Search results for: nutrition therapy guide

Authors: Aneesha Fonseca, Arij Daas, Muhammed Abdulkader

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Transient intraocular pressure (IOP) rise is a common occurrence after glaucoma laser procedures. However, this pressure spike usually lasts only a few days. We describe a case of a 60-year-old Caucasian gentleman who underwent selective laser trabeculoplasty (SLT) in both eyes for ocular hypertension previously treated with Bimatoprost and Timolol and developed a sustained raised IOP. His IOP rose from 34 and 33 mmHg pre-laser to 48 and 42 mmHg after SLT in the right and left eye, respectively. Even after maximum medical therapy (Bimatoprost, Timolol, Brinzolamide Apraclonidine, and oral Acetozolamide), his IOP remained at 32 and 28mmHg. A provisional diagnosis of trabeculitis was made, and topical Ketorolac was commenced in addition to the IOP-lowering medications. Within a week, his IOP came down to 21 and 18mmHg in the right and left eye, respectively.

Keywords: complications, selective laser trabeculoplasty, sustained pressure rise, trabeculitis

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Authors: Jawad Ul Haq, Evan Mazur, Ahmed Qureshi, Mohamed Al-Hussein

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The uses of wood in furniture, building, bridges and aluminum in transportation and construction, make aluminum and forest economy a prominent matter in North America. Machines available to date to cut the aforementioned materials are mostly industry oriented with complex structure and operations which require special training and skill. Furthermore, requirements such as pneumatics, 3-phase supply are associated with cost, maintenance, and safety hazards. Power saws are very useful tools used to cut and shape materials; however, they can cause serious hand injuries. Operator’s hands in table saw are vulnerable as they are used to guide pieces into the saw. Apart from hands, saw operator is also prone to material being kicked back out of the saw or sustain eye or respiratory injuries due to rapidly flying sawdust and other debris. In this paper, design of an automatic saw cutting machine has been proposed to ensure safety, portability, usage at domestic level and capability to cut both aluminum and wood. This paper demonstrates detailed Mechanical design in SOLIDWORKS and Control Systems using Programmable Logic Controller (PLC), based on the aforementioned design objectives.

Keywords: programmable logic controller, saw cutting, control, automation

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Authors: Mahdieh Dehghan Nayeri, Hani Arbabi, Seid Pooyan Ghafoori

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Civic crowdfunding- crowdfunding public projects- which goes beyond people management- as a significant part of public projects stakeholders- and requires the active engagement of the public in both the financing and decision-making processes of public projects, is expanding. However, in most countries of the world, no specific legal framework has been approved for governing and managing the implementation of projects through this method. Through a systematic literature review, following the Preferred Reporting Items for Systematic Reviews (PRISMA), this article has studied and discussed the legal issues of civic crowdfunded projects in the countries leading the use of this method, in four themes; one related to the legal environment and three related to three leading players in civic crowdfunded projects include the investor, the platform, and the investee. The review showed that despite the increasing attention to people's engagement in public projects -financial and non-financial- not much scientific research has been done to formulate fully structured legal structures. Finally, neglected areas in research have been discussed as a guide for future research.

Keywords: civic crowdfunding, equity crowdfunding, public projects, legal issues, crowdsourcing

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Authors: Shaine Mehta, Neelam Parmar, Patrick White, Mark Ashworth

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Patients with a history of substance have a high prevalence of comorbidities, including asthma and chronic obstructive pulmonary disease (COPD). Mortality rates are higher than that of the general population and the link to respiratory disease is reported. Randomised controlled trials (RCTs) support opioid substitution therapy as an effective means for harm reduction. However, whilst a high proportion of patients receiving opioid substitution therapy are smokers, to the author’s best knowledge there have been no studies of respiratory disease and smoking intensity in these patients. A cross sectional prevalence study was conducted using an anonymised patient-level database in primary care, Lambeth DataNet (LDN). We included patients aged 18 years and over who had records of ever having been prescribed methadone in primary care. Patients under 18 years old or prescribed buprenorphine (because of uncertainty about the prescribing indication) were excluded. Demographic, smoking, alcohol and asthma and COPD coding data were extracted. Differences between methadone and non-methadone users were explored with multivariable analysis. LDN contained data on 321, 395 patients ≥ 18 years; 676 (0.16%) had a record of methadone prescription. Patients prescribed methadone were more likely to be male (70.7% vs. 50.4%), older (48.9yrs vs. 41.5yrs) and less likely to be from an ethnic minority group (South Asian 2.1% vs. 7.8%; Black African 8.9% vs. 21.4%). Almost all those prescribed methadone were smokers or ex-smokers (97.3% vs. 40.9%); more were non-alcohol drinkers (41.3% vs. 24.3%). We found a high prevalence of COPD (12.4% vs 1.4%) and asthma (14.2% vs 4.4%). Smoking intensity data shows a high prevalence of ≥ 20 cigarettes per day (21.5% vs. 13.1%). Risk of COPD, adjusted for age, gender, ethnicity and deprivation, was raised in smokers: odds ratio 14.81 (95%CI 11.26, 19.47), and in the methadone group: OR 7.51 (95%CI: 5.78, 9.77). Furthermore, after adjustment for smoking intensity (number of cigarettes/day), the risk was raised in methadone group: OR 4.77 (95%CI: 3.13, 7.28). High burden of respiratory disease compounded by the high rates of smoking is a public health concern. This supports an integrated approach to health in patients treated for opiate dependence, with access to smoking cessation support. Further work may evaluate the current structure and commissioning of substance misuse services, including smoking cessation. Regression modelling highlights that methadone as a ‘risk factor’ was independently associated with COPD prevalence, even after adjustment for smoking intensity. This merits further exploration, as the association may be related to unexplored aspects of smoking (such as the number of years smoked) or may be related to other related exposures, such as smoking heroin or crack cocaine.

