Search results for: district early intervention center

Authors: Tracey Estriplet-Adams

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This paper focuses on the influence of maternal-fetal bonding by examining attachment theory, psycho-social-cultural influences/adaptations, and maternal well-being. A systematic review methodology was used to synthesize research results to summarize current evidence that can contribute to evidence-based practices. It explores the relationship between attachment styles, prenatal attachment, and perceptions of maternal-infant bonding/attachment six weeks postpartum. It also examines the protective factors of maternal-fetal attachment development. The research explores Bowlby's attachment theory and its relevance to maternal-fetal bonding with a Black Feminist Theory lens. Additionally, it discusses the impact of perceived stress, social support, and ecological models on maternal-fetal attachment. The relationship between maternal well-being, maternal-fetal attachment, and early postpartum bonding is reviewed. Moreover, the paper specifically addresses black mothers and maternal-fetal bonding, exploring the intersectionality of race, ethnicity, class, geographic location, cultural identities, and immigration status. It considers the role of familial and partner support, as well as the relationship between maternal attachment style and maternal-fetal bonding, within the framework of attachment theory and black feminist theory. Therefore, it is imperative to center Black women's voices in research, policy, and healthcare practices. Black women are experts in their own experiences and advocate for their autonomy in decision-making regarding maternal-fetal health. By amplifying their voices, we can ensure that interventions are grounded in their lived experiences.

Keywords: maternal-fetal bonding, infant well-being, maternal-infant attachment, black mothers

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Authors: Sadaf Salek

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Introduction: Cats are susceptible to various health conditions, and one such ailment that can affect their oral health is epulis in their lips. Epulis refers to a benign tumor or growth that can develop in different areas of a cat's mouth, including the lips. While epulis is not life-threatening, it can still cause discomfort and affect a cat's overall quality of life. This essay aims to delve into the causes, symptoms, and treatment options for epulis in cat's lips, shedding light on this lesser-known oral condition. Causes: Epulis in a cat's lips can have several causes. Firstly, genetic predisposition plays a significant role, with certain breeds being more prone to developing these growths. Secondly, chronic irritation to the mouth, such as from dental diseases or foreign objects, can also contribute to the development of epulis. Lastly, hormonal imbalances, specifically an excess of estrogen, have been associated with the occurrence of these tumors in cats. Understanding these causes can help cat owners take preventive measures to reduce the risk of epulis in their feline companions. Symptoms: Identifying the symptoms of epulis in a cat's lips is vital for early intervention and effective treatment. The most common symptoms include swelling, redness, and the presence of a visible growth or lump on the lip. Cats with epulis may also exhibit drooling, difficulty eating, and a reluctance to groom themselves. Any change in eating habits or oral behavior should not be overlooked and prompt a visit to the veterinarian for a thorough examination. Treatment ptions: When it comes to treating epulis in a cat's lips, various options are available, depending on the size, location, and characteristics of the growth. The primary treatment involves surgical removal of the tumor. This procedure should be performed by a qualified veterinarian, ensuring complete excision of the mass while preserving as much healthy tissue as possible. In some cases, radiation therapy may be necessary, especially if the tumor is large or aggressive. Additionally, a veterinarian may recommend oral hygiene care and regular dental cleaning to prevent further growths and maintain the cat's oral health. Prevention and Care: Preventing epulis in a cat's lips is not always possible, especially if genetic factors are involved. However, certain preventive measures can minimize the risk of these growths. Maintaining good oral hygiene through regular brushing and the use of appropriate dental products can help prevent chronic irritation and dental diseases. Routine veterinary check-ups should also include thorough oral examinations to detect any abnormal growths or changes in the mouth at an early stage. Pet owners should be observant and seek veterinary care promptly for any signs of discomfort or changes in eating habits. Conclusion: Epulis in a cat's lips is a condition that requires attention and proper treatment. Understanding the causes, identifying symptoms, and exploring treatment options are of utmost importance to help improve a cat's oral health and overall well-being.

Keywords: fibroma, cat, lip, epulis

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Authors: Yoseph Gela Ali

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Inadequate quality and quantity diet is one of the major reasons for high levels of malnutrition in pregnant women. Across-sectional survey was conducted in Shashemene District, Southern Oromia Region. A two-stage cluster sampling technique was used to select a representative sample of 15190 pregnant women aged 20-50 years from four rural villages Energy and nutrient intakes from foods were calculated from one-day weighed food records on a sub-sample (n = 83). The result of the study showed that the intakes of most nutrients were lower than the recommended intake. The energy intake of the study participants both in 2nd and 3rd trimesters of pregnancy were 2,308 kcal and 1,420.5 kcal compared to the recommended 2,340 kcal and 2,452 kcal, respectively. Except iron, almost all micronutrient intakes were lower than the recommended intake. Vitamin A intake was 3 µg compared with the recommended 800 µg, while protein intake of the study respondents in 2nd and 3rd trimester of pregnancy was 45.9 g and 31.5 g, respectively, compared with the recommended 71 g. Risk factors for under nutrition were multiple pregnancy and no consumption of cereal-based foods. This study revealed that the energy and nutrient intake of the pregnant women in the study area was below the recommended intakes. Furthermore, the situation might be aggravated by the high phytate content food consumption reported. Nutritional status of pregnant women in the study area was not adequate to support the increased energy and nutrient requirement of the participants.

