Search results for: assessing pain
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2812

Search results for: assessing pain

1312 Antepartum and Postpartum Pulmonary Cryptococcosis: A Case Report and Systematic Review

Authors: Ghadeer M Alkusayer, Adelicia Yu, Pamela Orr

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Study objective: To report a case of postpartum pulmonary cryptococcal infection (CCI) in an otherwise healthy 35-year-old woman. Additionally, the cases of pulmonary cryptococcal infections either in the antepartum or the postpartum period with pregnancy outcomes, were systematically reviwed. Methods: A systematic search of Cochrane Library, MEDLINE, and EMBASE was conducted for peer-reviewed studies without date restrictions, published in English and relating to CCI during pregnancy or postpartum period. Conference press, editorials, opinion pieces and letters were excluded. Two authors independently screened citations and full-text articles, extracted data and assessed study quality. Given the heterogeneity of study designs, a narrative synthesis was conducted. Results: The search identified 128 references, of which 22 case reports and series met the inclusion criteria. This is a total of 29 women (including the current case) . The mean age of the women was 28.3 ± 12.3 years. Nine (31.03%) presented and were diagnosed in the postpartum period. Two (6.90%) of the patients were reported as immunocompromised with HIV. Four maternal deaths (13.79%) were found in this case series with one (4.3%) patient with severe neurological deficits. Four (17.4%) infant deaths were reported. Women primary presentation varied with chest pain 13 (44.82%), headache 10 (35.70%), dyspnea 19 (65.51%), or fever 12 (41.38%). Three studies reported placental pathology positive for C. neoformans. Conclusion: This case of pulmonary cryptococcal infection in the postpartum period is an important addition to the literature of this rare infection in pregnancy. The patient is not immunocompromised. The patient was successfully treated with 4 months of Fluconazole 400 mg and continued to breastfeed the healthy baby.

Keywords: pulmonary cryptococcus, pregnancy, cryptococci , postpartum

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1311 Assessing Influence of End-Boundary Conditions on Stability and Second-Order Lateral Stiffness of Beam-Column Elements Embedded in Non-Homogeneous Soil

Authors: Carlos A. Vega-Posada, Jeisson Alejandro Higuita-Villa, Julio C. Saldarriaga-Molina

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This paper presents a simplified analytical approach to conduct elastic stability and second-order lateral stiffness analyses of beam-column elements (i.e., piles) with generalized end-boundary conditions embedded on a homogeneous or non-homogeneous Pasternak foundation. The solution is derived using the well-known Differential Transformation Method (DTM), and it consists simply of solving a system of two linear algebraic equations. Using other conventional approaches to solve the governing differential equation of the proposed element can be cumbersome and the solution challenging to implement, especially when the non-homogeneity of the soil is considered. The proposed formulation includes the effects of i) any rotational or lateral transverse spring at the ends of the pile, ii) any external transverse load acting along the pile, iii) soil non-homogeneity, and iv) the second-parameter of the elastic foundation (i.e., shear layer connecting the springs at the top). A parametric study is conducted to investigate the effects of different modulus of subgrade reactions, degrees of non-homogeneities, and intermediate end-boundary conditions on the pile response. The same set of equations can be used to conduct both elastic stability and static analyses. Comprehensive examples are presented to show the simplicity and practicability of the proposed method.

Keywords: elastic stability, second-order lateral stiffness, soil-non-homogeneity, pile analysis

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1310 Estimation of Time Loss and Costs of Traffic Congestion: The Contingent Valuation Method

Authors: Amira Mabrouk, Chokri Abdennadher

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The reduction of road congestion which is inherent to the use of vehicles is an obvious priority to public authority. Therefore, assessing the willingness to pay of an individual in order to save trip-time is akin to estimating the change in price which was the result of setting up a new transport policy to increase the networks fluidity and improving the level of social welfare. This study holds an innovative perspective. In fact, it initiates an economic calculation that has the objective of giving an estimation of the monetized time value during the trips made in Sfax. This research is founded on a double-objective approach. The aim of this study is to i) give an estimation of the monetized value of time; an hour dedicated to trips, ii) determine whether or not the consumer considers the environmental variables to be significant, iii) analyze the impact of applying a public management of the congestion via imposing taxation of city tolls on urban dwellers. This article is built upon a rich field survey led in the city of Sfax. With the use of the contingent valuation method, we analyze the “declared time preferences” of 450 drivers during rush hours. Based on the fond consideration of attributed bias of the applied method, we bring to light the delicacy of this approach with regards to the revelation mode and the interrogative techniques by following the NOAA panel recommendations bearing the exception of the valorization point and other similar studies about the estimation of transportation externality.

Keywords: willingness to pay, contingent valuation, time value, city toll

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1309 Quality of Life among Mothers of Children with Autism Spectrum Disorder in Saudi Arabia

Authors: Asma Alsaleh, Kara Makara

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Autistic spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties with communication and interaction. Besides presenting challenges for the ASD individual, the condition can entail negative outcomes for those who care for them, most often mothers. While this issue has been studied substantially in Western society, less is known about how mothers in the Arab world are affected by raising an ASD child. This study sought to gain insights into this area by assessing quality of life and stress in mothers with (n = 25) and without (n = 25) ASD children in Riyadh (Saudi Arabia) by using, respectively, the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF) and the Parenting Stress Index-Short Form (PSI-SF). Data pertaining to income and education were also attained to investigate how socioeconomic factors interact with the above-mentioned variables. The analysis revealed that total stress scores and scores on the individual subscales of the PSI-SF were significantly higher for the mothers with an ASD child compared to those without an ASD child, though the opposite was true of quality of life scores. Moreover, increased income was associated with increased quality of life and decreased stress. While there were not main effects of education, there were interactions between education, whether children were ASD or non-ASD, and the outcome variables. These results suggest that mothers of ASD children in an Arab culture are at increased risk of negative outcomes relative to mothers of typically developing children, and, therefore, this study may act as a foundation for the delivery of interventions to assist mothers in this position.