Keywords: methadone, respiratory disease, smoking cessation, substance misuse

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Authors: Soniya Nityanand, Ekta Minocha, Manali Jain, Rohit Anthony Sinha, Chandra Prakash Chaturvedi

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Amniotic fluid stem cells (AFSC) have been shown to contribute towards the amelioration of Acute Renal Failure (ARF), but the mechanisms underlying the renoprotective effect are largely unknown. Therefore, the main goal of the current study was to evaluate the therapeutic efficacy of AFSC in a cisplatin-induced rat model of ARF and to investigate the underlying mechanisms responsible for its renoprotective effect. To study the therapeutic efficacy of AFSC, ARF was induced in Wistar rats by an intra-peritoneal injection of cisplatin, and five days after administration, the rats were randomized into two groups and injected with either AFSC or normal saline intravenously. On day 8 and 12 after cisplatin injection, i.e., day 3 and day7 post-therapy respectively, the blood biochemical parameters, histopathological changes, apoptosis and expression of pro-apoptotic, anti-apoptotic and autophagy-related proteins in renal tissues were studied in both groups of rats. Administration of AFSC in ARF rats resulted in improvement of renal function and attenuation of renal damage as reflected by significant decrease in blood urea nitrogen, serum creatinine levels, tubular cell apoptosis as assessed by Bax/Bcl2 ratio, and expression of the pro-apoptotic proteins viz. PUMA, Bax, cleaved caspase-3 and cleaved caspase-9 as compared to saline-treated group. Furthermore, in the AFSC-treated group as compared to saline-treated group, there was a significant increase in the activation of autophagy as evident by increased expression of LC3-II, ATG5, ATG7, Beclin1 and phospho-AMPK levels with a concomitant decrease in phospho-p70S6K and p62 expression levels. To further confirm whether the protective effects of AFSC on cisplatin-induced apoptosis were dependent on autophagy, chloroquine, an autophagy inhibitor was administered by the intra-peritoneal route. Chloroquine administration led to significant reduction in the anti-apoptotic effects of the AFSC therapy and further deterioration in the renal structure and function caused by cisplatin. Collectively, our results put forth that AFSC ameliorates cisplatin-induced ARF through induction of autophagy and inhibition of apoptosis. Furthermore, the protective effects of AFSC were blunted by chloroquine, highlighting that activation of autophagy is an important mechanism of action for the protective role of AFSC in cisplatin-induced renal injury.

Keywords: amniotic fluid stem cells, acute renal failure, autophagy, cisplatin

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Authors: Hossain A, Hossain S.

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Introduction: In a small cohort, we sought to assess the magnetic resonance spectroscopy's (MRS) ability to predict the presence of metastatic lesions. Method: A Popular Diagnostic Centre Limited enrolled patients with neuroepithelial tumors. The 1H CSI MRS of the brain allows us to detect changes in the concentration of specific metabolites caused by metastatic lesions. Among these metabolites are N-acetyl-aspartate (NNA), creatine (Cr), and choline (Cho). For Cho, NAA, Cr, and Cr₂, the metabolic ratio was calculated using the division method. Results: The NAA values were 0.63 and 5.65 for tumor cells, 1.86 and 5.66 for normal cells, and 1.86 and 5.66 for normal cells 2. NAA values for normal cells 1 were 1.84, 10.6, and 1.86 for normal cells 2, respectively. Cho levels were as low as 0.8 and 10.53 in the tumor cell, compared to 1.12 and 2.7 in the normal cell 1 and 1.24 and 6.36 in the normal cell 2. Cho/Cr₂ barely distinguished itself from the other ratios in terms of significance. For tumor cells, the ratios of Cho/NAA, Cho/Cr₂, NAA/Cho, and NAA/Cr₂ were significant. Normal cell 1 had significant Cho/NAA, Cho/Cr, NAA/Cho, and NAA/Cr ratios. Conclusion: The clinical result can be improved by using 1H-MRSI to guide the size of resection for metastatic lesions. Even though it is non-invasive and doesn't present any difficulties during the procedure, MRS has been shown to predict the detection of metastatic lesions.