Keywords: nutrition, pregnancy, protein, vitamin, energy

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Authors: Reeta Devi, Hitender Kumar Tyagi, Dinesh Kumar

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In present scenario, cardiovascular problems are growing challenge for researchers and physiologists. As heart disease have no geographic, gender or socioeconomic specific reasons; detecting cardiac irregularities at early stage followed by quick and correct treatment is very important. Electrocardiogram is the finest tool for continuous monitoring of heart activity. Heart rate variability (HRV) is used to measure naturally occurring oscillations between consecutive cardiac cycles. Analysis of this variability is carried out using time domain, frequency domain and non-linear parameters. This paper presents HRV analysis of the online dataset for normal sinus rhythm (taken as healthy subject) and sudden cardiac death (SCD subject) using all three methods computing values for parameters like standard deviation of node to node intervals (SDNN), square root of mean of the sequences of difference between adjacent RR intervals (RMSSD), mean of R to R intervals (mean RR) in time domain, very low-frequency (VLF), low-frequency (LF), high frequency (HF) and ratio of low to high frequency (LF/HF ratio) in frequency domain and Poincare plot for non linear analysis. To differentiate HRV of healthy subject from subject died with SCD, k –nearest neighbor (k-NN) classifier has been used because of its high accuracy. Results show highly reduced values for all stated parameters for SCD subjects as compared to healthy ones. As the dataset used for SCD patients is recording of their ECG signal one hour prior to their death, it is therefore, verified with an accuracy of 95% that proposed algorithm can identify mortality risk of a patient one hour before its death. The identification of a patient’s mortality risk at such an early stage may prevent him/her meeting sudden death if in-time and right treatment is given by the doctor.

Keywords: early stage prediction, heart rate variability, linear and non-linear analysis, sudden cardiac death

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Authors: Stefaan Carpentier, Aya Al Masri, Fabrice Leroy, Thibault Julien, Safoin Aktaou, Malorie Martin, Fouad Maaloul

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Introduction: During an 'Interventional Radiology (IR)' procedure, the patient's skin-dose may become very high for a burn, necrosis, and ulceration to appear. In order to prevent these deterministic effects, a prediction of the peak skin-dose for the patient is important in order to improve the post-operative care to be given to the patient. The objective of this study is to estimate, before the intervention, the patient dose for ‘Chronic Total Occlusion (CTO)’ procedures by selecting relevant clinical indicators. Materials and methods: 103 procedures were performed in the ‘Interventional Cardiology (IC)’ department using a Siemens Artis Zee image intensifier that provides the Air Kerma of each IC exam. Peak Skin Dose (PSD) was measured for each procedure using radiochromic films. Patient parameters such as sex, age, weight, and height were recorded. The complexity index J-CTO score, specific to each intervention, was determined by the cardiologist. A correlation method applied to these indicators allowed to specify their influence on the dose. A predictive model of the dose was created using multiple linear regressions. Results: Out of 103 patients involved in the study, 5 were excluded for clinical reasons and 2 for placement of radiochromic films outside the exposure field. 96 2D-dose maps were finally used. The influencing factors having the highest correlation with the PSD are the patient's diameter and the J-CTO score. The predictive model is based on these parameters. The comparison between estimated and measured skin doses shows an average difference of 0.85 ± 0.55 Gy for doses of less than 6 Gy. The mean difference between air-Kerma and PSD is 1.66 Gy ± 1.16 Gy. Conclusion: Using our developed method, a first estimate of the dose to the skin of the patient is available before the start of the procedure, which helps the cardiologist in carrying out its intervention. This estimation is more accurate than that provided by the Air-Kerma.

Keywords: chronic total occlusion procedures, clinical experimentation, interventional radiology, patient's peak skin dose

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Authors: Antonio Marco Miotti, Antonella Ruffatto, Giampaola Basso, Antonio Madia, Giulia Zavatta, Emanuela Salvatico, Emanuela Zilli

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A National Action Plan to fight antimicrobial resistance was launched in Italy in 2017. In order to reduce inappropriate exposure to antibiotics and infections from multi-drug resistant bacteria, it is essential to set up a structured system of surveillance and monitoring of the implementation of National Action Plan standards, including antimicrobial consumption, with a special focus on quinolones, third generation cephalosporins and carbapenems. A quantitative estimate of antibiotic consumption (defined daily dose - DDD - consumption per 100 days of hospitalization) has been provided by the Pharmaceutical Service to the Hospital of Cittadella, ULSS 6 Euganea – Health Trust (District of Padua) for the years 2019 (before the pandemic), 2020 and 2021 for all classes of antibiotics. Multidisciplinary meetings have been organized monthly by the local Antimicrobial Stewardship Group. Between 2019 and 2021, an increase in the consumption of carbapenems in the Intensive Care Unit (from 12.2 to 18.2 DDD, + 49.2%) and a decrease in Medical wards (from 5.3 to 2.6 DDD, - 50.9%) was reported; a decrease in the consumption of quinolones in Intensive Care Unit (from 17.2 to 10.8 DDD, - 37.2%), Medical wards (from 10.5 to 6.6 DDD, - 37.1%) and Surgical wards (from 10.2 to 9.3 DDD, - 8.8%) was highlighted; an increase in the consumption of third generation cephalosporins in Medical wards (from 18.1 to 22.6 DDD, + 24,1%) was reported. Finally, after an increase in the consumption of macrolides between 2020 and 2019, in 2021, a decrease was reported in the Intensive Care Unit (DDD: 8.0 in 2019, 18.0 in 2020, 6.4 in 2021) and Medical wards (DDD: 9.0 in 2019, 13.7 in 2020, 10.9 in 2021). Constant monitoring of antimicrobial consumption and timely identifying of warning situations that may need a specific intervention are the cornerstone of Antimicrobial Stewardship programs, together with analysing data on bacterial resistance rates and infections from multi-drug resistant bacteria.

Keywords: carbapenems, quinolones, antimicrobial, stewardship

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Authors: Karen Detoya

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Decreasing cortisol usually leads to good psychological health. This is done in various ways, such as by hugging. Although hugging may decrease a person’s cortisol, it is not advisable during pandemics. Besides that, non-contact cultures and histories of molestation may elicit negative feelings in a person when hugged; thus, hugging a stuffed toy is an option. This research explored the effect of 15 minutes of hugging a stuffed toy among stressed government employees. There are two groups in the study and 15 participants per group. Cortisol was measured before and after the intervention. The first group hugged a stuffed toy for 15 minutes, while the second group stayed in the room without hugging anything. For data analysis, t-tests for dependent samples and t-tests for independent samples were utilized. Results showed no significant differences in the cortisol levels of the two groups before and after the experiment. It also showed no significant difference between the cortisol levels of the two groups after the experiment. Comparing the experimental group by age (18-41 years old and 42-65 years old) and gender (male and female), results showed no significant difference in their cortisol hormones after the intervention.

