based development. We introduce the quality parameters that define development and testing. While taking modern agile methodology (scrum) into consideration, we examined whether and to what extent the methodologies we found fit into this environment.

Keywords: safety-critical elements, quality managent, unit verification, model base testing, agile methods, scrum, metamodel, object-oriented programming, field specific modelling, sprint, user story, UML Standard

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Authors: Reza Mokhtari Malekabadi, Leila Jalalabadi, Zahra Kiyani Ghaleh No

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Today, systems of management and urban planning, attempt to reach more sustainable development through monitoring developments, urban development and development plans. Monitoring of changes in the urban places and sustainable urban development accounted a base for the realization of worthy goals urban sustainable development. The importance of women in environmental protection programs is high enough that in 21 agenda has been requested from all countries to allocate more shares to women in their policies. On the other hand, urban waste landfill has become one of the environmental concerns in modern cities. This research assumes that the impact of women on recycling, reduction and proper waste landfill is much more than men. For this reason, three districts; Yousef Abad, Heshmatieh and Nezam Abad are gauged through questionnaire and using the analytical research hypothesis model. This research will be categorized as functional research. The results have shown that noticing the power of women, their participation towards realization of the development objectives and programs can be used in solving their problems.

Keywords: citizens, urban, environmental, sustainability, solid waste, Tehran

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Authors: Maria Bonolo Mathevula

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Background: Children are important members of communities playing major role in the future of any given country (Pera, Fails, Gelsomini, &Garzotto, 2018). Visual Perceptual Skills (VPSs) in children are important health aspect of early childhood development through the Foundation Phases in school. Subsequently, children should undergo visual screening before commencement of schooling for early diagnosis ofVPSs anomalies because the primary role of VPSs is to capacitate children with academic performance in general. Aim : The aim of this study was to determine the anomalies of visual VPSs amongst school children in Foundation Phase. The study’s objectives were to determine the prevalence of VPSs anomalies amongst school children in Foundation Phase; Determine the relationship between children’s academic and VPSs anomalies; and to investigate the relationship between VPSs anomalies and refractive error. Methodology: This study was a mixed method whereby triangulated qualitative (interviews) and quantitative (questionnaire and clinical data) was used. This was, therefore, descriptive by nature. The study’s target population was school children in Foundation Phase. The study followed purposive sampling method. School children in Foundation Phase were purposively sampled to form part of this study provided their parents have given a signed the consent. Data was collected by the use of standardized interviews; questionnaire; clinical data card, and TVPS standard data card. Results: Although the study is still ongoing, the preliminary study outcome based on data collected from one of the Foundation Phases have suggested the following:While VPSs anomalies is not prevalent, it, however, have indirect relationship with children’s academic performance in Foundation phase; Notably, VPSs anomalies and refractive error are directly related since majority of children with refractive error, specifically compound hyperopic astigmatism, failed most subtests of TVPS standard tests. Conclusion: Based on the study’s preliminary findings, it was clear that optometrists still have a lot to do in as far as researching on VPSs is concerned. Furthermore, the researcher recommends that optometrist, as the primary healthcare professionals, should also conduct the school-readiness pre-assessment on children before commencement of their grades in Foundation phase.

Keywords: foundation phase, visual perceptual skills, school children, refractive error

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Authors: Albert T. Akume, Ankama G. Rosecana, Micheal Solomon

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Every citizen has rights that must be respected by others in the community. Ironically however, women in most communities are not accorded some of those rights as the male folks. This has not only facilitated their disempowerment but inhibited them from being treated with equal dignity that they deserve as their male counterpart; despite their valuable contribution to the society. Those forces against women empowerment are not limited to socio-cultural practices alone, but the character and nature of the state in Nigeria point to indicators of systemic and structural exclusion embedded in its framework. The consequence of this is that the vital contributions of women to sustainable community development have eluded many communities in Nigeria with adverse tell-tell signs on the environment. It is for this reason that the objective of this study is not only to highlight the causes and challenges associated with women disempowerment, but also to draw attention to the need to correct those anomaly against women in order to genuinely empower them to contribute to sustainable community development in Nigeria.

Keywords: capacity development, community, social sustainability, sustainable development, women empowerment

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Authors: Shivani Khare

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It is of paramount concern for economists to uncover the factors that determine human capital development, considered now to be one of the major factors behind economic growth and development. However, no human action is isolated but rather works within the set-up of the society. In recent years, a new field of investigation has come up that analyses the relationships that exist between social and human capital. Along these lines, this paper explores the effect of social capital on the indicators of human capital development – life expectancy at birth, mean years of schooling, and per capita income. The applied part of the analysis is performed using a panel data model for OECD countries and by using a series of chronological periods that within the 2005–2020 time frame.

