Search results for: surgery outcome

Authors: Eun Jeong Yu, Inn Soo Kang, Tae Ki Yoon, Mi Kyoung Koong

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Advanced female age is associated with higher cycle cancelation rates, lower clinical pregnancy rate, increased miscarriage and aneuploidy rates in IVF (In Vitro Fertilization) cycles. This retrospective cohort study was conducted at a Cha Fertility Center, Seoul Station. All fresh non-donor IVF cycles performed in women aged 40 years and above from January 2016 to December 2016 were reviewed. Donor/recipient treatment, PGD/PGS (Preimplantation Genetic Diagnosis/ Preimplantation Genetic Screening) were excluded from analysis. Of the 1,166 cycles from 753 women who completed ovulation induction, 1,047 were appropriate for the evaluation according to inclusion and exclusion criterion. IVF cycles were categorized according to age and grouped into the following 1-year age groups: 40, 41, 42, 43, 44, 45 and > 46. The mean age of patients was 42.4 ± 1.8 years. The median AMH (Anti-Mullerian Hormone) level was 1.2 ± 1.5 ng/mL. The mean number of retrieved oocytes was 4.9 ± 4.3. The clinical pregnancy rate and live birth rate in women > 40 years significantly decreased with each year of advancing age (p < 0.001). The clinical pregnancy rate decreased from 21% at the age of 40 years to 0% at ages above 45 years. Live birth rate decreased from 12.3% to 0%, respectively. There were no clinical pregnancy outcomes among 95 patients aged above 45 years of age. The overall miscarriage rate was 40.7% (range, 36.7%-70%). The transfer of at least one good quality embryo was associated with about 4-9% increased chance of a clinical pregnancy rate. Therefore, IVF in old age women less than 46 had a reasonable chance for successful pregnancy outcomes especially when good quality embryo is transferred.

Keywords: advanced maternal age, in vitro fertilization, pregnancy rate, live birth rate

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Authors: Muhammad Fairul Azreen Mohd Zahid

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Speech, text, and movement intensify aspects of creating choreography by connecting with emotional entanglements, tradition, literature, and other texts. This research focuses on the practice as research that will prioritise the choreography process as an inquiry approach. With the driven context, the study intervenes in critical conjunctions of choreographic theory, bringing together new reflections on the moving body, spaces of action, as well as intertextuality between text and movements in making choreography. Throughout the process, the researcher will introduce the level of deliberation from speech through movements and text to express emotion within a narrative context of an “illocutionary act.” This practice as research will produce a different meaning from the “utterance text” to “utterance movements” in the perspective of speech acts theory by J.L Austin based on fragmented text from “pidato adat” which has been used as opening speech in Randai. Looking at the theory of deconstruction by Jacque Derrida also will give a different meaning from the text. Nevertheless, the process of creating the choreography will also help to lay the basic normative structure implicit in “constative” (statement text/movement) and “performative” (command text/movement). Through this process, the researcher will also look at several methods of using text from two works by Joseph Gonzales, “Becoming King-The Pakyung Revisited” and Crystal Pite's “The Statement,” as references to produce different methods in making choreography. The perspective from the semiotic foundation will support how occurrences within dance discourses as texts through a semiotic lens. The method used in this research is qualitative, which includes an interview and simulation of the concept to get an outcome.

Keywords: intertextuality, choreography, speech act, performative, deconstruction

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Authors: Claude Alavoine, Ferkan Kaplanseren

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Negotiation is a specific form of interaction based on communication in which the parties enter into deliberately, each with clear but different interests or goals and a mutual dependency towards a decision due to be taken at the end of the confrontation. Consequently, negotiation is a complex activity involving many different disciplines from the strategic aspects and the decision making process to the evaluation of alternatives or outcomes and the exchange of information. While gender differences can be considered as one of the most researched topic within negotiation studies, empirical works and theory present many conflicting evidences and results about the role of gender in the process or the outcome. Furthermore, little interest has been shown over gender differences in the definition of what is negotiation, its essence or fundamental elements. Or, as differences exist in practices, it might be essential to study if the starting point of these discrepancies does not come from different considerations about what is negotiation and what will encourage the participants in their strategic decisions. Some recent and promising experiments made with diverse groups show that male and female participants in a common and shared situation barely consider the same way the concepts of power, trust or stakes which are largely considered as the usual driving forces of any negotiation. Furthermore, results from Human Resource self-assessment tests display and confirm considerable differences between individuals regarding essential behavioral dimensions like capacity to improvise and to achieve, aptitude to conciliate or to compete and orientation towards power and group domination which are also part of negotiation skills. Our intention in this paper is to confront these dimensions with negotiation’s usual driving forces in order to build up new paths for further research.

