Search results for: clinical outcome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5291

Search results for: clinical outcome

3431 Statistical Quality Control on Assignable Causes of Variation on Cement Production in Ashaka Cement PLC Gombe State

Authors: Hamisu Idi

Abstract:

The present study focuses on studying the impact of influencer recommendation in the quality of cement production. Exploratory research was done on monthly basis, where data were obtained from secondary source i.e. the record kept by an automated recompilation machine. The machine keeps all the records of the mills downtime which the process manager checks for validation and refer the fault (if any) to the department responsible for maintenance or measurement taking so as to prevent future occurrence. The findings indicated that the product of the Ashaka Cement Plc. were considered as qualitative, since all the production processes were found to be in control (preset specifications) with the exception of the natural cause of variation which is normal in the production process as it will not affect the outcome of the product. It is reduced to the bearest minimum since it cannot be totally eliminated. It is also hopeful that the findings of this study would be of great assistance to the management of Ashaka cement factory and the process manager in particular at various levels in the monitoring and implementation of statistical process control. This study is therefore of great contribution to the knowledge in this regard and it is hopeful that it would open more research in that direction.

Keywords: cement, quality, variation, assignable cause, common cause

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3430 EGF Serum Level in Diagnosis and Prediction of Mood Disorder in Adolescents and Young Adults

Authors: Monika Dmitrzak-Weglarz, Aleksandra Rajewska-Rager, Maria Skibinska, Natalia Lepczynska, Piotr Sibilski, Joanna Pawlak, Pawel Kapelski, Joanna Hauser

Abstract:

Epidermal growth factor (EGF) is a well-known neurotrophic factor that involves in neuronal growth and synaptic plasticity. The proteomic research provided in order to identify novel candidate biological markers for mood disorders focused on elevated EGF serum level in patients during depression episode. However, the EGF association with mood disorder spectrum among adolescents and young adults has not been studied extensively. In this study, we aim to investigate the serum levels of EGF in adolescents and young adults during hypo/manic, depressive episodes and in remission compared to healthy control group. In our study, we involved 80 patients aged 12-24 years in 2-year follow-up study with a primary diagnosis of mood disorder spectrum, and 35 healthy volunteers matched by age and gender. Diagnoses were established according to DSM-IV-TR criteria using structured clinical interviews: K-SADS for child and adolescents, and SCID for young adults. Clinical and biological evaluations were made at baseline and euthymic mood (at 3th or 6th month of treatment and after 1 and 2 years). The Young Mania Rating Scale and Hamilton Rating Scale for Depression were used for assessment. The study protocols were approved by the relevant ethics committee. Serum protein concentration was determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Human EGF (cat. no DY 236) DuoSet ELISA kit was used (R&D Systems). Serum EGF levels were analysed with following variables: age, age under 18 and above 18 years old, sex, family history of affective disorders, drug-free vs. medicated. Shapiro-Wilk test was used to test the normality of the data. The homogeneity of variance was calculated with Levene’s test. EGF levels showed non-normal distribution and the homogeneity of variance was violated. Non-parametric tests: Mann-Whitney U test, Kruskall-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation coefficient was applied in the analyses The statistical significance level was set at p<0.05. Elevated EGF level at baseline (p=0.001) and at month 24 (p=0.02) was detected in study subjects compared with controls. Increased EGF level in women at month 12 (p=0.02) compared to men in study group have been observed. Using Wilcoxon signed rank test differences in EGF levels were detected: decrease from baseline to month 3 (p=0.014) and increase comparing: month 3 vs. 24 (p=0.013); month 6 vs. 12 (p=0.021) and vs. 24 (p=0.008). EGF level at baseline was negatively correlated with depression and mania occurrence at 24 months. EGF level at 24 months was positively correlated with depression and mania occurrence at 12 months. No other correlations of EGF levels with clinical and demographical variables have been detected. The findings of the present study indicate that EGF serum level is significantly elevated in the study group of patients compared to the controls. We also observed fluctuations in EGF levels during two years of disease observation. EGF seems to be useful as an early marker for prediction of diagnosis, course of illness and treatment response in young patients during first episode od mood disorders, which requires further investigation. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: biological marker, epidermal growth factor, mood disorders, prediction

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3429 Cancer Burden and Policy Needs in the Democratic Republic of the Congo: A Descriptive Study

Authors: Jean Paul Muambangu Milambo, Peter Nyasulu, John Akudugu, Leonidas Ndayisaba, Joyce Tsoka-Gwegweni, Lebwaze Massamba Bienvenu, Mitshindo Mwambangu Chiro

Abstract:

In 2018, non-communicable diseases (NCDs) were responsible for 48% of deaths in the Democratic Republic of Congo (DRC), with cancer contributing to 5% of these deaths. There is a notable absence of cancer registries, capacity-building activities, budgets, and treatment roadmaps in the DRC. Current cancer estimates are primarily based on mathematical modeling with limited data from neighboring countries. This study aimed to assess cancer subtype prevalence in Kinshasa hospitals and compare these findings with WHO model estimates. Methods: A retrospective observational study was conducted from 2018 to 2020 at HJ Hospitals in Kinshasa. Data were collected using American Cancer Society (ACS) questionnaires and physician logs. Descriptive analysis was performed using STATA version 16 to estimate cancer burden and provide evidence-based recommendations. Results: The results from the chart review at HJ Hospitals in Kinshasa (2018-2020) indicate that out of 6,852 samples, approximately 11.16% were diagnosed with cancer. The distribution of cancer subtypes in this cohort was as follows: breast cancer (33.6%), prostate cancer (21.8%), colorectal cancer (9.6%), lymphoma (4.6%), and cervical cancer (4.4%). These figures are based on histopathological confirmation at the facility and may not fully represent the broader population due to potential selection biases related to geographic and financial accessibility to the hospital. In contrast, the World Health Organization (WHO) model estimates for cancer prevalence in the DRC show different proportions. According to WHO data, the distribution of cancer types is as follows: cervical cancer (15.9%), prostate cancer (15.3%), breast cancer (14.9%), liver cancer (6.8%), colorectal cancer (5.9%), and other cancers (41.2%) (WHO, 2020). Conclusion: The data indicate a rising cancer prevalence in DRC but highlight significant gaps in clinical, biomedical, and genetic cancer data. The establishment of a population-based cancer registry (PBCR) and a defined cancer management pathway is crucial. The current estimates are limited due to data scarcity and inconsistencies in clinical practices. There is an urgent need for multidisciplinary cancer management, integration of palliative care, and improvement in care quality based on evidence-based measures.

