Search results for: cardiovascular department

Authors: Miriam Fahmy, Shalini Fernando

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Educational links between teaching hospitals and universities can provide visits with great impact for both sides. As a visitor, one is responsible for the content, respecting current practice while offering guidance from a completely different perspective. There is little documented guidance for establishing links with universities in developing countries and providing meaningful teaching and exchange programmes. An initial contact retrieved one response with regards to written curriculum. The otolaryngology department from a Swansea teaching hospital visited a university in the Gambia. A consultant and clinical fellow visited with medical students to deliver lectures, clinical skills and informal teaching such as bedside and small group teaching. Students who had participated in teaching provided by the visiting university were asked to give feedback. This information was collated and used to evaluate the impact, and to guide future visits, including thinking of establishing a curriculum tailored to the West Africa region. The students felt they gained the most from informal sessions such as bedside teaching and felt that more practical experience on real patients and pathology would be most beneficial to them. Given that internet is poor, they also suggested a video library for their reference. Many of them look forward to visiting Swansea and are interested in the differences in practice and technologies. The findings are limited to little previous literature and student feedback. Student feedback sparked further questions and careful contemplation. There is great scope for introducing a range of teaching resources but it is important to avoid assumptions and imposition of a western curriculum and education system, a larger sample is needed with input from lecturers and curriculum writers in leading universities. In conclusion, more literature and guidance needs to be established for future visitors contemplating an educational link.

Keywords: education, impact, West Africa, university links

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Authors: Soojin Kim, Yongjae Kim

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Continuous economic downturn and ongoing budget cuts poses higher education with profound challenges which has a direct impact on the collegiate athletic programs. In response to the ever-changing landscape of the fiscal environment, universities seek to boost revenues, resorting to alternative sources of funding. In particular, athletic programs have become increasingly dependent on financial support from their alumni and boosters, which is how athletic departments attempt to offset budget shortfalls and make capital improvements. Although there currently exists three major divisions within National Collegiate Athletic Association (NCAA), the majority of the sport management studies on college sport tend to focus on Division I level. Particularly within the donor motivation literature, a plethora of donor motivation studies exist, but mainly on NCAA Division I athletic programs. Since each athletic department functions differently in a number of different dimensions, while institutional difference can also have a huge impact on athletic donor motivations, the current study attempts to fill this gap that exists in the literature. As such, the purpose of this study was to (I) reexamine the factor structure of the Athletic Donor motivation scale; and (II) identify the prominent athletic donor motives in a NCAA Division II athletic program. For the purpose of this study, a total of 232 actual donors were used for analysis. A confirmatory factor analysis (CFA) was employed to test construct validity, and the reliability of the scale was assessed using Composite Reliability. To identify the prominent motivational factors, the means and standard deviations were examined. Results of this study indicated that Vicarious Achievement, Philanthropy, and Commitment are the three primary motivational factors, while Tangible Benefits, was consistently found as an important motive in prior studies was found low. Such findings highlight the key difference and suggest different salient motivations exist that are specific to the context.

Keywords: college athletics, donor, motivation, NCAA

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is associated with cardiovascular disease risk factors and metabolic syndrome (MetS). In this study, associations between adipokines and adipokine as well as obesity indices were evaluated. Plasma adipokine levels may exhibit variations according to body adipose tissue mass. Besides, upon consideration of obesity as an inflammatory disease, adipokines may play some roles in this process. The ratios of proinflammatory adipokines to adiponectin may act as highly sensitive indicators of body adipokine status. The aim of the study is to present some adipokine indices, which are thought to be helpful for the evaluation of childhood obesity and also to determine the best discriminators in the diagnosis of MetS. 80 prepubertal children (aged between 6-9.5 years) included in the study were divided into three groups; 30 children with normal weight (NW), 25 morbid obese (MO) children and 25 MO children with MetS. Physical examinations were performed. Written informed consent forms were obtained from the parents. The study protocol was approved by Ethics Committee of Namik Kemal University Medical Faculty. Anthropometric measurements, such as weight, height, waist circumference (C), hip C, head C, neck C were recorded. Values for body mass index (BMI), diagnostic obesity notation model assessment Index-II (D2 index) as well as waist-to-hip, head-to-neck ratios were calculated. Adiponectin, resistin, leptin, chemerin, vaspin, progranulin assays were performed by ELISA. Adipokine-to-adiponectin ratios were obtained. SPSS Version 20 was used for the evaluation of data. p values ≤ 0.05 were accepted as statistically significant. Values of BMI and D2 index, waist-to-hip, head-to-neck ratios did not differ between MO and MetS groups (p ≥ 0.05). Except progranulin (p ≤ 0.01), similar patterns were observed for plasma levels of each adipokine. There was not any difference in vaspin as well as resistin levels between NW and MO groups. Significantly increased leptin-to-adiponectin, chemerin-to-adiponectin and vaspin-to-adiponectin values were noted in MO in comparison with those of NW. The most valuable adipokine index was progranulin-to-adiponectin (p ≤ 0.01). This index was strongly correlated with vaspin-to-adiponectin ratio in all groups (p ≤ 0.05). There was no correlation between vaspin-to-adiponectin and chemerin-to--adiponectin in NW group. However, a correlation existed in MO group (r = 0.486; p ≤ 0.05). Much stronger correlation (r = 0.609; p ≤ 0.01) was observed in MetS group between these two adipokine indices. No correlations were detected between vaspin and progranulin as well as vaspin and chemerin levels. Correlation analyses showed a unique profile confined to MetS children. Adiponectin was found to be correlated with waist-to-hip (r = -0.435; p ≤ 0.05) as well as head-to-neck (r = 0.541; p ≤ 0.05) ratios only in MetS children. In this study, it has been investigated if adipokine indices have priority over adipokine levels. In conclusion, vaspin-to-adiponectin, progranulin-to-adiponectin, chemerin-to-adiponectin along with waist-to-hip and head-to-neck ratios were the optimal combinations. Adiponectin, waist-to-hip, head-to-neck, vaspin-to-adiponectin, chemerin-to-adiponectin ratios had appropriate discriminatory capability for MetS children.

Keywords: adipokine indices, metabolic syndrome, obesity indices, pediatric obesity

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Authors: Mariana Mangas, Yaroslava Martins, M. Suárez, Célia Santos, Ana Matos Pires

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Baixo Alentejo is a region of Portugal characterized by an aging population, geographic isolation, social deprivation and a lack of medical staff. It is one of the most problematic regions in regards to mental health, particularly due to the factors mentioned. The aim of this study is a presentation of liaison psychiatry in Hospital José Joaquim Fernandes; a sample of the work done, the current situation and future perspectives. The aim is to present a retrospective study of internal psychiatric emergencies from January 1st, 2016 to August 31st, 2016. Liaison psychiatry of Department of Psychiatry and Mental Health (Psychiatry Service) of ULSBA includes the following activities: internal psychiatry emergencies, HIV consultation (comprised in the general consultation) and liaison psychology (oncology and pain), consisting of a total of 111 internal psychiatry emergencies during the identified period. Gender distribution was uniform. The most prevalent age group was 71-80 years, and 66,6% of patients were 60 years old and over. The majority of the emergency observations was requested by hospital services of medicine (56,8%) and surgery (24,3%). The most frequent reasons for admission were: respiratory disease (18,0%); tumors (15.3%); other surgical and orthopedic pathology (14,5%) and stroke (11,7%). The most frequent psychiatric diagnoses were: neurotic and organic depression (24,3%); delirium (26,1%) and adjustment reaction (14,5%). Major psychiatric pathology (schizophrenia and affective disorders) was found in 10,8%. Antidepressive medication was prescribed in 37,8% patients; antipsychotics in 34,2%. In 9.9% of the cases, no psychotropic drug was prescribed, and 5,4% of patients received psychologic support. Regarding hospital discharge, 42,4% of patients were referred to the general practitioner or to the medical specialist; 22,5% to outpatient gerontopsychiatry; 17,1% to psychiatric outpatient and 14,4% deceased. A future perspective is to start liaison in areas of HIV and psycho oncology in multidisciplinary approach and to improve collaboration with colleagues of other specialties for refining psychiatric referrals.

