Search results for: generalized anxiety disorder
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2692

Search results for: generalized anxiety disorder

952 Application of ATP7B Gene Mutation Analysis in Prenatal Diagnosis of Wilson’s Disease

Authors: Huong M. T. Nguyen, Hoa A. P. Nguyen, Chi V. Phan, Mai P. T. Nguyen, Ngoc D. Ngo, Van T. Ta, Hai T. Le

Abstract:

Wilson’s disease is an autosomal recessive disorder of copper metabolism, which is caused by mutation in copper- transporting P-type ATPase (ATP7B). The mechanism of this disease is a failure of hepatic excretion of copper to the bile, and it leads to copper deposits in the liver and other organs. Most clinical symptoms of Wilson’s disease can present as liver disease and/or neurologic disease. Objective: The goal of the study is prenatal diagnosis for pregnant women at high risk of Wilson’s disease in Northern Vietnam. Material and method: Three probands with clinically diagnosed liver disease were detected in the mutations of 21 exons and exon-intron boundaries of the ATP7B gene by direct Sanger-sequencing. Prenatal diagnoses were performed by amniotic fluid sampling from pregnant women in the 16th-18th weeks of pregnancy after the genotypes of parents with the probands were identified. Result: A total of three different mutations of the probands, including of S105*, P1052L, P1273G, were detected. Among three fetuses which underwent prenatal genetic testing, one fetus was homozygote; two fetuses were carriers. Conclusion: Genetic testing provided a useful method for prenatal diagnosis, and is a basis for genetic counseling.

Keywords: ATP7B gene, genetic testing, prenatal diagnosis, pedigree, Wilson disease

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951 A Multi-Release Software Reliability Growth Models Incorporating Imperfect Debugging and Change-Point under the Simulated Testing Environment and Software Release Time

Authors: Sujit Kumar Pradhan, Anil Kumar, Vijay Kumar

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The testing process of the software during the software development time is a crucial step as it makes the software more efficient and dependable. To estimate software’s reliability through the mean value function, many software reliability growth models (SRGMs) were developed under the assumption that operating and testing environments are the same. Practically, it is not true because when the software works in a natural field environment, the reliability of the software differs. This article discussed an SRGM comprising change-point and imperfect debugging in a simulated testing environment. Later on, we extended it in a multi-release direction. Initially, the software was released to the market with few features. According to the market’s demand, the software company upgraded the current version by adding new features as time passed. Therefore, we have proposed a generalized multi-release SRGM where change-point and imperfect debugging concepts have been addressed in a simulated testing environment. The failure-increasing rate concept has been adopted to determine the change point for each software release. Based on nine goodness-of-fit criteria, the proposed model is validated on two real datasets. The results demonstrate that the proposed model fits the datasets better. We have also discussed the optimal release time of the software through a cost model by assuming that the testing and debugging costs are time-dependent.

Keywords: software reliability growth models, non-homogeneous Poisson process, multi-release software, mean value function, change-point, environmental factors

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950 Pilot Trial of Evidence-Based Integrative Group Therapy to Improve Executive Functioning among Adults: Implications for Community Mental Health and Training Clinics

Authors: B. Parchem, M. Watanabe, D. Modrakovic, L. Mathew, A. Franklin, M. Cao, R. E. Broudy

Abstract:

Objective: Executive functioning (EF) deficits underlie several mental health diagnoses including ADHD, anxiety, and depression. Community mental health clinics face extensive waitlists for services with many referrals involving EF deficits. A pilot trial of a four-week group therapy was developed using key components from Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and mindfulness with an aim to improve EF skills and offer low-fee services. Method: Eight adults (M = 34.5) waiting for services at a community clinic were enrolled in a four-week group therapy at an in-house training clinic for doctoral trainees. Baseline EF, pre-/post-intervention ADHD and distress symptoms, group satisfaction, and curriculum helpfulness were assessed. Results: Downward trends in ADHD and distress symptoms pre/post-intervention were not significant. Favorable responses on group satisfaction and helpfulness suggest clinical utility. Conclusion: Preliminary pilot data from a brief group therapy to improve EF may be an efficacious, acceptable, and feasible intervention for adults waiting for services at community mental health and training clinics where there are high demands and limits to services and staffs.

Keywords: executive functioning, cognitive-behavioral therapy, dialectical behavior therapy, mindfulness, adult group therapy

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949 The Influence of Students’ Race and Socioeconomic Status on Teachers’ Assessment of ADHD: Implications for Educational Inequalities

Authors: Justine McKay

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Implicit Bias and its impact on the schooling experience of racial minorities with ADHD is significant. ADHD has become a globally diagnosed disorder. The lack of an objective diagnostic tool for ADHD has created controversy over the disease and its validity. ADHD is referred to as a social construct or a suburban problem related to active white boys who disrupt classrooms. The subjectivity of an ADHD diagnosis and the diagnostic process is based on norm-referenced checklists of behaviours completed by the student, caregiver, teachers, clinicians, and other community members. Teachers' perceptions of classroom behaviours are influenced by implicit bias related to race and socioeconomic status. The same behaviours displayed by white and marginalized or low-income students are perceived differently. The white student is perceived to be struggling academically and needing support, while the marginalized or lower-income student's behaviour is seen as disruptive or criminal. The presence of teacher implicit bias results in the inequity of diagnosis, and academic support, which has long-term implications for these students. The subjectivity of the diagnostic process socially reproduces the systemic injustice of opportunity for marginalized youth within the education system.

