Search results for: therapeutic assessment

Authors: Courtney Evans, Yuto Morimitsu, Tsubasa Hisadome, Futo Inomoto, Masahiro Yoshida, Takayuki Takei

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Hydrogels are useful biomaterials due to their highly biocompatible nature and their ability to absorb large quantities of liquid and mimic soft tissue. They are often used as therapeutic drug delivery systems. However, it is sometimes difficult to sustain controlled release when using hydrophobic medicines, as hydrogels are frequently hydrophilic. As such, this research shows the success of chitosan hydrogels modified through hydrophobic interaction. This was done through the imide bonding of the alkyl groups in fatty aldehydes and the amino groups in chitosan, followed by reductive animation. The resulting cryogels could be optimized for strength as well as sorption and desorption (of a hydrophobic dye used to mimic hydrophobic medicine) by varying the alkyl chain length and the substitution degree of the fatty aldehyde. Optimized cryogels showed potential as biomedical materials, particularly as drug delivery systems.

Keywords: biomedical materials, chitosan, drug carriers, hydrophobic modification

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Authors: Mostosi C., Stéphenne J., Kempeneers E.

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Introduction: Refuellers from Brussels South Charleroi Airport (BSCA) expressed concerns about the risks involved in handling JET-A1 fuel. The HSE Manager of BSCA, in collaboration with the occupational physician and the industrial hygiene unit of the External Service of Occupational Medicine, decided to assess the toxicological exposure of these workers. Materials and methods: Two measurement methods were used. The first was to assay three types of metabolites in urine to highlight the exposure to xylenes, toluene, and benzene in aircraft fuels. Out of 32 refuellers in the department, 26 participated in the sampling, and 23 samples were exploited. The second method targeted the assessment of environmental exposure to certain potentially hazardous substances that refuellers are likely to breathe in work areas at the airport. It was decided to carry out two ambient air measurement campaigns, using static systems on the one hand and, on the other hand, using individual sensors worn by the refuellers at the level of the respiratory tract. Volatile organic compounds and diesel particles were analyzed. Results: Despite the fears that motivated these analyzes, the overall results showed low levels of exposure, far below the existing limit values, both in air quality and in urinary measurements. Conclusion: These results are comparable to a study carried out in several French airports. The staff could be reassured, and then the medical surveillance was modified by the occupational physician. With the aviation development at BSCA, equipment and methods are evolving. Their exposure will have to be reassessed.

Keywords: refuelling, airport, exposure, fuel, occupational health, air quality

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Authors: Rezvan Najafi, Korosh Heydari, Massoud Saidijam

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5-FU is a chemotherapeutic agent that has been used in colorectal cancer (CRC) treatment. However, it is usually associated with the acquired resistance, which decreases the therapeutic effects of 5-FU. miR-200c is involved in chemotherapeutic drug resistance, but its mechanism is not fully understood. In this study, the effect of inhibition of miR-200c in sensitivity of HCT-116 CRC cells to 5-FU was evaluated. HCT-116 cells were transfected with LNA-anti- miR-200c for 48 h. mRNA expression of miR-200c was evaluated using quantitative real- time PCR. The protein expression of phosphatase and tensin homolog (PTEN) and E-cadherin were analyzed by western blotting. Annexin V and propidium iodide staining assay were applied for apoptosis detection. The caspase-3 activation was evaluated by an enzymatic assay. The results showed LNA-anti-miR-200c inhibited the expression of PTEN and E-cadherin protein, apoptosis and activation of caspase 3 compared with control cells. In conclusion, these results suggest that miR-200c as a prognostic marker can overcome to 5-FU chemoresistance in CRC.

Keywords: colorectal cancer, miR-200c, 5-FU resistance, E-cadherin, PTEN

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Authors: Mamta Rana, K. K. Singh, Nisha Kumari

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The simulation models with its soil-weather-plant atmosphere interacting system are important tools for assessing the crops in changing climate conditions. The CERES-Wheat & Rice vs. 4.6 DSSAT was calibrated and evaluated for one of the major producers of wheat and rice state- Haryana, India. The simulation runs were made under irrigated conditions and three fertilizer applications dose of N-P-K to estimate crop yield and other growth parameters along with the phenological development of the crop. The genetic coefficients derived by iteratively manipulating the relevant coefficients that characterize the phenological process of wheat and rice crop to the best fit match between the simulated and observed anthesis, physological maturity and final grain yield. The model validated by plotting the simulated and remote sensing derived LAI. LAI product from remote sensing provides the edge of spatial, timely and accurate assessment of crop. For validating the yield and yield components, the error percentage between the observed and simulated data was calculated. The analysis shows that the model can be used to simulate crop yield and yield components for wheat and rice cultivar under different management practices. During the validation, the error percentage was less than 10%, indicating the utility of the calibrated model for climate risk assessment in the selected region.

Keywords: simulation model, CERES-wheat and rice model, crop yield, genetic coefficient

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Authors: Dionisios Panagiotaras, Ioannis P. Kokkoris, Dionysios Koulougliotis, Dimitra Lekka, Alexandra Skalioti

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In the summer of 2021, Greece was affected by devastating forest fires in various regions of the country, resulting in human losses, destruction or degradation of the natural environment, infrastructure, livestock and cultivations. The present study concerns a pilot assessment of natural vegetation regeneration in the second, in terms of area, fire-affected region for 2021, at Ancient Olympia area, located in West Peloponnisos (Ilia Prefecture), Greece. A standardised field sampling protocol for assessing natural regeneration was implemented at selected sites where the forest fire had occurred previously (in 2007), and the vegetation (Pinus halepensis forest) had regenerated naturally. The results of the study indicate the loss of the established natural regeneration of Pinus halepensis forest, as well as of the tree-layer in total. Post-fire succession species are recorded to the shrub and the herb layer, with a varying cover. Present findings correspond to the results of field work and analysis one year after the fire, which will form the basis for further research and conclusions on taking action for restoration schemes in areas that have been affected by fire more than once within a 20-year period.