Keywords: hugging, cortisol, stuffed toy, stressed government employees

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Authors: Dyna Ann C. Sevilles, Noel J. Belonguel, Jarungchai Anton S. Vatanagul, Mary Jeanne O. Flordelis, Grace G. Anota

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Guillain Barre syndrome is an acute inflammatory polyradiculoneuropathy causing progressive symmetrical weakness which can be debilitating to the patient. Early diagnosis is important especially in the acute phase when treatment favors good outcome and reduces the incidence of the need for mechanical ventilation. Electrodiagnostic studies aid in the evaluation of patients suspected with GBS. However, the characteristic electrical changes may not be evident until after several weeks. Thus, studies performed early in the course may give unclear results. The aim of this study is to associate the symptom onset of patients diagnosed with Guillain Barre syndrome with the EMG NCV results and determine the earliest time when there is evident findings supporting the diagnosis. This is a retrospective descriptive chart review study involving patients of >/= 18 years of age with GBS written on their charts in a Tertiaty hospital in Cebu City, Philippines from January 2000 to July 2014. Twenty patients showed electrodiagnostic findings suggestive of GBS. The mean day of illness when EMG NCV was carried out was 7 days. The earliest with suggestive findings was done on day 2 (10%) of illness. Moreover, the highest frequency with positive results was done on day 3 (20%) of illness. Based on the Dutch Guillain Barre Study group criteria, the most frequent variables noted were: prolonged distal motor latency in both median and ulnar nerves(65%) and both peroneal and tibial nerves (71%); and reduced CMAP in both median and ulnar nerves (65%) and both tibial and peroneal nerves (71%). The EMG NCV findings showed majority of demyelinating type (59%). Electrodiagnostic studies are helpful in aiding the physician in the diagnosis and treatment of the disease in the early stage. Based on this study, neurophysiologic evidence of GBS can be seen in as early as day 2 of clinical illness.

Keywords: Acute Inflammatory Demyelinating Polyneuropathy, electrophysiologic study, EMG NCV, Guillain Barre Syndrome

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Authors: Shuen-Tai Wang, Ying-Chuan Chen, Yu-Ching Lin

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There has been renewal of interest in the relation between Green IT and cloud computing in recent years. Cloud computing has to be a highly elastic environment which provides stable services to users. The growing use of cloud computing facilities has caused marked energy consumption, putting negative pressure on electricity cost of computing center or data center. Each year more and more network devices, storages and computers are purchased and put to use, but it is not just the number of computers that is driving energy consumption upward. We could foresee that the power consumption of cloud computing facilities will double, triple, or even more in the next decade. This paper aims at resource allocation and scheduling technologies that are short of or have not well developed yet to reduce energy utilization in cloud computing platform. In particular, our approach relies on recalling services dynamically onto appropriate amount of the machines according to user’s requirement and temporarily shutting down the machines after finish in order to conserve energy. We present initial work on integration of resource and power management system that focuses on reducing power consumption such that they suffice for meeting the minimizing quality of service required by the cloud computing platform.

Keywords: cloud computing, energy utilization, power consumption, resource allocation

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Authors: Mohammadamin Hashemi, Mohammadreza Kashizadeh

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Droughts pose a significant threat to sustainable water resource management, agriculture, and socioeconomic sectors, particularly in the field of climate change. This study investigates drought simulation using rainfall-runoff modelling in the Cuneo district, Italy, over the past 60-year period. The study leverages the TUW model, a lumped conceptual rainfall-runoff model with a semi-distributed operation capability. Similar in structure to the widely used Hydrologiska Byråns Vattenbalansavdelning (HBV) model, the TUW model operates on daily timesteps for input and output data specific to each catchment. It incorporates essential routines for snow accumulation and melting, soil moisture storage, and streamflow generation. Multiple catchments' discharge data within the Cuneo district form the basis for thorough model calibration employing the Kling-Gupta Efficiency (KGE) metric. A crucial metric for reliable drought analysis is one that can accurately represent low-flow events during drought periods. This ensures that the model provides a realistic picture of water availability during these critical times. Subsequent validation of monthly discharge simulations thoroughly evaluates overall model performance. Beyond model development, the investigation delves into drought analysis using the robust Standardized Runoff Index (SRI). This index allows for precise characterization of drought occurrences within the study area. A meticulous comparison of observed and simulated discharge data is conducted, with particular focus on low-flow events that characterize droughts. Additionally, the study explores the complex interplay between land characteristics (e.g., soil type, vegetation cover) and climate variables (e.g., precipitation, temperature) that influence the severity and duration of hydrological droughts. The study's findings demonstrate successful calibration of the TUW model across most catchments, achieving commendable model efficiency. Comparative analysis between simulated and observed discharge data reveals significant agreement, especially during critical low-flow periods. This agreement is further supported by the Pareto coefficient, a statistical measure of goodness-of-fit. The drought analysis provides critical insights into the duration, intensity, and severity of drought events within the Cuneo district. This newfound understanding of spatial and temporal drought dynamics offers valuable information for water resource management strategies and drought mitigation efforts. This research deepens our understanding of drought dynamics in the Cuneo region. Future research directions include refining hydrological modelling techniques and exploring future drought projections under various climate change scenarios.

