Search results for: introduction

Authors: Saarah Juman, Ilona Johnson, Stephen Richmond, Brett Duane, Sheelagh Rogers

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Introduction: Researchers suggest that within 50 years or less, the available supply of a range of metals will be exhausted, potentially leading to increases in resource conflict and largescale production shortages. The healthcare, dental and orthodontic sectors will undoubtedly be affected as stainless steel instruments are generally heavily relied on. Although changing orthodontic archwires are unavoidable and necessary to allow orthodontic tooth movement through the progression of an archwire sequence with fixed appliances, they are thought to be manufactured in excess of what is needed. Furthermore, orthodontic archwires require trimming extraorally to allow safe intraoral insertion, thus contributing to unnecessary waste of natural resources. Currently, there is no evidence to support the optimisation of archwire length according to orthodontic fixed appliance stage. As such, this study aims to quantify archwire excess (extraoral archwire trimmings) for different stages of orthodontic fixed appliance treatment. Methodology: This prospective, observational, quantitative study observed trimmings made extraorally against pre-treatment study models by clinicians over a 3-month period. Archwires were categorised into one of three categories (initial aligning, sequence, working/finishing arcwhires) within the orthodontic fixed appliance archwire sequence. Data collection included archwire material composition and the corresponding length and weight of excess archwire. Data was entered using a Microsoft Excel spreadsheet and imported into statistical software to obtain simple descriptive statistics. Results: Measurements were obtained for a total of 144 archwires. Archwire materials included nickel titanium and stainless steel. All archwires observed required extraorally trimming to allow safe intraoral insertion. The manufactured lengths of orthodontic initial aligning, sequence, and working/finishing arcwhires were at least 31%, 26%, and 39% in excess, respectively. Conclusions: Orthodontic archwires are manufactured to be excessively long at all orthodontic archwire sequence stages. To conserve natural resources, this study’s findings support the optimisation of orthodontic archwire lengths by manufacturers according to the typical stages of an orthodontic archwire sequence.

Keywords: archwire, orthodontics, sustainability, waste

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Authors: Sairi Satari

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Introduction: Six-sigma is a metric that quantifies the performance of processes as a rate of Defects-Per-Million Opportunities. Sigma methodology can be applied in chemical pathology laboratory for evaluating process performance with evidence for process improvement in quality assurance program. In the laboratory, these methods have been used to improve the timeliness of troubleshooting, reduce the cost and frequency of quality control and minimize pre and post-analytical errors. Aim: The aim of this study is to evaluate the sigma values of the Cobas 8000 analyzer based on the minimum requirement of the specification. Methodology: Twenty-one analytes were chosen in this study. The analytes were alanine aminotransferase (ALT), albumin, alkaline phosphatase (ALP), Amylase, aspartate transaminase (AST), total bilirubin, calcium, chloride, cholesterol, HDL-cholesterol, creatinine, creatinine kinase, glucose, lactate dehydrogenase (LDH), magnesium, potassium, protein, sodium, triglyceride, uric acid and urea. Total error was obtained from Clinical Laboratory Improvement Amendments (CLIA). The Bias was calculated from end cycle report of Royal College of Pathologists of Australasia (RCPA) cycle from July to December 2016 and coefficient variation (CV) from six-month internal quality control (IQC). The sigma was calculated based on the formula :Sigma = (Total Error - Bias) / CV. The analytical performance was evaluated based on the sigma, sigma > 6 is world class, sigma > 5 is excellent, sigma > 4 is good and sigma < 4 is satisfactory and sigma < 3 is poor performance. Results: Based on the calculation, we found that, 96% are world class (ALT, albumin, ALP, amylase, AST, total bilirubin, cholesterol, HDL-cholesterol, creatinine, creatinine kinase, glucose, LDH, magnesium, potassium, triglyceride and uric acid. 14% are excellent (calcium, protein and urea), and 10% ( chloride and sodium) require more frequent IQC performed per day. Conclusion: Based on this study, we found that IQC should be performed frequently for only Chloride and Sodium to ensure accurate and reliable analysis for patient management.

