Search results for: clinical interpretation

Authors: Li Wang, Dan Shu, Shiguang Pang, Lixiu Wang, Bing Xiang Yang, Qian Liu

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Background: Cancer is one of the most severe diseases in childhood; long-term treatment and its side effects significantly impact the patient's physical, psychological, social functioning and quality of life while also placing substantial physical and psychological burdens on caregivers and families. Family resilience is crucial for children with cancer, helping them cope better with the disease and supporting the family in facing challenges together. As a family-level variable, family resilience requires information from multiple family members. However, to our best knowledge, there is currently no research investigating family resilience from both the perspectives of pediatric cancer patients and their caregivers. Therefore, this study aims to investigate the family resilience and quality of life of pediatric cancer patients from a patient–caregiver dyadic perspective. Methods: A total of 149 dyads of patients diagnosed with pediatric cancer patients and their principal caregivers were recruited from oncology departments of 4 tertiary hospitals in Wuhan and Taiyuan, China. All participants completed questionnaires that identified their demographic and clinical characteristics as well as assessed their family resilience and quality of life for both the patients and their caregivers. K-means cluster analysis was used to identify different clusters of family resilience based on the reports from patients and caregivers. Multivariate logistic regression and linear regression are used to analyze the factors influencing family resilience and quality of life, as well as the relationship between the two. Results: Three clusters of family resilience were identified: a cluster of high family resilience (HR), a cluster of low family resilience (LR), and a cluster of discrepant family resilience (DR). Most (67.1%) families fell into the cluster with low resilience. Characteristics such as the types of caregivers perceived social support of the patient were different among the three clusters. Compared to the LR group, families where the mother is the caregiver and where the patient has high social support are more likely to be assigned to the HR. The quality of life for caregivers was consistently highest in the HR cluster and lowest in the LR cluster. The patient's quality of life is not related to family resilience. In the linear regression analysis of the patient's quality of life, patients who are the first-born have higher quality of life, while those living with their parents have lower quality of life. The participants' characteristics were not associated with the quality of life for caregivers. Conclusions: In most families, family resilience was low. Families with maternal caregivers and patients receiving high levels of social support are more inclined to be higher levels of family resilience. Family resilience was linked to the quality of life of caregivers of pediatric cancer patients. The clinical implications of this findings suggest that healthcare and social support organizations should prioritize and support the participation of mothers in caregiving responsibilities. Furthermore, they should assist families in accessing social support to enhance family resilience. This study also emphasizes the importance of promoting family resilience for enhancing family health and happiness, as well as improving the quality of life for caregivers.

Keywords: pediatric cancer, cluster analysis, family resilience, quality of life

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Authors: Younes Abed

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The successful application of in-situ testing of soils heavily depends on development of interpretation methods of tests. The pressuremeter test simulates the expansion of a cylindrical cavity and because it has well defined boundary conditions, it is more unable to rigorous theoretical analysis (i. e. cavity expansion theory) then most other in-situ tests. In this article, and in order to make the identification process more convenient, we propose a relatively simple procedure which involves the numerical identification of some mechanical parameters of a granular soil, especially, the elastic modulus and the friction angle from a pressuremeter curve. The procedure, applied here to identify the parameters of generalised prager model associated to the Drucker & Prager criterion from a pressuremeter curve, is based on an inverse analysis approach, which consists of minimizing the function representing the difference between the experimental curve and the curve obtained by integrating the model along the loading path in in-situ testing. The numerical process implemented here is based on the established finite element program. We present a validation of the proposed approach by a database of tests on expansion of cylindrical cavity. This database consists of four types of tests; thick cylinder tests carried out on the Hostun RF sand, pressuremeter tests carried out on the Hostun sand, in-situ pressuremeter tests carried out at the site of Fos with marine self-boring pressuremeter and in-situ pressuremeter tests realized on the site of Labenne with Menard pressuremeter.

Keywords: granular soils, cavity expansion, pressuremeter test, finite element method, identification procedure

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Authors: Nour Daoud

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Patriarchy continues to thrive in Jordan where male-controlled values are still entrenched in a society that is suffering from upsetting percentages of Gender-based Violence (GBV). This paper is a systematic review of the literature with an attempt to evaluate and interpret all available research evidence relevant to determining the extent to which patriarchy contributes to the occurrence, re-occurrence, and continuation of GBV in Jordan. Twenty-one (21) full-text articles were selected for the in-depth review due to meeting the established criteria for inclusion. 81 percent of articles included primary data while 19 percent included secondary data. Analysis of data was based on a specific extraction form that was developed using the ‘Excel’ to respond to the main goal of the paper. Interpretation of data was in light of the theorization of different feminism schools on the relationship between patriarchy and gender-based violence. Findings show that 33 percent of the selected articles affirm that the patriarchal standpoint best explains the role of patriarchy in the incidence of gender-based violence in Jordan under its three main themes (Honor-based Violence, Intimate Partner Violence and Street Harassment). Apart from the limited number of articles that were found debating this argument and the low percentage of articles that acknowledged the role of patriarchy in the incidence of gender-based violence in Jordan, this paper breaks the ice to implement future empirical studies on this subject. Also, it is an invitation for all Jordanian women to unite their efforts in order to eradicate all forms of victimization against them.

