Search results for: orthopedic trauma during delivery

Authors: Ridwan Dewayanto Rusli

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We show how prisoner's dilemma-type competition problems can be mitigated through rapid platform diversification and ecosystem expansion. We analyze a ride-hailing company in Southeast Asia, Gojek, whose network grew to more than 170 million users comprising consumers, partner drivers, merchants, and complementors within a few years and has already achieved higher contribution margins than ride-hailing peers Uber and Lyft. Its ecosystem integrates ride-hailing, food delivery and logistics, merchant solutions, e-commerce, marketplace and advertising, payments, and fintech offerings. The company continues growing its network of complementors and App developers, expanding content and gaining critical mass in consumer data analytics and advertising. We compare the company's growth and diversification trajectory with those of its main international rivals and peers. The company's rapid growth and future potential are analyzed using Cusumano's (2012) Staying Power and Six Principles, Hax and Wilde's (2003) and Hax's (2010) The Delta Model as well as Santos' (2016) home-market advantages frameworks. The recently announced multi-billion-dollar merger with one of Southeast Asia's largest e-commerce majors lends additional support to the above arguments.

Keywords: ride-hailing, prisoner's dilemma, platform and ecosystem strategy, digital applications, diversification, home market advantages, e-commerce

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Authors: Narendra Kumar

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This study uses data from the ‘National Family Health Survey (NFHS-3) 2005-06’ to investigate the predictors of infant and child mortality among low economic households in East and Northeast region. The cross tabulation, life table survival estimates and Cox proportional hazard model techniques have been used to estimate the predictors of infant and child mortality. The life table survival estimates for infant and child mortality shows that infant mortality in female child is lower in comparison to male child but with child mortality, the rates are higher for female in comparison to male child and the Cox proportional hazard model also give highly significant in female in comparison to male child. The infant and child mortality rates among poor households highest in the Central region followed by North and Northeast region and the lowest in South region in comparison to all regions of India. Education of respondent has been found a significant characteristics in both analyzes, further birth interval, respondent occupation, caste/tribe and place of delivery has substantial impact on infant and child mortality among low economic households in East and Northeast region. Finally these findings specified that an increase in parents’ education, improve health care services and improve socioeconomic conditions of low economic households which should in turn raise infant and child survival and should decrease child mortality among low economic households in India.

Keywords: infant, child, mortality, socio-economic, India

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Authors: Mozhgan Chaichi, Farhad Sharif, Saeede Mazinani

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Polymer nanocomposites are a new class of materials for fabricating future multifunctional and lightweight structures. To obtain good mechanical, thermal and electrical properties, it is essential to achieve uniform dispersion of nanoparticles in polymer matrix. Alignment of nanoparticles in matrix can enhance mechanical, thermal, electrical and barrier properties of nanocomposites in oriented direction. Fe3O4 nanoparticles have generated huge activity in many areas of science and engineering due to its magnetic properties. Magnetic nanoparticles have been investigated for a wide range of applications in sensors, magnetic energy storage, environmental remediation, heterogeneous catalysts and drug delivery. The magnetic response from the Fe3O4 nanoparticles can facilitate with the alignment of nanofillers in a polymer matrix under magnetic field, aiming at fabricating composites with directional properties and functions. Here we report oriented nanocomposites based on Fe3O4 nanoparticles and poly (vinyl alcohol) (PVA), which prepared via a facile aqueous solution by applying a low external magnetic field (750 G). A significant enhancement of mechanical properties, and especially toughness of nanofilms, of oriented PVA/ Fe3O4 nanocomposites is obtained at low nanoparticles loading. Orientation of nanoparticles can align polymer chains and enhance mechanical properties. For example, orientation of 0.1 wt. % Fe3O4 nanoparticles increase 31% toughness and 23% modulus of oriented nanocomposite in compare of pure films, which indicate good dispersion of nanoparticles and efficient load transfer between nanoparticles and matrix.

Keywords: magnetic nanoparticles, nanocomposites, toughness, orientation

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Authors: Asma Alsaleh, Kara Makara

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Autistic spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties with communication and interaction. Besides presenting challenges for the ASD individual, the condition can entail negative outcomes for those who care for them, most often mothers. While this issue has been studied substantially in Western society, less is known about how mothers in the Arab world are affected by raising an ASD child. This study sought to gain insights into this area by assessing quality of life and stress in mothers with (n = 25) and without (n = 25) ASD children in Riyadh (Saudi Arabia) by using, respectively, the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF) and the Parenting Stress Index-Short Form (PSI-SF). Data pertaining to income and education were also attained to investigate how socioeconomic factors interact with the above-mentioned variables. The analysis revealed that total stress scores and scores on the individual subscales of the PSI-SF were significantly higher for the mothers with an ASD child compared to those without an ASD child, though the opposite was true of quality of life scores. Moreover, increased income was associated with increased quality of life and decreased stress. While there were not main effects of education, there were interactions between education, whether children were ASD or non-ASD, and the outcome variables. These results suggest that mothers of ASD children in an Arab culture are at increased risk of negative outcomes relative to mothers of typically developing children, and, therefore, this study may act as a foundation for the delivery of interventions to assist mothers in this position.