Keywords: ADHD, education, equity, implicit bias, subjectivity

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948 Effect of Particle Aspect Ratio and Shape Factor on Air Flow inside Pulmonary Region

Authors: Pratibha, Jyoti Kori

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Particles in industry, harvesting, coal mines, etc. may not necessarily be spherical in shape. In general, it is difficult to find perfectly spherical particle. The prediction of movement and deposition of non spherical particle in distinct airway generation is much more difficult as compared to spherical particles. Moreover, there is extensive inflexibility in deposition between ducts of a particular generation and inside every alveolar duct since particle concentrations can be much bigger than the mean acinar concentration. Consequently, a large number of particles fail to be exhaled during expiration. This study presents a mathematical model for the movement and deposition of those non-spherical particles by using particle aspect ratio and shape factor. We analyse the pulsatile behavior underneath sinusoidal wall oscillation due to periodic breathing condition through a non-Darcian porous medium or inside pulmonary region. Since the fluid is viscous and Newtonian, the generalized Navier-Stokes equation in two-dimensional coordinate system (r, z) is used with boundary-layer theory. Results are obtained for various values of Reynolds number, Womersley number, Forchsheimer number, particle aspect ratio and shape factor. Numerical computation is done by using finite difference scheme for very fine mesh in MATLAB. It is found that the overall air velocity is significantly increased by changes in aerodynamic diameter, aspect ratio, alveoli size, Reynolds number and the pulse rate; while velocity is decreased by increasing Forchheimer number.

Keywords: deposition, interstitial lung diseases, non-Darcian medium, numerical simulation, shape factor

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947 Identification of Outliers in Flood Frequency Analysis: Comparison of Original and Multiple Grubbs-Beck Test

Authors: Ayesha S. Rahman, Khaled Haddad, Ataur Rahman

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At-site flood frequency analysis is used to estimate flood quantiles when at-site record length is reasonably long. In Australia, FLIKE software has been introduced for at-site flood frequency analysis. The advantage of FLIKE is that, for a given application, the user can compare a number of most commonly adopted probability distributions and parameter estimation methods relatively quickly using a windows interface. The new version of FLIKE has been incorporated with the multiple Grubbs and Beck test which can identify multiple numbers of potentially influential low flows. This paper presents a case study considering six catchments in eastern Australia which compares two outlier identification tests (original Grubbs and Beck test and multiple Grubbs and Beck test) and two commonly applied probability distributions (Generalized Extreme Value (GEV) and Log Pearson type 3 (LP3)) using FLIKE software. It has been found that the multiple Grubbs and Beck test when used with LP3 distribution provides more accurate flood quantile estimates than when LP3 distribution is used with the original Grubbs and Beck test. Between these two methods, the differences in flood quantile estimates have been found to be up to 61% for the six study catchments. It has also been found that GEV distribution (with L moments) and LP3 distribution with the multiple Grubbs and Beck test provide quite similar results in most of the cases; however, a difference up to 38% has been noted for flood quantiles for annual exceedance probability (AEP) of 1 in 100 for one catchment. These findings need to be confirmed with a greater number of stations across other Australian states.

Keywords: floods, FLIKE, probability distributions, flood frequency, outlier

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946 The Effects of Consistently Reading Whole Novels on the Reading Comprehension of Adolescents with Developmental Disabilities

Authors: Pierre Brocas, Konstantinos Rizos

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This study was conducted to test the effects of introducing a consistent pace and volume of reading whole narratives on adolescents' reading comprehension with a diagnosis of autism spectrum disorder (ASD). The study was inspired by previous studies conducted on poorer adolescent readers in English schools. The setting was a Free Special Education Needs school in England. Nine male and one female student, between 11-13 years old, across two classrooms participated in the study. All students had a diagnosis of ASD, and all were classified as advanced learners. The classroom teachers introduced reading a whole challenging novel in 12 weeks with consistency as the independent variable. The study used a before-and-after design of testing the participants’ reading comprehension using standardised tests. The participants made a remarkable 1.8 years’ mean progress on the standardised tests of reading comprehension, with three participants making 4+ years progress. The researchers hypothesise that reading novels aloud and at a fast pace in each lesson, that are challenging but appropriate to the participants’ learning level, may have a beneficial effect on the reading comprehension of adolescents with learning difficulties, giving them a more engaged uninterrupted reading experience over a sustained period. However, more studies need to be conducted to test the independent variable across a bigger and more diverse population with a stronger design.

Keywords: autism, reading comprehension, developmental disabilities, narratives

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945 Transforming ESL Teaching and Learning with ICT

Authors: Helena Sit

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Developing skills in using ICT in the language classroom has been discussed at all educational levels. Digital tools and learning management systems enable teachers to transform their instructional activities while giving learners the opportunity to engage with virtual communities. In the field of English as a second language (ESL) teaching and learning, the use of technology-enhanced learning and diverse pedagogical practices continues to grow. Whilst technology and multimodal learning is a way of the future for education, second language teachers now face the predicament as to whether implementing these newer ways of learning is, in fact, beneficial or disadvantageous to learners. Research has shown that integrating multimodality and technology can improve students’ engagement and participation in their English language learning. However, students can experience anxiety or misunderstanding when engaging with E-learning or digital-mediated learning. This paper aims to explore how ESL teaching and learning are transformed via the use of educational technology and what impact it has had on student teachers. Case study is employed in this research. The study reviews the growing presence of technology and multimodality in university language classrooms, discusses their impact on teachers’ pedagogical practices, and proposes scaffolding strategies to help design effective English language courses in the Australian education context. The study sheds light on how pedagogical integration today may offer a way forward for language teachers of tomorrow and provides implications to implement an evidence-informed approach that blends knowledge from research, practice and people experiencing the practice in the digital era.