Keywords: honor-based violence, intimate partner violence, middle-east, street harassment

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Authors: Neerja Meena, Paresh Sukhani

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Dandy walker malformation is a generalised disorder of mesenchymal development that affect both the cerebellum and overlying meninges. Classically dandy-walker malformation consists of a triad of- 1:vermian and hemispheric cerebellar hypoplasia 2:cystic dilatation of 4th ventricle 3: enlarged posterior fossa with the upward migration of tentorium(lambdoid- torcular inversion). Clinical presentation: four months old female child with hydrocephalus and neurological symptoms. Generally- early death is common in classic dandy walker malformation. However, if it is relatively mild and uncomplicated by other CNS anomalies, intelligence can be normal and neurologic deficits minimal. Usually, VP shunting is the treatment of choice for this hydrocephalus. Conclusion: MRI is the modality of choice to diagnose posterior fossa malformation. However, it can be ruled out through using during the antenatal check as the prognosis of this malformation is not good; it's better to diagnose it inutero.

Keywords: Dandy Walker, Mri, Earlydaignosis, Treatment

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Authors: Junior Akunzi

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In the matter of patient treatment planning quality assurance in 3D conformational therapy (3D-CRT) and volumetric arc therapy (VMAT or RapidArc), the independent monitor unit verification calculation (MUVC) is an indispensable part of the process. Concerning 3D-CRT treatment planning, the MUVC can be performed manually applying the standard ESTRO formalism. However, due to the complex shape and the amount of beams in advanced treatment planning technic such as RapidArc, the manual independent MUVC is inadequate. Therefore, commercially available software such as RadCalc can be used to perform the MUVC in complex treatment planning been. Indeed, RadCalc (version 6.3 LifeLine Inc.) uses a simplified Clarkson algorithm to compute the dose contribution for individual RapidArc fields to the isocenter. The purpose of this project is the validation of RadCalc in 3D-CRT and RapidArc for treatment planning dosimetry quality assurance at Antoine Lacassagne center (Nice, France). Firstly, the interfaces between RadCalc and our treatment planning systems (TPS) Isogray (version 4.2) and Eclipse (version13.6) were checked for data transfer accuracy. Secondly, we created test plans in both Isogray and Eclipse featuring open fields, wedges fields, and irregular MLC fields. These test plans were transferred from TPSs according to the radiotherapy protocol of DICOM RT to RadCalc and the linac via Mosaiq (version 2.5). Measurements were performed in water phantom using a PTW cylindrical semiflex ionisation chamber (0.3 cm³, 31010) and compared with the TPSs and RadCalc calculation. Finally, 30 3D-CRT plans and 40 RapidArc plans created with patients CT scan were recalculated using the CT scan of a solid PMMA water equivalent phantom for 3D-CRT and the Octavius II phantom (PTW) CT scan for RapidArc. Next, we measure the doses delivered into these phantoms for each plan with a 0.3 cm³ PTW 31010 cylindrical semiflex ionisation chamber (3D-CRT) and 0.015 cm³ PTW PinPoint ionisation chamber (Rapidarc). For our test plans, good agreements were found between calculation (RadCalc and TPSs) and measurement (mean: 1.3%; standard deviation: ± 0.8%). Regarding the patient plans, the measured doses were compared to the calculation in RadCalc and in our TPSs. Moreover, RadCalc calculations were compared to Isogray and Eclispse ones. Agreements better than (2.8%; ± 1.2%) were found between RadCalc and TPSs. As for the comparison between calculation and measurement the agreement for all of our plans was better than (2.3%; ± 1.1%). The independent MU verification calculation software RadCal has been validated for clinical use and for both 3D-CRT and RapidArc techniques. The perspective of this project includes the validation of RadCal for the Tomotherapy machine installed at centre Antoine Lacassagne.

Keywords: 3D conformational radiotherapy, intensity modulated radiotherapy, monitor unit calculation, dosimetry quality assurance

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Authors: Abdalla Abdelnabi, Yousf Abushalah

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The G Formation is a major gas producing reservoir in the SM Field, eastern, Libya. It is called G limestone because it consists of shallow marine limestone. Well data and 3D-Seismic in conjunction with the results of a previous study were used to delineate the hydrocarbon reservoir of Middle Eocene G-Formation of SM Field area. The data include three-dimensional seismic data acquired in 2009. It covers approximately an area of 75 mi² and with more than 9 wells penetrating the reservoir. Seismic data are used to identify any stratigraphic and structural and features such as channels and faults and which may play a significant role in hydrocarbon traps. The well data are used to calculation petrophysical analysis of S field. The average porosity of the Middle Eocene G Formation is very good with porosity reaching 24% especially around well W 6. Average water saturation was calculated for each well from porosity and resistivity logs using Archie’s formula. The average water saturation for the whole well is 25%. Structural mapping of top and bottom of Middle Eocene G formation revealed the highest area in the SM field is at 4800 ft subsea around wells W4, W5, W6, and W7 and the deepest point is at 4950 ft subsea. Correlation between wells using well data and structural maps created from seismic data revealed that net thickness of G Formation range from 0 ft in the north part of the field to 235 ft in southwest and south part of the field. The gas water contact is found at 4860 ft using the resistivity log. The net isopach map using both the trapezoidal and pyramid rules are used to calculate the total bulk volume. The original gas in place and the recoverable gas were calculated volumetrically to be 890 Billion Standard Cubic Feet (BSCF) and 630 (BSCF) respectively.