Keywords: sigma matrics, analytical performance, total error, bias

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Authors: Bencharif Meriem, Sersar Ibrahim, Djaafri Zineb

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Introduction and purpose of the study: Education plays a fundamental role in the lives of young people, but what about their physical well-being as they spend long hours sitting at school? School inactivity is a problem that deserves particular attention because it can have significant repercussions on the health and development of students. The aim of this study was to describe and evaluate the physical activity of students in different practices in class, at recess and in the canteen. Material and methods: A physical activity diary and an anthropometric measurement sheet (weight, height) were provided to 123 school-aged adolescents. The measurements were carried out according to international recommendations. The statistical tests were carried out with the R software. 3.2.4. The significance threshold retained was 0.05. Results and Statistical Analysis: One hundred and twenty-three students agreed to participate in the study. Their average age was 16.5±1.60 years. Overweight was present in 8.13% and obesity in 4.06%. For the practice of physical activity, during physical education and sports classes, all students played sports with an average of 1.94±1.00 hours/week, of which 74.00% sweated or were out of breath during these hours of physical activity. It was also noted that boys practiced sports more than girls (p<0.0001). Each day, on average, students spent 39.78±37.85 min walking or running during recess. On the other hand, they spent, on average 4.25±2.65 hours sitting per day in class, at recess, in the canteen, etc., without counting the time spent in front of a screen. The increasing use of screens has become a major concern for parents and educators. On average, students spent approximately 42.90±38.41 min per day using screens in class, at recess, in the canteen and at home. (computer, tablet, telephone, video games, etc.) and therefore to a prolonged sedentary lifestyle. On average, students sat for more than 1.5 hours without moving for at least 2 minutes in a row approximately 1.72±0.71 times per day. Conclusion: These students spent many hours sitting at school. This prolonged inactivity can have negative consequences on their health, including problems with posture and cardiovascular health. It is crucial that schools, educators and parents collaborate to promote more active learning environments where students can move more and thus contribute to their overall well-being. It's time to rethink how we approach education and student health to give them a healthier, more active future.

Keywords: physical acivity, sedentarity, adolescents, school

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Authors: Anna Hadamus, Patryk Wasowski, Anna Mosiolek, Zbigniew Wronski, Sebastian Wojtowicz, Dariusz Bialoszewski

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Introduction: Kinesiology Taping is a very popular physiotherapy method, often used for healthy people, especially athletes, in order to stimulate the muscles and improve their performance. The aim of this study was to determine the effect of the muscle application of Kinesiology Taping on the joint position sense in active motion. Material and Methods: The study involved 50 healthy people - 30 men and 20 women, mean age was 23.2 years (range 18-30 years). The exclusion criteria were injuries and operations of the knee, which could affect the test results. The participants were divided randomly into two equal groups. The first group consisted of individuals with the applied Kinesiology Taping muscle application (KT group), whereas in the rest of the individuals placebo application from red adhesive tape was used (placebo group). Both applications were to enhance the effects of quadriceps muscle activity. Joint position sense (JPS) was evaluated in this study. Error of Active Reproduction of the Joint Position (EARJP) of the knee was measured in 45° flexion. The test was performed prior to applying the patch, with the applied application, then 24 hours after wearing, and after removing the tape. The interval between trials was not less than 30 minutes. Statistical analysis was performed using Statistica 12.0. We calculated distribution characteristics, Wilcoxon test, Friedman‘s ANOVA and Mann-Whitney U test. Results. In the KT group and the placebo group average test score of JPS before applying application KT were 3.48° and 5.16° respectively, after its application it was 4.84° and 4.88°, then after 24 hours of experiment JPS was 5.12° and 4.96°, and after application removal we measured 3.84° and 5.12° respectively. Differences over time in any of the groups were not statistically significant. There were also no significant differences between the groups. Conclusions: 1. Applying Kinesiology Taping to quadriceps muscle had no significant effect on the knee joint proprioception. Its use in order to improve sensorimitor skills seems therefore to be unreasonable. 2. No differences between applications of KT and placebo indicates that the clinical effect of stretch tape is minimal or absent. 3. The results are the basis for the continuation of prospective, randomized trials of numerous study groups.