Keywords: educational technology, ICT in higher education, curriculum design and innovation, teacher education, multiliteracies pedagogy

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944 Prevalence of Workplace Bullying in Hong Kong: A Latent Class Analysis

Authors: Catalina Sau Man Ng

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Workplace bullying is generally defined as a form of direct and indirect maltreatment at work including harassing, offending, socially isolating someone or negatively affecting someone’s work tasks. Workplace bullying is unfortunately commonplace around the world, which makes it a social phenomenon worth researching. However, the measurements and estimation methods of workplace bullying seem to be diverse in different studies, leading to dubious results. Hence, this paper attempts to examine the prevalence of workplace bullying in Hong Kong using the latent class analysis approach. It is often argued that the traditional classification of workplace bullying into the dichotomous 'victims' and 'non-victims' may not be able to fully represent the complex phenomenon of bullying. By treating workplace bullying as one latent variable and examining the potential categorical distribution within the latent variable, a more thorough understanding of workplace bullying in real-life situations may hence be provided. As a result, this study adopts a latent class analysis method, which was tested to demonstrate higher construct and higher predictive validity previously. In the present study, a representative sample of 2814 employees (Male: 54.7%, Female: 45.3%) in Hong Kong was recruited. The participants were asked to fill in a self-reported questionnaire which included measurements such as Chinese Workplace Bullying Scale (CWBS) and Chinese Version of Depression Anxiety Stress Scale (DASS). It is estimated that four latent classes will emerge: 'non-victims', 'seldom bullied', 'sometimes bullied', and 'victims'. The results of each latent class and implications of the study will also be discussed in this working paper.

Keywords: latent class analysis, prevalence, survey, workplace bullying

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943 Numerical Investigation of a New Two-Fluid Model for Semi-Dilute Polymer Solutions

Authors: Soroush Hooshyar, Mohamadali Masoudian, Natalie Germann

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Many soft materials such as polymer solutions can develop localized bands with different shear rates, which are known as shear bands. Using the generalized bracket approach of nonequilibrium thermodynamics, we recently developed a new two-fluid model to study shear banding for semi-dilute polymer solutions. The two-fluid approach is an appropriate means for describing diffusion processes such as Fickian diffusion and stress-induced migration. In this approach, it is assumed that the local gradients in concentration and, if accounted for, also stress generate a nontrivial velocity difference between the components. Since the differential velocity is treated as a state variable in our model, the implementation of the boundary conditions arising from the derivative diffusive terms is straightforward. Our model is a good candidate for benchmark simulations because of its simplicity. We analyzed its behavior in cylindrical Couette flow, a rectilinear channel flow, and a 4:1 planar contraction flow. The latter problem was solved using the OpenFOAM finite volume package and the impact of shear banding on the lip and salient vortices was investigated. For the other smooth geometries, we employed a standard Chebyshev pseudospectral collocation method. The results showed that the steady-state solution is unique with respect to initial conditions, deformation history, and the value of the diffusivity constant. However, smaller the value of the diffusivity constant is, the more time it takes to reach the steady state.

Keywords: nonequilibrium thermodynamics, planar contraction, polymer solutions, shear banding, two-fluid approach

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942 MMP-2 Gene Polymorphism and Its Influence on Serum MMP-2 Levels in Pre-Eclampsia in Indian Population

Authors: Ankush Kalra, Mirza Masroor, Usha Manaktala, B. C. Koner, T. K. Mishra

Abstract:

Introduction: Pre-eclampsia affects 3-5% of pregnancies worldwide and increases maternal-fetal morbidity and mortality. Reduced placental perfusion induces the release of biomolecules by the placenta into maternal circulation causing endothelial dysfunction. Zinc dependent matrix metalloproteinase-2 (MMP-2) may be up-regulated and interact with circulating factors of oxidative stress and inflammation to produce endothelial dysfunction in pre-eclampsia. Aim: To study the functional genetic polymorphism of MMP-2 gene (g-1306 C>T) in pre-eclampsia and its effect on serum MMP-2 levels in these patients. Method: Hundred pre-eclampsia patients and hundred age and gestation period matched healthy pregnant women with their consent were recruited in the study. Serum MMP-2 levels in all subjects were estimated using standard ELISA kits. MMP-2 gene (g.- 1306 C>T) SNPs were genotyped using whole blood by ASO-PCR. Result: The pre-eclampsia patients had higher serum levels of MMP-2 compared to the healthy pregnant (p < 0.05). Also the MMP-2 genotype was associated with significant alteration in the serum MMP-2 concentration in these patients (p < 0.05). Conclusion: This study results suggest an association of MMP-2 genetic polymorphism and serum levels of MMP-2 to the path physiology of hypertensive disorder of pregnancy.