Keywords: social capital, human capital development, trust, social networks, socioeconomics

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Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

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Background: DCIS accounts for 20% of malignancies diagnosed by the breast screening programme and is primarily managed by surgical excision. There is variable guidance on defining excision margins, and adjuvant treatments vary widely. This study aimed to investigate the clinical outcomes for patients following surgical excision of small volume DCIS. Methods: This single-centreretrospective cohort study of 101 consecutive breast screened patients diagnosed with DCIS who underwent surgical excision. All patients diagnosed with DCIS had radiological abnormalities <15mm. Clinical, radiological, and histological data were collected from patients who had been diagnosed within a 5 year period, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Outcomes included re-excision rates, radiotherapy usage, and the presence of invasive cancer. Results: Breast conservation surgery was performed in 94.1% (n=95). Following surgical excision, 74(73.27%)patients had complete DCIS excision (>2mm margin), 4(4.0%) had margins 1-2mm, and 17(16.84%)had margins <1mm. The median size of DCIS in the specimen sample was 4mm. In 86% of patients with involved margins (n=18), the mammogram underestimated the DCIS size by a median of 12.5mm (range: 1-42mm). Of the patients with involved margins, 11(10.9%)had a re-excision, and 6 of these (50%) required two re-excisions to completely excise the DCIS. Post-operative radiotherapy was provided to 53(52.48%)patients. Four (3.97%) patients were found to have invasive ductal carcinoma on surgical excision, which was not present on core biopsy – all had high-grade DCIS. Recurrence of DCIS was seen in the same site during follow-up in 1 patient (1%), 1 year after their first DCIS diagnosis. Conclusion: Breast conservation surgery is safe in patients with DCIS, with low rates of re-excision, recurrence, and upstaging to invasive cancer. Furthermore, the median size of DCIS found in the specimens of patients who had DCIS fully removed in surgery was low, suggesting it may be possible that total removal through VAE was possible for these patients.

Keywords: surgical excision, breast conservation surgery, DCIS, Re-excision, radiotherapy, invasive cancer

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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Background: Medical knowledge continuously evolves and to help health care providers to stay up-to-date, evidence-based medicine (EBM) has emerged as a model. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies, and the direct application of the findings to patient care. This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum. This course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. A survey was developed to assess the outcomes of the EBM course sequence. Methodology: The cornerstone of the three-semester sequence of EBM are interactive small group discussions that are designed to introduce students to the most clinically applicable skills to identify, manage and use the best clinical research evidence to improve the health of their patients. During the three-semester sequence, the students are assigned each semester to participate in small group discussions that are facilitated by faculty with varying background and expertise. Prior to the start of the first EBM course in the winter semester, PA students complete a knowledge-based survey that was developed by the authors to assess the effectiveness of the course series. The survey consists of 53 Likert scale questions that address the nine objectives for the course series. At the end of the three semester course series, the same survey was given to all students in the program and the results from before, and after the sequence of EBM courses are compared. Specific attention is paid to overall performance of students in the nine course objectives. Results: We find that students from the Class of 2016 and 2017 consistently improve (as measured by percent correct responses on the survey tool) after the EBM course series (Class of 2016: Pre- 62% Post- 75%; Class of 2017: Pre- 61 % Post-70%). The biggest increase in knowledge was observed in the areas of finding and evaluating the evidence, with asking concise clinical questions (Class of 2016: Pre- 61% Post- 81%; Class of 2017: Pre- 61 % Post-75%) and searching the medical database (Class of 2016: Pre- 24% Post- 65%; Class of 2017: Pre- 35 % Post-66 %). Questions requiring students to analyze, evaluate and report on the available clinical evidence regarding diagnosis showed improvement, but to a lesser extend (Class of 2016: Pre- 56% Post- 77%; Class of 2017: Pre- 56 % Post-61%). Conclusions: Outcomes identified that students did gain skills which will allow them to apply EBM principles. In addition, the outcomes of the knowledge-based survey allowed the faculty to focus on areas needing improvement, specifically the translation of best evidence into patient care. To address this area, the clinical faculty developed case scenarios that were incorporated into the lecture and discussion sessions, allowing students to better connect the research studies with patient care. Students commented that ‘class discussion and case examples’ contributed most to their learning and that ‘it was helpful to learn how to develop research questions and how to analyze studies and their significance to a potential client’. As evident by the outcomes, the EBM courses achieved the goals of the course and were well received by the students. 

Keywords: evidence-based medicine, clinical education, assessment tool, physician assistant

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Authors: Mina Salamatmanesh, Elizabeth Fitzpatrick, Tim Ramsay, Josee Lagacé, Lindsey Sikora, JoAnne Whittingham