Keywords: metabolite ratio, MRI images, metastatic lesion, MR spectroscopy, N-acetyl-aspartate

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Authors: Roger WUMBA

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The objective of this study was to determine the prevalence of intestinal parasites, with special emphasis on microsporidia and Cryptosporidium, as well as their association with human immunodeficiency virus (HIV) symptoms, risk factors, and other digestive parasites. We also wish to determine the molecular biology definitions of the species and genotypes of microsporidia and Cryptosporidium in HIV patients. In this cross-sectional study, carried out in Kinshasa, Democratic Republic of the Congo, stool samples were collected from 242 HIV patients (87 men and 155 women) with referred symptoms and risk factors for opportunistic intestinal parasites. The analysis of feces specimen were performed using Ziehl–Neelsen stainings, real-time polymerase chain reaction (PCR), immunofluorescence indirect monoclonal antibody, nested PCR-restriction fragment length polymorphism, and PCR amplification and sequencing. Odds ratio (OR) and 95% confidence intervals were used to quantify the risk. Of the 242 HIV patients, 7.8%, 0.4%, 5.4%, 0.4%, 2%, 10.6%, and 2.8% had Enterocytozoon bieneusi, Encephalitozoon intestinalis, Cryptosporidium spp., Isospora belli, pathogenic intestinal protozoa, nonpathogenic intestinal protozoa, and helminths, respectively. We found five genotypes of E. bieneusi: two older, NIA1 and D, and three new, KIN1, KIN2, and KIN3. Only 0.4% and 1.6% had Cryptosporidium parvum and Cryptosporidium hominis, respectively. Of the patients, 36.4%, 34.3%, 31%, and 39% had asthenia, diarrhea, a CD4 count of ,100 cells/mm³, and no antiretroviral therapy (ART), respectively. The majority of those with opportunistic intestinal parasites and C. hominis, and all with C. parvum and new E. bieneusi genotypes, had diarrhea, low CD4+ counts of ,100 cells/mm³, and no ART. There was a significant association between Entamoeba coli, Kaposi sarcoma, herpes zoster, chronic diarrhea, and asthenia, and the presence of 28 cases with opportunistic intestinal parasites. Rural areas, public toilets, and exposure to farm pigs were the univariate risk factors present in the 28 cases with opportunistic intestinal parasites. In logistic regression analysis, a CD4 count of ,100 cells/mm³ (OR = 4.60; 95% CI 1.70–12.20; P = 0.002), no ART (OR = 5.00; 95% CI 1.90–13.20; P , 0.001), and exposure to surface water (OR = 2.90; 95% CI 1.01–8.40; P = 0.048) were identified as the significant and independent determinants for the presence of opportunistic intestinal parasites. E. bieneusi and Cryptosporidium are becoming more prevalent in Kinshasa, Congo. Based on the findings, we recommend epidemiology surveillance and prevention by means of hygiene, the emphasis of sensitive PCR methods, and treating opportunistic intestinal parasites that may be acquired through fecal–oral transmission, surface water, normal immunity, rural area-based person–person and animal–human nfection, and transmission of HIV. Therapy, including ART and treatment with fumagillin, is needed.

Keywords: diarrhea, enterocytozoon bieneusi, cryptosporidium hominis, cryptosporidium parvum, risk factors, africans

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Authors: Raya Al Khayari, Rasha Al Jassim, Muna Al Balushi, Fatma Al Moqbali, Said El Hajjar

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This study utilizes linear regression analysis to investigate the correlation between user account passwords and the probability of civil ID exposure, offering statistical insights into civil ID security. The study employs multiple linear regression (MLR) analysis to further investigate the elements that influence consumers’ views of civil ID security. This aims to increase awareness and improve preventive measures. The results obtained from the MLR analysis provide a thorough comprehension and can guide specific educational and awareness campaigns aimed at promoting improved security procedures. In summary, the study’s results offer significant insights for improving existing security measures and developing more efficient tactics to reduce risks related to civil ID security in Oman. By identifying key factors that impact consumers’ perceptions, organizations can tailor their strategies to address vulnerabilities effectively. Additionally, the findings can inform policymakers on potential regulatory changes to enhance civil ID security in the country.

Keywords: civil-id disclosure, awareness, linear regression, multiple regression

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Authors: Joseph M. Njoroge

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The need for urgent adaptation have triggered tourism stakeholders and research community to develop generic adaptation framework(s) for national, regional and or local tourism desti-nations. Such frameworks have been proposed to guide the tourism industry in the adaptation process with an aim of reducing tourism industry’s vulnerability and to enhance their ability to cope to climate associated externalities. However research show that current approaches are far from sustainability since the adaptation options sought are usually closely associated with development needs-‘business as usual’-where the implication of adaptation to social justice and environmental integrity are often neglected. Based on this view there is a need to look at adaptation beyond addressing vulnerability and resilience to include the need for adaptation to enhance social justice and environmental integrity. This paper reviews the existing adaptation frameworks/models and evaluates their suitability in enhancing sustainable adaptation for regional tourist destinations. It is noted that existing frameworks contradicts the basic ‘principles of sustainable adaptation’. Further attempts are made to propose a Sustainable Regional Tourism Adaptation Framework (SRTAF) to assist regional tourism stakeholders in the achieving sustainable adaptation.