Keywords: allele specific oligonucleotide polymerase chain reaction (ASO-PCR), enzyme linked immunosorbent assay (ELISA), matrix metalloproteinase-2 (MMP-2), pre-eclampsia

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941 Foreign Investment, Technological Diffusion and Competiveness of Exports: A Case for Textile Industry in Pakistan

Authors: Syed Toqueer Akhter, Muhammad Awais

Abstract:

Pakistan is a country which is gifted by naturally abundant resources these resources are a pioneer towards a prospect and developed country. Pakistan is the fourth largest exporter of the textile in the world and with the passage of time the competitiveness of these exports is subject to a decline. With a lot of International players in the textile world like China, Bangladesh, India, and Sri Lanka, Pakistan needs to put up a lot of effort to compete with these countries. This research paper would determine the impact of Foreign Direct Investment upon technological diffusion and that how significantly it may be affecting on export performance of the country. It would also demonstrate that with the increase in Foreign Direct Investment, technological diffusion, strong property rights, and using different policy tools, export competitiveness of the country could be improved. The research has been carried out using time series data from 1995 to 2013 and the results have been estimated by using competing Econometrics modes such as Robust regression and Generalized least squares so that to consolidate the impact of the Foreign Investments and Technological diffusion upon export competitiveness comprehensively. Distributed Lag model has also been used to encompass the lagged effect of policy tools variables used by the government. Model estimates entail that 'FDI' and 'Technological Diffusion' do have a significant impact on the competitiveness of the exports of Pakistan. It may also be inferred that competitiveness of Textile Sector requires integrated policy framework, primarily including the reduction in interest rates, providing subsides, and manufacturing of value added products.

Keywords: high technology export, robust regression, patents, technological diffusion, export competitiveness

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940 Rare Case of Pyoderma Gangrenosum of the Upper Limb

Authors: Karissa A. Graham

Abstract:

Pyoderma gangrenosum (PG) is a prototypic autoinflammatory neutrophilic dermatosis that is a rare disorder. It presents a diagnostic challenge owing to its variable presentation, clinical overlap with other conditions, it is often associated with other systemic conditions, and there is no definitive histological or laboratory characteristic. The Delphai consensus for PG includes the presence of at least one ulcer on the anterior lower limb. Systemic corticosteroids and immunosuppressive therapies are the mainstay treatment for PG. We describe a case report of delayed diagnosis of ulcerative pyoderma gangrenosum in a 44-year-old male on his forearm. The patient presented with an infected ulcer on his right forearm that had been present for over three years. The patient was a Type 2 Diabetic with no personal or family history of inflammatory bowel disease or other autoimmune diseases. The patient was initially investigated for malignancy, but biopsies returned as chronic inflammatory tissue with neutrophilic infiltrate and no malignancy. The patient was commenced on systemic prednisone for the treatment of pyoderma gangrenosum. The diagnosis of ulcerative PG poses a challenge given the vast differential diagnosis for a cutaneous ulcer (i.e., malignant, vascular, autoimmune, trauma, infective, etc.). Diagnostic accuracy is important given that the treatment for PG with steroids does not go without risks and indeed may be contraindicated in other potential causes of the ulcer. Indeed, more common and more sinister causes of ulcers should be investigated first, as death from PG is quite rare.

Keywords: dermatological diagnosis, dermatosis, pyoderma gangrenosum, rare presentation

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939 Acute Severe Hyponatremia in Patient with Psychogenic Polydipsia, Learning Disability and Epilepsy

Authors: Anisa Suraya Ab Razak, Izza Hayat

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Introduction: The diagnosis and management of severe hyponatremia in neuropsychiatric patients present a significant challenge to physicians. Several factors contribute, including diagnostic shadowing and attributing abnormal behavior to intellectual disability or psychiatric conditions. Hyponatraemia is the commonest electrolyte abnormality in the inpatient population, ranging from mild/asymptomatic, moderate to severe levels with life-threatening symptoms such as seizures, coma and death. There are several documented fatal case reports in the literature of severe hyponatremia secondary to psychogenic polydipsia, often diagnosed only in autopsy. This paper presents a case study of acute severe hyponatremia in a neuropsychiatric patient with early diagnosis and admission to intensive care. Case study: A 21-year old Caucasian male with known epilepsy and learning disability was admitted from residential living with generalized tonic-clonic self-terminating seizures after refusing medications for several weeks. Evidence of superficial head injury was detected on physical examination. His laboratory data demonstrated mild hyponatremia (125 mmol/L). Computed tomography imaging of his brain demonstrated no acute bleed or space-occupying lesion. He exhibited abnormal behavior - restlessness, drinking water from bathroom taps, inability to engage, paranoia, and hypersexuality. No collateral history was available to establish his baseline behavior. He was loaded with intravenous sodium valproate and leveritircaetam. Three hours later, he developed vomiting and a generalized tonic-clonic seizure lasting forty seconds. He remained drowsy for several hours and regained minimal recovery of consciousness. A repeat set of blood tests demonstrated profound hyponatremia (117 mmol/L). Outcomes: He was referred to intensive care for peripheral intravenous infusion of 2.7% sodium chloride solution with two-hourly laboratory monitoring of sodium concentration. Laboratory monitoring identified dangerously rapid correction of serum sodium concentration, and hypertonic saline was switched to a 5% dextrose solution to reduce the risk of acute large-volume fluid shifts from the cerebral intracellular compartment to the extracellular compartment. He underwent urethral catheterization and produced 8 liters of urine over 24 hours. Serum sodium concentration remained stable after 24 hours of correction fluids. His GCS recovered to baseline after 48 hours with improvement in behavior -he engaged with healthcare professionals, understood the importance of taking medications, admitted to illicit drug use and drinking massive amounts of water. He was transferred from high-dependency care to ward level and was initiated on multiple trials of anti-epileptics before achieving seizure-free days two weeks after resolution of acute hyponatremia. Conclusion: Psychogenic polydipsia is often found in young patients with intellectual disability or psychiatric disorders. Patients drink large volumes of water daily ranging from ten to forty liters, resulting in acute severe hyponatremia with mortality rates as high as 20%. Poor outcomes are due to challenges faced by physicians in making an early diagnosis and treating acute hyponatremia safely. A low index of suspicion of water intoxication is required in this population, including patients with known epilepsy. Monitoring urine output proved to be clinically effective in aiding diagnosis. Early referral and admission to intensive care should be considered for safe correction of sodium concentration while minimizing risk of fatal complications e.g. central pontine myelinolysis.

