Search results for: health extension

Authors: Kyung Jin Kim, Jiwon Kwak, Jae-Hoon Lee, Soo Suk Lee

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MicroRNAs (miRNA) are a class of endogenous, single-stranded, small, and non-protein coding RNA molecules typically 20-25 nucleotides long. They are thought to regulate the expression of other genes in a broad range by binding to 3’- untranslated regions (3’-UTRs) of specific mRNAs. The detection of miRNAs is very important for understanding of the function of these molecules and in the diagnosis of variety of human diseases. However, detection of miRNAs is very challenging because of their short length and high sequence similarities within miRNA families. So, a simple-to-use, low-cost, and highly sensitive method for the detection of miRNAs is desirable. In this study, we demonstrate a novel bi-directional extension (BDE) assay. In the first step, a specific linear RT primer is hybridized to 6-10 base pairs from the 3’-end of a target miRNA molecule and then reverse transcribed to generate a cDNA strand. After reverse transcription, the cDNA was hybridized to the 3’-end which is BDE sequence; it played role as the PCR template. The PCR template was amplified in an SYBR green-based quantitative real-time PCR. To prove the concept, we used human brain total RNA. It could be detected quantitatively in the range of seven orders of magnitude with excellent linearity and reproducibility. To evaluate the performance of BDE assay, we contrasted sensitivity and specificity of the BDE assay against a commercially available poly (A) tailing method using miRNAs for let-7e extracted from A549 human epithelial lung cancer cells. The BDE assay displayed good performance compared with a poly (A) tailing method in terms of specificity and sensitivity; the CT values differed by 2.5 and the melting curve showed a sharper than poly (A) tailing methods. We have demonstrated an innovative, cost-effective BDE assay that allows improved sensitivity and specificity in detection of miRNAs. Dynamic range of the SYBR green-based RT-qPCR for miR-145 could be represented quantitatively over a range of 7 orders of magnitude from 0.1 pg to 1.0 μg of human brain total RNA. Finally, the BDE assay for detection of miRNA species such as let-7e shows good performance compared with a poly (A) tailing method in terms of specificity and sensitivity. Thus BDE proves a simple, low cost, and highly sensitive assay for various miRNAs and should provide significant contributions in research on miRNA biology and application of disease diagnostics with miRNAs as targets.

Keywords: bi-directional extension (BDE), microRNA (miRNA), poly (A) tailing assay, reverse transcription, RT-qPCR

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Authors: Ayşe Coban, Orhan Coban, Haldun Soydal, Sükrü Sürücü

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While health is a source of prosperity for individuals, it is also one of the most important determinants of economic growth for a country. Health, by increasing the productivity of labor, contributes to economic growth. Therefore, countries should give the necessary emphasis to health services. The primary aim of this study is to analyze the changes occurring in health services in Turkey by examining the developments in the sector. In this scope, the second aim of the study is to reveal the place of health expenditures in the Turkish economy. As a result of the analysis in the dataset, in which the 1999-2013 periods is considered, it was determined that some increase in health expenditures took place and that the increase in the share of health expenditures in GDP was too small. Furthermore, analysis of the results points out that in financing health expenditures, the public sector is prominent compared to the private sector.

Keywords: health, health service, health expenditures, Turkey

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Authors: Layal Karam, Rayan Roustom, Mohamad G. Abiad, Tahra El-Obeid, Ioannis N. Savvaidis

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The demand for marinated chicken worldwide, is continuously growing. To date, limited data on addition of active components of Essential Oils (EOs) to marinades for chicken preservation are available. The antimicrobial effect of carvacrol and thymol, added at 0.4 and 0.8% v/w to marinated fresh chicken, stored in air and under vacuum packaging (VP), for 21 days at 4°C, was examined. The samples were monitored for microbiological (total viable count (TVC), lactic acid bacteria (LAB), Brochothrix thermosphacta, Pseudomonas spp., total coliforms, Escherichia coli, yeasts and molds) and sensory attributes (odor characteristics). Our data supports that among the tested microorganisms, Pseudomonas spp., LAB and B. thermosphacta were the most dominant microbiota in the marinated chicken samples. Additionally, the use of active EOs components, especially the higher concentration (0.8% v/w) in combination with VP, retarded the growth of spoilage microbiota and resulted in a significant reduction of about 2.9-3.1 log cfu/g and a microbiological shelf-life extension of marinated chicken by > 6 days, as judged by TVC data. Interestingly, the combination of active components of EOs at the lower concentration (0.4% v/w) and packaging (air or vacuum) resulted in a significant sensorial shelf-life extension of 15 and >21 days, as compared to the controls’ shelf-life of 9 days. The results of our study demonstrated the potential of the active components, carvacrol and thymol, as natural effective antimicrobial hurdles to control the growth of spoilage microorganisms in marinated chicken meat.

Keywords: chicken, essential oils compounds, marination, meat spoilage, preservation

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Authors: Valentina Narvaez Gaitan, Paula K. Rodriguez Ramirez, Derian D. Espinosa

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Corrective orthosis has great importance in orthopedic treatments providing assistance in improving mobility and stability in order to improve the quality of life for a different patient. The corrective orthosis studied in this article can correct deformities, reduce pain, and improve the ability to perform daily activities. This work describes the design and evaluation of a corrective orthosis for knee hyperextension. This orthosis is capable of generating a progressive and variable alignment of the joint, limiting the range of motion according to medical criteria. The main objective was to design a corrective knee orthosis capable of correcting knee hyperextension progressively to return to its natural angle with greater economic affordability and adjustable size. The limiting mechanism is based on a goniometer to determine the desired angles. The orthosis was made of acrylic to reduce costs and maintenance; neoprene is also used to make comfortable contact; additionally, Velcro was used in order to adjust the orthosis for various sizes. Simulations of static and fatigue analysis of the mechanism were performed to verify its resistance and durability under normal conditions. A biomechanical gait study of gait was carried out on 10 healthy subjects without the orthosis and limiting their knee extension capacity in a normal gait cycle with the orthosis to observe the efficiency of the proposed system. In the results obtained, the knee angle curves show that the maximum extension angle was the established angle by the orthosis. Showing the efficiency of the proposed design for different leg sizes.