Keywords: 3D seismic data, well logging, petrel, kingdom suite

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Authors: Fathi Kallel, Saida Khachira, Mohamed Ben Slima, Ahmed Ben Hamida

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Speckle noise is a main characteristic of cardiac ultrasound images, it corresponding to grainy appearance that degrades the image quality. For this reason, the ultrasound images are difficult to use automatically in clinical use, then treatments are required for this type of images. Then a filtering procedure of these images is necessary to eliminate the speckle noise and to improve the quality of ultrasound images which will be then segmented to extract the necessary forms that exist. In this paper, we present the importance of the pre-treatment step for segmentation. This work is applied to cardiac ultrasound images. In a first step, a comparative study of speckle filtering method will be presented and then we use a segmentation algorithm to locate and extract cardiac structures.

Keywords: medical image processing, ultrasound images, Speckle noise, image enhancement, speckle filtering, segmentation, snakes

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

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Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: advanced palliative aquatics care, magnetic field therapy, medical device, research design

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Authors: Mehrnaz Mostafavi

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Recent advances in single-molecule protein identification (ID) and quantification techniques are poised to revolutionize proteomics, enabling researchers to delve into single-cell proteomics and identify low-abundance proteins crucial for biomedical and clinical research. This paper introduces a different approach to single-molecule protein ID and quantification using tri-color amino acid tags and a plasmonic nanopore device. A comprehensive simulator incorporating various physical phenomena was designed to predict and model the device's behavior under diverse experimental conditions, providing insights into its feasibility and limitations. The study employs a whole-proteome single-molecule identification algorithm based on convolutional neural networks, achieving high accuracies (>90%), particularly in challenging conditions (95–97%). To address potential challenges in clinical samples, where post-translational modifications affecting labeling efficiency, the paper evaluates protein identification accuracy under partial labeling conditions. Solid-state nanopores, capable of processing tens of individual proteins per second, are explored as a platform for this method. Unlike techniques relying solely on ion-current measurements, this approach enables parallel readout using high-density nanopore arrays and multi-pixel single-photon sensors. Convolutional neural networks contribute to the method's versatility and robustness, simplifying calibration procedures and potentially allowing protein ID based on partial reads. The study also discusses the efficacy of the approach in real experimental conditions, resolving functionally similar proteins. The theoretical analysis, protein labeler program, finite difference time domain calculation of plasmonic fields, and simulation of nanopore-based optical sensing are detailed in the methods section. The study anticipates further exploration of temporal distributions of protein translocation dwell-times and the impact on convolutional neural network identification accuracy. Overall, the research presents a promising avenue for advancing single-molecule protein identification and quantification with broad applications in proteomics research. The contributions made in methodology, accuracy, robustness, and technological exploration collectively position this work at the forefront of transformative developments in the field.

Keywords: nano proteomics, nanopore-based optical sensing, deep learning, artificial intelligence

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Authors: Ehsan Ahmed Yahia

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Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

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Authors: M. A. Sohaly, M. A. Elfouly

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Parkinson's disease (PD) is a heterogeneous movement disorder that often appears in the elderly. PD is induced by a loss of dopamine secretion. Some drugs increase the secretion of dopamine. In this paper, we will simply study the stability of PD models as a nonlinear delay differential equation. After a period of taking drugs, these act as positive feedback and increase the tremors of patients, and then, the differential equation has positive coefficients and the system is unstable under these conditions. We will present a set of suggested modifications to make the system more compatible with the biodynamic system. When giving a set of numerical examples, this research paper is concerned with the mathematical analysis, and no clinical data have been used.

Keywords: Parkinson's disease, stability, simulation, two delay differential equation

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Authors: Ya-Hsuan Wang

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This project of intercultural education aimed to explore pluricultural people’s interpretation and evaluation of the transnational community in Taiwan. Based on transnationalism and transculturalism, this study concerns the human right issues for immigrants and pluricultural people. Research participants as immigrants in Taiwan were asked about their typical thinking styles in the transnational community, their cultural integration in terms of transnational behaviors, and their collective memory of the transnational community. Interview questions included what key factors were involved in their identity negotiation, what roles the transnational community and collective memory would be for their identity negotiation and what were the positive or negative aspects impacting cross-border identity. Based on the experiences of pluricultural people and transnational communities, this project expected to enhance the depth and width of developing transcultural knowledge in textbook reform on History in K-12 schools. It is to transform cross-border identity into knowledge embedded with local culture in response to globalization and localization. The purpose of this paper is to portrait the cross-cultural practice of transnational community for Taiwan’s immigrants. It is to report their external socio-cultural expectation of ethnic economics, to understand their internal life course of national identity, and to clarify transnational community in relation to their cross-border identity. In conclusion, the cross-cultural practice of transnational community combined the external contexts such as ethnic economic interaction among transnational communities, social report and ethnic industry, and the internal contexts such as ethnic identity, language use, and collective memory in ethnic history.

