Search results for: clinical/non-clinical sample

Authors: Diemas Purnama Muhammad Firman Pratama, Denny Maulana Malik

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Development of Jatigede Dam that was the mega project in Indonesia, since 1963. Area of around Jatigede Dam is complex, it has structural geology active fault, and as possible can occur landslide. This research focus on soil test. The purpose of this research to know soil quality Jatigede Dam which caused by water seepage of Jatigede Dam, then can be made seepage modelling around Jatigede Dam including Cisampih Village. Method of this research is SRW (Soil Reaction to Water). There are three samples are taken nearby Jatigede Dam. Four paramaters to determine water seepage such as : V ( velocity of soil to release water), Dl (Ability of soil to release water), Ds (Ability of soil to absorb water), Dt (Ability of soil to hold water). meanwhile, another proscess of interaction beetween water and soil are produced angle, which is made of water flow and vertikal line. Called name SIAT. SIAT has two type is na1 and na2. Each samples has a value from the first sample is 280,333(degree), the second 270 (degree) and the third 270 (degree). The difference na1 is, water interaction towards Dt value angle, while na2 is water interaction towards Dl and Ds value angle. Result of calculating SRW method, first till third sample has a value 7, 11,5 and 9. Based on data, interpreted in around teritory of Jatigede Dam, will get easier impact from water seepage because, condition soil reaction too bad so, it can not hold water.

Keywords: Jatigede Dam, Cisampih village, water seepage, soil quality

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Authors: Roshanak Farjad, Amirhossein Hosseini

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Fecal incontinence (FI) is a stressful condition for children and their parents that may affect the patient’s psychological well-being. Evaluating the patients’ psychological status may help physicians manage the disease effectively. This study aimed to assess the emotional and behavioral disturbances in children with FI who were referred to the pediatric gastroenterology clinic in Mofid Children’s Hospital from April 2021 to 2022. This cross-sectional study included children (over four years old) with chronic constipation and fecal incontinence. The diagnosis of chronic constipation and FI were made according to Rome-IV criteria. The Child Behavior Checklist (CBCL) evaluated patients’ emotional, behavioral, and social problems. One hundred one patients with a mean age of 7.96 years were enrolled in the study; 67.32% were males. According to CBCL, 12% (12 patients) indicated emotional and behavioral problems, with CBCL scores in the clinical or at-risk range. We detected anxious/depressed problems in five (4.95%), withdrawn/depressed problems in eight (7.92%), somatic complaints in seven (6.93%), social problems in eight (7.92%), thought problems in nine (8.91%), attention problems in seven (6.93%), rule-breaking behavior in two (1.98%), and aggressive behavior in nine (8.91%) patients. The risk of internalizing and externalizing disorders was reported in four (3.96%) and five (4.95%) patients. Also, eight (7.92%) and seven (6.93%) patients had clinical symptoms of internalizing and externalizing disorders, respectively. There was no significant relationship between patients’ age and gender with the CBCL scores in any subscales. However, there was a significant difference in the total score among the age groups (P = 0.04). The relatively high prevalence of emotional, behavioral, and social problems in our study corroborates the importance of psychological screening of children with FI during the treatment process.

Keywords: chronic constipation, child behavior checklist (CBCL), fecal incontinence, rome-IV criteria

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Authors: Chih Jou Hsiao, Chung Ming Lo, Li Chun Hsieh

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Brain tumor is not the cancer having high incidence rate, but its high mortality rate and poor prognosis still make it as a big concern. On clinical examination, the grading of brain tumors depends on pathological features. However, there are some weak points of histopathological analysis which can cause misgrading. For example, the interpretations can be various without a well-known definition. Furthermore, the heterogeneity of malignant tumors is a challenge to extract meaningful tissues under surgical biopsy. With the development of magnetic resonance imaging (MRI), tumor grading can be accomplished by a noninvasive procedure. To improve the diagnostic accuracy further, this study proposed a computer-aided diagnosis (CAD) system based on MRI features to provide suggestions of tumor grading. Gliomas are the most common type of malignant brain tumors (about 70%). This study collected 34 glioblastomas (GBMs) and 73 lower-grade gliomas (LGGs) from The Cancer Imaging Archive. After defining the region-of-interests in MRI images, multiple quantitative morphological features such as region perimeter, region area, compactness, the mean and standard deviation of the normalized radial length, and moment features were extracted from the tumors for classification. As results, two of five morphological features and three of four image moment features achieved p values of <0.001, and the remaining moment feature had p value <0.05. Performance of the CAD system using the combination of all features achieved the accuracy of 83.18% in classifying the gliomas into LGG and GBM. The sensitivity is 70.59% and the specificity is 89.04%. The proposed system can become a second viewer on clinical examinations for radiologists.

Keywords: brain tumor, computer-aided diagnosis, gliomas, magnetic resonance imaging

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Authors: Netasha Shaikh, Bryony Wood, Demitra Tsivos, Michael Knight, Risto Kauppinen, Elizabeth Coulthard