Keywords: forest, pinus halepensis, ancient olympia, post fire vegetation

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Authors: N. J. Shanono, J. G. Ndiritu

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The poor performance of water resource systems (WRS) has been reportedly linked to not only climate variability and the water demand dynamics but also human behaviour-driven unlawful activities. Some of these unlawful activities that have been adversely affecting water sector include unauthorized water abstractions, water wastage behaviour, refusal of water re‐use measures, excessive operational losses, discharging untreated or improperly treated wastewater, over‐application of chemicals by agricultural users and fraudulent WRS operation. Despite advances in WRS planning, operation, and analysis incorporating such undesirable human activities to quantitatively assess their impact on WRS performance remain elusive. This study was then inspired by the need to develop a methodological framework for WRS performance assessment that integrates the impact of human behaviour with WRS performance assessment analysis. We, therefore, proposed a conceptual framework for assessing the impact of human behaviour on WRS performance using the concept of socio-hydrology. The framework identifies and couples four major sources of WRS-related values (water values, water systems, water managers, and water users) using three missing links between human and water in the management of WRS (interactions, outcomes, and feedbacks). The framework is to serve as a database for choosing relevant social and hydrological variables and to understand the intrinsic relations between the selected variables to study a specific human-water problem in the context of WRS management.

Keywords: conceptual framework, human behaviour; socio-hydrology; water resource systems

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Authors: Pedro Dias, Lurdes Verissimo, Maria Joao Baptista, Ana Pinheiro, Patricia Oliveira-Silva, Sofia Serra, Daniela Coimbra

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To achieve a high standard in performance, a musician must be well in all aspects of health (physical, mental and social). Anxiety in performance is related to the high level of coordination and skill needed in performance, as well as to the public evaluation of the performer. It affects some key elements of performance, such as concentration, memory, motor coordination, and relaxation. This work presents two studies focused on the adaptation and evaluation of the psychometric properties of the Music Performance Anxiety Inventory (MPAI-A) in young Portuguese music students. The first study was conducted with a sample of 161 adolescent music students, who responded to the Portuguese version of this instrument, and to the State-Trait Anxiety Inventory for Children (STAIC-c2). Validity and reliability were examined, and this measure revealed robust psychometric properties in this sample. The second study aimed to adapt the MPAI to a younger population (one hundred 8-10 years-old music students). Again, the MPAI and the STAIC c-2 were used in this study. Exploratory factor analysis, correlations, and internal consistency were used to evaluate the final children version of the instrument (MPAI-C), presenting a different factor structure compared to the adolescent version (10 items organized in 2 factors) and high levels of reliability and convergent validity.

Keywords: anxiety, assessment, children and adolescents, music performance

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Authors: Simone Galati, Adriano Troia

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Ultrasound (US) is widely used in medical field for a variety diagnostic techniques but, in recent years, it has also been creating great interest for therapeutic aims. Regarding drug delivery, the use of US as an activation source provides better spatial delivery confinement and limits the undesired side effects. However, at present there is no complete characterization at a fundamental level of the different signals produced by sono-activated nanocarriers. Therefore, the aim of this study is to obtain a metrological characterization of the cavitation phenomena induced by US through three parallel investigation approaches. US was focused into a channel of a customized phantom in which a solution with oxygen-loaded nanodroplets (OLNDs) was led to flow and the cavitation activity was monitored. Both quantitative and qualitative real-time analysis were performed giving information about the dynamics of bubble formation, oscillation and final implosion with respect to the working acoustic pressure and the type of nanodroplets, compared with pure water. From this analysis a possible interpretation of the observed results is proposed.

Keywords: cavitation, drug delivery, nanodroplets, ultra-sound

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Authors: Samuel Oludayo Alamu, Seong Lee

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The need for generating energy from biomass in an efficient way as well as maximizing the yield of total energy from the thermal conversion process has been a major concern for researchers. A holistic approach which involves the combination of First law of thermodynamics (FLT) and the second law of thermodynamics (SLT) is required for conducting an effective assessment of an energy plant since FLT analysis alone fails to identify the quality of the dissipated energy and how much work potential is available. The overall purpose of this study is to investigate the exergy analysis of direct combustion of poultry waste being converted to energy with a handful of environmental assessment of the conversion processes in order to maximize thermal efficiency. The exergy analysis around the shell and tube heat exchanger (STHE) was investigated primarily by varying the operating parameters for different tube shapes and flow direction, and an exergy model was obtained from estimations of the higher heating value and standard entropy of poultry waste from the elemental compositions. The STHE was designed and fabricated by Lee Research Group at Morgan State University. The analysis conducted on theSTHE using the flue gas temperature entering and exiting show that only about one-third of the energy input to the STHE was available to do work with an overall efficiency of 13.8%, while a huge amount was lost to the surrounding. By recirculating the flue gas, the exergy efficiency of the combustion system can be maximized with a greater reduction in the amount of exergy loss.

Keywords: exergy analysis, shell and tube heat exchanger, thermodynamics, combustion system, thermal efficiency

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Authors: Muhammad Arslan, Michael A. Kaminski, Bassam S. Tawabini, Fabrizio Frontalini

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We conducted a survey of living benthic foraminifera in a relatively unpolluted site of Bahrain in the Arabian Gulf, with the aim of determining the seasonal variability in their populations, as well as various environmental parameters that affect their distribution. The maximum standing crop was observed during winter, with highest population of rotaliids, followed by a peak in miliolids. The highest population is attributed to an increasing number juveniles observed along the depth transect. A strong correlation between sediment grain size and the foraminiferal population indicates that juveniles were most abundant on coarser sandy substrate and less abundant on fine substrate. In spring, the total living population decreased, and lowest values are observed in the summer. The population started to increase again in the autumn with highest juveniles/adult ratios. Moreover, results of relative abundance and species consistency show that Ammonia is found to be consistent from the shallowest to the deepest station, whereas miliolids start appearing in the deeper stations. The average numbers of Peneroplis and Elphidium also increases along the depth transect. Environmental characterization reveals that although the site is subjected to eutrophication caused by nitrates and sulfates, pollution caused by hydrocarbons and heavy metals is not significant. The assessment of 63 heavy metals showed that none of the metals had concentrations that exceed internationally accepted norms [the devised level of Effect Range-Low], with the exception of strontium. The lack of a significant environmental effect of heavy metals is confirmed by a Foraminiferal Deformities Index value of less than 2%. Likewise, no hydrocarbon contamination was detected in the water or sediment samples. Lastly, observations of cytoplasmic streaming and pseudopodial activity in Petri dishes suggest that the foraminiferal population is not stressed. We conclude that the site in Bahrain is not yet adversely affected by human development, and therefore can provide baseline information for future comparison and assessment of foraminiferal assemblages in contaminated zones of the Arabian Gulf.