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Introduction: Hearing loss (HL) is one of the most common disorders that presents at birth and in early childhood. Universal newborn hearing screening (UNHS) has been adopted based on the assumption that with early identification of HL, children will have access to optimal amplification and intervention at younger ages, therefore, taking advantage of the brain’s maximal plasticity. One particular challenge for parents in the early years is achieving consistent hearing aid (HA) use which is critical to the child’s development and constitutes the first step in the rehabilitation process. This study examined the consistency of hearing aid use in young children based on data logging information documented during audiology sessions in the first three years after hearing aid fitting. Methodology: The first 100 children who were diagnosed with bilateral HL before 72 months of age since 2003 to 2015 in a pediatric audiology clinic and who had at least two hearing aid follow-up sessions with available data logging information were included in the study. Data from each audiology session (age of child at the session, average hours of use per day (for each ear) in the first three years after HA fitting) were collected. Clinical characteristics (degree of hearing loss, age of HA fitting) were also documented to further understanding of factors that impact HA use. Results: Preliminary analysis of the results of the first 20 children shows that all of them (100%) have at least one data logging session recorded in the clinical audiology system (Noah). Of the 20 children, 17(85%) have three data logging events recorded in the first three years after HA fitting. Based on the statistical analysis of the first 20 cases, the median hours of use in the first follow-up session after the hearing aid fitting in the right ear is 3.9 hours with an interquartile range (IQR) of 10.2h. For the left ear the median is 4.4 and the IQR is 9.7h. In the first session 47% of the children use their hearing aids ≤5 hours, 12% use them between 5 to 10 hours and 22% use them ≥10 hours a day. However, these children showed increased use by the third follow-up session with a median (IQR) of 9.1 hours for the right ear and 2.5, and of 8.2 hours for left ear (IQR) IQR is 5.6 By the third follow-up session, 14% of children used hearing aids ≤5 hours, while 38% of children used them ≥10 hours. Based on the primary results, factors like age and level of HL significantly impact the hours of use. Conclusion: The use of data logging information to assess the actual hours of HA provides an opportunity to examine the: a) challenges of families of young children with HAs, b) factors that impact use in very young children. Data logging when used collaboratively with parents, can be a powerful tool to identify problems and to encourage and assist families in maximizing their child’s hearing potential.

Keywords: hearing loss, hearing aid, data logging, hours of use

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Authors: Dan Cristian Popescu

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The new territorial identities and global dynamics have determined a change of policies of economics, social and cultural development from a vertical to a horizontal approach, which is based on cooperation networks between institutional actors, economic operators or civil society representatives. The European integration has not only generated a different patterns of competitiveness, economic growth, concentration of attractive potential, but also disparities among regions of this country, or even in the countryside within a region. To a better understanding of the dynamics of regional development and the impact of this concept on Romania, I chose as a case study the region Bucharest-Ilfov which is analyzed on the basis of predetermined indicators and of the impact of European programs.

Keywords: regional competition, regional development, rural, urban

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Authors: Abeer Toheed Quadri, Maria Abubakar, Mehreen Sirshar

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Component Based Software Development (CBSD) is a new trend in software development. Selection of quality components is not enough to ensure software quality in Component Based Software System (CBSS). A software product is considered to be a quality product if it satisfies its customer’s needs and has minimum defects. Authors’ survey different research papers and analyzes various techniques which ensure software quality in component based software development. This paper includes an investigation about how to improve the quality of a component based software system without effecting quality attributes. The reported information is identified from literature survey. The developments of component based systems are rising as they reduce the development time, effort and cost by means of reuse. After analysis, it has been explored that in order to achieve the quality in a CBSS we need to have the components that are certified through software measure because the predictability of software quality attributes of system depend on the quality attributes of the constituent components, integration process and the framework used.

Keywords: CBSD (component based software development), CBSS (component based software system), quality components, SQA (software quality assurance)

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Authors: M. Volpini, D. Alves, A. Horta, M. Borges, P. Reis

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The gait pattern in people that present motor limitations foment the demand for auxiliary locomotion devices. These artifacts for movement assistance vary according to its shape, size and functional features, following the clinical applications desired. Among the ortheses of lower limbs, the ankle-foot orthesis aims to improve the ability to walk in people with different neuromuscular limitations, although they do not always answer patients' expectations for their aesthetic and functional characteristics. The purpose of this study is to explore the possibility of using new design in additive manufacturer to reproduce the shape and functional features of a ankle-foot orthesis in an efficient and modern way. Therefore, this work presents a study about the performance of the mechanical forces through the analysis of finite elements in an ankle-foot orthesis. It will be demonstrated a study of distribution of the stress on the orthopedic device in orthostatism and during the movement in the course of patient's walk.