Keywords: autism, education, income, mothers, quality of life, stress

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1308 Literature Review of Empirical Studies on the Psychological Processes of End-of-Life Cancer Patients

Authors: Kimiyo Shimomai, Mihoko Harada

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This study is a literature review of the psychological reactions that occur in end-of-life cancer patients who are nearing death. It searched electronic databases and selected literature related to psychological studies of end-of-life patients. There was no limit on the search period, and the search was conducted until the second week of December 2021. The keywords were specified as “death and dying”, “terminal illness”, “end-of-life”, “palliative care”, “psycho-oncology” and “research”. These literatures referred to Holly (2017): Comprehensive Systematic Review for Advanced Practice Nursing, P268 Figure 10.3 to ensure quality. These literatures were selected with a dissertation score of 4 or 5. The review was conducted in two stages with reference to the procedure of George (2002). First, these references were searched for keywords in the database, and then relevant references were selected from the psychology and nursing studies of end-of-life patients. The number of literatures analyzed was 76 for overseas and 17 for domestic. As for the independent variables, "physical variable" was the most common in 36 literatures (66.7%), followed by "psychological variable" in 35 literatures (64.8%), "spiritual variable" in 21 literatures (38%), and "social variable" in 17 literatures. (31.5%), "Variables related to medical care / treatment" were 16 literatures (29.6%). To summarize the relationship between these independent variables and the dependent variable, when the dependent variable is "psychological variable", the independent variables are "psychological variable", "social variable", and "physical variable". Among the independent variables, the physical variables were the most common. The psychological responses that occur in end-stage cancer patients who are nearing death are mutually influenced by psychological, social, and physical variables. Therefore, it supported the "total pain" advocated by Cicely Saunders.

Keywords: cancer patient, end-of-life, literature review, psychological process

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1307 Accessible Sustainability Assessment Tools and Approach of the University level Academic Programs

Authors: S. K. Ashiquer Rahman

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The innovative knowledge threshold significantly shifted education from traditional to an online version which was an emergent state of arts for academic programs of any higher education institutions; the substantive situation thus raises the importance of deliberative integration of education, Knowledge, technology and sustainability as well as knowledge platforms, e.g., ePLANETe. In fact, the concept of 'ePLANETe' an innovative knowledge platform and its functionalities as an experimental digitized platform for contributing sustainable assessment of academic programs of higher education institution(HEI). Besides, this paper assessed and define the common sustainable development challenges of higher education(HE) and identified effective approach and tools of 'ePLANETe’ that is enable to practices sustainability assessment of academic programs through the deliberation methodologies. To investigate the effectiveness of knowledge tools and approach of 'ePLANETe’, I have studied sustainable challenges digitized pedagogical content as well as evaluation of academic programs of two public universities in France through the 'ePLANETe’ evaluation space. The investigation indicated that the effectiveness of 'ePLANETe’s tools and approach perfectly fit for the quality assessment of academic programs, implementation of sustainable challenges, and dynamic balance of ecosystem within the university communities and academic programs through 'ePLANETe’ evaluation process and space. The study suggests to the relevant higher educational institution’s authorities and policymakers could use this approach and tools for assessing sustainability and enhancing the sustainability competencies of academic programs for quality education

Keywords: ePLANETe, deliberation, evaluation, competencies

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1306 An Activity Based Trajectory Search Approach

Authors: Mohamed Mahmoud Hasan, Hoda M. O. Mokhtar

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With the gigantic increment in portable applications use and the spread of positioning and location-aware technologies that we are seeing today, new procedures and methodologies for location-based strategies are required. Location recommendation is one of the highly demanded location-aware applications uniquely with the wide accessibility of social network applications that are location-aware including Facebook check-ins, Foursquare, and others. In this paper, we aim to present a new methodology for location recommendation. The proposed approach coordinates customary spatial traits alongside other essential components including shortest distance, and user interests. We also present another idea namely, "activity trajectory" that represents trajectory that fulfills the set of activities that the user is intrigued to do. The approach dispatched acquaints the related distance value to select trajectory(ies) with minimum cost value (distance) and spatial-area to prune unneeded directions. The proposed calculation utilizes the idea of movement direction to prescribe most comparable N-trajectory(ies) that matches the client's required action design with least voyaging separation. To upgrade the execution of the proposed approach, parallel handling is applied through the employment of a MapReduce based approach. Experiments taking into account genuine information sets were built up and tested for assessing the proposed approach. The exhibited tests indicate how the proposed approach beets different strategies giving better precision and run time.

