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Authors: Kaushalendra Kumar, Abhishek Kumar, Chandra Moni, Sanjay Kumar, P. K. Singh, Ajeet Kumar

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Present study investigated the dietary inclusion of Moringa oleifera leaf meal (MOLM) on production efficiency, hemato-biochemical profile and economy of Vanaraja birds under tropical condition. Experiment was conducted for a period of 56 days on 300 Vanaraja birds randomly divided in to five different experimental groups including control of 60 birds each group replicated with 20 chicks in each replicate. T1, T2, T3, T4, and T5 were offered with 0, 5, 10, 15, and 20% Moringa oleifera leaf meal along with basal ration. All the standard managemental practices were followed during experimental period including vaccination schedule. Locally available Moringa oleifera leaves were harvested at mature stage and allowed to dry under shady and aerated conditions. Thereafter, dried leaves were milled to make a leaf meal and stored in the airtight nylon bags to avoid any possible contamination from foreign material and use for experiment. Production parameters were calculated based on the amount of feed consumed and weight gain every weeks. The body weight gain of T2 group was significantly (P < 0.05) higher side whereas T3 group was comparable with control. The feed conversion ratio for T2 group was found to be significantly (P < 0.05) lower than all other treatment groups, while none of the group was comparable with each other. At the end of the experiment blood samples were collected from birds for haematology study while serum biochemistry performed using spectrophotometer following statndard protocols. The haematological attributes were significantly (P > 0.05) not differed among the groups. However, serum biochemistry showed significant reduction (P < 0.05) of blood urea nitrogen, uric acid and creatinine level with higher level of MOLM diet, indicates better utilization of protein supplemented through MOLM. The total cholesterol and triglyceride level was declined significantly (P < 0.05) as compare to control group with increased level of MOLM in basal diet, decreasing trend of serum cholesterol noted. However, value of HDL for T3 group was highest and for T1 group was lowest but no significant difference (P < 0.05) found among the groups. It might be due to presence of β-sitosterol a bioactive compound present in MOLM which causes lowering of plasma concentration of LDL. During experiment total, LDL and VLDL level was found to be decreased significantly (P < 0.05) as compare to control group. It was observed that the production efficiency of birds significantly improved with 5% followed by 10% Moringa oleifera leaf meal among the treatment groups. However, the maximum profit per kg live weight was noted in 10 % level and least profit observed in 20% MOLM fed group. It was concluded that the dietary inclusion of MOLM improved overall performances without affecting metabolic status and effective in reducing cholesterol level reflects healthy chicken production for human consumption.

Keywords: hemato biochemistry, Moringa oleifera leaf meal, performance, Vanaraja birds

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Authors: Farhad Ahmadi, Hamed Kimiaee, Fariba Rahimi

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This research study focuses on the effect of different levels and sources of calcium on egg production, egg traits, and calcium retention in laying Japanese quail. The study aims to determine the impact of nano calcium carbonate (NCC) and calcium carbonate (CC) on these factors. The research was conducted using a total of 280 laying quail with an average age of 8 weeks. The quails were randomly distributed in a completely randomized design (CRD) with 7 treatments, 4 replications, and 10 quails in each pen. The study lasted for 90 days. The experimental diets included a control group (T1) with a basal diet consisting of 3.17% CaCO₃, and other groups supplemented with different levels (0.5%, 0.1%, and 0.15%) of either calcium carbonate (CC) or nano calcium carbonate (NCC). The quails had free access to water and feed throughout the study period. Findings: The results of the study showed that NCC at the levels of 0.1% and 0.15% (T6 and T7) improved eggshell thickness, shell thickness, and shell breaking strength compared to the control group. Although not statistically significant, there was an increasing trend in quail egg production and calcium retention in the calcareous shell of the egg in birds that consumed the experimental diets containing different levels of NCC compared to the control and other treatment groups. Quail egg production was recorded monthly for each treatment group. At the end of the study, a total of 40 eggs (10 eggs/replicate) from each treatment group were randomly selected for analysis. Parameters such as eggshell thickness, shell thickness, shell breaking strength, and calcium retention were measured. Statistical analysis was performed to compare the results between the different treatment groups. In conclusion, this study suggests that NCC at the levels of 0.1% and 0.15% can improve the quantity and quality of eggs and calcium retention in laying Japanese quail. These findings highlight the potential benefits of using NCC as a calcium source in quail diets. Further research could be conducted to explore the mechanisms behind these improvements and optimize the dosage of NCC for maximum effect.

Keywords: egg, calcium, nanoparticles, physiology

Procedia PDF Downloads 44

Authors: Jose Carlos Tavares Carvalho, Hady Keita, Giovanna Rocha Santana, Igor Victor Ferreira Dos Santos, Jesus Rafael Rodriguez Amado, Ariadna Lafourcade Prada, Adriana Maciel Ferreira, Helison Oliveira

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Summary: As animal model, zebrafish can be a good opportunity to establish a profile of tissue alteration caused by Bothrops alternatus venom and to screen new anti-venom drugs. Objective: To establish tissue biomarkers from zebrafish injected by snake venom and elucidate the use of glucocorticoids in ophidic accidents. Materials and Methods: The Danio rerio fish were randomly divided into four groups: control group, venom group, Dexamethasone1h before venom injected group and Dexamethasone 1 h after venom injected group. The concentration of Bothrops alternatus venom was 0.13 mg/ml and the fish received 20µl/Fish. The Body weight measurement and histological characteristics of gills, kidneys, liver, and intestine were determinate. Results: Physical analysis shows necrosis accompanied by inflammation in animals receiving the Bothrops alternatus venom. Significant difference was observed in the variation of weight between the control group, and the groups received the venom (t student test, p < 0.05). The average histological alterations index of gill, liver, kidney or intestine was statistically higher in animals received the venom (t Student test, p < 0.05). The alterations were lower in the groups that received Dexamethasone 1h before and after venom injected compared to the group that received only the venom. Dexamethasone 1h before venom injected group had minor histopathological alterations. Conclusion: The organs of zebrafish may be a tissue biomarker of alterations from Bothrops alternatus venom and dexamethasone reduced the damage caused by this venom in the organs studied, which may suggest the use of zebrafish as animal model for research related to screening new drug against snake venom.