Keywords: cancer, risk factors, DRC, gene-environment interactions, survivors

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3428 Effects of the Treatment by Polypill Combinations vs Identical Monopill Therapies in Patients with Cardiovascular Comorbid Diseases

Authors: Denys Sebov, Viktoriia Korotaieva, Kateryna Markina

Abstract:

The clinical advantage of the multipill combination drugs administration (polypill-strategy) over single-component drugs (monopill-strategy) has been established in patients with comorbid arterial hypertension, heart failure, chronic coronary syndrome, diabetes. It was found that polypill-strategy provides better treatment adherence in 33.4% of the patients. It was proven a significant decrease in systolic and diastolic blood pressure, as well as a decrease in dispersion index due to the stability of the blood pressure profile in patients with the polypill-strategy treatment.

Keywords: polypill, artetial hypertension, cardiovascular disease, compliance

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3427 The Role and Importance of Genome Sequencing in Prediction of Cancer Risk

Authors: M. Sadeghi, H. Pezeshk, R. Tusserkani, A. Sharifi Zarchi, A. Malekpour, M. Foroughmand, S. Goliaei, M. Totonchi, N. Ansari–Pour

Abstract:

The role and relative importance of intrinsic and extrinsic factors in the development of complex diseases such as cancer still remains a controversial issue. Determining the amount of variation explained by these factors needs experimental data and statistical models. These models are nevertheless based on the occurrence and accumulation of random mutational events during stem cell division, thus rendering cancer development a stochastic outcome. We demonstrate that not only individual genome sequencing is uninformative in determining cancer risk, but also assigning a unique genome sequence to any given individual (healthy or affected) is not meaningful. Current whole-genome sequencing approaches are therefore unlikely to realize the promise of personalized medicine. In conclusion, since genome sequence differs from cell to cell and changes over time, it seems that determining the risk factor of complex diseases based on genome sequence is somewhat unrealistic, and therefore, the resulting data are likely to be inherently uninformative.

Keywords: cancer risk, extrinsic factors, genome sequencing, intrinsic factors

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3426 Increasing the Ability of State Senior High School 12 Pekanbaru Students in Writing an Analytical Exposition Text through Comic Strips

Authors: Budiman Budiman

Abstract:

This research aimed at describing and testing whether the students’ ability in writing analytical exposition text is increased by using comic strips at SMAN 12 Pekanbaru. The respondents of this study were the second-grade students, especially XI Science 3 academic year 2011-2012. The total number of students in this class was forty-two (42) students. The quantitative and qualitative data was collected by using writing test and observation sheets. The research finding reveals that there is a significant increase of students’ writing ability in writing analytical exposition text through comic strips. It can be proved by the average score of pre-test was 43.7 and the average score of post-test was 65.37. Besides, the students’ interest and motivation in learning are also improved. These can be seen from the increasing of students’ awareness and activeness in learning process based on observation sheets. The findings draw attention to the use of comic strips in teaching and learning is beneficial for better learning outcome.

Keywords: analytical exposition, comic strips, secondary school students, writing ability

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3425 EFL Learners' Attitudes towards the Proper Pronunciation of English and towards Podcasts as a Facilitator for Proper Pronunciation

Authors: Riam Almaqrn, Abdulrahman Alshabeb

Abstract:

The study aims to examine the attitudes of Saudi students of English towards proper pronunciation and towards podcasts as a facilitator for proper pronunciation. In order to fulfill the purpose of the study, twenty-three students participated in this study. The study used a questionnaire as the main data collection instrument. The questionnaire included two parts, one or proper pronunciation and the other for podcasts. Data analysis showed that the participants, in spite of the low rate of improvement in their pronunciation, had positive attitudes towards proper pronunciation of English. This outcome is compatible with previous studies` results that assert the fact that having a positive attitude towards a particular language and its speakers can improve pronunciation. As for podcasts, students received a total of five podcasts related to their listening and speaking textbook. At the end of the project, students showed high rate of acceptance for podcasts and positive attitudes towards them. The findings proved the usefulness of examining learners` attitudes towards new CALL applications before using them in a practical way. In the light of the findings, pedagogical implications and suggestions were presented for language instructors and academics.

Keywords: CALL, MALL, podcast, learning English

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3424 Early Identification and Early Intervention: Pre and Post Diagnostic Tests in Mathematics Courses

Authors: Kailash Ghimire, Manoj Thapa

Abstract:

This study focuses on early identification of deficiencies in pre-required areas of students who are enrolled in College Algebra and Calculus I classes. The students were given pre-diagnostic tests on the first day of the class before they are provided with the syllabus. The tests consist of prerequisite, uniform and advanced content outlined by the University System of Georgia (USG). The results show that 48% of students in College Algebra are lacking prerequisite skills while 52% of Calculus I students are lacking prerequisite skills but, interestingly these students are prior exposed to uniform content and advanced content. The study is still in progress and this paper contains the outcome from Fall 2017 and Spring 2018. In this paper, early intervention used in these classes: two days vs three days meeting a week and students’ self-assessment using exam wrappers and their effectiveness on students’ learning will also be discussed. A result of this study shows that there is an improvement on Drop, Fail and Withdraw (DFW) rates by 7%-10% compared to those in previous semesters.