Keywords: autism, education, income, mothers, quality of life, stress

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Authors: Mahdi Eskandarlou, Mehrdad Taghipour

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Background: Partial-thickness skin graft is the cornerstone for scalp defect repair. Routine donor sites include abdomen, thighs, and buttocks. Given the potential side effects following harvesting from these sites and the potential advantages of harvesting from scalp (broad surface, rapid healing, and better cosmetics results), this study is trying to compare the outcomes of graft harvesting from scalp and lower limb. Methods: This clinical trial is conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to plastic surgery clinic at Besat Hospital during the time period between 2018 and 2019. Sampling was done by simple randomization using random digit table. Data gathering was performed using a designated checklist. The donor site in case group and control group was scalp and lower limb, respectively. The resultant data were analyzed using chi-squared and t-test and SPPS version 21 (SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp). Results: Of the total 40 patients participating in this study, 28 patients (70%) were male, and 12 (30%) were female with and mean age of 63.62 ± 09.73 years. Hypertension and diabetes mellitus were the most common comorbidities among patients with basal cell carcinoma (BCC) and trauma being the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The most common anatomic location of defect for case and control groups was temporal and parietal, respectively. Most of the defects were deep to galea zone. The mean diameter of defect was 24.28 ± 45.37 mm for all of the patients. The difference between diameter of defect in both groups was statistically meaningful, while no such difference between graft diameter was seen. The graft 'Take' was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale, and the satisfaction was higher in them per Likert scale. Conclusion: Scalp can safely be used as donor site for skin graft to be used for scalp defects, which is associated with better results and lower complication rates compared to other donor sites.

Keywords: donor site, leg, partial-thickness graft, scalp

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Authors: Semyachkina-Glushkovskaya Oxana, Fedosov Ivan, Blokhina Inna, Terskov Andrey, Evsukova Arina, Elovenko Daria, Adushkina Viktoria, Dubrovsky Alexander, Jürgen Kurths

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In modern neurobiology, sleep is considered a novel biomarker and a promising therapeutic target for brain diseases. This is due to recent discoveries of the nighttime activation of the brain lymphatic system (BLS), playing an important role in the removal of wastes and toxins from the brain and contributes neuroprotection of the central nervous system (CNS). In our review, we discuss that night stimulation of BLS might be a breakthrough strategy in a new treatment of Alzheimer’s and Parkinson’s disease, stroke, brain trauma, and oncology. Although this research is in its infancy, however, there are pioneering and promising results suggesting that night transcranial photostimulation (tPBM) stimulates more effectively lymphatic removal of amyloid-beta from mouse brain than daily tPBM that is associated with a greater improvement of the neurological status and recognition memory of animals. In our previous study, we discovered that tPBM modulates the tone and permeability of the lymphatic endothelium by stimulating NO formation, promoting lymphatic clearance of wastes and toxins from the brain tissues. We also demonstrate that tPBM can also lead to angio- and lymphangiogenesis, which is another mechanism underlying tPBM-mediated stimulation of BLS. Thus, photo-augmentation of BLS might be a promising therapeutic target for preventing or delaying brain diseases associated with BLS dysfunction. Here we present pioneering technology for simultaneous tPBM in humans and sleep monitoring for stimulation of BLS to remove toxins from CNS and modulation of brain immunity. The wireless-controlled gadget includes a flexible organic light-emitting diode (LED) source that is controlled directly by a sleep-tracking device via a mobile application. The designed autonomous LED source is capable of providing the required therapeutic dose of light radiation at a certain region of the patient’s head without disturbing of sleeping patient. To minimize patients' discomfort, advanced materials like flexible organic LEDs were used. Acknowledgment: This study was supported by RSF project No. 23-75-30001.

Keywords: brain diseases, brain lymphatic system, phototherapy, sleep

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Authors: Han Xiao

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The development of nanomedicines has recently achieved several breakthroughs in the field of cancer treatment; however, the biocompatibility and targeted burst release of these medications remain a limitation, which leads to serious side effects and significantly narrows the scope of their applications. The self-assembly of intermediate filament protein (IFP) peptides was triggered by a hydrophobic cation drug 7-amino actinomycin D (7-AAD) to synthesize pH-activatable nanoparticles (NPs) that could simultaneously locate tumors and produce antitumor effects. The designed IFP peptide included a target peptide (arginine–glycine–aspartate), a negatively charged region, and an α-helix sequence. It also possessed the ability to encapsulate 7-AAD molecules through the formation of hydrogen bonds and hydrophobic interactions by a one-step method. 7-AAD molecules with excellent near-infrared fluorescence properties could be target delivered into tumor cells by NPs and released immediately in the acidic environments of tumors and endosome/lysosomes, ultimately inducing cytotoxicity by arresting the tumor cell cycle with inserted DNA. It is noteworthy that the IFP/7-AAD NPs tail vein injection approach demonstrated not only high tumor-targeted imaging potential, but also strong antitumor therapeutic effects in vivo. The proposed strategy may be used in the delivery of cationic antitumor drugs for precise imaging and cancer therapy.

Keywords: 7-amino actinomycin D, intermediate filament protein, nanoparticle, tumor image

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Authors: Jocelyn Jones, Louise Southalan, Lindey Andrews, Mandy Wilson, Emma Vieira, Jackie Oakley, Dorothy Bagshaw, Alice V. Brown, Patrick Egan, Duc Dau, Lucy Spanswick

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Working with people experiencing homelessness requires careful use of methods that support them to comfortably share their experiences. This is particularly important for Aboriginal and Torres Strait Islander peoples, the traditional owners of Australia, who have experienced intergenerational and compounding trauma since colonisation. Aboriginal cultures regularly experience research fatigue and distrust in research’s potential for impact. They often view research as an extraction -a process of taking the knowledge that empowers the research team and its institution, rather than benefiting those being researched. Through a partnership between an Aboriginal Community Controlled Organisation and a university research institute, we conducted a community-driven research project with 70-90 Aboriginal people experiencing homelessness in Perth, Western Australia. The project aimed to listen to and advocate for the voices of those who are experiencing homelessness, guided by the Aboriginal community. In consultation with Aboriginal Elders, we selected methods that are considered culturally safe, including those who would prefer to express their experiences creatively. This led us to run a series of Photovoice workshops -an established method that supports people to share their experiences through photography. This method treats participants as experts and is regularly used with marginalised groups across the world. We detail our experience and lessons in using Photovoice with Aboriginal community members experiencing homelessness. This includes the ways the method needed to be moulded to community needs and driven by their individual choices, such as being dynamic in the length of time participants would spend with us, how we would introduce the method to them, and providing support workers for participants when taking photos. We also discuss lessons in establishing and retaining engagement and how the method was successful in supporting participants to comfortably share their stories. Finally, we outline the insights into homelessness that the method offered, including highlighting the difficulty experienced by participants in transitioning from homelessness to accommodation and the diversity of hopes people who have experienced homelessness have for the future.