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Background: Effective treatment of dementia will require early diagnosis, before significant brain damage has accumulated. Memory loss is an early symptom of Alzheimer’s disease (AD). The hippocampus, a brain area critical for memory, degenerates early in the course of AD. The hippocampus comprises several subfields. In contrast to healthy aging where CA3 and dentate gyrus are the hippocampal subfields with most prominent atrophy, in AD the CA1 and subiculum are thought to be affected early. Conventional clinical structural neuroimaging is not sufficiently sensitive to identify preferential atrophy in individual subfields. Here, we will explore the sensitivity of new magnetic resonance imaging (MRI) sequences designed to interrogate medial temporal regions as an early marker of Alzheimer’s. As it is likely a combination of tests may predict early Alzheimer’s disease (AD) better than any single test, we look at the potential efficacy of such imaging alone and in combination with standard and novel cognitive tasks of hippocampal dependent memory. Methods: 20 patients with mild cognitive impairment (MCI), 20 with mild-moderate AD and 20 age-matched healthy elderly controls (HC) are being recruited to undergo 3T MRI (with sequences designed to allow volumetric analysis of hippocampal subfields) and a battery of cognitive tasks (including Paired Associative Learning from CANTAB, Hopkins Verbal Learning Test and a novel hippocampal-dependent abstract word memory task). AD participants and healthy controls are being tested just once whereas patients with MCI will be tested twice a year apart. We will compare subfield size between groups and correlate subfield size with cognitive performance on our tasks. In the MCI group, we will explore the relationship between subfield volume, cognitive test performance and deterioration in clinical condition over a year. Results: Preliminary data (currently on 16 participants: 2 AD; 4 MCI; 9 HC) have revealed subfield size differences between subject groups. Patients with AD perform with less accuracy on tasks of hippocampal-dependent memory, and MCI patient performance and reaction times also differ from healthy controls. With further testing, we hope to delineate how subfield-specific atrophy corresponds with changes in cognitive function, and characterise how this progresses over the time course of the disease. Conclusion: Novel sequences on a MRI scanner such as those in route in clinical use can be used to delineate hippocampal subfields in patients with and without dementia. Preliminary data suggest that such subfield analysis, perhaps in combination with cognitive tasks, may be an early marker of AD.

Keywords: Alzheimer's disease, dementia, memory, cognition, hippocampus

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Authors: Olaniyi Awe, Adelana R. Adetunji, Abraham Adeleke

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Mining of alluvial gold ore by artisanal miners has been going on for decades at Itagunmodi, Southwestern Nigeria. In order to optimize the traditional panning gravity separation method commonly used in the area, a mineral particle size analysis study is critical. This study analyzed alluvial gold ore samples collected at identified five different locations in the area with a view to determine the ore particle size distributions. 500g measured of as-received alluvial gold ore sample was introduced into the uppermost sieve of an electrical sieve shaker consisting of sieves arranged in the order of decreasing nominal apertures of 5600μm, 3350μm, 2800μm, 355μm, 250μm, 125μm and 90μm, and operated for 20 minutes. The amount of material retained on each sieve was measured and tabulated for analysis. A screen analysis graph using the Gaudin Schuman method was drawn for each of the screen tests on the alluvial samples. The study showed that the percentages of fine particle size -125+90 μm fraction were 45.00%, 36.00%, 39.60%, 43.00% and 36.80% for the selected samples. These primary ore characteristic results provide reference data for the alluvial gold ore processing method selection, process performance measurement and optimization.

Keywords: alluvial gold ore, sieve shaker, particle size, Gaudin Schumann

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Authors: David Chapola Nggada

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Although the concept of terrorism is not a new phenomenon to Nigeria, the protracted terrorist activities experiencing in the north-eastern part of the country since 2009, had left an indelible mark on virtually every aspects of lives whether directly or indirectly, particularly the educational sector. Indeed, since the abduction of over 200 schoolgirls at Chibok in 2014 by the insurgence, education had witnessed a setback as most school remains closed for sometimes. The aftermath of this development on education and its future multiplier effect on national development is a source of concern. Consequently, this paper is designed to examine the consequences of terrorism on educational attainment and national development among the Chibok community of Borno State. The technique employed involves a mixture of both qualitative and quantitative research work on a sample size of 79 secondary school students currently displaced from Chibok, Damboa and Askira-Uba, now residing as internally displaced persons(IDPs) in Biu, Gombe, Maiduguri. A random sample technique is used. Structured and semi-unstructured questionnaire were administered. The result shows that, a significant number of students over these years, lacked access to education and this posed a great danger to national development. Recommendations towards reinvigorating education as a panacea to social, economic cum political vices were articulated. Concerted effort should be made to create confidence in the community.

Keywords: education, effect, terrorism, national, development

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Authors: Antarip Bhattacharya, Dhritiman Maitra

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Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia due to autonomous production of parathormone (PTH) and the third most common endocrine disorder. Upto 2% of postmenopausal women could have this condition. Primary hyperparathyroidism is characterized by hypercalcemia with a high or insufficiently suppressed level of parathyroid hormone and is caused by a solitary parathyroid adenoma in 85-90% of patients. PHPT may also be caused by parathyroid hyperplasia (involving multiple glands) or parathyroid carcinoma. Associated morbidities and sequelae include decreased bone mineral density, fractures, kidney stones, hypertension, cardiac comorbidities and psychiatric disorder which entail huge costs for treatment. In the year 2021, by virtue of running a Breast and Endocrine Surgery clinic in a Tier 1 city at a tertiary care hospital, the opportunity to be associated with patients of hyperparathyroidism came our way. Here, we shall describe the spectrum of clinical presentations and customisation of treatment for parathyroid diseases with reference to the above patients. A retrospective analysis of the data of all patients presenting with symptoms of parathyroid diseases was made and classified according to the cause. 13 patients had presented with symptoms of hyperparathyroidism and each case presented with unique symptoms and necessitated detailed evaluation. The treatment or surgery offered to each patient was tailored to his/her individual disease and led to favourable outcomes. Diseases affecting parathyroid are not as rare as we believe. Each case merits detailed clinical evaluation, investigations and tailoring of suitable treatment with regard to medical management and extent of surgery. Intra-operative frozen section/iOPTH monitoring are really useful adjuncts for intra-operative decision making.