Keywords: zebrafish, snake venom, biomarker, drugs

Procedia PDF Downloads 328

Authors: A. M. Nour, M. A. Zaki, E. A. Omer, Nourhan Mohamed

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Performances of mixed-sex Nile tilapia (Oreochromis niloticus) fingerlings (11.33 ± 1.78 g /fish) reared under biofloc system developed by molasses and sucrose as carbon sources in indoor fiberglass tanks were evaluated. Six indoor fiberglass tanks (1m 3 each filled with 1000 l of underground fresh water), each was stocked with 2kg fish were used for 14 weeks experimental period. Three experimental groups were designed (each group 2 tanks) as following: 1-control: 20% daily without biofloc, 2-zero water exchange rate with biofloc (molasses as C source) and 3-zero water exchange rate with biofloc (sucrose as C source). Fish in all aquariums were fed on floating feed pellets (30% crude protein, 3 mm in diameter) at a rate of 3% of the actual live fish body, 3 times daily and 6 days a week. Carbohydrate supplementations were applied daily to each tank two hrs, after feeding to maintain the carbon: nitrogen ratio (C: N) ratio 20:1. Fish were reared under continuous aeration by pumping air into the water in the tank bottom using two sandy diffusers and constant temperature between 27.0-28.0 ºC by using electrical heaters for 10 weeks. Criteria's for assessment of water quality parameters, biofloc production and fish growth performances were collected and evaluated. The results showed that total ammonia nitrogen in control group was higher than biofloc groups. The biofloc volumes were 19.13 mg/l and 13.96 mg/l for sucrose and molasses, respectively. Biofloc protein (%), ether extract (%) and gross energy (kcal/100g DM), they were higher in biofloc molasses group than biofloc sucrose group. Tilapia growth performances were significantly higher (P < 0.05) with molasses group than in sucrose and control groups, respectively. The highest feed and nutrient utilization values for protein efficiency ratio (PER), protein productive (PPV%) and energy utilization (EU, %) were higher in molasses group followed by sucrose group and control group respectively.

Keywords: biofloc, Nile tilapia, cabohydrates, performances

Procedia PDF Downloads 192

Authors: Abdeta Bayissa Mekessa

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The purpose of this study was to examine the effects of plyometric exercises on agility, power, and speed and improvement of U-17 female sprinters in the case of the Burayu Athletics project. The true experimental research design was employed for conducting this study. The total populations of the study were 14 U-17 female sprinters from Burayu athletics project. The populations were small in numbers; therefore, the researcher took all as a sample by using comprehensive sampling techniques. These subjects were classified into the Experimental group (N=7) and the Control group (N=7) by using simple random sampling techniques. The Experimental group participated in plyometric training for 8 weeks, 3 days per week and 60 minutes duration per day in addition to their regular training. But, the control groups were following their only regular training program. The variables selected for the purpose of this study were agility, power and speed. The tests were the Illinois agility test, standing long jump test, and 30m sprint test, respectively. Both groups were tested before (pre-test) and after (post-test) 8 weeks of plyometric training. For data analysis, the researcher used SPSS version 26.0 software. The collected data was analyzed using a paired sample t-test to observe the difference between the pre-test and post-test results of the plyometric exercises of the study. The significant level of p<0.05 was considered. The result of the study shows that after 8 weeks of plyometric training, significant improvements were found in Agility (MD=0.45, p<0.05), power (MD=-1.157, P<0.05) and speed (MD=0.37, P<0.05) for experimental group subjects. On the other hand, there was no significant change (P>0.05) in those variables in the control groups. Finally, the findings of the study showed that eight (8) weeks of plyometric exercises had a positive effect on agility, power and speed improvement of female sprinters. Therefore, Athletics coaches and athletes are highly recommended to include plyometric exercise in their training program.

Keywords: ploymetric exercise, speed power, aglity, female sprinter

Procedia PDF Downloads 39

Authors: Carlos Minguez, Christian F. Sagbay, Erika E. Ordoñez

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Guinea pigs (Cavia porcellus) play prominent roles as experimental models for medical research and as pets. However, in developing countries like South America, the Philippines, and sub-Saharan Africa, the meat of guinea pigs is an economic source of animal protein for the poor and malnourished humans because guinea pigs are mainly fed with forage and do not compete directly with human beings for food resources, such as corn or wheat. To achieve efficient production of guinea pigs, it is essential to provide insurance against vitamin C deficiency. The objective of this research was to investigate the effect of the partial replacement of alfalfa with fresh citrus pulp (Citrus sinensis) in a diet of guinea pigs on the growth performance, slaughter traits and mortality during the fattening period (between 20 and 74 days of age). A total of 300 guinea pigs were housed in collective cages of about ten animals (2 x 1 x 0.4 m) and were distributed into two completely randomized groups. Guinea pigs in both groups were fed ad libitum, with a standard commercial pellet diet (10 MJ of digestible energy/kg, 17% crude protein, 11% crude fiber, and 4.5% crude fat). Control group was supplied with fresh alfalfa as forage. In the treatment group, 30% of alfalfa was replaced by fresh citrus pulp. Growth traits, including body weight (BW), average daily gain (ADG), feed intake (FI), and feed conversion ratio (FCR), were measured weekly. On day 74, the animals were slaughtered, and slaughter traits, including live weight at slaughter (LWS), full gastrointestinal tract weight (FGTW), hot carcass weight (with head; HCW), cold carcass weight (with head; CCW), drip loss percentage (DLP) and dressing out carcass yield percentage (DCY), were evaluated. Contrasts between groups were obtained by calculated generalized least squares values. Mortality was evaluated by Fisher's exact test due to low numbers in some cells. In the first week, there were significant differences in the growth traits BW, ADG, FI, and FCR, which were superior in control group. These differences may have been due to the origin of the young guinea pigs, which, before weaning, were all raised without fresh citrus pulp, and they were not familiarized with the new supplement. In the second week, treatment group had significantly increased ADG compared with control group, which may have been the result of a process of compensatory growth. During subsequent weeks, no significant differences were observed between animals raised in the two groups. Neither were any significant differences observed across the total fattening period. No significant differences in slaughter traits or mortality rate were observed between animals from the two groups. In conclusion, although there were no significant differences in growth performance, slaughter traits, or mortality, the use of fresh citrus pulp is recommended. Fresh citrus pulp is a by-product of orange juice industry and it is cheap or free. Forage made with fresh citrus pulp could reduce about of 30 % the quantity of alfalfa in guinea pig for meat and as consequence, reduce the production costs.

Keywords: fresh citrus, growth, Guinea pig, mortality

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Authors: Sonam Agarwal, Renu Bist

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Current study emphasizes the toxic effects of dichlorvos on serum in terms of oxidative stress. Meanwhile, a protective action of bacoside A and bromelain was investigated against the biochemical alterations in serum. The experimental design included six groups of mice: saline was given as a vehicle to the control mice (group I). Mice belonging to groups II, III and IV, were administered with dichlorvos (40 mg/kg b.w.), bromelain and bacoside A, respectively. The fifth group received a combination of bromelain and bacoside A. In group VI, Bacoside A, and bromelain were administered 20 minutes prior to exposure of dichlorvos. Thiobarbituric acid reactive substances (TBARS), protein carbonyl content (PCC), catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) and reduced glutathione (GSH) level were used as biochemical test of toxic action for dichlorvos intoxication. Significantly increased TBARS and PCC level in second group suggests that dichlorvos enhances the production of free radicals in serum of mice (p< 0.05). Antioxidants treatment significantly decreased the levels of TBARS and PCC (p< 0.05). Dichlorvos administration causes a significant reduction in the level of CAT, SOD, GPx and GSH (p< 0.05) which was restored significantly by co-administration of bromelain and Bacoside A in dichlorvos exposed mice (p< 0.05). Treatment of bromelain and Bacoside A in combination served as better scavengers of toxicity induced by dichlorvos.

