Search results for: health effects

Authors: Annie Ramanbhai Mecwan

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Cleaning validation in a pharmaceutical manufacturing facility is documented evidence that a cleaning process has effectively removed contaminants, residues from previous drug products and cleaning agents below a pre-defined threshold from the reusable tools and parts of equipment. In shared manufacturing facilities more than one drug product is prepared. After cleaning of reusable tools and parts of equipment after one drug product manufacturing, there are chances that some residues of drug substance from previously manufactured drug products may be retained on the equipment and can carried forward to the next drug product and thus cause cross-contamination. Health-based limits through the derivation of a safe threshold value called permitted daily exposure (PDE) for the residues of drug substances should be employed to identify the risks posed at these manufacturing facilities. The PDE represents a substance-specific dose that is unlikely to cause an adverse effect if an individual is exposed to or below this dose every day for a lifetime. There are different practices to calculate PDE. Data for all APIs in the public domain are considered to calculate PDE value though, company to company may vary the final PDE value based on different toxicologist’s perspective or their subjective evaluation. Hence, Regulatory agencies should take responsibility for publishing PDE values for all APIs as it is done for elemental PDEs. This will harmonize the PDE values all over the world and prevent the unnecessary load on manufacturers for cleaning validation

Keywords: active pharmaceutical ingredient, good manufacturing practice, NOAEL, no observed adverse effect level, permitted daily exposure

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Authors: Evans V. Mauda, Stefan H. Foord, Thinandavha C. Munyai

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The greatest threat to biodiversity is a loss of habitat through landscape fragmentation and attrition. Land use changes are therefore among the most immediate drivers of species diversity. Urbanization and agriculture are the main drivers of habitat loss and transformation in the Savanna biomes of South Africa. Agricultural expansion and the intensification in particular, take place at the expense of biodiversity and will probably be the primary driver of biodiversity loss in this century. Arthropods show measurable behavioural responses to changing land mosaics at the smallest scale and heterogeneous environments are therefore predicted to support more complex and diverse biological assemblages. Ants are premier soil turners, channelers of energy and dominate insect fauna, while spiders are a mega-diverse group that can regulate other invertebrate populations. This study aims to quantify the response of these two taxa in a rural-urban mosaic of a rapidly developing communal area. The study took place in and around two villages in the north-eastern corner of South Africa. Two replicates for each of the dominant land use categories, viz. urban settlements, dryland cultivation and cattle rangelands, were set out in each of the villages and sampled during the dry and wet seasons for a total of 2 villages × 3 land use categories × 2 seasons = 24 assemblages. Local scale variables measured included vertical and horizontal habitat structure as well as structural and chemical composition of the soil. Ant richness was not affected by land use but local scale variables such as vertical vegetation structure (+) and leaf litter cover (+), although vegetation complexity at lower levels was negatively associated with ant richness. However, ant richness was largely shaped by regional and temporal processes invoking the importance of dispersal and historical processes. Spider species richness was mostly affected by land use and local conditions highlighting their landscape elements. Spider richness did not vary much between villages and across seasons and seems to be less dependent on context or history. There was a considerable amount of variation in spider richness that was not explained and this could be related to factors which were not measured in this study such as temperature and competition. For both ant and spider assemblages the constrained ordination explained 18 % of variation in these taxa. Three environmental variables (leaf litter cover, active carbon and rock cover) were important in explaining ant assemblage structure, while two (sand and leaf litter cover) were important for spider assemblage structure. This study highlights the importance of disturbance (land use activities) and leaf litter with the associated effects on ant and spider assemblages across the study area.

Keywords: ants, assemblages, biosphere, diversity, land use, spiders, urbanization

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Authors: German Ricci

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The research aims to analyse the symbolic power of the International Monetary Fund (IMF) in its relationship with a borrowing country, drawing upon Pierre Bourdieu’s Field Theory. This theory of power, typical of constructivist structuralism, has been minor used in international relations. Thus, selecting this perspective offers a new understanding of how the IMF's power operates and is structured. The IMF makes periodic economic reviews in which the staff evaluates the Government's performance. It also offers “last instance” loans when private external credit is not accessible. This relationship generates great expectations in financial agents because the IMF’s statements indicate the capacity of the Nation-State to meet its payment obligations (or not). Therefore, it is argued that the IMF is a legitimate actor for financial agents concerned about a government facing an economic crisis both for the effects of its immediate economic contribution through loans and the promotion of adjustment programs, helpful to guarantee the payment of the external debt. This legitimacy implies a symbolic power relationship in addition to the already known economic power relationship. Obtaining the IMF's consent implies that the government partially puts its political-economic decisions into play since the monetary policy must be agreed upon with the Fund. This has consequences at the local level. First, it implies that the debtor state must establish a daily relationship with the Fund. This everyday interaction with the Fund influences how officials and policymakers internalize the meaning of political management. On the other hand, if the Government has access to the IMF's seal of approval, the State will be again in a position to re-enter the financial market and go back into debt to face external debt. This means that private creditors increase the chances of collecting the debt and, again, grant credits. Thus, it is argued that the borrowing country submits to the relationship with the IMF in search of the latter's economic and symbolic capital. Access to this symbolic capital has objective and subjective repercussions at the national level that might tend to reproduce the relevance of the financial market and legitimizes the IMF’s intervention during economic crises. The paper has Argentina as its case study, given its historical relationship with the IMF and the relevance of the current indebtedness period, which remains largely unexplored. Argentina’s economy is characterized by recurrent financial crises, and it is the country to which the Fund has lent the most in its entire history. It surpasses more than three times the second, Egypt. In addition, Argentina is currently the country that owes the most to the Fund after receiving the largest loan ever granted by the IMF in 2018, and a new agreement in 2022. While the historical strong association with the Fund culminated in the most acute economic and social crisis in the country’s contemporary history, producing an unprecedented political and institutional crisis in 2001, Argentina still recognized the IMF as the only way out during economic crises.

Keywords: IMF, fields theory, symbolic power, Argentina, Bourdieu

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Authors: Ozlem Uguz, Ali Demirci, Hanzade Haykiri-Acma, Serdar Yaman

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Lignitic coal holds its position as Turkey’s most important indigenous energy source to generate energy in thermal power plants. Hence, efficient and environmental-friendly use of lignite in electricity generation is of great importance. Thus, clean coal technologies have been planned to mitigate emissions and provide more efficient burning in power plants. In this context, oxygen enriched combustion (oxy-combustion) is regarded as one of the clean coal technologies, which based on burning with oxygen concentrations higher than that in air. As it is known that the most of the Turkish coals are low rank with high mineral matter content, unburnt carbon trapped in ash is, unfortunately, high, and it leads significant losses in the overall efficiencies of the thermal plants. Besides, the necessity of burning huge amounts of these low calorific value lignites to get the desired amount of energy also results in the formation of large amounts of ash that is rich in unburnt carbon. Oxygen enriched combustion technology enables to increase the burning efficiency through the complete burning of almost all of the carbon content of the fuel. This also contributes to the protection of air quality and emission levels drop reasonably. The aim of this study is to investigate the unburnt carbon content and the burning reactivities of several different lignite samples under oxygen enriched conditions. For this reason, the combined effects of temperature and oxygen/nitrogen ratios in the burning atmosphere were investigated and interpreted. To do this, Turkish lignite samples from Adıyaman-Gölbaşı and Kütahya-Tunçbilek regions were characterized first by proximate and ultimate analyses and the burning profiles were derived using DTA (Differential Thermal Analysis) curves. Then, these lignites were subjected to slow burning process in a horizontal tube furnace at different temperatures (200ºC, 400ºC, 600ºC for Adıyaman-Gölbaşı lignite and 200ºC, 450ºC, 800ºC for Kütahya-Tunçbilek lignite) under atmospheres having O₂+N₂ proportions of 21%O₂+79%N₂, 30%O₂+70%N₂, 40%O₂+60%N₂, and 50%O₂+50%N₂. These burning temperatures were specified based on the burning profiles derived from the DTA curves. The residues obtained from these burning tests were also analyzed by proximate and ultimate analyses to detect the unburnt carbon content along with the unused energy potential. Reactivity of these lignites was calculated using several methodologies. Burning yield under air condition (21%O₂+79%N₂) was used a benchmark value to compare the effectiveness of oxygen enriched conditions. It was concluded that oxygen enriched combustion method enhanced the combustion efficiency and lowered the unburnt carbon content of ash. Combustion of low-rank coals under oxygen enriched conditions was found to be a promising way to improve the efficiency of the lignite-firing energy systems. However, cost-benefit analysis should be considered for a better justification of this method since the use of more oxygen brings an unignorable additional cost.