Keywords: hyperparathyroidism, parathyroid adenoma, parathyroid surgery, PTH

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Authors: Yemane Hailu Fissuh, Zhongzhan Zhang

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In biomedical researches and randomized clinical trials, the most commonly interested outcomes are time-to-event so-called survival data. The importance of robust models in this context is to compare the effect of randomly controlled experimental groups that have a sense of causality. Causal estimation is the scientific concept of comparing the pragmatic effect of treatments conditional to the given covariates rather than assessing the simple association of response and predictors. Hence, the causal effect based semiparametric transformation model was proposed to estimate the effect of treatment with the presence of possibly time-varying covariates. Due to its high flexibility and robustness, the semiparametric transformation model which shall be applied in this paper has been given much more attention for estimation of a causal effect in modeling left-truncated and right censored survival data. Despite its wide applications and popularity in estimating unknown parameters, the maximum likelihood estimation technique is quite complex and burdensome in estimating unknown parameters and unspecified transformation function in the presence of possibly time-varying covariates. Thus, to ease the complexity we proposed the modified estimating equations. After intuitive estimation procedures, the consistency and asymptotic properties of the estimators were derived and the characteristics of the estimators in the finite sample performance of the proposed model were illustrated via simulation studies and Stanford heart transplant real data example. To sum up the study, the bias of covariates was adjusted via estimating the density function for truncation variable which was also incorporated in the model as a covariate in order to relax the independence assumption of failure time and truncation time. Moreover, the expectation-maximization (EM) algorithm was described for the estimation of iterative unknown parameters and unspecified transformation function. In addition, the causal effect was derived by the ratio of the cumulative hazard function of active and passive experiments after adjusting for bias raised in the model due to the truncation variable.

Keywords: causal estimation, EM algorithm, semiparametric transformation models, time-to-event outcomes, time-varying covariate

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Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir

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Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.

Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar

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Authors: Suja Karkada, Jayanthi Radhakrishnan, Jansi Natarajan, Gerald, Amandu Matua, Sujatha Shanmugasundaram

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Simulation-based learning is an educational strategy designed to simulate actual clinical situations in a safe environment. Globally, simulation is recognized by several landmark studies as an effective teaching-learning method. A systematic review of the literature on simulation revealed simulation as a useful strategy in creating a learning environment which contributes to knowledge, skills, safety, and confidence. However, to the best of the author's knowledge, there are no studies on assessing the anxiety of the students undergoing simulation. Hence the researchers undertook a study with the aim to evaluate the effectiveness of simulation on anxiety and knowledge among novice nursing students. This quasi-experimental study had a total sample of 69 students (35- Intervention group with simulation and 34- Control group with case scenario) consisting of all the students enrolled in the Fundamentals of Nursing Laboratory course during Spring 2016 and Fall 2016 semesters at a college of nursing in Oman. Ethical clearance was obtained from the Institutional Review Board (IRB) of the college of nursing. Informed consent was obtained from every participant. Study received the Dean’s fund for research. The data were collected regarding the demographic information, knowledge and anxiety levels before and after the use of simulation and case scenario for the procedure nasogastric tube feeding in intervention and control group respectively. The intervention was performed by four faculties who were the core team members of the course. Results were analyzed in SPSS using descriptive and inferential statistics. Majority of the students’ in intervention (82.9%) and control (89.9%) groups were equal to or below the age of 20 years, were females (71%), 76.8% of them were from rural areas and 65.2% had a GPA of more than 2.5. The selection of the samples to either the experimental or the control group was from a homogenous population (p > 0.05). There was a significant reduction of anxiety among the students of control group (t (67) = 2.418, p = 0.018) comparing to the experimental group, indicating that simulation creates anxiety among Novice nursing students. However, there was no significant difference in the mean scores of knowledge. In conclusion, the study was useful in that it will help the investigators better understand the implications of using simulation in teaching skills to novice students. Since previous studies with students indicate better knowledge acquisition; this study revealed that simulation can increase anxiety among novice students possibly it is the first time they are introduced to this method of teaching.

Keywords: anxiety, knowledge, novice students, simulation

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Authors: Gulam Anwer Khan, A. Gautam

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Background: The arch of aorta is a large artery that arches over the root of the left lung and connects the ascending aorta and descending aorta. It is situated in the superior mediastinum behind the manubrium sterni. It gives off three major branches i.e. brachiocephalic trunk, left common carotid artery and left subclavian artery arising from the superior surface of arch of aorta from right to left. Material and Methods: This was a descriptive study. It was carried out in 44 cadavers, obtained during dissections for undergraduates of Department of Anatomy, Chitwan Medical College, Bharatpur, Chitwan, between March 2015 to October 2016. Cadavers of both sexes were included in the present study. The arch of aorta was dissected and exposed according to the methods described by Romanes in Cunningham’s manual of practical anatomy. Results: Out of 44 dissected cadavers, 35 (79.54%) were male and 9 (20.46%) were female cadavers. The normal branching pattern of the arch of aorta was encountered in 28 (63.64%) cadavers and the remaining 16 (36.36%) cadavers showed variations in the branching pattern of arch of aorta. Two different types of variations on the branching pattern of arch of aorta were noted in the present study, in which 12 (27.27%) cadavers had common trunk of the Arch of Aorta. In 3 (5.00%) male cadavers, we found the origin of the Thyroid ima artery. This variation was noted in 1(1.66%) female cadaver. Conclusion: The present study carried out on adult human cadavers’ revealed wide variations in the branching pattern of the arch of ao rta. These variations are of clinical significance and also very useful for the anatomists, radiologists, anesthesiologists, surgeons for practice during angiography, instrumentation, supra-aortic thoracic, head and neck surgery.