Keywords: Arabian Gulf, benthic foraminifera, standing crop, Western Bahrain

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Authors: Naziema B. Jappie

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The objective of this study is to examine the relationship between college readiness characteristics and learning outcome assessment scores. About this, it is important to examine the first-year retention and success rate. In order to undertake this study, it will be necessary to look at proficiency levels on general and domain-specific knowledge and skills reflected on national benchmark test scores (NBT), in-college interventions and course-taking patterns. Preliminary results based on data from more than 1000 students suggest that there is a positive association between NBT scores and students’ 1st-year college GPA and their retention status. For example, 63% of students with a proficient level of math skills in the NBT had the highest level of GPA at the end of 1st-year of college in comparison to 56% of those who started with a primary or intermediate level, respectively. The retention rates among those with proficiency levels were also higher than those with basic or intermediate levels (98% vs. 93% and 88%, respectively). By the end of 3rd year in college, students with intermediate or proficient entering NBT math skills had 7% and 8% of dropout rate, compared to 14% for those started at primary level; a greater percentage of students qualified by the end of 3rd-year qualified among proficient students than that among intermediate or basic level students (50% vs. 44% and 27% respectively). The findings of this study added knowledge to the field in South Africa and are expected to help stakeholders and policymakers to better understand college learning and challenges for students with disadvantaged backgrounds and provide empirical evidence in support of related practices and policies.

Keywords: assessment, data analysis, performance, proficiency, policy, student success

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Authors: Mariola Głowacka

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Aim: The aim of this study was to present the assessment of dyspnea and anxiety in seniors staying in the hospice in the context of the nurse's tasks. Materials and methods: The presented research was carried out at the "Hospicjum Płockie" Association of St. Urszula Ledóchowska in Płock, in a stationary ward, for adults. The research group consisted of 100 people, women, and men. In the study described in this paper, the method of diagnostic survey, the method of estimation and analysis of patient records were used, and the research tools were the numerical scale of the NRS assessment, the modified Borg scale to assess dyspnea, the Trait Anxiety scale to test the intensity of anxiety and the sociodemographic assessment of the respondent. Results: Among the patients, the greatest number were people without dyspnoea (38 people) and with average levels of dyspnoea (26 people). People with lung cancer had a higher level of breathlessness than people with other cancers. Half of the patients included in the study felt anxiety at a low level. On average, men had a higher level of anxiety than women. Conclusion: 1) Patients staying in the hospice require comprehensive nursing care due to the underlying disease, comorbidities, and a wide range of medications taken, which aggravate the feeling of dyspnea and anxiety. 2) The study showed that in patients staying in the hospice, the level of dyspnea was of varying severity. The greatest number of people were without dyspnea (38) and patients with a low level of dyspnea (34). There were 12 people experiencing an average level of dyspnea and a high level of dyspnea 15. 3) The main factor influencing the severity of dyspnea in patients was the location of cancer. There was no significant relationship between the intensity of dyspnea and the age, gender of the patient, and time from diagnosis. 4) The study showed that in patients staying in the hospice, the level of anxiety was of varying severity. Most people experience a low level of anxiety (51). There were 16 people with a high level of anxiety, while there were 33 people experiencing anxiety at an average level. 5) The patient's gender was the main factor influencing the increase in anxiety intensity. Men had higher levels of anxiety than women. There was no significant correlation between the intensity of anxiety and the age of the respondents, as well as the type of cancer and time since diagnosis. 6) The intensity of dyspnea depended on the type of cancer the subjects had. People with lung cancer had a higher level of breathlessness than those with breast cancer and bowel cancer. It was not found that the anxiety increased depending on the type of cancer and comorbidities of the examined person.

Keywords: cancer, shortness of breath, anxiety, senior, hospice

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Authors: Ritesh K. Shukla

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Degradation of biological samples in terms of macromolecules (DNA, RNA, and protein) are the major challenges in the forensic investigation which misleads the result interpretation. Currently, there are no precise methods available to circumvent this problem. Therefore, at the preliminary level, some methods are urgently needed to solve this issue. In this order, Comet assay is one of the most versatile, rapid and sensitive molecular biology technique to assess the DNA degradation. This technique helps to assess DNA degradation even at very low amount of sample. Moreover, the expedient part of this method does not require any additional process of DNA extraction and isolation during DNA degradation assessment. Samples directly embedded on agarose pre-coated microscopic slide and electrophoresis perform on the same slide after lysis step. After electrophoresis microscopic slide stained by DNA binding dye and observed under fluorescent microscope equipped with Komet software. With the help of this technique extent of DNA degradation can be assessed which can help to screen the sample before DNA fingerprinting, whether it is appropriate for DNA analysis or not. This technique not only helps to assess degradation of DNA but many other challenges in forensic investigation such as time since deposition estimation of biological fluids, repair of genetic material from degraded biological sample and early time since death estimation could also be resolved. With the help of this study, an attempt was made to explore the application of well-known molecular biology technique that is Comet assay in the field of forensic science. This assay will open avenue in the field of forensic research and development.