Keywords: negotiation, gender, trust, power, stakes, strategies

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Authors: Jerzy Bański

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The purpose of the paper is to describe the role of urban-rural partnership in social and economic development. The concept of urban-rural collaboration is relatively new and assumes the need to link large metropolitan areas with surrounding rural areas in a number of ways. It is strongly related to the existing concept of polycentric spatial development. At the European Union level, the first document to address the need for urban-rural partnerships was the European Spatial Development Perspective from 1999. The paper focuses on factors that generate social and economic success on examples of several metropolitan territories in Poland (Warsaw, Poznan, Wroclaw, Krakow). A survey focused on rural communes made it possible to assess key success factors (location, social and economic, technological and organizational) that could be later used to determine the right course of action in the area of urban-rural cooperation, with the desired outcome being effective metropolitan area development. The main challenges to urban-rural partnership are issues associated with spatial planning, infrastructure and public services. These are areas of the greatest conflict of interest, too. Any analysis of urban-rural cooperation in metropolitan areas really needs to focus on the unique nature of this type of relationship. This includes issues such as commuting to work in the urban core and vice versa, complementarity of technical infrastructure, and joint strategic planning. Other forms of cooperation should focus on the tourist and recreational aspects of areas surrounding the urban core.

Keywords: partnership, rural areas, urbanization, metropolitan areas, Poland

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Authors: Fatema Tasmia, Brishti Majumder, Atiqur Rahman

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Attaining appropriate thermal comfort conditions in a place where the climate is hot and humid can be perplexing. Especially, when it resides at a congested place like old Dhaka Bangladesh, the provision of giving cross ventilation and building with proper orientation is quite difficult. This paper aims to investigate the indoor thermal environment of a room with and without transitional space or threshold in traditional row houses adjacent to a narrow alley of old Dhaka through field measurements. Transitional spaces are the part of buildings which are used for semi-outdoor household activities, social gathering and it is also proved to provide an indoor thermal effect. The field study was conducted by collecting thermal data (temperature, humidity and airflow) respectively, among the outdoor narrow alley, transitional space and adjacent indoor. This east-west elongated alley has an average width of 2.13 meter (varies from 1.5 to 2.6 meter) holding row houses on both sides. Among different aspects of thermal environment, the study of this paper is based on the analysis of temperature of corresponding cases. Other aspects and their variables were considered as constant (especially material) for accuracy and avoidance of confusion. This study focuses on the outcome that can ultimately contribute to the configuration of row houses with transitional spaces and in its relation to the adjacent outdoor space while achieving thermal comfort.

Keywords: alley, Old-Dhaka, row houses, temperature, thermal comfort, threshold, transitional space

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Authors: S. Zith Dey Babu, S. Kour, S. Verma, C. Verma, V. Pathania, A. Agrawal, V. Chaudhary, A. Manoj Puthur, R. Goyal, A. Pal, T. Danti Dey, A. Kumar, K. Wadhwa, O. Ved

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Background: Skin cancer is now is the buzzing button in the field of medical science. The cyst's pandemic is drastically calibrating the body and well-being of the global village. Methods: The extracted image of the skin tumor cannot be used in one way for diagnosis. The stored image contains anarchies like the center. This approach will locate the forepart of an extracted appearance of skin. Partitioning image models has been presented to sort out the disturbance in the picture. Results: After completing partitioning, feature extraction has been formed by using genetic algorithm and finally, classification can be performed between the trained and test data to evaluate a large scale of an image that helps the doctors for the right prediction. To bring the improvisation of the existing system, we have set our objectives with an analysis. The efficiency of the natural selection process and the enriching histogram is essential in that respect. To reduce the false-positive rate or output, GA is performed with its accuracy. Conclusions: The objective of this task is to bring improvisation of effectiveness. GA is accomplishing its task with perfection to bring down the invalid-positive rate or outcome. The paper's mergeable portion conflicts with the composition of deep learning and medical image processing, which provides superior accuracy. Proportional types of handling create the reusability without any errors.

Keywords: computer-aided system, detection, image segmentation, morphology

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Authors: Amin Akhnoukh, Halla Elea, Lawrence Benzmiller

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The objective of this research is to evaluate the possibility of using nano-sized materials, mainly titanium dioxide (TiO2), in producing economic self-cleaning concrete using photo-catalysis process. In photo-catalysis, the nano-particles react and dissolve smog, dust, and dirt particles in the presence of sunlight, resulting in a cleaned concrete surface. To-date, the Italian cement company (Italcementi) produces a proprietary self-cleaning cementitious material that is currently used in government buildings and major highways in Europe. The high initial cost of the proprietary product represents a major obstacle to the wide spread of the self-cleaning concrete in industrial and commercial projects. In this research project, titanium dioxide nano-sized particles are infused to the top layer of a concrete pour before the concrete surface is finished. Once hardened, a blue dye is applied to the concrete surface to simulate smog and dirt effect. The concrete surface is subjected to direct light to investigate the effectiveness of the nano-sized titanium dioxide in cleaning the concrete surface. The outcome of this research project proved that the titanium dioxide can be successfully used in reducing smog and dirt particles attached to the concrete when infused to the surface concrete layer. The majority of cleansing effect due to photocatalysis happens within 24 hours of photocatalysis process. The non-proprietary mix can be used in highway, industrial, and commercial projects due to its economy and ease of production.