Keywords: sustainable adaptation, sustainability principles, sustainability portfolio, Regional Tourism

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Authors: Kaan Koyuncu, Umut Celen Arican, Sevilay Can

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In the maritime industry, there have been regulations to prevent pollution, and the first attempt to offer a legal basis was Marpol Convention which was held in 1973 in order to provide a framework for the disposal of ship wastes. Based on this convention, ports are obliged to build waste receiving facilities. European Union regulations make several member countries to follow these directions, In Turkey, under Blue Card System, the quantity and types of wastes, the delivery time, the capacity of the receiving facilities, and other required information can be monitored online. Therefore, yachts and other boats with the bilge, sewage, and waste which illegally discharge into the sea, can be blocked. This system is an outcome of the law adopted from European Union regulations. In this study, the present systems in Turkey which occurred in 2010 after the integration of the system, which has been put in the force in 2000 in Europe will be analyzed and interpreted to provide a useful comparison, a practical guide, and a roadmap for potential improvements.

Keywords: Europe-Turkey, blue card, marine environment, ship waste tracking system

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Authors: Hazem Abuorf

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From the perspective of viewing urban design as the architecture of public spaces, the latter has many advantages; for example, in achieving attractive and vibrant public spaces, ensuring safety and amenity, supporting a strong sense of place and local character. Besides all advantages, such spaces nevertheless trigger numerous dilemmas, how to design urban spaces preserving the quality of life in the long term while equally achieving cohesion between new urban developments and the already existing urban structure without causing a split in history through the cause of functional and aesthetic degradation. Analysis of this article seeks to propose a methodology deemed essential for assessing and stimulating design criteria of the public spaces when rehabilitating urban sites. The method’s utility is shown by analyzing rehabilitation projects in Gaza Strip, whose design of the public spaces has mainly focused on the physical aspect ignoring the place’s local identity, users’ needs, and history. The proposed methodology serves as a guide for municipal authorities and technical teams to deal with interventions that would rework the role of urban design towards making sense of place.

Keywords: urban design, public realm, rehabilitation projects, quality of life

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Authors: Roba Zakariah Shaheen

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In the 21st-century Interior, design pedagogy has developed rapidly due to social and economical factors. Socially, this paper presents research findings that shows a significant relationship between educators and students in interior design education. It shows that students’ personal traits, design process, and thinking process are significantly interrelated. Constructively, this paper presented how personal traits can guide educators in the interior design education domain to develop students’ thinking process. In the same time, it demonstrated how students should use their own personal traits to create their own design process. Constructivism was the theory underneath this research, as it supports the grounded theory, which is the methodological approach of this research. Moreover, Mayer’s Briggs Type Indicator strategy was used to investigate the personality traits scientifically, as a psychological strategy that related to cognitive ability. Conclusions from this research strongly recommends that educators and students should utilize their personal traits to foster interior design education.

Keywords: interior design, pedagogy, constructivism, grounded theory, personality traits, creativity

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Authors: Saeedeh Shahbazkhany

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Cancer is a terrible disease that, if not diagnosed early, therapy can be difficult while it is easily medicable if it is diagnosed in early stages. So it is very important for cancer diagnosis that medical procedures are performed. In this paper we introduce a new method. In this method, we only need pictures of healthy cells and cancer cells. In fact, where we suspect cancer, we take a picture of cells or tissue in that area, and then take some pictures of the surrounding tissues. Then, fractal dimension of images are calculated and compared. Cancer can be easily detected by comparing the fractal dimension of images. In this method, we use Matlab software.

Keywords: Matlab software, fractal dimension, cancer, surrounding tissues, cells or tissue, new method

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Authors: A. Baviskar, C. Sandeep, K. Shankar

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Solving Multi-objective Optimization Problems requires faster convergence and better spread. Though existing Evolutionary Algorithms (EA's) are able to achieve this, the computation effort can further be reduced by hybridizing them with innovative strategies. This study is focuses on converging to the pareto front faster while adapting the advantages of Strength Pareto Evolutionary Algorithm-II (SPEA-II) for a better spread. Two different approaches based on optimizing the objective functions independently are implemented. In the first method, the decision variables corresponding to the optima of individual objective functions are strategically used to guide the search towards the pareto front. In the second method, boundary points of the pareto front are calculated and their decision variables are seeded to the initial population. Both the methods are applied to different constrained and unconstrained multi-objective test functions. It is observed that proposed guided search based algorithm gives better convergence and diversity than several well-known existing algorithms (such as NSGA-II and SPEA-II) in considerably less number of iterations.

Keywords: boundary points, evolutionary algorithms (EA's), guided search, strength pareto evolutionary algorithm-II (SPEA-II)