Keywords: Aboriginal and Torres Strait Islander peoples, photovoice, homelessness, community-led research

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Authors: Kristel Dame Bañez Sumagaysay, Marie Victoria Cruz-javier

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The current subject is a case of a 21 year-old woman at 29 1/7 weeks of gestation with Pre-B cell Acute Lymphoblastic Leukemia who was admitted to the coronary care unit (CCU) of the St. Luke’s Medical Center-Global City for Severe Acute Respiratory Distress Syndrome (ARDS) secondary to hospital-acquired pneumonia secondary to pneumocystis jiroveci; central line-associated bloodstream infection (E. aerogenes). She presented with chronic hypoxemia caused by Pulmonary edema, probably secondary to heart failure secondary to cardiomyopathy chemotherapy-induced. Due to worsening feto-maternal status, extracorporeal membrane oxygenation (ECMO) for respiratory support was instituted, and an elective cesarean section was done due to multiple maternal factors and deteriorating health status under total intravenous anesthesia assisted by veno-venous extracorporeal membrane oxygenation. She delivered a live preterm newborn male, APGAR Score: 1, 0, 0, birth weight 985 grams, birth length: 40.5cm, small for gestational age.

Keywords: extracorporeal membrane oxygenation, pre-b cell acute lymphoblastic leukemia, severe acute respiratory distress syndrome, ethical dilemmas

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Authors: Amr Hamdy

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Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Many methods have been developed to decrease its rate. The aim of this study was to evaluate the applicability of a new non-pharmacologic maneuver in decreasing its rate. Methods: This case series study was conducted in one centre in Cairo, Egypt, from January-2010 to June-2013. 400 pregnant–women aged 18 years or more and candidate for normal labour; were enrolled to this study. High-risk subjects for PPH were excluded. After placental delivery, the new maneuver was done by sustained traction of the anterior and posterior lips of the cervix by two ovum forceps for duration of 90 seconds. The amount of blood loss was estimated by standardized visual estimation after removal of the forceps. All subjects were followed up for 6 hours. Results: The rate of PPH, defined as more than 500 ml, was 8 cases (2%) with 95% CI (0.63-3.37%). The rate of PPH was not affected by parity, gestational age, episiotomy or the presence of tears. PPH is more in cases with anemia (p 0.032). It occurred in all cases with uterine atony (p <0.001). The range of estimated blood loss was 550-600ml in cases with PPH and 150-450ml in cases without PPH. Severe PPH more than 1000 ml, did not occur. Conclusion: This pilot study introduced a novel maneuver that can be helpful in decreasing the rate of PPH and reducing the amount of post partum blood loss.Despite the low rate of PPH showed in this study, the need for conducting a randomized controlled study is at its highest level before further inclusion of such manoeuvre to be a part of the current medical practice and before considering it as an evident tool to decrease the burden of PPH.

Keywords: maternal mortality, new manoeuvre, post-partum haemorrhage, uterine atony

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Authors: Devyani Shete, Sudeep Rai

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Background: The COVID-19 pandemic has caused one of the highest disruptions to the NHS (National Health Service), especially to the fundamental cervical cancer screening service. To prioritize screening response effectively, it is vital to understand the underlying disease risks amongst groups of women who are less likely to resume their screening/follow up at General Practices. The current government target is to have>=80% of women have an adequate test within the previous 3.5 years (ages 25-49) or 5.5 years (ages 50-64). Aims/Objectives: To increase the number of eligible people aged 25-49 attending cervical screening by 5% at Lakeside Healthcare (a General Practice in Corby). Methods: An online survey was posted on the Lakeside Healthcare website to find out what the barriers towards cervical screening were. It was apparent that patients needed more information catered to their responses. 6 informational videos and a “Cervical Screening Guide” were created for Lakeside patients about cervical screening, which were posted on the Healthcare website. Lakeside also started sending reminder texts to those eligible, with a link to a booking form. Results: On 18th January 2022, 69.7% of patients aged 25-49 years (7207) had an adequate cervical screening test in the last 3.5 years. There were 80 total responders to the online survey. In response to “which of the following are reasons why you have not attended screening”, 30% ticked “I kept putting it off/did not get around to it,” and 13% ticked “I was worried it would be painful or daunting.” In response to “which of the following would make you more likely to book an appointment”, 23% ticked “More detailed explanations of what the risks are if I don’t have screening,” and 20% ticked “I would like more information about the test and what the smear entails.” 10% of responders had previous trauma, whilst 28% of responders said the pandemic had impacted them getting a smear. Survey results were used to carry out interventions to increase smear uptake. On 23rdMarch 2022 (after a 2-month period), 75%of patients aged 25-49 (7119) attended the screening, which was a 5.3% increase from January. Discussion/Conclusion: The survey was vital in carrying out the exact interventions that were required for patients to increase screening uptake, as it is important to know what the populations’ needs are in order to create personalized invitations. This helps to optimise response during a pandemic. A HPV self-sample kit at home could be a popular method of dealing with further outbreaks.