Keywords: hydrologic extremes, hydrological drought, hydrological modelling, machine learning, rainfall-runoff modelling

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Authors: Kazuma Mizukoshi

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Are electoral politics in contemporary Brazil still local in organization and focus? The importance of this question lies in its paradoxical trajectories. First, often coupled with institutional and sociological ‘barriers’ (e.g. the selection and election of candidates relatively loyal to the local party leadership, the predominance of territorialized electoral campaigns, and the resilience of political clientelism), the regionalization of electoral politics has been a viable and practical solution especially for pragmatic politicians in some Latin American countries. On the other hand, some leftist parties that once served as minor opposition forces at the time of foundational or initial elections have certainly expanded vote shares. Some were eventually capable of holding most (if not a majority) legislative seats since the 1990s. Though not yet rigorously demonstrated, theoretically implicit in the rise of leftist parties in legislative elections is the gradual (if not complete) nationalization of electoral support—meaning the growing equality of a party’s vote share across electoral districts and its change over time. This study will develop four hypotheses to explain the dynamics of party nationalization in contemporary Brazil: district magnitude, ethnic and class fractionalization of each district, voting intentions in federal and state executive elections, and finally the left-right stances of electorates. The study will demonstrate these hypotheses by closely working with the Brazilian Electoral Study (2002-2014).

Keywords: party nationalization, presidential coattails, Left, Brazil

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Authors: Muhammad Zafarullah Khan, Sumeera Abbasi

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The Farmers Field School (FFS) aims at benefiting poor farmers by improving their knowledge of existing agricultural technologies and integrated crop management to become independent and confident in their decision. The study on effect of farmer’s field school on vegetables production before and after FFS implementation in district Peshawar in four selected villages on each crop in 2011 was conducted from 80 farmers. The results were compared by using paired t-test. It was observed that 80% of the respondents were satisfied with FFS approach as there was a significant increase in vegetable production. The seed rate of tomato and cucumber decreased from 0.185kg/kanal to 0.1 kg/ kanal and 0.120kg/kanal to 0.01kg/kanal while production of tomato and cucumber were increased from 8158.75kgs/kanal to 1030.25kgs/kanal and 3230kgs/kanal to 5340kgs/kanal, respectively after the activities of FFS. FFS brought a positive effect on vegetable production and technology adoption improving their income, skills and knowledge ultimately lead farmers towards empowerment. The input cost including seed, crop management, FYM, and weedicides for tomato were reduced by Rs.28, Rs. 3170 and Rs.658 and cucumber reduced by Rs.35, Rs.570 and Rs.430. Only fertilizers cost was increased by Rs. 2200 in case of tomato and 465 in case of cucumber. FFS facilitator and coordinator should be more skilled and practical oriented to facilitate poor farmers. In light of the above study, more FFS should be planned so that the more farmers should be benefited.

Keywords: effect, farmer field school, vegetables production, integrated crop management

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Authors: Tali Capua, Karin Hermon, Miguel Glatstein, Oren Tavor, Ayelet Rimon

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Background: Electric bicycles (E-bikes) are one of a wide range of light electric vehicles that provide convenient local transportation and attractive recreational opportunities. Along with their growing use worldwide, the E-bike related injury rate increases. To the best of our knowledge, this study is the first to specifically compare E-bike with classic bicycle related injuries in children. Methods: Data of all pediatric ( < 16 years of age) bicycle related injuries presenting to an urban level I trauma center between 2014 and 2015 were collected and analyzed. The recorded data included age, gender, details of the accident, as well severity of injury, medical diagnosis, and the outcome. Abbreviated Injury Score (AIS) and Injury Severity Score (ISS) were calculated for each patient. Data of E-bike related injuries and classic bicycle were then compared. Results: A total of 124 bicycle related injuries and 97 E-bike related injuries presented to the emergency department. Once pedestrians and bicycle passengers were removed, the groups of riders consisted of 111 bikers and 85 E-bikers. The mean age of bikers was 9.9 years (range 3-16 years) and of E-bikers was 13.7 years (range 7.5-16 years). Injuries to the head and the extremities were common in both groups. Compared to bikers, E-bikers had significantly more injuries to intra-abdominal organs (p = 0.04). Twenty patients (16%) with bicycle related injuries were admitted, and 13 (15%) patients with E-bike related injuries, of the latter group four underwent surgical intervention. ISS scores were low overall, but the injuries of higher severity (ISS > 9) were among the E-bikers. Conclusions: This study provides unique information which suggests that injuries in E-bikers tend to be more severe than in classic bikers. There is a need for regulation regarding the use of E-bikes to enhance the safety of both bikers and other road and pavement users.

Keywords: bicycle, electric bicycle, injury, pediatric, trauma

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Authors: Matias Micheletto, Rodrigo Santos, Sergio F. Ochoa

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In developing countries, the most roads in rural areas are dirt road. They require frequent maintenance since are affected by erosive events, such as rain or wind, and the transit of heavy-weight trucks and machinery. Early detection of damages on the road condition is a key aspect, since it allows to reduce the main-tenance time and cost, and also the limitations for other vehicles to travel through. Most proposals that help address this problem require the explicit participation of drivers, a permanent internet connection, or important instrumentation in vehicles or roads. These constraints limit the suitability of these proposals when applied into developing regions, like in Latin America. This paper proposes an alternative method, based on unattended crowdsensing, to determine the quality of dirt roads in rural areas. This method involves the use of a mobile application that complements the road condition surveys carried out by organizations in charge of the road network maintenance, giving them early warnings about road areas that could be requiring maintenance. Drivers can also take advantage of the early warnings while they move through these roads. The method was evaluated using information from a public dataset. Although they are preliminary, the results indicate the proposal is potentially suitable to provide awareness about dirt roads condition to drivers, transportation authority and road maintenance companies.