Keywords: biomechanical study, corrective orthosis, efficiency, goniometer, knee hyperextension.

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Authors: Ahmed A. Abd El Rahim, Mohamed M. M. Essa, Magdy M. A. Shabana, Said A. Mohamed, Mohamed Ibrahim Mabrouk

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Background: Sacroiliac joint (SIJ) dysfunction is considered the main cause of pregnancy-related back pain, which may continue to persist postnatally. Myofascial release technique (MFR) is an application of low-intensity, prolonged stretch to myofascial structures to improve function by increasing the sliding properties of restricted myofascial tissues. Purpose: This study was designed to investigate the effect of MFR on postnatal SIJ hypo-mobility. Materials and Methods: Fifty postnatal women complaining of SIJ hypo-mobility participated in this study. Their ages ranged from 26 to 35 yrs., and their body mass index (BMI) didn`t exceed 30 kg/m2. They were randomly assigned to two equal groups, group A (Gr. A) and group B (Gr. B). Both groups received three sessions per week for eight successive weeks. Gr. A received a traditional physical therapy program, while Gr. B received a traditional physical therapy program in addition to MFR. Doppler imaging of vibration was utilized to measure SIJ mobility pre- and post-intervention, and an electronic digital goniometer was used to measure back flexion and extension Range of motion. Results: Findings revealed a statistical improvement in post-intervention values of SIJ mobility in addition to trunk flexion and extension ROM in Gr. B compared to Gr. A (P<0.001). Conclusion: Adding MFR to traditional physical therapy programs is highly recommended in the treatment of SIJ hypo-mobility in postnatal women.

Keywords: sacroiliac hypo-mobility, sacroiliac dysfunction, myofascial release technique, traditional physical therapy, postnatal

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Authors: Franklin Nantui Mabe, Samuel A. Donkoh, Seidu Al-Hassan

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Rice yields among agro-ecological zones are heterogeneous. Farmers, researchers and policy makers are making frantic efforts to bridge rice yield gaps between agro-ecological zones through the promotion of improved agricultural technologies (IATs). Farmers are also modifying these IATs and blending them with indigenous farming practices (IFPs) to form farmer innovation systems (FISs). Also, different metafrontier models have been used in estimating productivity performances and their drivers. This study used the two-step stochastic metafrontier model to estimate the productivity performances of rice farmers and their determining factors in GSZ, FSTZ and CSZ. The study used both primary and secondary data. Farmers in CSZ are the most technically efficient. Technical inefficiencies of farmers are negatively influenced by age, sex, household size, education years, extension visits, contract farming, access to improved seeds, access to irrigation, high rainfall amount, less lodging of rice, and well-coordinated and synergized adoption of technologies. Albeit farmers in CSZ are doing well in terms of rice yield, they still have the highest potential of increasing rice yield since they had the lowest TGR. It is recommended that government through the ministry of food and agriculture, development partners and individual private companies promote the adoption of IATs as well as educate farmers on how to coordinate and synergize the adoption of the whole package. Contract farming concept and agricultural extension intensification should be vigorously pursued to the latter.

Keywords: efficiency, farmer innovation systems, improved agricultural technologies, two-step stochastic metafrontier approach

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Authors: Solly M. Seeletse, Joel L. Thabane

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Students enrolling at the Sefako Makgatho Health Sciences University (SMU) come mostly from the previously disadvantaged communities of South Africa. Their backgrounds are deprived in resources and modern technologies of education. Most of those admitted in the basic sciences were rejected in medicine and health related study programmes in SMU. Mathematics (maths) is the main subject for admission into SMU study programmes. However, maths results are usually low. In an attempt to help to prepare the students in the neighbourhood schools of SMU, some Maths educators partnered with local schools to communicate the needs and investigate the causes of poor maths results. They embarked on an action research to determine the level of educators’ maths education. The general aim of the research was to investigate the causes of deficiencies in maths teaching and results in the local secondary schools, focusing on teachers and learners. Asking the teachers about their education and learners about maths concepts of most difficulty, these were identified. The researchers assisted in teaching the difficult concepts. The study highlighted the most difficult concepts and the teachers’ lack of training in some content. Intervention of the researchers showed to be effective only for the very poor performing schools. Those with descent pass rates of over 50% did not benefit from it. This was the sign of lack of optimality in the methods used. The research recommendations suggested that intervention methods should be improved to be effective in all schools, and extension of the endeavours to more schools.