Keywords: student at risk, diagnostic tests, identification, intervention, normalization gain, validity of tests

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3423 Functional Outcome of Speech, Voice and Swallowing Following Excision of Glomus Jugulare Tumor

Authors: B. S. Premalatha, Kausalya Sahani

Abstract:

Background: Glomus jugulare tumors arise within the jugular foramen and are commonly seen in females particularly on the left side. Surgical excision of the tumor may cause lower cranial nerve deficits. Cranial nerve involvement produces hoarseness of voice, slurred speech, and dysphagia along with other physical symptoms, thereby affecting the quality of life of individuals. Though oncological clearance is mainly emphasized on while treating these individuals, little importance is given to their communication, voice and swallowing problems, which play a crucial part in daily functioning. Objective: To examine the functions of voice, speech and swallowing outcomes of the subjects, following excision of glomus jugulare tumor. Methods: Two female subjects aged 56 and 62 years had come with a complaint of change in voice, inability to swallow and reduced clarity of speech following surgery for left glomus jugulare tumor were participants of the study. Their surgical information revealed multiple cranial nerve palsies involving the left facial, left superior and recurrent branches of the vagus nerve, left pharyngeal, left soft palate, left hypoglossal and vestibular nerves. Functional outcomes of voice, speech and swallowing were evaluated by perceptual and objective assessment procedures. Assessment included the examination of oral structures and functions, dysarthria by Frenchey dysarthria assessment, cranial nerve functions and swallowing functions. MDVP and Dr. Speech software were used to evaluate acoustic parameters of voice and quality of voice respectively. Results: The study revealed that both the subjects, subsequent to excision of glomus jugulare tumor, showed a varied picture of affected oral structure and functions, articulation, voice and swallowing functions. The cranial nerve assessment showed impairment of the vagus, hypoglossal, facial and glossopharyngeal nerves. Voice examination indicated vocal cord paralysis associated with breathy quality of voice, weak voluntary cough, reduced pitch and loudness range, and poor respiratory support. Perturbation parameters as jitter, shimmer were affected along with s/z ratio indicative of voice fold pathology. Reduced MPD(Maximum Phonation Duration) of vowels indicated that disturbed coordination between respiratory and laryngeal systems. Hypernasality was found to be a prominent feature which reduced speech intelligibility. Imprecise articulation was seen in both the subjects as the hypoglossal nerve was affected following surgery. Injury to vagus, hypoglossal, gloss pharyngeal and facial nerves disturbed the function of swallowing. All the phases of swallow were affected. Aspiration was observed before and during the swallow, confirming the oropharyngeal dysphagia. All the subsystems were affected as per Frenchey Dysarthria Assessment signifying the diagnosis of flaccid dysarthria. Conclusion: There is an observable communication and swallowing difficulty seen following excision of glomus jugulare tumor. Even with complete resection, extensive rehabilitation may be necessary due to significant lower cranial nerve dysfunction. The finding of the present study stresses the need for involvement of as speech and swallowing therapist for pre-operative counseling and assessment of functional outcomes.

Keywords: functional outcome, glomus jugulare tumor excision, multiple cranial nerve impairment, speech and swallowing

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3422 Optimization of Radiation Therapy with a Nanotechnology Based Enzymatic Therapy

Authors: R. D. Esposito, V. M. Barberá, P. García Morales, P. Dorado Rodríguez, J. Sanz, M. Fuentes, D. Planes Meseguer, M. Saceda, L. Fernández Fornos, M. P. Ventero

Abstract:

Results obtained by our group on glioblastoma multiforme (GBM) primary cultures , show a dramatic potentiation of radiation effects when 2 units/ml of D-amino acid oxidase (DAO) enzyme are added, free or immobilized in magnetic nanoparticles, to irradiated samples just after the irradiation. Cell cultures were exposed to radiation doses of 7Gy and 15Gy of 6 MV photons from a clinical linear accelerator. At both doses, we observed a clear enhancing effect of radiation-induced damages due to the addition of DAO.

Keywords: D-amino Acid Oxidase (DAO) enzyme, magnetic particles, nanotechnology, radiation therapy enhancement

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3421 An Essay on Origamic and Isomorphic Approach as Interface of Form in Architectural Basic Design Education

Authors: Gamze Atay, Altay Colak

Abstract:

It is a fact that today's technology shapes the change and development of architectural forms by creating different perspectives. The research is an experimental study that explores the integration of architectural forms in this process of change/development into design education through traditional design tools. An examination of the practices in the studio environment shows that the students who just started architectural education have difficulty accessing the form. The main objective of this study has been to enable students to use and interpret different disciplines in the design process to improve their perception of form. In this sense, the origami, which is defined as "the art of paper folding", and isomorphous (equally formed) approaches have been used with design studio students at the beginning stage as methods in the process of 3-dimensional thinking and creating the form. These two methods were examined with students in three stages: analysis, creation, and outcome. As a result of the study, it was seen that the use of different disciplines as a method during form creation gave the designs of the student originality, freedom, and dynamism.

Keywords: architectural form, design education, isomorphic approach, origamic approach

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3420 Adaptation to the Current Health Situation as a Determinant of Adherence in Pre - and Senior Age People

Authors: Mariola Głowacka

Abstract:

The aim of the study was to determine the level of adaptation to the current health situation and its impact on the adherence state of people in the pre- and senior age. The work covers the results of the first of the fourteen parts of the study conducted in a group of 2,000 people aged 55 plus. This part of the project was carried out with the use of two standardized tools: the HLC adaptation scale (the health locus of control scale and The Adherence in Chronic DiseasesScale (ACDS). The obtained results showed the range of influence of particular areas of self-acceptance of the health state (health and disease) on their adherence, taking into account specific clinical conditions.