Keywords: self-cleaning concrete, photocatalysis, Smog-eating concrete, titanium dioxide

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Authors: Anurag Niranjan, Michael Fitzpatrick, Yin Jin Janin, Jazeel Chukkan, Niall Smyth

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Fillet welds are used in joining longitudinal stiffeners in ship structures. Welding residual stresses in fillet welds are generally distributed in a non-uniform manner, as shown in previous research the residual stress redistribution occurs under the cyclic loading that is experienced by such joints during service, and the combination of the initial residual stress, local constraints, and loading can alter the stress field in ways that are extremely difficult to predict. As the residual stress influences the crack propagation originating from the toe of the fillet welds, full understanding of the residual stress field and how it evolves is very important for structural integrity calculations. Knowledge of the residual stress redistribution in the presence of a flaw is therefore required for better fatigue life prediction. Moreover, defect assessment procedures such as BS7910 offer very limited guidance for flaw acceptance and the associated residual stress redistribution in the assessment of fillet welds. Therefore the objective of this work is to study a surface-breaking flaw at the weld toe region in a fillet weld under cyclic load, in conjunction with residual stress measurement at pre-defined crack depths. This work will provide details of residual stress redistribution under cyclic load in the presence of a crack. The outcome of this project will inform integrity assessment with respect to the treatment of residual stress in fillet welds. Knowledge of the residual stress evolution for this weld geometry will be greatly beneficial for flaw tolerance assessments (BS 7910, API 591).

Keywords: fillet weld, fatigue, residual stress, structure integrity

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Authors: Bara Yousef

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The development of independency and functional participation is an important therapeutic goal for many children with cerebral palsy,They was many therapeutic approach have been used for treatment those children like neurodevelopment treatment, balance training strengthening and stretching exercise. More recently, therapy for children with cerebral palsy has focused on achieving functional goals using task-oriented interventions and summer camping model, which focus on activities that relevant and meaningful to the child, to learn more efficient and effective motor skills. We explore the effectiveness of using functional rehabilitation comparing with regular rehabilitation among 40 Saudi children with cerebral palsy in pediatric unit at Sultan Bin Abdul Aziz Humanitarian City-Ksa ,where 20 children randomly assign in control group who received rehabilitation based on regular therapy approach and other 20 children assign on experiment group who received rehabilitation based on functional therapy approach with an average of 45min OT treatment and 45 min PT treatment- daily within a period of 6 week. Our finding reported that children in experiment group has improved in gross motor function with an average from 49.4 to 57.6 based on GMFM 66 as primary outcome measure and improved in WeeFIM with an average from 52 to 62 while children in control group has improved with an average from 48.4 to 53.7 in GMFM and from 53 to and 58 in WeeFIM. Consequently, there has been growing interest in determining the effects of functional training programs as promising approach for these children.

Keywords: Cerebral Palsy (CP), gross motor function measure (GMFM66), pediatric Functional Independent Measure (WeeFIM), rehabilitation, disability

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Authors: Yeliz Karaca, Rana Karabudak

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Multifractal Denoising techniques are used in the identification of significant attributes by removing the noise of the dataset. Magnetic resonance (MR) image technique is the most sensitive method so as to identify chronic disorders of the nervous system such as Multiple Sclerosis. MRI and Expanded Disability Status Scale (EDSS) data belonging to 120 individuals who have one of the subgroups of MS (Relapsing Remitting MS (RRMS), Secondary Progressive MS (SPMS), Primary Progressive MS (PPMS)) as well as 19 healthy individuals in the control group have been used in this study. The study is comprised of the following stages: (i) L2 Norm Multifractal Denoising technique, one of the multifractal technique, has been used with the application on the MS data (MRI and EDSS). In this way, the new dataset has been obtained. (ii) The new MS dataset obtained from the MS dataset and L2 Multifractal Denoising technique has been applied to the K-Means and Fuzzy C Means clustering algorithms which are among the unsupervised methods. Thus, the clustering performances have been compared. (iii) In the identification of significant attributes in the MS dataset through the Multifractal denoising (L2 Norm) technique using K-Means and FCM algorithms on the MS subgroups and control group of healthy individuals, excellent performance outcome has been yielded. According to the clustering results based on the MS subgroups obtained in the study, successful clustering results have been obtained in the K-Means and FCM algorithms by applying the L2 norm of multifractal denoising technique for the MS dataset. Clustering performance has been more successful with the MS Dataset (L2_Norm MS Data Set) K-Means and FCM in which significant attributes are obtained by applying L2 Norm Denoising technique.

Keywords: clinical decision support, clustering algorithms, multiple sclerosis, multifractal techniques

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Authors: Michelangelo Liban, Debbie Liquete

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A 70-year-old right-handed Filipina was seen by the Neurology service due to a new onset headache, bi-occipital in location, dull squeezing in character with a pain score of 8/10 with associated nausea and one episode of non-projectile, which provided no relief. Due to the alarming features of the headache despite the absence of risk factors and an essentially normal neurologic examination, a cranial CTA+CTV was done, which revealed a small left frontal and small right pontine hyper density with minimal perilesional edema. Findings also revealed filling defects in the straight and right transverse sinus and a consideration of hypoplastic left transverse sinus with no definite evidence of aneurysm nor A-V malformation. She had normal levels of D-Dimer, Protein C, ANA and Anti-DS DNA but had a low Protein S of 56% (N.V is 70-120%). Antithrombin, homocysteine and Factor V Leiden were not done due to unavailability of the tests. She was then treated as a case of Cerebral Venous Thrombosis with multiple hemorrhage from venous infraction and was given anticoagulants which provided relief of the headache. She did not manifest with any further cortical, bulbar or sensorimotor deficits hence was discharged improved after 15 hospital days. To our knowledge, there are no case reports of patients with CVT from Protein S deficiency and venous anomaly that presented with multiple hemorrhage from venous infarction, more so affecting the brainstem. In this paper, a rare location of CVT in a newly diagnosed Protein S deficient patient is presented together with an uneventful course and favorable outcome.