Keywords: coal, energy, oxygen enriched combustion, reactivity

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Authors: Wooseok Byon, Eunyoung Kim, Junseong Kwon, Byung Joo Song, Chan Heun Park

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Background/Purpose: Previous preclinical and clinical data suggest that increased lymphocytic infiltration would be associated with good prognosis and benefit from immunogenic chemotherapy especially in triple-negative breast cancer (TNBC). We investigated a single-center experience of TNBC and relationship with lymphocytic infiltration. Methods: From January 2004 to December 2012, at the Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, we retrospectively reviewed 897 breast cancer patients-clinical outcomes, clinicopathological characteristics, breast cancer subtypes. And we reviewed lymphocytic infiltration of TNBC specimens by two pathologists. Statistical analysis of risk factors associated with recurrence was performed. Results: A total of 897 patients, 76 were TNBC (8.47%). Mean age of TNBC patients were 50.95 (SD10.42) years, mean follow-up periods was 40.06 months. We reviewed 49 slides, and there were 8 recurrent breast cancer patients (16.32%), and 4 patients were expired (8.16%). There were 9 lymphocytic predominant breast cancers (LPBC)-carcinomas with either intratumoral lymphocytes in >60% of tumor cell nests. 1 patient of LPBC was recurred and 8 were not. In multivariate logistic regression, the odds ratio of lymphocytic infiltration was 0.59 (p=0.643). Conclusion: In a single-center experience of TNBC, the lymphocytic infiltration in tumor cell nest might be a good trend on the prognosis but there was not statistically significant.

Keywords: tumor-infiltrating lymphocytes, triple negative breast cancer, medical and health sciences

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Authors: M. Talebzadegan, S. Bina, I. Riazi

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The purpose of this paper is to present an active solar energy system to supply heating demands of the teaching staff dormitory of the Islamic Azad University of Ramhormoz. The design takes into account the solar radiations and climate data of Ramhormoz town and is based on the daily warm water consumption for health demands of 450 residents of the dormitory, which is equal to 27000 lit of 50-C° water, and building heating requirements with an area of 3500 m² well-protected by heatproof materials. First, heating demands of the building were calculated, then a hybrid system made up of solar and fossil energies was developed and finally, the design was economically evaluated. Since there is only roof space for using 110 flat solar water heaters, the calculations were made to hybridize solar water heating system with heat pumping system in which solar energy contributes 67% of the heat generated. According to calculations, the net present value “N.P.V.” of revenue stream exceeds “N.P.V.” of cash paid off in this project over three years, which makes economically quite promising. The return of investment and payback period of the project is 4 years. Also, the internal rate of return (IRR) of the project was 25%, which exceeds bank rate of interest in Iran and emphasizes the desirability of the project.

Keywords: Solar energy, Heat Demand, Renewable , Pollution

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Authors: Constantinos S. Mammas, Andreas Lazaris, Adamantia S. Mamma-Graham, Georgia Kostopanagiotou, Chryssa Lemonidou, John Mantas, Eustratios Patsouris

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The process to build a better safety culture, methods of error analysis, and preventive measures, starts with an understanding of the effects when human factors engineering refer to remote microscopic diagnosis in surgery and specially in organ transplantation for the evaluation of the grafts. Α high percentage of solid organs arrive at the recipient hospitals and are considered as injured or improper for transplantation in the UK. Digital microscopy adds information on a microscopic level about the grafts (G) in Organ Transplant (OT), and may lead to a change in their management. Such a method will reduce the possibility that a diseased G will arrive at the recipient hospital for implantation. Aim: The aim of this study is to analyze the ergonomics of digital microscopy (DM) based on virtual slides, on telemedicine systems (TS) for tele-pathological evaluation (TPE) of the grafts (G) in organ transplantation (OT). Material and Methods: By experimental simulation, the ergonomics of DM for microscopic TPE of renal graft (RG), liver graft (LG) and pancreatic graft (PG) tissues is analyzed. In fact, this corresponded to the ergonomics of digital microscopy for TPE in OT by applying virtual slide (VS) system for graft tissue image capture, for remote diagnoses of possible microscopic inflammatory and/or neoplastic lesions. Experimentation included the development of an OTE-TS similar experimental telemedicine system (Exp.-TS) for simulating the integrated VS based microscopic TPE of RG, LG and PG Simulation of DM on TS based TPE performed by 2 specialists on a total of 238 human renal graft (RG), 172 liver graft (LG) and 108 pancreatic graft (PG) tissues digital microscopic images for inflammatory and neoplastic lesions on four electronic spaces of the four used TS. Results: Statistical analysis of specialist‘s answers about the ability to accurately diagnose the diseased RG, LG and PG tissues on the electronic space among four TS (A,B,C,D) showed that DM on TS for TPE in OT is elaborated perfectly on the ES of a desktop, followed by the ES of the applied Exp.-TS. Tablet and mobile-phone ES seem significantly risky for the application of DM in OT (p<.001). Conclusion: To make the largest reduction in errors and adverse events referring to the quality of the grafts, it will take application of human factors engineering to procurement, design, audit, and awareness-raising activities. Consequently, it will take an investment in new training, people, and other changes to management activities for DM in OT. The simulating VS based TPE with DM of RG, LG and PG tissues after retrieval, seem feasible and reliable and dependable on the size of the electronic space of the applied TS, for remote prevention of diseased grafts from being retrieved and/or sent to the recipient hospital and for post-grafting and pre-transplant planning.

Keywords: digital microscopy, organ transplantation, tele-pathology, virtual slides

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Authors: Maisarah Jaafar, Neil I. Ward

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Volcanic and geothermal activity can result in the release of arsenic (As), manganese (Mn), iron, selenium (Se), molybdenum (Mo) and uranium (U) into natural waters. Several studies have reported high levels of these elements in surface and groundwater in Argentina. The main focus has been on As associated with volcanic ash deposits. This study reports the trace element levels of groundwater from an agricultural region of south-eastern La Pampa and southern Buenos Aires provinces, Argentina which have reported high levels of human health problems (bone/teeth disorders, depression, arthritis, etc). Fifty-eight groundwater samples were collected from wells adjacent to Ruta 35 and an Agilent 7700x inductively coupled plasma mass spectrometer (ICP-MS) were used for total elemental analysis. Physicochemical analysis confirmed pH range of 7.05-8.84 and variable conductivity (988-3880 µS/cm) with total dissolved solid content of 502-1989 mg/l. The majority water samples are in an oxidizing environment (Eh= 45-146 mV). Total As levels ranged from (µg/l): 13.08 – 319.4 for La Pampa (LP) and 39.6 – 189.4 for Buenos Aires (BA); all above the WHO Guideline for Drinking Water, 10 µg/l As. Interestingly, Mo (LP: 1.85 – 85.39 µg/l; BA: 4.61– 55.55 µg/l;), Se (LP: 1.2 – 16.59 µg/l; BA: 0.3– 6.94 µg/l;) and U (LP: 1.85 – 85.39 µg/l; BA: 4.61– 55.55 µg/l;) levels are lower than reported values for northern La Pampa. Inter-elemental correlation displayed positive statistically significant between As-Mo, A-Se, As-U while negative statistically significant between As-Mn and As-Fe. This confirms that the source of the trace element is similar to that reported for other region of Argentina, namely volcanic ash deposition.