Keywords: action research, intervention, social responsibility, support

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Authors: Jing Li, Li Jin, Fulin Wang, Jie Dong, Wenjiang Ding

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Mg-Li dual-phase alloy exhibits better combination of yield strength and elongation than the Mg single-phase alloy. To exploit its deformation behavior, the deformation mechanisms of Mg-2Gd alloy with or without Li addition, i.e., Mg-6Li-2Gd and Mg-2Gd alloy, have been studied at both microscale and mesoscale. EBSD-assisted slip trace, twin trace, and texture evolution analysis show that the α-Mg phase of Mg-6Li-2Gd alloy exhibits different microscopic deformation mechanisms with the Mg-2Gd alloy, i.e., mainly prismatic slip in the former one, while basal slip, prismatic slip and extension twin in the latter one. Further Schmid factor analysis results attribute this different intra-phase deformation mechanisms to the higher critical resolved shear stress (CRSS) value of extension twin and lower ratio of CRSSprismatic /CRSSbasal in the α-Mg phase of Mg-6Li-2Gd alloy. Additionally, Li addition can induce dual-phase microstructure in the Mg-6Li-2Gd alloy, leading to the formation of hetero-deformation induced (HDI) stress at the mesoscale. This can be evidenced by the hysteresis loops appearing during the loading-unloading-reloading (LUR) tensile tests and the activation of multiple slip activity in the α-Mg phase neighboring β-Li phase. The Mg-6Li-2Gd alloy shows higher yield strength is due to the harder α-Mg phase arising from solid solution hardening of Li addition, as well asthe strengthening of soft β-Li phase by the HDI stress during yield stage. Since the strain hardening rate of Mg-6Li-2Gd alloy is lower than that of Mg-2Gd alloy after ~2% strain, which is partly due to the weak contribution of HDI stress, Mg-6Li-2Gd alloy shows no obvious increase of uniform elongation than the Mg-2Gd alloy.But since the β-Li phase is effective in blunting the crack tips, the Mg-6Li-2Gd alloy shows ununiform elongation, which, thus, leads to the higher total elongation than the Mg-2Gd alloy.

Keywords: Mg-Li-Gd dual-phase alloy, phase boundary, HDI stress, dislocation slip activity, mechanical properties

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Authors: Shaibu Baanni Azumah, Ignatius Tindjina, Stella Obanyi, Tara N. Wood

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This study examined the effect of Urea Deep Placement (UDP) technology on the output of irrigated rice farmers in the northern region of Ghana. Multi-stage sampling technique was used to select 142 rice farmers from the Golinga and Bontanga irrigation schemes, around Tamale. A treatment effect model was estimated at two stages; firstly, to determine the factors that influenced farmers’ decision to adopt the UDP technology and secondly, to determine the effect of the adoption of the UDP technology on the output of rice farmers. The significant variables that influenced rice farmers’ adoption of the UPD technology were sex of the farmer, land ownership, off-farm activity, extension service, farmer group participation and training. The results also revealed that farm size and the adoption of UDP technology significantly influenced the output of rice farmers in the northern region of Ghana. In addition to the potential of the technology to improve yields, it also presents an employment opportunity for women and youth, who are engaged in the deep placement of Urea Super Granules (USG), as well as in the transplantation of rice. It is recommended that the government of Ghana work closely with the IFDC to embed the UDP technology in the national agricultural programmes and policies. The study also recommends an effective collaboration between the government, through the Ministry of Food and Agriculture (MoFA) and the International Fertilizer Development Center (IFDC) to train agricultural extension agents on UDP technology in the rice producing areas of the country.

Keywords: Northern Ghana, output , irrigation rice farmers, treatment effect model, urea deep placement

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Authors: Franklin N. Mabe, Samuel A. Donkoh, Seidu Al-Hassan

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In order to increase and bridge the differences in rice yield, many farmers have resorted to adopting Farmer Innovation Systems (FISs) and Improved Agricultural Technologies (IATs). This study econometrically analysed the impacts of adoption of FISs and IATs on rice yield using multinomial endogenous switching regression (MESR). Nine-hundred and seven (907) rice farmers from Guinea Savannah Zone (GSZ), Forest Savannah Transition Zone (FSTZ) and Coastal Savannah Zone (CSZ) were used for the study. The study used both primary and secondary data. FBO advice, rice farming experience and distance from farming communities to input markets increase farmers’ adoption of only FISs. Factors that increase farmers’ probability of adopting only IATs are access to extension advice, credit, improved seeds and contract farming. Farmers located in CSZ have higher probability of adopting only IATs than their counterparts living in other agro-ecological zones. Age and access to input subsidy increase the probability of jointly adopting FISs and IATs. FISs and IATs have heterogeneous impact on rice yield with adoption of only IATs having the highest impact followed by joint adoption of FISs and IATs. It is important for stakeholders in rice subsector to champion the provision of improved rice seeds, the intensification of agricultural extension services and contract farming concept. Researchers should endeavour to researched into FISs.

Keywords: farmer innovation systems, improved agricultural technologies, multinomial endogenous switching regression, treatment effect

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Authors: Ahmed M. Debela, Mayreli Ortiz , Ciara K. O´Sullivan

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The completion of the human genome Project (HGP) has paved the way for mapping the diversity in the overall genome sequence which helps to understand the genetic causes of inherited diseases and susceptibility to drugs or environmental toxins. Arrayed primer extension (APEX) is a microarray based minisequencing strategy for screening disease causing mutations. It is derived from Sanger DNA sequencing and uses fluorescently dideoxynucleotides (ddNTPs) for termination of a growing DNA strand from a primer with its 3´- end designed immediately upstream of a site where single nucleotide polymorphism (SNP) occurs. The use of DNA polymerase offers a very high accuracy and specificity to APEX which in turn happens to be a method of choice for multiplex SNP detection. Coupling the high specificity of this method with the high sensitivity, low cost and compatibility for miniaturization of electrochemical techniques would offer an excellent platform for detection of mutation as well as sequencing of DNA templates. We are developing an electrochemical APEX for the analysis of SNPs found in the MYH7 gene for group of cardiomyopathy patients. ddNTPs were labeled with four different redox active compounds with four distinct potentials. Thiolated oligonucleotide probes were immobilised on gold and glassy carbon substrates which are followed by hybridisation with complementary target DNA just adjacent to the base to be extended by polymerase. Electrochemical interrogation was performed after the incorporation of the redox labelled dedioxynucleotide. The work involved the synthesis and characterisation of the redox labelled ddNTPs, optimisation and characterisation of surface functionalisation strategies and the nucleotide incorporation assays.