Keywords: epilepsy, psychogenic polydipsia, seizure, severe hyponatremia

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938 Psychological Impacts of Over-the-Top Services on Consumer Behaviors during the COVID-19 Pandemic

Authors: Hector Liu, Chih-Ming Tsai

Abstract:

Consumer behaviors in the subscription of over-the-top (OTT) media services have substantially changed because of the COVID-19 pandemic; hence, this study aims to determine the factors affecting subscription intentions. The increased usage of OTT media, particularly in the lockdowns during the COVID-19 pandemic, has intensified the competition between both global and local streaming providers. While studies have discussed antecedents accounting for this change, they have paid limited attention to the psychological factors that shape consumer behavior in using OTT services. Given the changes in consumers’ psychological states during the pandemic, this study seeks to fill the research gap by integrating the expectancy-value model to provide insights into the key gratifications that consumers seek and obtain and that have affected their subscription to OTT services. This study proposes a theoretical model and assesses this framework on data collected from 1,068 OTT service users in Taiwan. The results strengthen the literature by indicating a clear growth in the popularity and subscription of OTT services because of the COVID-19 lockdowns as well as factors such as perceived quality and satisfaction, which influence behavioral intentions for OTT services. Most crucially, however, OTT viewers who acquired a sense of belonging, a sense of being accompanied, and a sense of reduction in anxiety due to being quarantined and in lockdown show a higher tendency to continue their subscriptions to their OTT services of choice during the pandemic. With consumer behavior trends forever changed by the COVID-19 pandemic, the implications from this study provide OTT service platforms with an opportunity to capitalize on their current and potential customers’ changing desires, demands, and factors for a continued subscription.

Keywords: consumer behavior, COVID-19, expectancy-value model, OTT media services

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937 Financial Markets Integration between Morocco and France: Implications on International Portfolio Diversification

Authors: Abdelmounaim Lahrech, Hajar Bousfiha

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This paper examines equity market integration between Morocco and France and its consequent implications on international portfolio diversification. In the absence of stock market linkages, Morocco can act as a diversification destination to European investors, allowing higher returns at a comparable level of risk in developed markets. In contrast, this attractiveness is limited if both financial markets show significant linkage. The research empirically measures financial market’s integration in by capturing the conditional correlation between the two markets using the Generalized Autoregressive Conditionally Heteroscedastic (GARCH) model. Then, the research uses the Dynamic Conditional Correlation (DCC) model of Engle (2002) to track the correlations. The research findings show that there is no important increase over the years in the correlation between the Moroccan and the French equity markets, even though France is considered Morocco’s first trading partner. Failing to prove evidence of the stock index linkage between the two countries, the volatility series of each market were assumed to change over time separately. Yet, the study reveals that despite the important historical and economic linkages between Morocco and France, there is no evidence that equity markets follow. The small correlations and their stationarity over time show that over the 10 years studied, correlations were fluctuating around a stable mean with no significant change at their level. Different explanations can be attributed to the absence of market linkage between the two equity markets.

Keywords: equity market linkage, DCC GARCH, international portfolio diversification, Morocco, France

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936 International Classification of Primary Care as a Reference for Coding the Demand for Care in Primary Health Care

Authors: Souhir Chelly, Chahida Harizi, Aicha Hechaichi, Sihem Aissaoui, Leila Ben Ayed, Maha Bergaoui, Mohamed Kouni Chahed

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Introduction: The International Classification of Primary Care (ICPC) is part of the morbidity classification system. It had 17 chapters, and each is coded by an alphanumeric code: the letter corresponds to the chapter, the number to a paragraph in the chapter. The objective of this study is to show the utility of this classification in the coding of the reasons for demand for care in Primary health care (PHC), its advantages and limits. Methods: This is a cross-sectional descriptive study conducted in 4 PHC in Ariana district. Data on the demand for care during 2 days in the same week were collected. The coding of the information was done according to the CISP. The data was entered and analyzed by the EPI Info 7 software. Results: A total of 523 demands for care were investigated. The patients who came for the consultation are predominantly female (62.72%). Most of the consultants are young with an average age of 35 ± 26 years. In the ICPC, there are 7 rubrics: 'infections' is the most common reason with 49.9%, 'other diagnoses' with 40.2%, 'symptoms and complaints' with 5.5%, 'trauma' with 2.1%, 'procedures' with 2.1% and 'neoplasm' with 0.3%. The main advantage of the ICPC is the fact of being a standardized tool. It is very suitable for classification of the reasons for demand for care in PHC according to their specificity, capacity to be used in a computerized medical file of the PHC. Its current limitations are related to the difficulty of classification of some reasons for demand for care. Conclusion: The ICPC has been developed to provide healthcare with a coding reference that takes into account their specificity. The CIM is in its 10th revision; it would gain from revision to revision to be more efficient to be generalized and used by the teams of PHC.