Keywords: Argentina, groundwater, trace element, volcanic activity

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Authors: Tessy Treesa Jose, Sripathy M. Bhat

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Nursing is recognized as a stressful occupation and has indicated a probable high prevalence of distress. It is a helping profession requiring a high degree of commitment and involvement. If stress is intense, continuous and repeated, it becomes a negative phenomenon or "distress," which can lead to physical illness and psychological disorders. The frequency of common psychosomatic symptoms including sleeping problems, tension headache, chronic fatigue, palpitation etc. may be an indicator of nurses’ work-related stress level. Objectives of the study were to determine psychiatric morbidity among nurses and to find its association with selected variables. The study population consisted of 1040 registered nurses working in selected medical college hospitals and government hospitals of Udupi and Mangalore districts. Descriptive survey design was used to conduct the study. Subjects were selected by using purposive sampling. Data were gathered by administering background proforma and General Health questionnaire. Severe distress was experienced by 0.9% of nurses and 5.6% had some evidence of distress. Subjects who did not have any distress were 93.5%. No significant association between psychiatric morbidity in nurses and demographic variables was observed. With regard to work variables significant association is observed between psychiatric morbidity and total years of experience (z=10.67, p=0.03) and experience in current area of work (z=9.43, p=0.02).

Keywords: psychiatric morbidity, nurse, selected hospitals, working

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Authors: Lei Li, Ming M. Chai, Xiao X. Lu, Jia W. Wang

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The mixing process of two liquid layers in a cylindrical container includes the upper liquid with higher density rushing into the lower liquid with lighter density, the lower liquid rising into the upper liquid, meanwhile the two liquid layers having interactions with each other, forming vortices, spreading or dispersing in others, entraining or mixing with others. It is a complex process constituted of flow instability, turbulent mixing and other multiscale physical phenomena and having a fast evolution velocity. In order to explore the mechanism of the process and make further investigations, some experiments about the interfacial instability and mixing behavior between two liquid layers bounded in different volumes are carried out, applying the planar laser induced fluorescence (PLIF) and the high speed camera (HSC) techniques. According to the results, the evolution of interfacial instability between immiscible liquid develops faster than theoretical rate given by the Rayleigh-Taylor Instability (RTI) theory. It is reasonable to conjecture that some mechanisms except the RTI play key roles in the mixture process of two liquid layers. From the results, it is shown that the invading velocity of the upper liquid into the lower liquid does not depend on the upper liquid's volume (height). Comparing to the cases that the upper and lower containers are of identical diameter, in the case that the lower liquid volume increases to larger geometric space, the upper liquid spreads and expands into the lower liquid more quickly during the evolution of interfacial instability, indicating that the container wall has important influence on the mixing process. In the experiments of miscible liquid layers’ mixing, the diffusion time and pattern of the liquid interfacial mixing also does not depend on the upper liquid's volumes, and when the lower liquid volume increases to larger geometric space, the action of the bounded wall on the liquid falling and rising flow will decrease, and the liquid interfacial mixing effects will also attenuate. Therefore, it is also concluded that the volume weight of upper heavier liquid is not the reason of the fast interfacial instability evolution between the two liquid layers and the bounded wall action is limited to the unstable and mixing flow. The numerical simulations of the immiscible liquid layers’ interfacial instability flow using the VOF method show the typical flow pattern agree with the experiments. However the calculated instability development is much slower than the experimental measurement. The numerical simulation of the miscible liquids’ mixing, which applying Fick’s diffusion law to the components’ transport equation, shows a much faster mixing rate than the experiments on the liquids’ interface at the initial stage. It can be presumed that the interfacial tension plays an important role in the interfacial instability between the two liquid layers bounded in finite volume.

Keywords: interfacial instability and mixing, two liquid layers, Planar Laser Induced Fluorescence (PLIF), High Speed Camera (HSC), interfacial energy and tension, Cahn-Hilliard Navier-Stokes (CHNS) equations

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Authors: Maha J. Balgoon, Gehan A. Raouf, Safaa Y. Qusti, Soad S. Ali

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The main cause of Alzheimer disease (AD) was believed to be mainly due to the accumulation of free radicals owing to oxidative stress (OS) in brain tissue. The mechanism of the neurotoxicity of Aluminum chloride (AlCl3) induced AD in hippocampus Albino wister rat brain tissue, the curative & the protective effects of Lipidium sativum group (LS) water extract were assessed after 8 weeks by attenuated total reflection spectroscopy ATR-IR and histologically by light microscope. ATR-IR results revealed that the membrane phospholipid undergo free radical attacks, mediated by AlCl3, primary affects the polyunsaturated fatty acids indicated by the increased of the olefinic -C=CH sub-band area around 3012 cm-1 from the curve fitting analysis. The narrowing in the half band width(HBW) of the sνCH2 sub-band around 2852 cm-1 due to Al intoxication indicates the presence of trans form fatty acids rather than gauch rotomer. The degradation of hydrocarbon chain to shorter chain length, increasing in membrane fluidity, disorder and decreasing in lipid polarity in AlCl3 group were indicated by the detected changes in certain calculated area ratios compared to the control. Administration of LS was greatly improved these parameters compared to the AlCl3 group. Al influences the Aβ aggregation and plaque formation, which in turn interferes to and disrupts the membrane structure. The results also showed a marked increase in the β-parallel and antiparallel structure, that characterize the Aβ formation in Al-induced AD hippocampal brain tissue, indicated by the detected increase in both amide I sub-bands around 1674, 1692 cm-1. This drastic increase in Aβ formation was greatly reduced in the curative and protective groups compared to the AlCl3 group and approaches nearly the control values. These results were supported too by the light microscope. AlCl3 group showed significant marked degenerative changes in hippocampal neurons. Most cells appeared small, shrieked and deformed. Interestingly, the administration of LS in curative and protective groups markedly decreases the amount of degenerated cells compared to the non-treated group. Also the intensity of congo red stained cells was decreased. Hippocampal neurons looked more/or less similar to those of control. This study showed a promising therapeutic effect of Lipidium sativum group (LS) on AD rat model that seriously overcome the signs of oxidative stress on membrane lipid and restore the protein misfolding.

Keywords: aluminum chloride, alzheimer disease, ATR-IR, Lipidium sativum

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Authors: Kunwar Paritosh, Vivekanand Vivekanand, Nidhi Pareek

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Presently, India depends primarily on fossil fuels for its acute energy demand. The swift in development of India in last two decades is accentuating its natural resources and compelling expenditures to cope energy security for the habitats. A total inhabitant of 1.2 billion, observing growing industrialization; is generating 68.8 million tonnes of municipal solid waste per year, 53.7 million tonnes is collected, and only trifling amount of 10.3 million tonnes of waste is treated per year that integrates to a massive amount of unimaginable land hill. In India, waste is mostly landfilled and/or incinerated with low technology and is poorly managed. Underutilization of this waste not only gulps resources but also stresses environment, public health and bionetwork thus affecting the bioeconomy negatively. It also creates conditions that invoke inevitable expenditures and loss of its renewable energy potential. The non-scientific approach to manage waste may lead to an economy downfall, underutilization and degradation of natural resources. Waste treatment technologies must be scientifically tailored and engineered as per the type of waste where it may be utilized as a source of energy (here biogas) and nutrients employing anaerobic digestion to the sorted waste. This paper presents a brief review on current practices, key achievements and forthcoming aspects of harnessing energy from municipal solid waste in Indian scenario.