Keywords: protein S deficiency, cerebral venous thrombosis, pontine hemorrhage from venous infarction, elderly

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Authors: Shao-Cyuan Yewang, Yu-Wen Chen

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Background: Exercise training is well known to alleviate chronic pain syndromes improve of chronic pain. This study investigated the effect of swimming exercise training on thoracotomy and rib retraction-induced allodynia. Methods: Male Sprague Dawley rats that received animal model of persistent postthoracotomy pain. All rats were divided into three groups: sham operations group (Sham), thoracotomy and rib retraction group (TRR), and TRR with swimming exercise training for 90min/day, 7 days a week for 4 weeks (TRR-SEW). The sham group did not receive retraction of the ribs. Thus, they received a pleural incision. The levels of mechanical and cold allodynia were measured by von Frey and acetone test. Results: In von Frey test, the level of mechanical allodynia in the TRR group was significantly higher than the sham group. The level of mechanical allodynia in the TRR-SEW group was significantly lower than the TRR group. In acetone test, the level of cold allodynia in the TRR group was significantly higher than the sham group. The level of cold allodynia in the TRR-SEW group was significantly lower than the TRR group. Conclusions: These results suggest that swimming exercise training decreases persistent postthoracotomy pain caused by TRR surgery. It may provide one of the new therapeutic effects of swimming exercise training could alleviate persistent postthoracotomy pain.

Keywords: chronic pain, thoracotomy pain, swimming, von Frey test, acetone test

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Authors: Lise Retat, Maria Carmen Huerta, Laura Webber, Franco Sassi

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Background: Intra-generational social mobility (ISM) can be defined as the extent to which individuals change their socio-economic position over a period of time or during their entire life course. The relationship between poor health and ISM is established. Therefore, quantifying the impact that potential health policies have on ISM now and into the future would provide evidence for how social inequality could be reduced. This paper takes the condition of overweight and obesity as an example and estimates the mean earning change per individual if the UK were to introduce policies to effectively reduce overweight and obesity. Methods: The HealthLumen individual-based model was used to estimate the impact of obesity on social mobility measures, such as earnings, occupation, and wealth. The HL tool models each individual's probability of experiencing downward ISM as a result of their overweight and obesity status. For example, one outcome of interest was the cumulative mean earning per person of implementing a policy which would reduce adult overweight and obesity by 1% each year between 2020 and 2030 in the UK. Results: Preliminary analysis showed that by reducing adult overweight and obesity by 1% each year between 2020 and 2030, the cumulative additional mean earnings would be ~1,000 Euro per adult by 2030. Additional analysis will include other social mobility indicators. Conclusions: These projections are important for illustrating the role of health in social mobility and for providing evidence for how health policy can make a difference to social mobility outcomes and, in turn, help to reduce inequality.

Keywords: modelling, social mobility, obesity, health

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Authors: Nodi Islam

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This paper critically reads Rumi’s poems in The Masnavi (Book One) and the philosophy of master-disciple relationship, as reflected as a medium to attain the higher consciousness in the poems which is considered as spiritual by the Sufi practitioners. This paper further applies the concept of collective consciousness introduced by Durkheim, which stands for a set of beliefs, ideas, moral attitudes that operate as a unifying force in a certain society, in reading Rumi’s poems. According to Sufi philosophy, in order to reach to the beloved who is the Higher Being, a lover has to be a disciple of a master and dedicate himself completely even if it means to give up the earthly desires. When the process is completed, he achieves the divinity which is the utmost happiness to be one with the beloved. As this process is considered spiritual by the Sufi practitioners, this paper suggests that, apart from being spiritual, this is a reflection of collective consciousness also. This process plays a part to construct the collectivity as a means to create masters and disciples. Collective consciousness operates in this particular belief system of Sufis who tend to follow this phenomenon as a rule of obedience and accepts the rule because this is how their particular community proceeds on. This paper offers a view of Rumi’s poems which reflect such relationship and tends to offer a general discussion on the hegemonic approach of the Sufi society especially of the Mevlevi order. Finally, this paper offers a constructive representation of Mevlevi society based upon the idea of spirituality which could be an outcome of psychological and social issues and practices.