Keywords: location based recommendation, map-reduce, recommendation system, trajectory search

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1305 Demographic Characteristics of the Atlas Barbary Sheep in Amassine Nature Reserve, Atlas Range, Morocco: Implications For Conservation and Management

Authors: Hakim Bachiri, Mohammed Znari, Moulay Abdeljalil Ait Baamranne

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Population characteristics of Atlas Barbary sheep (Ammotragus lervia lervia) were investigated 20 years following the 1999 introduction of 10 individuals into the fenced nature reserve of Amassine, High Atlas range, Morocco, for promoting wildlife watching and tourism. Population age-sex structure and density were determined in late winter-early spring during four consecutive years (2016-2019) by direct observation before the dispersal of the herd. In this latter case, the line transect distance sampling was successfully applied. Population size increased from 37 to 62 animals during the four-year study period; the maximal population size being 82 individuals recorded in 2006. An estimated population density ranged from 0.25 to 0.41 Barbary sheep/ha during the study period. The adult sex ratio varied from 91 to 67 per 100 females. The apparent birth rate was 14 to 73/100 females. Juveniles and subadults comprised 27-43% of the population, adult males 26-31% and adult females 29-45%. The survival rate from birth to 1 year of age approximated 35%, for adult males was estimated to average 69%/year. The obtained results would be helpful for developing sustainable population management and habitat restoration plan and assessing the feasibility of potential reintroduction/restocking in other areas of the Atlas range.

Keywords: atlas mountains, barbary sheep, demography, management

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1304 Numerical and Experimental Investigation of Airflow Inside Car Cabin

Authors: Mokhtar Djeddou, Amine Mehel, Georges Fokoua, Anne Tanière, Patrick Chevrier

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Commuters' exposure to air pollution, particularly to particle matter, inside vehicles is a significant health issue. Assessing particles concentrations and characterizing their distribution is an important first step to understand and propose solutions to improve car cabin air quality. It is known that particles dynamics is intimately driven by particles-turbulence interactions. In order to analyze and model pollutants distribution inside the car the cabin, it is crucialto examine first the single-phase flow topology and turbulence characteristics. Within this context, Computational Fluid Dynamics (CFD) simulations were conducted to model airflow inside a full-scale car cabin using Reynolds Averaged Navier-Stokes (RANS)approach combined with the first order Realizable k- εmodel to close the RANS equations. To validate the numerical model, a campaign of velocity field measurements at different locations in the front and back of the car cabin has been carried out using hot-wire anemometry technique. Comparison between numerical and experimental results shows a good agreement of velocity profiles. Additionally, visualization of streamlines shows the formation of jet flow developing out of the dashboard air vents and the formation of large vortex structures, particularly in the back seats compartment. These vortex structures could play a key role in the accumulation and clustering of particles in a turbulent flow

Keywords: car cabin, CFD, hot wire anemometry, vortical flow

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1303 Assessing the Implementation of Community Driven Development through Social Capital in Migrant and Indigenous Informal Settlements in Accra, Ghana

Authors: Beatrice Eyram Afi Ziorklui, Norihisa Shima

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Community Driven Development (CDD) is now a widely recommended and accepted development strategy for informal communities across the continent. Centered on the utilization of social capital through community structures, different informal settlements have different structures and different levels of social capital, which affect the implementation and ability to overcome CDD challenges. Although known to be very successful, there are few perspectives on the implementation of CDD initiatives in different informal settlements. This study assesses the implementation of CDD initiatives in migrant and indigenous informal settlements and their ability to navigate challenges. The case study research design was adopted in this research, and respondents were chosen through simple random sampling. Using the Statistical Package for social scientists (SPSS) for data analysis, the study found that migrant informal settlements implement CDD projects through the network of hierarchical structures based on government systems, whereas indigenous informal settlements implement through the hierarchical social structure based on traditions and culture. The study also found that, with the exception of the challenge of land accessibility in migrant informal settlements, all other challenges, such as participation, resource mobilization, and maintenance, have a significant relationship with social capital, although indigenous informal settlements have higher levels of social capital than migrant informal settlements. The study recommends a framework that incorporates community characteristics and the underlying social capital to facilitate upgrading strategies in informal in Ghana.

Keywords: community driven development, informal settlements, social capital, upgrading

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1302 Influence of Cooking on the Functional Properties of Dioscorea Schimperiana During Chips Production

Authors: Djeukeu Asongni William, Leng Marlyse, Gouado Inocent

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Background: Process for obtaining D. schimperiana chips involves a long period of cooking followed by drying of obtained products in the sun. Such a process could induce the modification of the functional properties of the chips, thus reducing the technological uses of these products. This study was conducted with a view to assessing the impact of this process on the chips of D. schimperiana. Methods: The chips used were purchased in Baham, Bamendjou and Bagangté markets during the month of February 2013. A representative sample of each market chips was formed by mixing the chips of several sellers. The control sample consisted of fresh yams that have been sliced to the average size of local chips then dried in the oven at 45 ° C for 36 h. On each sample was performed the analysis of the physico-chemical properties (carbohydrates, lipids, proteins, iron , phosphorus, reducing sugars, ash and total starch) and gelling properties both with and without inhibitor alpha-amylases (0.018 and 0.146 mol / l). Results: Results show that the levels of ash 2.99 g / 100gms, iron 1.01 g / 100gms and phosphorus 532.06 mg / 100gms fresh sample were significantly higher than those of the products obtained in the traditional process. The functional properties of the chips obtained from different methods shows that the peak viscosity of the fresh sample is larger than the other samples with or without inhibitor. In addition, the fresh sample has the lowest breakdown under the same conditions. Conclusion: These results show that traditional process reduces technological potential of chips, thus limiting the value of D. schimperiana.

Keywords: Dioscorea schimperiana, chips, functional properties, technological properties, valorization

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1301 A Systematic Review Examining the Experimental methodology behind in vivo testing of hiatus hernia and Diaphragmatic Hernia Mesh

Authors: Whitehead-Clarke T., Beynon V., Banks J., Karanjia R., Mudera V., Windsor A., Kureshi A.