Keywords: municipal discards, organic waste, anaerobic digestion, incineration, energy

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Authors: Nashalla Gwyn Nyinda

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The ancient system of Tibetan Medicine, known as Sowa Rigpa across the Himalayan regions, is a systematic system of healing encouraging balance primarily through diet and behavior modifications. With the rise of the popularity of Tibetan Medicine, compliance is critical to successful treatment outcomes. As patients learn more about who they are as individuals and how their elemental balances or imbalances affect disorders and mental-emotional balance, they develop faith and dedication to their healing process. Specifically, regarding diet and behavior and the basic principles of the medical system, patient compliance increases dramatically in all treatment areas when they understand why a treatment or dietary prescription guidance is effective. Successful responses to Tibetan treatment rely on a buy-in from the patient. Trust between the slower process of Traditional medicine treatments, the Tibetan physician and the patient is a cornerstone of treatment. The resulting decrease in the use of allopathic medicine and better health outcomes for acute and chronic disorders are well documented. This paper addresses essential points of the Tibetan Medicine system, dialogue between doctor and patient focused on appropriate and seasonal changing dietetics. Such fluctuating treatment approaches, based on external elemental factors, dramatically increase treatment outcomes. Specifically, this work addresses why allopathic medicine models may need more trust development between practitioner and patient.

Keywords: compliancy in treatment, diet and lifestyle medicine, nature and elements as medicine, seasonal diets, Sowa Rigpa, traditional Tibetan medicine, treatment outcomes

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Authors: Aprajita Singh, Anamika Tripathi, Surya P. Dwivedi

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Moradabad is a small town in the Northern area of Uttar Pradesh, India. It is situated on the bank of river Ramganga which is also known as ‘Brass City of India’. There is eventually increase in the environmental pollution due to uncontrolled and inappropriate e-waste burning (recycling) activities which have been reported in many areas of Moradabad. In this paper, analysis of toxic heavy metals, causing pollution to the surrounding environment released from the e-waste burning and much other recycling process. All major e-waste burning sites are situated on the banks of the river which is burned in open environmental conditions. Soil samples were collected from seven (n=3) different sites including control site, after digestion of soil samples using triacid mixture, analysis of different toxic metals (Pb, Ar, Hg, Cd, Cr, Cu, Zn, Fe, and Ni) has been carried out with the help of instrument ICP-AAS. After the study, the outcome is that the soil of those areas contains a relatively high level of the toxic metals in order of Cu>Fe>Pb>Cd>Cr>Zn>Ar>Hg. The concentration of Cd, Pb, Cr, Ar and Zn (the majority of samples experimentally proved) exceeded the maximum standard level of WHO. Sequentially this study showed that uncontrolled e-waste processing operations caused serious pollution to local soil and release of toxic metals in the environment is also causing adverse effect on the health of people living in the nearby areas making them more prone to various harmful diseases.

Keywords: brass city, environment pollution, e-waste, toxic heavy metals

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Authors: Jonathan Doku

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The study's goal was to evaluate construction site safety management in Ghana. The construction sector has long been seen as a high-risk business. It entails a variety of hazardous and challenging labor duties, such as lifting and working at a height, among others. The accident rate is a standard indicator for comparing the safety performance of construction projects. Because of its high-risk and fast-changing work environment, the construction business is regarded as one of the industries with the highest accident rates in the world. Many mishaps and work-related diseases have occurred there, and construction workers are particularly vulnerable to catastrophic calamities such as falls, collapses, and burial. The study's main goals were to discover characteristics that have a substantial impact on construction site safety, to evaluate the safety management methods utilized on construction sites, and to assess the obstacles associated with construction site safety management. The study was conducted using a quantitative research method and a purposive sampling strategy. Google forms were used to distribute self-administered surveys to 85 responders. 72 of the 85 questionnaires were completed and submitted for analysis, accounting for 84.7 percent of the total. The variables were analyzed using descriptive statistics, mean score ranking, and Cronbach's Alpha Coefficient to ensure the scale's reliability. The formal safety organization structure and the Safety checklist were identified as the key practices of safety management on site as part of the study goals. In addition, it was discovered that the most serious problem with safety management is ineffective supervision. To guarantee efficient monitoring and proper implementation of health and safety rules on building sites, management must be on the ball.

Keywords: construction, safety, risk, management

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Authors: Reham H. Diab, Amira A. A. Abdallah, Eman A. Embaby

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Background: The effectiveness of bracing on preventing spino-pelvic alignment deterioration in idiopathic scoliosis has been extensively studied especially in the frontal plane. Yet, there is lack of knowledge regarding the effect of soft braces on spino-pelvic alignment in the sagittal plane. Achieving harmonious sagittal plane spino-pelvic balance is critical for the preservation of physiologic posture and spinal health. Purpose: This study examined the kyphotic angle, lordotic angle and pelvic inclination in the sagittal plane and trunk imbalance in the frontal plane before and after a six-month rehabilitation period. Methods: Nineteen patients with idiopathic scoliosis participated in the study. They were divided into two groups; experimental and control. The experimental group (group I) used the SpineCor brace in addition to a rehabilitation exercise program while the control group (group II) had the exercise program only. The mean ±SD age, weight and height were 16.89±2.15 vs. 15.3±2.5 years; 59.78±6.85 vs. 62.5±8.33 Kg and 162.78±5.76 vs. 159±5.72 cm for group I vs. group II. Data were collected using for metric Π system. Results: Mixed design MANOVA showed that there were significant (p < 0.05) decreases in all the tested variables after the six-month period compared with “before” in both groups. Moreover, there was a significant decrease in the kyphotic angle in group I compared with group II after the six-month period. Interpretation and conclusion: SpineCor brace is beneficial in reducing spino-pelvic alignment deterioration in both sagittal and frontal planes.

Keywords: adolescent idiopathic scoliosis, SpineCor, spino-pelvic alignment, biomechanics

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Authors: Ran Yue, Zhejing Li