Keywords: psychiatry, liaison, internal emergency, psychiatric referral

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Authors: Magdalena B. Kaziuk, Waldemar Kosiba, Marek J. Kuzniewski

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Introduction: Adipose tissue is a typical place for storage water-insoluble toxins in the body. It's connective tissue, where the intercellular substance consist of fat, which level in people with low physical activity should be 18-25% for women and 13-18% for men. Due to the fat distribution in the body we distinquish two types of obesity: android (visceral, abdominal) and gynoidal (gluteal-femoral, peripheral). Abdominal obesity increases the risk of complications of the cardiovascular system diseases, and impaired renal and liver function. Through the influence on disorders of metabolism, lipid metabolism, diabetes and hypertension, leading to emergence of the metabolic syndrome. So thus, obesity will especially overload kidney function in patients after transplantation. Aim: An attempt was made to estimate the impact of amount fat tissue on transplanted kidney function and excretory function of the liver in patients after Ktx. Material and Methods: The study included 108 patients (50 females, 58 male, age 46.5 +/- 12.9 years) with active kidney transplant after more than 3 months from the transplantation. An analysis of body composition was done by using electrical bioimpedance (BIA) and anthropometric measurements. Estimated basal metabolic rate (BMR), muscle mass, total body water content and the amount of body fat. Information about physical activity were obtained during clinical examination. Nutritional status, and type of obesity were determined by using indicators: Waist to Height Ratio (WHR) and Waist to Hip Ratio (WHR). Excretory functions of the transplanted kidney was rated by calculating the estimated renal glomerular filtration rate (eGFR) using the MDRD formula. Liver function was rated by total bilirubin and alanine aminotransferase levels ALT concentration in serum. In our patients haemolitic uremic syndrome (HUS) was excluded. Results: In 19.44% of patients had underweight, 22.37% of the respondents were with normal weight, 11.11% had overweight, and the rest were with obese (49.08%). People with android stature have a lower eGFR compared with those with the gynoidal stature (p = 0.004). All patients with obesity had higher amount of body fat from a few to several percent. The higher amount of body fat percentage, the lower eGFR had patients (p <0.001). Elevated ALT levels significantly correlated with a high fat content (p <0.02). Conclusion: Increased amount of body fat, particularly in the case of android obesity can be a predictor of kidney and liver damage. Due to that obese patients should have more frequent control of diagnostic functions of these organs and the intensive dietary proceedings, pharmacological and regular physical activity adapted to the current physical condition of patients after transplantation.

Keywords: obesity, body fat, kidney transplantation, glomerular filtration rate, liver function

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Authors: Maria Luz Macasinag

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This study aims to determine and to examine critically successful family-owned higher educational institutions towards identifying the attributes and practices that may likely have led to their success. This research is confined to private, non-sectarian, family-owned higher institutions of learning that have been operating for more than fifty years, had only one founder and had at least two transitions in terms of generation. The criteria for selecting family-owned universities to be part of the cases under investigation include institutions (1) with increasing enrollment over the past five years, with level III accreditation status, (3) with good performance in the Board examinations in most of its programs and (4) with high employability of graduates. The study uses the multiple case study method. A model based on the cross-case analysis of the attributes and practices of all the case studies of successful family- owned higher institutions of learning is the output. The paper provides insights to current and future school owners and administrators in the management of their institutions for competitiveness, sustainability and advancement. This research encourages the evaluation of how the ideas that may lead to the success of schools owned by families in developing a sense of community, a reciprocal relationship among colleagues, the students and other stakeholders will result to the attainment of the vision and mission of the school. The study is beneficial to entrepreneurs and to business students whose know-how may provide insights that would be helpful in guiding prospective school owners. The commission on higher education and the Department of Education stand to benefit from this academic paper for the guidance that they provide to family-owned educational institutions. Banks and other financial institutions may find valuable ideas from this academic paper for the purpose of providing financial assistance to colleges and universities that are family-owned. Researchers in the field of educational management and administration may be able to extract from this study related topics for future research.

Keywords: administration practices, attributes, family-owned schools, success factors

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Authors: Rashmi Tomar, A. Srinivasan, Nayan K. Mohanty, Arun K. Jain

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Phthalates have been used as additives in industrial products since the 1930s, and are universally considered to be ubiquitous environmental contaminants. The general population is exposed to phthalates through consumer products, as well as diet and medical treatments. Animal studies showing the existence of an association between some phthalates and testicular toxicity have generated public and scientific concern about the potential adverse effects of environmental changes on male reproductive health. Unprecedented declines in fertility rates and semen quality have been reported during the last half of the 20th century in developed countries and increasing interest exists on the potential relationship between exposure to environmental contaminants, including phthalates, and human male reproductive health Studies. Phthalates may be associated with altered endocrine function and adverse effects on male reproductive development and function, but human studies are limited. The aim of the present study was detection of phthalate compounds, estimation of their metabolites in infertile & fertile male. Blood and urine samples were collected from 150 infertile patients & 75 fertile volunteers recruited through Department of Urology, Safdarjung Hospital, New Delhi. Blood have been collected in separate glass tubes from the antecubital vein of the patients, serum have been separate and estimate the phthalate level in serum samples by Gas Chromatography / Mass Spectrometry using NIOSH / OSHA detailed protocol. Urine of Infertile & Fertile Subjects was collected & extracted using solid phase extraction method, analysis by HPLC. In conclusion, to the best of our knowledge the present study based on human is first to show the presence of phthalate in human serum samples and their metabolites in urine samples. Significant differences were observed between several phthalates in infertile and fertile healthy individuals.