Keywords: dirt roads automatic quality assessment, collaborative system, unattended crowdsensing method, roads quality awareness provision

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Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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Authors: Mohammad Imani, JabraeilNasl Seraji, Abolfazl Zakerian

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Background: Reaction time is the amount of time it takes to respond to a stimulus. In fact The time that passes between the introduction of a stimulus and the reaction by the subject to that stimulus. The aim of this interventional study is evaluation of bright light effects on concentration and diffuse attention reaction time, tension, angry, fatigue and alertness among shift workers. There are several incentives that can reduce the reaction time or added. Bright light as one of the environmental factors can reduce reaction time. Material &Method: This cross-sectional descriptive study was conducted in 1391, in 88 subjects (44 Fixed morning worker and 44 shift worker ) In a 24 h time (13-16-19-22-1-4-7-10) in an ordinary light situation after a randomly selected sample size calculation, concentration and diffuse attention test (reaction time) has been done. After intervention and using of bright light (4500lux), again reaction time test was done. After analyzing by ElISA method obtained data were analyzed by statistical software SPSS 19 and using T-test and ANOVA statistical analysis. Results: Between average of reaction time tests in ordinary light exposed to fixed morning workers and bright light exposed to shift worker, with 95% CI, (P>%5) there was no significant relationship. After the intervention and the use of bright light (4500 lux),between average of concentration and diffused attention reaction time tests in ordinary light exposure on the fixed morning workers and bright light exposure shift workers with 95% CI, (P<5%) there was significant relationship. Conclusion: In sometimes of 24 h during ordinary light exposure concentration and diffused attention reaction time has changed in shift workers. After intervention, during bright light (4500lux) exposure as a light shower, focused and diffuse attention reaction time, tension ,angry and fatigue decreased.

Keywords: bright light, reaction time, tension, angry, fatigue, alertness

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Authors: Bouami Hind, Millot Patrick

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The implementation of automated devices in life-critical systems such as hospitals can bring a new set of challenges related to automation malfunctions. While automation has been identified as great leverage for the medication dispensing system’s security and efficiency, it also increases the complexity of the organization. In particular, the installation and operation stage of automated devices can be complex when malfunctions related to automated systems occur. This paper aims to document operators’ situation awareness about the malfunctions of automated drug delivery systems (ADCs) during their implementation through Saint Brieuc hospital’s feedback. Our evaluation approach has been deployed in Saint Brieuc hospital center’s pharmacy, which has been equipped with automated nominative drug dispensing systems since January of 2021. The analysis of Saint Brieuc hospital center pharmacy’s automation revealed numerous malfunctions related to the implementation of Automated Delivery Cabinets. It appears that the targeted performance is not reached in the first year of implementation in this case study. Also, errors have been collected in patients' automated treatments’ production such as lack of drugs in pill boxes or nominative carnets, excess of drugs, wrong location of the drug, drug blister damaged, non-compliant sachet, or ticket errors. Saint Brieuc hospital center’s pharmacy is doing a tremendous job of setting up and monitoring performance indicators from the beginning of automation and throughout ADC’s operation to control ADC’s malfunctions and meet the performance targeted by the hospital. Health professionals, including pharmacists, biomedical engineers and directors of work, technical services and safety, are heavily involved in an automation project. This study highlights the importance of the evaluation of ADCs’ performance throughout the implementation process and the hospital’s team involvement in automation supervision and management.

Keywords: life-critical systems, situation awareness, automated delivery cabinets, implementation, risks and malfunctions

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Authors: Soran Aminiaghdam, Christian Rode, Reinhard Blickhan, Astrid Zech

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Despite considerable studies on the impact of imposed trunk posture on human walking, less is known about such locomotion while negotiating changes in ground level. The aim of this study was to investigate the behavior of the VBCOM in response to a two-fold expected perturbation, namely alterations in body posture and in ground level. To this end, the kinematic data and ground reaction forces of twelve able participants were collected. We analyzed the vertical position of the body center of mass (VBCOM) from the ground determined by the body segmental analysis method relative to the laboratory coordinate system at touchdown and toe-off instants during walking across uneven ground — characterized by perturbation contact (a 10-cm visible drop) and pre- and post-perturbation contacts — in comparison to unperturbed level contact while maintaining three postures (regular erect, ~30° and ~50° of trunk flexion from the vertical). The VBCOM was normalized to the distance between the greater trochanter marker and the lateral malleoli marker at the instant of TD. Moreover, we calculated the backward rotation during step-down as the difference of the maximum of the trunk angle in the pre-perturbation contact and the minimal trunk angle in the perturbation contact. Two-way repeated measures ANOVAs revealed contact-specific effects of posture on the VBCOM at touchdown (F = 5.96, p = 0.00). As indicated by the analysis of simple main effects, during unperturbed level and pre-perturbation contacts, no between-posture differences for the VBCOM at touchdown were found. In the perturbation contact, trunk-flexed gaits showed a significant increase of VBCOM as compared to the pre-perturbation contact. In the post-perturbation contact, the VBCOM demonstrated a significant decrease in all gait postures relative to the preceding corresponding contacts with no between-posture differences. Main effects of posture revealed that the VBCOM at toe-off significantly decreased in trunk-flexed gaits relative to the regular erect gait. For the main effect of contact, the VBCOM at toe-off demonstrated changes across perturbation and post-perturbation contacts as compared to the unperturbed level contact. Furthermore, participants exhibited a backward trunk rotation during step-down possibly to control the angular momentum of their whole body. A more pronounced backward trunk rotation (2- to 3-fold compared with level contacts) in trunk-flexed walking contributed to the observed elevated VBCOM during the step-down which may have facilitated drop negotiation. These results may shed light on the interaction between posture and locomotion in able gait, and specifically on the behavior of the body center of mass during perturbed locomotion.

Keywords: center of mass, perturbation, posture, uneven ground, walking

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Authors: Anurag Sharma, Arun Khosla, Mamta Khosla, Yogeswara Rao M.