Keywords: comet assay, DNA degradation, forensic, molecular biology

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Authors: Jen-Te Pai, Jao-Heng Liu, Shin-En Pai

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The impact of climate change has intensified in recent years, causing Taiwan to face higher frequency and serious natural disasters. Therefore, it is imperative for industrial parks manufacturers to promote adaptation policies in response to climate change. On the other hand, with the rise of the international anti-terrorism situation, once a terrorist attack occurs, it will attract domestic and international media attention, especially the strategic and economic status of the science park. Thus, it is necessary to formulate adaptation and mitigation strategies under climate change and social economic disasters. After reviewed the literature about climate change, urban disaster prevention, vulnerability assessment, and risk communication, the study selected 62 industrial parks compiled by the Industrial Bureau of the Ministry of Economic Affairs of Taiwan as the research object. This study explored the vulnerability and disaster prevention and disaster relief functional assessment of these industrial parks facing of natural and socio-economic disasters. Furthermore, this study explored planned adaptation of industrial parks management section and autonomous adaptation of corporate institutions in the park. The conclusion of this study is that Taiwan industrial parks with a higher vulnerability to natural and socio-economic disasters should employ positive adaptive behaviours.

Keywords: adaptive behaviours, analytic network process, vulnerability, industrial parks

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Authors: Li-Ting Kung, Hui-Zhu Chen, Hsin-Tzu Lee, Wan-Yin Hsu

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Patients with spinal cord injury combined with diabetic nephropathy may under a lot of painful conditions due to complications related to the illness itself or treatments, such as recurrent pressure ulcers, autonomic and peripheral neuropathy, as well as dialysis, for long term. This case report illustrated the nursing experience of transferring a spine cord injure patient who received hemodialysis due to adverse lifestyle-induced diabetic nephropathy to the hospice ward. Nursing care was provided in this patient from July 25th to August 30th, 2015. The tool of 'Gordon’s 11-item functional health assessment' and clinical observation, interviews as well as physical examination were used as data collections. Based on results of health assessment as above, the patient’s health problems were identified as the following: impaired skin integrity, chronic pain, and hopeless. Besides to relieve the symptom of pain due to disease or the treatment of hemodialysis and provide wound care, the first author also played a role to assist the patient to achieve his goal of receiving the hospice palliative care. Finally, with much effort of nurses to communicate with medical teams between the surgical and hospice wards, the patient was transferred to the hospice ward to have fulfilled his last wish of having a good death. We hope this nursing experience can be applied to other similar cases in the future.

Keywords: diabetic nephropathy, hospice care, palliative care, spinal cord injury

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Authors: Karen L. Lindsay, Sonja Entringer, Claudia Buss, Pathik D. Wadhwa

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Maternal nutrition and stress are independently recognized as among the most important factors that influence prenatal biology, with implications for fetal development and poor pregnancy outcomes. While there is substantial evidence from non-pregnancy human and animal studies that a complex, bi-directional relationship exists between nutrition and stress, to the author’s best knowledge, their interaction in the context of pregnancy has been significantly understudied. The aim of this study is to assess the interaction between maternal psychological stress and diet quality across pregnancy and its effects on biomarkers of prenatal insulin resistance and inflammation. This is a prospective longitudinal study of N=235 women carrying a healthy, singleton pregnancy, recruited from prenatal clinics of the University of California, Irvine Medical Center. Participants completed a 4-day ambulatory assessment in early, middle and late pregnancy, which included multiple daily electronic diary entries using Ecological Momentary Assessment (EMA) technology on a dedicated study smartphone. The EMA diaries gathered moment-level data on maternal perceived stress, negative mood, positive mood and quality of social interactions. The numerical scores for these variables were averaged across each study time-point and converted to Z-scores. A single composite variable for 'STRESS' was computed as follows: (Negative mood+Perceived stress)–(Positive mood+Social interaction quality). Dietary intakes were assessed by three 24-hour dietary recalls conducted within two weeks of each 4-day assessment. Daily nutrient and food group intakes were averaged across each study time-point. The Alternative Healthy Eating Index adapted for pregnancy (AHEI-P) was computed for early, middle and late pregnancy as a validated summary measure of diet quality. At the end of each 4-day ambulatory assessment, women provided a fasting blood sample, which was assayed for levels of glucose, insulin, Interleukin (IL)-6 and Tumor Necrosis Factor (TNF)-α. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was computed. Pearson’s correlation was used to explore the relationship between maternal STRESS and AHEI-P within and between each study time-point. Linear regression was employed to test the association of the stress-diet interaction (STRESS*AHEI-P) with the biological markers HOMA-IR, IL-6 and TNF-α at each study time-point, adjusting for key covariates (pre-pregnancy body mass index, maternal education level, race/ethnicity). Maternal STRESS and AHEI-P were significantly inversely correlated in early (r=-0.164, p=0.018) and mid-pregnancy (-0.160, p=0.019), and AHEI-P from earlier gestational time-points correlated with later STRESS (early AHEI-P x mid STRESS: r=-0.168, p=0.017; mid AHEI-P x late STRESS: r=-0.142, p=0.041). In regression models, the interaction term was not associated with HOMA-IR or IL-6 at any gestational time-point. The stress-diet interaction term was significantly associated with TNF-α according to the following patterns: early AHEI-P*early STRESS vs early TNF-α (p=0.005); early AHEI-P*early STRESS vs mid TNF-α (p=0.002); early AHEI-P*mid STRESS vs mid TNF-α (p=0.005); mid AHEI-P*mid STRESS vs mid TNF-α (p=0.070); mid AHEI-P*late STRESS vs late TNF-α (p=0.011). Poor diet quality is significantly related to higher psychosocial stress levels in pregnant women across gestation, which may promote inflammation via TNF-α. Future prenatal studies should consider the combined effects of maternal stress and diet when evaluating either one of these factors on pregnancy or infant outcomes.