Keywords: adaptation to the current health situation, adherence, senior, badania

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3419 On the Bias and Predictability of Asylum Cases

Authors: Panagiota Katsikouli, William Hamilton Byrne, Thomas Gammeltoft-Hansen, Tijs Slaats

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An individual who demonstrates a well-founded fear of persecution or faces real risk of being subjected to torture is eligible for asylum. In Danish law, the exact legal thresholds reflect those established by international conventions, notably the 1951 Refugee Convention and the 1950 European Convention for Human Rights. These international treaties, however, remain largely silent when it comes to how states should assess asylum claims. As a result, national authorities are typically left to determine an individual’s legal eligibility on a narrow basis consisting of an oral testimony, which may itself be hampered by several factors, including imprecise language interpretation, insecurity or lacking trust towards the authorities among applicants. The leaky ground, on which authorities must assess their subjective perceptions of asylum applicants' credibility, questions whether, in all cases, adjudicators make the correct decision. Moreover, the subjective element in these assessments raises questions on whether individual asylum cases could be afflicted by implicit biases or stereotyping amongst adjudicators. In fact, recent studies have uncovered significant correlations between decision outcomes and the experience and gender of the assigned judge, as well as correlations between asylum outcomes and entirely external events such as weather and political elections. In this study, we analyze a publicly available dataset containing approximately 8,000 summaries of asylum cases, initially rejected, and re-tried by the Refugee Appeals Board (RAB) in Denmark. First, we look for variations in the recognition rates, with regards to a number of applicants’ features: their country of origin/nationality, their identified gender, their identified religion, their ethnicity, whether torture was mentioned in their case and if so, whether it was supported or not, and the year the applicant entered Denmark. In order to extract those features from the text summaries, as well as the final decision of the RAB, we applied natural language processing and regular expressions, adjusting for the Danish language. We observed interesting variations in recognition rates related to the applicants’ country of origin, ethnicity, year of entry and the support or not of torture claims, whenever those were made in the case. The appearance (or not) of significant variations in the recognition rates, does not necessarily imply (or not) bias in the decision-making progress. None of the considered features, with the exception maybe of the torture claims, should be decisive factors for an asylum seeker’s fate. We therefore investigate whether the decision can be predicted on the basis of these features, and consequently, whether biases are likely to exist in the decisionmaking progress. We employed a number of machine learning classifiers, and found that when using the applicant’s country of origin, religion, ethnicity and year of entry with a random forest classifier, or a decision tree, the prediction accuracy is as high as 82% and 85% respectively. tentially predictive properties with regards to the outcome of an asylum case. Our analysis and findings call for further investigation on the predictability of the outcome, on a larger dataset of 17,000 cases, which is undergoing.

Keywords: asylum adjudications, automated decision-making, machine learning, text mining

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3418 Canadian Undergraduate and Graduate Nursing Students: Interest in Education in Medical and Recreational Cannabis for Practice and Career Development

Authors: Margareth S. Zanchetta, Kateryna Metersky, Valerie Tan, Charissa Cordon, Stephanie Lucchese, Yana Siganevich, Prasha Sivasundaram, Truong Binh Nguyen, Imran Qureshi

Abstract:

Due to a new area of practice, Canadian nurses possess knowledge gaps regarding the use of cannabis-based therapies by clients/patients. Education related to medical cannabis (MC) and recreational cannabis (RC) is required to promote nurses’ competency and confidence in supporting clients/patients using MC/RC toward the improvement of health outcomes. A team composed of nursing researchers and undergraduate/graduate students implemented a national survey to explore this theme with the population of undergraduate, graduate (MN and NP), and Post-Diploma (RN Bridging) nursing students enrolled in Canadian Universities Nursing Programs. Upon Research Ethics Board approval, survey recruitment was supported by major nursing stakeholders. The research questions were : (a) Which are the most preferred sources of information on MC/RC for nursing students? (b) Which are the factors and preferred learning modalities that could increase interest in learning about MC/RC, and (c) What are the future career plans among nursing students, and how would they consider the prospective use of cannabis in their practice? The survey was available from Sept. 2022 to Feb. 2023, hosted by a remote platform. An original questionnaire (English-French) was composed of 18 multiple choice questions and 2 open-ended questions. Sociodemographic information and closed-ended responses were compiled as descriptive statistics, while narrative accounts will be analysed through thematic analysis. Respondents (n=153) were from 7 Canadian provinces, national (99%) and international students (1%); the majority of respondents (61%) were in the age range of 21-30 years old. Results indicated that respondents perceive a gap in the undergraduate curriculum on the topics of MC/RC (91%) and that their learning needs include regulations (90%), data on effectiveness (88%), dosing best practices (86%), contraindications (83%), and clinical and medical indications (76%). Respondents reported motivation to learn more about MC/RC through online lectures/videos (65%), e-learning modules or online interactive training (61%), workshops (51%), webinars (36%), and social media (35%). Their primary career-related motivations regarding MC/RC knowledge include enhancing nursing practice (76%), learning about this growing scope of practice (61%), keeping up-to-date responding to scientific curiosity (59%), learning about evidence-based practice (59%), and utilizing alternative forms of medical treatment (37%). Respondents indicated that the integration of topics on cannabis in any course in the undergraduate and/or graduate curriculum would increase their desire to learn about MC/RC as equally as exposure within a clinical setting (75%). The emerging trend in the set of narrative responses (n=130) suggests that respondents believe educational MC/RC content should be integrated into core nursing courses. Respondents also urged educators to be well-informed about evidence-based practice related to MC/RC and to reflect upon stigma and biases surrounding its use. Future knowledge dissemination and translation activities include scholarly products and presentations to stimulate discussion amongst nursing faculty and students, as well as nurses in clinical settings. The goal is to mobilise talents and build collaboration for the development of a socially responsive curriculum on MC/RC competency to address the education-related expectations of all these social actors.