Keywords: arch of aorta, brachiocephalic trunk, left common carotid artery, left subclavian artery, Thyroidea ima artery

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Authors: C. O. Agu, C. C. Okafor

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Maize and soybean flours were produced using different methods of processing which include fermentation (FWF), roasting (RWF) and malting (MWF). Products from the different methods were mixed in the ratio 60:40 maize/soybean, respectively. These composites mixed with other ingredients such as sugar, vegetable oil, vanilla flavour and vitamin mix were analyzed for proximate composition, physical/functional, sensory and nutritional properties. The results for the protein content ranged between 6.25% and 16.65% with sample RWF having the highest value. Crude fibre values ranged from 3.72 to 10.0%, carbohydrate from 58.98% to 64.2%, ash from 1.27 to 2.45%. Physical and functional properties such as bulk density, wettability, gelation capacity have values between 0.74 and 0.76g/ml, 20.33 and 46.33 min and 0.73 to 0.93g/ml, respectively. On the sensory quality colour, flavour, taste, texture and general acceptability were determined. In terms of colour and flavour there was no significant difference (P < 0.05) while the values for taste ranged between 4.89 and 7.1 l, texture 5.50 to 8.38 and general acceptability 6.09 and 7.89. Nutritionally there is no significant difference (P < 0.05) between sample RWF and the control in all parameters considered. Samples FWF and MWF showed significantly (P < 0.5) lower values in all parameters determined. In the light of the above findings, roasting method is highly recommend in the production of weaning foods.

Keywords: fermentation, malting, ratio, roasting, wettability

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Authors: Soudeh Tabashi, Mohammadreza Moshari, Parisa Sezari

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Introduction: Postoperative analgesia in Orthotopic Liver Transplantation (OLT) surgery is challenging for anesthesiologists. Although OLT is one of the most extensive abdominal operations, it seems that patients don’t suffer from severe post operative pain. On the other hands drug metabolism is unpredictable due to unknown graft function. The aim of this study was to compare intraoperative infusion of remifentanil versus fentanyl in postoperative opioid demand in patients with OLT and evaluating the complications in two groups. Method: In this double-blind clinical trial 34 patients who had OLT were included. They divided randomly in two groups of Remifentanil (R) and Fentanyl (F). Patients in group R and F received infusion of Remifentanil 0.3-1 µg/Kg/min and Fentanyl 0.3-1 µg/Kg/min during maintenance of anesthesia. Post operative pain were measured in 6, 12, 18, 24 hours and second and third days after surgery with Numeric Rate Scale (NRS). Patients had received intravenous acetaminophen as rescue therapy with NRS of 3 or more. In addition to demographic information, post operative opioid consumption were recorded as the primary outcome. Intraoperative blood transfusion, intraoperative inotropic drugs consumption, weaning time and intensive care unit stay were also evaluated. Results: Total dose of acetaminophen consumption in first 3 days after surgery did not have significant difference between two groups (Pvalue=0.716). intraoperative inotrope consumption, blood transfusion and post operative weaning time and ICU stay were also similar in both groups. Conclusion: This study demonstrates that intraoperative infusion of remifentanil in OLT have the same effect on post operative pain management as fentanyl. Despite the complications of operation were not increased by remifentanil.

Keywords: liver transplantation, postoperative pain, remifentanil, fentanyl

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Authors: Shrikant Chavan, Vikas Minchekar

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The present study examined the self-efficacy, emotional intelligence and social maturity of High school boys and girls. Furthermore, study aimed at to foster the self-efficacy, emotional intelligence and social maturity of high school students. The study was conducted on 100 high school students, out of which 50 boys and 50 girls were selected through simple random sampling method from the Sangli city of Maharashtra state, India. The age range of the sample is 14 to 16 years. Self-efficacy scale developed by Jesusalem Schwarzer, Emotional intelligence scale developed by Hyde, Pethe and Dhar and social maturity scale developed by Rao were administered to the sample. Data was analyzed using mean, SD and ‘t’ test further Karl Pearson’s product moment, correlation of coefficient was used to know the correlation between emotional intelligence, self-efficacy, and social maturity. Results revealed that boys and girls did not differ significantly in their self-efficacy and social maturity. Further, the analysis revealed that girls are having high emotional intelligence compared to boys, which is significant at 0.01 level. It is also found that there is a significant and positive correlation between self-efficacy and emotional intelligence, self-efficacy and social maturity and emotional intelligence and social maturity. Some developmental strategies to strengthen the self-efficacy, emotional intelligence and social maturity of high school students are suggested in the study.

Keywords: self-efficacy, emotional intelligence, social maturity, developmental model and high school students

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Authors: Ubaka Chukwuemeka Michael, Ukwe Chinwe Victoria

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Background: The use of antipsychotic monotherapy remains the standard for schizophrenic disorders so also a prescription switch from older typical to newer atypical classes of antipsychotics on the basis of better efficacy and tolerability. However, surveys on the quality of antipsychotic drug use and substitution in developing countries are very scarce. This study was intended to evaluate quality and factors that drive the prescription and substitution of antipsychotic drugs among schizophrenic patients visiting a regional psychiatric hospital. Methods: Case files of patients visiting a federal government funded Neuropsychiatric Hospital between July 2012 and July 2014 were systematically retrieved. Patient demographic characteristics, clinical details and drug management data were collected and subjected to descriptive and inferential data analysis to determine quality and predictors of utilization. Results: Of the 600 case files used, there were more male patients (55.3%) with an overall mean age of 33.7±14.4 years. Typical antipsychotic agents accounted for over 85% of prescriptions, with majority of the patients receiving more than 2 drugs in at least a visit (80.9%). Fluphenazine (25.2%) and Haloperidol (18.8%) were mostly given as antipsychotics for treatment initiation while Olazenpine (23.0%) and Benzhexol (18.3%) were the most currently prescribed antipsychotics. Nearly half (42%, 252/600) of these patients were switched from one class to another, with 34.5% (207/600) of them switched from typical to atypical drug classes. No demographic or clinical factors influenced drug substitutions but a younger age and being married influenced being prescribed a polypharmacy regimen (more than 2 drugs) and an injectable antipsychotic agent. Conclusion: The prevalence of antipsychotic polypharmacy and use of typical agents among these patients was high. However, only age and marital status affected the quality of antipsychotic prescriptions among these patients.