Keywords: bacoside A, bromelain, dichlorvos, serum

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Authors: Zahra Solgi, Hossein Rassi

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Colorectal cancer (CRC) is a multi-step disease, and chronic gastric infection with H. pylori could play a role in one or more of the steps in this pathogenic process. Polymorphisms in several miRNAs are considered to increase the risk for the development of CRC by controlling proliferation, apoptosis and H. pylori pathogenesis. Therefore, the aim of this study was to investigate miRNA146a rs2910164 polymorphism and Helicobacter pylori infection in CRC. A total of 65 patients with CRC were divided into 2 groups: 28 patients < 50 years of age and 37 patients ≥ 50 years of age. DNA was extracted from all samples by a standard method and H. pylori cagA and miRNA146a rs2910164 genotypes were determined by PCR method. The results show that there was no significant difference in the frequency of H. pylori cagA gene between the two groups but there was a significant difference in the distribution of rs2910164 genotypes in patients < 50 years of age with the p-value of 0.05 and odds ratio equal to 2.69. On other hand, patients < 50 years of age with genotype CC of miRNA146a showed a significant difference in CRC risk. Furthermore, there was a significant correlation between rs2910164 CC genotype with Helicobacter pylori infection in patients < 50 years of age. The present study suggests that the CC genotype of miRNA146a in combination with H. pylori infection can be effective as risk factors and molecular markers for early diagnosis and treatment of CRC.

Keywords: colorectal cancer, Helicobacter pylori, miRNA146a, rs2910164 polymorphism

Procedia PDF Downloads 152

Authors: Paulo O. Motita

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The Philippine Association of State Colleges and University (PASUC) is an association of State owned and operated higher learning institutions in the Philippines, it is the association that spearhead the conduct of the Annual National Athletic competitions for State Colleges and Universities and Arnis is one of the regular sports. In 2009, Republic Act 9850 also known as declared Arnis as the National Sports and Martial arts of the Philippines. Arnis an ancient Filipino Martial Arts is the major sports in the Annual Palarong Pambansa and other school based sports events. The researcher as a Filipino Martial Arts master and a former athlete desired to determine the extent of acceptability of the arnis rules in competition which serves as the basis for the development of arnis rules. The study aimed to assess the conduct of Arnis competition in PASUC Olympics 2015 in Tugegarao City, Cagayan, Philippines.the rules and conduct itself as perceived by Officiating officials, Coaches and Athletes during the competition last February 7-15, 2015. The descriptive method of research was used, the survey questionnaire as the data gathering instrument was validated. The respondents were composed of 12 Officiating officials, 19 coaches and 138 athletes representing the different regions. Their responses were treated using the Mean, Percentage and One-way Analysis of Variance. The study revealed that the conduct of Arnis competition in PASUC Olympics 2015 was at the low extent to moderate extent as perceived by the three groups of respondents in terms of officiating, scoring and giving violations. Furthermore there is no significant difference in the assessment of the three groups of respondents in the assessment of Anyo and Labanan. Considering the findings of the study, the following conclusions were drawn: 1). There is a need to identify the criteria for judging in Anyo and a tedious scrutiny on the rules of the game for labanan. 2) The three groups of respondents have similar views towards the assessment on the overall competitions for anyo that there were no clear technical guidelines for judging the performance of anyo event. 3). The three groups of respondents have similar views towards the assessment on the overall competitions for labanan that there were no clear technical guidelines for majority rule of giving scores in labanan. 4) The Anyo performance should be rated according to effectiveness of techniques and performance of weapon/s that are being used. 5) On other issues and concern towards the rules of competitions, labanan should be addressed in improving rules of competitions, focus on the applications of majority rules for scoring, players shall be given rest interval, a clear guidelines and set a standard qualifications for officiating officials.

Keywords: PASUC Olympics 2015, Arnis rules of competition, Anyo, Labanan, officiating

Procedia PDF Downloads 458

Authors: Farouk A. N. Bouhadiba

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This work addresses the issue of the LMD(Licence, Master, Doctorat) in Algeria and the impact it has had on education quality in terms of educational affect and effect. It starts with a brief introduction to the financial means, the educational settings, and the social environment in place when the LMD was institutionalized in Algeria (2003-2004). Some factors for the success or failure of this top-down institutional endeavor are examined and analyzed. These include – among other factors - the teacher/student attitudes, apprehensions, and motivations on the one hand and the institutional euphoria for the LMD in Algeria on the other hand. Some issues at stake are discussed. More specifically, the professional versus the student affect on today’s attitudes, interests, and values is examined as a result of nearly two decades of LMD teaching and learning in Algerian universities. We shall then present some official curricula that, in terms of content, reflect the spirit, principles, and architectures of the LMD but which, in reality, are partially, if not fully, set aside when it comes to teaching practices, learning behaviors, motivation, and evaluation. The discussion on effect highlights attitudinal, developmental, and social markers that are indicative of the extent to which Education Quality in Algeria has been positively or negatively affected by the implementation of the LMD.

Keywords: LMD bachelor's masters doctorat, affects and effects, education quality, Algeria

Procedia PDF Downloads 30

Authors: Bambang Wispriyono, Satria Pratama, Haryoto Kusnoputranto, Faisal Yunus, Meliana Sari

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Introduction/objective: The impact of the development of motor vehicles is increasing the number of pollutants in the air. One of the substances that cause serious health problems is NO2. The health impacts arising from exposure to NO2 include pulmonary function impairment. The purpose of this study was to determine the relationship of NO2 exposure on the incidence of pulmonary function impairment. Methods: We are using a cross-sectional study design with 110 traffic police who were divided into two groups: exposed (police officers working on the highway) and the unexposed group (police officers working in the office). Election subject convenient sampling carried out in each group to the minimum number of samples met. Results: The results showed that the average NO2 in the exposed group was 18.72 ppb and unexposed group is 4.14 ppb. Pulmonary dysfunction on exposed and unexposed groups showed that FVC (Forced Vital Capacity) value are 88.68 and 90.27. And FEV1 (Forced Expiratory Volume in One) value are 94.9 and 95.16. Some variables like waist circumference, Body Mass Index, Visceral Fat, and Fat has associated with the incidence of Pulmonary Dysfunction (p < 0.05). Conclusion: Health monitoring is needed to decreasing health risk in Policeman.