Keywords: diet quality, inflammation, insulin resistance, nutrition, pregnancy, stress, tumor necrosis factor-alpha

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Authors: Aamna Tufail, Catherine Anyanwu

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Introduction/Aims: Neurosensory deficits following third molar removal affect the quality of life markedly. The purpose of this audit was to evaluate the incidence of IDN and LN damage and to compare departmental rates to an established standard. A secondary objective was to provide a descriptive summary of identified cases for clinical learning. Materials and Methods: A retrospective audit was conducted by a telephone survey of 101 patients who had third molar extractions performed under LA, IVS, or GA from January 2019 to June 2020 at a District General Hospital. The results were compared to a clinical standard identified as Cheng et al1. Data collection included mode of surgery, mode of anaesthesia, grade of clinician, assessment of difficulty, severity, and duration of symptoms. Results/Statistics: A total of 101 patients had 136 third molars extracted. Age range was 18-84 years. 44% extractions were under LA, 52% under GA, and 4% under IV sedation. 30% were simple extractions, 68% were surgical removals, 2% were unspecified. 89% extractions were performed by an Associate Specialist, 5% by a consultant, and 6% by unspecified grade of clinician. The rate of IDN injuries was 2.9% (n=4), higher than standard (0.3%). The rate of LN injuries was 0.7% (n=1), same as standard (0.7%). The 5 cases of neurosensory deficits are discussed in detail. Conclusions/Clinical Relevance: The rate of ID nerve injuries was higher than the standard. The rate of LN complications was lower than the standard.

Keywords: inferior dental nerve, lingual nerve, nerve injuries, third molars

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Authors: Boitumelo Ditshwane, Zelda Janse van Rensburg, Wanda Jacobs,

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Health literacy is defined as competencies and skills that individuals need to find, comprehend, evaluate, and use to make knowledgeable choices to improve their health and well-being. Low health literacy has been found to affect people’s ability to take care of their own health. Incomprehension of health education and health care instructions due to low health literacy is often due to information given at a level that is above the patient’s level of understanding. The study aimed to test the health literacy levels of South African PHC patients using a previously developed health literacy assessment tool. Determining health literacy levels may assist PHC nurses in providing health education and health care instructions to the patient on the patient’s level of understanding and, therefore, ensuring positive health outcomes for the patient. A health literacy assessment tool, translated into ten official South African languages, was used to quantitatively determine the health literacy levels of 400 PHC patients in five clinics in Gauteng, South Africa. Patients’ health literacy levels were tested in English, and nine other official languages spoken in South Africa and were compared. The results revealed that patients understand information better when given in their preferred language. Giving health education in a language and level that is better understood by the patient may lead to better health outcomes and prevent adverse health. Patients may better understand instructions provided, be more likely to follow the correct route of medication, honor appointments, comply with medication, and thus have better treatment outcomes.

Keywords: health literacy, primary health care, South Africa, patients

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Authors: Marzouk Benali, Jawad Jeaidi, Behrang Mansoornejad, Olumoye Ajao, Banafsheh Gilani, Nima Ghavidel Mehr

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Canadian forest industry is seeking to identify and implement transformational strategies for enhanced financial performance through the emerging bioeconomy or more specifically through the concept of the biorefinery. For example, processing forest residues or surplus of biomass available on the mill sites for the production of biofuels, biochemicals and/or biomaterials is one of the attractive strategies along with traditional wood and paper products and cogenerated energy. There are many possible process-product biorefinery pathways, each associated with specific product portfolios with different levels of risk. Thus, it is not obvious which unique strategy forest industry should select and implement. Therefore, there is a need for analytical and design tools that enable evaluating biorefinery strategies based on a set of criteria considering a perspective of sustainability over the short and long terms, while selecting the existing core products as well as selecting the new product portfolio. In addition, it is critical to assess the manufacturing flexibility to internalize the risk from market price volatility of each targeted bio-based product in the product portfolio, prior to invest heavily in any biorefinery strategy. The proposed paper will focus on introducing a systematic methodology for designing integrated biorefineries using process systems engineering tools as well as a multi-criteria decision making framework to put forward the most effective biorefinery strategies that fulfill the needs of the forest industry. Topics to be covered will include market analysis, techno-economic assessment, cost accounting, energy integration analysis, life cycle assessment and supply chain analysis. This will be followed by describing the vision as well as the key features and functionalities of the I-BIOREF software platform, developed by CanmetENERGY of Natural Resources Canada. Two industrial case studies will be presented to support the robustness and flexibility of I-BIOREF software platform: i) An integrated Canadian Kraft pulp mill with lignin recovery process (namely, LignoBoost™); ii) A standalone biorefinery based on ethanol-organosolv process.

Keywords: biorefinery strategies, bioproducts, co-production, multi-criteria decision making, tool

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Authors: Sutapa Mondal Roy, Suban K. Sahoo

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The primary aim of this work is to synthesis silver nanoparticles (AgNPs) through environmentally benign routes to avoid any chemical toxicity related undesired side effects. The nanoparticles were stabilized with drug ciprofloxacin (Cp) and were studied for their effectiveness as drug delivery agent. Targeted drug delivery improves the therapeutic potential of drugs at the diseased site as well as lowers the overall dose and undesired side effects. The small size of nanoparticles greatly facilitates the transport of active agents (drugs) across biological membranes and allows them to pass through the smallest capillaries in the body that are 5-6 μm in diameter, and can minimize possible undesired side effects. AgNPs are non-toxic, inert, stable, and has a high binding capacity and thus can be considered as biomaterials. AgNPs were synthesized from the nutrient broth supernatant after the culture of environment-friendly bacteria Bacillus subtilis. The AgNPs were found to show the surface plasmon resonance (SPR) band at 425 nm. The Cp capped Ag nanoparticles formation was complete within 30 minutes, which was confirmed from absorbance spectroscopy. Physico-chemical nature of the AgNPs-Cp system was confirmed by Dynamic Light Scattering (DLS), Transmission Electron Microscopy (TEM) etc. The AgNPs-Cp system size was found to be in the range of 30-40 nm. To monitor the kinetics of drug release from the surface of nanoparticles, the release of Cp was carried out by careful dialysis keeping AgNPs-Cp system inside the dialysis bag at pH 7.4 over time. The drug release was almost complete after 30 hrs. During the drug delivery process, to understand the AgNPs-Cp system in a better way, the sincere theoretical investigation is been performed employing Density Functional Theory. Electronic charge transfer, electron density, binding energy as well as thermodynamic properties like enthalpy, entropy, Gibbs free energy etc. has been predicted. The electronic and thermodynamic properties, governed by the AgNPs-Cp interactions, indicate that the formation of AgNPs-Cp system is exothermic i.e. thermodynamically favorable process. The binding energy and charge transfer analysis implies the optimum stability of the AgNPs-Cp system. Thus, the synthesized Cp-Ag nanoparticles can be effectively used for biological purposes due to its environmentally benign routes of synthesis procedures, which is clean, biocompatible, non-toxic, safe, cost-effective, sustainable and eco-friendly. The Cp-AgNPs as biomaterials can be successfully used for drug delivery procedures due to slow release of drug from nanoparticles over a considerable period of time. The kinetics of the drug release show that this drug-nanoparticle assembly can be effectively used as potential tools for therapeutic applications. The ease of synthetic procedure, lack of possible chemical toxicity and their biological activity along with excellent application as drug delivery agent will open up vista of using nanoparticles as effective and successful drug delivery agent to be used in modern days.