Keywords: antipsychotics, drug substitution, pharmacoepidemiology, polypharmacy

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Authors: Nona Mirzamohammadi, Bahram Nasernejad

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This work mainly focuses on studying the mechanism governing the adsorption of tetraethylammonium bromide, a short-chain quaternary ammonium salt, on the surface of natural zeolite and to characterize modified and raw zeolites in order to study the removal of nitrate anions from water. Natural clinoptilolite, as the most common zeolite, was chosen and modified in an ultrasonication process using tetraethylammonium bromide, subsequent to being contacted with NaCl solutions. FT-IR studies indicated a peak attributed to the stretching vibrations of the –CH₂ group in the molecule of tetraethylammonium bromide in the spectrum of the modified sample. Moreover, the SEM images showed some obvious changes in the surface morphology and crystallinity of clinoptilolite after being modified. Batch adsorption experiments show that the modified zeolite is capable of removing nitrate anions, and the predominant removal mechanism is suggested to be a combination of electrostatic attraction and ion exchange since the results from the zeta potential analysis showed a decrease in the net negative charge of clinoptilolite after modification, while bromide ions were detected in the modified sample in the µXRF analysis.

Keywords: adsorption, clinoptilolite, short-chain quaternary ammonium salt, tetraethylammoniumbromide, ultrasonication

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Authors: A. Dinelka Panagoda, Bathiya Bandara, Chamod Wijetunga, Chathura Malinda, Lakmal Rupasinghe, Chethana Liyanapathirana

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This research takes us forward with the concepts of Federated Learning and Software-Defined Networking (SDN) to introduce an efficient malware detection technique and provide a mitigation mechanism to give birth to a resilient and automated healthcare sector network system by also adding the feature of extended privacy preservation. Due to the daily transformation of new malware attacks on hospital Integrated Clinical Environment (ICEs), the healthcare industry is at an undefinable peak of never knowing its continuity direction. The state of blindness by the array of indispensable opportunities that new medical device inventions and their connected coordination offer daily, a factor that should be focused driven is not yet entirely understood by most healthcare operators and patients. This solution has the involvement of four clients in the form of hospital networks to build up the federated learning experimentation architectural structure with different geographical participation to reach the most reasonable accuracy rate with privacy preservation. While the logistic regression with cross-entropy conveys the detection, SDN comes in handy in the second half of the research to stack up the initial development phases of the system with malware mitigation based on policy implementation. The overall evaluation sums up with a system that proves the accuracy with the added privacy. It is no longer needed to continue with traditional centralized systems that offer almost everything but not privacy.

Keywords: software-defined network, federated learning, privacy, integrated clinical environment, decentralized learning, malware detection, malware mitigation

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Authors: Phutthiwat Waiyawuththanapoom

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This study has only one objective which is to identify the different in factors of choosing the distributor for food and non-food OTOP entrepreneur in Thailand. In this research, the types of OTOP product will be divided into two groups which are food and non-food. The sample for the food type OTOP product was the processed fruit and vegetable from Nakorn Pathom province and the sample for the non-food type OTOP product was the court doll from Ang Thong province. The research was divided into 3 parts which were a study of the distribution pattern and how to choose the distributor of the food type OTOP product, a study of the distribution pattern and how to choose the distributor of the non-food type OTOP product and a comparison between 2 types of products to find the differentiation in the factor of choosing distributor. The data and information was collected by using the interview. The populations in the research were 5 producers of the processed fruit and vegetable from Nakorn Pathom province and 5 producers of the court doll from Ang Thong province. The significant factor in choosing the distributor of the food type OTOP product is the material handling efficiency and on-time delivery but for the non-food type OTOP product is focused on the channel of distribution and cost of the distributor.

Keywords: distributor, OTOP, food and non-food, selection

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Authors: Hamzeh Awad

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Disability is considered to be a worldwide complex phenomenon which rising at a phenomenal rate and caused by many different factors. Chronic diseases such as cardiovascular disease and diabetes can lead to mobility disability in particular and disability in general. The ICF is an integrative bio-psycho-social model of functioning and disability and considered by the World Health Organization (WHO) to be a reference for disability classification using its categories and core set to classify disorder’s functional limitations. Specialist programs at Sultan Bin Abdul Aziz Humanitarian City (SBAHC) are providing both inpatient and outpatient services have started to implement the ICF and use it as a problem solving tool in Rehab. Diabetes is leading contributing factor for disability and considered epidemic in several Gulf countries including the Kingdom of Saudi Arabia (KSA), where its prevalence continues to increase dramatically. Metabolic disorders, mainly diabetes are not well covered in Rehab field. The purpose of this study is present to research and clinical rehabilitation field of DREAM and ICF as a framework in clinical and research setting in Rehab service. Also, shed the light on using the ICF as problem solving tool at SBAHC. There are synergies between disability causes and wider public health priorities in relation to both chronic disease and disability prevention. Therefore, there is a need for strong advocacy and understanding of the role of ICF as a reference in Rehab settings in Middle East if we wish to seize the opportunity to reverse current trends of acquired disability in the region.