Keywords: array based primer extension, labelled ddNTPs, electrochemical, mutations

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Authors: Austin Oduor Otieno

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There is an ingrained belief that the use of performance-enhancing drugs by athletes enable them to perform better. While this has been found to be truth, it also raises ethical and health issues. This paper analyzes the health hazards associated with performance enhancing drugs. It seeks to achieve this through the analysis of different academic journals as well as publications on the relationship between doping in sports and health. It concludes that there are inherent health hazards associated with the use of performance-enhancing drugs as they affect the physical and psychological health and wellbeing of a user (athlete).

Keywords: doping, health hazards, athletes, drugs

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Authors: Luiz G. Véras, Felipe L. Medeiros, Lamartine F. Guimarães

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This work approaches the automatic planning of paths for Unmanned Aerial Vehicles (UAVs) through the application of the Rapidly Exploring Random Tree Star-Smart (RRT*-Smart) algorithm. RRT*-Smart is a sampling process of positions of a navigation environment through a tree-type graph. The algorithm consists of randomly expanding a tree from an initial position (root node) until one of its branches reaches the final position of the path to be planned. The algorithm ensures the planning of the shortest path, considering the number of iterations tending to infinity. When a new node is inserted into the tree, each neighbor node of the new node is connected to it, if and only if the extension of the path between the root node and that neighbor node, with this new connection, is less than the current extension of the path between those two nodes. RRT*-smart uses an intelligent sampling strategy to plan less extensive routes by spending a smaller number of iterations. This strategy is based on the creation of samples/nodes near to the convex vertices of the navigation environment obstacles. The planned paths are smoothed through the application of the method called quintic pythagorean hodograph curves. The smoothing process converts a route into a dynamically-viable one based on the kinematic constraints of the vehicle. This smoothing method models the hodograph components of a curve with polynomials that obey the Pythagorean Theorem. Its advantage is that the obtained structure allows computation of the curve length in an exact way, without the need for quadratural techniques for the resolution of integrals.

Keywords: path planning, path smoothing, Pythagorean hodograph curve, RRT*-Smart

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Authors: H. Hadjeris, R. B. Ghoul, Lekhlaf, M. Nebbal

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Introduction: Adenoid cystic carcinomas of the lacrimal gland or orbital cylindroma constitute the second cause of epithelial tumors of this gland. It is a malignant tumor usually developed at the expense of the salivary glands; its orbital location is exceptional. It is a rare clinical entity, formidable by its malignancy and local aggressiveness; the recurrence rate is high. Materials and methods: Clinical case: 63 years old woman who presents with irreducible no pulsatile painful left exophthalmos with inflammatory chemosis and a decrease in visual acuity with a moderate intracranial hypertension syndrome that has been evolving for 03 months. Antecedent; a biopsy of the tumor was made; the histological examination was in favor of an adenoid cystic carcinoma of the lacrimal gland. Lesion assessment: computed tomography and brain MRI: show an intra and extra-conical mass; with sinus (ethmoido-frontal) and cerebral (left frontal) extension strongly enhanced after injection of contrast product surrounded by edema around the lesion, associated with left frontal bone lysis extension assessment: unremarkable treatment: Patient operated by left frontotemporal approach, a total exenteration was performed with macroscopically complete excision of the frontal lesion and wide frontal craniectomy with craniofacial reconstruction, followed by complementary radiotherapy. Results: The patient was seen again after 3 months in consultation; she does not present any signs in favor of a recurrence. Conclusion: Adenoid cystic carcinomas of the lacrimal gland are rare malignant tumors; they are very infiltrating and invasive. The prognosis is strongly linked to the treatment time.

Keywords: adenoid cystic, lacrimal gland, orbital location, fronto-temporal approac

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Authors: Kaouther Jaouadi, Jihene Bettaieb, Amira Bennour, Ghassen Kharroubi, Sadok Salem, Afif Ben Salah

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In Tunisia, chronic cutaneous leishmaniasis due to Leishmania (L) tropica is an important health problem. Its spreading has not been fully elucidated. Information on sandfly vectors, as well as their associated Leishmania species, is of paramount importance since vector dispersion is one of the major factors responsible for pathogen dissemination. In total, 650 sandflies were captured between June and August 2015 using sticky paper traps in the governorate of Sidi Bouzid, a classical focus of L. major in the Central-West of Tunisia. Polymerase chain reaction-restriction fragment length polymorphism analysis of the internal transcribed spacer 1 and sequencing were used for Leishmania detection and identification. Ninety-seven unfed females were tested for the presence of Leishmania parasite DNA. Six Phlebotomus sergenti were found positive for L. tropica. This finding enhances the understanding of the cycle extension of L. tropica outside its original focus of Tataouine in the South-East of the country.