Keywords: silver nanoparticles, ciprofloxacin, density functional theory, drug delivery

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Authors: Bheeshma B., Mathivanan N., Manoj Deepak M., Prabhu Thangaraju, K. Venkatachalam

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This study involves the effect of autologous blood injection for patients who had degeneration of the origin of extensor carpi radialis brevis which was confirmed radio logically and by ultrasound examination and failed cortisone injections to the lateral epicondylitis. In this prospective longitudinal series involves pre-injection assessment of grip strength, pain, and function, using the patient-rated tennis elbow evaluation. In this study, blood from the contralateral limb is taken and injected into the affected limb with the help of ultrasound guidance and then the patient wore a customized wrist support for five days, after which they were commenced with stretching, strengthening, and massage programme with an occupational therapist. In these patients assessment was done after six months and then finally at 12 months after injection, using the patient-rated tennis elbow evaluation. 50 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not. Our study thus concludes that autologous blood injection show significant improvement in pain and function in patients with chronic lateral epicondylitis, who did not have relief with cortisone injection.

Keywords: lateral epicondylitis, autologous blood injection, conservative treatment, plasma-rich proteins (PRPs)

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Authors: E. Lacasa, J. L. Santolaya, I. Millán

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The progress toward sustainability implies maintaining and preferably improving both, human and ecosystem well-being, according to a triple bottom line that includes the environmental, economic and social dimensions. The life cycle assessment (LCA) is a method applicable to all production sectors that aims to quantify the environmental pressures and the benefits related to goods and services, as well as the trade-offs and the scope for improving areas of the production process. While using LCA to measure the environmental dimension of sustainability is widespread, similar approaches for the economic and the social dimensions still have limited application worldwide and there is a need for consistent and robust methods and indicators. This paper focuses on the milk production process and presents the analysis of the flows exchanged by an industrial installation through accounting all the energy and material inputs and the associated emissions and waste outputs at this stage of its life cycle. The functional unit is one litre of milk produced. Different metrics and indicators are used to assess the three dimensions of sustainability. Metrics considered useful to assess the production activities are the total water and energy consumptions and the milk production volume of each cow. The global warming, the value added and the working hours are indicators used to measure each sustainability dimension. The study is performed with two types of feeding of the cows, which includes a change in percentages of components as well. Nutritional composition of the milk obtained is almost kept. It is observed that environmental and social improvements involve high economic costs.

Keywords: milk production, sustainability, indicators, life cycle assessment

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Authors: Maria Kazantzaki, Evangelos Tsakalos, Eleni Filippaki, Yannis Bassiakos

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Mediterranean areas are characterized by intense seismic and volcanic activity as well as eustatic changes, the result of which is the creation of particularly vulnerable coastal zones. The most vulnerable are low-lying coastal areas, the geomorphological evolution of which are highly affected by natural processes and anthropogenic interventions. Therefore, assessing changes that take place along coastal zones is of great importance in order to enable the development of integrated coastal management plans. A characteristic case is the gulf of Mirabello in N.E Crete, where intense coastal erosion, in combination with the tectonic subsidence of the area, threatens a large part of the coastal zone, resulting in direct socio-economic impacts. The present study assesses the temporal geomorphological changes that have taken place in the coastal zone of Mirabello gulf to provide a clear frame of the coastal zone evolution over time and performs a vulnerability assessment based on the coastal vulnerability index (CVI) methodology by Thieler and Hammar-Klose, considering geological features, coastal slope, relative sea-level change, shoreline erosion/accretion rates and mean significant wave height as well as mean tide range in the area. In light of this, an impact assessment, based on three different sea level rise scenarios, is also performed and presented.

Keywords: coastal vulnerability index, coastal erosion, GIS, sea level rise

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Authors: Nebojsa Stefanovic, Sasa Milijic, Natasa Danilovic Hristic