Keywords: joint position sense, kinesiology taping, kinesiotaping, knee

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Authors: Aniko Babits, Ahmad Daoud

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Introduction: The beach chair position (BCP) is a good approach to almost all types of shoulder procedures. However, moving an anaesthetized patient from the supine to sitting position may pose a risk of cerebral hypoperfusion and potential cerebral ischaemia as a result of significant reductions in blood pressure and cardiac output. Hypocapnia in ventilated patients and impaired blood flow to the vertebral artery due to hyperextension, rotation, or tilt of the head may have an impact too. Co-morbidities that may increase the risk of cerebral ischaemia in the BCP include diabetes with autonomic neuropathy, cerebrovascular disease, cardiac disease, severe hypertension, generalized vascular disease, history of fainting, and febrile conditions. Beach chair surgery requires a careful anaesthetic and surgical management to optimize patient safety and minimize the risk of adverse outcomes. Methods: We describe the necessary steps for optimal patient positioning and the aims of intraoperative management, including anaesthetic techniques to ensure patient safety in the BCP. Results: Regardless of the anaesthetic technique, adequate patient positioning is paramount in the BCP. The key steps to BCP are aimed at optimizing surgical success and minimizing the risk of severe neurovascular complications. The primary aim of anaesthetic management is to maintain cardiac output and mean arterial pressure (MAP) to protect cerebral perfusion. Blood pressure management includes treating a fall in MAP of more than 25% from baseline or a MAP less than 70 mmHg. This can be achieved by using intravenous fluids or vasopressors. A number of anaesthetic techniques could also improve cerebral oxygenation, including avoidance of intermittent positive pressure ventilation (IPPV) with general anaesthesia (GA), using regional anaesthesia, maintaining normocapnia and normothermia, and the application of compression stockings. Conclusions: In summary, BCP is a reliable and effective position to perform shoulder procedures. Simple steps to patient positioning and careful anaesthetic management could maximize patient safety and avoid unwanted adverse outcomes in patients undergoing surgery in BCP.

Keywords: beach chair position, cerebral oxygenation, cerebral perfusion, sitting position

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Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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Authors: Sabrina Sebbane, Alina Elena Parvu

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Introduction: Santolina rosmarinifolia is a plant of the Santolina genus, a family made of medicinal plants widely used. Some of the Santolina species have been proven to have potent anti-inflammatory and anti-oxidant effects. However, no in vivo study has been made to demonstrate this in Santolina rosmarinifolia. The aim of our study is to experimentally evaluate the potential anti-inflammatory and anti-oxidant effects of Santolina rosmarinifolia plant extracts on acute inflammation in rats. These effects are defined by measuring the modifications on nitric oxide, reactive oxygen species and anti-oxidant response in serum. Materials and Methods: Rats were divided into 5 groups (n=6). Three groups were given Santolina rosmarinifolia extract by gavage in different concentrations(100%, 50%, 25%) for a week. Inflammation was induced by i.m injection of turpentine oil on the 8th day. One group was only given turpentine oil and the fifth group acted as control and was given only saline solution. Blood was collected and serum separated. Global tests were used to measure the oxidative stress, total oxidative status (TOS), total antioxidant reactivity (TAR) and the modified method of Griess assay to measure NO synthesis. Malondilaldehyde (MDA) and thiols levels were also assessed. Results: Santolina rosmarinifolia did not significantly change the TOS levels (p > 0.05). Santolina rosmarinifolia 25% and 50% decreased significantly the TAR levels (p < 0.001). Santolina 100% didn't have a significant effect on TAR (p > 0.05). All concentrations of Santolina rosmarinifolia increased the oxidative stress index (OSI) significantly(p < 0.05). Santolina rosmarinifolia 100% significantly decreased NO synthesis (p value < 0.05). In the diluted Santolina groups, no significant effect on NO synthesis was observed. In the groups treated with Santolina 100% and Santolina rosmarinifolia 50%, thiols concentration were significantly higher compared to the inflammation group (p < 0.02). A higher stimulatory effect was found in the Santolina 25% group (p value < 0.05). MDA levels were not significantly modified by the administration of Santolina rosmarinifolia (p > 0.05). Conclusion: All three solutions of Santolina rosmarinifolia had no important effect on oxidant production. However, Santolina rosmarinifolia solutions had a positive effect by increasing the thiols concentration in the serum of the models. The sum of all the effects produced by the administration of Santolina did not show a significant decrease of nitro-oxidative stress. Further experiments including smaller concentrations of Santolina rosmarinifolia will be made. Santolina rosmarinifolia should also be tested as a curative treatment.