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Introduction: Mesh implants are regularly used to help repair both hiatus hernias (HH) and diaphragmatic hernias (DH). In vivo studies are used to test not only mesh safety but increasingly comparative efficacy. Our work examines the field of in vivo mesh testing for HH and DH models to establish current practices and standards. Method: This systematic review was registered with PROSPERO. Medline and Embase databases were searched for relevant in vivo studies. 44 articles were identified and underwent abstract review, where 22 were excluded. 4 further studies were excluded after full text review – leaving 18 to undergo data extraction. Results: Of 18 studies identified, 9 used an in vivo HH model and 9 a DH model. 5 studies undertook mechanical testing on tissue samples – all uniaxial in nature. Testing strip widths ranged from 1-20mm (median 3mm). Testing speeds varied from 1.5-60mm/minute. Upon histology, the most commonly assessed structural and cellular factors were neovascularization and macrophages, respectively (n=9 each). Structural analysis was mostly qualitative, where cellular analysis was equally likely to be quantitative. 11 studies assessed adhesion formation, of which 8 used one of four scoring systems. 8 studies measured mesh shrinkage. Discussion: In vivo studies assessing mesh for HH and DH repair are uncommon. Within this relatively young field, we encourage surgical and materials testing institutions to discuss its standardisation.

Keywords: hiatus, diaphragmatic, hernia, mesh, materials testing, in vivo

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1300 Investigation of Crack Formation in Ordinary Reinforced Concrete Beams and in Beams Strengthened with Carbon Fiber Sheet: Theory and Experiment

Authors: Anton A. Bykov, Irina O. Glot, Igor N. Shardakov, Alexey P. Shestakov

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This paper presents the results of experimental and theoretical investigations of the mechanisms of crack formation in reinforced concrete beams subjected to quasi-static bending. The boundary-value problem has been formulated in the framework of brittle fracture mechanics and has been solved by using the finite-element method. Numerical simulation of the vibrations of an uncracked beam and a beam with cracks of different size serves to determine the pattern of changes in the spectrum of eigenfrequencies observed during crack evolution. Experiments were performed on the sequential quasistatic four-point bending of the beam leading to the formation of cracks in concrete. At each loading stage, the beam was subjected to an impulse load to induce vibrations. Two stages of cracking were detected. At the first stage the conservative process of deformation is realized. The second stage is an active cracking, which is marked by a sharp change in eingenfrequencies. The boundary of a transition from one stage to another is well registered. The vibration behavior was examined for the beams strengthened by carbon-fiber sheet before loading and at the intermediate stage of loading after the grouting of initial cracks. The obtained results show that the vibrodiagnostic approach is an effective tool for monitoring of cracking and for assessing the quality of measures aimed at strengthening concrete structures.

Keywords: crack formation, experiment, mathematical modeling, reinforced concrete, vibrodiagnostics

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1299 Dietary Practices of Adult Type 2 Diabetes Mellitus Patients Attending Kitui Out Patient Clinic at Kitui County, Kenya

Authors: Alice W. Theuri, Anselimo O. Makokha, Florence M. Kyallo

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Type 2 diabetes mellitus (T2DM) is a serious metabolic disorder whose prevalence among adults has been increasing in the last decade. It is estimated that by 2030, the number of cases in Africa will almost double. Diet and lifestyle modifications are considered the cornerstone for the treatment and management of T2DM. Despite this, there is minimum literature assessing the dietary practices and glycemic control in a semi arid region context in Kenya. The objective of this study was to determine the dietary practices of adult T2DM patients attending Kitui out patient clinic in Kitui County. This was a cross sectional study design where every consenting second patient attending diabetic clinic was interviewed. A total of 138 T2DM patients were interviewed using a structured interview guide on socio-economic and dietary practices administered. The study was carried out in April and May 2017. There were more female (64%) than male (36%) in this study with majority being unemployed (38.4%). Forty seven percent (47.6%) had elevated HbA1c. Majority took three meals per day while DDS was 4.3 ± 1.09. The mean energy intake for men and women was 2823.8 ± 82.45 and 2766.3.30 ± 76.74 respectively. There was a non significant positive relationship (r= 131; P value = 0.124) between amount energy consumed and glycemic control. There were suboptimal dietary practices leading to poor glycemic control among T2DM patients attending diabetic clinic at Kitui District Hospital.

Keywords: adults, dietary practices, semi arid region, T2DM

Procedia PDF Downloads 155
1298 Simplifying Seismic Vulnerability Analysis for Existing Reinforced Concrete Buildings

Authors: Maryam Solgi, Behzad Shahmohammadi, Morteza Raissi Dehkordi

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One of the main steps for seismic retrofitting of buildings is to determine the vulnerability of structures. While current procedures for evaluating existing buildings are complicated, and there is no limitation between short, middle-high, and tall buildings. This research utilizes a simplified method for assessing structures, which is adequate for existing reinforced concrete buildings. To approach this aim, Simple Lateral Mechanisms Analysis (SLaMA) procedure proposed by NZSEE (New Zealand Society for Earthquake Engineering) has been carried out. In this study, three RC moment-resisting frame buildings are determined. First, these buildings have been evaluated by inelastic static procedure (Pushover) based on acceptance criteria. Then, Park-Ang Damage Index is determined for the whole members of each building by Inelastic Time History Analysis. Next, the Simple Lateral Mechanisms Analysis procedure, a hand method, is carried out to define the capacity of structures. Ultimately, existing procedures are compared with Peak Ground Acceleration caused to fail (PGAfail). The results of this comparison emphasize that the Pushover procedure and SLaMA method define a greater value of PGAfail than the Park-Ang Damage model.