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Multimedia devices have received repute in the special desires community. The wide display screen makes it appealing and easy to use, specifically for the ones who've susceptible pleasant motor skill. This paper highlights how an Android-based game named as 'KIDDY' can be used to enhance confront face perceiving capacities in adults with autism and aid the children to develop social interaction capabilities. This game improved concentration and imagination via repetitive movement and visual commentary. Four students with autism, diverse in the historic period, social behavior and communiqué ability had been enrolled in the program and provided an opportunity to recognize new faces thrilling way. This paper offers resultant role based on 'Social Skills Rating System' that shows how cellular generation used as an academician intervention to decorate studying and communiqué among children with autism and additionally proven the tremendous behavior toward cell primarily based game.

Keywords: autism spectrum disorder, screen-based technology, mobile phone-based intercession

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Authors: Muhammad Haitham Albahnassi, Adnan Malki, Shokri Almekdad

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In this paper, a method for reconfiguring bandwidth in a circular dual-mode resonator is presented. The method concerns the optimized geometry of a structure that may be used to host the tuning elements, which are typically RF (Radio Frequency) switches. The tuning elements themselves, and their performance during tuning, are not the focus of this paper. The designed resonator is able to reconfigure its fractional bandwidth by adjusting the inter-coupling level between the degenerate modes, while at the same time improving its response by adjusting the external-coupling level and keeping the center frequency fixed. The inter-coupling level has been adjusted by changing the dimensions of the perturbation element, while the external-coupling level has been adjusted by changing one of the feeder dimensions. The design was arrived at via optimization. Agreeing simulation and measurement results of the designed and implemented filters showed good improvements in return loss values and the stability of the center frequency.

Keywords: dual-mode resonators, perturbation theory, reconfigurable filters, software defined radio, cognitine radio

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Authors: Walter M. Millanzi, Stephen M. Kibusi

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Background: Currently, there has been a progressive shortage not only to the number but also the quality of medical practitioners for the most of nursing. Despite that, those who are present exhibit unethical and illegal practices, under standard care and malpractices. The concern is raised in the ways they are prepared, or there might be something missing in nursing curricula or how it is delivered. There is a need for transforming or testing new teaching modalities to enhance competent health workforces. Objective: to investigate the Effect of Facilitation in a Problem-based Environment (FPBE) on metacognition, self-directed learning and learning motivation to undergraduate nurse student in Tanzanian higher learning institutions. Methods: quasi-experimental study (quantitative research approach). A purposive sampling technique was employed to select institutions and achieving a sample size of 401 participants (interventional = 134 and control = 267). Self-administered semi-structured questionnaire; was the main data collection methods and the Statistical Package for Service Solution (v. 20) software program was used for data entry, data analysis, and presentations. Results: The pre-post test results between groups indicated noticeably significant change on metacognition in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05). SDL in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05. Motivation to learn in an intervention (M = 62.67, SD = 14.14) and the control (n = 267, M = 57.75), t (399) = 2.907, p < 0.01). A FPBE teaching pedagogy, was observed to be effective on the metacognition (AOR = 1.603, p < 0.05), SDL (OR = 1.729, p < 0.05) and Intrinsic motivation in learning (AOR = 1.720, p < 0.05) against conventional teaching pedagogy. Needless, was less likely to enhance Extrinsic motivation (AOR = 0.676, p > 0.05) and Amotivation (AOR = 0.538, p > 0.05). Conclusion and recommendation: FPBE teaching pedagogy, can improve student’s metacognition, self-directed learning and intrinsic motivation to learn among nurse students. Nursing curricula developers should incorporate it to produce 21st century competent and qualified nurses.

Keywords: facilitation, metacognition, motivation, self-directed

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Authors: Jamal Alasiri, Naif Hakeem, Saoud Almaslmani

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Background: Patients with humeral shaft fractures have two different treatment options. Surgical therapy has lesser risks of non-union, mal-union, and re-intervention than non-surgical therapy. These positive clinical outcomes of the surgical approach make it a preferable treatment option despite the risks of radial nerve palsy and additional surgery-related risk. We aimed to evaluate patients’ outcomes and return to work after surgical vs. non-surgical management of shaft humeral fracture. Methods: We used databases, including PubMed, Medline, and Cochrane Register of Controlled Trials, from 2010 to January 2022 to search for potential randomised controlled trials (RCTs) and cohort studies comparing the patients’ related outcome measures and return to work between surgical and non-surgical management of humerus fracture. Results: After carefully evaluating 1352 articles, we included three RCTs (232 patients) and one cohort study (39 patients). The surgical intervention used plate/nail fixation, while the non-surgical intervention used a splint or brace procedure to manage shaft humeral fracture. The pooled DASH effects of all three RCTs at six (M.D: -7.5 [-13.20, -1.89], P: 0.009) I2:44%) and 12 months (M.D: -1.32 [-3.82, 1.17], p:0.29, I2: 0%) were higher in patients treated surgically than in non-surgical procedures. The pooled constant Murley score at six (M.D: 7.945[2.77,13.10], P: 0.003) I2: 0%) and 12 months (M.D: 1.78 [-1.52, 5.09], P: 0.29, I2: 0%) were higher in patients who received non-surgical than surgical therapy. However, pooled analysis for patients returning to work for both groups remained inconclusive. Conclusion: Altogether, we found no significant evidence supporting the clinical benefits of surgical over non-surgical therapy. Thus, the non-surgical approach remains the preferred therapeutic choice for managing shaft humeral fractures due to its lesser side effects.