Keywords: gynaecology, cervical screening, public health, COVID-19

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Authors: G. A. Khalid, R. Prabhu, W. Whittington, M. D. Jones

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To establish a causal relationship of infant head injury consequences, this present study addresses the necessary challenges of cranial geometry and the physical response complexities of the paediatric head tissues. Herein, we describe a new approach to characterising and understanding infant head impact mechanics by developing printed head models, using high resolution clinical postmortem imaging, to provide the most complete anatomical representation currently available, and biological material response data-matched polypropylene polymers, to replicate the relative mechanical response properties of immature cranial bone, sutures and fontanelles. Additive manufacturing technology was applied to creating a physical polymeric model of a newborn infant skull, using PolyJet printed materials. Infant skull materials responses, were matched by a response characterisation study, utilising uniaxial tensile testing (1 mm min-1 loading rate), to determine: the stiffness, ultimate tensile strength and maximum strain of rigid and rubber additively manufactured acrylates. The results from the mechanical experiments confirm that the polymeric materials RGD835 Vero White Plus (White), representing the frontal and parietal bones; RGD8510- DM Rigid Light Grey25 (Grey), representing the occipital bone; and FLX9870-DM (Black) representing the suture and fontanelles, were found to show a close stiffness -correlation (E) at ambient temperatures. A 3D physical model of infant head was subsequently printed from the matched materials and subsequently validated against results obtained from a series of Post Mortem Human Surrogate (PMHS) tests. A close correlation was demonstrated between the model impact tests and the PMHS. This study, therefore, represents a key step towards applying printed physical models to understanding head injury biomechanics and is useful in the efforts to predict and mitigate head injury consequences in infants, whether accidental or by abuse.

Keywords: infant head trauma, infant skull, material response, post mortem human subjects, polyJet printing

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Authors: Salako Emmanuel Adekunle

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With numerous advantages of ICT in teaching such as using images to improve the retentive memory of students, academic staff is yet to deliver instructions adequately and effectively due to no power supply, lack of technical supports and non-availability of functional ICT tools. This study was conducted to investigate the attitudes of academic staff towards the use of information communication technology as a pedagogical tool for effective teaching in FCT College of Education, Zuba-Abuja, Nigeria. A sample of 200 academic staff from five schools/faculties was involved in the study. The respondents were selected by using simple random sampling technique (SRST). A questionnaire was developed and validated by the experts in Measurement and Evaluation, and reliability co-efficient of 0.85 was obtained. It was used to gather relevant data from the respondents. This study revealed that the respondents had positive attitudes towards the use of ICT as a pedagogical tool for effective teaching. Also, the uses of ICT by the academic staff included: to encourage closer relationship for attainment of higher academic, and to deliver instructions effectively. The study also revealed that there is a significant relationship between the attitudes and the uses of ICT by the academic staff. Based on these findings, some recommendations were made which include: power supply should be provided to operate ICT facilities for effective teaching, and technical assistance on ICT usage for effective delivery of instructions should be provided among other recommendations.

Keywords: academic staff, attitudes, information communication technology, pedagogical tool, teaching, use

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Authors: Rudra Vaghela, P. K. Kulkarni

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The aim of the present research was to develop oral Amphotericin B (AmB) nanocrystals (Nc) grafted with suitable ligand in order to enhance drug transport across the intestinal epithelial barrier and subsequently, active uptake by macrophages. AmB Nc were prepared by liquid anti-solvent precipitation technique (LAS). Poloxamer 188 was used to stabilize the prepared AmB Nc and grafted with mannose for actively targeting M cells in Peyer’s patches. To prevent shedding of the stabilizer and ligand, N,N’-Dicyclohexylcarbodiimide (DCC) was used as a cross-linker. The prepared AmB Nc were characterized for particle size, PDI, zeta potential, X-ray diffraction (XRD) and surface morphology using scanning electron microscope (SEM) and evaluated for drug content, in vitro drug release and cell uptake studies using caco-2 cells. The particle size of stabilized AmB Nc grafted with WGA was in the range of 287-417 nm with negative zeta potential between -18 to -25 mV. XRD studies revealed crystalline nature of AmB Nc. SEM studies revealed that ungrafted AmB Nc were irregular in shape with rough surface whereas, grafted AmB Nc were found to be rod-shaped with smooth surface. In vitro drug release of AmB Nc was found to be 86% at the end of one hour. Cellular studies revealed higher invasion and uptake of AmB Nc towards caco-2 cell membrane when compared to ungrafted AmB Nc. Our findings emphasize scope on developing oral delivery system for passively targeting M cells in Peyer’s patches.

Keywords: leishmaniasis, amphotericin b nanocrystals, macrophage targeting, LAS technique

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Authors: Donghun Lee, Jiyoung Shin, Youjin Kim, Jin Joo Kim

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The sinking of Sewol ferry occurred in Korea on the morning of 16 April 2014 while carrying 476 people. In all, 304 passengers, mostly secondary school students from Danwon High School in Ansan City died in the disaster. The sinking of Sewol ferry has resulted in widespread social and political turmoil within South Korea. Many criticize the actions of the captain and crews of the ferry as well as the ferry operator and the regulators who oversaw its operations. However, huge criticism has been directed at the South Korean government for its national disaster response system. This disaster has made Korean government build up a new disaster management and psychological support system. The purpose of this study was to understand developmental and change process of a female counselor in her late fifties participated in Sewol ferry disaster counseling for a year. She has participated in providing as a counselor counseling and psychological support for the victims' families of Sewol ferry disaster, additionally as a director of community youth counseling center operated by local government by establishing governmental psychological supports plan for recovering collective trauma in the community, through which she have gotten self-reflection of whole her life. For in-depth interview data analysis, Mandelbaum’s three conceptual frameworks were employed; dimensions, turnings, and adaptation. The result of the study indicates extracted categories of life dimension, turning point and adaptation. The details of these categories are ‘having a self-image in youth’, ‘marriage in fairy-tale’, ‘unexpected death of husband’, ‘taking a step forward from darkness’, the way of counselor’, nice grown child’, ‘Sewol ferry disaster’ in life dimension, ‘death in front of life’, ‘milestone in life, counseling’ in turning points, ‘before Sewol ferry disaster’, ‘after Sewol ferry disaster’ in adaptation. Life history methods revealed the counselor’s internal developmental process by analyzing what Sewol ferry disaster influenced on an individual life, especially a counselor's one, what changes she went through, and how she adapted herself to that. Based on the results, discussions and suggestions are provided.