Keywords: international classification of functioning, disability and health (ICF), prototype, rehabilitation and diabetes

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Authors: Christian Röling, Elena Y. Poimanova, Vladimir V. Bruevich

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Here we demonstrate a non-destructive optical technique to localize and characterize single crystals of semiconductive organic materials – Spectroscopic Imaging Ellipsometry. With a combination of microscopy and ellipsometry, it is possible to characterize even micro-sized thin film crystals on plane surface regarding anisotropy, optical properties, crystalline domains and thickness. The semiconducting thiophene-phenylene co-oligomer 1,4-bis(5'-hexyl-[2,2'-bithiophen]-5-yl)benzene (dHex-TTPTT) crystals were grown by solvent based self-assembly technique on silicon substrate with 300 nm thermally silicon dioxide. The ellipsometric measurements were performed with an Ep4-SE (Accurion). In an ellipsometric high-contrast image of the complete sample, we have localized high-quality single crystals. After demonstrating the uniaxial anisotropy of the crystal by using Müller-Matrix imaging ellipsometry, we determined the optical axes by rotating the sample and performed spectroscopic measurements (λ = 400-700 nm) in 5 nm intervals. The optical properties were described by using a Lorentz term in the Ep4-Model. After determining the dispersion of the crystals, we converted a recorded Delta and Psi-map into a 2D thickness image. Based on a quantitative analysis of the resulting thickness map, we have calculated the height of a molecular layer (3.49 nm).

Keywords: anisotropy, ellipsometry, SCFET, thin film

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Authors: Ali M. Alsagheir

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Effective teaching is concerned to be one of the research fields of teaching, and its fundamental case is to reach the most successful ways that makes teaching fruitful. Undoubtedly, these methods are common factors between all parties who are concerned with the educational process such as instructors, directors, parents, and others. This study had aimed to recognize the cognitions of physical education supervisors and teachers for conceptions of effective teaching according to the interests theory. A questionnaire was used to collect data of the study; the sample contained 230 teachers and supervisors.The results were ended in: that the average of conceptions of effective teaching expressions for the sample of the study decreases at the progress through stages of teaching development in general. The study showed the absence of statistical indicator between teachers and supervisors at the core of both teaching principals and teaching tasks although the results showed that there are statistical indicators at the core of teaching achievements between supervisors and teachers in favor of supervisors. The study ended in to recommendations which can share in increasing the effectiveness of teaching such as: putting clear and specific standards for the effectiveness of teaching in which teacher's performance is based, constructing practical courses that focus on bringing on both supervisors and teachers with skills and strategies of effectiveness teaching, taking care of children achievement as an important factor and a strong indicator on effectiveness of teaching and learning.

Keywords: concerns theory, effective teaching, physical education, supervisors, teachers

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Authors: Fatima Faraz

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BACKGROUND: While Artificial intelligence (AI) provides new opportunities across a wide variety of industries, healthcare is no exception. AI can lead to advancements in how the healthcare system functions and improves the quality of patient care. Developing countries like Pakistan are lagging in the implementation of AI-based solutions in healthcare. This demands increased knowledge and AI literacy among health care professionals. OBJECTIVES: To assess the level of awareness among medical students and faculty about AI in preparation for teaching AI basics and data science applications in clinical practice in an integrated medical curriculum. METHODS: An online 15-question semi-structured questionnaire, previously tested and validated, was delivered among participants through convenience sampling. The questionnaire composed of 3 parts: participant’s background knowledge, AI awareness, and attitudes toward AI applications in medicine. RESULTS: A total of 182 students and 39 faculty members from Rawalpindi Medical University, Pakistan, participated in the study. Only 26% of students and 46.2% of faculty members responded that they were aware of AI topics in clinical medicine. The major source of AI knowledge was social media (35.7%) for students and professional talks and colleagues (43.6%) for faculty members. 23.5% of participants answered that they personally had a basic understanding of AI. Students and faculty (60.1%) were interested in AI in patient care and teaching domain. These findings parallel similar published AI survey results. CONCLUSION: This survey concludes interest among students and faculty in AI developments and technology applications in healthcare. Further studies are required in order to correctly fit AI in the integrated modular curriculum of medical education.

Keywords: medical education, data science, artificial intelligence, curriculum

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Authors: Sonal Sethi, Mukesh Yadav, Abhimanyu Gupta

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The upcoming field of radiogenomics has the potential to upgrade the role of imaging in lung cancer management by noninvasive characterization of tumor histology and genetic microenvironment. Receptor positivity like epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) genotyping are critical in lung adenocarcinoma for treatment. As conventional identification of receptor positivity is an invasive procedure, we analyzed the features on non-invasive computed tomography (CT), which predicts the receptor positivity in lung adenocarcinoma. Retrospectively, we did a comprehensive study from 77 proven lung adenocarcinoma patients with CT images, EGFR and ALK receptor genotyping, and clinical information. Total 22/77 patients were receptor-positive (15 had only EGFR mutation, 6 had ALK mutation, and 1 had both EGFR and ALK mutation). Various morphological characteristics and metastatic distribution on CT were analyzed along with the clinical information. Univariate and multivariable logistic regression analyses were used. On multivariable logistic regression analysis, we found spiculated margin, lymphangitic spread, air bronchogram, pleural effusion, and distant metastasis had a significant predictive value for receptor mutation status. On univariate analysis, air bronchogram and pleural effusion had significant individual predictive value. Conclusions: Receptor positive lung cancer has characteristic imaging features compared with nonreceptor positive lung adenocarcinoma. Since CT is routinely used in lung cancer diagnosis, we can predict the receptor positivity by a noninvasive technique and would follow a more aggressive algorithm for evaluation of distant metastases as well as for the treatment.