Keywords: cutaneous leishmaniasis, Leishmania tropica, sandflies, Tunisia

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Authors: Lillian M. Seo, Curtis L. Petersen, Ryan J. Halter, David Kotz, John A. Batsis

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Background: Resistance-based exercises effectively enhance muscle strength, which is especially important in older populations as it reduces the risk of disability. Our group developed a Bluetooth-enabled handle for resistance exercise bands that wirelessly transmits relative force data through low-energy Bluetooth to a local smartphone or similar device. The system has the potential to measure home-based exercise interventions, allowing health professionals to monitor compliance. Its feasibility has already been demonstrated in both clinical and field-based settings, but it remained unclear whether the system’s usability persisted upon repeated use. The current study sought to assess the usability of this system and its users’ satisfaction with repeated use by deploying the device among younger adults to gather formative information that can ultimately improve the device’s design for older adults. Methods: A usability study was conducted in which 32 participants used the above system. Participants executed 10 repetitions of four commonly performed exercises: bicep flexion, shoulder abduction, elbow extension, and triceps extension. Each completed three exercise sessions, separated by at least 24 hours to minimize muscle fatigue. At its conclusion, subjects completed an adapted version of the usefulness, satisfaction, and ease (USE) questionnaire – assessing the system across four domains: usability, satisfaction, ease of use, and ease of learning. The 20-item questionnaire examined how strongly a participant agrees with positive statements about the device on a seven-point Likert scale, with one representing ‘strongly disagree’ and seven representing ‘strongly agree.’ Participants’ data were aggregated to calculate mean response values for each question and domain, effectively assessing the device’s performance across different facets of the user experience. Summary force data were visualized using a custom web application. Finally, an optional prompt at the end of the questionnaire allowed for written comments and feedback from participants to elicit qualitative indicators of usability. Results: Of the n=32 participants, 13 (41%) were female; their mean age was 32.4 ± 11.8 years, and no participants had a physical impairment. No usability questions received a mean score < 5 of seven. The four domains’ mean scores were: usefulness 5.66 ± 0.35; satisfaction 6.23 ± 0.06; ease of use 6.25 ± 0.43; and ease of learning 6.50 ± 0.19. Representative quotes of the open-ended feedback include: ‘A non-rigid strap-style handle might be useful for some exercises,’ and, ‘Would need different bands for each exercise as they use different muscle groups with different strength levels.’ General impressions were favorable, supporting the expectation that the device would be a useful tool in exercise interventions. Conclusions: A simple usability assessment of a Bluetooth-enabled resistance exercise band supports a consistent and positive user experience among young adults. This study provides adequate formative data, assuring the next steps can be taken to continue testing and development for the target population of older adults.

Keywords: Bluetooth, exercise, mobile health, mHealth, usability

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Authors: Sisira Edirippulige, Anthony C. Smith, Sumudu Wickramasinghe, Nigel R. Armfield

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Background: E-Health is steadily integrating into modern health services, making significant changes in the way health services are traditionally delivered. To work in this new environment, healthcare workers are required to have new knowledge, skills, and competencies specific to e-Health. The aim of this study was to understand the self-reported perceptions of graduates regarding the influence of an e-Health postgraduate program on their professional careers. Methods: All graduates from 2005 to 2015 were surveyed using an online questionnaire that consisted of a mixture of closed and open-ended questions. Results: The number of participants in the study was 32. Response rate was 62%. Graduates thought that the postgraduate e-Health program had an influence on their professional practice. The majority of the participants mentioned that they had worked in the e-Health field since their graduation. Their professional roles mainly involved implementation of e-Health in health service settings and the use of e-Health in clinical practice. Conclusions: While e-Health may be steadily integrating into modern health services, e-Health specific job opportunities are still relatively limited. E-Health workforce development must be given priority.

Keywords: e-health, postgraduate education, clinical practice, curriculum

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Authors: Ishith Seth, Lyndel Hewitt, Takako Yabe, James Wykes, Jonathan Clark, Bruce Ashford

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Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor-site morbidity is not well described. This study aimed to assess donor-site morbidity after VL flap harvest. The results will determine future directions for preventative and post-operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor-site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length, tactile sensation), quality of life (SF-12), and lower limb function (lower extremity function, gait (function and speed), sit to stand were assessed using validated and standardized procedures. Outcomes were compared to age-matched healthy reference values or the non-operative side. Analyses were conducted using descriptive statistics and non-parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit-to-stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non-operated leg (P=0.02) and walking speed was slower than age-matched healthy values (P<0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF-12 (P<0.001). The mental health component of the SF-12 was similar to healthy controls (P=0.26). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit-to-stand, and muscle length. VL harvest affected donor-site knee flexion strength, walking speed, tactile sensation, and physical health-related quality of life.

Keywords: vastus lateralis, morbidity, head and neck, surgery, donor-site morbidity

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Authors: Mahmood Iqbal, Khalid Nawab, Tachibana Satoshi

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Farmer Field School (FFS) is constantly aims to assist farmers to determine and learn about field ecology and integrated crop management. The study was conducted to examine the change in productivity of tomato crop in the study area; to determine increase in per acre yield of the crop, and find out reduction in per acre input cost. A study of tomato crop was conducted in ten villages namely Jabban, Bijligar Colony, Palonow, Heroshah, Zara Maira, Deghar Ghar, Sidra Jour, Anar Thangi, Miangano Korona and Wartair of district Malakand. From each village 15 respondents were selected randomly on the basis of identical allocation making sample size of 150 respondents. The research was based on primary as well as secondary data. Primary data was collected from farmers while secondary data were taken from Agriculture Extension Department Dargai, District Malakand. Interview schedule was planned and each farmer was interviewed personally. The study was based on comparison of cost, yield and income of tomato before and after FFS. Paired t-test and Statistical Package for Social Sciences (SPSS) was used for analysis; outcome of the study show that integrated pest management project has brought a positive change in the attitude of farmers of the project area through FFS approach. In district Malakand 66.0% of the respondents were between the age group of 31-50 years, 11.3% of respondents had primary level of education, 12.7% of middle level, 28.7% metric level, 3.3% of intermediate level and 2.0% of graduate level of education while 42.0% of respondents were illiterate and have no education. Average land holding size of farmers was 6.47 acres, cost of seed, crop protection from insect pest and crop protection from diseases was reduced by Rs. 210.67, Rs. 2584.43 and Rs. 3044.16 respectively, the cost of fertilizers and cost of farm yard manure was increased by Rs.1548.87 and Rs. 1151.40 respectively while tomato yield was increased by 1585.03 kg/acre from 7663.87 to 9248.90 kg/acre. The role of FFS initiate by integrated pest management project through department of agriculture extension for the development of agriculture was worth mentioning. It has brought enhancement in crop yield of tomato and their income through FFS approach. On the basis of results of the research studies, integrated pest management project should spread their developmental activities for maximum participation of the complete rural masses through participatory FFS approach.