Keywords: NO2, pulmonary dysfunction, police traffic, Jakarta

Procedia PDF Downloads 257

Authors: Haoming Ma, Guo Yu, Peiru Zhou

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Background: Previous studies show that dysglycemia, mostly hyperglycemia, hypoglycemia and glycemic variability(GV), are associated with excess mortality in critically ill patients, especially those without diabetes. Glycemic variability is an increasingly important measure of glucose control in the intensive care unit (ICU) due to this association. However, there is limited data pertaining to the relationship between different clinical factors and glycemic variability and clinical outcomes categorized by their DM status. This retrospective study of 958 intensive care unit(ICU) patients was conducted to investigate the relationship between GV and outcome in critically ill patients and further to determine the significant factors that contribute to the glycemic variability. Aim: We hypothesize that the factors contributing to mortality and the glycemic variability are different from critically ill patients with or without diabetes. And the primary aim of this study was to determine which dysglycemia (hyperglycemia\hypoglycemia\glycemic variability) is independently associated with an increase in mortality among critically ill patients in different groups (DM/Non-DM). Secondary objectives were to further investigate any factors affecting the glycemic variability in two groups. Method: A total of 958 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The glycemic variability was defined as the coefficient of variation (CV) of blood glucose. The main outcome was death during hospitalization. The secondary outcome was GV. The logistic regression model was used to identify factors associated with mortality. The relationships between GV and other variables were investigated using linear regression analysis. Results: Information on age, APACHE II score, GV, gender, in-ICU treatment and nutrition was available for 958 subjects. Predictors remaining in the final logistic regression model for mortality were significantly different in DM/Non-DM groups. Glycemic variability was associated with an increase in mortality in both DM(odds ratio 1.05; 95%CI:1.03-1.08,p＜0.001) or Non-DM group(odds ratio 1.07; 95%CI:1.03-1.11,p=0.002). For critically ill patients without diabetes, factors associated with glycemic variability included APACHE II score(regression coefficient, 95%CI:0.29,0.22-0.36,p＜0.001), Mean BG(0.73,0.46-1.01,p＜0.001), total parenteral nutrition(2.87,1.57-4.17,p＜0.001), serum albumin(-0.18,-0.271 to -0.082,p＜0.001), insulin treatment(2.18,0.81-3.55,p=0.002) and duration of ventilation(0.006,0.002-1.010,p=0.003).However, for diabetes patients, APACHE II score(0.203,0.096-0.310,p＜0.001), mean BG(0.503,0.138-0.869,p=0.007) and duration of diabetes(0.167,0.033-0.301,p=0.015) remained as independent risk factors of GV. Conclusion: We found that the relation between dysglycemia and mortality is different in the diabetes and non-diabetes groups. And we confirm that GV was associated with excess mortality in DM or Non-DM patients. Furthermore, APACHE II score, Mean BG, total parenteral nutrition, serum albumin, insulin treatment and duration of ventilation were significantly associated with an increase in GV in Non-DM patients. While APACHE II score, mean BG and duration of diabetes (years) remained as independent risk factors of increased GV in DM patients. These findings provide important context for further prospective trials investigating the effect of different clinical factors in critically ill patients with or without diabetes.

Keywords: diabetes, glycemic variability, predictors, severe disease

Procedia PDF Downloads 189

Authors: Victoria Bila, Iryna Ventskivska, Oleksandra Zahorodnia

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The goal of the study: To study the distribution of patients of the Kiyv Perinatal Center according to the Robson system and compare it with world data. Materials and methods: a comparison of the distribution of patients of Kiyv Perinatal center according to the Robson system for 2 periods - the first quarter of 2019 and 2020. For each group, 3 indicators were analyzed - the share of this group in the overall structure of patients of the Perinatal Center for the reporting period, the frequency of abdominal delivery in this group, as well as the contribution of this group to the total number of abdominal delivery. Obtained data were compared with those of the WHO in the guidelines for the implementation of the Robson system in 2017. Results and its discussion: The distribution of patients of the Perinatal Center into groups in the Robson classification is not much different from that recommended by the author. So, among all women, patients of group 1 dominate; this indicator does not change in dynamics. A slight increase in the share of group 2 (6.7% in 2019 and 9.3% - 2020) was due to an increase in the number of labor induction. At the same time, the number of patients of groups 1 and 2 in the Perinatal Center is greater than in the world population, which is determined by the hospitalization of primiparous women with reproductive losses in the past. The Perinatal Center is distinguished from the world population and the proportion of women of group 5 - it was 5.4%, in the world - 7.6%. The frequency of caesarean section in the Perinatal Center is within limits typical for most countries (20.5-20.8%). Moreover, the dominant groups in the structure of caesarean sections are group 5 (21-23.3%) and group 2 (21.9-22.9%), which are the reserve for reducing the number of abdominal delivery. In group 2, certain results have already been achieved in this matter - the frequency of cesarean section in 2019 here amounted to 67.8%, in the first quarter of 2020 - 51.6%. This happened due to a change in the leading method of induction of labor. Thus, the Robson system is a convenient and affordable tool for assessing the structure of caesarean sections. The analysis showed that, in general, the structure of caesarean sections in the Perinatal Center is close to world data, and the identified deviations have explanations related to the specialization of the Center.

Keywords: cesarian section, Robson system, Kyiv Perinatal Center, labor induction

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Authors: Faghihnia Torshizi Mostafa, Saitoh Masato

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An efficient method is developed for the response of a group of vertical, cylindrical fixed-head, finite length piles embedded in a homogeneous elastic stratum, subjected to harmonic force atop the pile group cap. Pile to pile interaction is represented through simplified beam-on-dynamic-Winkler-foundation (BDWF) with realistic frequency-dependent springs and dashpots. Pile group effect is considered through interaction factors. New closed-form expressions for interaction factors and curvature ratios atop the pile are extended by considering different boundary conditions at the tip of the piles (fixed, hinged). In order to investigate the fundamental characteristics of inertial bending strains in pile groups, inertial bending strains at the head of each pile are expressed in terms of slenderness ratio. The results of parametric study give valuable insight in understanding the behavior of fixed head pile groups in fundamental natural frequency of soil stratum.

Keywords: Winkler-foundation, fundamental frequency of soil stratum, normalized inertial bending strain, harmonic excitation

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Authors: Lorand Bodo

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There are many stories of young British citizens who have left their country and families to join Islamist militant groups. So, what drives these young people to abandon their families and countries to join terrorist groups such as the so-called Islamic State? Much has been written to explain the phenomenon of violent radicalisation, whereby the concepts of identity and belonging are identified as one of the most significant drivers for violent radicalisation. In this respect, this paper explores the connection between the sense of belonging and violent radicalisation. That is necessary to gain a more nuanced understanding of the process of violent radicalisation in order to create and implement more effective counter-measures for tackling violent radicalisation. By using an inductive approach, this dissertation attempts to answer the question to what extent does the sense of non-belonging lead to the violent radicalisation of a few individuals. Therefore, alongside an expert interview, a survey, and qualitative content analysis of secondary sources, an exclusive semi-structured interview was conducted with a former violently radicalised Jihadi and recruiter. Overall, the sense of non-belonging significantly affects the process of violent radicalisation of a few individuals. Nevertheless, being religiously fundamental is not the problem of becoming violently radicalised in the first place, but belonging to the wrong group that is strongly determined by ideology, constitutes the main problem.