Keywords: Canada, medical cannabis, nursing education, nursing graduate student, nursing undergraduate student, online survey, recreational cannabis

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3417 Use of Beta Blockers in Patients with Reactive Airway Disease and Concomitant Hypertension or Ischemic Heart Disease

Authors: Bharti Chogtu Magazine, Dhanya Soodana Mohan, Shruti Nair, Tanwi Trushna

Abstract:

The study was undertaken to analyse the cardiovascular drugs being prescribed in patients with concomitant reactive airway disease and hypertension or ischemic heart diseases (IHD). Also, the effect of beta-blockers on respiratory symptoms in these patients was recorded. Data was collected from medical records of patients with reactive airway disease and concomitant hypertension and IHD. It included demographic details of the patients, diagnosis, drugs prescribed and the patient outcome regarding the exacerbation of asthma symptoms with intake of beta blockers. Medical records of 250 patients were analysed.13% of patients were prescribed beta-blockers. 12% of hypertensive patients, 16.6% of IHD patients and 20% of patients with concomitant hypertension and IHD were prescribed beta blockers. Of the 33 (13%) patients who were on beta-blockers, only 3 patients had an exacerbation of bronchial asthma symptoms. Cardioselective beta-blockers under supervision appear to be safe in patients with reactive airway disease and concomitant hypertension and IHD.

Keywords: beta blockers, hypertension, ischemic heart disease, asthma

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3416 Culture and Health Equity: Unpacking the Sociocultural Determinants of Eye Health for Indigenous Australian Diabetics

Authors: Aryati Yashadhana, Ted Fields Jnr., Wendy Fernando, Kelvin Brown, Godfrey Blitner, Francis Hayes, Ruby Stanley, Brian Donnelly, Bridgette Jerrard, Anthea Burnett, Anthony B. Zwi

Abstract:

Indigenous Australians experience some of the worst health outcomes globally, with life expectancy being significantly poorer than those of non-Indigenous Australians. This is largely attributed to preventable diseases such as diabetes (prevalence 39% in Indigenous Australian adults > 55 years), which is attributed to a raised risk of diabetic visual impairment and cataract among Indigenous adults. Our study aims to explore the interface between structural and sociocultural determinants and human agency, in order to understand how they impact (1) accessibility of eye health and chronic disease services and (2) the potential for Indigenous patients to achieve positive clinical eye health outcomes. We used Participatory Action Research methods, and aimed to privilege the voices of Indigenous people through community collaboration. Semi-structured interviews (n=82) and patient focus groups (n=8) were conducted by Indigenous Community-Based Researchers (CBRs) with diabetic Indigenous adults (> 40 years) in four remote communities in Australia. Interviews (n=25) and focus groups (n=4) with primary health care clinicians in each community were also conducted. Data were audio recorded, transcribed verbatim, and analysed thematically using grounded theory, comparative analysis and Nvivo 10. Preliminary analysis occurred in tandem with data collection to determine theoretical saturation. The principal investigator (AY) led analysis sessions with CBRs, fostering cultural and contextual appropriateness to interpreting responses, knowledge exchange and capacity building. Identified themes were conceptualised into three spheres of influence: structural (health services, government), sociocultural (Indigenous cultural values, distrust of the health system, ongoing effects of colonialism and dispossession) and individual (health beliefs/perceptions, patient phenomenology). Permeating these spheres of influence were three core determinants: economic disadvantage, health literacy/education, and cultural marginalisation. These core determinants affected accessibility of services, and the potential for patients to achieve positive clinical outcomes at every level of care (primary, secondary, tertiary). Our findings highlight the clinical realities of institutionalised and structural inequities, illustrated through the lived experiences of Indigenous patients and primary care clinicians in the four sampled communities. The complex determinants surrounding inequity in health for Indigenous Australians, are entrenched through a longstanding experience of cultural discrimination and ostracism. Secure and long term funding of Aboriginal Community Controlled Health Services will be valuable, but are insufficient to address issues of inequity. Rather, working collaboratively with communities to build trust, and identify needs and solutions at the grassroots level, while leveraging community voices to drive change at the systemic/policy level are recommended.

Keywords: indigenous, Australia, culture, public health, eye health, diabetes, social determinants of health, sociology, anthropology, health equity, aboriginal and Torres strait islander, primary care

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3415 Coexisting Pathology of Unruptured Ectopic Pregnancy With Concurrent Ipsilateral Dermoid Cyst: A Rare Occurrence

Authors: Anne Nicole Fuentes

Abstract:

A 29 year old Gravida 1 Para 0 who presented at the hospital with a 5-week history of amenorrhea, abdominal pain and vaginal bleeding. Transvaginal ultrasound revealed 3 pathologic findings : Tuboovarian complex on the right adnexa, a complex mass indicative of an unruptured ectopic pregnancy and right ovarian new growth probably endometrioma. Pelvic laparotomy was done and histopathologic finding revealed tubal pregnancy, right and mature cystic teratoma of the right ovary. This case report demonstrates the importance of considering the coexistence of different gynecologic pathologies in the same patient and clinical importance of an accurate diagnostic evaluation.

Keywords: mature cystic teratoma, ectopic pregnancy, Tuboovarian abscess, bHCG

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3414 A Comparative Study of Medical Image Segmentation Methods for Tumor Detection

Authors: Mayssa Bensalah, Atef Boujelben, Mouna Baklouti, Mohamed Abid

Abstract:

Image segmentation has a fundamental role in analysis and interpretation for many applications. The automated segmentation of organs and tissues throughout the body using computed imaging has been rapidly increasing. Indeed, it represents one of the most important parts of clinical diagnostic tools. In this paper, we discuss a thorough literature review of recent methods of tumour segmentation from medical images which are briefly explained with the recent contribution of various researchers. This study was followed by comparing these methods in order to define new directions to develop and improve the performance of the segmentation of the tumour area from medical images.