Keywords: Gas Chromatography, HPLC, male infertility, phthalates, serum, toxicity, urine

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Authors: Kassahun Tilahun Dessie

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The purpose of this study was to explore the awareness of teachers and the attitude they have to the curriculum they implement as well as to assess the actual and desired magnitude of teachers' participation in curriculum development process. It also aimed at investigating the factors that affect teachers' level of conception and perception towards the new higher education curriculum. The study was carried out in Debre Birhan University. Teachers, course coordinators, team leaders and presidents were included in the study as research subjects. Teachers were proportionally selected from each department (of the six faculties) based on available sampling technique. Accordingly, a total of 103 teachers were chosen as a subject of the study. In order to collect first hand data from the teachers, a questionnaire with four parts was developed by the researcher. To this end, scales were designed for measuring the extent of teachers' awareness and attitude. Each of the scales encompasses 11 and 17 items respectively. An open ended questionnaire was also attached for the purpose of obtaining elaborated data on the issue. Information was also obtained from interviews with presidents, team leaders and course coordinators. The data obtained were analyzed qualitatively using descriptive statistical tools. The overall results of the analysis revealed that the awareness of teachers on the curriculum was low. The meager participation of teachers in the process of curriculum development and the deficiency of trainings on the concern were major factors. Teachers' perception towards the existence and implementation of the new curriculum was also inclined to the negative, though difficult to generalize. Lack of awareness, administrators poor approach and lack of facilitating appropriate incentives as well as absence of room for evaluating the curriculum etc plays big role in endangering teachers attitude while the up to datedness of the new curriculum, involvement of teachers in the curriculum development process, the wide ranging quality of the new curriculum etc laid a better ground to boost teachers attitude towards the curriculum. This may have implication to the university in that there is a need to facilitate workshops or awareness creation trainings, to have positive and cooperative administrators, and embracing committed teachers to implement the curriculum efficiently.

Keywords: conception, perception, curriculum, higher education, Ethiopia

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Authors: Sipho Mbatha, Anne Mastament-Mason

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South African manufacturing global competitiveness was ranked 22nd (out of 38 countries), dropped to 24th in 2013 and is expected to drop further to 25th by 2018. These impacts negatively on the industrialisation project of South Africa. For industrialization to be achieved through labour intensive industries like the Apparel Manufacturing Industries of South Africa (AMISA), South Africa needs to identify and respond to factors negatively impacting on the development of competitive advantage This paper applied factor conditions from Porter’s Diamond Model (1990) to understand the various challenges facing the AMISA. Factor conditions highlighted in Porter’s model are grouped into two groups namely, basic and advance factors. Two AMISA associations representing over 10 000 employees were interviewed. The largest Clothing, Textiles and Leather (CTL) apparel retail group was also interviewed with a government department implementing the industrialisation policy were interviewed The paper points out that while AMISA have basic factor conditions necessary for competitive advantage in the clothing and textiles industries, Advance factor coordination has proven to be a challenging task for the AMISA, Higher Education Institutions (HEIs) and government. Poor infrastructural maintenance has contributed to high manufacturing costs and poor quick response as a result of lack of advanced technologies. The use of Porter’s Factor Conditions as a tool to analyse the sector’s competitive advantage challenges and opportunities has increased knowledge regarding factors that limit the AMISA’s competitiveness. It is therefore argued that other studies on Porter’s Diamond model factors like Demand conditions, Firm strategy, structure and rivalry and Related and supporting industries can be used to analyse the situation of the AMISA for the purposes of improving competitive advantage.

Keywords: compliance rule, apparel manufacturing industry, factor conditions, advance skills and South African industrial policy

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Authors: Amna Imtiaz

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Aims: To correlate serum ferritin with left ventricular function in beta thalassemia major patients with increased transfusion dependence and to find out whether echocardiography can be used to assess pre clinical cardiac disease in these patients. Methods: The cross sectional study was conducted at Department of Pathology, Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences, Islamabad. 60 patients of beta thalassemia major with increased transfusion dependence were enrolled in this study. Serum ferritin levels of all patients were measured by using indirect enzyme linked immunosorbent assay (ELISA). Echocardiography was performed on all patients by a consultant cardiologist by linking conventional echocardiography with tissue Doppler imaging. Ejection fraction and E/A ratio were measured in all patients to assess left ventricular systolic and diastolic function. Results: On the basis of serum ferritin level, patients were divided into three groups. Group I consisted of patients having serum ferritin level equal to or less than 2500 ng/ml. A total of 25 patients were placed in this group. Group II included patients having serum ferritin level between 2500 to 5000 ng/ml. A total of 22 patients were placed in this group. Group III included patients having serum ferritin level more than 5000 ng/ml. This group consisted of 13 patients. All patients having serum ferritin below 2500ng/ml had normal systolic function, and only 16% of the patients in this group had diastolic dysfunction as reflected by abnormal E/A ratio. In group II, 27% of the patients had systolic dysfunction reflected by subnormal ejection fraction while 40% of the patients had diastolic dysfunction. In group III, 62% of the patients had abnormal systolic and diastolic function. Pearson correlation was used to find a correlation between serum ferritin and left ventricular function. A strong negative correlation was found which is reflected by a p value of less than 0.05 which is significant. Chi square test is used to correlate serum ferritin with E/A ratio. P value came out to be less than 0.05 which is significant.

Keywords: beta thalassemia major, left ventricular function, serum ferritin, transfusion dependence

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Authors: Martin Dupuy, Solange Grunenwald, Pierre-Louis Colombo, Laurence Mahieu, Pomone Richard, Philippe Bartoli

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Endonasal endoscopic trans-sphenoidal surgery for pituitary tumours has become a mainstay of treatment over the last two decades. Although it is generally accepted that there is no significant difference between endoscopic versus microscopic approach for surgical outcomes (endocrine and ophthalmologic status), nasal morbidity seems to the benefit of endoscopic procedures. Minimally invasive endoscopic surgery needs an operative learning curve to achieve surgeon’s efficiency. This learning curve is now well known for surgical outcomes and complications rate, however, few data are available for nasal morbidity. The aim of our series is to document operative experience and nasal quality of life after (NQOL) endoscopic trans-sphenoidal surgery. The prospective pituitary surgical cohort consisted of 525 consecutives patients referred to our Skull Base Diseases Department. Endoscopic procedures were performed by a single neurosurgeon using an uninostril approach. NQOL was evaluated using the Sino-Nasal Test (SNOT-22), the Anterior Base Nasal Inventory (ASBNI) and the Skull Base Inventory Score (SBIS). Data were collected before surgery during hospital stay and 3 months after the surgery. The seventy first patients were compared to the latest 70 patients. There was no significant difference between comparison score before versus after surgery for SNOT-22, ASBNI and SBIS during the single surgeon’s learning curve. Our series demonstrates that in our institution there is no statistically significant learning curve for NQOL after uninostril endoscopic pituitary surgery. A careful progression through sinonasal structures with very limited mucosal incision is associated with minimal morbidity and preserves nasal function. Conservative and minimal invasive approach could be achieved early during learning curve.