Keywords: international classification of primary care, medical file, primary health care, Tunisia

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935 The Effectiveness of Non-surgical Treatment for Androgenetic Alopecia in Men: A Systematic Review and Meta-Analysis

Authors: Monica Trifitriana, Rido Mulawarman

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Introduction: Androgenetic alopecia (AGA) is a genetically predetermined disorder due to an excessive response to dihydrotestosterone (DHT). Currently, non-surgical treatment of androgenetic alopecia is more in demand by the patient. There are many non-surgical treatments, ranging from topical treatments oral medications, and procedure treatments. Objective: We aim to assess the latest evidence of the efficacy of non-surgical treatments of androgenetic alopecia in men in comparison to placebo for improving hair density, thickness, and growth. Method: We performed a comprehensive search on topics that assess non-surgical treatments of androgenetic alopecia in men from inception up until November 2021. Result: There were 24 studies out of a total of 2438 patients divided into five non-surgical treatment groups to assess the effectiveness of hair growth, namely: minoxidil 2% (MD: 8.11 hairs/cm²), minoxidil 5% (MD: 12.02 hairs/cm²), low-level laser light therapy/LLLT (MD: 12.35 hairs/cm²), finasteride 1mg (MD: 20.43 hairs/cm²), and Platelete-Rich Plasma/PRP with microneedling (MD: 26.33 hairs/cm²). All treatments had significant results for increasing hair growth, particularly in cases of androgenetic alopecia in men (P<0.00001). Conclusion: From the results, it was found that the five non-surgical treatment groups proved to be effective and significant for hair growth, particularly in cases of androgenetic alopecia in men. In order of the best non-surgical treatment for hair growth is starting from PRP with microneedling, Finasteride 1mg, LLLT, minoxidil 5%, to minoxidil 2%.

Keywords: androgenetic alopecia, non-surgical, men, meta-analysis, systematic review

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934 Manifestation of Behavioral and Emotional Disturbances and Perceived Coping Strategies of Earthquake Survived Children

Authors: Mahwish Rabia, Najma Najam

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The present study was conducted to identify emotional and behavioral disturbances among earthquake survived children and the perceived coping strategies of affected children. In the present study, a sample of 50 children (6-16 years) belonging to badly affected areas (earthquake) was selected from different camps in Islamabad. Child Behavioral Checklist (CBCL) and Rotter Incomplete Sentence Blank (RISB) interpretations were used to assess variety of emotional and behavioral patterns, and Child Coping Strategies Checklist (CCSC) was used to assess the perceived coping strategies of affected children. Results showed that some of the frequent emotional/behavioral reactions exhibited by children like withdrawal, anxiety\depression, aggression and attention seeking behavior. Whereas gender-based comparisons indicated that female children showed more internalizing behavioral patterns (withdrawn, somatic complaints) as compared to male children who exhibited more externalizing emotions (aggression, delinquent behavior).Coping strategies in which male children tried to adopt Positive Cognitive Restructuring and for distracting attention they used distraction strategies of coping. It is concluded that significant negative emotional and behavioral reactions are exhibited by the earthquake affected children. Male children adopt coping strategies more as compared to female children. The study identifies the negative emotional and behavioral reactions towards trauma, which can be helpful for identifying the problematic area for counseling and therapeutic interventions for these children.

Keywords: behavioural disturbances, emotional disturbances, coping strategies, earthquake, children

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933 Information Overload, Information Literacy and Use of Technology by Students

Authors: Elena Krelja Kurelović, Jasminka Tomljanović, Vlatka Davidović

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The development of web technologies and mobile devices makes creating, accessing, using and sharing information or communicating with each other simpler every day. However, while the amount of information constantly increasing it is becoming harder to effectively organize and find quality information despite the availability of web search engines, filtering and indexing tools. Although digital technologies have overall positive impact on students’ lives, frequent use of these technologies and digital media enriched with dynamic hypertext and hypermedia content, as well as multitasking, distractions caused by notifications, calls or messages; can decrease the attention span, make thinking, memorizing and learning more difficult, which can lead to stress and mental exhaustion. This is referred to as “information overload”, “information glut” or “information anxiety”. Objective of this study is to determine whether students show signs of information overload and to identify the possible predictors. Research was conducted using a questionnaire developed for the purpose of this study. The results show that students frequently use technology (computers, gadgets and digital media), while they show moderate level of information literacy. They have sometimes experienced symptoms of information overload. According to the statistical analysis, higher frequency of technology use and lower level of information literacy are correlated with larger information overload. The multiple regression analysis has confirmed that the combination of these two independent variables has statistically significant predictive capacity for information overload. Therefore, the information science teachers should pay attention to improving the level of students’ information literacy and educate them about the risks of excessive technology use.

Keywords: information overload, computers, mobile devices, digital media, information literacy, students

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932 A Comparative Study of Active Release Technique and Myofascial Release Technique in Treatment of Patients with Upper Trapezius Spasm

Authors: Daxa Mishra, R. Harihara, Ankita

Abstract:

Trapezius muscle pain is the most common musculoskeletal disorder occurring in individuals who work with awkward positions, have repetitive movements and movements with precision demands. Treatment techniques like active release technique (ART) and myofascial release (MFR) can be used to relieve muscle spasm. The aim of the study is to compare the effect of ART and MFR on the upper trapezius muscle spasm. Methodology: A series of 60 patients of both sexes between the age group of 20 and 55 with upper trapezius spasm were divided into two groups by computerized randomization. Subjects in each group received treatment in the form of either ART or MFR for the period of seven days. cervical range of motion (ROM), neck disability index scale (NDI) and visual analog scale (VAS) tools were used to measure the outcome. Results: Paired Sample ‘t’ test was used to compare the Outcome differences within each group, while Independent ‘t’ test was used to compare the differences between the two groups for the same outcome measures. The improvement was found in both the groups at 7th day following intervention, but the group which received ART showed significant improvements as compared to group which received MFR. Conclusion: Although both techniques are effective in alleviation of symptoms and associated disability in upper trapezius muscle spasm, ART gave better results as compared to MRF.