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Context: The context of this study is the field of Digital Basketball Sports Games (DBSG). The existing DBSGs often prioritize competitiveness and confrontation, neglecting the narrative and progressive expression, especially from a female standpoint. This study aims to address this gap by analyzing existing DBSGs and proposing a comprehensive framework tailored to meet the needs and desires of women in basketball. Research Aim: The aim of this research is to examine the narrative perspectives of women in basketball and understand their desires and expectations within the sport. It also seeks to investigate methods to seamlessly integrate women's basketball stories into gameplay, addressing their specific needs and expectations. Additionally, the study aims to develop a digital basketball sports game framework that combines narrative richness and entertainment, with a focus on the female audience. Methodology: The study utilizes affective-arousal theories as a psychological framework to explore how emotional arousal influences player engagement and responses in the digital basketball sports game. It employs in-depth case studies to examine specific instances and gain insights into the implementation and impact of narrative elements and educational features in existing DBSGs. Comparative studies are conducted to analyze different DBSGs, identifying effective strategies and shortcomings. Findings: The research findings contribute to the development of a digital basketball game framework from a female perspective. This framework enhances the completeness, diversity, and inclusivity of digital basketball sports games. By addressing the specific needs of women in basketball, including fundamental knowledge, sports skills, safety awareness, and rehabilitation training methods, the framework provides a foundational reservoir for a broader range of basketball participation. It enriches the gaming experience by enhancing enjoyment, narrative, and diversity. It also acts as a catalyst to encourage more women to engage with basketball stories, participate in the sport, persevere, and derive greater enjoyment while benefiting their physical fitness and health. Theoretical Importance: The study contributes to the existing literature by incorporating game motivation psychology theories and proposing a comprehensive framework that caters to the specific needs of women in basketball. It emphasizes the importance of considering the narrative and progressive expression in DBSGs, especially from a female perspective. The research explores affective-arousal theories and provides insights into how emotional arousal can influence player engagement and responses in digital basketball sports games. Data Collection and Analysis Procedures: The study collects data through in-depth case studies of existing DBSGs, examining specific instances to uncover insights into the implementation and impact of narrative elements and educational features. Comparative studies are conducted to contrast and analyze various DBSGs, identifying effective strategies and shortcomings. The analysis procedures involve identifying commonalities, differences, strengths, and weaknesses among the DBSGs, guiding the development of a female-centric perspective in the proposed framework. Questions Addressed: The study addresses the following questions: What are the narrative perspectives of women in basketball? How can women's basketball stories be seamlessly integrated into gameplay? What are the specific needs and expectations of women in basketball? What effective strategies and shortcomings exist in current DBSGs? How can a digital basketball game framework be developed to cater to the female audience? Conclusion: In conclusion, this study contributes to the field of DBSGs by proposing a comprehensive digital basketball game framework from a female perspective. The framework enhances the inclusivity, diversity, and enjoyment of DBSGs by addressing the specific needs and desires of women in basketball. It provides a foundation for a broader range of basketball participation, enriching the gaming experience and benefiting women's physical fitness and health. The research, using affective-arousal theories and in-depth case studies, provides valuable insights into the implementation and impact of narrative elements and educational features in existing DBSGs, guiding the development of the proposed female-centric framework.

Keywords: digital basketball game, game framework, female perspective, game narratives

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Authors: Yaiprae Chatree, Tawan Chaiwon, Rodjana Chunhabundit, Kritsana Piriyawatcharakon, Waralai Ratwiset, Sasiwimol Chaiya

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The world is facing a serious situation of aging society. Elderly may have many physical health problems due to degenerative diseases including Alzheimer’s disease. Riceberry rice relatively contain high levels of carbohydrate, vitamin E, -oryzanol, and also abundant of bioactive compound of anthocyanin. This study aimed to determine the inhibitory effect of Riceberry rice crude extract on acetylcholinesterase activity. The active compound was extracted by using 70% ethanol (v/v). The inhibitory effect of Riceberry rice on acetylcholinesterase was evaluated by using slightly modified method of Ellman’s method. The 120 seconds time interval of kinetics measurement showed that Riceberry rice extract at concentrations of 2.5-12.5 mg/ml presented the acetylcholinesterase inhibitory activity at the statistically significant difference at p  0.05 compared to control group over 60 -120 seconds. At the concentrations of 10 and 12.5 mg/ml of Riceberry rice extract expressed the high percentage of inhibitory activity of 50.86 and 71.22%, respectively. The half maximal inhibitory concentration (IC50) of acetylcholinesterase inhibitory activity of Riceberry rice extract; considered to the end point, was found at concentration of 9.34 mg/ml. The physostigmine (positive control); however, showed a higher inhibitory capacity than that of Riceberry rice extract. The inhibitory activity of the positive control group was around at 80.40 – 90.41%. In conclusion, the results of this study indicated that Riceberry rice extract possessed the inhibitory capacity of acetylcholinesterase activity. Moreover, at the concentrations of 12.5 mg/ml it showed the identical inhibitory effect with physostigmine group. The Riceberry rice extract might be able to alleviate the clinical manifestations of Alzheimer’s disease.

Keywords: acetylcholine, acetylcholinesterase, Alzheimer's disease, riceberry rice

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Authors: Simon Grossemy, Peggy P. Y. Chan, Pauline M. Doran

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Nerve tissue engineering is the main field of research aimed at finding an alternative to autografts as a treatment for nerve injuries. Scaffolds are used as a support to enhance nerve regeneration. In order to successfully design novel scaffolds and in vitro cell culture systems, a deep understanding of the factors affecting nerve regeneration processes is needed. Physical and biological parameters associated with the culture environment have been identified as potentially influential in nerve cell differentiation, including electrical stimulation, exposure to extracellular-matrix (ECM) proteins, dynamic medium conditions and co-culture with glial cells. The mechanisms involved in driving the cell to differentiation in the presence of these factors are poorly understood; the complexity of each of them raises the possibility that they may strongly influence each other. Some questions that arise in investigating nerve regeneration include: What are the best protein coatings to promote neural cell attachment? Is the scaffold design suitable for providing all the required factors combined? What is the influence of dynamic stimulation on cell viability and differentiation? In order to study these effects, scaffolds adaptable to bioreactor culture conditions were designed to allow electrical stimulation of cells exposed to ECM proteins, all within a dynamic medium environment. Gold coatings were used to make the surface of viscose rayon microfiber scaffolds (VRMS) conductive, and poly-L-lysine (PLL) and laminin (LN) surface coatings were used to mimic the ECM environment and allow the attachment of rat PC12 neural cells. The robustness of the coatings was analyzed by surface resistivity measurements, scanning electron microscope (SEM) observation and immunocytochemistry. Cell attachment to protein coatings of PLL, LN and PLL+LN was studied using DNA quantification with Hoechst. The double coating of PLL+LN was selected based on high levels of PC12 cell attachment and the reported advantages of laminin for neural differentiation. The underlying gold coatings were shown to be biocompatible using cell proliferation and live/dead staining assays. Coatings exhibiting stable properties over time under dynamic fluid conditions were developed; indeed, cell attachment and the conductive power of the scaffolds were maintained over 2 weeks of bioreactor operation. These scaffolds are promising research tools for understanding complex neural cell behavior. They have been used to investigate major factors in the physical culture environment that affect nerve cell viability and differentiation, including electrical stimulation, bioreactor hydrodynamic conditions, and combinations of these parameters. The cell and tissue differentiation response was evaluated using DNA quantification, immunocytochemistry, RT-qPCR and functional analyses.