Keywords: cross-cultural practice, immigrants, pluricultural people, transnational community

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Authors: Chiao-Wen Lan, David Gere

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Background and Significance: Performance has a rich history of imparting information and encouraging reflection, yet there is a paucity of literature on applying performance as a method of analysis and not as a medium for health education. This study aimed to apply ethnodrama strategies to the issue of HIV-related stigma in rural China and to use a critical performance as a vehicle for communication of health research. Methods: The program, titled 'STOP STIGMA,' included dance, narratives and original quotes from people living with HIV/AIDS in China, and spectacle such as photographs, set, and props corresponding to the history of HIV in rural China. Results: The performance represented a step away from a completely textual interpretation of data towards a theatrical style that begins to privilege what arts-based research scholars Rossiter and colleagues have termed 'an embodied, theatrical representation of data.' It offered an opportunity to deliver individual and collective stories that represent how HIV-positive people experience living with HIV/AIDS in China, which could play an integral part in the formulation of actions to effect change. Discussion: This method of communicating health research has implications for fostering dialogue among researchers, community members, and medical practitioners. Although arts-based approaches are not new to the scientific community, the integration of dance, video, ethnodrama, and sciences provides opportunities to innovate in non-traditional research dissemination and communication.

Keywords: health communication, HIV/AIDS, stigma, vulnerable populations

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Authors: Sabrina Rahman

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The Mosque is Islam’s most symbolic structure, as well as the expression of collective identity. From the explicit words of our Prophet, 'The earth has been created for me as a masjid and a place of purity, and whatever man from my Ummah finds himself in need of prayer, let him pray' (anywhere)! it is obvious that a devout Muslim does not require a defined space or structure for divine worship since the whole earth is his prayer house. Yet we see that from time immemorial man throughout the Muslim world has painstakingly erected innumerable mosques. However, mosque design spans time, crosses boundaries, and expresses cultures. It is a cultural manifestation as much as one based on a regional building tradition or a certain interpretation of religion. The trend to express physical signs of religion is not new. Physical forms seem to convey symbolic messages. However, in recent times physical forms of mosque architecture are dominantly demising from mosque architecture projects in Bangladesh. Dome & minaret, the most prominent symbol of the mosque, is replacing by contextual and contemporary improvisation rather than subcontinental mosque architecture practice of early fellows. Thus the recent mosque projects of the last 15 years established the contemporary architectural realm in their design. Contextually, spiritual lighting, the serenity of space, tranquility of outdoor spaces, the texture of materials is widely establishing a new genre of Muslim prayer space. A case study based research will lead to specify its significant factors of modernism. Based on the findings, the paper presents evidence of recent projects as well as a guideline for the future image of contemporary Mosque architecture in Bangladesh.

Keywords: contemporary architecture, modernism, prayer space, symbolism

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Authors: Nayera E. Hassan, Sahar A. El-Masry, Rokia El-Banna, Mohamed S. El Hussieny

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There are several different modalities for treatment of obesity. Common intervention methods for obesity include low-calorie diet, exercise. Also acupuncture has shown good therapeutic results in the treatment of obesity. A recent clinical observation showed that laser acupuncture could reduce body weight and body mass index in obese persons. So, the aim of this research is focused on body composition changes as related to type of intervention, before and after intentional weight loss in overweight and obesity. 76 subjects were included in the study analysis. The present study recommended that every obese female must do lipid profile and fasting blood sugar analysis before weight-loss intervention to take the decision of which method should be used.

Keywords: obesity, weight-loss, body composition, modalities

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Authors: Denis Jordan, Daniel Golkowski, Mathias Lukas, Katharina Merz, Caroline Mlynarcik, Max Maurer, Valentin Riedl, Stefan Foerster, Eberhard F. Kochs, Andreas Bender, Ruediger Ilg

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Introduction: So far, clinical assessments that rely on behavioral responses to differentiate coma states or even predict outcome in coma patients are unreliable, e.g. because of some patients’ motor disabilities. The present study was aimed to provide prognosis in coma patients using markers from electroencephalogram (EEG), blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) and [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET). Unsuperwised principal component analysis (PCA) was used for multimodal integration of markers. Methods: Approved by the local ethics committee of the Technical University of Munich (Germany) 20 patients (aged 18-89) with severe brain damage were acquired through intensive care units at the Klinikum rechts der Isar in Munich and at the Therapiezentrum Burgau (Germany). At the day of EEG/fMRI/PET measurement (date I) patients (<3.5 month in coma) were grouped in the minimal conscious state (MCS) or vegetative state (VS) on the basis of their clinical presentation (coma recovery scale-revised, CRS-R). Follow-up assessment (date II) was also based on CRS-R in a period of 8 to 24 month after date I. At date I, 63 channel EEG (Brain Products, Gilching, Germany) was recorded outside the scanner, and subsequently simultaneous FDG-PET/fMRI was acquired on an integrated Siemens Biograph mMR 3T scanner (Siemens Healthineers, Erlangen Germany). Power spectral densities, permutation entropy (PE) and symbolic transfer entropy (STE) were calculated in/between frontal, temporal, parietal and occipital EEG channels. PE and STE are based on symbolic time series analysis and were already introduced as robust markers separating wakefulness from unconsciousness in EEG during general anesthesia. While PE quantifies the regularity structure of the neighboring order of signal values (a surrogate of cortical information processing), STE reflects information transfer between two signals (a surrogate of directed connectivity in cortical networks). fMRI was carried out using SPM12 (Wellcome Trust Center for Neuroimaging, University of London, UK). Functional images were realigned, segmented, normalized and smoothed. PET was acquired for 45 minutes in list-mode. For absolute quantification of brain’s glucose consumption rate in FDG-PET, kinetic modelling was performed with Patlak’s plot method. BOLD signal intensity in fMRI and glucose uptake in PET was calculated in 8 distinct cortical areas. PCA was performed over all markers from EEG/fMRI/PET. Prognosis (persistent VS and deceased patients vs. recovery to MCS/awake from date I to date II) was evaluated using the area under the curve (AUC) including bootstrap confidence intervals (CI, *: p<0.05). Results: Prognosis was reliably indicated by the first component of PCA (AUC=0.99*, CI=0.92-1.00) showing a higher AUC when compared to the best single markers (EEG: AUC<0.96*, fMRI: AUC<0.86*, PET: AUC<0.60). CRS-R did not show prediction (AUC=0.51, CI=0.29-0.78). Conclusion: In a multimodal analysis of EEG/fMRI/PET in coma patients, PCA lead to a reliable prognosis. The impact of this result is evident, as clinical estimates of prognosis are inapt at time and could be supported by quantitative biomarkers from EEG, fMRI and PET. Due to the small sample size, further investigations are required, in particular allowing superwised learning instead of the basic approach of unsuperwised PCA.