Keywords: peak ground acceleration caused to fail, reinforced concrete moment-frame buildings, seismic vulnerability analysis, simple lateral mechanisms analysis

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1297 Assessing the Walkability and Urban Design Qualities of Campus Streets

Authors: Zhehao Zhang

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Walking has become an indispensable and sustainable way of travel for college students in their daily lives; campus street is an important carrier for students to walk and take part in a variety of activities, improving the walkability of campus streets plays an important role in optimizing the quality of campus space environment, promoting the campus walking system and inducing multiple walking behaviors. The purpose of this paper is to explore the effect of campus layout, facility distribution, and location site selection on the walkability of campus streets, and assess the street design qualities from the elements of imageability, enclosure, complexity, transparency, and human scale, and further examines the relationship between street-level urban design perceptual qualities and walkability and its effect on walking behavior in the campus. Taking Tianjin University as the research object, this paper uses the optimized walk score method based on walking frequency, variety, and distance to evaluate the walkability of streets from a macro perspective and measures the urban design qualities in terms of the calculation of street physical environment characteristics, as well as uses behavior annotation and street image data to establish temporal and spatial behavior database to analyze walking activity from the microscopic view. In addition, based on the conclusions, the improvement and design strategy will be presented from the aspects of the built walking environment, street vitality, and walking behavior.

Keywords: walkability, streetscapes, pedestrian activity, walk score

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1296 An Analytical Approach to Assess and Compare the Vulnerability Risk of Operating Systems

Authors: Pubudu K. Hitigala Kaluarachchilage, Champike Attanayake, Sasith Rajasooriya, Chris P. Tsokos

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Operating system (OS) security is a key component of computer security. Assessing and improving OSs strength to resist against vulnerabilities and attacks is a mandatory requirement given the rate of new vulnerabilities discovered and attacks occurring. Frequency and the number of different kinds of vulnerabilities found in an OS can be considered an index of its information security level. In the present study five mostly used OSs, Microsoft Windows (windows 7, windows 8 and windows 10), Apple’s Mac and Linux are assessed for their discovered vulnerabilities and the risk associated with each. Each discovered and reported vulnerability has an exploitability score assigned in CVSS score of the national vulnerability database. In this study the risk from vulnerabilities in each of the five Operating Systems is compared. Risk Indexes used are developed based on the Markov model to evaluate the risk of each vulnerability. Statistical methodology and underlying mathematical approach is described. Initially, parametric procedures are conducted and measured. There were, however, violations of some statistical assumptions observed. Therefore the need for non-parametric approaches was recognized. 6838 vulnerabilities recorded were considered in the analysis. According to the risk associated with all the vulnerabilities considered, it was found that there is a statistically significant difference among average risk levels for some operating systems, indicating that according to our method some operating systems have been more risk vulnerable than others given the assumptions and limitations. Relevant test results revealing a statistically significant difference in the Risk levels of different OSs are presented.

Keywords: cybersecurity, Markov chain, non-parametric analysis, vulnerability, operating system

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1295 The Effects of L-Arginine Supplementation on Clinical Symptoms, Quality of Life, and Anal Internal Sphincter Pressure in Patients with Chronic Anal Fissure

Authors: Masoumeh Khailghi Sikaroudi, Mohsen Masoodi, Fazad Shidfar, Meghdad Sedaghat

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Background: The hypertonicity of internal anal sphincter resting pressure is one of the main reasons for chronic anal fissures. The aim of this study is to assess the effect of oral administration of L-arginine on anal fissure symptom improvement by relaxation of the internal anal sphincter. Method: Seventy-six chronic anal fissure patients (age: 18-65 years) took part in this randomized, double-blind, placebo-controlled trial study from February 2019 to October 2020 at Rasoul-e-Akram Hospital, Tehran, Iran. Participants were allocated into treatment (L-arginine) or placebo groups. They took a 1000 mg capsule three times a day for one month and were followed up at the end of the first and third months after receiving the intervention. Clinical symptoms, anal sphincter resting pressure, and quality of life (QoL) were completed at baseline and the end of the study. Result: The analysis of data was shown significant improvement in bleeding, fissure size, and pain within each group; however, this effect was more seen in the arginine group compared to the control group at the end of the study (P-values<0.001). Following that, a significant increase in QoL was seen just in patients who were treated with arginine (P-value=0.006). Also, the comparison of anal pressures to baseline and between groups at the end of the study showed a significant reduction in sphincter pressure in treated patients (P-value<0.001, =0.049; respectively). Conclusion: Oral administration of 3000 mg L-arginine can heal chronic anal fissures by reducing anal internal sphincter pressure with fewer side effects. However, a long-term study with more follow-up is recommended.

Keywords: L-arginine, anal fissure, sphincter pressure, clinical symptoms, quality of life

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1294 Assessing the Sheltering Response in the Middle East: Studying Syrian Camps in Jordan

Authors: Lara A. Alshawawreh, R. Sean Smith, John B. Wood

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This study focuses on the sheltering response in the Middle East, specifically through reviewing two Syrian refugee camps in Jordan, involving Zaatari and Azraq. Zaatari camp involved the rapid deployment of tents and shelters over a very short period of time and Azraq was purpose built and pre-planned over a longer period. At present, both camps collectively host more than 133,000 occupants. Field visits were taken to both camps and the main issues and problems in the sheltering response were highlighted through focus group discussions with camp occupants and inspection of shelter habitats. This provided both subjective and objective research data sources. While every case has its own significance and deployment to meet humanitarian needs, there are some common requirements irrespective of geographical region. The results suggest that there is a gap in the suitability of the required habitat needs and what has been provided. It is recommended that the global international response and support could be improved in relation to the habitat form, construction type, layout, function and critically the cultural aspects. Services, health and hygiene are key elements to the shelter habitat provision. The study also identified the amendments to shelters undertaken by the beneficiaries providing insight into their key main requirements. The outcomes from this study could provide an important learning opportunity to develop improved habitat response for future shelters.