Keywords: additive manufacture, new designs, orthoses, finite elements

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Authors: Alua Massalimova

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Situation analysis of Blood Service revealed that the strengths dominated over the weak 1.4 times. The possibilities dominate over the threats by 1.1 times. It follows that by using timely the possibility the Service, it is possible to strengthen its strengths and avoid threats. Priority directions of the resulting analysis are the use of subjective factors, such as personal management capacity managers of the Blood Center in the field of possibilities of legal activity of administrative decisions and the mobilization of stable staff in general market conditions. We have studied for the period 2011-2015 retrospectively indicators of Blood Service of Kazakhstan. Strengths of Blood Service of RK(Ps4,5): 1) indicators of donations for 1000 people is higher than in some countries of the CIS (in Russia 14, Kazakhstan - 17); 2) the functioning science centre of transfusiology; 3) the legal possibility of additional financing blood centers in the form of paid services; 4) the absence of competitors; 5) training on specialty Transfusiology; 6) the stable management staff of blood centers, a high level of competence; 7) increase in the incidence requiring transfusion therapy (oncohematology); 8) equipment upgrades; 9) the opening of a reference laboratory; 10) growth of the proportion of issued high-quality blood components; 11) governmental organization 'Drop of Life'; 12) the functioning bone marrow register; 13) equipped with modern equipment HLA-laboratory; 14) High categorization of average medical workers; 15) availability of own specialized scientific journal; 16) vivarium. The weaknesses (Ps = 3.5): 1) the incomplete equipping of blood centers and blood transfusion cabinets according to standards; 2) low specific weight of paid services of the CC; 3) low categorization of doctors; 4) high staff turnover; 5) the low scientific potential of industrial and clinical of transfusiology; 6) the low wages paid; 7) slight growth of harvested donor blood; 8) the weak continuity with offices blood transfusion; 9) lack of agitation work; 10) the formally functioning of Transfusion Association; 11) the absence of scientific laboratories; 12) high standard deviation from the average for donations in the republic. The possibilities (Ps = 2,7): 1): international grants; 2) organization of international seminars on clinical of transfusiology; 3) cross-sectoral cooperation; 4) to increase scientific research in the field of clinical of transfusiology; 5) reduce the share of donation unsuitable for transfusion and processing; 6) strengthening marketing management in the development of fee-based services; 7) advertising paid services; 8) strengthening the publishing of teaching aids; 9) team-building staff. The threats (Ps = 2.1): 1) an increase of staff turnover; 2) the risk of litigation; 3) reduction gemoprodukts based on evidence-based medicine; 4) regression of scientific capacity; 5) organization of marketing; 6) transfusiologist marketing; 7) reduction in the quality of the evidence base transfusions.

Keywords: blood service, healthcare, Kazakhstan, quantative swot analysis

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Authors: Devieta Romadhon Saendardy

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Introduction: The case of aneurysmal subarachnoid hemorrhage (SAH) associated with intraventricular hemorrhage (IVH) in many way. In general, the anterior communicating artery and posterior circulation aneurysms cause Intraventricular Hemorrhage. The development of intraventricular hemorrhage (IVH) in aneurysmal subarachnoid hemorrhage (aSAH) is linked with higher mortality and poor neurological recovery. Case: This case report presents a 51-year-old female patient who developed IVH following SAH. The patient's Glasgow Coma Scale score was 14, the patient has a severe headache, and there were right extremity hemipharese neurological deficits. A non-contrast head CT scan revealed a massive intraventricular haemorrhage. In an hour, the patient got her headache and pharese worse. Discussion: Intraventricular hemorrhage is a serious complication of subarachnoid hemorrhage, necessitating prompt recognition and management. This case highlights the importance of a time management, medical management and surgical intervention to optimize outcomes in patients with intraventricular hemorrhage caused by subarachnoid hemorrhage. Placement of a shunt system improves clinical outcome in intraventricular hemorrhage.

Keywords: Intraventricular hemorrhage, subarachnoid hemorrhage, shunt, time

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Authors: Mujahid Sultan

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The IT industry has seen many transformations in the Software Development Life Cycle (SDLC) methodologies and development approaches. SDLCs range from waterfall to agile, and the development approaches from monolith to microservices. Management, orchestration, and monetization of microservices have created an API economy in the modern enterprise. There are two approaches to API design, code first and design first. Design first is gaining popularity in the industry as this allows capturing the API needs from the stakeholders rather than the development teams guesstimating the needs and associating a monetary value with the APIs and microservices. In this publication, we describe an approach to organizing and creating stakeholder needs and requirements for designing microservices and APIs.

Keywords: requirements engineering, enterprise architecture, APIs, microservices, DevOps, continuous delivery, continuous integration, stakeholder viewpoints

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Authors: Nino Grigolaia

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The paper discusses the importance of the development of the gig economy in the economy of Georgia, analyzes the trends of the development of the gig economy, and identifies the main challenges in this field. Objective. The objective of the study is to assess the role of the gig economy, identify the main challenges and develop recommendations. Methodologies. Analysis, synthesis, comparison, induction and other methods are used; A desk study has been conducted. Findings. The advantages and disadvantages of the gig economy are identified, and the impact of the changes caused by the development of the gig economy on labor relations and employment is determined. It is argued that the ongoing technological changes have led to the emergence of new global trends in the labor market and increased the inequality of income distribution. Conclusions. Based on the analysis of the gig economy in the world and in Georgia, relevant recommendations are proposed, namely: establishing a new system of regulating the incomes of employees in this field, developing a real social protection mechanism, Development of political and legal instruments for regulation of gig economy and others.