Keywords: inflammation, MDA, nitric oxide, santolina rosmarinifolia, thiols, TAR, TOS

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Authors: Fernanda Ludmilla Rossi Rocha, Thamiris Cavazzani Vegro, Silvia Helena Henriques Camelo, Carmen Silvia Gabriel, Andrea Bernardes

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Introduction: Organizations are cultural, symbolic and imaginary systems composed by values and norms. These values and norms represent the organizational culture, which determines the behavior of the workers, guides the work practices and impacts the quality of care and the safety culture of health services worldwide. Objective: To analyze the organizational culture of a public and a private hospital in Brazil. Method: Descriptive study with quantitative approach developed in a public and in a private hospital of Brazil. Sample was composed by 281 nursing workers, of which 73 nurses and 208 nursing auxiliaries and technicians. The data collection instrument comprised the Brazilian Instrument for Assessing Organizational Culture. Data were collected from March to December 2013. Results: At the public hospital, the results showed an average score of 2.85 for the values concerning cooperative professionalism (CP); 3.02 for values related to hierarchical rigidity and the centralization of power (HR); 2.23 for individualistic professionalism and competition at work (IP); 2.22 for values related to satisfaction, well-being and motivation of workers (SW); 3.47 for external integration (EI); 2.03 for rewarding and training practices (RT); 2.75 for practices related to the promotion of interpersonal relationships (IR) About the private hospital, the results showed an average score of 3.24 for the CP; 2.83 for HR; 2.69 for IP; 2.71 for SW; 3.73 for EI; 2.56 for RT; 2.83 for IR at the hospital. Discussion: The analysis of organizational values of the studied hospitals shows that workers find the existence of hierarchical rigidity and the centralization of power in the institutions; believed there was cooperation at workplace, though they perceived individualism and competition; believed that values associated with the workers’ well-being, satisfaction and motivation were seldom acknowledged by the hospital; believed in the adoption of strategic planning actions within the institution, but considered interpersonal relationship promotion, continuous education and the rewarding of workers to be little valued by the institution. Conclusion: This work context can lead to professional dissatisfaction, compromising the quality of care and contributing to the occurrence of occupational diseases.

Keywords: nursing management, organizational culture, quality of care, interpersonal relationships

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Authors: Kathryn Nderitu, Atunga Nyachieo, Ezekiel Mecha

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Introduction: Solanum nigrum , also known as black nightshade, biosynthesizes various phytochemical compounds with various pharmacological activities, including treating cardiovascular diseases and type 2 diabetes, among others. Materials and Methods: To assess the anti-obesity effects of Solanum nigrum using high-fat-fed diet rats, Sprague Dawley male rats (n = 35) of weights 160–180 g were assigned randomly into seven groups comprising n = 5 rats each. Each group was fed for 11 weeks as follows: normal group (normal chow rat feed); high-fat diet control (HFD); HFD and standard drug (Orlistat 30 mg/kg bw); HFD and methanolic extract 150 mg/kgbw; HFD and methanolic extract 300 mg/kgbw; HFD and dichloromethane extract 150 mg/kgbw; HFD and dichloromethane extract 300 mg/kgbw. Body mass index and food intake were monitored per week, and an oral glucose tolerance test was measured in weeks 5 and 10. Lipid profiles, liver function tests, adipose tissue, liver weights, and phytochemical analysis of Solanum nigrum were later carried out. Results: High-fat diet control group rats exhibited a significant increase in body mass index (BMI), while rats administered with leaf extracts of Solanum nigrum showed a reduction in BMI. Both low doses of dichloromethane (150 mg/kgbw) and high doses of methanol extracts (300 mg/kgbw) showed a better reduction in BMI than the other treatment groups. A significant decrease (p <0.05) in low-density lipoprotein-cholesterol, triglycerides, and cholesterol was observed among the rats administered with Solanum nigrum extracts compared to those of HFD control. Moreover, the HFD control group significantly increased liver and adipose tissue weights compared to other treatment groups (p<0.05). Solanum nigrum also decreased glycemic levels and normalized the hepatic enzymes of HFD control. However, food intake among the groups showed no significant difference (p>0.05). Qualitative analysis of Solanum nigrum leaf extracts indicated the presence of various bioactive compounds associated with anti-obesity. Conclusion: These results validate the use of Solanum nigrum in controlling obesity.