Keywords: culture, post-disaster, refugees, shelters

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1293 Improving Health Care and Patient Safety at the ICU by Using Innovative Medical Devices and ICT Tools: Examples from Bangladesh

Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

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1292 The Impact of International Financial Reporting Standards (IFRS) Adoption on Performance’s Measure: A Study of UK Companies

Authors: Javad Izadi, Sahar Majioud

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This study presents an approach of assessing the choice of performance measures of companies in the United Kingdom after the application of IFRS in 2005. The aim of this study is to investigate the effects of IFRS on the choice of performance evaluation methods for UK companies. We analyse through an econometric model the relationship of the dependent variable, the firm’s performance, which is a nominal variable with the independent ones. Independent variables are split into two main groups: the first one is the group of accounting-based measures: Earning per share, return on assets and return on equities. The second one is the group of market-based measures: market value of property plant and equipment, research and development, sales growth, market to book value, leverage, segment and size of companies. Concerning the regression used, it is a multinomial logistic regression performed on a sample of 130 UK listed companies. Our finding shows after IFRS adoption, and companies give more importance to some variables such as return on equities and sales growth to assess their performance, whereas the return on assets and market to book value ratio does not have as much importance as before IFRS in evaluating the performance of companies. Also, there are some variables that have no impact on the performance measures anymore, such as earning per share. This article finding is empirically important for business in subjects related to IFRS and companies’ performance measurement.

Keywords: performance’s Measure, nominal variable, econometric model, evaluation methods

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1291 Quality of Life of Elderly People in Urban West Bengal, India

Authors: Debalina Datta, Pratyaypratim Datta, Kunal Kanti Majumdar

Abstract:

Introduction: In India 8.1% of total population is elderly. The standard of living and meaningfulness of life are indirectly measured by assessing quality of life of elderly. So, it is important to improve quality of life. Quality of life is an individual’s understanding of his/ her life situation with respect to his/ her values and cultural context as well as in relation to his/her goals, expectations and concerns. The present study was planned to assess the quality of life of geriatric people in urban West Bengal, India. Materials and methods: It was a community based cross sectional observational study conducted among people aged 60 years and above in Kolkata and Sonarpur region of West Bengal, India. Data collection was done by house to house visit using Quality of Life- BREF questionnaire (WHOQOL-BERF) developed by WHO. Analysis of quality of life of physical, psychological, social relationship and environmental domain was done using SPSS (version 16.0). Results: Transformed score (0-100 scale) was used for each domain. Mean of physical, psychological, social relationship and environmental domain were found to be 42.25, 40.84, 39.62 and 48.36 respectively. There was no significant difference in score between Kolkata and Sonarpur people in any domain except social relationship domain, where people living at Sonarpur scored significantly better. Conclusion: Rehabilitation of old age people can be done by improving their quality of life. Social interaction with people of all ages, allowing them to take important family decision, engaging them in different social activities can help a lot.

Keywords: quality of life, elderly, Urban West Bengal, India

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1290 Assessing Conceptions of Climate Change: An Exploratory Study among Japanese Early-Adolescents

Authors: Kelvin Tang

Abstract:

As the world is approaching global warming of 1.5°C above pre-industrial levels, more atrocious consequences of climate change are projected to occur in the future. Consequently, it is today’s adolescents who will encounter the grand consequences of climate change. Therefore, nurturing adolescents that are well-informed, emotionally engaged, and motivated to take actions for combating climate change may be pivotal. Climate change education has a role in not only raising awareness, but also promoting behaviour change for climate change mitigation and adaptation. However, what kind of climate change education is suitable for whom? Requiring a learner-centred approach, tailoring climate change education requires a comprehensive understanding of the audience and their preconditions. In Japan, where climate change education has yet to be recognised as a field of environmental education, understanding climate change conceptions possessed by early adolescents is critical for a better design and more impactful implementation of climate change education. This exploratory study aims to investigate climate change conceptions among Japanese early adolescents from the perspective of cognition, affective, and conative dimensions. Questionnaire surveys were conducted targeting 423 students aged 12–14 in three public junior high schools located in Kashiwa City and Oita City. Findings suggest that the majority of Japanese early adolescents belong to groups that exhibit lower levels of cognition, affect, and conation in relation to climate change. The relationships among those dimensions were found to be positive and bidirectional. Moreover, several misconceptions about climate change and the effectiveness of its solutions were identified among the sample.