Keywords: coma states and prognosis, electroencephalogram, entropy, functional magnetic resonance imaging, machine learning, positron emission tomography, principal component analysis

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Authors: Nancy Wilson

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In utero, fetal drug exposure is prevalent amongst birthing facilities. Assessment tools for neonatal abstinence syndrome (NAS) are often cumbersome and ill-fitting, harboring immense subjectivity. This paradox often leads the clinical assessor to be hypervigilant when assessing the newborn for subtle symptoms of NAS, often mistaken for normal newborn behaviors. As a quality improvement initiative, this project led to a more adaptable NAS tool termed eat, sleep, console (ESC). This function-based NAS assessment scores the infant based on the ability to accomplish three basic newborn necessities- to sleep, to eat, and to be consoled. Literature supports that ESC methodology improves patient and family outcomes while providing more cost-effective care.

Keywords: neonatal abstinence syndrome, neonatal opioid withdrawal, maternal substance abuse, pregnancy, and addiction, Finnegan neonatal abstinence syndrome tool, eat, sleep, console

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Authors: N. Hedayat, E. Karamifar

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Sustainable food and fiber production is emerging as an irresistible option in agrarian planning. Although one should not underestimate the successes of the Green Revolution in enhancing crop production, its adverse environmental and ecosystem consequences have also been remarkable. The aim of this paper is to identify ways of improving crop production to ensure agricultural sustainability and environmental integrity. Systematic observations are used for data collection on intensive farming, deforestation and the environmental implications of industrial pollutants on agricultural sustainability at national and international levels. These were achieved within a comparative analytical model of data interpretation. Results show that while multiple factors enhance yield, they have a simultaneous effect in undermining the ecosystem and environmental integrity. Results show that application of excessive agrichemical have been one of the major cause of polluting the surface and underground water bodies as well as soil layers in affected croplands. Results consider rapid deforestation in the tropical regions has been the underlying cause of impairing the integrity of biodiversity and oxygen-generation regime. These, coupled with production of greenhouse gasses, have contributed to global warming and hydrological irregularities. Continuous production of pollutants and effluents has affected marine and land biodiversity arising from acid rains generated by modern farming and deforestation. Continuous production of greenhouse gases has also been instrumental in affecting climatic behavior manifested in recurring draughts and contraction of lakes and ponds as well as emergence of potential flooding of waterways and floodplains in the future.

Keywords: agricultural sustainability, environmental integrity, pollution, eco-system

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Authors: Rajish Shil, Amal Alduhoori, Vipin Thomachan, Jamal Teir, Radhakrishnan Renganathan

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Background: Antiphospholipid antibody syndrome (APS) has a broad spectrum of thrombotic and non-thrombotic clinical manifestations. We present a case of APS presenting with seizure, stroke, and atrial mass. Case Description: A 38-year-old male presented with headache of 10 days duration and tonic-clonic seizure. The neurological examination was normal. Magnetic resonance imaging of brain showed small acute right cerebellar infarct. Magnetic resonance angiography of brain and neck showed a focal narrowing in the origin of the internal carotid artery bilaterally. Electroencephalogram was normal. He was started on aspirin, atorvastatin, and carbamazepine. Transthoracic and trans-esophageal echocardiography showed a pedunculated and lobular atrial mass, measuring 1 X 1.5 cm, which was freely mobile across mitral valve opening across the left ventricular inflow. Autoimmune screening showed positive Antiphospholipid antibodies in high titer (Cardiolipin IgG > 120 units/ml, B2 glycoprotein IgG 90 units/mL). Anti-nuclear antibody was negative. Erythrocyte sedimentation rate and C-reactive protein levels were normal. Platelet count was low (111 x 109/L). The patient underwent successful surgical removal of the mass, which looked like a thrombotic clot, and Histopathological analysis confirmed it as a fibrinous clot, with no evidence of tumor cells. The patient was started on full anticoagulation treatment and was followed up regularly in the clinic, where our patient did not have any further complications from the disease. Discussion: Our patient was diagnosed to have APS based on the features of high positive anticardiolipin antibody IgG and B2 glycoprotein IgG levels, Stroke, thrombocytopenia, and abnormal echo findings. Thrombotic vegetation can mimic an atrial myxoma on echo. Conclusion: APS can present with neurological and cardiac manifestations, and therefore a high index of suspicion is necessary for a diagnosis of the disease as it can affect both short and long term treatment plans and prognosis. Therefore, in patients presenting with neurological symptoms like seizures, weakness and radiological diagnosis of stroke in a young patient, where atrial masses could be thought to be the cause of stroke, they should be screened for any concomitant findings of thrombocytopenia and/or activated partial thromboplastin time prolongation, which should raise the suspicion of vasculitis, specifically APS to be the primary cause of the clinical presentation.