Keywords: development and change, disaster counseling, identity of female counselor, Mandelbaum’s life history, Sewol ferry

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Authors: Surena V.

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Background and Aim: Periodontal diseases are among the most common infectious diseases all around the world, even in developed countries. Considering the increased rate of microbial resistance to antibiotics and the chemical side effects of antibiotics and antiseptics used for the treatment of periodontal disease, there is a need for an alternative antimicrobial agent with fewer complications. Medicinal herbs have recently become popular as antimicrobial and preventive agents. This study aimed to assess the antibacterial effects of hydroalcoholic extracts of Lawsonia inermis, Malva sylvestris and Boswellia serrata on Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans). Materials and Methods: Hydroalcoholic extracts of the three medicinal plants were obtained by the maceration technique and A. actinomycetemcomitans was cultured. The antimicrobial efficacy of the three medicinal plants was compared with that of 0.2% chlorhexidine (CHX) according to the CLSI protocol using agar disc diffusion and broth microdilution techniques. All tests were repeated three times. Results: Hydroalcoholic extracts of all three plants had antimicrobial activity against A. actinomycetemcomitans. The minimum inhibitory concentration (MIC) of Lawsonia inermis, Malva sylvestris, and Boswellia serrata was 78.1, 156.2, and 1666 µg/mL with no significant difference between them. The MIC of CHX was 3.33 µg/mL, which was significantly higher than that of Boswellia serrata extract. Conclusion: Given that, further in vivo studies confirm other properties of these extracts and their safety in terms of cytotoxicity and mutagenicity, hydroalcoholic extracts of Lawsonia inermis and Malva sylvestris may be used in mouthwashes or local delivery systems to affect periodontal biofilm.

Keywords: actinobacilus actinomycetem commitans, lawsonia inermis, malva sylvestris, boswellia serrata

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Authors: Amr Mansour, Boaz Granot, Amani Tatar, Assil Mahamid, Mohammad Haj Yahia, Fairoz Jayyusi, Eyal Behrbalk

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INTRODUCTION: Distal radius fractures are common orthopedic injuries often treated in the fast-paced, high-stress environment of emergency departments (EDs). In such settings, patient satisfaction can be significantly influenced by the clarity of communication and the accessibility of information This study explores the impact of providing an informational pamphlet that outlines ED processes, treatment expectations, and follow-up instructions on patient satisfaction across key domains, including trust, communication, organization, responsiveness, and overall experience. We hypothesize that a structured informational pamphlet will enhance patient satisfaction by fostering better understanding and aligning patient expectations with the realities of the ED visit. METHODS: A total of 100 adult patients treated for distal radius fractures between January and August 2024 participated in this survey-based study. Patients were randomized into two equal groups: one group received an informational pamphlet detailing their condition and treatment, while the other did not. Satisfaction levels were assessed using a structured questionnaire addressing five domains. Fisher's exact test was used to compare satisfaction measures between the two groups, and multivariate logistic regression analysis was conducted to evaluate the association between receiving an information sheet and high satisfaction. The study was approved by the Institutional Review Board. RESULTS SECTION: Patients who received an informational pamphlet reported significantly higher satisfaction across all five domains (p < .001). In Trust and Understanding, 82% of info-sheet recipients felt “in good hands,” compared to 10% of non-recipients. For Communication, 86% rated doctor explanations as “very clear,” versus 16% among non-recipients. Logistic regression showed that receiving an informational pamphlet was a significant predictor of high satisfaction with Discharge Explanation—clarity on condition, treatment, and follow-up (OR = 17.65, 95% CI: 4.74 - 65.77, p < .001) and Reasonable Solution—feeling their primary concern was resolved (OR = 37.82, 95% CI: 8.75 - 163.42, p < .001). Other predictors, including fracture reduction, gender, and age, were not significant. DISCUSSION: This study highlights the substantial role that simple, cost-effective interventions like informational pamphlets can play in enhancing patient satisfaction in emergency care. By improving communication, fostering trust, and promoting a patient-centered approach, informational pamphlets offer a valuable tool for healthcare providers seeking to enhance the quality of care and patient experience in high-pressure emergency environments. However, the study's limitations, including its single-center design and reliance on self-reported satisfaction scores, may affect the generalizability of the results. Future research should consider a multi-center approach and explore long-term outcomes to further validate the efficacy of informational pamphlets in diverse ED settings. Ultimately, sustained improvement in patient satisfaction is a complex and dynamic issue necessitating a multifactorial approach, and other methods should also be explored to complement this strategy. SIGNIFICANCE/CLINICAL RELEVANCE: This study demonstrates that providing an informational pamphlet in the ED setting can significantly improve patient satisfaction across multiple domains, emphasizing its potential as a simple, cost-effective tool to enhance communication, trust, and overall patient experience during emergency care for distal radius fractures. Integrating such interventions into standard ED protocols may foster a more patient-centered approach, improving both patient outcomes and healthcare efficiency.