Keywords: climate change conceptions, climate change education, environmental education, adolescents, three learning dimensions, Japan

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1289 Persistent Toxicity of Imidacloprid to Aphis gossypii Glover and Amarasca biguttula biguttula Ishida on Okra

Authors: M. A. Pawar, C. S. Patil

Abstract:

Investigations were carried out to evaluate the persistent toxicity of imidacloprid, thiamethoxam and dimethoate to Aphis gossypii and Amrasca biguttula biguttula under laboratory condition during 2012. The experiment was conducted in a completely randomized block design with three replications in the glass house of department of Entomology M. P. K. V. Rahuri. Okra plants were raised in glass house following all recommended agronomic practices. The 21 days old plants were used for assessing the effect of insecticides on aphids and jassids. The insecticides were diluted with distilled water to make desired concentrations and used for foliar application. The insecticides included in the study were imidacloprid 17.8 SL, imidacloprid 70 WG, thiamethoxam 25 WG and dimethoate 30 EC. Untreated check was maintained by spraying with distilled water. The mortality of aphids and jassids on treated leaf were recorded at 1, 3, 5, 7, 9, 11, 13, 15, 17, 21, and 25 days after spray till zero per cent mortality observed for each treatment. Treated leaves from the glasshouse were brought to laboratory and were put in tube with moist cotton swab at the bottom of leaf and sucking apparatus was fit to the tube. Ten jassids were sucked in each tube from the plants in the field. Evaluated insecticides differed in their persistence and index of persistence toxicity against both insects of different treatments. Recommended dose of imidacloprid (25 g a.i/ha) persisted for 21 days against both aphids and jassids. However dimethoate, a conventional insecticide persisted for 11 days.

Keywords: Amrasca biguttula biguttula, Aphis gossypii, imidacloprid, persistent toxicity

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1288 Differential Expression of GABA and Its Signaling Components in Ulcerative Colitis and Irritable Bowel Syndrome Pathogenesis

Authors: Surbhi Aggarwal, Jaishree Paul

Abstract:

Background: Role of GABA has been implicated in autoimmune diseases like multiple sclerosis, type1 diabetes and rheumatoid arthritis where they modulate the immune response but role in gut inflammation has not been defined. Ulcerative colitis (UC) and diarrhoeal predominant irritable bowel syndrome (IBS-D) both involve inflammation of gastrointestinal tract. UC is a chronic, relapsing and idiopathic inflammation of gut. IBS is a common functional gastrointestinal disorder characterised by abdominal pain, discomfort and alternating bowel habits. Mild inflammation is known to occur in IBS-D. Aim: Aim of this study was to investigate the role of GABA in UC as well as in IBS-D. Materials and methods: Blood and biopsy samples from UC, IBS-D and controls were collected. ELISA was used for measuring level of GABA in serum of UC, IBS-D and controls. RT-PCR analysis was done to determine GABAergic signal system in colon biopsy of UC, IBS-D and controls. RT-PCR was done to check the expression of proinflammatory cytokines. CurveExpert 1.4, Graphpad prism-6 software were used for data analysis. Statistical analysis was done by unpaired, two-way student`s t-test. All sets of data were represented as mean± SEM. A probability level of p < 0.05 was considered statistically significant. Results and conclusion: Significantly decreased level of GABA and altered GABAergic signal system was detected in UC and IBS-D as compared to controls. Significantly increased expression of proinflammatory cytokines was also determined in UC and IBS-D as compared to controls. Hence we conclude that insufficient level of GABA in UC and IBS-D leads to overproduction of proinflammatory cytokines which further contributes to inflammation. GABA may be used as a promising therapeutic target for treatment of gut inflammation or other inflammatory diseases.

Keywords: diarrheal predominant irritable bowel syndrome, γ-aminobutyric acid (GABA), inflammation, ulcerative colitis

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1287 Technical, Environmental and Financial Assessment for Optimal Sizing of Run-of-River Small Hydropower Project: Case Study in Colombia

Authors: David Calderon Villegas, Thomas Kaltizky

Abstract:

Run-of-river (RoR) hydropower projects represent a viable, clean, and cost-effective alternative to dam-based plants and provide decentralized power production. However, RoR schemes cost-effectiveness depends on the proper selection of site and design flow, which is a challenging task because it requires multivariate analysis. In this respect, this study presents the development of an investment decision support tool for assessing the optimal size of an RoR scheme considering the technical, environmental, and cost constraints. The net present value (NPV) from a project perspective is used as an objective function for supporting the investment decision. The tool has been tested by applying it to an actual RoR project recently proposed in Colombia. The obtained results show that the optimum point in financial terms does not match the flow that maximizes energy generation from exploiting the river's available flow. For the case study, the flow that maximizes energy corresponds to a value of 5.1 m3/s. In comparison, an amount of 2.1 m3/s maximizes the investors NPV. Finally, a sensitivity analysis is performed to determine the NPV as a function of the debt rate changes and the electricity prices and the CapEx. Even for the worst-case scenario, the optimal size represents a positive business case with an NPV of 2.2 USD million and an IRR 1.5 times higher than the discount rate.

Keywords: small hydropower, renewable energy, RoR schemes, optimal sizing, objective function

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1286 Relationship between Trauma and Acute Scrotum: Test Torsion and Epididymal Appendix Torsion

Authors: Saimir Heta, Kastriot Haxhirexha, Virtut Velmishi, Nevila Alliu, Ilma Robo

Abstract:

Background: Testicular rotation can occur at any age. The possibility to save the testicle is the fastest possible surgical intervention which is indicated by the presence of acute pain even at rest. The time element is more important to diagnose and proceed further with surgical intervention. Testicular damage is a consequence which mainly depends on the moment of onset of symptoms, at the time when the symptoms are diagnosed, the earliest action to be performed is surgical intervention. Sometimes medical tests are needed to confirm a diagnosis, or to help identify another cause for symptoms; for example, the urine test, that is used to check for infection, associated with the scrotal ultrasound test. Control of blood flow to the longitudinal supply vessels of the testicles is indicated. The sign that indicates testicular rotation is a reduction in blood flow. This is the element which is distinguished from ultrasound examination. Surgery may be needed to determine if the patient’s symptoms are caused by the rotation of the testis or any other condition. Discussion: As a surgical intervention of the emergency, the torsion of the test depends very much on the duration of the torsion, as the success in the life of the testicle depends on the fastest surgical intervention. From the previous clinic, it is noted that in any case presented to the pediatric patient diagnosed with testicular rotation, there is always a link with personal history that the patient refers to the presence of a previous episode of testicular trauma. Literature supports this fact very logically. Conclusions: Salvation without testicular atrophy depends closely on establishing the diagnosis of testicular rotation as soon as possible. Following the logic above, it can be said that the diagnosis for rotation should be performed as soon as possible, to avoid consequences that will not be favorable for the patient.