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Authors: Junior Akunzi

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In the matter of patient treatment planning quality assurance in 3D conformational therapy (3D-CRT) and volumetric arc therapy (VMAT or RapidArc), the independent monitor unit verification calculation (MUVC) is an indispensable part of the process. Concerning 3D-CRT treatment planning, the MUVC can be performed manually applying the standard ESTRO formalism. However, due to the complex shape and the amount of beams in advanced treatment planning technic such as RapidArc, the manual independent MUVC is inadequate. Therefore, commercially available software such as RadCalc can be used to perform the MUVC in complex treatment planning been. Indeed, RadCalc (version 6.3 LifeLine Inc.) uses a simplified Clarkson algorithm to compute the dose contribution for individual RapidArc fields to the isocenter. The purpose of this project is the validation of RadCalc in 3D-CRT and RapidArc for treatment planning dosimetry quality assurance at Antoine Lacassagne center (Nice, France). Firstly, the interfaces between RadCalc and our treatment planning systems (TPS) Isogray (version 4.2) and Eclipse (version13.6) were checked for data transfer accuracy. Secondly, we created test plans in both Isogray and Eclipse featuring open fields, wedges fields, and irregular MLC fields. These test plans were transferred from TPSs according to the radiotherapy protocol of DICOM RT to RadCalc and the linac via Mosaiq (version 2.5). Measurements were performed in water phantom using a PTW cylindrical semiflex ionisation chamber (0.3 cm³, 31010) and compared with the TPSs and RadCalc calculation. Finally, 30 3D-CRT plans and 40 RapidArc plans created with patients CT scan were recalculated using the CT scan of a solid PMMA water equivalent phantom for 3D-CRT and the Octavius II phantom (PTW) CT scan for RapidArc. Next, we measure the doses delivered into these phantoms for each plan with a 0.3 cm³ PTW 31010 cylindrical semiflex ionisation chamber (3D-CRT) and 0.015 cm³ PTW PinPoint ionisation chamber (Rapidarc). For our test plans, good agreements were found between calculation (RadCalc and TPSs) and measurement (mean: 1.3%; standard deviation: ± 0.8%). Regarding the patient plans, the measured doses were compared to the calculation in RadCalc and in our TPSs. Moreover, RadCalc calculations were compared to Isogray and Eclispse ones. Agreements better than (2.8%; ± 1.2%) were found between RadCalc and TPSs. As for the comparison between calculation and measurement the agreement for all of our plans was better than (2.3%; ± 1.1%). The independent MU verification calculation software RadCal has been validated for clinical use and for both 3D-CRT and RapidArc techniques. The perspective of this project includes the validation of RadCal for the Tomotherapy machine installed at centre Antoine Lacassagne.

Keywords: 3D conformational radiotherapy, intensity modulated radiotherapy, monitor unit calculation, dosimetry quality assurance

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Authors: H. Yousefnia, A. Golabi Dezfuli, S. Zolghadri, M. Hosntalab

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Peptide receptor radionuclide therapy is nowadays used for the treatment of various abnormalities with somatostatin receptors. In this study, 166Ho-DOTATOC was prepared and the best conditions for its radiolabeling was obtained. For this purpose, a certain of DOTATOC was added to a vial containing 166Ho. various experiments by varying ligand concentration, pH, temperature and time were performed to determine the best conditions. Radiochemical purity of the complex was assessed by instant thin layer chromatography method utilizing 0.9% NaCl as the mobile phase. 166Ho-DOTATOC was prepared with radiochemical purity of higher than 95% at the optimized condition (pH=4, temperature: 95° C, time:30 min). In 0.9% NaCl, free Ho cation was developed at Rf of 0.8 while the complex was remained at the front of the paper.

Keywords: Ho-166, neuroendocrine, octreotide, quality control

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Authors: H. P. Kerry

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Drone technology has become a significant discourse in a nation’s national security, while this technology could constitute a danger to national security on the one hand, on the other hand, it is used in developed and developing countries for border security, and in some cases, for protection of security agents and migrants. In the case of Nigeria, drones are used by the military to monitor and tighten security around the borders. However, terrorist groups have devised a means to utilize the technology to their advantage. Therefore, the potential danger in the widespread proliferation of this technology has become a myriad of risks. The research on the effects of cross-border use of drones in Nigerian national security looks at the negative and positive consequences of using drone technology. The study employs the use of interviews and relevant documents to obtain data while the study applied the Just War theory to justify the reason why countries use force; it further buttresses the points with what the realist theory thinks about the use of force. In conclusion, the paper recommends that the Nigerian government through the National Assembly should pass a bill for the establishment of a law that will guide the use of armed and unarmed drones in Nigeria enforced by the Nigeria Civil Aviation Authority and the office of the National Security Adviser.

Keywords: armed drones, drones, cross-border, national security

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Authors: Abigail Amoako Kayser, Brian Kayser

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This study aimed to examine Ghana's 6th-grade Basic School history curriculum to determine how Ghanaian history is taught. We used qualitative methods and document analysis. The document analysis served two primary purposes: (1) To gain insight into what the curriculum materials covered and from whom's perspectives, and (2) To triangulate with teacher interview data. Documents obtained included: (1) Textbooks used by 6th-grade students, (2) Teacher pacing guide provided by the Department of Education in Ghana, and (3) Student work samples. This study was guided through Post-colonial theory and criticisms to explore the remnants of colonial power and hegemony that persist in history curricula used in public schools in Ghana. We also applied African Feminist Thought and Black Feminist Thought to unpack the extent to which issues of patriarchy, race, traditions, underdevelopment, and sexuality impact how we see the experiences of people on the continent. The findings indicated that the remnant of colonial rule persisted in the contents of the history curriculum, and the atrocities of slavery were overlooked or eliminated from the curriculum. The findings also indicated that Ghana's history centered on men's experiences.