Keywords: agriculture, Farmers field schools, extension education, tomato

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Authors: Georgiana Onicescu, Yuqian Shen

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Due to the complex nature of geo-referenced data, multicollinearity of the risk factors in public health spatial studies is a commonly encountered issue, which leads to low parameter estimation accuracy because it inflates the variance in the regression analysis. To address this issue, we proposed a two-stage variable selection method by extending the least absolute shrinkage and selection operator (Lasso) to the Bayesian spatial setting, investigating the impact of risk factors to health outcomes. Specifically, in stage I, we performed the variable selection using Bayesian Lasso and several other variable selection approaches. Then, in stage II, we performed the model selection with only the selected variables from stage I and compared again the methods. To evaluate the performance of the two-stage variable selection methods, we conducted a simulation study with different distributions for the risk factors, using geo-referenced count data as the outcome and Michigan as the research region. We considered the cases when all candidate risk factors are independently normally distributed, or follow a multivariate normal distribution with different correlation levels. Two other Bayesian variable selection methods, Binary indicator, and the combination of Binary indicator and Lasso were considered and compared as alternative methods. The simulation results indicated that the proposed two-stage Bayesian Lasso variable selection method has the best performance for both independent and dependent cases considered. When compared with the one-stage approach, and the other two alternative methods, the two-stage Bayesian Lasso approach provides the highest estimation accuracy in all scenarios considered.

Keywords: Lasso, Bayesian analysis, spatial analysis, variable selection

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Authors: Meseret Gebeyehu Yehuala

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Women represent the majority of urban farmers engaged in vegetable and fruit production in Bahir Dar, Ethiopia. We examine urban agriculture in Bahir Dar city in the context of disruptions caused by the civil war and COVID-19. The Sustainable Livelihoods Framework serves as a conceptual frame to explore the vulnerability context, the structural and institutional challenges faced by women, and how this impacts their livelihoods. A total of 25 urban women farmers and 6 key informants were involved in the study through explorative and structured interviews conducted in 2021. Observations and informal conversations during repeated visits provided deeper insights. In addition, key informants employed in civil service institutions and experts were interviewed. Data were analysed by applying qualitative content analysis by using Atlas tia software. Women report that they experience a lack of access to land, insecurity of tenure, irregular technical support and input provision by agricultural extension services, and lack of access to credit and formal marketplaces. The COVID-19 pandemic restrictions aggravated this situation by delaying agricultural extension offices’ provision of necessary inputs and disrupting food handling and storage leading to the loss of perishable products. Bombing in relation to the civil war has destroyed harvests and left women in fear of returning to their fields. Women stated that vegetable and fruit production could contribute to their incomes, household food supplies, and more diversified diets. However, the city municipal office has, so far, not committed to supporting urban agriculture as a livelihood strategy.

Keywords: urban agriculture, institutional challenges, Bahir Dar, sustainable livelihood framework

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Authors: Emmanuel Olugbenga Fakoya

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The study examined the perceived impact of climate change on the livelihood of arable crop farmers in Ipokia Local Government Area of Ogun State, Nigeria. Multistage sampling technique was used to select 80 arable crop farmers in the study area. Data collected were analyzed using percentages, frequencies and Chi square analysis. The result showed that 63.8 percent of the respondents were male while 55.0 percent were married. Less than half (30.0 percent) of the respondents were between the age bracket of 41-50 years and 50.0 percent had 6-10 household size. Furthermore, majority (40.0 percent) of the arable crop farmers farmed on an inherited land and 51.3 percent had 2-3 hectares of land. Majority (38.8 percent) of the farmers intercrop maize with cassava and maize with yam. Various strategies adapted to reduce the effect of climate change on their crop and livelihood include: crop rotation (53.8 percent), planting of leguminous crop (35.0 percent), application of organic fertilizers (45.0 percent), mulching (56.3 percent) and by planting drought resistance crops (46.5 percent). Reported among the effects of climate change on crop and farmers’ livelihood were: discoloration of crop leave (63.8 percent), increase infestation of pests and diseases (58.8 percent) and reduction of crop yield (60.0 percent). Chi- square analysis showed significant relationship between impact of climate change on arable crop production and thus famers’ livelihood. It was concluded from the study that climate change is an impinging factor that seriously affect arable crop production and hence farmers’ livelihood despite coping strategies to minimize its effect. It was however recommended that Agricultural policies and practices that could minimize or eliminate its effect should be seriously enacted to boost production and increase farmers’ livelihood.