Keywords: features extraction, image segmentation, medical images, tumor detection

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3413 The Composition and Activity of Germinated Broccoli Seeds and Their Extract

Authors: Boris Nemzer, Tania Reyes-Izquierdo, Zbigniew Pietrzkowski

Abstract:

Glucosinolate is a family of glucosides that can be found in a family of brassica vegetables. Upon the damage of the plant, glucosinolate breakdown by an internal enzyme myrosinase (thioglucosidase; EC 3.2.3.1) into isothiocyanates, such as sulforaphane. Sulforaphane is formed by glucoraphanin cleaving the sugar off by myrosinase and rearranged. Sulforaphane nitrile is formed in the same reaction as sulforaphane with the active of epithiospecifier protein (ESP). Most common food processing procedure would break the plant and mix the glucoraphanin and myrosinase together, and the formed sulforaphane would be further degraded. The purpose of this study is to understand the glucoraphanin/sulforaphane and the myrosinase activity of broccoli seeds germinated at a different time and technological processing conditions that keep the activity of the enzyme to form sulforaphane. Broccoli seeds were germinated in the house. Myrosinase activities were tested as the glucose content using glucose assay kit and measured UV-Vis spectrophotometer. Glucosinolates were measured by HPLC/DAD. Sulforaphane was measured using HPLC-DAD and GC/MS. The 6 hr germinated sprouts have a myrosinase activity 32.2 mg glucose/g, which is comparable with 12 and 24 hour germinated seeds and higher than dry seeds. The glucoraphanin content in 6 hour germinated sprouts is 13935 µg/g which is comparable to 24 hour germinated seeds and lower than the dry seeds. GC/MS results show that the amount of sulforaphane is higher than the amount of sulforaphane nitrile in seeds, 6 hour and 24 hour germinated seeds. The ratio of sulforaphane and sulforaphane nitrile is high in 6 hour germinated seeds, which indicates the inactivated ESP in the reaction. After evaluating the results, the short time germinated seeds can be used as the source of glucoraphanin and myrosinase supply to form potential higher sulforaphane content. Broccoli contains glucosinolates, glucoraphanin (4-methylsulfinylbutyl glucosinolate), which is an important metabolite with health-promoting effects. In the pilot clinical study, we observed the effects of a glucosinolates/glucoraphanin-rich extract from short time germinated broccoli seeds on blood adenosine triphosphate (ATP), reactive oxygen species (ROS) and lactate levels. A single dose of 50 mg of broccoli sprouts extract increased blood levels of ATP up to 61% (p=0.0092) during the first 2 hours after the ingestion. Interestingly, this effect was not associated with an increase in blood ROS or lactate. When compared to the placebo group, levels of lactate were reduced by 10% (p=0.006). These results indicate that broccoli germinated seed extract may positively affect the generation of ATP in humans. Due to the preliminary nature of this work and promising results, larger clinical trials are justified.

Keywords: broccoli glucosinolates, glucoraphanin, germinated seeds, myrosinase, adenosine triphosphate

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3412 Enhancing Organizational Performance through Adaptive Learning: A Case Study of ASML

Authors: Ramin Shadani

Abstract:

This study introduces adaptive performance as a key organizational performance dimension and explores the relationship between the dimensions of a learning organization and adaptive performance. A survey was therefore conducted using the dimensions of the Learning Organization Questionnaire (DLOQ), followed by factor analysis and structural equation modeling in order to investigate the dynamics between learning organization practices and adaptive performance. Results confirm that adaptive performance is indeed one important dimension of organizational performance. The study also shows that perceived knowledge and adaptive performance mediate the positive relationship between the practices of a learning organization with perceived financial performance. We extend existing DLOQ research by demonstrating that adaptive performance, as a nonfinancial organizational learning outcome, has a significant impact on financial performance. Our study also provides additional validation of the measures of DLOQ's performance. Indeed, organizations need to take a glance at how the activities of learning and development can provide better overall improvement in performance, especially in enhancing adaptive capability. The study has provided requisite empirical support that activities of learning and development within organizations allow much-improved intangible performance outcomes, especially through adaptive performance.

Keywords: adaptive performance, continuous learning, financial performance, leadership style, organizational learning, organizational performance

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3411 Spatial Integrity of Seismic Data for Oil and Gas Exploration

Authors: Afiq Juazer Rizal, Siti Zaleha Misnan, M. Zairi M. Yusof

Abstract:

Seismic data is the fundamental tool utilized by exploration companies to determine potential hydrocarbon. However, the importance of seismic trace data will be undermined unless the geo-spatial component of the data is understood. Deriving a proposed well to be drilled from data that has positional ambiguity will jeopardize business decision and millions of dollars’ investment that every oil and gas company would like to avoid. Spatial integrity QC workflow has been introduced in PETRONAS to ensure positional errors within the seismic data are recognized throughout the exploration’s lifecycle from acquisition, processing, and seismic interpretation. This includes, amongst other tests, quantifying that the data is referenced to the appropriate coordinate reference system, survey configuration validation, and geometry loading verification. The direct outcome of the workflow implementation helps improve reliability and integrity of sub-surface geological model produced by geoscientist and provide important input to potential hazard assessment where positional accuracy is crucial. This workflow’s development initiative is part of a bigger geospatial integrity management effort, whereby nearly eighty percent of the oil and gas data are location-dependent.

Keywords: oil and gas exploration, PETRONAS, seismic data, spatial integrity QC workflow

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3410 Intended-Actual First Asking/Offer Price Discrepancies and Their Impact on Negotiation Behaviour and Outcomes

Authors: Liuyao Chai, Colin Clark

Abstract:

Analysis of 574 participants in a simulated two-person distributive negotiation revealed that the first price 245 (42.7%) of these participants actually asked/offered for the item under negotiation (a used car) differed from the first price they previously stated they intended to ask/offer during their negotiation. This discrepancy between a negotiator’s intended first asking/offer price and his/her actual first asking/offer price had a significant and economically consequential impact on both the course and the outcomes of the negotiations studied. Participants whose actual first price remained the same as their intended first price tended to secure better negotiation outcomes. Moreover, participants who changed their intended first price tended to obtain relatively lower outcomes regardless of whether their modified first announced price had created a negotiating position that was ‘stronger’ or ‘weaker’ than if they had opened with their intended first price. Subsequent investigation of over twenty negotiation behaviours and pre-negotiation perceptual variables within this dataset indicated that the three types of first price announcers—i.e. intended first asking/offer price ‘weakeners’, ‘maintainers’ and ‘strengtheners’— comprised persons who tended to have significantly different pre-negotiation perceptions and behaved in systematically different ways during their negotiation. Typically, the most negative, outcome-compromising consequences of changing, weakening or strengthening an intended first price occurred at the very beginning of a negotiation when participants exchanged their actual first asking/offer prices.