Keywords: lung cancer, multidisciplinary cancer care, oncologic imaging, radiobiology

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Authors: Thakur Pushpawati, Singh Vinita, Agrawal Sarita, Mohapatra Eli

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Polycystic ovary syndrome (PCOS) is a disease of endocrine and frequently encountered in women in their reproductive period, and it is characterized by clinical features of anovulation, clinical and biochemical features of hyperandrogenism, and PCOS morphology on ultrasonographic examination. In Indian scenario, only a few studies are available on the correlation of serum 25-dihydroxy vitamin D3 level and insulin level. The present study is a prospective case-control study and aims to estimate the concentration of serum 25-dihydroxy vitamin D3 and insulin resistance and determine the association of serum 25-dihydroxy vitamin D3 with insulin resistance in PCOS women of 18-40 years age group. In this study, the primary objective is to estimate the concentration of 25-dihydroxy vitamin D3, insulin, glycaemic status, calcium and phosphorus levels in 18-40 year age women with polycystic ovary syndrome and to compare these parameters with age and BMI matched healthy control of same age group women. The secondary objective is to determine the association between 25-dihydroxy vitamin D3 concentration and insulin resistance among PCOS cases in 18-40 years age group women. This study was carried on at outpatient Department of Obstetrics & Gynaecology, Aiims Raipur. It took one year from the date of approval. In case, 32 women were diagnosed (Diagnosed PCOS cases as per Rotterdoms criteria among women of 18-40 years of age), as control group 32 women of 18-40 years of age were diagnosed As a result, serum insulin level was elevated among PCOS women along with 25-dihydroxy vitamin D3 deficiency.Conclude up, PCOS is more common in the age group of 20-40 years. There is a strong correlation between vitamin D deficiency and insulin resistance among PCOS patients.

Keywords: vitamin D, insulin resistance, PCOS, reproductive age group

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Authors: Thiago Fabrizio Gavilano Farje, Marcelo Patricio Herrera Malpartida

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This study examines the influence of artificial intelligence (AI) on the work efficiency of administrative employees in the financial sector of Metropolitan Lima, Peru, during the year 2024. Focusing on the relationship between AI implementation and work efficiency, it addresses specific variables such as decision-making, motivation, and employee productivity. To accomplish the analysis between AI and work efficiency within the financial sector of Metropolitan Lima, it is necessary to evaluate how AI optimizes time in administrative tasks, examine how AI impacts the agility of the process of making decisions, and investigate the influence of AI on the satisfaction and motivation of employees. The research adopts a correlational and explanatory approach, designed to establish and understand the connections between AI and work efficiency. A survey design adapted from an OECD study is used, applying questionnaires to a representative sample of administrative workers in the financial sector who incorporate AI into their functions. The target population includes administrative workers in the financial sector of Metropolitan Lima, estimated at 73,097 employees based on data from the Censo Nacional de Empresas y Establecimientos and studies by the BCRP. The sample, selected through simple random sampling, comprises 246 workers.

Keywords: business management, artificial intelligence, decision making, labor efficiency, financial sector

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Authors: Yael Rieder, Yael Gilboa, S. O. Adva, Efrat Halevi, Ronnie Tepper

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Background: Operation of ultrasound equipment is a core skill for many clinical specialties. As part of the training program at -Simultech- a simulation center for Ob\Gyn at the Meir Medical Center, Israel, teaching how to operate ultrasound equipment requires dealing with misunderstandings of spatial and 3D orientation, failure of the operator to hold a transducer correctly, and limited ability to evaluate the data on the screen. We have developed a platform intended to endow physicians and sonographers with clinical and operational skills of obstetric ultrasound. Simultech's simulations are focused on medical knowledge, risk management, technology operations and physician-patient communication. The simulations encompass extreme work conditions. Setup: Between eight and ten of the eight hundred and fifty physicians and sonographers of the Clalit health services from seven hospitals and eight community centers across Israel, participate in individual Ob/Gyn training sessions each week. These include Ob/Gyn specialists, experts, interns, and sonographers. Innovative teaching and training methodologies: The six-hour training program includes: (1) An educational computer program that challenges trainees to deal with medical questions based upon ultrasound pictures and films. (2) Sophisticated hands-on simulators that challenge the trainees to practice correct grip of the transducer, elucidate pathology, and practice daily tasks such as biometric measurements and analysis of sonographic data. (3) Participation in a video-taped simulation which focuses on physician-patient communications. In the simulation, the physician is required to diagnose the clinical condition of a hired actress based on the data she provides and by evaluating the assigned ultrasound films accordingly. Giving ‘bad news’ to the patient may put the physician in a stressful situation that must be properly managed. (4) Feedback at the end of each phase is provided by a designated trainer, not a physician, who is specially qualified by Ob\Gyn senior specialists. (5) A group exercise in which the trainer presents a medico-legal case in order to encourage the participants to use their own experience and knowledge to conduct a productive ‘brainstorming’ session. Medical cases are presented and analyzed by the participants together with the trainer's feedback. Findings: (1) The training methods and content that Simultech provides allows trainees to review their medical and communications skills. (2) Simultech training sessions expose physicians to both basic and new, up-to-date cases, refreshing and expanding the trainee's knowledge. (3) Practicing on advanced simulators enables trainees to understand the sonographic space and to implement the basic principles of ultrasound. (4) Communications simulations were found to be beneficial for trainees who were unaware of their interpersonal skills. The trainer feedback, supported by the recorded simulation, allows the trainee to draw conclusions about his performance. Conclusion: Simultech was found to contribute to physicians at all levels of clinical expertise who deal with ultrasound. A break in daily routine together with attendance at a neutral educational center can vastly improve performance and outlook.