Keywords: identity, sense of non-belonging, social identity theory, violent radicalisation

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Authors: Metrek Almetrek, Naser Alqahtani, Eisa Ghazwani, Mona Asiri, Mohammed Alqahtani, Magboolah Balobaid

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Background: Advocacy of potential for community coalitions to positively address social determinants of health and quality of life, little is known about the views of stakeholders involved in such efforts. This study sought to assess the provinces leaders’ perspectives about social determinants related to the Health Neighborhood Initiative (HNI), a new county effort to support community coalitions. Method and Subjects: We used a descriptive, qualitative study using personal interviews in 2022. We conducted it in the community coalition's “main cities committees” set across service planning areas that serve vulnerable groups located in the seven registered healthy cities to WHO (Abha, Tareeb, Muhayel, Balqarn, Alharajah, Alamwah, and Bisha). We conducted key informant interviews with 76 governmental, profit, non-profit, and community leaders to understand their perspectives about the HNI. As part of a larger project, this study focused on leaders’ views about social determinants of health related to the HNI. All interviews were audio-recorded and transcribed. An inductive approach to coding was used, with text segments grouped by social determinant categories. Results: Provinces leaders described multiple social determinants of health and quality of life that were relevant to the HNI community coalitions: housing and safety, community violence, economic stability, city services coordination and employment and education. Leaders discussed how social determinants were interconnected with each other and the need for efforts to address multiple social determinants simultaneously to effectively improve health and quality of life. Conclusions: Community coalitions have an opportunity to address multiple social determinants of health and quality of life to meet the social needs of vulnerable groups. Future research should examine how community coalitions, like those in the HNI, can actively engage with community members to identify needs and then deliver evidence-based care.

Keywords: social determinants, health and quality of life, vulnerable groups, qualitative research

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Authors: Mohamed M. Mashaly, Ahmed M. F. El Shiwi

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Background: Shoulder impingement syndrome is an encroachment of subacromial tissues, rotator cuff, subacromial bursa, and the long head of the biceps tendon, as a result of narrowing of the subacromial space. Activities requiring repetitive or sustained use of the arms over head often predispose the rotator cuff tendon to injury. Purpose: To compare between Combined effect therapeutic exercises and Shockwave therapy versus therapeutic exercises and phonophoresis in the treatment of shoulder impingement syndrome. Methods: Thirty patients diagnosed as shoulder impingement syndrome stage II Neer classification due to mechanical causes. Patients were randomly distributed into two equal groups. The first group consisted of 15 patients with a mean age of (45.46+8.64) received therapeutic exercises (stretching exercise of posterior shoulder capsule and strengthening exercises of shoulder muscles) and shockwave therapy (6000 shocks, 2000/session, 3 sessions, 2 weeks apart, 0.22mJ/mm^2) years. The second group consisted of 15 patients with a mean age of 46.26 (+ 8.05) received same therapeutic exercises and phonophoresis (3 times per week, each other day, for 4 consecutive weeks). Patients were evaluated pretreatment and post treatment for shoulder pain severity, shoulder functional disability, shoulder flexion, abduction and internal rotation motions. Results: Patients of both groups showed significant improvement in all the measured variables. In between groups difference the shock wave group showed a significant improvement in all measured variables than phonophoresis group. Interpretation/Conclusion: Combined effect of therapeutic exercises and shock wave were more effective than therapeutic exercises and phonophoresis on decreasing shoulder pain severity, shoulder functional disability, increasing in shoulder flexion, abduction, internal rotation in patients with shoulder impingement syndrome.

Keywords: shoulder impingement syndrome, therapeutic exercises, shockwave, phonophoresis

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Authors: Mohamed A. Eid, Sobhy M. Aly, Marwa M. Ibrahim, Nadia L. Radwan

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To investigate the interaction effects of vitamin D supplementation combined with aerobic exercises (AE) and conventional physical therapy program (CPTP) on balance and physical performance in children with Down syndrome (DS).Methods: A randomized controlled trial was conducted for 38 children with DS, with ages ranging from 8 to 12 years. They were divided randomly to two groups. The control group (n=19) received the CPTP, while the study group (n=19) received the CPTP, AE, and vitamin D in the form of an oral daily dose of vitamin D3 400 IU (Cholecalciferol). Evaluation of balance by using the Biodex Stability System and physical performance by using the six-minute walk test (6MWT)was performed before and after 12 weeks of the treatment program. Findings: All groups showed a significant improvement in balance and physical performance after treatment (p < 0.05). The study group showed a significant improvement in balance and physical performancecompared with that of the control group (p < 0.05). Conclusion: Vitamin D supplementation combined with AE and CPTP could improve balance and physical performance in children with DS. Therefore, vitamin D and AEshould be considered as adjunctive to the rehabilitation program of these children.

Keywords: aerobic exercises, balance, down syndrome, physical performance, vitamin D

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Authors: Billel Kenidra, Mohamed Benmohammed

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Data mining technique used in the field of clustering is a subject of active research and assists in biological pattern recognition and extraction of new knowledge from raw data. Clustering means the act of partitioning an unlabeled dataset into groups of similar objects. Each group, called a cluster, consists of objects that are similar between themselves and dissimilar to objects of other groups. Several clustering methods are based on partitional clustering. This category attempts to directly decompose the dataset into a set of disjoint clusters leading to an integer number of clusters that optimizes a given criterion function. The criterion function may emphasize a local or a global structure of the data, and its optimization is an iterative relocation procedure. The K-Means algorithm is one of the most widely used partitional clustering techniques. Since K-Means is extremely sensitive to the initial choice of centers and a poor choice of centers may lead to a local optimum that is quite inferior to the global optimum, we propose a strategy to initiate K-Means centers. The improved K-Means algorithm is compared with the original K-Means, and the results prove how the efficiency has been significantly improved.

Keywords: microarray data mining, biological pattern recognition, partitional clustering, k-means algorithm, centroid initialization

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Authors: Hi̇lal Surat

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People who want to get rid of stress and intensive working tempo for a while head for recreation operations in order to get rest and have fun. Therefore, planning recreation operation makes contributions to social, physiological, economic and psychological development of an individual and the community in a way that the needs of people meet regularly and constantly. The rapid increase of world population rate makes necessary of benefit from natural or man-made resources in a multiple way. Dams and reservoirs which are built near urban area with the aim of electrical energy conversion and agricultural irrigation are considered as natural area providing various opportunities such as recreation operations. Dams have a great importance regarding to protection and improvement of water resources and coming into service of community. There should be a priority to protect these water resources, which are essential for nature and living organisms. It should be taken into consideration that these water resources are the most important input in the area and have high nature value to make sustainability of recreation effectiveness. The Deriner reservoir that has been built yet near the province of Artvin with natural and cultural properties is considered as an alternative option for meeting the needs of people for sportive and recreation activities and as a potential for planning of water-based recreation activities. Hence, in this study, activities that meet the expectations of people who get benefit from the area considering to natural, cultural and sportive recreation opportunities will be developed. In the first place, planning criteria for some sportive and water-based recreation operations will be defined in order to use the area for recreation and sportive activities and these criteria will be a base for a macro planning work within the holistic perspective of natural, cultural, and economical structure of the area. After this time, necessities of local people and evaluation of reservoir recreational potential will be determined, end then different socio-economic groups according to their in-come, age groups will be chosen and the questionnaire which has already prepared will be done these groups, as a result of these questionnaire recreational activities in water necessities will determine and we are going to develop different suggestion for this reservoir.