Keywords: bioreactor, electrical stimulation, nerve differentiation, PC12 cells, scaffold

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Authors: Nalini Kaul, Barrie Drewitt, Elsie Kohoot

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Hyperpigmentation is the third most common pigmentary disorder where dermatologic treatment is sought. It affects all ages resulting in skin darkening because of melanin accumulation. An uneven skin tone because of either exposure to the sun (solar lentigos/age spots/sun spots or skin disruption following acne, or rashes (post-inflammatory hyperpigmentation -PIH) or hormonal changes (melasma) can lead to significant psychosocial impairment. Dyschromia is a result of various alterations in biochemical processes regulating melanogenesis. Treatments include the daily use of sunscreen with lightening, brightening, and exfoliating products. Depigmentation is achieved by various depigmenting agents: common examples are hydroquinone, arbutin, azelaic acid, aloesin, mulberry, licorice extracts, kojic acid, niacinamide, ellagic acid, arbutin, green tea, turmeric, soy, ascorbic acid, and tranexamic acid. These agents affect pigmentation by interfering with mechanisms before, during, and after melanin synthesis. While immediate correction is much sought after, patience and diligence are key. Our objective was to assess the effects of a facial product with pigmentation treatment and UV protection in 35 healthy F (35-65y), meeting the study criteria. Subjects with mild to moderate hyperpigmentation and fine lines with no use of skin-lightening products in the last six months or any dermatological procedures in the last twelve months before the study started were included. Efficacy parameters included expert clinical grading for hyperpigmentation, radiance, skin tone & smoothness, fine lines, and wrinkles bioinstrumentation (Corneometer®, Colorimeter®), digital photography and imaging (Visia-CR®), and self-assessment questionnaires. Safety included grading for erythema, edema, dryness & peeling and self-assessments for itching, stinging, tingling, and burning. Our results showed statistically significant improvement in clinical grading scores, bioinstrumentation, and digital photos for hyperpigmentation-brown spots, fine lines/wrinkles, skin tone, radiance, pores, skin smoothness, and overall appearance compared to baseline. The product was also well-tolerated and liked by subjects. Conclusion: Facial hyperpigmentation is of great concern, and treatment strategies are increasingly sought. Clinical trials with both subjective and objective assessments, imaging analyses, and self-perception are essential to distinguish evidence-based products. The multifunctional cosmetic product tested in this clinical study showed efficacy, tolerability, and subject satisfaction in reducing hyperpigmentation and global photoaging.

Keywords: hyperpigmentation; photoaging, clinical testing, expert visual evaluations, bio-instruments

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Authors: Ponghyung Lee

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This study seeks to investigate the variations occurring to Korean consonantal variations center around laryngeal features of the concerned sounds, to the exclusion of others. Our fundamental premise is that the weak contrast associated with concerned segments might be held accountable for the oscillation of the status quo of the concerned consonants. What is more, we assume that an array of notions as a measure of communicative efficiency of linguistic units would be significantly influential on triggering those variations. To this end, we have tried to compute the surprisal, entropic contribution, and relative contrastiveness associated with Korean obstruent consonants. What we found therein is that the Information-theoretic perspective is compelling enough to lend support our approach to a considerable extent. That is, the variant realizations, chronologically and stylistically, prove to be profoundly affected by a set of Information-theoretic factors enumerated above. When it comes to the biblical proper names, we use Georgetown University CQP Web-Bible corpora. From the 8 texts (4 from Old Testament and 4 from New Testament) among the total 64 texts, we extracted 199 samples. We address the issue of laryngeal feature variations associated with Korean obstruent consonants under the presumption that the variations stem from the weak contrast among the triad manifestations of laryngeal features. The variants emerge from diverse sources in chronological and stylistic senses: Christianity biblical texts, ordinary casual speech, the shift of loanword adaptation over time, and ideophones. For the purpose of discussing what they are really like from the perspective of Information Theory, it is necessary to closely look at the data. Among them, the massive changes occurring to loanword adaptation of proper nouns during the centennial history of Korean Christianity draw our special attention. We searched 199 types of initially capitalized words among 45,528-word tokens, which account for around 5% of total 901,701-word tokens (12,786-word types) from Georgetown University CQP Web-Bible corpora. We focus on the shift of the laryngeal features incorporated into word-initial consonants, which are available through the two distinct versions of Korean Bible: one came out in the 1960s for the Protestants, and the other was published in the 1990s for the Catholic Church. Of these proper names, we have closely traced the adaptation of plain obstruents, e. g. /b, d, g, s, ʤ/ in the sources. The results show that as much as 41% of the extracted proper names show variations; 37% in terms of aspiration, and 4% in terms of tensing. This study set out in an effort to shed light on the question: to what extent can we attribute the variations occurring to the laryngeal features associated with Korean obstruent consonants to the communicative aspects of linguistic activities? In this vein, the concerted effects of the triad, of surprisal, entropic contribution, and relative contrastiveness can be credited with the ups and downs in the feature specification, despite being contentiousness on the role of surprisal to some extent.

Keywords: entropic contribution, laryngeal feature variation, relative contrastiveness, surprisal

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Authors: D. A. Dakul, T. M. Akindigh, B. J. Dogonyaro, O. J. Abba, K. T. Tangtur, N. Sambo, J. A. E. Okopi, J. A. Yohanna, G. E. Imade, G. S. Mwansat, S. Oguche

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Malaria and urinary Schistosomaisis are both endemic in Nigeria and pose a serious health challenge in rural areas where co-infections are common. This descriptive cross sectional study was carried out to determine the prevalence of co-infection and the impact of concurrent infection on haemoglobin concentration, Eosinophil and CD4+ T-lymphocyte counts. Plasmodium falciparum and Schistosoma haematobium infection were determined by Malaria Rapid Diagnostic Test (MRDT) kits and the presence of visible haematuria respectively and confirmed by conventional Polymerase Chain Reaction (cPCR). P values < 0.05 were considered statistically significant. Of the 110 children examined, 13 (11.8%) had concurrent infection with Schistosoma haematobium falciparum, 46(41.8%) had Plasmodium falciparum infection while 16(14.5%) had Schistosoma haematobium infection. A strong association between co-infection and the ages of 10-15 years with a 36.4% prevalence of anaemia was observed. Malaria was significantly associated with anaemia than with concurrent infections or schistomiasis alone. Co-infection with both pathogens and a high prevalence of anaemia was observed in Jinduut community. Although the causes of anaemia are multi-factorial, further investigation into the extent to which malaria and urinary schistosomiasis contribute to anaemia is needed. Also, integrated control efforts must be strengthened to mitigate the impact of concurrent infection in this group of vulnerable members in the community. The results can be applied to other communities during control.

Keywords: co-Infection, plasmodium falciparum and scistosoma haematobium, Jinduut, Nigeria

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Authors: Emily Wood, James K. Westphal, Itamar Lerner

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Background: Polysomnography (PSG) recordings are regularly used in research and clinical settings to study sleep and sleep-related disorders. Typical PSG studies are conducted in professional laboratories and performed by qualified researchers. However, the number of sleep labs worldwide is disproportionate to the increasing number of individuals with sleep disorders like sleep apnea and insomnia. Consequently, there is a growing need to supply cheaper yet reliable means to measure sleep, preferably autonomously by subjects in their own home. Over the last decade, a variety of devices for self-monitoring of sleep became available in the market; however, very few have been directly validated against PSG to demonstrate their ability to perform reliable automatic sleep scoring. Two popular mobile EEG-based systems that have published validation results, the DREEM 3 headband and the Z-Machine, have never been directly compared one to the other by independent researchers. The current study aimed to compare the performance of DREEM 3 and the Z-Machine to help investigators and clinicians decide which of these devices may be more suitable for their studies. Methods: 26 participants have completed the study for credit or monetary compensation. Exclusion criteria included any history of sleep, neurological or psychiatric disorders. Eligible participants arrived at the lab in the afternoon and received the two devices. They then spent two consecutive nights monitoring their sleep at home. Participants were also asked to keep a sleep log, indicating the time they fell asleep, woke up, and the number of awakenings occurring during the night. Data from both devices, including detailed sleep hypnograms in 30-second epochs (differentiating Wake, combined N1/N2, N3; and Rapid Eye Movement sleep), were extracted and aligned upon retrieval. For analysis, the number of awakenings each night was defined as four or more consecutive wake epochs between sleep onset and termination. Total sleep time (TST) and the number of awakenings were compared to subjects’ sleep logs to measure consistency with the subjective reports. In addition, the sleep scores from each device were compared epoch-by-epoch to calculate the agreement between the two devices using Cohen’s Kappa. All analysis was performed using Matlab 2021b and SPSS 27. Results/Conclusion: Subjects consistently reported longer times spent asleep than the time reported by each device (M= 448 minutes for sleep logs compared to M= 406 and M= 345 minutes for the DREEM and Z-Machine, respectively; both ps<0.05). Linear correlations between the sleep log and each device were higher for the DREEM than the Z-Machine for both TST and the number of awakenings, and, likewise, the mean absolute bias between the sleep logs and each device was higher for the Z-Machine for both TST (p<0.001) and awakenings (p<0.04). There was some indication that these effects were stronger for the second night compared to the first night. Epoch-by-epoch comparisons showed that the main discrepancies between the devices were for detecting N2 and REM sleep, while N3 had a high agreement. Overall, the DREEM headband seems superior for reliably scoring sleep at home.