Keywords: solanum nigrum, High fat diet, phytocompounds, obesity

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Authors: Rhea Khosla, Victoria Tzortziou-Brown

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Introduction: Adolescent SRH has been neglected since the start of the millennium. Adolescents comprise 16% of the global population, with the largest proportion living in Asia (650 million). By late adolescence, individuals in these regions are likely to become sexually active, and thus they must understand their SRH rights. Many lack knowledge of SRH, using unreliable sources for such information. Sex education is necessary to standardize and inform sexual knowledge, which empowers adolescents to make informed SRH decisions. School is an appropriate environment for this, however, SRH education requires effective policy to enforce. Nonetheless, this issue remains of low political priority in Asia and Africa. Current literature on sex education policy in schools in these regions is scarce and tends to have broad aims. Thus, a scoping review was necessary. Methods: Literature searches were conducted in February 2023 using six databases, including grey literature databases (PubMed, Scopus, Embase, Web of Science, Google Scholar, Global Index Medicus), returning a total of 1537 unique articles. After screening titles, abstracts and full text, 17 articles remained. References of included articles were additionally searched, producing a further 7 articles, which then underwent thematic analysis Results: Most countries in Africa and Asia did not have studies on this topic. Studies derived data from interviews with key stakeholders and quantitative methods quantified questionnaire responses. Barriers were: policy/curriculum issues, societal opinions, teaching discomfort, and lack of educator training. Limitations were insufficient timing, inconsistent implementation, insufficient hours dedicated to teaching, education received late into schooling, and discrepancies between teachers, schools, and students about whether policies were being implemented. Discussion: Based on the existing limited evidence, a cultural shift to reduce stigma seems necessary, alongside teacher and student involvement in policy formulation with effective implementation monitoring and educator training.

Keywords: adolescent, Africa, Asia, education, sexual and reproductive health, policy

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Authors: Sultan Ahmad Azizi, Gaurang J. Joshi

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Urban transportation has come to lime light in recent times due to deteriorating travel quality. The economic growth of India has boosted significant rise in private vehicle ownership in cities, whereas public transport systems have largely been ignored in metropolitan cities. Even though there is latent demand for public transport systems like organized bus services, most of the metropolitan cities have unsustainably low share of public transport. Unfortunately, Indian metropolitan cities have failed to maintain balance in mode share of various travel modes in absence of timely introduction of mass transit system of required capacity and quality. As a result, personalized travel modes like two wheelers have become principal modes of travel, which cause significant environmental, safety and health hazard to the citizens. Of late, the policy makers have realized the need to improve public transport system in metro cities for sustaining the development. However, the challenge to the transit planning authorities is to design a transit system for cities that may attract people to switch over from their existing and rather convenient mode of travel to the transit system under the influence of household socio-economic characteristics and the given travel pattern. In this context, the fast-growing industrial city of Surat is taken up as a case for the study of likely shift to bus transit. Deterioration of public transport system of bus after 1998, has led to tremendous growth in two-wheeler traffic on city roads. The inadequate and poor service quality of present bus transit has failed to attract the riders and correct the mode use balance in the city. The disaggregate travel behavior for trip generations and the travel mode choice has been studied for the West Adajan residential sector of city. Mode specific utility functions are calibrated under multi-nominal logit environment for two-wheeler, cars and auto rickshaws with respect to bus transit using SPSS. Estimation of shift to bus transit is carried indicate an average 30% of auto rickshaw users and nearly 5% of 2W users are likely to shift to bus transit if service quality is improved. However, car users are not expected to shift to bus transit system.

Keywords: bus transit, disaggregate travel nehavior, mode choice Behavior, public transport

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Authors: Judith Awacorach, Quentin Gausset

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Wood charcoal and firewood are the primary sources of energy for cooking fuel in most Sub-Saharan African countries, including Uganda. This leads to unsustainable forest use and to rapid deforestation. Green charcoal (made out of agricultural residues that are carbonized, reduced in char powder, and glued in briquettes, using a binder such as sugar molasse, cassava flour or clay) is a promising and sustainable alternative to wood charcoal and firewood. It is considered as renewable energy because the carbon emissions released by the combustion of green charcoal are immediately captured again in the next agricultural cycle. If practiced on a large scale, this has the potential to replace wood charcoal and stop deforestation. However, the uptake of green charcoal for cooking remains low in Uganda despite the introduction of the technology 15 years ago. The present paper reviews the barriers to the production and commercialization of green charcoal. The paper is based on the study of 13 production sites, recording the raw materials used, the production techniques, the quantity produced, the frequency of production, and the business model. Observations were made on each site, and interviews were conducted with the managers of the facilities and with one or two employees in the larger facilities. We also interviewed project administrators from four funding agencies interested in financing green charcoal production. The results of our research identify the main barriers as follows: 1) The price of green charcoal is not competitive (it is more labor and capital-intensive than wood charcoal). 2) There is a problem with quality control and labeling (one finds a wide variety of green charcoal with very different performances). 3) The carbonization of agricultural crop residues is a major bottleneck in green char production. Most briquettes are produced with wood charcoal dust or powder, which is a by-product of wood charcoal. As such, they increase the efficiency of wood charcoal but do not yet replace it. 4) There is almost no marketing chain for the product (most green charcoal is sold directly from producer to consumer without any middleman). 5) The financing institutions are reluctant to lend money for this kind of activity. 6) Storage can be challenging since briquettes can dissolve due to moisture. In conclusion, a number of important barriers need to be overcome before green charcoal can become a serious alternative to wood charcoal.