Keywords: medical training, simulations, ultrasound, Simultech

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Authors: Ali H. Muhammad

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The present study examines some antecedents and consequences of employee job involvement in Kuwaiti business organization. The model presented in the current study suggests that job satisfaction and organizational commitments are determinates of job involvements. Employees who are satisfied with their jobs tend to be more attached to their jobs and view their jobs as an essential part of their existence. Similarly, employees who are committed to organizational goals, and identify with organizational values, tend to have high level of involvement. Furthermore, our model suggests that job involvement is positively related to work performance and organizational citizenship behavior. The negative consequences of job involvement include burnout and work family conflict. To test the hypotheses, a sample of 204 Kuwaiti employees representing 8 Kuwaiti work organizations is used. The sample covers a variety of business sectors in Kuwait, including manufacturing, services, and transportation. The data were analyzed using non-parametric tests, Pearson correlations, and structural equation modeling. Results indicate that job satisfaction and organizational commitment have significant positive effects on job involvement. Furthermore, findings reveal that job involvement is positively associated with performance, organization citizenship behavior, and work family conflict. Findings are discussed, and future areas of research are identified.

Keywords: job involvement, organizational citizenship behavior, work family conflict, burnout

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Authors: Luana Guerra, Silvio C. Sampaio, Vladimir Pavan Margarido, Ralpho R. Reis

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Brazil is the world's largest consumer of pesticides. The excessive use of these compounds has negative impacts on animal and human life, the environment, and food security. Bees, crucial for pollination, are exposed to pesticides during the collection of nectar and pollen, posing risks to their health and the food chain, including honey contamination. Aquatic sediments are also affected, impacting water quality and the microbiota. Therefore, the analysis of aquatic sediments and bee honey is essential to identify environmental contamination and monitor ecosystems. The aim of this study was to use samples of honey from honeybees (Apis mellifera) and aquatic sediment as bioindicators of environmental contamination by pesticides and their relationship with agricultural use in the surrounding areas. The sample collections of sediment and honey were carried out in two stages. The first stage was conducted in the Bituruna municipality region in the second half of the year 2022, and the second stage took place in the regions of Laranjeiras do Sul, Quedas do Iguaçu, and Nova Laranjeiras in the first half of the year 2023. In total, 10 collection points were selected, with 5 points in the first stage and 5 points in the second stage, where one sediment sample and one honey sample were collected for each point, totaling 20 samples. The honey and sediment samples were analyzed at the Laboratory of the Paraná Institute of Technology, with ten samples of honey and ten samples of sediment. The selected extraction method was QuEChERS, and the analysis of the components present in the sample was performed using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). The pesticides Azoxystrobin, Epoxiconazole, Boscalid, Carbendazim, Haloxifope, Fomesafen, Fipronil, Chlorantraniliprole, Imidacloprid, and Bifenthrin were detected in the sediment samples from the study area in Laranjeiras do Sul, Paraná, with Carbendazim being the compound with the highest concentration (0.47 mg/kg). The honey samples obtained from the apiaries showed satisfactory results, as they did not show any detection or quantification of the analyzed pesticides, except for Point 9, which had the fungicide tebuconazole but with a concentration Keywords: contamination, water research, agrochemicals, beekeeping activity

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Authors: Arezou Hajhashemi, Karim Asgari, Masoud Etemadifar, Maryam Keyvani, Ali Hekmatnia

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Multiple Sclerosis (MS) is one of the most prevalent demyelinating diseases in CNS. As in other chronic cerebral diseases, impairment in cognitive functioning and in memory is popular. Because of the inflammatory and demyelinating nature of the disease, the localization of plaques in different parts of the Prefrontal and Limbic System, may lead to memorial symptoms. This investigation was intended to study relationship between frequency of plaques and memorial symptoms arising from dysfunction limbic system and prefrontal of patients with MS. The sample was selected randomly from patients with MS with memory problem, who have been referred to Isfahan Multiple Sclerosis Society. Brain System Test and Memory Test was administered to the sample, and their MRI's were analyzed by specialist in order to indentify two different parts of plaques. The data was analyzed by SPSS. The results showed that there were significant relationship between MS plaques and prefrontal's dysfunction and memorial symptom related to prefrontal area; however, there were no significant relationship between MS plaques and limbic system's dysfunction and memorial symptoms related to limbic system area. The results of this study suggest that memorial symptoms due to injury regions of the brain have the most significant relationship to prefrontal. Better judgment about these results needs more studies in future.

Keywords: multiple sclerosis, magnetic image, brain injury, behavior disorder

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Authors: Saleem Z. Ramadan

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This paper discusses the effects of using progressive Type-I right censoring on the design of the Simple Step Accelerated Life testing using Bayesian approach for Weibull life products under the assumption of cumulative exposure model. The optimization criterion used in this paper is to minimize the expected pre-posterior variance of the PTH percentile time of failures. The model variables are the stress changing time and the stress value for the first step. A comparison between the conventional and the progressive Type-I right censoring is provided. The results have shown that the progressive Type-I right censoring reduces the cost of testing on the expense of the test precision when the sample size is small. Moreover, the results have shown that using strong priors or large sample size reduces the sensitivity of the test precision to the censoring proportion. Hence, the progressive Type-I right censoring is recommended in these cases as progressive Type-I right censoring reduces the cost of the test and doesn't affect the precision of the test a lot. Moreover, the results have shown that using direct or indirect priors affects the precision of the test.

Keywords: reliability, accelerated life testing, cumulative exposure model, Bayesian estimation, progressive type-I censoring, Weibull distribution

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