Keywords: collective consciousness, divinity, master-disciple relationship, Mevlevi order

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Authors: P. Panwalkar, K. Veravalli, M. Tofighi, A. Mofidi

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Introduction: Anterior femoral perforation or distal anterior nail position is a known complication of femoral nailing specifically in pertrochantric fractures fixed with cephalomedullary nail. This has been attributed to wrong entry point for the femoral nail, nail with large radius of curvature or malreduced fracture. Left alone anterior perforation of femur or abutment of nail on anterior femur will result in pain and risk stress riser at distal femur and periprosthetic fracture. There have been multiple techniques described to avert or correct this problem ranging from using different nail, entry point change, poller screw to deflect the nail position, use of shorter nail or use of curved guidewire or change of nail to ensure a nail with large radius of curvature Methods: We present this technique which we have used in order to centralise the femoral nail either when the nail has been put anteriorly or when the guide wire has been inserted too anteriorly prior to the insertion of the nail. This technique requires the use of femoral reduction spool from the nailing set. This technique was used by eight trainees of different level of experience under supervision. Results: This technique was easily reproducible without any learning curve without a need for opening of fracture site or change in the entry point with three different femoral nailing sets in twenty-five cases. The process took less than 10 minutes even when revising a malpositioned femoral nail. Conclusion: Our technique of using femoral reduction spool is easily reproducible and repeatable technique for avoidance of non-centralised femoral nail insertion and distal anterior perforation of femoral nail.

Keywords: femoral fracture, nailing, malposition, surgery

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Authors: Beryl Apondi Obola

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Introduction: Mosquitoes are known to transmit various diseases such as malaria, dengue fever, and Zika virus. Mosquito repellents are commonly used to prevent mosquito bites. However, some of these repellents contain chemicals that can be harmful to human health and the environment. Therefore, there is a need to find alternative mosquito repellents that are safe and effective. Objective: The objective of this research is to investigate the effectiveness of banana leaves as an alternative mosquito repellent on Plasmodium falciparum and Plasmodium vivax. Methodology: The research will be conducted in two phases. In the first phase, the repellent properties of banana leaves will be tested in a laboratory setting. The leaves will be crushed and mixed with water to extract the active ingredients. The extract will be tested against mosquitoes in a controlled environment. The number of mosquitoes that are repelled by the extract will be recorded. In the second phase, the effectiveness of the banana leaf extract will be tested in the field. The extract will be applied to the skin of human volunteers, and the number of mosquito bites will be recorded. The results will be compared to a commercially available mosquito repellent. Expected Outcomes: The expected outcome of this research is to determine whether banana leaves can be used as an effective mosquito repellent. If the results are positive, banana leaves could be used as an alternative to chemical-based mosquito repellents. Conclusion: Banana leaves have been used for various purposes in traditional medicine. This research aims to investigate the potential of banana leaves as an alternative mosquito repellent. The results of this research could have significant implications for public health and the environment

Keywords: banana leaf extract, mosquito repellant, plasmodium falciparum, public health

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Authors: Rui Du

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This paper attempts to assess the impact of a major sporting event —the Super Bowl on the local economies. The identification strategy is to compare the winning and losing cities at the National Football League (NFL) conference finals under the assumption of similar pre-treatment trends. The stock market performances of companies headquartered in these cities are used to capture the sudden changes in local economic activities during a short time span. The exogenous variations in the football game outcome allow a straightforward difference-in-differences approach to identify the effect. This study finds that the post-event trends in winning and losing cities diverge despite the fact that both cities have economically and statistically similar pre-event trends. Empirical analysis provides suggestive evidence of a positive, significant local economic impact of conference final wins, possibly through city image enhancement. Further empirical evidence shows the presence of heterogeneous effects across industrial sectors, suggesting that city image enhancing the effect of the Super Bowl participation is empirically relevant for the changes in the composition of local industries. Also, this study also adopts a similar strategy to examine the local economic impact of Super Bowl successes, however, finds no statistically significant effect.

Keywords: Super Bowl Participation, local economies, city image enhancement, difference-in-differences, industrial sectors

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Authors: Blanca Fatela Cantillo, Silvia Iglesias Cerrato, Guadalupe Garrido Ceca

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Purpose: Bleb dysfunction is a late complication following glaucoma filtration surgery. We describe our surgical technique for excision and reconstruction of a hypertrophic bleb complication using bovine pericardium patch graft (Tutopatch®) and amniotic membrane. Material and methods: The case report presents a hypertrophic bleb over the cornea with good intraocular pressure control. The hanging bleb without leak caused dysesthesia and high irregular astigmatism. Bleb reconstruction involved the excision of corneal fibrous material and avascular conjunctiva, preserving the original scleral and tennon. Bovine pericardium patch graft (Tutopatch®) was sited over these with fixed sutures, reinforcing the underlying scleral, and the conjunctiva advanced. The superior epithelium corneal defect was covered using an amniotic membrane. Conclusion: Repair of bleb dysfunction with varied techniques has been reported, including conjunctival advancement, use of scleral patch graft, dural patch graft, or pericardium. Additional use of amniotic membrane promotes epithelialization and exhibits anti-fibrotic and anti-inflammatory features. Reconstruction with bovine pericardium patch graft and amniotic membrane resulted in pain relief, visual rehabilitation, and good aesthetic results, with preservation of bleb function.