Keywords: gig economy, economy of Georgia, digital platforms, labor relations

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Authors: Madhuri S. Ghate, Rahul P. Chavhan, Shriya S. Nahar

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Learning objective: •To describe Magnetic Resonance Imaging (MRI) imaging appearances of typical and atypical uterine fibroids with emphasis on differentiating it from other similar conditions. •To classify uterine fibroids according to International Federation of Gynecology and Obstetrics (FIGO) Sub-classifications system and emphasis on its clinical significance. •To show cases with atypical imaging appearances atypical fibroids Material and methods: MRI of Pelvis had been performed in symptomatic women of child bearing age group on 1.5T and 3T MRI using T1, T2, STIR, FAT SAT, DWI sequences. Contrast was administered when degeneration was suspected. Imaging appearances of Atypical fibroids and various degenerations in fibroids were studied. Fibroids were classified using FIGO Sub-classification system. Its impact on surgical decision making and clinical outcome were also studied qualitatively. Results: Intramural fibroids were most common (14 patients), subserosal 7 patients, submucosal 5 patients . 6 patients were having multiple fibroids. 7 were having atypical fibroids. (1 hyaline degeneration, 1 cystic degeneration, 1 fatty, 1 necrosis and hemorrhage, 1 red degeneration, 1 calcification, 1 unusual large bilobed growth). Fibroids were classified using FIGO system. In uterus conservative surgeries, the lesser was the degree of myometrial invasion of fibroid, better was the fertility outcome. Conclusion: Relationship of fibroid with mucosal and serosal layers is important in the management of symptomatic fibroid cases. Risk to fertility involved in uterus conservative surgeries in women of child bearing age group depends on the extent of myometrial invasion of fibroids. FIGO system provides better insight into the degree of myometrial invasion. Knowledge about the atypical appearances of fibroids is important to avoid diagnostic confusion and untoward treatment.

Keywords: degeneration, FIGO sub-classification, MRI pelvis, uterine fibroids

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Authors: Jeong-Hyun Park, Young-Sik Park, Hyo-Teag Jung

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This paper presents static analysis deployment model for code quality on R&D Projects of SW Development. The proposed model includes the scope of R&D projects and index for static analysis of source code, operation model and execution process, environments and infrastructure system for R&D projects of SW development. There is the static analysis result of pilot project as case study based on the proposed deployment model and environment, and strategic considerations for success operation of the proposed static analysis deployment model for R&D Projects of SW Development. The proposed static analysis deployment model in this paper will be adapted and improved continuously for quality upgrade of R&D projects, and customer satisfaction of developed source codes and products.

Keywords: static analysis, code quality, coding rules, automation tool

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Authors: Minhas Alam, Muhammad Hidayat Rasool, Mohsin Khurshid, Bilal Aslam

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The genus Acinetobacter has emerged as a significant concern in hospital-acquired infections, particularly due to the versatility of Acinetobacter baumannii in causing nosocomial infections. The organism's remarkable metabolic adaptability allows it to thrive in various environments, including the environment, animals, and humans. However, the extent of antimicrobial resistance in Acinetobacter species from veterinary settings, especially in developing countries like Pakistan, remains unclear. This study aimed to isolate and characterize Acinetobacter spp. from veterinary settings in Punjab, Pakistan. A total of 2,230 specimens were collected, including 1,960 samples from veterinary settings (nasal and rectal swabs from dairy and beef cattle), 200 from the environment, and 70 from human clinical settings. Isolates were identified using routine microbiological procedures and confirmed by polymerase chain reaction (PCR). Antimicrobial susceptibility was determined by the disc diffusion method, and minimum inhibitory concentration (MIC) was measured by the micro broth dilution method. Molecular techniques, such as PCR and DNA sequencing, were used to screen for antimicrobial-resistant determinants. Genetic diversity was assessed using standard techniques. The results showed that the overall prevalence of A. baumannii in cattle was 6.63% (65/980). However, among cattle, a higher prevalence of A. baumannii was observed in dairy cattle, 7.38% (54/731), followed by beef cattle, 4.41% (11/249). Out of 65 A. baumannii isolates, the carbapenem resistance was found in 18 strains, i.e. 27.7%. The prevalence of A. baumannii in nasopharyngeal swabs was higher, i.e., 87.7% (57/65), as compared to rectal swabs, 12.3% (8/65). Class D β-lactamases genes blaOXA-23 and blaOXA-51 were present in all the CRAB from cattle. Among carbapenem-resistant isolates, 94.4% (17/18) were positive for class B β-lactamases gene blaIMP, whereas the blaNDM-1 gene was detected in only one isolate of A. baumannii. Among 70 clinical isolates of A. baumannii, 58/70 (82.9%) were positive for the blaOXA-23-like gene, and 87.1% (61/70) were CRAB isolates. Among all clinical isolates of A. baumannii, blaOXA-51-like gene was present. Hence, the co-existence of blaOXA-23 and blaOXA-51 was found in 82.85% of clinical isolates. From the environmental settings, a total of 18 A. baumannii isolates were recovered; among these, 38.88% (7/18) strains showed carbapenem resistance. All environmental isolates of A. baumannii harbored class D β-lactamases genes, i.e., blaOXA-51 and blaOXA-23 were detected in 38.9% (7/18) isolates. Hence, the co-existence of blaOXA-23 and blaOXA-51 was found in 38.88% of isolates. From environmental settings, 18 A. baumannii isolates were recovered, with 38.88% showing carbapenem resistance. All environmental isolates harbored blaOXA-51 and blaOXA-23 genes, with co-existence in 38.88% of isolates. MLST results showed ten different sequence types (ST) in clinical isolates, with ST 589 being the most common in carbapenem-resistant isolates. In veterinary isolates, ST2 was most common in CRAB isolates from cattle. Immediate control measures are needed to prevent the transmission of CRAB isolates among animals, the environment, and humans. Further studies are warranted to understand the mechanisms of antibiotic resistance spread and implement effective disease control programs.