Keywords: pituitary surgery, quality of life, minimal invasive surgery, learning curve, pituitary tumours, skull base surgery, endoscopic surgery

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Authors: Amal Shehata

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Low back pain related to disc prolapse is localized in the lumbar area and it may be radiated to the lower extremities, starting from neurons near or around the spinal canal. Most of the population may be affected with disc prolapse within their lifetime and leads to lost productivity, disability and loss of function. The study purpose was to examine the effect of rehabilitative nursing program on pain intensity and functional status among patients with discectomy. Design: Aquasi experimental design was utilized. Setting: The study was carried out at neurosurgery department and out patient's clinic of Menoufia University and Teaching hospitals at Menoufia governorate, Egypt. Instrument of the study: Five Instruments were used for data collection: Structured interviewing questionnaire, Functional assessment instrument, Observational check list, Numeric rating Scale and Oswestry low back pain disability questionnaire. Results: There was an improvement in mean total knowledge score about disease process, discectomy and rehabilitation program in study group (25.32%) than control group (7.32%). There was highly statistically significant improvement in lumbar flexibility among study group (80%) than control group (30%) after rehabilitation program than before. Also there was a decrease in pain score in study group (58% no pain) than control group (28% no pain) after rehabilitation program. There was an improvement in total disability score of study group (zero %) regarding effect of pain on the activity of daily living after rehabilitation program than control group (16%). Conclusion: Application of rehabilitative nursing program for patient with discectomy had proven a positive effect in relation to knowledge score, pain reduction, activity of daily living and functional abilities. Recommendation: A continuous rehabilitative nursing program should be carried out for all patients immediately after discectomy surgery on regular basis. Also A colored illustrated booklet about rehabilitation program should be available and distributed for all patients before surgery.

Keywords: discectomy, rehabilitative nursing program, pain intensity, functional status

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Authors: Misbah Nizamani, Saira Malik

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Introduction: Bariatric surgery is the most effective treatment for patients suffering from morbid obesity. Laparoscopic sleeve gastrectomy (LSG) accounts for over 50% of total bariatric procedures. The aim of our meta-analysis is to investigate the effectiveness and safety of Enhanced Recovery After Surgery (ERAS) protocols for patients undergoing laparoscopic sleeve gastrectomy. Method: To gather data, we searched PubMed, Google Scholar, ScienceDirect, and Cochrane Central. Eligible studies were randomized controlled trials and cohort studies involving adult patients (≥18 years) undergoing bariatric surgeries, i.e., Laparoscopic sleeve gastrectomy. Outcome measures included LOS, postoperative narcotic usage, postoperative pain score, postoperative nausea and vomiting, postoperative complications and mortality, emergency department visits and readmission rates. RevMan version 5.4 was used to analyze outcomes. Results: Three RCTs and three cohorts with 1522 patients were included in this study. ERAS group and control group were compared for eight outcomes. LOS was reduced significantly in the intervention group (p=0.00001), readmission rates had borderline differences (p=0.35) and higher postoperative complications in the control group, but the result was non-significant (p=0.68), whereas postoperative pain score was significantly reduced (p=0.005). Total MME requirements became significant after performing sensitivity analysis (p= 0.0004). Postoperative mortality could not be analyzed on account of invalid data showing 0% mortality in two cohort studies. Conclusion: This systemic review indicated the effectiveness of the application of ERAS protocols in LSG in reducing the length of stay, post-operative pain and total MME requirements postoperatively, indicating the feasibility and assurance of its application.

Keywords: eras protocol, sleeve gastrectomy, bariatric surgery, enhanced recovery after surgery

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Authors: Kathrina Aseanne Acapulco-Gomez, Shayne Julieane Morales, Tzar Francis Verame

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Mean platelet volume (MPV) is the most accurate measure of the size of platelets and is routinely measured by most automated hematological analyzers. Several studies have shown associations between MPV and cardiovascular risks and outcomes. Although its measurement may provide useful data, MPV remains to be a diagnostic tool that is yet to be included in routine clinical decision making. The aim of this systematic review and meta-analysis is to determine summary estimates of the diagnostic accuracy of mean platelet volume for the diagnosis of myocardial infarction among adult patients with angina and/or its equivalents in terms of sensitivity, specificity, diagnostic odds ratio, and likelihood ratios, and to determine the difference of the mean MPV values between those with MI and those in the non-MI controls. The primary search was done through search in electronic databases PubMed, Cochrane Review CENTRAL, HERDIN (Health Research and Development Information Network), Google Scholar, Philippine Journal of Pathology, and Philippine College of Physicians Philippine Journal of Internal Medicine. The reference list of original reports was also searched. Cross-sectional, cohort, and case-control articles studying the diagnostic performance of mean platelet volume in the diagnosis of acute myocardial infarction in adult patients were included in the study. Studies were included if: (1) CBC was taken upon presentation to the ER or upon admission (within 24 hours of symptom onset); (2) myocardial infarction was diagnosed with serum markers, ECG, or according to accepted guidelines by the Cardiology societies (American Heart Association (AHA), American College of Cardiology (ACC), European Society of Cardiology (ESC); and, (3) if outcomes were measured as significant difference AND/OR sensitivity and specificity. The authors independently screened for inclusion of all the identified potential studies as a result of the search. Eligible studies were appraised using well-defined criteria. Any disagreement between the reviewers was resolved through discussion and consensus. The overall mean MPV value of those with MI (9.702 fl; 95% CI 9.07 – 10.33) was higher than in those of the non-MI control group (8.85 fl; 95% CI 8.23 – 9.46). Interpretation of the calculated t-value of 2.0827 showed that there was a significant difference in the mean MPV values of those with MI and those of the non-MI controls. The summary sensitivity (Se) and specificity (Sp) for MPV were 0.66 (95% CI; 0.59 - 0.73) and 0.60 (95% CI; 0.43 – 0.75), respectively. The pooled diagnostic odds ratio (DOR) was 2.92 (95% CI; 1.90 – 4.50). The positive likelihood ratio of MPV in the diagnosis of myocardial infarction was 1.65 (95% CI; 1.20 – 22.27), and the negative likelihood ratio was 0.56 (95% CI; 0.50 – 0.64). The intended role for MPV in the diagnostic pathway of myocardial infarction would perhaps be best as a triage tool. With a DOR of 2.92, MPV values can discriminate between those who have MI and those without. For a patient with angina presenting with elevated MPV values, it is 1.65 times more likely that he has MI. Thus, it is implied that the decision to treat a patient with angina or its equivalents as a case of MI could be supported by an elevated MPV value.

Keywords: mean platelet volume, MPV, myocardial infarction, angina, chest pain

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Authors: Vu Hoang Thu Huong

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Background: Surface electrical stimulation (SES) is a popular non-invasive approach that offers a wide range of treatments for many diseases of physical therapy. It involves applying electrical stimulation to the skin via surface electrodes to stimulate nerve fibers. SES was regularly used to treat the back and upper or lower extremities, but it was rarely used to treat the chest and abdomen. SES on the thorax and abdomen should be administered with more attention because crucial organs are under those areas (i.e., heart, lungs, liver, etc.). In these areas, safety precautions are suggested, and some SES applications might even be a contraindication. The fact that physical therapists have less experience with SES in these situations can also be attributed to these. Although a few earlier studies applied it to these settings and discovered hopeful results, none of them highlight the relationship between the intensity of SES and its depth of impact for safety considerations. Objective: To assure feasibility when using SES in these areas, the purpose of this study is to summarize the common location and intensity of those areas that have been conducted in previous studies. Method: A thorough systematic review was conducted to determine the common surface electrode position for the thorax and abdomen areas. The studies with the randomized controlled design were systematically searched using inclusion and exclusion criteria through nine electronic databases, including Pubmed, Scopus, etc., between 1975 and Dec 2021. Results: Thirty-three studies with over 1800 participants and 4 types of SES (TENS, IFC, NMES, and FES) with various categories of department hospitals were found. Following an anterior, lateral, and posterior observation, the particular SES positions found that it concentrated on 6 regions (the thoracic, abdomen, upper lateral, lower lateral, upper back, and lower back regions), and its intensity for each region was also summarized. Conclusion: This systematic review figured out the popular locations of SES in the thorax and abdominal areas as well as a summarized maximum of intensity that was found in previous studies with outstanding outcomes.