Keywords: history, curriculum, decolonialization, culturally relevant pedagogy

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

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Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: advanced palliative aquatics care, magnetic field therapy, medical device, research design

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Authors: Enas R. Shouman

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Economic development with population growth is leading to a continuous increase in energy demand. At the same time, growing global concern for the environment is driving to decrease the use of conventional energy sources and to increase the use of renewable energy sources. The objective of this study is to present the market trends of solar energy photovoltaic technology over the world and to represent economics methods for PV financial analyzes on the basis of expectations for the expansion of PV in many applications. In the course of this study, detailed information about the current PV market was gathered and analyzed to find factors influencing the penetration of PV energy. The paper methodology depended on five relevant economic financial analysis methods that are often used for investment decisions maker. These methods are payback analysis, net benefit analysis, saving-to-investment ratio, adjusted internal rate of return, and life-cycle cost. The results of this study may be considered as a marketing guide that helps diffusion of using PV Energy. The study showed that PV cost is economically reliable. The consumers will pay higher purchase prices for PV system installation but will get lower electricity bill.

Keywords: photovoltaic, financial methods, solar energy, economics, PV panel

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Authors: Maha Hamoud Alatawi

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Drawing on the work of John McLeod and Ariel Watson, this paper explains the relationship between narrative and psychotherapy in two plays by the Irish playwright Conor McPherson. Dublin Carol presents John’s chequered past through his reminiscences of alcohol addiction and Shining City tells the story of John who is haunted by the ghost of his wife, recently died in a car accident, and who seeks the help of Ian, a therapist. At first, the significance of storytelling as an integral part of Irish culture is highlighted. Such a tradition features prominently in contemporary Irish drama. The paper concludes that it is the power of narrative and its therapeutic impact and not the act of psychotherapy and treatment which brings signs of change to characters’ lives.

Keywords: Conor McPherson, drama, psychotherapy, storytelling

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Authors: S. H. Kazmi, T. Ahmed, K. Javed, A. Ghani

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In this paper static scheme of under-frequency based load shedding is considered for chemical and petrochemical industries with islanded distribution networks relying heavily on the primary commodity to ensure minimum production loss, plant downtime or critical equipment shutdown. A simplistic methodology is proposed for in-house implementation of this scheme using underfrequency relays and a step by step guide is provided including the techniques to calculate maximum percentage overloads, frequency decay rates, time based frequency response and frequency based time response of the system. Case study of FFL electrical system is utilized, presenting the actual system parameters and employed load shedding settings following the similar series of steps. The arbitrary settings are then verified for worst overload conditions (loss of a generation source in this case) and comprehensive system response is then investigated.

Keywords: islanding, under-frequency load shedding, frequency rate of change, static UFLS

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Authors: Mmbulaheni Ramulondi, Sandy Van Vuuren, Helene De Wet

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The use of plant combinations to treat various medical conditions is not a new concept, and it is known that traditional people do not only rely on a single plant extract for efficacy but often combine various plant species for treatment. The knowledge of plant combinations is transferred from one generation to the other in the belief that combination therapy may enhance efficacy, reduce toxicity, decreases adverse effects, increase bioavailability and result in lower dosages. However, combination therapy may also be harmful when the interaction is antagonistic, since it may result in increasing toxicity. Although a fair amount of research has been done on the toxicity of medicinal plants, there is very little done on the toxicity of medicinal plants in combination. The aim of the study was to assess the toxicity potential of 19 plant combinations which have been documented as treatments of hypertension in northern KwaZulu-Natal by lay people. The aqueous extracts were assessed using two assays; the Brine shrimp assay (Artemia franciscana) and the Ames test (Mutagenicity). Only one plant combination (Aloe marlothii with Hypoxis hemerocallidea) in the current study has been previously assessed for toxicity. With the Brine shrimp assay, the plant combinations were tested in two concentrations (2 and 4 mg/ml), while for mutagenicity tests, they were tested at 5 mg/ml. The results showed that in the Brine shrimp assay, six combinations were toxic at 4 mg/ml. The combinations were Albertisia delagoensis with Senecio serratuloides (57%), Aloe marlothii with Catharanthus roseus (98%), Catharanthus roseus with Hypoxis hemerocallidea (66%), Catharanthus roseus with Musa acuminata (89%), Catharanthus roseus with Momordica balsamina (99%) and Aloe marlothii with Trichilia emetica and Hyphaene coriacea (50%). However when the concentration was reduced to 2 mg/ml, only three combinations were toxic which were Aloe marlothii with Catharanthus roseus (76%), Catharanthus roseus with Musa acuminata (66%) and Catharanthus roseus with Momordica balsamina (73%). For the mutagenicity assay, only the combinations between Catharanthus roseus with Hypoxis hemerocallidea and Catharanthus roseus with Momordica balsamina were mutagenic towards the Salmonella typhimurium strains TA98 and TA100. Most of the combinations which were toxic involve C. roseus which was also toxic when tested singularly. It is worth noting that C. roseus was one of the most frequently used plant species both to treat hypertension singularly and in combination and some of the individuals have been using this for the last 20 years. The mortality percentage of the Brine shrimp showed a significant correlation between dosage and toxicity thus toxicity was dosage dependant. A combination which is worth noting is the combination between A. delagoensis and S. serratuloides. Singularly these plants were non-toxic towards Brine shrimp, however their combination resulted in antagonism with the mortality rate of 57% at the total concentration of 4 mg/ml. Low toxicity was mostly observed, giving some validity to combined use, however the few combinations showing increased toxicity demonstrate the importance of analysing plant combinations.