Keywords: reconstruction, hypertrophic bleb, bovine pericardium, amniotic membrane, dysesthesia of the bleb

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Authors: Reza Beheshti

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This paper examines remedies for defective manufactured goods in commercial circular economic transactions. The linear ‘take-make-dispose’ model fits well with the conventional remedial framework in which damages are considered the primary remedy. Damages under English Sales Law encourages buyers to look for a substitute seller with broadly similar goods to the ones agreed on in the original contract, enter into contract with this new seller and hence terminate the original contract. By doing so, the buyer ends the contractual relationship. This seems contrary to the core principles of the circular economy: keeping products, components, and materials in longer use, which can partly be achieved by product refurbishment. This process involves returning a product to good working condition by replacing or repairing major components that are faulty or close to failure and making ‘cosmetic’ changes to update the appearance of a product. This remedy has not been widely accepted or applied in commercial cases, which in turn flags up the secondary nature of performance-related remedies. This paper critically analyses the laws concerning the seller’s duty to cure in English law and the extent to which they correspond with core principles of the circular economy. In addition, this paper takes into account the potential of circular economic transactions being characterised as something other than sales. In such situations, the likely outcome will be a license to use products, which may limit the choice of remedy further. Consequently, this paper suggests an outline remedial framework specifically for commercial circular economic transactions in manufactured goods.

Keywords: circular economy, contract law, remedies, English Sales Law

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Authors: Tukundane Hillary

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This research paper analytically evaluates the project control practice levels used by the building construction companies within Kampala, Uganda. The research also assesses the outcome of project control practices on the productivity of the companies. The research was performed to ascertain the current control practices among 160 respondents from various construction companies registered with the Uganda Registration Services Bureau. This research used amalgamation from multiple literature to obtain the variables. The research adopts 34 standard control practices from four vital project control duties: planning, monitoring, analyzing, and reporting. These project control tasks were organized using mean response ratings grounded on their relevance to the construction companies. Results showed that evaluating performance with the use of curves (4.32), timely access to information and encouragement (4.55), report representation using quantitative tools 4.75, and cost value comparison application during analysis (4.76) were rated least among the control practices. On the other hand, the top project control practices included formulation of the project schedule (8.88), Project feasibility validation (8.86), Budgeting for each activity (8.84), Key project route definition (8.81), Team awareness of the budget (8.77), Setting realistic targets for projects (8.50) and Consultation from subcontractors (8.74). From the results obtained by the sample respondents specified, it can be concluded that planning is the most vital project control task practiced in the building construction industry in Uganda. In addition, this research ascertained a substantial relationship between project control practices and the performance of building construction companies. Accordingly, this research recommends that project control practices be effectively observed by both contracting and consulting companies to enhance their overall performance and governance.

Keywords: cost value, project control, cost control, time control, project performance, control practices

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

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

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

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Authors: Rohit Gupta, Ravinder Agarwal

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Surface electromyographic (sEMG) signal has the potential to identify the human activities and intention. This potential is further exploited to control the artificial limbs using the sEMG signal from residual limbs of amputees. The paper deals with the development of multichannel cost efficient sEMG signal interface for research application, along with evaluation of proposed class dependent statistical approach of the feature selection method. The sEMG signal acquisition interface was developed using ADS1298 of Texas Instruments, which is a front-end interface integrated circuit for ECG application. Further, the sEMG signal is recorded from two lower limb muscles for three locomotions namely: Plane Walk (PW), Stair Ascending (SA), Stair Descending (SD). A class dependent statistical approach is proposed for feature selection and also its performance is compared with 12 preexisting feature vectors. To make the study more extensive, performance of five different types of classifiers are compared. The outcome of the current piece of work proves the suitability of the proposed feature selection algorithm for locomotion recognition, as compared to other existing feature vectors. The SVM Classifier is found as the outperformed classifier among compared classifiers with an average recognition accuracy of 97.40%. Feature vector selection emerges as the most dominant factor affecting the classification performance as it holds 51.51% of the total variance in classification accuracy. The results demonstrate the potentials of the developed sEMG signal acquisition interface along with the proposed feature selection algorithm.

Keywords: classifiers, feature selection, locomotion, sEMG

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Authors: Pitchaporn Purngpiputtrakul, Suttasinee Petsakul, Sunisa Chatmongkolchart

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Nasogastric tube (NGT) insertion in anaesthetized and intubated patients can be challenging even for experienced anesthesiologists. Various techniques have been proposed to facilitate NGT insertion in these patients. This study aimed to compare the success rate and time required for NGT insertion between the GlideScope visualization and neck flexion with lateral neck pressure techniques. This randomized clinical trial was performed at a teaching hospital on 86 adult patients undergoing abdominal surgery under relaxant general anaesthesia who required intraoperative NGT insertion. The patients were randomized into two groups, the GlideScope group (group G) and the neck flexion with lateral neck pressure group (group F). The success rate of first and second attempts, duration of insertion, and complications were recorded. The total success rate was 79.1% in Group G compared with 76.7% in Group F (P=1) The median time required for NGT insertion was significantly longer in Group G, for both first and second attempts (97 vs 42 seconds P<0.001) and (70 vs 48.5 seconds P=0.015), respectively. Complications were reported in 23 patients (53.5%) in group G and 13 patients (30.2%) in group F. Bleeding and kinking were the most common complications in both techniques. Using GlideScope visualization to facilitate NGT insertion was comparable to neck flexion with lateral neck pressure technique in degree of success rate of insertion, while neck flexion with lateral neck pressure technique had fewer complications and was less time-consuming.