Keywords: dam, dam lakes, Deriner, recreation, water based activities

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Authors: Karitikeya Sonker

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Religion as a discrete system through its lawful internal working produces an output in the form of realised spatial order with its social logic and a social order with its spatial logic. Thus, it appears to exhibit its duality of spatial and trans-spatial. The components of this system share a relevance forming a collective. This shared relevance creates meaning forming a group where all collectives share one identity. This group with its new social order and its spatial logic revive the already existing spatial order. These religious groups do so having a tendency to expand resulting in the production of space in a situation of encounter where they have found relevance. But an encounter without a lawful internal working of a discrete system results in anomaly because groups do not find relevance due to the absence of collective identity. Events happen all around. One of the main reasons we could say that something became an event is because of conflict. Conflict not in its definitive sense but any occurrence that happens because of an intervention that creates an event worth remembering. The unfolding of such events creates Cities and Urban spaces which exhibit their duality of spatial and trans-spatial by behaving as a discrete system. This system through its lawful internal working produces an output in the form of realized spatial order with its social logic and a social order with spatial logic. The components of this system form a collective through a shared a relevance. This shared relevance creates meaning forming a group where all collectives share one identity. This group with its new social order and its spatial logic revives the already existing spatial order. These groups do so having a tendency to expand resulting in the production of space in a situation of encounter where they have found relevance. But an encounter without a lawful internal working of the discrete system results in anomaly because groups do not find relevance due to the absence of collective identity. This paper makes an effort to explore one such even in the case of Babri Mosque and Ramjanmabhumi, Ayodhya to explain the anomaly as transposition of social and spatial. The paper through the case studies makes an attempt to generate an equation explaining the two different situations of religious encounters, former reviving the social and spatial order and the other resulting in anomaly. Through the case study, it makes an attempt to generate an equation explaining the two different situations of religious encounters, former reviving the social and spatial order and the other resulting in anomaly.

Keywords: Babri Masjid, Ayodhya, conflict, religion

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Authors: Nazila Dehbari, Javad Tavakoli, Yakani Kambu, Youhong Tang

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Superabsorbent hydrogels (SAP), as an enviro-sensitive material have been widely used for industrial and biomedical applications due to their unique structure and capabilities. Poor mechanical properties of SAPs - which is extremely related to their large volume change – count as a great weakness in adopting for high-tech applications. Therefore, improving SAPs’ mechanical properties via toughening methods by mixing different types of cross-linked polymer or introducing energy-dissipating mechanisms is highly focused. In this work, in order to change the intrinsic brittle character of commercialized Poly Acrylic Acid (here as SAP) to be semi-ductile, a commercial available highly branched tree-like dendritic polymers with numerous –OH end groups known as hyper-branched polymer (HB) has been added to PAA-SAP system in a single step, cost effective and environment friendly solvent casting method. Samples were characterized by FTIR, SEM and TEM and their physico-chemical characterization including swelling capabilities, hydraulic permeability, surface tension and thermal properties had been performed. Toughness energy, stiffness, elongation at breaking point, viscoelastic properties and samples extensibility were mechanical properties that had been performed and characterized as a function of samples lateral cracks’ length in different HB concentration. Addition of HB to PAA-SAP significantly improved mechanical and surface properties. Increasing equilibrium swelling ratio by about 25% had been experienced by the SAP-HB samples in comparison with SAPs; however, samples swelling kinetics remained without changes as initial rate of water uptake and equilibrium time haven’t been subjected to any changes. Thermal stability analysis showed that HB is participating in hybrid network formation while improving mechanical properties. Samples characterization by TEM showed that, the aggregated HB polymer binders into nano-spheres with diameter in range of 10–200 nm. So well dispersion in the SAP matrix occurred as it was predictable due to the hydrophilic character of the numerous hydroxyl groups at the end of HB which enhance the compatibility of HB with PAA-SAP. As the profused -OH groups in HB could react with -COOH groups in the PAA-SAP during the curing process, the formation of a 2D structure in the SAP-HB could be attributed to the strong interfacial adhesion between HB and the PAA-SAP matrix which hinders the activity of PAA chains (SEM analysis). FTIR spectra introduced new peaks at 1041 and 1121 cm-1 that attributed to the C–O(–OH) stretching hydroxyl and O–C stretching ester groups of HB polymer binder indicating the incorporation of HB polymer into the SAP structure. SAP-HB polymer has significant effects on the final mechanical properties. The brittleness of PAA hydrogels are decreased by introducing HB as the fracture energies of hydrogels increased from 8.67 to 26.67. PAA-HBs’ stretch ability enhanced about 10 folds while reduced as a function of different notches depth.

Keywords: superabsorbent polymer, toughening, viscoelastic properties, hydrogel network

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Authors: Yannis Stavrakakis, Damian Gordon

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Critical Thinking and Reflective Practice are two vital skills that students undertaking postgraduate studies should ideally possess. To help students develop and enhance these skills, this research developed several authentic activities to be undertaken as part of a module that is delivered early in a taught MSc to enhance these skills. One of the challenges of these topics is that they are somewhat ill-defined in terms of precisely what they mean, and also, there is no clear route to operationalizing the teaching of these skills. This research focuses on identifying suitable models of these skills and delivering them in a manner that is both clear and highly motivating. To achieve this, a class of 22 Master's students was divided into two groups, one was provided with a presentation and checklist about critical thinking skills, and the other group was given the same materials on the reflective practice process. The groups were given two scenarios each to analyze using their respective checklists and were asked to present their outcomes to each other and give peer review. The results were coded and compared, and key differences were noted, including the fact that the Critical Thinking outcomes were more future-focused, and the Reflective Practice outcomes were more past-focused and present-focused, as well as the fact that the Reflective Practice process generated a significantly wider range of perspectives on the scenarios.