Keywords: dosage, hypertension, plant combinations, toxicity

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Authors: Hee Sun (Sunny) Choi, Gerhard Bruyns, Wang Zhang, Sky Cheng, Saijal Sharma

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This research addresses the need for a comprehensive framework that can guide the design and assessment of multi-level public spaces and public realms and their impact on the built environment. The study aims to understand and measure the neural mechanisms involved in this process. By doing so, it can lay the foundation for vertical and volumetric urbanism and ensure consistency and excellence in the field while also supporting scientific research methods for urban design with cognitive neuroscientists. To investigate these aspects, the paper focuses on the neighborhood scale in Hong Kong, specifically examining multi-level public spaces and quasi-public spaces within both commercial and residential complexes. The researchers use predictive Artificial Intelligence (AI) as a methodology to assess and comprehend the applicability of the urban design framework for vertical and volumetric urbanism. The findings aim to identify the factors that contribute to successful public spaces within a vertical living environment, thus introducing a new typology of public spaces.

Keywords: vertical urbanism, scientific research methods, spatial cognition, urban design guideline

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Authors: Ching-Yi Yiu, Hui-Chen Hsu

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Objectives: Head and neck cancer (HNC) is a big global health problem in the world. Despite the development of diagnosis and treatment, the overall survival of HNC is still low. The well recognition of the interaction of the host immune system and cancer cells has led to realizing the processes of tumor initiation, progression and metastasis. Many systemic inflammatory responses have been shown to play a crucial role in cancer progression. The pre and post-treatment nutritional and immunological status of HNC patients is a reliable prognostic indicator of tumor outcomes and survivors. Methods: Between July 2020 to June 2022, We have enrolled 60 HNC patients, including 59 males and 1 female, in Chi Mei Medical Center, Liouying, Taiwan. The age distribution was from 37 to 81 years old (y/o), with a mean age of 57.6 y/o. We evaluated the pre-and post-treatment nutritional and immunological status of these HNC patients with body weight, body weight loss, body mass index (BMI), whole blood count including hemoglobin (Hb), lymphocyte, neutrophil and platelet counts, biochemistry including prealbumin, albumin, c-reactive protein (CRP), with the time period of before treatment, post-treatment 3 and 6 months. We calculated the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to assess how these biomarkers influence the outcomes of HNC patients. Results: We have carcinoma of the hypopharynx in 21 cases with 35％, carcinoma of the larynx in 9 cases, carcinoma of the tonsil and tongue every 6 cases, carcinoma soft palate and tongue base every 5 cases, carcinoma of buccal mucosa, retromolar trigone and mouth floor every 2 cases, carcinoma of the hard palate and low lip each 1 case. There were stage I 15 cases, stage II 13 cases, stage III 6 cases, stage IVA 10 cases, and stage IVB 16 cases. All patients have received surgery, chemoradiation therapy or combined therapy. We have wound infection in 6 cases, 2 cases of pharyngocutaneous fistula, flap necrosis in 2 cases, and mortality in 6 cases. In the wound infection group, the average BMI is 20.4 kg/m2; the average Hb is 12.9 g/dL, the average albumin is 3.5 g/dL, the average NLR is 6.78, and the average PLR is 243.5. In the PC fistula and flap necrosis group, the average BMI is 21.65 kg/m2; the average Hb is 11.7 g/dL, the average albumin is 3.15 g/dL, average NLR is 13.28, average PLR is 418.84. In the mortality group, the average BMI is 22.3 kg/m2; the average Hb is 13.58 g/dL, the average albumin is 3.77 g/dL, the average NLR is 6.06, and the average PLR is 275.5. Conclusion: HNC is a big challenging public health problem worldwide, especially in the high prevalence of betel nut consumption area Taiwan. Besides the definite risk factors of smoking, drinking and betel nut related, the other biomarkers may play significant prognosticators in the HNC outcomes. We concluded that the average BMI is less than 22 kg/m2, the average Hb is low than 12.0 g/dL, the average albumin is low than 3.3 g/dL, the average NLR is low than 3, and the average PLR is more than 170, the surgical complications and mortality will be increased, and the prognosis is poor in HNC patients.

Keywords: nutritional, immunological, neutrophil-to-lymphocyte ratio, paltelet-to-lymphocyte ratio.