Keywords: agricultural extension, extension agent, private sector, perception

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Authors: Bandana Koirala, Shivalal Sharma

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Introduction: Gingival enlargements are quite common and may be either inflammatory, non-inflammatory or a combination of both. Idiopathic gingival enlargement is a rare condition with a proliferative fibrous lesion of the gingival tissue that causes esthetic and functional problems. It is of undetermined etiology. Case Description: This case report addresses the diagnosis and treatment of a case of idiopathic gingival enlargement in a 9-year-old male patient. The patient presented with a generalized diffuse gingival enlargement involving the entire maxillary and the mandibular arch with extension on occlusal, buccal, lingual, and palatal surfaces with just parts of occlusal surfaces of few upper and lower molars visible resulting in open mouth, difficulty in mastication and speech. Biopsy report confirmed the diagnosis of fibromatosis gingivae. Gingivectomy was carried out in all four quadrants by using external bevel incision. Conclusion: Though total esthetics could not be restored due to unusual bony enlargement, the general appearance improved satisfactorily. Treatment after complete excision however, improved the masticatory competence to a great extent.

Keywords: idiopathic gingival fibromatosis, gingival enlargement, gingivectomy, medical and health sciences

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Authors: Dil Ware Alam, Faiza Zebeen, Sumaya Binte Masud

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COVID-19) has impacted the whole world, including Bangladesh. The epidemic has reduced access to health care, particularly for women, creating challenges for an increasingly disadvantaged population. Women's health and well-being in Bangladesh are susceptible to a rise in domestic violence and need to be addressed quickly. The planet has been greatly influenced by Coronavirus disease 2019 (COVID-19), and Bangladesh is no difference. The pandemic has resulted in a decline in the availability of health care, notably for women's health problems, leading to an increase in difficulties for an increasingly marginalized group. Maternity care, maternal health programs, medical interventions, nutritional counseling and mental health care, are not discussed, and women's health and well-being in Bangladesh is vulnerable with a spike in domestic violence and needs to be resolved urgently.

Keywords: Covid-19, mental health, reproductive health, Bangladesh

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Authors: Belayneh Yohannes

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In Ethiopia, onion production is increasing from time to time mainly due to its high profitability per unit area. Onion has a significant contribution to generating cash income for farmers in the Raya Azebo district. Therefore, enhancing onion producers’ access to the market and improving market linkage is an essential issue. Hence, this study aimed to analyze structure-conduct-performance of onion market and identifying factors affecting the market supply of onion producers. Data were collected from both primary and secondary sources. Primary data were collected from 150 farm households and 20 traders. Four onion marketing channels were identified in the study area. The highest total gross margin is 27.6 in channel IV. The highest gross marketing margin of producers of the onion market is 88% in channel II. The result from the analysis of market concentration indicated that the onion market is characterized by a strong oligopolistic market structure, with the buyers’ concentration ratio of 88.7 in Maichew town and 82.7 in Mekelle town. Lack of capital, licensing problems, and seasonal supply was identified as the major entry barrier to onion marketing. Market conduct shows that the price of onion is set by traders while producers are price takers. Multiple linear regression model results indicated that family size in adult equivalent, irrigated land size, access to information, frequency of extension contact, and ownership of transport significantly determined the quantity of onion supplied to the market. It is recommended that strengthening and diversifying extension services in information, marketing, post-harvest handling, irrigation application, and water harvest technology is highly important.

Keywords: oligopoly, onion, market chain, multiple linear regression

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Authors: Ricardo Hugo Gonzalez, Amanda Figueiredo Vasconcelos, Francisco Loureiro Neto Monteiro, Yara Luiza Freitas Silva, Ana Cristina Lindsay, Márcia Maria Tavares Machado

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The use of sport as an integration mean is a very important tool regarding the social involvement of children and teenagers in a vulnerability situation. This study aims to report the experiences of a multidisciplinary program that intends to improve the quality of life of children and teenagers in Fortaleza, in the Northeast of Brazil. More than 400 children and teenagers aging 11 and 16 years participated in this study. Poor communities experience many particular difficulties in the urban centers such as violence, poor housing conditions, unemployment, lack in health care and deficient physical education in school. Physical education, physiotherapy, odontology, medicine and pharmacy students are responsible for the activities in the project supervised by a general coordinator and a counselor teacher of each academic unit. There are classes about team sports like basketball and soccer. Lectures about sexual behavior and sexually transmitted diseases are ministered beside the ones about oral health education, basic life support education, first aids, use and care with pharmaceuticals and orientations about healthy nutrition. In order to get the children’s family closer, monthly informative lectures are ministered. There is also the concern about reflecting the actions and producing academic paperwork such as graduation final projects and books. The number of participants has oscillated lately, and one of the causes is the lack of practicing physical activities and sports regularly. However, 250 teenagers have participated regularly for at least two years. These teenagers have shown a healthier lifestyle and a better physical fitness profile. The resources for maintaining the project come from the Pro-Reitoria of Extension, Federal University of Ceara, as well as from the PROEXT/MEC, Federal Government. Actions of this nature need to be done thinking for long periods so the effects results can become effective. Public and private investments are needed due to low socioeconomic families who are most vulnerable and have fewer opportunities to enhance to health prevention services.

Keywords: children and teenagers, health, multidisciplinary program, quality of life

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Authors: Garima Singh, Kunal Malhotra