Keywords: distal radius fracture, quality care, patient satisfaction, emergency medicine, patient-centered care, communication

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Authors: Leila Najeh

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This study investigates the motivational factors influencing Tunisian university students learning English through online platforms. Using a mixed-methods approach, data were collected from 112 undergraduate students of English across universities in Tunisia. The study employed an online questionnaire to measure intrinsic and extrinsic motivation, incorporating the Learning Motivation Questionnaire (FFLLM-Q) developed by Gonzales in 2001 and semi-structured interviews to explore students’ perspectives on their online learning experiences. Quantitative analysis revealed a significant correlation between intrinsic motivation and interactive features such as gamification and adaptive content delivery, while extrinsic motivation was strongly linked to career aspirations and academic requirements. Qualitative findings highlighted challenges such as limited interaction with peers and teachers, technical constraints, and a lack of immediate feedback as demotivating factors. Participants expressed a preference for blended learning models, combining the flexibility of online education with the collaborative environment of traditional classrooms. This study underscores the need for tailored online learning solutions to enhance the motivational landscape for Tunisian students, emphasizing the importance of culturally relevant content, accessible platforms, and supportive learning communities. Further research is recommended to evaluate the long-term impact of these interventions on language proficiency and learner autonomy.

Keywords: motivational factor, online foreign language learnig, tunsian students of english, online learning platforms

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Authors: Anant Deogaonkar, Archana Nanoty

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The term civil service plays a vital role in functioning of any government. In today’s modern era of globalization civil services essentially contribute for the success of the good governance system. The civil service in India refers to the body of government officials employed in civil occupations that are neither political nor judicial. The Indian Civil Services were created to foster the idea of unity in diversity with the expectation of giving continuity and change in administration independent of the political scenario and turmoil affecting the country. The civil service is an integral part of administration and the structures of administration to determine the way civil service functions. The concept of good governance necessarily precludes the effective human resource management ensuring the root level reach of the good governance. The serious matter of concern is the element of change. The civil service in general has maintained status quo instead of sweeping changes in social and economic scenario. One may disagree for this but it is a fact on the street that the Indian civil service was not able to deliver up to the expectations of the people and was lacking on the service front. The effective management of human resources at civil service needs to be prioritized and will form a key factor in successful delivery of the desired results may be in minimum duration. This paper focuses on the various ways of effective management of human resources in civil services. It also highlights the importance of improvement in human resource management in civil services with the detailed discussion of positives and negatives if any of the human resource management in civil services.

Keywords: civil services, human resources management, India, governance

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Authors: Nino Gogatishvili, Davit Kvernadze, Giorgi Japharidze

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Background and aims: Landau Kleffner syndrome (LKS) is a rare disorder with epileptic seizures and acquired aphasia. It usually starts in initially healthy children. The first symptoms are language regression and behavioral disturbances, and the sleep EEG reveals abnormal epileptiform activity. The aim was to discuss the efficacy of Clobazam for Landau Kleffner syndrome. Case report: We report a case of an 11-year-old boy with an uneventful pregnancy and delivery. He began to walk at 11 months and speak with simple phrases at the age of 2,5 years. At the age of 18 months, he had febrile convulsions; at the age of 5 years, the parents noticed language regression, stuttering, and serious behavioral dysfunction, including hyperactivity, temper outbursts. The epileptic seizure was not noticed. MRI was without any abnormality. Neuropsychological testing revealed verbal auditory agnosia. Sleep EEG showed abundant left fronto-temporal spikes, reaching over 85% during non-rapid eye movement sleep (non-REM sleep). Treatment was started with Clobazam. After ten weeks, EEG was improved. Stuttering and behavior also improved. Results: Since the start of Clobazam treatment, stuttering and behavior improved. Now, he is 11 years old, without antiseizure medication. Sleep EEG shows fronto-temporal spikes on the left side, over 10-49 % of non-REM sleep, bioccipital spikes, and slow-wave discharges and spike-waves. Conclusions: This case provides further support for the efficacy of Clobazam in patients with LKS.

Keywords: Landau-Kleffner syndrome, antiseizure medication, stuttering, aphasia

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Authors: Zety Shakila Binti Mohd Yusof, Muhammad Adib Bin Ishak, Hajah Fatimah Binti Hussein

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The international shipping business is related to numerous controls or regulations of export and import shipments. It is costly and time consuming, and when something goes wrong or when the buyer or seller fails to comply with the regulations, it can result in penalties, delays, and unexpected costs etc. For the focus of this study, the researchers have selected a local forwarder that provides forwarding and clearance services, Nexus Zone Logistics. It was identified that this company currently has many extra costs to be paid including local and detention charges, which negatively impacts the flow of income and reduces overall stability. Two variables have been identified as factors of extra charges; loaded containers entering the port by exceeded closing time and late delivery of empty containers to the container yard. This study is a qualitative in nature and the secondary data collected was analyzed using self-administered observation. The findings of this study were covered by one selected case for each export and import shipment between July and December 2014. The data were analyzed using frequency analysis based on tables and graphs. The researcher recommends Nexus Zone Logistics impose a 1% deposit payment per container for each shipment (export and import) to its customers.