Keywords: goniometer, myofascial release, active release, physiotherapy

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931 90-Day Strength Training Intervention Decreases Incidence of Sarcopenia: A Pre- and Posttest Pilot Study of Older Adults in a Skilled Nursing Facility

Authors: Donna-Marie Phyllis Lanton

Abstract:

Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

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930 Hair Regrowth Effect of Herbal Formula on Androgenic Alopecia Rat Model

Authors: Jian-You Wang, Feng Yi Hsu, Chieh-Hsi Wu

Abstract:

Androgenetic alopecia (AGA) is an androgen-dependent disorder caused by excess testosterone in blood capillaries or excess enzyme activity of 5α- reductase in hair follicles. Plants, alone or in combination, have been widely used for hair growth promotion since ancient times in Asia. In this study, the efficacy of a traditional Chinese herbal formula, Shen-Ying-Yang-Zhen-Dan (SYYZD) with different kinds of extract solvents, facilitating hair regrowth in testosterone-induced hair loss have been determined. The study was performed by treating with either 95 % ethanol aqueous extracts, 50% ethanol aqueous extracts or deionized water extracts orally in four-week-old male S.D. rats that experienced hair regrowth interruption induced by testosterone treatment. The 50% ethanol aqueous extracts group showed better hair regrowth promotion activities than either 95% ethanol aqueous extracts or deionized water extracts groups in 14 days treatment. In conclusion, our results suggest that 50% ethanol aqueous SYYZD extracts have hair growth promoting potential and may be beneficial as an alternative medicine for androgenetic alopecia treatment.

Keywords: Shen-Ying-Yang-Zhen-Dan, androgenic alopecia, hair loss, hair growth promotion, hair regrowth effect

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929 Improvement of Sleep Quality Through Manual and Non-Pharmacological Treatment

Authors: Andreas Aceranti, Sergio Romanò, Simonetta Vernocchi, Silvia Arnaboldi, Emilio Mazza

Abstract:

As a result of the Sars-Cov2 pandemic, the incidence of thymism disorders has significantly increased and, often, patients are reluctant to want to take drugs aimed at stabilizing mood. In order to provide an alternative approach to drug therapies, we have prepared a study in order to evaluate the possibility of improving the quality of life of these subjects through osteopathic treatment. Patients were divided into visceral and fascial manual treatment with the aim of increasing serotonin levels and stimulating the vagus nerve through validated techniques. The results were evaluated through the administration of targeted questionnaires in order to assess quality of life, mood, sleep and intestinal functioning. At a first endpoint we found, in patients undergoing fascial treatment, an increase in quality of life and sleep: in fact, they report a decrease in the number of nocturnal awakenings; a reduction in falling asleep times and greater rest upon waking. In contrast, patients undergoing visceral treatment, as well as those included in the control group, did not show significant improvements. Patients in the fascial group have, in fact, reported an improvement in thymism and subjective quality of life with a generalized improvement in function. Although the study is still ongoing, based on the results of the first endpoint we can hypothesize that fascial stimulation of the vagus nerve with manual and osteopathic techniques may be a valid alternative to pharmacological treatments in mood and sleep disorders.

Keywords: ostheopathy, insomnia, noctural awakening, thymism

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928 Characterization of the Pore System and Gas Storage Potential in Unconventional Reservoirs: A Case of Study of the Cretaceous la Luna Formation, Middle Magdalena Valley Basin, Colombia

Authors: Carlos Alberto Ríos-Reyes, Efraín Casadiego-Quintero

Abstract:

We propose a generalized workflow for mineralogy investigation of unconventional reservoirs using multi-scale imaging and pore-scale analyses. This workflow can be used for the integral evaluation of these resources. The Cretaceous La Luna Formation´s mudstones in the Middle Magdalena Valley Basin (Colombia) inherently show a heterogeneous pore system with organic and inorganic pores. For this reason, it is necessary to carry out the integration of high resolution 2D images of mapping by conventional petrography, scanning electron microscopy and quantitative evaluation of minerals by scanning electron microscopy to describe their organic and inorganic porosity to understand the transport mechanism through pores. The analyzed rocks show several pore types, including interparticle pores, organoporosity, intraparticle pores, intraparticle pores, and microchannels and/or microfractures. The existence of interconnected pores in pore system of these rocks promotes effective pathways for primary gas migration and storage space for residual hydrocarbons in mudstones, which is very useful in this type of gas reservoirs. It is crucial to understand not only the porous system of these rocks and their mineralogy but also to project the gas flow in order to design the appropriate strategies for the stimulation of unconventional reservoirs. Keywords: mudstones; La Luna Formation; gas storage; migration; hydrocarbon.