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Objective: The expansion of telehealth has been instrumental in increasing access to medical services, especially for underserved and rural communities. In 2020, 14 million patients received virtual care through telemedicine and the global telemedicine market is expected to reach up to $185 million by 2023. It provides a platform and allows a patient to receive primary care as well as specialized care using technology and the comfort of their homes. Telemedicine was particularly useful during COVID-pandemic and the number of telehealth visits increased by 5000% during that time. It continues to serve as a significant resource for patients seeking care and to bridge the gap between the disease and the treatment. Method: As per APA (American Psychiatric Association), Telemedicine is the process of providing health care from a distance through technology. It is a subset of telemedicine, and can involve providing a range of services, including evaluations, therapy, patient education and medication management. It can involve direct interaction between a physician and the patient. It also encompasses supporting primary care providers with specialist consultation and expertise. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review. Results: In our organization, we are using telepsychiatry and serving 25 counties and approximately 1.4 million people. We provide multiple services, including inpatient, outpatient, crisis intervention, Rehab facility, autism services, case management, community treatment and multiple other modalities. With project ECHO (Extension for Community Healthcare Outcomes) it has been used to advise and assist primary care providers in treating mental health. It empowers primary care providers to treat patients in their own community by sharing knowledge. Conclusion: Telemedicine has shown to be a great medium in meeting patients’ needs and accessible mental health. It has been shown to improve access to care in both urban and rural settings by bringing care to a patient and reducing barriers like transportation, financial stress and resources. Telemedicine is also helping with reducing ER visits, integrating primary care and improving the continuity of care and follow-up. There has been substantial evidence and research about its effectiveness and its usage.

Keywords: telehealth, telemedicine, access to care, medical technology

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Authors: Ilja Käch, Abdul R. Jandali, Nadja Zechmann-Müller

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Introduction: We discuss the treatment of two young male patients suffering from scaphoid non-union after a traumatic scaphoid fracture. The currently propagated techniques for treating a scaphoid non-union in children are either the operative reconstruction of the scaphoid or the conservative treatment with splinting in a scaphoid cast. Cases: In the first case, we operated on a 13 years old male patient with a posttraumatic scaphoid non-union in the middle third with a humpback deformity. We resected the middle third of the scaphoid and grafted the defect with an iliac crest bone, and the DISI-Deformity was reduced. Fixation was performed with K-Wires and immobilisation in a scaphoid cast. In the second case a 13 years old male patient also with a posttraumatic scaphoid non-union in the middle third and humpback deformity, DISI-deformity, was treated conservatively. Immobilisation in a scaphoid cast for four months was performed. Results: Operative: One year postoperatively the patient achieved a painless free arc of motion. Flexion/Extension 70/0/60°, Radial-/Ulnarduction 30/0/30° and Pro-/Supination 90/0/90°. The computer tomogram showed complete consolidation and bony fusion of the iliac crest bone. Conservative: Six to eight months after conservative treatment the patient demonstrated painless motion and AROM Flexion/Extension 80/0/80°, Radial-/Ulnarduction and Pro-/Supination in maximum range. Complete consolidation in the computer tomogram with persistent humpback- and DISI deformity. Conclusion: In the literature, both techniques are described, either the operative scaphoid reconstruction or the conservative treatment with splinting. In our cases, both the operative and conservative treatments showed comparable good results. However, the humpback- and DISI deformity can only be addressed with a surgical approach.

Keywords: scaphoid, non-union, trauma, operative vs. non operative

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Authors: Saeed Ilbeigi, Bart Van Gheluwe

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The purpose of this study was to identify the three-dimensional kinematics of the sprint start during the start phase of the sprint. The purpose of this study was to identify the three-dimensional kinematics of the sprint start during the start phase of the sprint. Moreover, the effect of anthropometrical factors such as skeletal muscle mass, thigh girth, and calf girth also were considered on the kinematics of the sprint start. Among all young sprinters involved in the national Belgium league, sixty sprinters (boys: 14.7 ± 1.8 years and girls: 14.8±1.5 years) were randomly selected. The kinematics data of the sprint start were collected with a Vicon® 620 motion analysis system equipped with 12 infrared cameras running at 250 Hz and running the Vicon Data Station software. For statistical analysis, T-tests and ANOVA׳s with Scheffé post hoc test were used and the significant level was set as p≤0.05. The results showed that the angular positions of the lower joints of the young sprinters in the set position were comparable with adult figures from literature, however, with a greater range of joint extension. The most significant difference between boys and girls was found in the set position, where the boys presented a more dorsiflexed ankle. No further gender effect was observed during the leaving the blocks and contact phase. The sprinters with a higher age, skeletal muscle mass, thigh girth, and calf girth displayed a better angular position of the lower joints (e.g. ankle, knee, hip) in the set position, a more optimal angular position for the foot and knee for absorbing impact forces at foot contact and finally a higher range of flexion/extension motion to produce force and power when leaving the blocks.

Keywords: anthropometry, kinematics, sprint start, young elite sprinters

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Authors: Arun Dhakal, Geoff Cockfield, Tek Narayan Maraseni

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This paper attempts to fulfil the gap in measuring adoption in agroforestry studies. It explains the derivation of an index of adoption rate in a Nepalese context and examines the factors affecting adoption of agroforestry-based land management practice (AFLMP) in the Dhanusha District of Nepal. Data about the different farm practices and the factors (bio-physical, socio-economic) influencing adoption were collected during focus group discussion and from the randomly selected households using a household survey questionnaire, respectively. A multivariate regression model was used to determine the factors. The factors (variables) found to significantly affect adoption of AFLMP were: farm size, availability of irrigation water, education of household heads, agricultural labour force, frequency of visits by extension workers, expenditure on farm inputs purchase, household’s experience in agroforestry, and distance from home to government forest. The regression model explained about 75% of variation in adoption decision. The model rejected ‘erosion hazard’, ‘flood hazard’ and ‘gender’ as determinants of adoption, which in case of single agroforestry practice were major variables and played positive role. Out of eight variables, farm size played the most powerful role in explaining the variation in adoption, followed by availability of irrigation water and education of household heads. The results of this study suggest that policies to promote the provision of irrigation water, extension services and motivation to obtaining higher education would probably provide the incentive to adopt agroforestry elsewhere in the terai of Nepal.

Keywords: agroforestry, adoption index, determinants of adoption, step-wise linear regression, Nepal

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