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Authors: Nancy N. Sharmila, Aparna Mishra

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Hemiparesis affects almost 80% of stroke patients each year. It is marked by paralysis or weakness on one half of the body. Our model provides both assistance and physical therapy for hemiparesis patients for swift recovery. In order to accomplish our goal a force is provided that pulls the forearm up (as in flexing the arm), and pushes the forearm down (as in extending the arm), which will also assist the user during ADL (Activities of Daily Living). The model consists of a mechanical component which is placed around the patient’s bicep and an EMG control circuit to assist patients in daily activities, which makes it affordable and easy to use. In order to enhance the neuromuscular system’s effectiveness in synchronize the movement, proprioceptive neuromuscular facilitation (PNF) concept is used. The EMG signals are acquired from the unaffected arm as an input to drive the orthosis. This way the patient is invigorated to use the orthosis for regular exercise.

Keywords: EMG, hemiparesis, orthosis, rehabilitation

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Authors: S. Mohd Afzal, R. O'Connell

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Kaposi's sarcoma (KS) is the most common HIV-related cancer, and ocular manifestations constitute at least 25% of all KS cases. However, ocular presentations often occur in the context of systemic KS, and isolated lesions are rare. We report a unique case of ocular KS masquerading as subconjunctival haemorrhage, and only developing systemic manifestations after initiation of HIV treatment. Case: A 49-year old man with previous hypertensive stroke and newly diagnosed HIV infection presented with an acutely red left eye following repeated bouts of coughing. Given the convincing history of poorly controlled hypertension and cough, a diagnosis of subconjunctival haemorrhage was made. Over the next week, his ocular lesion began to improve and he subsequently started anti-retroviral therapy. Prior to receiving anti-retroviral therapy, his CD4+ lymphocyte count was 194 cells/mm3 with HIV viral load greater than 1 million/ml. This rapidly improved to a viral load of 150 copies/ml within 2 weeks of starting treatment. However, a few days after starting HIV treatment, his ocular lesion recurred. Ophthalmic examination was otherwise normal. He also developed widespread lymphadenopathy and multiple dark lesions on his torso. Histology and virology confirmed KS, systemically triggered by Immune Reconstitution Syndrome (KS-IRIS). The patient has since undergone chemotherapy successfully. Discussion: Kaposi's sarcoma is an atypical tumour caused by human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus (KSHV). In immunosuppressed patients, KSHV can also cause lymphoproliferative disorders such as primary effusion lymphoma and Castleman's disease (in our patient’s case, this was excluded through histological analysis of lymph nodes). KSHV is one of the seven currently known human oncoviruses, and its pathogenesis is poorly understood. Up to 13% of patients with HIV-related KS experience worsening of the disease after starting anti-retroviral treatment, due to a sudden increase in CD4 cell counts. Histology remains the diagnostic gold standard. Current British HIV Association (BHIVA) guidelines recommend treatment using anti-retroviral drugs, with either intralesional vinblastine for local disease or systemic chemotherapy for disseminated KS. Conclusion: This case is unique as ocular KS as initial presentation is rare and our patient's diagnosis was only made after systemic lesions were triggered by immune reconstitution. KS should be considered as an important differential diagnosis for red eyes in all patients at risk of acquiring HIV infection.

Keywords: human herpesvirus 8, human immunodeficiency virus, immune reconstitution syndrome, Kaposi’s sarcoma, Kaposi’s sarcoma-associated herpesvirus

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Authors: Reyhaneh Hashemi, Shahrooz Saviz

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In his study, we have survey the theory of gyrotron amplifier in a vane-loaded waveguide with inner dielectric material. Dispersion relation for electromagnetic waves emitted by a cylindrical waveguide that provided with wedge-shaped metal vanes projecting radially inward from the wall of the guide and exited in the transverse-electric mode was analysed. From numerical analysis of this dispersion relation, it is shown that the stability behavior of the fast-wave mode is dependent of the dielectric constant. With a small axial momentum spreed, a super bandwidth is shown to be attainable by a mixed mode operation. Also, with the utilization from the numeric analysis of relation dispersion. We show that in the –speed mode, the constant is independent de-electric. With the ratio of dispersion of smell, high –bandwith was obtained for the combined mode. And at the end, we were comparing the result of our work (vane-loaded) by the waveguide with a smooth wall.

Keywords: gyrotron amplifier, waveguide, vane-loaded waveguide, dielectric material, dispersion relation, cylindrical waveguide, fast-wave mode, mixed mode operation

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Authors: Behrooz Balaei, Suzanne Wilkinson, Regan Potangaroa, Larry Abel, Philip McFarlane

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Water supply system failure has serious direct and indirect effects on people wellbeing. Post-disaster water system serviceability depends on a variety of factors from technical characteristics to social, economic, and organizational attributes of communities. This paper tests the organizational factors affecting water supply resilience to outline how these factors contributed to previous disasters. To do so, a framework is briefly introduced in this study to provide a clear guide to identify the significant relevant organizational factors. Then the factors affecting water serviceability following a disaster are outlines. Next, these factors are measured in the case of Tropical Cyclone Pam, which hit Vanuatu in March 2015. Reviewing the existing literature has also been carried out to obtain a comprehensive understanding of the background A site visit and a series of interviews have also been undertaken following the cyclone to collect site-specific data and information. In the end, the organizational factors were ranked to enable decision makers to identify significance of each factor compared to the others.

Keywords: water supply, resilience, organizational capacity, Vanuatu, Tropical Cyclone Pam

Procedia PDF Downloads 124