Keywords: critical thinking, ethical scenarios, formative assessment, reflective practice

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Authors: Ani Kojoyan

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The Syrian refugee crisis has been a matter of worldwide concern during the recent years. And though refugees’ problems are contextualized in terms of time and space, the refugee crisis still remains a global issue to discuss. Since the start of the conflict, Armenia has welcomed thousands of Syrian refugees too. Taking into consideration Armenia’s current socio-economic and geopolitical situation, the flow of refugees is a challenge both for the country and for refugees themselves. However, these people are not simply refugees from Syria, they are Syrian-Armenian refugees; people whose ancestors were survivals of the Armenian Genocide, perpetrated by the Ottoman Turks in 1915, people whose ancestors became refugees a century ago in Syria and now, ironically, a century later they follow their ancestors’ paths, turning into refugees themselves in their historical homeland, facing various difficulties, among them socio-economic, socio-ideological, and identity and gender issues, the latter being the main topic of discussion in the present paper. The situation presented above makes us discuss certain questions within this study: how do Syrian-Armenian refugees define themselves and their status? Which are their gender roles in the socio-economic context? How do social and economic challenges re-shape Syrian-Armenian women refugees’ identities? The study applies qualitative research methods of analysis, which includes semi-structured and in-depth interviews with 15 participants (18-25, 26-40 age groups), and two focus group works, involving 8 participants (18-35 age group) for each focus group activity. The activities were carried out in October 2016, Yerevan, Armenia. The study also includes Secondary Data Analysis. In addition, in order to centralize refugee women’s experiences and identity issues, the study adopts a qualitative lens from a feminist standpoint position. It is based on the assumption that human activity structures and limits understanding, and that the distorted comprehension of events or activities has emerged from the male-oriented dominant judgement which can be discovered through uncovering the understanding of the situation from women’s activity perspectives. The findings suggest that identity is dynamic, complex, over-changing and sensitive to time and space, gender and class. The process of re-shaping identity is even more complicated and multi-layered and is based on internal and external factors, conditioned by individual and collective needs and interests. Refugees are mostly considered as people who lost their identity in the past since they have no longer connection anywhere and try to find it in the present. In turn, female refugees, being a more vulnerable class, go through more complicated identity re-formulating discourse negotiations. They stand between the borders of the old and new, borders of lost and re-found selves, borders of creating and self-fashioning, between illusions and the challenging reality. Particularly, refugee women become more sensitive within the discourses of the private and the public domains: some of them try to create a ‘new-self’, creating their space in a new society, whereas others try to negotiate their affective/emotional labour within their own family domains.

Keywords: feminist standpoint position, gender, identity, refugee studies, Syrian-Armenian women refugees

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Authors: Tayyaba Zahra, Shehla Gul Bokhari, Asim Khalid Mahmood, Raheela Akhtar, Khizar Matloob

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In Pakistan, dogs are commonly infested with ticks, especially in summers, causing not only dermatological issues but also systemic problems. Persistence of tick infestation often leads to heavy losses. Different acaricides are locally available with variable efficacy; however, recurrence of infestation is commonly reported. The present study was thus designed to compare the efficacy of a novel drug Fluralaner and conventionally used Ivermectin against tick infestation. Dogs positive for tick infestation were randomly divided into 2 groups viz, Groups A and B having 8 dogs each. Ticks were enumerated manually from the whole body of dogs at day 0 before the administration of drugs Dogs in Group A were treated with Fluralaner at day 0, and dogs in Group B were treated with Ivermectin. Post-treatment, ticks were counted again at days 7, 14, 21, 28, and 35. At day 07 of the study, no tick was found on the dogs treated with Fluralaner, while many ticks were present on the dogs treated with Ivermectin showing an efficacy up to 50%. On the consecutive follow-up evaluations, similar results were found for Fluralaner while the efficacy of Ivermectin was further reduced to less than 50%. Furthermore, Fluralaner treated dogs had better RBC counts, PCV, Hgb concentration, LFTs, RFTs post-treatment than the dogs treated with Ivermectin. Statistically, oral Fluralaner proved a more effective drug (P≤0.05)than oral Ivermectin against tick infestation in dogs.

Keywords: fluralaner, ivermectin, dogs, tick infestations

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Authors: Solmaz Eskandarion, Haniyeh Eftekhar, Amin Fallahi

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Introduction: Nowadays cosmetic dentistry has gained greater attention because of the changing demands of dentistry patients. Composite resin restorations play an important role in the field of esthetic restorations. Due to the variation between the resin composites, it is important to be aware of their mechanical properties and surface roughness. So, the aim of this study was to compare the mechanical properties (surface hardness, compressive strength, diametral tensile strength) and surface roughness of four kinds of resin composites after thermal aging process. Materials and Method: 10 samples of each composite resins (Gradia-direct (GC), Filtek Z250 (3M), G-ænial (GC), Filtek Z350 (3M- filtek supreme) prepared for evaluation of each properties (totally 120 samples). Thermocycling (with temperature 5 and 55 degree of centigrade and 10000 cycles) were applied. Then, the samples were tested about their compressive strength and diametral tensile strength using UTM. And surface hardness was evaluated with Microhardness testing machine. Either surface roughness was evaluated with Scanning electron microscope after surface polishing. Result: About compressive strength (CS), Filtek Z250 showed the highest value. But there were not any significant differences between 4 groups about CS. Either Filtek Z250 detected as a composite with highest value of diametral tensile strength (DTS) and after that highest to lowest DTS was related to: Filtek Z350, G-ænial and Gradia-direct. And about DTS all of the groups showed significant differences (P<0.05). Vickers Hardness Number (VHN) of Filtek Z250 was the greatest. After that Filtek Z350, G-ænial and Gradia-direct followed it. The surface roughness of nano-filled composites was less than Microhybrid composites. Either the surface roughness of GC Ganial was a little greater than Filtek Z250. Conclusion: This study indicates that there is not any evident significant difference between the groups amoung their mechanical properties. But it seems that Filtek Z250 showed slightly better mechanical properties. About surface roughness, nanofilled composites were better that Microhybrid.

Keywords: mechanical properties, surface roughness, resin composite, compressive strength, thermal aging

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Authors: P. Cavlan, B. Kırmızıgil

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Introduction: Each exercise in suspension exercises offer the use of gravity and body weight; and is thought to develop the equilibrium, flexibility and body stability necessary for daily life activities and sports, in addition to creating the correct functional force. Suspension exercises based on body weight focus the human body as an integrated system. Total Resistance Exercises (TRX) suspension training that physiotherapists, athletic health clinics, exercise centers of hospitals and chiropractic clinics now use for rehabilitation purposes. The purpose of this study is to investigate and compare the effects of TRX suspension exercises on physical performance in healthy individuals. Method: Healthy subjects divided into two groups; the study group and the control group with 40 individuals for each, between ages 20 to 45 with similar gender distributions. Study group had 2 sessions of suspension exercises per week for 8 weeks and control group had no exercises during this period. All the participants were given explosive strength, flexibility, strength and endurance tests before and after the 8 week period. The tests used for evaluation were respectively; standing long jump test and single leg (left and right) long jump tests, sit and reach test, sit up and back extension tests. Results: In the study group a statistically significant difference was found between prior- and final-tests in all evaluations, including explosive strength, flexibility, core strength and endurance of the group performing TRX exercises. These values were higher than the control groups’ values. The final test results were found to be statistically different between the study and control groups. Study group showed development in all values. Conclusions: In this study, which was conducted with the aim of investigating and comparing the effects of TRX suspension exercises on physical performance, the results of the prior-tests of both groups were similar. There was no significant difference between the prior and the final values in the control group. It was observed that in the study group, explosive strength, flexibility, strength, and endurance development was achieved after 8 weeks. According to these results, it was shown that TRX suspension exercise program improved explosive strength, flexibility, especially core strength and endurance; therefore the physical performance. Based on the results of our study, it was determined that the physical performance, an indispensable requirement of our life, was developed by the TRX suspension system. We concluded that TRX suspension exercises can be used to improve the explosive strength and flexibility in healthy individuals, as well as developing the muscle strength and endurance of the core region. The specific investigations could be done in this area so that programs that emphasize the TRX's physical performance features could be created.