Keywords: international shipping, export and import, detention charges, container shipment

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Authors: Jayoung Cho

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Poverty has become a social problem in South Korea, given that seven out of ten elderly experience multidimensional poverty. As quality of life is a major social welfare measure of a society, verifying the major factors affecting the quality of life among the elderly in poverty can be used as baseline data for the promotion of welfare. This study aims to investigate the longitudinal relationships between food insecurity and quality of life among the elderly in poverty. In this study, panel regression analysis using 5-year longitudinal panel data were derived from Korea Welfare Panel Study (KWPS, 2011-2015) were used to identify the research question. A total of 1,327 elderly people aged 65 or older with less than 60% of median income was analyzed. The main results of the study are as follows; first, the level of quality of life of the poor elderly was on average of 5, and repeated the increase and decrease over time. Second, food insecurity and quality of life of the elderly in poverty had a longitudinal causal relationship. Furthermore, the statistical significance of food insecurity was the highest despite controlling for major variables affecting the quality of life among the poor elderly. Therefore, political and practical approaches are strongly suggested and considered regarding the food insecurity for the quality of life among the elderly in poverty. In practical intervention, it is necessary to pay attention to food insecurity when assessing the poor elderly. Also, there is a need to build a new delivery system that incorporates segmented health and nutrition-related services. This study has an academic significance in that it brought out the issue of food insecurity of the poor elderly and confirmed the longitudinal relationship between food insecurity and quality of life.

Keywords: food insecurity, longitudinal panel analysis, poor elderly, quality of life

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Authors: Tia Morosin, Marie Shella De Robles

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Rectocele may be associated with symptoms of both obstructed defecation and faecal incontinence. Currently, numerous operative techniques exist to treat patients with rectocele; however, no single technique has emerged as the optimal approach in patients with post-partum faecal incontinence. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele for patients presenting with faecal incontinence as the predominant symptom. Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon. All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range 21 to 90 years). The median operating time and length of hospital stay were 2 hours and 7 days, respectively. Two patients developed urinary retention post-operatively, which required temporary bladder catheterization. One patient had wound dehiscence, which was managed by absorbent dressing applied by the patient and her carer. There was no operative mortality. In all patients with rectocele, there was a concomitant anal sphincter disruption. All patients had satisfactory improvement with regard to faecal incontinence on follow-up. This study suggests this method provides excellent anatomic and physiologic results with minimal morbidity. However, because none of the patients gained full continence postoperatively, pelvic floor rehabilitation might be also needed to achieve better sphincter function in patients with incontinence.

Keywords: anal sphincter defect, faecal incontinence, rectocele, transperineal repair

Procedia PDF Downloads 127

Authors: Vijaykumar Patel, P. Bahadur

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Microstructural evolution of a cationic gemini surfactant 12-4-12 micelles in the presence of bile salts has been investigated using different techniques. A negative value of interaction parameter evaluated from surface tension measurements is a signature of strong synergistic interaction between oppositely charged surfactants. Both the bile salts compete with each other in inducing the micellar transition of 12-4-12 micelles depending on their hydrophobicity. Viscosity measurements disclose that loading of bile salts induces morphological changes in 12-4-12 micelles; sodium deoxycholate is more efficient in altering the aggregation behaviour of 12-4-12 micelles compared to sodium cholate and presents pronounced increase in viscosity and micellar growth which is suppressed at elevated temperatures. A remarkable growth of 12-4-12 micelles in the presence of sodium deoxycholate at low pH has been ascribed to the solubilization of bile acids formed in acidic medium. Small angle neutron scattering experiments provided size and shape of 12-4-12/bile salt mixed micelles are explicated on the basis of hydrophobicity of bile salts. The location of bile salts in micelle was determined from nuclear overhauser effect spectroscopy. The present study characterizes 12-4-12 gemini-bile salt mixed systems which significantly enriches our knowledge, and such a structural transition provides an opportunity to use these bioamphiphiles as delivery vehicles and in some pharmaceutical formulations.

Keywords: gemini surfactants, bile salts, SANS (small angle neutron scattering), NOESY (nuclear overhauser effect spectroscopy)

Procedia PDF Downloads 151

Authors: Michael Amankwaa Adu

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This study investigates the speech acts employed by a Career Technology teacher during classroom interactions in a junior high school. While much research exists on speech acts in language teaching, little attention has been given to technical subjects. This has created a gap in understanding how teachers of non-language subjects utilize speech acts in classroom communication. This study aims to analyze the types and frequencies of speech acts used by a Career Technology teacher during three key classroom encounters: lesson introduction, content delivery, and classroom management. Using a mixed-methods approach, the study examines 113 utterances from the teacher's lesson, categorizing them into four primary speech act types: directives, assertives, expressives, and commissives. Directives emerged as the most dominant form, accounting for 59.3% of the utterances, followed by assertives (20.4%), expressives (14.2%), and commissives (6.2%). No declarations were observed. The study demonstrates how the teacher uses directives to manage student behavior and assertives to reinforce information. Expressives are used sparingly but play a role in motivating or disciplining students, while commissives help establish classroom rules and set expectations. The findings contribute to understanding classroom interaction strategies in non-language subjects, offering insights that could inform teacher training and curriculum development. The study underscores the importance of effective communication in technical subjects and suggests ways in which language teaching techniques might be integrated into other subject areas.

Keywords: classroom management, directives, speech acts, technical subjects., assertives

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Authors: Siddhartha Paul, Debabrata Das

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Closed-loop supply chain (CLSC) management focuses on integrating forward and reverse flow of material as well as information to maximize value creation over the entire life-cycle of a product. Bullwhip effect in supply chain management refers to the phenomenon where a small variation in customers’ demand results in larger variation of orders at the upstream levels of supply chain. Since the quality and quantity of products returned to the collection centers (as a part of reverse logistics process) are uncertain, bullwhip effect is inevitable in CLSC. Therefore, in the present study, first, through an extensive literature survey, we identify all the important factors related to forward as well as reverse supply chain which causes bullwhip effect in CLSC. Second, we develop a system dynamics model to study the interrelationship among the factors and their effect on the performance of overall CLSC. Finally, the results of the simulation study suggest that demand forecasting, lead times, information sharing, inventory and work in progress adjustment rate, supply shortages, batch ordering, price variations, erratic human behavior, parameter correcting, delivery time delays, return rate of used products, manufacturing and remanufacturing capacity constraints are the important factors which have a significant influence on system’s performance, specifically on bullwhip effect in a CLSC.