Keywords: antiphospholipid syndrome, seizures, atrial mass, stroke

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Authors: Rajendra Kanojia

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Femoral components with inbuilt rotation require thicker flexion resection of the lateral femoral condyle and could potential risk to damage the popliteus tendon especially in the smaller Asian knees. We prospectively evaluated 10 patients with bilateral varus osteoarthritis knee to size the cuts and their location in relation to the popliteus tendon. Two different types of implant were used on either side, one side requires resection in 3° external rotation (group A) and other side femoral component with inbuilt external roation (group B). We had popliteus tendon injury in 3 knees all from group B. Risk of damaging the popliteus tendon was found higher in group B.

Keywords: popliteaus tendon injury, TKA, orthopaedic surgery, biomechanics and clinical applications

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Authors: Esmaeil Asadzadeh, Mehtab Alam

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Well documented records of the past failures of the structures reveals that the progressive collapse of structures is one of the major reasons for dramatic human loss and economical consequences. Progressive collapse is the failure mechanism in which the structure fails gradually due to the sudden removal of the structural elements. The sudden removal of some structural elements results in the excessive redistributed loads on the others. This sudden removal may be caused by any sudden loading resulted from local explosion, impact loading and terrorist attacks. Hyperbolic thin walled concrete shell structures being an important part of nuclear and thermal power plants are always prone to such terrorist attacks. In concrete structures, the gradual failure would take place by generation of initial cracks and its propagation in the supporting columns along with the tower shell leading to the collapse of the entire structure. In this study the mechanism of progressive collapse for such high raised towers would be simulated employing the finite element method. The aim of this study would be providing clear conceptual step-by-step descriptions of various procedures for progressive collapse analysis using commercially available finite element structural analysis software’s, with the aim that the explanations would be clear enough that they will be readily understandable and will be used by practicing engineers. The study would be carried out in the following procedures: 1. Provide explanations of modeling, simulation and analysis procedures including input screen snapshots; 2. Interpretation of the results and discussions; 3. Conclusions and recommendations.

Keywords: progressive collapse, cooling towers, finite element analysis, crack generation, reinforced concrete

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Authors: Farid Adisaputra Gumilang

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Kucing Liar Underground Mine is a future mine of PT Freeport Indonesia PTFI that is currently being developed. In the development process, problems were found when blasting the tunnels; there were overbreak, and void occur caused by geological contact or poor rock conditions. Geotechnical engineers must evaluate not only the remnant capacity of ground support systems but also investigate the depth of rock mass yield within pillars. To prevent the potential hazard caused by void zones, geotechnical engineers must ensure the planned drift is mined in the best location where people can work safely. GPR, or Ground penetrating radar, is a geophysical method that can image the subsurface. This non-destructive method uses electromagnetic radiation and detects the reflected signals from subsurface structures. The GPR survey measurements are conducted 48 meters along the drift that has a poor ground condition with 150MHz antenna with several angles (roof, wall, and floor). Concern grounds are determined by the continuity of reflector/low reflector in the radargram section. Concern grounds are determined by the continuity of reflector/low reflector in the radargram section. In this paper, processing data using instantaneous amplitude to identify the void zone. In order to have a good interpretation and result, it combines with the geological information and borehole camera data, so the calibrated GPR data allows the geotechnical engineer to determine the safe location to change the drift location.

Keywords: underground mine, ground penetrating radar, reflectivity, borehole camera

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Authors: Jun-Ki Choi

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The usage of valuable resources and the potential for waste generation at the end of the life cycle of photovoltaic (PV) technologies necessitate a proactive planning for a PV recycling infrastructure. To ensure the sustainability of PV in large scales of deployment, it is vital to develop and institute low-cost recycling technologies and infrastructure for the emerging PV industry in parallel with the rapid commercialization of these new technologies. There are various issues involved in the economics of PV recycling and this research examine those at macro and micro levels, developing a holistic interpretation of the economic viability of the PV recycling systems. This study developed mathematical models to analyze the profitability of recycling technologies and to guide tactical decisions for allocating optimal location of PV take-back centers (PVTBC), necessary for the collection of end of life products. The economic decision is usually based on the level of the marginal capital cost of each PVTBC, cost of reverse logistics, distance traveled, and the amount of PV waste collected from various locations. Results illustrated that the reverse logistics costs comprise a major portion of the cost of PVTBC; PV recycling centers can be constructed in the optimally selected locations to minimize the total reverse logistics cost for transporting the PV wastes from various collection facilities to the recycling center. In the micro- process level, automated recycling processes should be developed to handle the large amount of growing PV wastes economically. The market price of the reclaimed materials are important factors for deciding the profitability of the recycling process and this illustrates the importance of the recovering the glass and expensive metals from PV modules.