Keywords: shaft humeral fracture, surgical treatment, Patient-related outcomes, return to work, DASH

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Authors: Mirzaii Khadigeh

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Background and objectives: Sexual health education is an important part of health promotion services. The major role of sex education is on mothers’ shoulders. So, they have to be equipped with enough knowledge, attitude and self-efficacy for teens’ education. The present study aimed to determine the effect of team-learning and multimedia software on mothers’ knowledge, attitudes and self-efficacy in sexual health education to 12-14-year-old sons in Mashhad in 1395. Materials and methods: In this research, two experimental and one control group were employed using random sampling, which was done on 132 mothers of high school pupils. They were randomly assigned into experimental and control groups. The data were collected using demographic information and a researcher-constructed questionnaire to investigate the mothers’ knowledge, attitude, and self-efficacy and DASS21(The Depression, Anxiety and Stress Scale). They were run after confirming their reliability and validity. Intervention for the multimedia group was in the form of four CDs- each for 45 minutes- that were given to the mothers each week. At the end of the fourth week, a question-and-answer session was administered for 60 minutes. The team-learning group received intervention once a week (totally four weeks). Two weeks later, the data were collected and analyzed via Chi-square, Fisher, Kruskal-Wallis and ANOVA. Findings: Knowledge, attitude and self-efficacy of mothers in sexual health before the intervention did not have any significant differences (p >0.05). At the end of the study, the difference between the scores of the knowledge, attitude and self-efficacy in the three groups was meaningfully different (p < 0/001), but the difference between the two groups of multimedia and team-learning was not significant (p> 0.05 ). Discussion and conclusion: The result reported the efficacy of both team-leaning and multimedia software, which implies that the multimedia software training method was as effective as team-learning training one on the knowledge, attitude and self-efficacy of mothers. But, the multimedia training method is highly advised due to its availability, flexibility, and interest.

Keywords: training one on the knowledge, attitude, self-efficacy of mothers, boys

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Authors: Md. Samim Hossain Molla, Md. Mazharul Anwar, Md. Akkas Ali, Mian Sayeed Hassan

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Being detached about 68 years from the mainland, the previous enclaves’ (Chhitmohal) farmers were engaged only in subsistence farming with low agricultural productivity and restricted access to inputs technology. To increase crop productivity for attaining food security by addressing soil status, the experiments were undertaken in 2017 and 2018 in three previous enclaves of Northern Bangladesh i.e. Dasiarchhara of Kurigram district; Dahalakhagrabari of Panchagarh district and Banskata of Lalmonirhat district under On-Farm Research Division, Bangladesh Agricultural Research Institute, Rangpur. The Mustard (var. BARI Sarisha-14)-Boro rice (var. BRRI dhan58)-T. Aman rice (var. BRRI dhan49) cropping pattern using soil test based (STB) fertilizer with cowdung (T1) or recommended fertilizer dose (T2) were tested against existing cropping pattern Fallow-Boro rice (var. BRRI dhan28)-T. Aman rice (var. Swarna) using farmers’ practices fertilizer dose (T3) in six disperse replications at each location maintaining Randomized Complete Block design. Almost all crops yields were relatively higher in T1 followed by T2. Farmers existing pattern with local varieties and imbalance fertilizer (T3) use may be decreased the crop yield. The rice equivalent yield of T1 was 109, 103 and 95% higher than T3 and the gross margin was 164, 153 and 133% higher in T1 than T3 at Dasiarchhara, Dahalakhagrabari and Banskata, respectively. The Benefit Cost Ratio for T1, T2 and T3 were 1.99, 1.78 and 1.28 in Dasiarchhara; 1.93, 1.81 and 1.27 in Dahalakhagrabari and 1.78, 1.71 and 1.25 in Banskata, respectively. There was a remarkable decrease in mineral N, P and K in the topsoil (0–15 cm) of T3 and T2 treatments at Dasiarchhara and Dahalakhagrabari, and a generally less marked decline under the same treatments at Banskata. The same practices (T1) exhibited the greatest nutrients uptake by the test crops. The apparent balance of N, P and K was negative in most cases, where it was less negative in T1 treatment. However, from the experimentation, it is revealed that balanced fertilization (STB) and inclusion of National Agricultural Research Institutes developed improved crops varieties in cropping pattern may increase the crop productivity, farm efficiency and farmer’s income in a remarkable level.

Keywords: cropping pattern, fertilizer management, nutrient balance, previous enclaves

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Authors: Irfan Ahmad, Raza Ghafoor, Hammad Raza Ahmad, Muhammad Asif, Farrakh Nawaz, M. Tahir Siddiqui

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Due to the exploding population of Pakistan the pressure on natural forests is increasing to meet the demands of wood and wood based products. Agroforestry is being practiced throughout the world on scientific basis but unfortunately the farmers of Pakistan are reluctant in its adoption. The presents study was designed to assess the adoption of agroforestry practices in Faisalabad with respect to land holdings of farmers and future suitability by using Geographic information system (GIS). Faisalabad is the third largest city of the country and is famous due to the textile industry. A comprehensive survey from target villages of the Lyallpur town of Faisalabad district was carried out. Out of total 65 villages, 40 were selected for study. From each selected village, one farmer who was actively engaged in farming activities was selected. It was observed that medium sized farmers having 10-20 acre were more in number as compared to small and large farmers. Number of trees was found maximum in large farm lands, ratio of diseased trees was almost similar in all categories with maximum in small farmlands (24.1%). Regarding the future prospects 35% farmer were interested in agroforestry practices 65% were not interested in the promotion of trees due to the non-availability of technical guidance and proper markets. Geographic images of the study site can further help the researchers and policy makers in the promotion of agroforestry.

Keywords: agroforestry trends, adoption, Faisalabad, geographic information system (GIS)

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Authors: Kamakshaiah Kolli, R. Seshadri

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Water is a key resource in all economic activities ranging from agriculture to industry. Only a tiny fraction of the planet's abundant water is available to us as fresh water. Assessment of water quality has always been paramount in the field of environmental quality management. It is the foundation for health, hygiene, progress and prosperity. With ever increasing pressure of human population, there is severe stress on water resources. Therefore efficient water management is essential to civil society for betterment of quality of life. The present study emphasizes on the groundwater quality, sources of ground water contamination, variation of groundwater quality and its spatial distribution. The bases for groundwater quality assessment are groundwater bodies and representative monitoring network enabling determination of chemical status of groundwater body. For this study, water samples were collected from various areas of the entire corporation area of Guntur. Water is required for all living organisms of which 1.7% is available as ground water. Water has no calories or any nutrients, but essential for various metabolic activities in our body. Chemical and physical parameters can be tested for identifying the portability of ground water. Electrical conductivity, pH, alkalinity, Total Alkalinity, TDS, Calcium, Magnesium, Sodium, Potassium, Chloride, and Sulphate of the ground water from Guntur district: Different areas of the District were analyzed. Our aim is to check, if the ground water from the above areas are potable or not. As multivariate are present, Data mining technique using JRIP rules was employed for classifying the ground water.