Keywords: surface electrical stimulation, electrical stimulation, thoracic, abdomen, abdominal.

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Authors: Hitalo Silva

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The most famous corruption scandals in the past four years were taken in Latin America, especially in Brazil, but besides the stain that these countries suffered in an international field, there was a huge effort to create or modernize its national anti-corruption laws. Also, the countries are implementing new standards for investigations and corporate compliance programs, in order to combat corruption and prevent the money laundering. But here is the following question: is here an invisible uniformization/transnationalization of the anti-corruption systems in Latin America? This new scenario reflects the impacts of the corruption investigations conducted in Latin America countries, such as Car Wash Operation in Brazil, Pretelt Case in Colombia, Gasoducto Sur Peruano case and the Mr. Alex Kouri’s case both in Peru. Legal and institutional pro-transparency reforms were made recently, the companies are trying to implement new standards of conduct and investing in their compliance department. In this sense, there is a huge homogeneity in Latin America concerning the structuring of corporate compliance programs, a truly transnationalization not only of laws but also corporate standards among these countries. Although legislative initiatives vary among the countries, there is a tendency to impose rigid liability standards for the companies being investigated for corruption, not only the personal punishments of their executives, which demonstrate the power of authorities to strength the investigative tools. Also, instruments such as leniency agreements and plea bargain are essential to put a central role in enforcement activities in Latin America. In other words, in a region where six former Presidents were convicted for acts of corruption, and, companies such as Odebrecht that is accused of offering bribes to politicians from Argentina to México, passing through Ecuador, Colombia, Guatemala and Panama, this demonstrates the necessity to increase strength of their legal framework in a sense that unify transnational goals. All things considered, this paper will show how anti-corruption regulators are cooperating in Latin America jurisdictions in order to unify their laws and how the private sector is dealing with this new scenario of corporate culture change.

Keywords: compliance, corruption, investigations, Latin America, transnational

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Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha

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Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.

Keywords: C-peptide, insulin, large for gestational age, maternal weight

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Authors: Akshay B. Pawar, Rohit Y. Parasnis

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Heart Rate Variability (HRV) is a widely used indicator of the regulation between the autonomic nervous system (ANS) and the cardiovascular system. Besides being non-invasive, it also has the potential to predict mortality in cases involving critical injuries. The gold standard method for determining HRV is based on the analysis of RR interval time series extracted from ECG signals. However, because it is much more convenient to obtain photoplethysmogramic (PPG) signals as compared to ECG signals (which require the attachment of several electrodes to the body), many researchers have used pulse cycle intervals instead of RR intervals to estimate HRV. They have also compared this method with the gold standard technique. Though most of their observations indicate a strong correlation between the two methods, recent studies show that in healthy subjects, except for a few parameters, the pulse-based method cannot be a surrogate for the standard RR interval- based method. Moreover, the former tends to overestimate short-term variability in heart rate. This calls for improvements in or alternatives to the pulse-cycle interval method. In this study, besides the systolic peak-peak interval method (PP method) that has been studied several times, four recent PPG-based techniques, namely the first derivative peak-peak interval method (P1D method), the second derivative peak-peak interval method (P2D method), the valley-valley interval method (VV method) and the tangent-intersection interval method (TI method) were compared with the gold standard technique. ECG and PPG signals were obtained from 10 young and healthy adults (consisting of both males and females) seated in the armchair position. In order to de-noise these signals and eliminate baseline drift, they were passed through certain digital filters. After filtering, the following HRV parameters were computed from PPG using each of the five methods and also from ECG using the gold standard method: time domain parameters (SDNN, pNN50 and RMSSD), frequency domain parameters (Very low-frequency power (VLF), Low-frequency power (LF), High-frequency power (HF) and Total power or “TP”). Besides, Poincaré plots were also plotted and their SD1/SD2 ratios determined. The resulting sets of parameters were compared with those yielded by the standard method using measures of statistical correlation (correlation coefficient) as well as statistical agreement (Bland-Altman plots). From the viewpoint of correlation, our results show that the best PPG-based methods for the determination of most parameters and Poincaré plots are the P2D method (shows more than 93% correlation with the standard method) and the PP method (mean correlation: 88%) whereas the TI, VV and P1D methods perform poorly (<70% correlation in most cases). However, our evaluation of statistical agreement using Bland-Altman plots shows that none of the five techniques agrees satisfactorily well with the gold standard method as far as time-domain parameters are concerned. In conclusion, excellent statistical correlation implies that certain PPG-based methods provide a good amount of information on the pattern of heart rate variation, whereas poor statistical agreement implies that PPG cannot completely replace ECG in the determination of HRV.

Keywords: photoplethysmography, heart rate variability, correlation coefficient, Bland-Altman plot

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Authors: G. Alex Ambrose, Melissa Paulsen, Abrar Fitwi, Masud Akbari

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In 2016, a U.S. business college was awarded a sub grant to work with FHI360, a nonprofit human development organization, to support a university in Afghanistan funded by the State Department’s U.S. Agency for International Development (USAID). A newly designed Master’s Degree in Finance and Accounting is being implemented to support Afghanistan’s goal of 20% females in higher education and industry by 2020 and to use finance and accounting international standards to attract capital investment for economic development. This paper will present a case study to describe the co-construction of an approach to an International Flipped Faculty Development Model grounded in blended learning theory. Like education in general, faculty development is also evolving from the traditional face to face environment and interactions to the fully online and now to a best of both blends. Flipped faculty development is both a means and a model for careful integration of the strengths of the synchronous and asynchronous dynamics and technologies with the combination of intentional sequencing to pre-online interactions that prepares and enhances the face to face faculty development and mentorship residencies with follow-up post-online support. Initial benefits from this model include giving the Afghan faculty an opportunity to experience and apply modern teaching and learning strategies with technology in their own classroom. Furthermore, beyond the technological and pedagogical affordances, the reciprocal benefits gained from the mentor-mentee, face-to-face relationship will be explored. Evidence to support this model includes: empirical findings from pre- and post-Faculty Mentor/ Mentee survey results, Faculty Mentorship group debriefs, Faculty Mentorship contact logs, and student early/end of semester feedback. In addition to presenting and evaluating this model, practical challenges and recommendations for replicating international flipped faculty development partnerships will be provided.