Keywords: core strength, endurance, explosive strength, flexibility, physical performance, suspension exercises

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Authors: In Kyong Yi, Yun Jeong Chae, Jihoon Hwang, Sook-Young Lee, Jong-Yeop Kim

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Background: Pentax airway scope (AWS) is a recently developed video laryngoscope for use in both normal and difficult airways, providing a good laryngeal view. The purpose of this randomized noninferior study was to evaluate the efficacy of the Pentax-AWS regarding intubation time, laryngeal view and ease of intubation in pediatric patients with normal airway, compared to Macintosh laryngoscope. Method: A total of 136 pediatric patients aged 1 to 10 with American Society of Anesthesiologists physical status I or II undergoing general anesthesia required orotracheal intubation were randomly allocated into two groups: Macintosh laryngoscope (n =68) and Pentax AWS (n=68). Anesthesia was induced with propofol, rocuronium, and sevoflurane. The primary outcome was intubation time. Cormack-Lehane laryngeal view grade, application of optimal laryngeal external manipulation (OELM), intubation difficulty scale (IDS), intubation failure rate and adverse events were also measured. Result: No significant difference was observed between the two groups regarding intubation time (Macintosh; 23[22-26] sec vs. Pentax; 23.5[22-27.75] sec, p=0.713). As for the laryngeal view grade, the Pentax group showed less number of grade 2a or higher grade cases compared to the Macintosh group (1/2a/2b/3; 52.9%/41.2%/4.4%/1.5% vs. 98.5%/1.5%/0%/0%, p=0.000). No optimal laryngeal external manipulation application was required in the Pentax group (38.2% vs. 0%, p=0.000). Intubation difficulty scale resulted in lower values for Pentax group (0 [0-2] vs. 0 [0-0.55], p=0.001). Failure rate was not different between the two groups (1.5% vs. 4.4%, p=0.619). Adverse event-wise, slightly higher incidence of bleeding (1.5% vs. 5.9%, p=0.172) and teeth injury (0% vs. 5.9%, p=0.042) occurred in the Pentax group. Conclusion: In conclusion, Pentax-AWS provided better laryngeal view, similar intubation time and similar success rate compared with Macintosh laryngoscope in children with normal airway. However, the risk of teeth injury might increase and warrant special attention.

Keywords: Pentax-AWS, pediatric, video laryngoscope, intubation

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Authors: Gi-Young Park, Dong Rak Kwon, Sung Cheol Cho

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Objective: The synovium is known to be involved in many pathological characteristic processes. Also, synovitis is common in advanced osteoarthritis. We aimed to evaluate the clinical, radiographic, and ultrasound findings in patients with knee osteoarthritis and to compare the clinical and imaging findings between knee osteoarthritis with and without synovial hypertrophy confirmed by ultrasound. Methods: One hundred knees (54 left, 46 right) in 95 patients (64 women, 31 men; mean age, 65.9 years; range, 43-85 years) with knee osteoarthritis were recruited. The Visual Analogue Scale (VAS) was used to assess the intensity of knee pain. The severity of knee osteoarthritis was classified according to Kellgren and Lawrence's (K-L) grade on a radiograph. Ultrasound examination was performed by a physiatrist who had 24 years of experience in musculoskeletal ultrasound. Ultrasound findings, including the thickness of joint effusion in the suprapatellar pouch, synovial hypertrophy, infrapatellar tendinosis, meniscal tear or extrusion, and Baker cyst, were measured and detected. The thickness of knee joint effusion was measured at the maximal anterior-posterior diameter of fluid collection in the suprapatellar pouch. Synovial hypertrophy was identified as the soft tissue of variable echogenicity, which is poorly compressible and nondisplaceable by compression of an ultrasound transducer. The knees were divided into two groups according to the presence of synovial hypertrophy. The differences in clinical and imaging findings between the two groups were evaluated by independent t-test and chi-square test. Results: Synovial hypertrophy was detected in 48 knees of 100 knees on ultrasound. There were no significant differences in demographic parameters and VAS score except in sex between the two groups (P<0.05). Medial meniscal extrusion and tear were significantly more frequent in knees with synovial hypertrophy than those in knees without synovial hypertrophy. K-L grade and joint effusion thickness were greater in patients with synovial hypertrophy than those in patients without synovial hypertrophy (P<0.05). Conclusion: Synovial hypertrophy in knee osteoarthritis was associated with greater suprapatellar joint effusion and higher K-L grade and maybe a characteristic ultrasound feature of late knee osteoarthritis. These results suggest that synovial hypertrophy on ultrasound can be regarded as a predictor of rapid progression in patients with knee osteoarthritis.

Keywords: knee osteoarthritis, synovial hypertrophy, ultrasound, K-L grade

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Authors: Kenji Gwee

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The Mental Capacity Act is a new legislation that allows for lasting powers of attorney and court-appointed deputies, in respect of people who lack legal capacity. While the UK Act, after which the Singapore Act is modeled, has been shown to be therapeutic to donors, the Singapore Act differs from its UK counterpart and it is unclear if the Singapore Act can be beneficial to donors as purported. The purpose of this study was to determine what the perceptions of three groups of stakeholders (patients, caregivers and psychiatrists) are about the aspects of the Mental Capacity Act that are therapeutic to donors. In addition, ways to increase the therapeutic value of the Act to donors are sought. A qualitative methodology was used and the research was guided by two theoretical frameworks: therapeutic jurisprudence and an interpretive constructive framework. Interviews with 12 psychiatrists, and focus groups with twenty three patients and seven caregivers showed agreement that, allowing donors to nominate more than one decision- maker, and whistle-blowing mechanisms for recourse for abuse, were therapeutic to donors. To further increase the therapeutic value of the Act, 2 suggestions were made: the Act should provide for (i) advanced healthcare directives- allowing donors to make advance decisions to refuse treatment, or cease existing treatment, and (ii) independent advocacy services- to have a case worker to represent people who have no family or friends and are thus unable to find suitable donees.

Keywords: Mental Capacity Act, therapeutic jurisprudence, qualitative methodology, the UK Act

Procedia PDF Downloads 408