Keywords: Acinetobacter baumannii, carbapenemases, drug resistance, MSLT

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Authors: Ayoub Kafyulilo, Petra Fisser, Joke Voogt

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This study was conducted to assess the continuation of the use of technology in science and mathematics teaching of the pre-service and in-service teachers who attended the professional development programme. It also assessed professional development, personal, institutional, and technological factors contributing to the continuous use of technology in teaching. The study involved 42 teachers, thirteen pre-service teachers, and twenty-nine in-service teachers. A mixed-method research approach was used to collect data for this study. Findings showed that the continuous use of technology in teaching after the termination of the professional development arrangement was high among the pre-service teachers, and differed for the in-service teachers. The regression model showed that knowledge and skills, access to technology and ease of use were strong predictors (R2 = 55.3%) of the teachers’ continuous use of technology after the professional development arrangement. The professional development factor did not have a direct effect on the continuous use of technology, rather had an influence on personal factors (knowledge and skills). In turn, the personal factors had influence on the institutional factors (access to technology) and technological factors (ease of use), which together had an effect on the teachers’ continuous use of technology in teaching.

Keywords: technology, professional development, teachers, science and mathematics

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Authors: Albert T. Akume, Yahya M. Abdullahi

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The impact of poverty on individual and society is grave, hence the efforts by the government to eradicate or alleviate. In Nigeria the various efforts to reduce rural poverty by empowering them and making the process of their development self-sustaining have ended dismally. That notwithstanding, government determination to conquer poverty has not diminish as in the early 1990s the government with financial collaboration from the World Bank and African Development Bank introduced the fadama project. It is against this backdrop that this paper uses the documentary and analytical research methods to examine the implication the fadama development project has for community capacity development and human security in Nigeria. From the analysis it was discovered the fadama project improved household income of fadama farmers, community empowerment, participatory development planning and support for demand driven productive investment in farm and non-farm activities including community infrastructures. Despite this impressive result the fadama project is challenged by conflict especially in northern Nigeria and late delivery of necessary farm consumables that aid improved productivity. It was therefore recommended that the government should strengthen her various state security institutions to proactively mitigate conflicts and to ensure that farm consumables and other support services reach farmers timely.

Keywords: capacity development, empowerment, fadama, human security, poverty reduction, theory of change, sustainable development

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Authors: Kareem Saber

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Many products’ design instructors search for how to help students to develop their designs simply by reducing design stages and extrapolating simple design process forms to achieve design creativity. So, the researcher extrapolated a new design process form called “hierarchical design” which reduced design process into three stages and he had tried that methodology on about two hundred students. That trial had led to great results as students could develop their designs which characterized by creativity and innovation. That proved the success and effectiveness of the proposed methodology.

Keywords: mind mapping, morphological analysis, product design, design process

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Authors: Eda Jazexhiu-Postoli, Gladiola Hoxha, Ada Simeoni, Sonila Biba

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Background Neonatal hypotonia represents a commonly encountered issue in the Neonatal Intensive Care Unit and newborn nursery. The differential diagnosis is broad, encompassing chromosome abnormalities, primary muscular dystrophies, neuropathies and inborn errors of metabolism. Aim of study Our study describes some of the main clinical features of hypotonia in newborns and presents clinical cases of neonatal hypotonia we treated in our Neonatal unit in the last 3 years. Case reports Four neonates born in our hospital presented with hypotonia after birth, one preterm newborn 35-36 weeks of gestational age and three other term newborns (38-39 weeks of gestational age). Prenatal data revealed a decrease in fetal movements in both cases. Intrapartum meconium-stained amniotic fluid was found in 75% of our hypotonic newborns. Clinical features included inability to establish effective respiratory movements and need for resuscitation in the delivery room, respiratory distress syndrome, feeding difficulties and need for oro-gastric tube feeding, dysmorphic features, hoarse voice and moderate to severe muscular hypotonia. The genetic workup revealed the diagnosis of Autosomal Recessive Congenital Myasthenic Syndrome 1-B, Sotos Syndrome, Spinal Muscular Atrophy Type 1 and Transient Hypotonia of the Newborn. Two out of four hypotonic neonates were transferred to the Pediatric Intensive Care Unit and died at the age of three to five months old. Conclusion Hypotonia is a concerning finding in neonatal care and it is suggested by decreased intrauterine fetal movements, failure to establish first breaths, respiratory distress and feeding difficulties in the neonate. Prognosis is determined by its etiology and time of diagnosis and intervention.