Keywords: educational development, faculty development, international development, flipped learning

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Authors: Fabiana Franceschi, Martha Cobo, Manuel Figueredo

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Bogotá, the capital of Colombia, is its largest city and one of the most polluted in Latin America due to the fast economic growth over the last ten years. Bogotá has been affected by high pollution events which led to the high concentration of PM10 and NO2, exceeding the local 24-hour legal limits (100 and 150 g/m3 each). The most important pollutants in the city are PM10 and PM2.5 (which are associated with respiratory and cardiovascular problems) and it is known that their concentrations in the atmosphere depend on the local meteorological factors. Therefore, it is necessary to establish a relationship between the meteorological variables and the concentrations of the atmospheric pollutants such as PM10, PM2.5, CO, SO2, NO2 and O3. This study aims to determine the interrelations between meteorological variables and air pollutants in Bogotá, using data mining techniques. Data from 13 monitoring stations were collected from the Bogotá Air Quality Monitoring Network within the period 2010-2015. The Principal Component Analysis (PCA) algorithm was applied to obtain primary relations between all the parameters, and afterwards, the K-means clustering technique was implemented to corroborate those relations found previously and to find patterns in the data. PCA was also used on a per shift basis (morning, afternoon, night and early morning) to validate possible variation of the previous trends and a per year basis to verify that the identified trends have remained throughout the study time. Results demonstrated that wind speed, wind direction, temperature, and NO2 are the most influencing factors on PM10 concentrations. Furthermore, it was confirmed that high humidity episodes increased PM2,5 levels. It was also found that there are direct proportional relationships between O3 levels and wind speed and radiation, while there is an inverse relationship between O3 levels and humidity. Concentrations of SO2 increases with the presence of PM10 and decreases with the wind speed and wind direction. They proved as well that there is a decreasing trend of pollutant concentrations over the last five years. Also, in rainy periods (March-June and September-December) some trends regarding precipitations were stronger. Results obtained with K-means demonstrated that it was possible to find patterns on the data, and they also showed similar conditions and data distribution among Carvajal, Tunal and Puente Aranda stations, and also between Parque Simon Bolivar and las Ferias. It was verified that the aforementioned trends prevailed during the study period by applying the same technique per year. It was concluded that PCA algorithm is useful to establish preliminary relationships among variables, and K-means clustering to find patterns in the data and understanding its distribution. The discovery of patterns in the data allows using these clusters as an input to an Artificial Neural Network prediction model.

Keywords: air pollution, air quality modelling, data mining, particulate matter

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Authors: O. Benabdeljelil, A. Karioun, S. Amami, R. Rouger, M. Hamidine

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A model for preventing the risks related to climate conditions in the agricultural sector is presented. It will determine the yearly optimum premium to be paid by a producer in order to reach his required turnover. The model is based on both climatic stability and 'soft' responses of usually grown species to average climate variations at the same place and inside a safety ball which can be determined from past meteorological data. This allows the use of linear regression expression for dependence of production result in terms of driving meteorological parameters, the main ones of which are daily average sunlight, rainfall and temperature. By simple best parameter fit from the expert table drawn with professionals, optimal representation of yearly production is determined from records of previous years, and yearly payback is evaluated from minimum yearly produced turnover. The model also requires accurate pricing of commodity at N+1. Therefore, a pricing model is developed using 3 state variables, namely the spot price, the difference between the mean-term and the long-term forward price, and the long-term structure of the model. The use of historical data enables to calibrate the parameters of state variables, and allows the pricing of commodity. Application to beet sugar underlines pricer precision. Indeed, the percentage of accuracy between computed result and real world is 99,5%. Optimal premium is then deduced and gives the producer a useful bound for negotiating an offer by insurance companies to effectively protect its harvest. The application to beet production in French Oise department illustrates the reliability of present model with as low as 6% difference between predicted and real data. The model can be adapted to almost any agricultural field by changing state parameters and calibrating their associated coefficients.

Keywords: agriculture, production model, optimal price, meteorological factors, 3-factor model, parameter calibration, forward price

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Authors: Mara A. C. Lopes

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Hiring a second teacher to accompany deaf students inserted at Brazilian inclusive school system has raised questions about its role in the educational process of deaf students. Federal policies determine that deaf students inserted in regular education are accompanied by sign language interpreters, which leads to the understanding that the second teacher should assume this function. However, what those professionals do is to assume the function of teaching deaf student, instead of the classroom main teacher. Historical-Cultural Psychology was used as a reference for analysis, which aimed to identify the social function of the second teacher in the classroom. Two studies were accomplished in the public schools of Sao Paulo State: In Study 1, videotaped lectures provided by the Department of Education for collective reflection about the second teacher's role were examined, to identify the social meaning of that professional activity. Study 2 aimed to analyze the process of assigning personal sense to the teacher activity, considering the opinions of 21 professionals from Sao Paulo. Those teachers were interviewed individually with the support of a semi-structured interview. The analysis method utilized was: empirical description of data; development of categories, for reality abstraction; identifying the unit analysis; and return to reality, in order to explain it. Study 1 showed that the social meaning of the second teacher's activity is, also, to teach. However, Study 2 showed that this meaning is not shared among professionals of the school, so they understand that they must act as sign language interpreters. That comprehension causes a disruption between social meaning and the personal sense they attach to their activity. It also shows the need of both teachers at the classroom planning and executing activity together. On the contrary, a relationship of subordination of one teacher to another was identified, excluding the second teacher and the deaf student of the main activity. Results indicate that the second teacher, as a teacher, must take the responsibility for deaf student education, consciously, and to promote the full development of the subjects involved.

Keywords: deaf education, historical-cultural psychology, inclusion, teacher function

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Authors: Canan Duzan

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For most language learners, mastery of the speaking skill is the proof of the mastery of the foreign language. On the other hand, the speaking skill is considered as the most difficult aspect of language learning to develop for both learners and teachers. Especially in countries like Turkey where exposure to the target language is minimum and resources and opportunities provided for language practice are scarce, teaching and learning to speak the language become a real struggle for teachers and learners alike. Data collected from students, instructors, faculty members and the business sector in needs analysis studies conducted previously at Middle East Technical University (METU) consistently revealed the need for addressing the problem of lack of confidence in speaking English. Action was taken during the design of the only EAP speaking course offered in Modern Languages Department since lack of confidence is considered to be a serious barrier for effective communication and causes learners to suffer from insecurity, uncertainty and fear. “Confidence building” served as the guiding principle in the syllabus design, nature of the tasks created for the course and the assessment procedures to help learners become more confident speakers of English. In order to see the effectiveness of the decisions made during the design phase of the course and whether students become more confident speakers upon completion of the course, a case study was carried out with 100 students at METU. A questionnaire including both Likert-Scale and open-ended items were administered to students to collect data and this data were analyzed using the SPSS program. Group interviews were also carried out to gain more insight into the effectiveness of the course in terms of building speaking confidence. This presentation will explore the specific actions taken to develop students’ confidence based on the findings of program evaluation studies and to what extent the students believe these actions to be effective in improving their confidence. The unique design of this course and strategies adopted for confidence building are highly applicable in other EAP contexts and may yield similar positive results.