Keywords: acute scrotum, test torsion, newborns, clinical presentation

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1285 Role of Moderate Intensity Exercises in the Amelioration of Oxidant-Antioxidant Status and the Levels of Inflammatory Cytokines in Rheumatoid Arthritis Patients

Authors: Somaiya Mateen, Shagufta Moin, Abdul Qayyum, Atif Zafar

Abstract:

Cytokines and reactive species play an important role in the pathophysiology of rheumatoid arthritis (RA). This study was done to determine the levels of reactive oxygen and nitrogen species (ROS and RNS), inflammatory cytokines and the markers of protein, DNA and lipid oxidation in the blood of RA patients, with the aim to study the antioxidant and anti-inflammatory role of moderate intensity exercises in the management of RA. RA patients were subdivided into two groups- first group (n=30) received treatment with conventional RA drugs while the second group (n=30) received moderate exercise therapy along with the conventional drugs for a period of 12 weeks. The levels of ROS, RNS, inflammatory cytokines and markers of biomolecule oxidation were monitored before and after 12 weeks of treatment. RA patients showed a marked increase in the levels of ROS, RNS, inflammatory cytokines, lipid, protein and DNA oxidation as compared to the healthy controls. These parameters were ameliorated after treatment with drugs alone and exercise combined with drugs, with the amelioration being more significant in patients given drugs along with the moderate intensity exercise treatment. In conclusion, the role of ROS, RNS and inflammatory cytokines in the pathogenesis of RA has been confirmed by this study. These may also serve as potential biomarker for assessing the disease severity. Finally, the addition of moderate intensity exercises in the management of RA may be of great value.

Keywords: rheumatoid arthritis, reactive oxygen species, inflammatory cytokines, moderate intensity exercises

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1284 Malignant Idiopathic Intracranial Hypertension Revealed a Hidden Primary Spinal Leptomeningeal Medulloblastoma

Authors: Naim Izet Kajtazi

Abstract:

Context: Frequently, the cause of raised intracranial pressure remains unresolved and rarely is related to spinal tumors, moreover less to spinal medulloblastoma without primary brain focus. Process: An 18-year-old woman had a 3-month history of headaches and impaired vision. Neurological examination revealed bilateral sixth cranial nerve palsies with bilateral papilloedema of grade III. No focal brain or spine lesion was found on imaging. Consecutive lumbar punctures showed high opening pressure and subsequent increasing protein level. The meningeal biopsy was negative. At one point, she developed an increasing headache, vomiting and back pain. Spine MRI showed diffuse nodular leptomeningeal enhancement with the largest nodule at T6–T7. Malignant cells were detected in cerebrospinal fluid. She underwent laminectomy with excisional biopsy, and pathology showed medulloblastoma WHO grade IV. Outcome: She was treated with chemotherapy and craniospinal irradiation and made a good recovery. Relevance: Primary spinal leptomeningeal medulloblastoma is extremely rare, especially without primary brain focus, but may cause increased intracranial pressure, even in the early microscopic phases, and it should be considered in the differential diagnosis if conventional and aggressive treatment of idiopathic intracranial hypertension fails. We assume that arachnoiditis from tumor seeding caused increased intracranial pressure. Appropriate neurosurgical intervention and surgical biopsy are mandated if a suspicious lesion is detected. Consider proper rescreening of the whole neuroaxis in refractory cases of intracranial hypertension.

Keywords: CNS infection, IIH, headache, primary spinal leptomeningeal medulloblastoma

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1283 A Refined Nonlocal Strain Gradient Theory for Assessing Scaling-Dependent Vibration Behavior of Microbeams

Authors: Xiaobai Li, Li Li, Yujin Hu, Weiming Deng, Zhe Ding

Abstract:

A size-dependent Euler–Bernoulli beam model, which accounts for nonlocal stress field, strain gradient field and higher order inertia force field, is derived based on the nonlocal strain gradient theory considering velocity gradient effect. The governing equations and boundary conditions are derived both in dimensional and dimensionless form by employed the Hamilton principle. The analytical solutions based on different continuum theories are compared. The effect of higher order inertia terms is extremely significant in high frequency range. It is found that there exists an asymptotic frequency for the proposed beam model, while for the nonlocal strain gradient theory the solutions diverge. The effect of strain gradient field in thickness direction is significant in low frequencies domain and it cannot be neglected when the material strain length scale parameter is considerable with beam thickness. The influence of each of three size effect parameters on the natural frequencies are investigated. The natural frequencies increase with the increasing material strain gradient length scale parameter or decreasing velocity gradient length scale parameter and nonlocal parameter.

Keywords: Euler-Bernoulli Beams, free vibration, higher order inertia, Nonlocal Strain Gradient Theory, velocity gradient

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