Keywords: hypotonic neonate, respiratory distress, feeding difficulties, fetal movements

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Authors: Dagmara A. Niedziela, Mark P. Murphy, Orla M. Keane, Finola C. Leonard

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Staphylococcus aureus is the most frequent cause of clinical and subclinical bovine mastitis in Ireland. Mastitis caused by S. aureus is often chronic and tends to recur after antibiotic treatment. This may be due to several virulence factors, including attributes that enable the bacterium to internalize into bovine mammary epithelial cells, where it may evade antibiotic treatment, or evade the host immune response. Four bovine-adapted lineages (CC71, CC97, CC151 and ST136) were identified among a collection of Irish S. aureus mastitis isolates. Genotypic variation of mastitis-causing strains may contribute to different presentations of the disease, including differences in milk somatic cell count (SCC), the main method of mastitis detection. The objective of this study was to investigate the influence of bacterial strain and lineage on host immune response, by employing cell culture methods in vitro as well as an in vivo infection model. Twelve bovine adapted S. aureus strains were examined for internalization into bovine mammary epithelial cells (bMEC) and their ability to induce an immune response from bMEC (using qPCR and ELISA). In vitro studies found differences in a variety of virulence traits between the lineages. Strains from lineages CC97 and CC71 internalized more efficiently into bovine mammary epithelial cells (bMEC) than CC151 and ST136. CC97 strains also induced immune genes in bMEC more strongly than strains from the other 3 lineages. One strain each of CC151 and CC97 that differed in their ability to cause an immune response in bMEC were selected on the basis of the above in vitro experiments. Fourteen first-lactation Holstein-Friesian cows were purchased from 2 farms on the basis of low SCC (less than 50 000 cells/ml) and infection free status. Seven cows were infected with 1.73 x 102 c.f.u. of the CC97 strain (Group 1) and another seven with 5.83 x 102 c.f.u. of the CC151 strain (Group 2). The contralateral quarter of each cow was inoculated with PBS (vehicle). Clinical signs of infection (temperature, milk and udder appearance, milk yield) were monitored for 30 days. Blood and milk samples were taken to determine bacterial counts in milk, SCC, white blood cell populations and cytokines. Differences in disease presentation in vivo between groups were observed, with two animals from Group 2 developing clinical mastitis and requiring antibiotic treatment, while one animal from Group 1 did not develop an infection for the duration of the study. Fever (temperature > 39.5⁰C) was observed in 3 animals from Group 2 and in none from Group 1. Significant differences in SCC and bacterial load between groups were observed in the initial stages of infection (week 1). Data is also being collected on cytokines and chemokines secreted during the course of infection. The results of this study suggest that a strain from lineage CC151 may cause more severe clinical mastitis, while a strain from lineage CC97 may cause mild, subclinical mastitis. Diversity between strains of S. aureus may therefore influence the clinical presentation of mastitis, which in turn may influence disease detection and treatment needs.

Keywords: Bovine mastitis, host immune response, host-pathogen interactions, Staphylococcus aureus

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Authors: Indri Nilam Sari, Aris Subagiyo, Nindya Sari

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Malinau Regency border area is an area which is based on the RTRWN and the development priority. But, in real border area Malinau Regency placed as backyard from Indonesian area and caused development lag that is fairly large compared by town area in Malinau Regency. This research aimed to know the condition of the gap in the Malinau Regency border and its influence on the development of the border region as well as knowing the problems related to the economy development of society in the area of the border district of Malinau. Methods of analysis are used in namely descriptive analysis that represent analysis of land use and analysis of movement activities of the population, level analysis facility and infrastructure, economy analysis that represent top commodity determination analysis (LQ and Growth Share) and accessibility. The results of the study showed that the condition of the Malinau Regency border come within the gap as seen from the contributions of infrastructure repair facilities and accessibility advocates, communities, scattered seed commodities come within the borders and human resources with the condition of the most Upstream Bahau town in the backwaters of the town more. There are a few problems that cause the condition area of the border experiencing inequality, lack of human resources, poor infrastructure, lack of accessibility and low levels of security so that it brings development recommendations was the development of the flagship commodities and infrastructure as well as supporting community economic infrastructure, as well as human resources.