Keywords: groundwater, water quality standards, potability, data mining, JRIP, PCA, classification

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Authors: Chrysanthi Nega, Fotini-Sonia Apergi

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Child sexual abuse (CSA) in Greece is a highly prevalent phenomenon and yet remains largely underreported. CSA can negatively impact cognitive, emotional and psychosocial development, as well as personality formation and capacity for initiation and maintenance of healthy interpersonal relationships. It is particularly important for school-based prevention programs to be implemented early in elementary school, as they are reportedly effective in lowering abuse incidences and providing knowledge for coping in threatening environments. The purpose of the current study was to test the effectiveness of a school-based CSA prevention program (Safe-Touches) on Greek elementary school students (grades 1-3, N=272) and explore the effect of age and time of testing (academic term). There was a significant effect of age in the knowledge of Inappropriate Touch, when comparing pre and post-intervention assessments, with third graders showing greatest gains in knowledge, followed by second and first graders. Time of testing during the academic year also had a significant effect, as first graders tested later in the school year, scored higher on knowledge of Inappropriate Touch. The findings of the current study provide insight into the optimal timing to implement CSA prevention programs. Exposure to such programs and incorporation in the school curricula could largely benefit children of the Greek community in terms of safety and awareness.

Keywords: child sexual abuse, Safe-Touches, school-based prevention, schooling

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Authors: Syamimi Shamsuddin, Hanafiah Yussof, Fazah Akhtar Hanapiah, Salina Mohamed, Nur Farah Farhan Jamil, Farhana Wan Yunus

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Robot-based intervention for children with autism is an evolving research niche in human-robot interaction (HRI). Recent studies in this area mostly covered the role of robots in the clinical and experimental setting. Our previous work had shown that interaction with a robot pose no adverse effects on the children. Also, the presence of the robot, together with specific modules of interaction was associated with less autistic behavior. Extending this impact on school-going children, interactions that are in-tune with special education lessons are needed. This methodological paper focuses on how a robot can be incorporated in a current learning environment for autistic children. Six interaction scenarios had been designed based on the existing syllabus to teach communication skills, using the Applied Behavior Analysis (ABA) technique as the framework. Development of the robotic experience in class also covers the required set-up involving participation from teachers. The actual research conduct involving autistic children, teachers and robot shall take place in the next phase.

Keywords: autism spectrum disorder, ASD, humanoid robot, communication skills, robot-assisted learning

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Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Vivane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal sepsis is a systemic response to the acute generalized infection caused by one or more bacterial agents, representing the main infectious cause of neonatal mortality in dogs during the first three weeks of life. This study aims to describe the incidence of sepsis in neonate dogs, as well as the main clinical signs and mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. Seven hundred thirty-five neonates, 14% (98/703) presented neonatal sepsis. The main sources of infection for the neonates were intrauterine (72.5%, 71/98), lactogenic (13.2%, 13/98), umbilical (5.1%, 5/98) and unidentified sources (9.2%, 9/98). The main non-specific clinical signs observed in the newborns were weakness, depression, impaired or absent reflexes, hypothermia, hypoglycemia, dehydration, reduced muscle tonus and diarrhea. The newborns also manifested clinical signs of severe infection, such as hyperemia in the abdominal and anal regions, omphalitis, hematuria, abdomen and extremities with purplish-blue coloration necrosing injuries in the pads, bradycardia, dyspnea, epistaxis, hypotension and evolution to septic shock. Infections acquired during intrauterine life led to the onset of the clinical signs at the time of birth, with fast evolution during the first hours of life. On the other hand, infections acquired via milk or umbilical cord presented clinical signs later. The total mortality rate was 5.4% (38/703) and the mortality rate among the neonates with sepsis was 38.7% (38/98). The early mortality rate (0 to 2 days) accounted for 86.9% (33/38) and the late mortality rate (3 to 30 days) for 13.1% (5/38) of the deaths among the newborns with sepsis. The main bacterial agents observed were Staphylococcus spp., Streptococcus spp., Proteus spp. Mannheimia spp. and Escherichia coli. Neonatal sepsis evolves quickly and may lead to high mortality in a litter. The prognosis is usually favorable if the diagnosis is reached early and the antibiotic therapy instituted as soon as possible, even before the results of blood cultures and antibiograms. The therapeutic recommendations should meet the special physiological conditions of a neonate in terms of metabolism and excretion of medication. Therefore, it is of utmost importance that the veterinarian is knowledgeable regarding neonatology to provide effective intervention and improve the survival rates of these patients.

Keywords: Neonatal infection , bacteria, puppies, newborn

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Authors: Jianhua Zhou, Yuwen Zhang

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A two-step multigrid approach is proposed to solve the inverse heat conduction problem in a 3-D object under laser irradiation. In the first step, the location of the laser center is estimated using a coarse and uniform grid system. In the second step, the front-surface temperature is recovered in good accuracy using a multiple grid system in which fine mesh is used at laser spot center to capture the drastic temperature rise in this region but coarse mesh is employed in the peripheral region to reduce the total number of sensors required. The effectiveness of the two-step approach and the multiple grid system are demonstrated by the illustrative inverse solutions. If the measurement data for the temperature and heat flux on the back surface do not contain random error, the proposed multigrid approach can yield more accurate inverse solutions. When the back-surface measurement data contain random noise, accurate inverse solutions cannot be obtained if both temperature and heat flux are measured on the back surface.

Keywords: conduction, inverse problems, conjugated gradient method, laser

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