Keywords: confidence, EAP, speaking, strategy

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Authors: Suegnet Smit

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Prior to 1994, special education in South Africa was marginalized and fragmented. Moving away from a Medical model approach to special education, the Government, after 1994, promoted an Inclusive approach, as a means to transform education in general, and special education in particular. This transformation, however, is moving at too a slow pace for learners with barriers to learning and development to benefit fully from their education. The goal of the Department of Basic Education is to minimize, remove, and prevent barriers to learning and development in the educational setting, by attending to the unique needs of the individual learner. However, the implementation of Inclusive education is problematic, and general education remains poor. This paper highlights the historical development of special education in South Africa, underpinned by a bio-ecological perspective. Problematic areas within the systemic levels of the education system are highlighted in order to indicate how the interactive processes within the systemic levels affect special needs learners on the personal dimension of the bio-ecological approach. As part of the methodology, thorough document analysis was conducted on information collected from a large body of research literature, which included academic articles, reports, policies, and policy reviews. Through a qualitative analysis, data were grouped and categorized according to the bio-ecological model systems, which revealed various successes and challenges within the education system. The challenges inhibit change, growth, and development for the child, who experience barriers to learning. From these findings, it is established that special education in South Africa has been, and still is, on a bumpy road. Sadly, the transformation process of change, envisaged by implementing Inclusive education, is still yet a dream, not fully realized. Special education seems to be stuck at what is, and the education system has not moved forward significantly enough to reach what special education should and could be. The gap that exists between a vision of Inclusive quality education for all, and the current reality, is still too wide. Problems encountered in all the education system levels, causes a funnel-effect downward to learners with special educational needs, with negative effects for the development of these learners.

Keywords: bio-ecological perspective, education systems, inclusive education, special education

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Authors: B. M. Pardeshi

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Introduction: Minerals and trace elements are chemical elements required by our bodies for numerous biological and physiological processes that are necessary for the maintenance of health. Medicinal plants are highly beneficial for the maintenance of good health and prevention of diseases. They are known as potential sources of minerals and vitamins. 30 to 40% of today’s conventional drugs used in the medicinal and curative properties of various plants are employed in herbal supplement botanicals, nutraceuticals and drug. Aim: The authors explored the mineral element content of some herbs, because mineral elements may have significant role in the development and treatment of gastrointestinal diseases, and a close connection between the presence or absence of mineral elements and inflammatory mediators was noted. Methods: Present study deals with the elemental analysis of medicinal plants by Instrumental Neutron activation Analysis and Atomic Absorption Spectroscopy. Medicinal herbals prescribed for skin diseases were purchased from markets and were analyzed by Instrumental Neutron Activation Analysis (INAA) using 252Cf Californium spontaneous fission neutron source (flux * 109 n s-1) and the induced activities were counted by γ-ray spectrometry and Atomic Absorption Spectroscopy (AAS) techniques (Perkin Elmer 3100 Model) available at Department of Chemistry University of Pune, INDIA, was used for the measurement of major, minor and trace elements. Results: 15 elements viz. Al, K, Cl, Na, Mn by INAA and Cu, Co, Pb, Ni, Cr, Ca, Fe, Zn, Hg and Cd by AAS were analyzed from different medicinal plants from India. A critical examination of the data shows that the elements Ca , K, Cl, Al, and Fe are found to be present at major levels in most of the samples while the other elements Na, Mn, Cu, Co, Pb, Ni, Cr, Ca, Zn, Hg and Cd are present in minor or trace levels. Conclusion: The beneficial therapeutic effect of the studied herbs may be related to their mineral element content. The elemental concentration in different medicinal plants is discussed.

Keywords: instrumental neutron activation analysis, atomic absorption spectroscopy, medicinal plants, trace elemental analysis, mineral contents

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Authors: Karlygash Tulendieva

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Presently vaccination is the most effective method of prevention of flu and its complications. The purpose of this study was to analyze the impact of the increase of coverage of the population of South Kazakhstan region with flu vaccination and decrease of the ARVI morbidity. The analysis was performed on the data of flu vaccination of risk groups, including children under one year and pregnant women. Data on ARVI morbidity during 2010-2015 and data on vaccination were taken from the reports of the Epidemiological Surveillance Unit of Department of Consumers’ Rights Protection of South Kazakhstan region. Coverage with flu vaccination of the risk groups was annually increasing and in 2015 it reached 16% (450,000/2,800,682) from the total population. The ARVI morbidity rate in the entire population in 2010 was 2,010.4 per 100,000 of the population and decreased 3.2 times to 609.9 per 100,000 of the population in 2015. Annual growth was observed from 2010 to 2015 of specific weight of the vaccinated main risk groups: healthcare workers by 51% (from 17,331 in 2010 to 33,538 in 2015), children with chronic pulmonary and cardio-vascular diseases, immune deficiency, weak and sickly children above six months by 39% (from 63,122 in 2010 to 158,023 in 2015), adults with chronic co-morbidities by 27% (from 44,271 in 2010 to 162,595 in 2015), persons above 65 by 17% (from 10,276 in 2010 to 57,875 in 2015), and annual coverage of pregnant women on second or third trimester from 34,443 in 2010 to 37,969 in 2015. Starting from 2013 and until 2015 vaccination was performed in the region with coverage of at least 90% of children from 6 months to one year. The ARVI morbidity in this age group decreased 3.3 times from 8,687.8 per 100,000 of the population in 2010 to 2,585.8 per 100,000 of the population in 2015. Vaccination of pregnant women on 2-3 trimester was started in the region in 2012. Annual increase of vaccination coverage of pregnant women from 86.1% (34,443/40,000) in 2012 to 95% (37,969/40,000) in 2015 decreased the morbidity 1.5 times from 4,828.8 per 100,000 of population in 2012 to 3,022.7 per 100,000 of population in 2015. Following the increase of vaccination coverage of the population in South Kazakhstan region, the trend was observed of decrease of ARVI morbidity rates among the population and main risk groups, among pregnant women and children under one year.

Keywords: acute respiratory viral infections, flu, risk groups, vaccination

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Authors: Mansoureh Karimollahi, Mehriar Adrmohammadi, Mohsen Mohammadi

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Introduction: Patient satisfaction with nursing care is considered as an important indicator of the quality and effectiveness of the health care system, and improving the quality of care is not possible without paying attention to the opinions and expectations of patients. Considering that the scales for assessing satisfaction with nursing care in our country are not comprehensive and measure very few areas, therefore, in this study, psychometrically, the Persian version of the Newcastle Nursing Care Satisfaction Scale was used in patients hospitalized in the wards. Internal medicine and general surgery were discussed. Methods: This cross-sectional study was conducted on 200 patients admitted to the surgery and internal departments of hospitals affiliated to Ardabil University of Medical Sciences. The Newcastle nursing care satisfaction scale was used for the first time in Iran in comparison with the good nursing care scale from the patients' point of view to evaluate the criterion validity. The Newcastle nursing care satisfaction scale was used after translation, validity, and reliability. Results: The level of satisfaction of patients and the experience of patients with nursing care was at a favorable level, respectively, with an average of 111.8 ± 14.2 and 69.07 ± 14.8. Total CVI was estimated at 0.96 for the experience section, 0.95 for the satisfaction section, and 0.96 for the whole scale. The index (CVR) was also 0.95 for the experience section, 0.95 for the satisfaction section, and 0.95 for the whole scale. Criterion validity was also estimated using 0.725 correlation. The validity of the construct was also confirmed using the goodness of fit index (X2=1932/05, p=0.013, KMO=0.913). Convergent validity was estimated at 0.99 in the experience subscale and 0.98 in the satisfaction subscale. . The overall reliability in the experience subscale and satisfaction subscale was 94%, 92%, and 98%, respectively, which indicated the acceptable reliability of the questionnaire. Conclusion: The Persian version of the Newcastle nursing care satisfaction scale as a comprehensive tool that can be easily completed by patients and is easy to interpret, has good validity and reliability and can be used in patient care centers, in departments Surgery, and internal medicine are recommended.