Keywords: briquettes, competitiveness, deforestation, green charcoal, renewable energy

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Authors: Amina Akhtar, Rory O'Connor

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Introduction: There remains significant morbidity and mortality in young pedestrians hit by motor vehicles, even in the era of pedestrian crossings and speed limits. The aim of this study was to compare incidence and injury severity of motor vehicle-related pedestrian trauma according to time of day and season in a young population, based on the supposition that injuries would be more prevalent during dusk and dawn and during autumn and winter. Methods: Data was retrieved for patients between 10-25 years old from the National Trauma Audit and Research Network (TARN) database who had been involved as pedestrians in motor vehicle accidents between 2015-2020. The incidence of injuries, their severity (using the Injury Severity Score [ISS]), hospital transfer time, and mortality were analysed according to the hours of daylight, darkness, and season. Results: The study identified a seasonal pattern, showing that autumn was the predominant season and led to 34.9% of injuries, with a further 25.4% in winter in comparison to spring and summer, with 21.4% and 18.3% of injuries, respectively. However, visibility alone was not a sufficient factor as 49.5% of injuries occurred during the time of darkness, while 50.5% occurred during daylight. Importantly, the greatest injury rate (number of injuries/hour) occurred between 1500-1630, correlating to school pick-up times. A further significant relationship between injury severity score (ISS) and daylight was demonstrated (p-value= 0.0124), with moderate injuries (ISS 9-14) occurring most commonly during the day (72.7%) and more severe injuries (ISS>15) occurred during the night (55.8%). Conclusion: We have identified a relationship between time of day and the frequency and severity of pedestrian trauma in young people. In addition, particular time groupings correspond to the greatest injury rate, suggesting that reduced visibility coupled with school pick-up times may play a significant role. This could be addressed through a targeted public health approach to implementing change. We recommend targeted public health measures to improve road safety that focus on these times and that increase the visibility of children combined with education for drivers.

Keywords: major trauma, paediatric trauma, road traffic accidents, diurnal pattern

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Authors: I. Gupta, C. Kathpal

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Introduction: Time is really the only capital that any human being has, and the only thing he cannot afford to lose. Work life balance is a contested term on which researchers have begun to study in 1960s. Work-life balance refers to how people allocate time between their jobs and other pursuits, such as family, hobbies, and community involvement and includes the mental health fitness of the employees so that the future goal of organization to sustain the employees and earning profits can be achieved. Every organization primarily involves making a parity between the employees' work and their personal life by contributing the maximum. Aims and Objectives: The aim of the present study is to examine the impact of work-life balance as well as employee satisfaction on the organizational performance by evaluating the inter-related factors in order to maintain the healthy growth of concerns. Materials and Methods: To realize the aim of the study, an unstructured questionnaire, as well as face to face interview, was conducted from 100 persons which consisted majority of male members of top as well as middle level positions in the various organizations. The prime source of data collection was primary; however, the study has also used the theoretical contribution done in this respective field by various researchers. Results: Majority of the respondents were males(80%) from age group of 25-45. The collected data was analyzed through hypothesis testing statistical techniques such as correlation analysis, single regression analysis and ANOVA which has rejected the null hypothesis that there is no relation between work-life interface and organizational performance. The major finding of this study is that work-life balance is directly related to the organizations performance. The results show that the organization which works on the employee satisfaction earns more. Along with, there is a reduction of turnout rates, absenteeism, moreover, enhancement of productivity as well as revenue of corporations. Conclusion: The present study reflects that the disparity in the work-life balance gives invitation to many disorders either mental or physical which leads the dearth in performance. As a result, not only employees, however, organizations also suffers which is clearly shown in the interviews conducted face to face with employees. The study is not targeting the particular class of audience; however, it brings out benefits to the masses.