Keywords: anaesthesia, nasogastric tube, GlideScope, intubation

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Authors: Waqas Ahmad, Eisha Tahir, Shahper Aqeel, Imran Khalid Niazi, Amjad Iqbal

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Background: Breast conservation surgery applies a number of techniques for accurate localization of lesions. Wire localization remains the method of choice in non-palpable breast cancers post-neoadjuvant chemotherapy. Objective: The aim of our study was to determine the accuracy of wire localization procedures in our department and compare it with internationally set protocols as per the Royal College of Radiologists. Post wire mammography, as well as the margin status of the postoperative specimen, assessed the accuracy of the procedure. Methods: We retrospectively reviewed the data of 225 patients who presented to our department from May 2014 to June 2015 post neoadjuvant chemotherapy with non-palpable cancers. These patients are candidates for wire localized lumpectomies either under ultrasound or stereotactic guidance. Metallic marker was placed in all the patients at the time of biopsy. Post wire mammogram was performed in all the patients and the distance of the wire tip from the marker was calculated. The presence or absence of the metallic clip in the postoperative specimen, as well as the marginal status of the postoperative specimen, was noted. Results: 157 sonographic and 68 stereotactic wire localization procedures were performed. 95% of the wire tips were within 1 cm of the metallic marker. Marginal status was negative in 94% of the patients in histopathological specimen. Conclusion: Our audit report declares more than 95% accuracy of image guided wire localization in successful excision of non-palpable breast lesions.

Keywords: breast, cancer, non-palpable, wire localization

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Authors: Shikha Gupta, Suneet Kathuria, Supriya Sampley, Sunil Katyal

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Opioids are being increasingly used these days as adjuvants to local anesthetics in spinal anesthesia. The aim of this prospective, randomized, double‑blind study is to compare the effects of adding sufentanil or fentanyl to low dose bupivacaine in spinal anesthesia for endoscopic urological procedures. A total of 90 elective endoscopic urological surgery patients, 40‑80 years old, received spinal anesthesia with 7.5 mg hyperbaric bupivacaine 0.5% (Group A) or by adding sufentanil 10 μg (Group B) or fentanyl 25 μg (Group C) to 5 mg hyperbaric bupivacaine 0.5%. These groups were compared in terms of the quality of spinal anesthesia as well as analgesia. Analysis of variance and Chi‑square test were used for Statistical analysis. The onset of sensory and motor blockade was significantly rapid in Group A as compared with Groups B and C. The maximum upper level of sensory block was higher in Group A patients than Groups B and C patients. Quality of analgesia was significantly better and prolonged in sufentanil group as compared with other two groups. Motor block was more intense and prolonged in Group A as compared with Groups B and C patients. Request for post‑operative analgesic was significantly delayed in Group B patients. Hence in conclusions, spinal anesthesia for endoscopic urological procedures in elderly patients using low dose bupivacaine (5 mg) combined with 10 μg sufentanil is associated with a lower incidence of hemodynamic instability, better quality and prolonged duration as compared to that by adding 25 μg fentanyl.

Keywords: adjuvants, bupivacaine, fentanyl, intrathecal, low dose spinal, sufentanil

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Authors: Van-Thanh Ho, Hyoungsoon Lee, Jaiyoung Ryu

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Efficient pressure distribution within soft robotic systems, specifically to the pneumatic artificial muscle (PAM) regions, is essential to minimize energy consumption. This optimization involves adjusting reservoir pressure, pipe diameter, and branching network layout to reduce flow speed and pressure drop while enhancing flow efficiency. The outcome of this optimization is a lightweight power source and reduced mechanical impedance, enabling extended wear and movement. To achieve this, a branching network system was created by combining pipe components and intricate cross-sectional area variations, employing the principle of minimal work based on a complete virtual human exosuit. The results indicate that modifying the cross-sectional area of the branching network, gradually decreasing it, reduces velocity and enhances momentum compensation, preventing flow disturbances at separation regions. These optimized designs achieve uniform velocity distribution (uniformity index > 94%) prior to entering the connection pipe, with a pressure drop of less than 5%. The design must also consider the length-to-diameter ratio for fluid dynamic performance and production cost. This approach can be utilized to create a comprehensive PAM system, integrating well-designed tube networks and complex pneumatic models.

Keywords: pneumatic artificial muscles, pipe networks, pressure drop, compressible turbulent flow, uniformity flow, murray's law

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Authors: Lovro Štefan

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The main purpose of the present study was to investigate the associations between the overweight/obesity status and lifestyle factors. In this cross-sectional study, participants were 1950 urban secondary-school students (54.7% of female students) aged 17-18 years old. Dependent variable was body-mass index status derived from self-reported height and weight. The outcome was binarised, where participants with value <25 kg/m2 were collapsed into „normal“, while those ≥25 kg/m2 into „overweight/obesity“ category. Independent variables were gender, type of school, physical activity, sedentary behaviour, self-rated health, self-perceived socioeconomic status and psychological distress. The associations between the dependent and independent variables were analyzed by using multiple logistic regression analysis. In the univariate model, being overweight/obese was significantly associated with being a male student (OR 0.31; 95% CI 0.23 to 0.42), attending a vocational school (OR 1.87; 95% CI 1.42 to 2.48), not meeting the recommendations for moderate-to-vigorous physical activity (OR 0.44; 95% CI 0.22 to 0.88), more time spending in sedentary behaviour (OR 1.53; 95% CI 1.07 to 2.19), poor self-rated health (OR 0.35, 95% CI 0.20 to 0.56) and lower socioeconomic status (OR 0.63; 95% CI 0.48 to 0.84). In the multivariate model, the same associations occured between the dependent and independent variable. In both models, psychological distress was not associated with being overweight/obese. In conclusion, our findings suggest, that lifestyle factors are independently associated with body-mass index