Keywords: psychometrics, Newcastle nursing care satisfaction scale, nursing care satisfaction, general surgery department

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Authors: Jyoti Singh, Ranju Bansal

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Fighting pain and inflammation is a common problem faced by physicians while dealing with a wide variety of diseases. Since ancient time nonsteroidal anti-inflammatory agents (NSAIDs) and opioids have been the cornerstone of treatment therapy, however, the usefulness of both these classes is limited due to severe side effects. NSAIDs, which are mainly used to treat mild to moderate inflammatory pain, induce gastric irritation and nephrotoxicity whereas opioids show an array of adverse reactions such as respiratory depression, sedation, and constipation. Moreover, repeated administration of these drugs induces tolerance to the analgesic effects and physical dependence. Further discovery of selective COX-2 inhibitors (coxibs) suggested safety without any ulcerogenic side effects; however, long-term use of these drugs resulted in kidney and hepatic toxicity along with an increased risk of secondary cardiovascular effects. The basic approaches towards inflammation and pain treatment are constantly changing, and researchers are continuously trying to develop safer and effective anti-inflammatory drug candidates for the treatment of different inflammatory conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriasis and multiple sclerosis. Synthetic 3(2H)-pyridazinones constitute an important scaffold for drug discovery. Structure-activity relationship studies on pyridazinones have shown that attachment of a lactam at N-2 of the pyridazinone ring through a methylene spacer results in significantly increased anti-inflammatory and analgesic properties of the derivatives. Further introduction of the heterocyclic ring at lactam nitrogen results in improvement of biological activities. Keeping in mind these SAR studies, a new series of compounds were synthesized as shown in scheme 1 and investigated for anti-inflammatory, analgesic, anti-platelet activities and docking studies. The structures of newly synthesized compounds have been established by various spectroscopic techniques. All the synthesized pyridazinone derivatives exhibited potent anti-inflammatory and analgesic activity. Homoveratryl substituted derivative was found to possess highest anti-inflammatory and analgesic activity displaying 73.60 % inhibition of edema at 40 mg/kg with no ulcerogenic activity when compared to standard drugs indomethacin. Moreover, 2-substituted-4-benzo[d][1,3]dioxole-6-phenylpyridazin-3(2H)-ones derivatives did not produce significant changes in bleeding time and emerged as safe agents. Molecular docking studies also illustrated good binding interactions at the active site of the cyclooxygenase-2 (hCox-2) enzyme.

Keywords: anti-inflammatory, analgesic, pyridazin-3(2H)-one, selective COX-2 inhibitors

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Authors: Meriem Taleb, Ghania Tail, Fatma Zohra Kara, Brahim Djedouani, T. Moussa

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Forensic entomology is the use of insects and their arthropod relatives as silent witnesses to aid legal investigations by interpreting information concerning a death. The main purpose of forensic entomology is to establish the postmortem interval or PMI Postmortem interval is a matter of crucial importance in the investigations of homicide and other untimely deaths when the body found is after three days. Forensic entomology has grown immensely as a discipline in the past thirty years. In Algeria, forensic entomology was introduced in 2010 by the National Institute for Criminalistics and Criminology of the National Gendarmerie (NICC). However, all the work that has been done so far in this growing field in Algeria has been unknown at both the national and international levels. In this context, the aim of this paper is to describe the state of forensic entomology in Algeria. The Laboratory of Entomology of the NICC is the only one of its kind in Algeria. It started its activities in 2010, consisting of two specialists. The main missions of the laboratory are estimation of the PMI by the analysis of entomological evidence, and determination if the body was moved. Currently, the laboratory is performing different tasks such as the expert work required by investigators to estimate the PMI using the insects. The estimation is performed by the accumulated degree days method (ADD) in most of the cases except for those where the cadaver is in dry decay. To assure the quality of the entomological evidence, crime scene personnel are trained by the laboratory of Entomology of the NICC. Recently, undergraduate and graduate students have been studying carrion ecology and insect activity in different geographic locations of Algeria using rabbits and wild boar cadavers as animal models. The Laboratory of Entomology of the NICC has also been involved in some of these research projects. Entomotoxicology experiments are also conducted with the collaboration of the Toxicology Department of the NICC. By dint of hard work that has been performed by the Laboratory of Entomology of the NICC, official bodies have been adopting more and more the use of entomological evidence in criminal investigations in Algeria, which is commendable. It is important, therefore, that steps are taken to fill in the gaps in the knowledge necessary for entomological evidence to have a useful future in criminal investigations in Algeria.

Keywords: forensic entomology, corpse, insects, postmortem interval, expertise, Algeria

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Authors: E. E. Tereshatov, M. Yu. Boltoeva, V. Mazan, M. F. Volia, C. M. Folden III

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Room temperature ionic liquids (RTILs) are a class of liquid organic salts with melting points below 20 °C that are considered to be environmentally friendly ‘designers’ solvents. Pure hydrophobic ILs are known to extract metallic species from aqueous solutions. The closest analogues of ionic liquids are deep eutectic solvents (DESs), which are a eutectic mixture of at least two compounds with a melting point lower than that of each individual component. DESs are acknowledged to be attractive for organic synthesis and metal processing. Thus, these non-volatile and less toxic compounds are of interest for critical metal extraction. The US Department of Energy and the European Commission consider indium as a key metal. Its chemical homologue, thallium, is also an important material for some applications and environmental safety. The aim of this work is to systematically investigate In and Tl extraction from aqueous solutions into pure fluorinated ILs and hydrophobic DESs. The dependence of the Tl extraction efficiency on the structure and composition of the ionic liquid ions, metal oxidation state, and initial metal and aqueous acid concentrations have been studied. The extraction efficiency of the TlXz3–z anionic species (where X = Cl– and/or Br–) is greater for ionic liquids with more hydrophobic cations. Unexpectedly high distribution ratios (> 103) of Tl(III) were determined even by applying a pure ionic liquid as receiving phase. An improved mathematical model based on ion exchange and ion pair formation mechanisms has been developed to describe the co-extraction of two different anionic species, and the relative contributions of each mechanism have been determined. The first evidence of indium extraction into new quaternary ammonium- and menthol-based hydrophobic DESs from hydrochloric and oxalic acid solutions with distribution ratios up to 103 will be provided. Data obtained allow us to interpret the mechanism of thallium and indium extraction into ILs and DESs media. The understanding of Tl and In chemical behavior in these new media is imperative for the further improvement of separation and purification of these elements.

Keywords: deep eutectic solvents, indium, ionic liquids, thallium

Procedia PDF Downloads 241