Keywords: business communication, negotiation, persuasion, intended first asking/offer prices, bargaining

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3409 Institutional Legitimacy and Professional Boundary: Western Medicine-Trained Doctors' Attitudes and Behaviors toward Traditional Chinese Medicine

Authors: Xiaoli Tian

Abstract:

The recent growing interest in and use of complementary and alternative medicine is a global phenomenon. In many regions, traditional Chinese medicine (TCM), an important type of complementary and alternative medicine, has been formally integrated into the healthcare system. Consequently, today’s doctors face increasing requests and questions from patients regarding TCM. However, studies of TCM focus either on patients’ approaches to TCM and Western medicine (WM) or on the politics involved in the institutionalization of TCM. To our knowledge, sociological studies on doctors’ attitudes toward TCM are rare. This paper compares the receptivity of WM-trained Chinese doctors to TCM in Hong Kong and mainland China, in order to evaluate the interplay between professional training and dominant medical paradigms, on the one hand, and institutional legitimacy and government and client pressures to accept TCM, on the other. Based on survey and in-depth interviews with Western-medicine doctors in Hong Kong and mainland China, this research finds that: there is major difference between Western-medicine doctors’ attitude toward traditional Chinese medicine (TCM) in Hong Kong and mainland China. Doctors in Hong Kong are still suspicious toward TCM, no matter if they have exposure to TCM or not. Even some doctors who have much knowledge about TCM, such as got a diploma or certificate in TCM or tried TCM themselves, are still suspicious. This is because they hold up to the ideal of 'evidence-based medicine' and emphasize the kind of evidence based on randomized controlled trial (RCT). To Western medicine doctors in Hong Kong, this is the most reliable type of evidence for any medical practice, but it is lacking in TCM. This is the major reason why they do not trust TCM and would not refer patients to TCM in clinical practices. In contrast, western medicine doctors in mainland China also know about randomized controlled trial (RCT) and believe that’s the most reliable evidence, but they tend to think experience-based evidence is also reliable. On this basis, they think TCM also has clinical effectiveness. Research findings reveal that legitimacy based on institutional arrangements is a relevant factor, but how doctors understand their professional boundaries also play an important role. Doctors in Hong Kong are more serious about a strict professional boundary between Western medicine and TCM because they benefited from it, such as a very prestigious status and high income. Doctors in mainland China tend to be flexible about professional boundaries because they never benefited from a well-defined strict professional boundary. This is related to a long history of the lack of professionalism in China but is also aggravated by the increasing state support of TCM.

Keywords: evidence-based decision-making, institutional legitimacy, professional behavior, traditional Chinese medicine

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3408 Green Human Recourse Environment Performance, Circular Performance Environment Reputation and Economics Performance: The Moderating Role of CEO Ethical Leadership

Authors: Muhammad Umair Ahmed, Aftab Shoukat

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Today the global economy has become one of the key strategies in dealing with environmental issues. To allow for a round economy, organizations have begun to work to improve their sustainability management. The contribution of green resource management to the transformation of the global economy has not been investigated. The purpose of the study was to evaluate the effects of green labor management on the global economy, environmental and economic performance, and the organisation's environmental dignity. We strongly evaluate the different roles of the various processes of green personnel management (i.e., green recruitment, training, and engagement green, as well as green performance management and reward) in organizational operations. We are also investigating the leadership role of CEO Ethical. Our outcome will have a positive impact on the performance of the organization. Green Human Resource Management contributes to the evolution of a roundabout economy without the influence of different external factors such as market demand and commitment. Finally, the results of our research will provide a few aspects for future research, both academic and human.

Keywords: sustainability, green human resource management, circular economy, human capital

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3407 Citizens’ Readiness to Adopt and Use Electronic Voting System in Ghana

Authors: Isaac Kofi Mensah

Abstract:

The adoption and application of Information and Communication Technologies (ICTs) in government administration through e-government is expected to permeate all sectors of state/ public institutions as well as democratic institutions. One of such public institutions is the Electoral Commission of Ghana mandated by the 1992 Constitution to hold all public elections including presidential and parliamentary elections. As Ghana holds its 7th General Elections since 1992, on 7th November 2016, there are demands from key stakeholders for the Election Management Body, which is the Electoral Commission (EC) of Ghana to adopt and implement an electronic voting system. This case study, therefore, attempts to contribute significantly to the debate by examining influencing factors that would impact on citizen’s readiness to adopt and use an electronic voting system in Ghana. The Technology Acceptance Model (TAM) was used as a theoretical framework for this study, out of which a research model and hypotheses were developed. Importantly, the outcome of this research finding would form a basis for appropriate policy recommendation for consideration of Government and EC of Ghana.

Keywords: citizens readiness, e-government, electronic voting, technology acceptance model (TAM)

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3406 Improving Cost and Time Control of Construction Projects Management Practices in Nigeria

Authors: Mustapha Yakubu, Ahmed Usman, Hashim Ambursa

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This paper presents the findings of a research which sought to investigate techniques used to improve cost and time control of construction projects management practice in Nigeria. However, there is limited research on issues surrounding the practical usage of these techniques. Data were collected through a questionnaire distributed to construction experts through a survey conducted on the 100 construction organisations and 50 construction consultancy firms in the Nigeria aimed at identifying common project cost and time control practices and factors inhibiting effective project control in practice. The study reveals that despite the vast application of control techniques a high proportion of respondents still experienced cost and time overruns on a significant proportion of their projects. Analysis of the survey results concluded that more effort should be geared at the management of the identified top project control inhibiting factors. This paper has outlined some measures for mitigating these inhibiting factors so that the outcome of project time and cost control can be improved in practice.