Keywords: body mass index, secondary-school students, Croatia, physical activity, sedentary behaviour, logistic regression

Procedia PDF Downloads 86

Authors: Busiswa Madikazi

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This systematic mapping study explores the underrepresentation of women's contributions to farming in the Global South within the development of Information and Communication Technologies (ICT)-based extension methods. Despite women farmers constituting 70% of the agricultural labour force, their productivity is hindered by various constraints, including illiteracy, household commitments, and limited access to credit and markets. A systematic mapping approach was employed with the aim of identifying evidence gaps in existing ICT extension for women farmers. The data collection protocol follows a structured approach, incorporating key criteria for inclusion, exclusion, search strategy, and coding and the PICO strategy (Population, Intervention, Comparator, and Outcome). The results yielded 119 articles that qualified for inclusion. The findings highlight that mobile phone apps (WhatsApp) and radio/television programming are the primary extension methods employed while integrating ICT with training, field visits, and demonstrations are underutilized. Notably, the study emphasizes the inadequate attention to critical issues such as food security, gender equality, and attracting youth to farming within ICT extension efforts. These findings indicate a significant policy and practice gap, neglecting community-driven approaches that cater to women's specific needs and enhance their agricultural production. Map highlights the importance of refocusing ICT extension efforts to address women farmers’ unique challenges, thereby contributing to their empowerment and improving agricultural practices.

Keywords: agricultural extension, ICT, women farmers, smallholders

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Authors: Manal Al Bahri, Saif Al Mubahisi, Shamsa Al Shahaimi, Asma Al Qasabi, Jamal Al Aghbari

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Introduction: ILD is a common disease worldwide and in Oman. No previous Omani study was published regarding ILD prognosis based on baseline PFT results and other factors. This study aims to determine the severity of ILD by the baseline PFT, correlate between baseline PFT and outcome, and study other factors that influence disease mortality. Method: It is a retrospective cohort study; data was collected from January 2011 to December 2021 from electronic patient records (EPR). Means, Standard Deviations, frequencies, and Chi-square tests were used to examine the different variables in the study. Results: The total population of the study was 146 patients; 87 (59.6%) were females, and 59 (40.4%) were males. The median age was 59 years. Age at diagnosis, CVA, rheumatological disease, and baseline FVC were found to be statistically significant predictors of mortality .59.6% of the patients are diagnosed with IPF. Most of our study patients had mild disease based on baseline FVC. Death was higher with the more severe disease based on FVC. In mild disease (FVC >70%), 26.9% of the patients died. In moderate disease (FVC 50-69%),55.7% of the patients died, and in the severe group (FVC <50 %), 55.1% died. This was statistically significant with a P value of 0. 001. There is no statistically significant difference in the overall survival distribution between the different groups of DLCO. Conclusion: In our study, we found that ILD is more common among females, but death is more common among males. Based on baseline PFT, we can predict mortality by FVC level, as moderate to severe limitation is associated with a lower survival rate. DLCO was not a statistically significant parameter associated with mortality.

Keywords: PFT, ILD, FVC, DLCO, mortality

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Authors: Karim Hajjar, Luis Lillo, Diego Martinez, Manuel Hermosilla, Nicholas Risko

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Objectives: This study examines the relationship between universal health coverage (UCH) and the burden of emergency diseases at a global level. Methods: Data on Disability-Adjusted Life Years (DALYs) from emergency conditions were extracted from the Institute for Health Metrics and Evaluation (IHME) database for the years 2015 and 2019. Data on UHC, measured using two variables, 1) coverage of essential health services and 2) proportion of population spending more than 10% of household income on out-of-pocket health care expenditure, was extracted from the World Bank Database for years preceding our outcome of interest. Linear regression was performed, analyzing the effect of the UHC variables on the DALYs of emergency diseases, controlling for other variables. Results: A total of 133 countries were included. 44.4% of the analyzed countries had coverage of essential health services index of at least 70/100, and 35.3% had at least 10% of their population spend greater than 10% of their household income on healthcare. For every point increase in the coverage of essential health services index, there was a 13-point reduction in DALYs of emergency medical diseases (95% CI -16, -11). Conversely, for every percent decrease in the population with large household expenditure on healthcare, there was a 0.48 increase in DALYs of emergency medical diseases (95% CI -5.6, 4.7). Conclusions: After adjusting for multiple variables, an increase in coverage of essential health services was significantly associated with improvement in DALYs for emergency conditions. There was, however, no association between catastrophic health expenditure and DALYs.

Keywords: emergency medicine, universal healthcare, global health, health economics

Procedia PDF Downloads 89