Keywords: border, economy, development, Malinau

Procedia PDF Downloads 442

Authors: A. Lubis, R. Widayanti, Z. Hikmah, A. Endaryanto, A. Harsono, A. Harianto, R. Etika, D. K. Handayani, M. Sampurna

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: neonatus lupus erythematous, maternal autoantibody, clinical characteristic, multiple organ manifestation

Procedia PDF Downloads 409

Authors: Yoon Kyung Song, Seung Won Han, Sang Hyun Hwang, Do Hoon Lee

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Laboratory tests is a significant part for the diagnosis, prognosis, treatment of diseases. Blood collection is a simple process, but can be a potential cause of pre-analytical errors. Vacuum blood collection tubes used to collect and store the blood specimens is necessary for accurate test results. The purpose of this study was to validate Improve serum separator tube(SST) (Guanzhou Improve Medical Instruments Co., Ltd, China) for routine clinical chemistry laboratory testing. Blood specimens were collected from 100 volunteers in three different serum vacuum tubes (Greiner SST , Becton Dickinson SST , Improve SST). The specimens were evaluated for 16 routine chemistry tests using TBA-200FR NEO (Toshiba Medical Co. JAPAN). The results were statistically analyzed by paired t-test and Bland-Altman plot. For stability test, the initial results for each tube were compared with results of 72 hours preserved specimens. Their clinical availability was evaluated by biological Variation of Ricos data bank. Paired t-test analysis revealed that AST, ALT, K, Cl showed statistically same results but calcium (CA), phosphorus(PHOS), glucose(GLU), BUN, uric acid(UA), cholesterol(CHOL), total protein(TP), albumin(ALB), total bilirubin(TB), ALP, creatinine(CRE), sodium(NA) were different(P < 0.05) between Improve SST and Greiner SST. Also, CA, PHOS, TP, TB, AST, ALT, NA, K, Cl showed statistically the same results but GLU, BUN, UA, CHOL, ALB, ALP, CRE were different between Improve SST and Becton Dickinson SST. All statistically different cases were clinically acceptable by biological Variation of Ricos data bank. Improve SST tubes showed satisfactory results compared with Greiner SST and Becton Dickinson SST. We concluded that the tubes are acceptable for routine clinical chemistry laboratory testing.

Keywords: blood collection, Guanzhou Improve, SST, vacuum tube

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Authors: Mergleda Hodo

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All national governments aim to achieve economic equilibrium to build sustainable welfare, political stability, and economic equilibrium. There are various instruments to stimulate economic development and growth and achieve macroeconomic objectives. After the collapse of the political and economic system in the 1990s, some countries faced the complex challenge of economic development. This study aims to determine, based on empirical research, whether and to what extent tax revenue has an impact on the economic development of Albania. Furthermore, it gives an overview of the ways in which high tax burdens on the western Balkan countries have negatively affected foreign investment and reduced economic growth. This analysis is important for these selected countries, as the financial system has changed significantly over the years and has been affected significantly by a period of economic transition. The analysis is performed based on secondary data possessed by the World Bank and the central bank of each participating country between 2005 and 2018. The research findings indicate that tax policy affects, to a significant extent, the economic development of Albania. An efficient tax system is when individuals are willing to pay tax liability which will help in improving the economic well-being of a country.

Keywords: tax, development, economic growth, tax revenue

Procedia PDF Downloads 63

Authors: Camille Plant, Katherine McGill, Pek Ang

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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.

Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry

Procedia PDF Downloads 133

Authors: Syed Makhdoom Hussain, Muhammad Afzal, Farhat Jabeen, Arshad Javid, Tasneem Hameed

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A feeding trial was conducted with Cirrhinus mrigala fingerlings to study the effects of microbial phytase with graded levels (0, 500, 1000, 1500, and 2000 FTUkg-1) by sunflower meal based diet on growth performance and nutrient digestibility. The chromic oxide was added as an indigestible marker in the diets. Three replicate groups of 15 fish (Average wt 5.98 g fish-1) were fed once a day and feces were collected twice daily. The results of present study showed improved growth and feed performance of Cirrhinus mrigala fingerlings in response to phytase supplementation. Maximum growth performance was obtained by the fish fed on test diet-III having 1000 FTU kg-1 phytase level. Similarly, nutrient digestibility was also significantly increased (p<0.05) by phytase supplementation. Digestibility coefficients for sunflower meal based diet increased 15.76%, 17.70%, and 12.70% for crude protein, crude fat and apparent gross energy as compared to the reference diet, respectively at 1000 FTU kg-1 level. Again, maximum response of nutrient digestibility was recorded at the phytase level of 1000 FTU kg-1 diet. It was concluded that the phytase supplementation to sunflower meal based diet at 1000 FTU kg-1 level is optimum to release adequate chelated nutrients for maximum growth performance of C. mrigala fingerlings. Our results also suggested that phytase supplementation to sunflower meal based diet can help in the development of sustainable aquaculture by reducing the feed cost and nutrient discharge through feces in the aquatic ecosystem.

Keywords: sunflower meal, Cirrhinus mrigala, growth, nutrient digestibility, phytase

Procedia PDF Downloads 289