Keywords: construction project, cost control, Nigeria, time control

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3405 Effect of Bulk Density and Fiber Blend Content of Nonwoven Textiles on Flammability Properties

Authors: Klara Masnicova, Jiri Chaloupek

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Flammability plays an important role in applications such as thermal and acoustic insulation and other technical nonwoven textiles. The study was conducted in an attempt to investigate the flammability behavior of nonwoven textiles in relation to their structural and material characteristics, with emphasis given to the blending ratios of flammable and non-flammable fibers or fibers with reduced flammability. Nonwoven structures made of blends of viscose/oxidized polyacrylonitrile (VS/oxidized PAN fibers and polyethylene terephthalate/oxidized polyacrylonitrile (PET/oxidized PAN) fibers in several bulk densities are evaluated. The VS/oxidized PAN blend is model material. The flammability was studied using a cone calorimeter. Reaction to fire was observed using the small flame test method. Interestingly, the results show some of the blending ratios do not react to the heat in linear response to bulk density. This outcome can have a huge impact on future product development in fire safety and for the general understanding of flammability behavior of nonwovens made of staple fibers.

Keywords: bulk density, cone calorimetry, flammability, nonwoven textiles

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3404 Patterns of Eosinophilia in Cardiac Patients and its Association with Endomyocardial Disease Presenting to Tertiary Care Hospital in Peshawar

Authors: Rashid Azeem

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Introduction: Eosinophilia, which can be categorized as mild, moderate, and severe form on the basis of increasing eosinophil counts, might be responsible for a wide range of cardiac manifestations, varying from a simple myocarditis to a severe state like endomyocardial fibrosis. Eosinophils are involved in the pathogenesis of a variety of cardiovascular disorder like Loffler endocarditis, eosinophilic granulomatosis with polyangitis (EGPH), and hyper eosinophilic (HES). Among them HES carries and incidence rate b/w 48% and 75% and is the main causes of cardiac motility and mobility due to eosinophilia involvement. Aims and objectives: The aim of this study is to determine the frequency of eosinophilia in cardiac patients and to ascertain the evidence of endomyocardial diseases in eosinophilic patients in a cardiology institution Material and Methods: This cross sectional analytical study was conducted in hematology Department of Peshawar institute of Cardiology after approval from hospital ethical and research committee. All 70 patients were subjected to detailed history and clinical examination. Investigation like CBC, Chest X-ray, ECG, Echo, Angiography findings were used to monitor patient’s clinical status. Data is analyzed using SPSS version 25 and MS Excel. Results: Out of 70 patients in our study, a total of 66 patients(94 %) shows evidence of cardiac manifestations. In our study, we have observed a number of abnormal ECG patterns in cardiac patients presenting with eosinophilia, like T wave changes, loss of R wave, sinus bradycardia with LVH strain, and ST wave abnormality. abnormal echocardiographic findings were observed in our patients, like valvular abnormalities (in 45.7%), RWMA abnormalities (in 2.8%), isolated ventricular dysfunction (in 21.4%), and in 10% patients, normal echocardiography. We further noted abnormal coronary angiography findings in cardiac patients with eosinophilia ranging from single vessel to multi vessel occlusions. Conclusions: Eosinophils are involved in the pathogenesis of a variety of cardiovascular disorders which can be detected by various diagnostic means, and the severity of the disease increases with time and with increasing eosinophil count ranging from simple myocarditis to a fatal condition like endomyocardial fibrosis. Thus, increased eosinophilic count as a laboratory parameter in cardiac patients may be a sign of endomyocardial damage which will further help cardiologist to intervene more aggressively then routine approach to a cardiac patient.

Keywords: eosinophilia, endomyocardial fibrosis, cardiac, hypereosinophilic syndrome

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3403 Analyzing the Readiness of Resuscitation Team during Cardiac Arrest

Authors: J. Byimana, I. A. Muhire, J. E. Nzabahimana, A. Nyombayire

Abstract:

Introduction: A successful cardiopulmonary resuscitation during a sudden cardiac arrest can be delayed by different components including new hospital setting, lack of adequate training, lack of pre-established resuscitation team and ineffective communication and lead to an unexpected outcome which is death. The main objective of the study was to assess the readiness of resuscitation teams during cardiac arrest and the organizational approaches that would best support their functioning in a new hospital facility, and to detect any factor that may have contributed to responses. This study analyses the readiness of Resuscitation Team (RT) during cardiac arrest. —Material and methods: A prospective Analytic design was carried out at a newly established United Nations level 2 hospital facility, on four RTM (resuscitation team member). A semi structured questionnaire was used to collect data. —Results: This study highlights indicate that the response time during cardiac arrest simulation meet both American heart association (AHA) and European resuscitation council guidelines. The study offers useful evidence about the impact of a new facility on RTM performance and provides an exposure of staff to emergency events within the Work setting.

Keywords: cardiac arrest, code blue, simulation, resuscitation team member

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3402 The Buccal Fat Pad for Closure of Oroantral Communication

Authors: Stefano A. Denes, Riccardo Tieghi, Giovanni Elia

Abstract:

The buccal fat pad is a well-established tool in oral and maxillofacial surgery and its use has proved of value for the closure of oroantral communications. Oroantral communication may be a common complication after sequestrectomy in "Bisphosphonate-related osteonecrosis of the jaws". We report a clinical case of a 70-year-old female patient in bisphosphonate therapy presented with right maxillary sinusitis and oroantral communication after implants insertion. The buccal fat pad was used to close the defect. The case had an uneventful postoperative healing without dehiscence, infection and necrosis. We postulate that the primary closure of the site with buccal fat pad may ensure a sufficient blood supply and adequate protection for an effective bone-healing response to occur.

Keywords: buccal fat pad, oroantral communication, oral surgery, dehiscence

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