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Spatial plan of the special purpose area constitutes a basic tool in the planning of infrastructure corridor of a highway. The aim of the plan is to define the planning basis and provision of spatial conditions for the construction and operation of the highway, as well as for developing other infrastructure systems in the corridor. This paper presents a methodology and approach to the preparation of the Spatial Plan for the special purpose area for the infrastructure corridor of the highway E-80, Section Niš-Merdare in Serbia. The applied methodological approach is based on the combined application of the integrative and participatory method in the decision-making process on the sustainable development of the highway corridor. It was found that, for the planning and management of the infrastructure corridor, a key problem is coordination of spatial and urban planning, strategic environmental assessment and sectoral traffic planning and designing. Through the development of the plan, special attention is focused on increasing the accessibility of the local and regional surrounding, reducing the adverse impacts on the development of settlements and the economy, protection of natural resources, natural and cultural heritage, and the development of other infrastructure systems in the corridor of the highway. As a result of the applied methodology, this paper analyzes the basic features such as coverage, the concept, protected zones, service facilities and objects, the rules of development and construction, etc. Special emphasis is placed to methodology and results of the Strategic Environmental Assessment of the Spatial Plan, and to the importance of protection measures, with the special significance of air and noise protection measures. For evaluation in the Strategic Environmental Assessment, a multicriteria expert evaluation (semi-quantitative method) of planned solutions was used in relation to the set of goals and relevant indicators, based on the basic set of indicators of sustainable development. Evaluation of planned solutions encompassed the significance and size, spatial conditions and probability of the impact of planned solutions on the environment, and the defined goals of strategic assessment. The framework of the implementation of the Spatial Plan is presented, which is determined for the simultaneous elaboration of planning solutions at two levels: the strategic level of the spatial plan and detailed urban plan level. It is also analyzed the relationship of the Spatial Plan to other applicable planning documents for the planning area. The effects of this methodological approach relate to enabling integrated planning of the sustainable development of the infrastructure corridor of the highway and its surrounding area, through coordination of spatial, urban and sectoral traffic planning and design, as well as the participation of all key actors in the adoption and implementation of planned decisions. By the conclusions of the paper, it is pointed to the direction for further research, particularly in terms of harmonizing methodology of planning documentation and preparation of technical-design documentation.

Keywords: corridor, environment, highway, impact, methodology, spatial plan, urban

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Authors: Rihab Hamdi, Amel Hadri Hamida, Ouafae Bennis, Sakina Zerouali

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This paper features a performance analysis and robustness assessment of a digitally controlled DC-DC three-cell buck converter associated in parallel, operating in continuous conduction mode (CCM), facing feeding parameters variation and loads disturbance. The control strategy relies on the continuous-time with an averaged modeling technique for high-frequency switching converter. The methodology is to modulate the complete design procedure, in regard to the existence of an instantaneous current operating point for designing the digital closed-loop, to the same continuous-time domain. Moreover, the adopted approach is to include a digital voltage control (DVC) technique, taking an account for digital control delays and sampling effects, which aims at improving efficiency and dynamic response and preventing generally undesired phenomena. The results obtained under load change, input change, and reference change clearly demonstrates an excellent dynamic response of the proposed technique, also as provide stability in any operating conditions, the effectiveness is fast with a smooth tracking of the specified output voltage. Simulations studies in MATLAB/Simulink environment are performed to verify the concept.

Keywords: continuous conduction mode, digital control, parallel multi-cells converter, performance analysis, power electronics

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Authors: Monkiz Khasreen

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In the context of the global trend towards reducing new buildings carbon footprint, the design team is required to make early decisions that have a major influence on embodied and operational carbon. Sustainability strategies should be clear during early stages of building design process, as changes made later can be extremely costly. Life-Cycle Assessment (LCA) could be used as the vehicle to carry other tools and processes towards achieving the requested improvement. Although LCA is the ‘golden standard’ to evaluate buildings from 'cradle to grave', lack of details available on the concept design makes LCA very difficult, if not impossible, to be used as an estimation tool at early stages. Issues related to transparency and accessibility of information in the building industry are affecting the credibility of LCA studies. A verified database derived from LCA case studies is required to be accessible to researchers, design professionals, and decision makers in order to offer guidance on specific areas of significant impact. This database could be the build-up of data from multiple sources within a pool of research held in this context. One of the most important factors that affects the reliability of such data is the temporal factor as building materials, components, and systems are rapidly changing with the advancement of technology making production more efficient and less environmentally harmful. Recent LCA studies on different building functions, types, and structures are always needed to update databases derived from research and to form case bases for comparison studies. There is also a need to make these studies transparent and accessible to designers. The work in this paper sets out to address this need. This paper also presents life-cycle case study of a new-build educational building in England. The building utilised very current construction methods and technologies and is rated as BREEAM excellent. Carbon emissions of different life-cycle stages and different building materials and components were modelled. Scenario and sensitivity analyses were used to estimate the future of new educational buildings in England. The study attempts to form an indicator during the early design stages of similar buildings. Carbon dioxide emissions of this case study building, when normalised according to floor area, lie towards the lower end of the range of worldwide data reported in the literature. Sensitivity analysis shows that life cycle assessment results are highly sensitive to future assumptions made at the design stage, such as future changes in electricity generation structure over time, refurbishment processes and recycling. The analyses also prove that large savings in carbon dioxide emissions can result from very small changes at the design stage.

Keywords: architecture, building, carbon dioxide, construction, educational buildings, England, environmental impact, life-cycle assessment

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Authors: Eddy K. Mukadi

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The aim of this study was to provide contributing elements to improve the management of the asthma crisis in the intensive care unit of the General Reference Hospital of Kinshasa. This was a descriptive study of all patients in the intensive care unit presenting with the asthma attack during the period from February 5, 2013 to February 5, 2014. The main data were obtained from consultation registry and medical records. A total of 35 patients, 21 of whom were male (majority) compared to 14 female. Average age of patients was 46.48 plus or minus 16.98 with extremes ranging from 21-75 years. The clinic was dominated by dyspnea in 100% of cases, followed by rales with 91.4% of cases. In spite of the control of the crisis obtained after the treatment with B2 mimetic by inhalation was introduced A 91.5%; 88% corticosteroids; 80% oxygen, the therapeutic principle recommended for the management of asthma attacks was not respected in the majority of cases. This is why we suggest that improving the quality of care to be administered to patients will yield more adequate results.