Keywords: photovoltaic, recycling, mathematical models, sustainability

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Authors: Neha Bhattacharyya, Soumendra Singh, Amrita Banerjee, Ria Ghosh, Oindrila Sinha, Nairit Das, Rajkumar Gayen, Somya Subhra Pal, Sahely Ganguly, Tanmoy Dasgupta, Tanusree Dasgupta, Pulak Mondal, Aniruddha Adhikari, Sharmila Sarkar, Debasish Bhattacharyya, Asim Kumar Mallick, Om Prakash Singh, Samir Kumar Pal

Abstract:

Background: We aim to develop an integrated device comprised of single-probe EEG and CCD-based motion sensors for a more objective measure of Attention-deficit Hyperactivity Disorder (ADHD). While the integrated device (MAHD) relies on the EEG signal (spectral density of beta wave) for the assessment of attention during a given structured task (painting three segments of a circle using three different colors, namely red, green and blue), the CCD sensor depicts movement pattern of the subjects engaged in a continuous performance task (CPT). A statistical analysis of the attention and movement patterns was performed, and the accuracy of the completed tasks was analysed using indigenously developed software. The device with the embedded software, called MAHD, is intended to improve certainty with criterion E (i.e. whether symptoms are better explained by another condition). Methods: We have used the EEG signal from a single-channel dry sensor placed on the frontal lobe of the head of the subjects (3-5 years old pre-schoolers). During the painting of three segments of a circle using three distinct colors (red, green, and blue), absolute power for delta and beta EEG waves from the subjects are found to be correlated with relaxation and attention/cognitive load conditions. While the relaxation condition of the subject hints at hyperactivity, a more direct CCD-based motion sensor is used to track the physical movement of the subject engaged in a continuous performance task (CPT) i.e., separation of the various colored balls from one table to another. We have used our indigenously developed software for the statistical analysis to derive a scale for the objective assessment of ADHD. We have also compared our scale with clinical ADHD evaluation. Results: In a limited clinical trial with preliminary statistical analysis, we have found a significant correlation between the objective assessment of the ADHD subjects with that of the clinician’s conventional evaluation. Conclusion: MAHD, the integrated device, is supposed to be an auxiliary tool to improve the accuracy of ADHD diagnosis by supporting greater criterion E certainty.

Keywords: ADHD, CPT, EEG signal, motion sensor, psychometric test

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Authors: Jing Yuan, Hongwei Yang

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This paper aims to understand U.S. middle school students’ mathematics achievements by examining relevant student and school-level predictors. Through a variance component analysis, the study first identifies evidence supporting the use of multilevel modeling. Then, a multilevel analysis is performed under Bayesian statistical inference where prior information is incorporated into the modeling process. During the analysis, independent variables are entered sequentially in the order of theoretical importance to create a hierarchy of models. By evaluating each model using Bayesian fit indices, a best-fit and most parsimonious model is selected where Bayesian statistical inference is performed for the purpose of result interpretation and discussion. The primary dataset for Bayesian modeling is derived from the Program for International Student Assessment (PISA) in 2012 with a secondary PISA dataset from 2003 analyzed under the traditional ordinary least squares method to provide the information needed to specify informative priors for a subset of the model parameters. The dependent variable is a composite measure of mathematics literacy, calculated from an exploratory factor analysis of all five PISA 2012 mathematics achievement plausible values for which multiple evidences are found supporting data unidimensionality. The independent variables include demographics variables and content-specific variables: mathematics efficacy, teacher-student ratio, proportion of girls in the school, etc. Finally, the entire analysis is performed using the MCMCpack and MCMCglmm packages in R.

Keywords: Bayesian multilevel modeling, mathematics education, PISA, multilevel

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Authors: Gal Belsitzman, Rose Stamp, Atay Citron, Wendy Sandler

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Sign languages are considered endangered. The vitality of sign languages is compromised by its unique sociolinguistic situation, in which hearing parents that give birth to deaf children usually decide to cochlear implant their child. Therefore, these children don’t acquire their natural language – Sign Language. Despite this, many sign languages, such as Israeli Sign Language (ISL) are thriving. The continued survival of similar languages under threat has been associated with the remarkable resilience of the language community. In particular, deaf literary traditions are central in reminding the community of the importance of the language. One example of a deaf literary tradition which has received increased popularity in recent years is deaf theatre. The Ebisu Sign Language Theatre Laboratory, developed as part of the multidisciplinary Grammar of the Body Research Project, is the first deaf theatre company in Israel. Ebisu Theatre combines physical theatre and sign language research, to allow for a natural laboratory to analyze the creative use of the body. In this presentation, we focus on the recent theatre production called ‘Their language’ which tells of the struggle faced by the deaf community to use their own natural language in the education system. A thorough analysis unravels how linguistic properties are integrated with the use of poetic devices and physical theatre techniques in this performance, enabling wider access by both deaf and hearing audiences, without interpretation. Interviews with the audience illustrate the significance of this art form which serves a dual purpose, both as empowering for the deaf community and educational for the hearing and deaf audiences, by raising awareness of community-related issues.