Keywords: mudstones, La luna formation, gas storage, migration, hydrocarbon

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927 Statistical Modeling of Local Area Fading Channels Based on Triply Stochastic Filtered Marked Poisson Point Processes

Authors: Jihad Daba, Jean-Pierre Dubois

Abstract:

Multi path fading noise degrades the performance of cellular communication, most notably in femto- and pico-cells in 3G and 4G systems. When the wireless channel consists of a small number of scattering paths, the statistics of fading noise is not analytically tractable and poses a serious challenge to developing closed canonical forms that can be analysed and used in the design of efficient and optimal receivers. In this context, noise is multiplicative and is referred to as stochastically local fading. In many analytical investigation of multiplicative noise, the exponential or Gamma statistics are invoked. More recent advances by the author of this paper have utilized a Poisson modulated and weighted generalized Laguerre polynomials with controlling parameters and uncorrelated noise assumptions. In this paper, we investigate the statistics of multi-diversity stochastically local area fading channel when the channel consists of randomly distributed Rayleigh and Rician scattering centers with a coherent specular Nakagami-distributed line of sight component and an underlying doubly stochastic Poisson process driven by a lognormal intensity. These combined statistics form a unifying triply stochastic filtered marked Poisson point process model.

Keywords: cellular communication, femto and pico-cells, stochastically local area fading channel, triply stochastic filtered marked Poisson point process

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926 Stem Cell Fate Decision Depending on TiO2 Nanotubular Geometry

Authors: Jung Park, Anca Mazare, Klaus Von Der Mark, Patrik Schmuki

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In clinical application of TiO2 implants on tooth and hip replacement, migration, adhesion and differentiation of neighboring mesenchymal stem cells onto implant surfaces are critical steps for successful bone regeneration. In a recent decade, accumulated attention has been paid on nanoscale electrochemical surface modifications on TiO2 layer for improving bone-TiO2 surface integration. We generated, on titanium surfaces, self-assembled layers of vertically oriented TiO2 nanotubes with defined diameters between 15 and 100 nm and here we show that mesenchymal stem cells finely sense TiO2 nanotubular geometry and quickly decide their cell fate either to differentiation into osteoblasts or to programmed cell death (apoptosis) on TiO2 nanotube layers. These cell fate decisions are critically dependent on nanotube size differences (15-100nm in diameters) of TiO2 nanotubes sensing by integrin clustering. We further demonstrate that nanoscale topography-sensing is feasible not only in mesenchymal stem cells but rather seems as generalized nanoscale microenvironment-cell interaction mechanism in several cell types composing bone tissue network including osteoblasts, osteoclast, endothelial cells and hematopoietic stem cells. Additionally we discuss the synergistic effect of simultaneous stimulation by nanotube-bound growth factor and nanoscale topographic cues on enhanced bone regeneration.

Keywords: TiO2 nanotube, stem cell fate decision, nano-scale microenvironment, bone regeneration

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925 Evaluating Models Through Feature Selection Methods Using Data Driven Approach

Authors: Shital Patil, Surendra Bhosale

Abstract:

Cardiac diseases are the leading causes of mortality and morbidity in the world, from recent few decades accounting for a large number of deaths have emerged as the most life-threatening disorder globally. Machine learning and Artificial intelligence have been playing key role in predicting the heart diseases. A relevant set of feature can be very helpful in predicting the disease accurately. In this study, we proposed a comparative analysis of 4 different features selection methods and evaluated their performance with both raw (Unbalanced dataset) and sampled (Balanced) dataset. The publicly available Z-Alizadeh Sani dataset have been used for this study. Four feature selection methods: Data Analysis, minimum Redundancy maximum Relevance (mRMR), Recursive Feature Elimination (RFE), Chi-squared are used in this study. These methods are tested with 8 different classification models to get the best accuracy possible. Using balanced and unbalanced dataset, the study shows promising results in terms of various performance metrics in accurately predicting heart disease. Experimental results obtained by the proposed method with the raw data obtains maximum AUC of 100%, maximum F1 score of 94%, maximum Recall of 98%, maximum Precision of 93%. While with the balanced dataset obtained results are, maximum AUC of 100%, F1-score 95%, maximum Recall of 95%, maximum Precision of 97%.

Keywords: cardio vascular diseases, machine learning, feature selection, SMOTE

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924 Can Demyelinative Lesion Cause To Behaviora Change?

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

Abstract:

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

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

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923 Recent Trend in Gluten-Free Bakery Products

Authors: Madhuresh Dwivedi, Navneet Singh Deora, H. N. Mishra

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In the context of bakery products, the gluten component of wheat has a crucial role in stabilizing the gas-cell and crumb structures, appearance, mouth feel and maintaining the rheological properties, thus the acceptability of these products. However, because of coeliac disease, some individuals cannot tolerate the protein gliadin present in the gluten fraction of wheat flour. Also termed as gluten-sensitive enteropathy, it is a common chronicle disorder in populations throughout the world with average prevalence of 0.37%. The safest way for celiac sufferers is to stay away from gluten-containing foods such as wheat, rye, barley as well as durum wheat, spelt wheat, and triticale. Thus, in view of the current increasing incidence of gluten intolerant sufferers (due to improved diagnostic procedures), the development of gluten-free cereal-based bakery products suitable for celiac patients represents a challenging and serious task, but also very demanding call for food technologists as well as for the bakers. The use of alternative cereal starches (like rice, soy, maize, potato and so on), gums, hydrocolloids, dietary fibres, alternative protein sources, prebiotics and combinations of them represent the most widespread approach used as replacement to mimic gluten in the manufacture of industrial processable gluten-free bakery products due to their structure-building and water binding properties.

Keywords: gluten-free, coeliac disease, alternative flour, hydrocolloid, crumb structure

Procedia PDF Downloads 263