Keywords: work-life balance, performance, culture, organization, satisfaction

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Authors: Betül Ersoy, Deniz Özalp Kizilay, Gül Gümüşer, Fatma Taneli

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Introduction: Peak bone mass is reached in late adolescence in females. Age at menarche influences estrogen exposure, which plays a vital role in bone metabolism. The relationship between age at menarche and bone mineral density (BMD) is still controversial. In this study, we investigated the relationship between age at menarche, BMD, socioeconomic status (SES) and body composition in female university student. Participant and methods: A total of 138 healthy girls at late adolescence period (mean age 20.13±0.93 years, range 18-22) were included in this university school-based cross-sectional study in the urban area western region of Turkey. Participants have been randomly selected to reflect the university students studying in all faculties. We asked relevant questions about socioeconomic status and age at menarche to female university students. Students were grouped into three SES as lower, middle and higher according to the educational and occupational levels of their parents using Hollingshead index. Height and weight were measured. Body Mass Index (BMI) (kg/m2 ) was calculated. Dual energy X-ray absorptiometry (DXA) was performed using the Lunar DPX series, and BMD and body composition were evaluated. Results: The mean age of menarche of female university student included in the study was 13.09.±1.3 years. There was no significant difference between the three socioeconomic groups in terms of height, body weight, age at menarche, BMD [BMD (gr/cm2 ) (L2-L4) and BMD (gr/cm2 ) (total body)], and body composition (lean tissue, fat tissue, total fat, and body fat) (p>0.05). While no correlation was found between the age at menarche and any parameter (p>0.05), a positive significant correlation was found between lean tissue and BMD L2-L4 (r=0.286, p=0.01). When the relationships were evaluated separately according to socioeconomic status, there was a significant correlation between BMDL2-L4 (r: 0.431, p=0.005) and lean tissue in females with low SES, while this relationship disappeared in females with middle and high SES. Conclusion: Age at menarche did not change according to socioeconomic status, nor did BMD and body composition in female at late adolescents. No relationship was found between age at menarche and BMD and body composition determined by DEXA in female university student who were close to reaching peak bone mass. The results suggested that especially BMDL2-L4 might increase as lean tissue increases.

Keywords: bone, osteoposis, menarche, dexa

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Authors: Tiago N. P. Valente, Erico S. Lima, Roberto O. Roça

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Introduction: Research has stimulated animal production studies on solutions to decrease the level of saturated fatty acids and increase unsaturated in foods of animal origin. The objective of this study was to determine the effect of the dietary inclusion of lipid-based diets on the fatty acid profiles from finishing cattle. Materials and Methods: The study was carried out in the Chapéu de Couro Farm in Aguaí/SP, Brazil. A group of 39 uncastrated Nellore cattle. Mean age of the animals was 36 months, and initial mean live weight was 494.1 ± 10.1. Animals were randomly assigned to one of three treatments, based on dry matter: feed with control diet 2.50% cottonseed, feed with 11.50% cottonseed, and feed with 3.13% cottonseed added of 1.77% protected lipid. Forage:concentrate ratio was 50:50 on a dry matter basis. Sugar cane chopped was used as forage. After 63 days mean final live weight was 577.01 kg ± 11.34. After slaughter, carcasses were identified and divided into two halves that were kept in a cold chamber for 24 hours at 2°C. Then, part of the M. longissimus thoracis of each animal was removed between the 12th and 13th rib of the left half carcass. The samples steaks were 2.5 cm thick and were identified and stored frozen in a freezer at -18°C. The analysis of methyl esters of fatty acids was carried out in a gas chromatograph. Desirable fatty acids (FADes) were determined by the sum of unsaturated fatty acids and stearic acid (C18:0). Results and Discussion: No differences (P>0.05) between the diets for the proportion of FADes in the meat of the animals in this study, according to the lipid sources used. The inclusion of protected fat or cottonseed in the diet did not change the proportion of FADes in the meat. The proportion mean of FADes in meat in the present study were: as pentadecanoic acid (C15:1 = 0.29%), palmitoleic acid (C16:1 = 4.26%), heptadecanoic acid (C17:1 = 0.07%), oleic acid (C18:1n9c = 37.32%), γ-linolenic acid (0.94%) and α-linolenic acid (1.04%), elaidic acid (C18:1n9t = 0.50%), eicosatrienoic acid (C20:3n3 = 0.03%), eicosapentaenoic acid (C20:5n3 = 0.04%), erucic acid (C22:1n9 = 0.89%), docosadienoic acid (C22:2 = 0.04%) and stearic acid (C18:0 = 21.53%). Conclusions: The add the cottonseed or protected lipid in diet is not affected fatty acids profiles the desirable fatty acids in meat. Acknowledgements: IFGoiano, FAPEG and CNPq (Brazil).