Keywords: asthma crisis, intensive care, general hospital, Kinshasa

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Authors: Demisash, Abate Getnet, Gudisa, Ababo Geleta, Daba, Berhane Olani

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As consumption trends of fish are rising in Ethiopia, assessment of the environmental performance of Fisheries becomes vital. Hence, Cleaner Production Assessment was conducted on Lake Tana No.1 Fish Supply Association. This paper focuses on determining the characteristics, quantity, and setting up cleaner production options for the site with the experimental investigation. The survey analysis showed that illegal waste dumping in Lake Tana is common practice in the area, and some of the main reasons raised were they have no option than doing this for dis-charging fish wastes. Quantifying a fish waste by examination of records at the point of generation resulted in a generation rate of 72,822.61 kg per year, which is a significant amount of waste and needs management system. The result of the proximate analysis showed high free fat content of about 12.33%, and this was a good candidate for the production of biodiesel that has been set as an option for fish waste utilization. Among the different waste management options, waste reduction by product optimization, which involves biodiesel production, was chosen as a potential method. Laboratory scale experiments were performed to produce a renewable energy source from the wastes. The resulting biodiesel was characterized and found to have a density of 0.756kg/L, viscosity 0.24p, and 153°C flashpoints, which shows the product has values in compliance with the American Society for Testing and Materials (ASTM) standards.

Keywords: biodiesel, cleaner production, renewable energy, waste management

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Authors: Hiromi Kawasaki, Satoko Yamasaki, Mika Iwasa, Tomoko Iki, Akiko Takaki

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In basic nursing, the conditions necessary for maintaining human health -temperature, humidity, illumination, distance from others, noise, moisture, meals, and excretion- were explained. Nursing students often think of these conditions in the context of a hospital room. In order to make students think of these conditions in terms of an environment necessary for maintaining health and preventing illness for residents, in the third year of community health nursing, students learned how to assess and improve the environment -particularly via the case of shelters in the event of a disaster. The importance of environmental management has increased in 2020 as a preventive measure against COVID-19 infection. We verified the effect of the lessons, which was decided to be conducted through distance learning. Sixty third-year nursing college students consented to participate in this study. Environmental standard knowledge for conducting environmental assessment was examined before and after class, and the percentage of correct answers was compared. The χ² test was used for the test, with a 5% significance level employed. Measures were evaluated via a report submitted by the students after class. Student descriptions were analyzed both qualitatively and descriptively with respect to expected health problems and suggestions for improvement. Students have already learned about the environment in terms of basic nursing in their second year. The correct answers for external environmental values concerning interpersonal distance, illumination, noise, and room temperature (p < 0.001) increased significantly after taking the class. Humidity was registered 83.3% before class and 93.3% after class (p = 0.077). Regarding the body, the percentage of students who answered correctly was 70% or more, both before and after the class. The students’ reports included overcrowding, high humidity/high temperature, and the number of toilets as health hazards. Health disorders to be prevented were heat stroke, infectious diseases, and economy class syndrome; improvement methods were recommended for hyperventilation, stretching, hydration, and waiting at home. After the public health nursing class, the students were able to not only propose environmental management of a hospital room but also had an understanding of the environment in terms of the lives of individuals, environmental assessment, and solutions to health problems. The response rate for basic items learned in the second year was already high before and after class, and interpersonal distance and ventilation were described by students. Students were able to use what they learned in basic nursing about the standards of the human mind and body. In the external environment, the memory of specific numerical values was ambiguous. The environment of the hospital room is controlled, and interest in numerical values may decrease. Nursing staff needs to maintain and improve human health as well as hospital rooms. With COVID-19, it was thought that students would continue to not only consider this point in reference to hospital rooms but also in regard to places where people gather. Even in distance learning, students were able to learn the important issues and lessons.

Keywords: environmental assessment, evacuation center, nursing education, nursing students

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Authors: Mohammad Javaherian, Siamak Bashardoust Tajali, Monavvar Hadizadeh

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Objective: This systematic review study was conducted to evaluate the effects of Pulsed Electromagnetic (PEMF) and Static Magnetic Fields (SMG) on pain relief and functional improvement in patients with musculoskeletal Low Back Pain (LBP). Methods: Seven electronic databases were searched by two researchers independently to identify the published Randomized Controlled Trials (RCTs) on the efficacy of pulsed electromagnetic, static magnetic, and therapeutic nuclear magnetic fields. The identified databases for systematic search were Ovid Medline®, Ovid Cochrane RCTs and Reviews, PubMed, Web of Science, Cochrane Library, CINAHL, and EMBASE from 1968 to February 2016. The relevant keywords were selected by Mesh. After initial search and finding relevant manuscripts, all references in selected studies were searched to identify second hand possible manuscripts. The published RCTs in English would be included to the study if they reported changes on pain and/or functional disability following application of magnetic fields on chronic musculoskeletal low back pain. All studies with surgical patients, patients with pelvic pain, and combination of other treatment techniques such as acupuncture or diathermy were excluded. The identified studies were critically appraised and the data were extracted independently by two raters (M.J and S.B.T). Probable disagreements were resolved through discussion between raters. Results: In total, 1505 abstracts were found following the initial electronic search. The abstracts were reviewed to identify potentially relevant manuscripts. Seventeen possibly appropriate studies were retrieved in full-text of which 48 were excluded after reviewing their full-texts. Ten selected articles were categorized into three subgroups: PEMF (6 articles), SMF (3 articles), and therapeutic nuclear magnetic fields (tNMF) (1 article). Since one study evaluated tNMF, we had to exclude it. In the PEMF group, one study of acute LBP did not show significant positive results and the majority of the other five studies on Chronic Low Back Pain (CLBP) indicated its efficacy on pain relief and functional improvement, but one study with the lowest sessions (6 sessions during 2 weeks) did not report a significant difference between treatment and control groups. In the SMF subgroup, two articles reported near significant pain reduction without any functional improvement although more studies are needed. Conclusion: The PEMFs with a strength of 5 to 150 G or 0.1 to 0.3 G and a frequency of 5 to 64 Hz or sweep 7 to 7KHz can be considered as an effective modality in pain relief and functional improvement in patients with chronic low back pain, but there is not enough evidence to confirm their effectiveness in acute low back pain. To achieve the appropriate effectiveness, it is suggested to perform this treatment modality 20 minutes per day for at least 9 sessions. SMFs have not been reported to be substantially effective in decreasing pain or improving the function in chronic low back pain. More studies are necessary to achieve more reliable results.

Keywords: pulsed electromagnetic field, static magnetic field, magnetotherapy, low back pain

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