Keywords: DREEM, EEG, seep monitoring, Z-machine

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Authors: Elnaz Lalezari, Ramin Ghasemi Shaya

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The birth way is influenced by a fracture within the quiet care handle, making a brokenness of this final one. The pregnant lady has got to interface with numerous experts, both amid the pregnancy, the childbirth, and the puerperium. Be that as it may, amid the final ten a long time, there has been an expanding of the pregnancy care worked by the midwife, who is considered to be the administrator with the correct competences, who can beware of each pregnancy and may profit herself of other professionals' commitments in arrange to make strides the results of maternal and neonatal health. To confirm whether there are proofs of viability that bolster the caseload birthing assistance care show, and in case it is conceivable to apply this show within the birth way in Italy. A amendment of writing has been done utilizing a few look motor (Google, Bing) and particular databases (MEDLINE, CINAHL, Embase, Domestic - ClinicalTrials.gov). There has, too, been a discussion of the Italian directions, the national rules, and the proposals of WHO. Results: The look string, legitimately adjusted to the three databases, has given the taking after comes about: MEDLINE 64 articles, CINAHL 94 articles, Embase 88 articles. From this choice, 14 articles have been extricated: 1 orderly survey, 3 controlled arbitrary trial, 7 observational ponders, 3 subjective studies. The caseload maternity care appears to be an successful and dependable organisational/caring strategy. It reacts to the criterions of quality and security, to the requirements of ladies not as it were amid the pregnancy but moreover amid the post-partum stage. For these reasons, it appears exceptionally valuable also for the birth way within the Italian reality.

Keywords: midwifery, care, caseload, maternity

Procedia PDF Downloads 133

Authors: Mitra Abtahi, Esmat Nasseri, Morteza Abodllahi

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Introduction: Adequate hydration is necessary for proper physical and mental function. The aim of this study is to determine the consumption of water and all other beverages in children (8-13 years) and adolescents (14-17 years) in Tehran metropolitan city of Iran. Materials and Methods: In this cross-sectional study, 455 children (8-13 years) and 334 adolescents (14-17 years) were retrieved from north, center, and south of Tehran (18 schools). Instrument for data collection consisted of a “demographic and general health” questionnaire and a “7-day fluid record”. Data analyses were performed with SPSS 16 software. Results: The mean total consumption of fluids in school children was 1302 ± 500.6 ml/day. The highest mean intakes were observed for water (666 ± 398 ml/day), followed by milk (239 ± 183 ml/day), regular soft beverages (RSB) (188 ± 148 ml/day), and juices (60 ± 74 ml/day). Water, hot drinks (mainly tea) and soft drinks intake was significantly more in boys than girls. A significantly lower intake of milk and a higher intake of RSB and hot beverages (mainly tea) have been seen among adolescents compared to children. Conclusion: The most important finding is that mean fluid intake of children and adolescents does not meet international adequate intake references for water and fluids. This finding may suggest the necessity of development of the local references. To improve fluid intake habits of children and adolescents, relevant policy making and actions are warranted.

Keywords: adolescents, beverages, children, water

Procedia PDF Downloads 175

Authors: Ammal M. Metwally, Dalia M. Elmosalami, Walaa A. Fouad, Abla G. Khalifa, Lobna A. El Etreby, Mohamed AbdelRahman

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People with hepatitis C are likely to experience psychological distress related to adjustment issues following diagnosis. Objective: The study was conducted to determine the psycho-social stressors accompanying Hepatitis C virus (HCV) chronic infection. The study focused on immediate and later on reactions to being diagnosed as infected HCV patients. Effect of HCV on disruption of patients’ relationships in term of family relationship and friendship, employment and financial status was assessed. The magnitude and causes of the social stigma and its relation to awareness about illness, level of education were also assessed. Methods: During this study the subjective experiences of people having HCV was explored through a designed questionnaire targeted 540 cases; 359 males and 181 females from ten out of 21 National Treatment Reference Centers of National Hepatology and Tropical Medicine Research Institutes of Ministry of Health (MOH) hospitals. The study was conducted along a period of six months from September 2011 to March 2012. Results: The study revealed that the financial problems are the commonest problems faced by 75.5 % of the cases. More than 70% of the cases suffered from immediate sadness versus 67.4% suffered from worry. Social stigma was reported by 13 % of HCV +patients, the majority of which were females. Conclusions: Exploring the psychosocial consequences of HCV infection can act as pressing motivators for behavior change needed for limiting HCV endemicity in Egypt.

Keywords: Egypt, HCV infection, psycho-social adjustment, stigma

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Authors: Hamad Albadr

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Joint Commission International (JCI) accreditation process intent to improve the safety and quality of care in the international community through the provision of education, publications, consultation, and evaluation services. These standards apply to the entire organization as well as to each department, unit, or service within the organization. Medical Technology that contains both medical equipment and devices, is an essential part of health care. Appropriate management of equipment maintenance for ensuring medical technology safe, the equipment life is maximized, and the total costs are minimized. JCI medical technology evaluation and accreditation use standards, intents, and measurable elements. The paper focuses on evaluation of JCI standards for medical technology in Saudi Arabian hospitals: a Study Case of PSMMC that define the performance expectation, structures, or functions that must be in place for a hospital to be accredited by JCI through measurable elements that indicate a score during the survey process that identify the requirements for full compliance with the standard specially through Facility Management and Safety (FMS) section that require the hospital establishes and implements a program for inspecting, testing, and maintaining medical technology and documenting the results, to ensure that medical technology is available for use and functioning properly, the hospital performs and documents; an inventory of medical technology; regular inspections of medical technology; testing of medical technology according to its use and manufacturers’ requirements; and performance of preventive maintenance.

Keywords: joint commission international (JCI) accreditation, medical technology, Saudi Arabia, Saudi Arabian hospitals

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Authors: Jenny Carpenter, Josh Chan, Persephone MacKinlay, Madeline Chiang, Devlyn Sun, Hiba Syed, Jana Lau, Mariam Arshad, Joy Xu