Keywords: bullwhip effect, closed-loop supply chain, system dynamics, variance ratio

Procedia PDF Downloads 163

Authors: Suzanne Ahmed

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Nanomotors, also commonly referred to as nanorobotics or nanomachines, have garnered considerable research attention due to their numerous potential applications in biomedicine, including drug delivery and microsurgery. Nanomotors typically consist of inorganic or polymeric particles that are powered to undergo motion. These artificial, man-made nanoscale motors operate in the low Reynolds number regime and typically have no moving parts. Several methods have been developed to actuate the motion of nanomotors including magnetic fields, electrical fields, electromagnetic waves, and chemical fuel. Since their introduction in 2012, ultrasonically powered nanomotors have been explored in biocompatible fluids and even within living cells. Due to the common use of ultrasound within the biomedical community for both imaging and therapeutics, the introduction of ultrasonically propelled nanomotors holds significant potential for biomedical applications. In this work, metallic nanomotors are electrochemically plated within porous anodic alumina templates to have a diameter of 300 nm and a length that is 2-4 µm. Nanomotors are placed within an acoustic chamber capable of producing bulk acoustic waves in the ultrasonic range. The motion of nanomotors within biomimetic confines is explored. The control over nanomotor motion is exerted by virtue of the properties of the acoustic signal within these biomimetic confines to control speed, modes of motion and directionality of motion. To expand the range of control over nanorod motion within biomimetic confines, external forces from biocompatible magnetic fields, are exerted onto the acoustically propelled nanomotors.

Keywords: nanomotors, nanomachines, nanorobots, ultrasound

Procedia PDF Downloads 76

Authors: Mukul Anand

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Quality oriented affordable shelter for all has always been the key issue in the housing sector of our country. Homelessness is the acute form of housing need. It is a paradox that in spite of innumerable government initiated programmes for affordable housing, certain section of society is still devoid of shelter. About nineteen million (18.78 million) households grapple with housing shortage in Urban India in 2012. In Indian scenario there is major mismatch between the people for whom the houses are being built and those who need them. The prime force faced by public authorities in facilitation of quality housing for all is high cost of construction. The present paper will comprehend executable techniques for dilution of cost factor in housing the homeless. The key actors responsible for delivery of cheap housing stock such as capacity building, resource optimization, innovative low cost building material and indigenous skeleton housing system will also be incorporated in developing these techniques. Time performance, which is an important angle of above actors, will also be explored so as to increase the effectiveness of low cost housing. Along with this best practices will be taken up as case studies where both conventional techniques of housing and innovative low cost housing techniques would be cited. Transportation consists of approximately 30% of total construction budget. Thus use of alternative local solutions depending upon the region would be covered so as to highlight major components of low cost housing. Government is laid back regarding base line information on use of innovative low cost method and technique of resource optimization. Therefore, the paper would be an attempt to bring to light simpler solutions for achieving low cost housing.

Keywords: construction, cost, housing, optimization, shelter

Procedia PDF Downloads 445

Authors: Kenneth N. Ohei, Roelien Brink

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For decades, teaching and learning processes have centered on the traditional approach (Web 1.0) that promoted teacher-directed pedagogical practices. Currently, there is a realization that the traditional approach is not adequate to effectively address and improve all student-learning outcomes. The subsequent incorporation of social software, Information, and Communication Technology (ICT) tools in universities may serve as complementary to support educational goals, offering students the affordability and opportunity to educational choices and learning platforms. Consequently, educators’ inability to incorporate these instructional ICT tools in their teaching and learning practices remains a challenge. This will signify that educators still lack the ICT skills required to administer lectures and bridging learning gaps. This study probes a methodological concept with the aim of developing a framework towards the adoption of social software in HES to help facilitate business processes and can build social presence among students. A mixed method will be appropriate to develop a comprehensive framework needed in Higher Educational System (HES). After research have been conducted, the adoption of social software will be based on the developed comprehensive framework which is supposed to impact positively on education and approach of delivery, improves learning experience, engagement and finally, increases educational opportunities and easy access to educational contents.

Keywords: blended and integrated learning, learning experience and engagement, higher educational system, HES, information and communication technology, ICT, social presence, Web 1.0, Web 2.0, Web 3.0

Procedia PDF Downloads 157

Authors: Varsha V. Rohini, P. R. Shreya, B. Renukadevi

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In the web analytics the information delivery and the web usage is optimized and the analysis of data is done. The analytics is the measurement, collection and analysis of webpage data. Page statistics and user metrics are the important factor in most of the web analytics tool. This is the limitation of the existing tools. It does not provide design inputs for the optimization of information. This paper aims at providing an extension for the scope of web analytics to provide analysis and statistics of each segment of a webpage. The number of click count is calculated and the concentration of links in a web page is obtained. Its user metrics are used to help in proper design of the displayed content in a webpage by Vision Based Page Segmentation (VIPS) algorithm. When the algorithm is applied on the web page it divides the entire web page into the visual block tree. The visual block tree generated will further divide the web page into visual blocks or segments which help us to understand the usage of each segment in a page and its content. The dynamic web pages and deep web pages are used to extend the scope of web page segment analytics. Space optimization concept is used with the help of the output obtained from the Vision Based Page Segmentation (VIPS) algorithm. This technique provides us the visibility of the user interaction with the WebPages and helps us to place the important links in the appropriate segments of the webpage and effectively manage space in a page and the concentration of links.

Keywords: analytics, design optimization, visual block trees, vision based technology

Procedia PDF Downloads 266