Keywords: deaf theatre, empowerment, language revitalization, sign language

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Authors: J. Luché-Thayer, C. Perronne, C. Meseko

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We reviewed how certain institutional policies and practices, as well as questionable research, are creating obstacles to care and informed consent for Lyme and relapsing fever Borreliosis patients. The interference is denying access to treatments that meet the internationally accepted standards as set by the Institute of Medicine. This obstruction to care contributes to significant human suffering, disability and negative economic effect across many nations and in many regions of the world. We note how evidence based medicine emphasizes the importance of clinical experience and patient-centered care and how these patients benefit significantly when their rights to choose among treatment options are upheld.  

Keywords: conflicts of interest, obstacles to healthcare accessibility, patient-centered care, the right to informed consent

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Authors: Lucie Mrackova, Helena Kisvetrova

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Spirituality is an integral part of human life. In a secular environment, spiritual needs are often overlooked, especially in acute nursing care. Spiritual needs assessment for patients (SNAP), which also exists in the Czech version (SNAP-CZ), can be used for objective evaluation. The aim of this study was to measure the psychometric properties of SNAP-CZ and to find correlations between SNAP-CZ and sociodemographic and clinical variables. A cross-sectional study with tools assessing spiritual needs (SNAP-CZ), anxiety (Beck Anxiety Inventory; BAI), depression (Beck Depression Inventory; BDI), pain (Visual Analogue Scale; VAS), self-sufficiency (Barthel Index; BI); cognitive function (Montreal Cognitive Test; MoCa) and selected socio-demographic data was performed. The psychometric properties of SNAP-CZ were tested using factor analysis, reliability and validity tests, and correlations between the questionnaire and sociodemographic data and clinical variables. Internal consistency was established with Cronbach’s alfa for the overall score, respective domains, and individual items. Reliability was assessed by test-retest by Interclass correlation coefficient (ICC). Data for correlation analysis were processed according to Pearson's correlation coefficient. The study included 172 trauma patients (the mean age = 40.6 ± 12.1 years) who experienced polytrauma or severe monotrauma. There were a total of 106 (61.6%) male subjects, 140 (81.4%) respondents identified themselves as non-believers. The full-scale Cronbach's alpha was 0.907. The test-retest showed the reliability of the individual domains in the range of 0.924 to 0.960 ICC. Factor analysis resulted in a three-factor solution (psychosocial needs (alfa = 0.788), spiritual needs (alfa = 0.886) and religious needs (alfa = 0.841)). Correlation analysis using Pearson's correlation coefficient showed that the domain of psychosocial needs significantly correlated only with gender (r = 0.178, p = 0.020). Males had a statistically significant lower average value in this domain (mean = 12.5) compared to females (mean = 13.8). The domain of spiritual needs significantly correlated with gender (r = 0.199, p = 0.009), social status (r = 0.156, p = 0.043), faith (r = -0.250, p = 0.001), anxiety (r = 0.194, p = 0.011) and depression (r = 0.155, p = 0.044). The domain of religious needs significantly correlated with age (r = 0,208, p = 0,007), education (r = -0,161, p = 0,035), faith (r = -0,575, p < 0,0001) and depression (r = 0,179, p = 0,019). Overall, the whole SNAP scale significantly correlated with gender (r = 0.219, p = 0.004), social status (r = 0.175, p = 0.023), faith (r = -0.334, p <0.0001), anxiety (r = 0.177, p = 0.022) and depression (r = 0.173, p = 0.025). The results of this study corroborate the reliability of the SNAP-CZ and support its future use in the nursing care of trauma patients in a secular society. Acknowledgment: The study was supported by grant nr. IGA_FZV_2020_003.

Keywords: acute nursing care, assessment of spiritual needs, patient, psychometric validation, spirituality

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Authors: Virany Diana, Martono Tri Utomo, Risa Etika

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Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal.

Keywords: preterm infant, regional muscle oxygen saturation, regional cerebral oxygen saturation, NIRS, shock

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Authors: Binish Ahmed

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Corporate Social Responsibility (CSR) is regarded as voluntary behaviors that contribute to the social welfare based on the concept of sustainable development. The corporations should not only stress on their economic and business outcomes but also pay attention to their effect on the society and environment. It could attract investors and customers, as well as maintain a positive interaction with the government. In spite of the broad diffusion, and its potential significance to employees' perspective, CSR is now examined and has built-in Organizational Behavior (OB), and Human Resource Management (HRM) look into the broad structure of relationship between employees' perspective, work attitudes and behavior to improve the research on CSR. The purpose of this research is to investigate the impact of employees’ perception of CSR on work attitudes and behaviors of employees. A conceptual framework is proposed, based on the literature and practices. The research would conduct the primary data survey of convenient sampling from the employees and managers-using detailed questionnaire- to address the following questions. The survey of 180 respondents of age greater than 20 having at least six-month experience from companies based in Karachi are source of data. The application of professional empirical models for data analysis and interpretation are source to draw the conclusion. 1. What are the dynamics of CSR in an organization? Why is it important to have a CSR department? What sort of business approach are CSR activities practiced? Do CSR activities improve the quality of life of workplace? And, how it linked with welfare of society? 2. How the positive job attitude and behavior does encourage the employees about the perception of CSR? How is it linked with the job satisfaction? What is the relationship between employees’ perception of CSR and job satisfaction?

Keywords: corporate social responsibility, job satisfaction, organizational commitment, work behaviors

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