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Introduction: Psoriasis is a chronic inflammatory skin condition that affects 1 million Canadians and over 8 million Americans. It is associated with psychosocial challenges exacerbated by the presence of visible lesions, which can lead to feelings of embarrassment and social discomfort. Children often experience bullying and lower self-esteem, while adults face workplace discrimination, impaired productivity, and higher rates of comorbid mental health conditions. Understanding these impacts across age groups is vital for tailored interventions. Objective: The main objective is to compare the longitudinal psychological impact of psoriasis between adults and children in Canada and the United States. Methods: This systematic review was conducted following PRISMA guidelines and a PROSPERO-registered protocol. Studies were identified from PubMed, Scopus, ProQuest, PsycINFO, Dermatology Online Journal, JMIR Dermatology, and Embase. The included studies were published between 2014 and 2024, measured standardized psychological outcomes, and had a longitudinal design with at least a one-year follow-up period. Methodological quality was assessed using the GRADE tool. Results: Fifteen studies encompassing 67,964 participants (mean age 49.1 years, 53.3% female) were included. Adults with moderate-to-severe psoriasis demonstrated significant impairments in Dermatology Life Quality Index (DLQI) scores, with a mean baseline score of 9.0 to 10.2 for severe cases, reflecting moderate-to-severe quality of life (QoL) impairments. Treatment with biologic therapies significantly improved outcomes, with DLQI scores decreasing by an average of 7 points (from 9.6 to 2.6; p < 0.001). Key areas of improvement included social functioning, reduced physical symptoms, and increased work productivity. In severe cases, DLQI scores were 7.95 points higher compared to mild cases (p < 0.05), indicating a disproportionate burden of disease severity. Anxiety and depression were common in adults, affecting 16-23% and 18-22%, respectively. These conditions were linked to visible lesions, social stigma, and comorbidities such as hypertension and metabolic syndrome. Children with psoriasis also exhibited similar impairments in QoL, as assessed by the Children’s Life Quality Index (CLDQI). Visible lesions negatively affected school participation and peer interactions, with bullying and stigma consistently reported as major contributors to social isolation and emotional distress. Although biological therapies improved CDLQI scores, children faced persistent challenges in psychological well-being, including lower self-esteem and stigma, which often persisted in adolescence. Disease severity was quantified using the Psoriasis Area and Severity Index (PASI). Among adults, severe cases had a mean baseline PASI score of 13.9, improving by 87.1% (to 1.8, p < 0001) following biologic therapy. Canadian cohorts showed greater PASI improvements, with biologic-naive adults achieving a 95.1% reduction (from 16.3 to 0.7, p < 0.0001). Canadian patients also had higher biologic continuation rates (89.9%). Conclusion: Psoriasis significantly impacts quality of life and psychological well-being across age groups, with notable differences in outcomes between adults and children. Regional differences further highlighted greater work-related impairments in U.S. adults and more pronounced psychological challenges in Canadian children, where bullying and stigma delayed recovery. These findings emphasize the need for age- and region-specific strategies to address both the physical and psychosocial dimensions of psoriasis and support long-term well-being.

Keywords: psoriasis, psychological impact, mental health, quality of life, self-esteem, autoimmune, chronic skin condition

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Authors: Heiko Jessen, Laura Tanus, Slobodan Ruzicic

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Objectives: The efficacy of Stribild®, an integrase strand transfer inhibitor (INSTI) -based STR, has been evaluated in randomized clinical trials and it has demonstrated durable capability in terms of achieving sustained suppression of HIV-1 RNA-levels. However, differences in monitoring frequency, existing selection bias and profile of patients enrolled in the trials, may all result in divergent efficacy of this regimen in routine clinical settings. The aim of this study was to assess the virologic outcomes, safety and tolerability profile of Stribild® in a routine clinical setting. Methods: This was a retrospective monocentric analysis on HIV-1-infected patients, who started with or were switched to Stribild®. Virological failure (VF) was defined as confirmed HIV-RNA>50 copies/ml. The minimum time of follow-up was 24 weeks. The percentage of patients remaining free of therapeutic failure was estimated using the time-to-loss-of-virologic-response (TLOVR) algorithm, by intent-to-treat analysis. Results: We analyzed the data of 197 patients (56 ART-naïve and 141 treatment-experienced patients), who fulfilled the inclusion criteria. Majority (95.9%) of patients were male. The median time of HIV-infection at baseline was 2 months in treatment-naïve and 70 months in treatment-experienced patients. Median time [IQR] under ART in treatment-experienced patients was 37 months. Among the treatment-experienced patients 27.0% had already been treated with a regimen consisting of two NRTIs and one INSTI, whereas 18.4% of them experienced a VF. The median time [IQR] of virological suppression prior to therapy with Stribild® in the treatment-experienced patients was 10 months [0-27]. At the end of follow-up (median 33 months), 87.3% (95% CI, 83.5-91.2) of treatment-naïve and 80.3% (95% CI, 75.8-84.8) of treatment-experienced patients remained free of therapeutic failure. Considering only treatment-experienced patients with baseline VL<50 copies/ml, 83.0% (95% CI, 78.5-87.5) remained free of therapeutic failure. A total of 17 patients stopped treatment with Stribild®, 5.4% (3/56) of them were treatment-naïve and 9.9% (14/141) were treatment-experienced patients. The Stribild® therapy was discontinued in 2 (1.0%) because of VF, loss to follow-up in 4 (2.0%), and drug-drug interactions in 2 (1.0%) patients. Adverse events were in 7 (3.6%) patients the reason to switch from therapy with Stribild® and further 2 (1.0%) patients decided personally to switch. The most frequently observed adverse events were gastrointestinal side effects (20.0%), headache (8%), rash events (7%) and dizziness (6%). In two patients we observed an emergence of novel resistances in integrase-gene. The N155H evolved in one patient and resulted in VF. In another patient S119R evolved either during or shortly upon switch from therapy with Stribild®. In one further patient with VF two novel mutations in the RT-gene were observed when compared to historical genotypic test result (V106I/M and M184V), whereby it is not clear whether they evolved during or already before the switch to Stribild®. Conclusions: Effectiveness of Stribild® for treatment-naïve patients was consistent with data obtained in clinical trials. The safety and tolerability profile as well as resistance development confirmed clinical efficacy of Stribild® in a daily practice setting.

Keywords: ART, HIV, integrase inhibitor, stribild

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Authors: Julio Jesus Salazar, Manuel Andres Jesus De Lama

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There are very few models that serve to analyze the use of water in the socio-economic process. On the supply side, the joint use of groundwater has been considered in addition to the simple limits on the availability of surface water. In addition, we have worked on waterlogging and the effects on water quality (mainly salinity). In this paper, a 'complex' water economy is examined; one in which demands grow differentially not only within but also between sectors, and one in which there are limited opportunities to increase consumptive use. In particular, high-value growth, the growth of the production of irrigated crops of high value within the basins of the case study, together with the rapidly growing urban areas, provides a rich context to examine the general problem of water management at the basin level. At the same time, the long-term aridity of nature has made the eco-environment in the basins located on the coast of Peru very vulnerable, and the exploitation and immediate use of water resources have further deteriorated the situation. The presented methodology is the optimization with embedded simulation. The wide basin simulation of flow and water balances and crop growth are embedded with the optimization of water allocation, reservoir operation, and irrigation scheduling. The modeling framework is developed from a network of river basins that includes multiple nodes of origin (reservoirs, aquifers, water courses, etc.) and multiple demand sites along the river, including places of consumptive use for agricultural, municipal and industrial, and uses of running water on the coast of Peru. The economic benefits associated with water use are evaluated for different demand management instruments, including water rights, based on the production and benefit functions of water use in the urban agricultural and industrial sectors. This work represents a new effort to analyze the use of water at the regional level and to evaluate the modernization of the integrated management of water resources and socio-economic territorial development in Peru. It will also allow the establishment of policies to improve the process of implementation of the integrated management and development of water resources. The input-output analysis is essential to present a theory about the production process, which is based on a particular type of production function. Also, this work presents the Computable General Equilibrium (CGE) version of the economic model for water resource policy analysis, which was specifically designed for analyzing large-scale water management. As to the platform for CGE simulation, GEMPACK, a flexible system for solving CGE models, is used for formulating and solving CGE model through the percentage-change approach. GEMPACK automates the process of translating the model specification into a model solution program.

Keywords: water economy, simulation, modeling, integration

Procedia PDF Downloads 156