Keywords: beef quality, cottonseed, protected fat, unsaturated fatty acids

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Authors: Onyekachi Ogbonnaya Iroanya, Taiye Abdullahi Gegele, Frank Tochukwu Egwuatu

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Introduction: Forensic taphonomy is a multifaceted area that incorporates decomposition, chemical and biological cadaver exposure in post-mortem event chronology and reconstruction to predict the Post Mortem Interval (PMI). The aim of this study was to evaluate the integrity of DNA extracted from the remains of embalmed decomposed Sus domesticus tissues buried in different soil types. Method: A total of 12 limbs of Sus domesticus weighing between 0.7-1.4 kg were used. Each of the samples across the groups was treated with 10% formaldehyde, absolute methanol and 50% Pine oil for 24 hours before burial except the control samples, which were buried immediately. All samples were buried in shallow simulated Clay, Sandy and Loamy soil graves for 12 months. The DNA for each sample was extracted and quantified with Nanodrop Spectrophotometer (6305 JENWAY spectrometers). The rate of decomposition was examined through the modified qualitative decomposition analysis. Extracted DNA was amplified through PCR and bands visualized via gel electrophoresis. A biochemical enzyme assay was done for each burial grave soil. Result: The limbs in all burial groups had lost weight over the burial period. There was a significant increase in the soil urease level in the samples preserved in formaldehyde across the 3 soil type groups (p≤0.01). Also, the control grave soils recorded significantly higher alkaline phosphatase, dehydrogenase and calcium carbonate values compared to experimental grave soils (p≤0.01). The experimental samples showed a significant decrease in DNA concentration and purity when compared to the control groups (p≤0.01). Obtained findings of the soil biochemical analysis showed the embalming treatment altered the relationship between organic matter decomposition and soil biochemical properties as observed in the fluctuations that were recorded in the soil biochemical parameters. The PCR amplified DNA showed no bands on the gel electrophoresis plates. Conclusion: In criminal investigations, factors such as burial grave soil, grave soil biochemical properties, antemortem exposure to embalming chemicals should be considered in post-mortem interval (PMI) determination.

Keywords: forensic taphonomy, post-mortem interval (PMI), embalmment, decomposition, grave soil

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Authors: Olusola Omolola Olafuyi, Michael Coleman, Raj Kumar Singh Badhan

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Introduction: Malaria in pregnancy has morbidity and mortality implication on both mother and unborn child. Piperaquine (PQ) based antimalarial treatment is emerging as a choice antimalarial for pregnant women in the face of resistance to current antimalarial treatment recommendation in pregnancy. Physiological and biochemical changes in pregnant women may affect the pharmacokinetics of the antimalarial drug in these. In malaria endemic regions other infectious diseases like HIV/AIDs are prevalent. Pregnant women who are co-infected with malaria and HIV/AID are at even more greater risk of death not only due to complications of the diseases but also due to drug-drug interactions (DDIs) between antimalarials (AMT) and antiretroviral (ARVs). In this study, physiologically based pharmacokinetic (PBPK) modelling was used to investigate the effect of physiological and biochemical changes on the impact of ARV mediated DDIs in pregnant women in three countries. Method: A PBPK model for PQ was developed on SimCYP® using published physicochemical and pharmacokinetic data of PQ from literature, this was validated in three customized population groups from Thailand, Sudan and Papua New Guinea with clinical data. Validation of PQ model was also done in presence of interaction with efavirenz (pre-validated on SimCYP®). Different albumin levels and pregnancy stages was simulated in the presence of interaction with standard doses of efavirenz and ritonavir. PQ day 7 concentration of 30ng/ml was used as the efficacy endpoint for PQ treatment.. Results: The median day 7 concentration of PQ remained virtually consistent throughout pregnancy and were satisfactory across the three population groups ranging from 26-34.1ng/ml; this implied the efficacy of PQ throughout pregnancy. DDI interaction with ritonavir and efavirenz resulted in modest effect on the day 7 concentrations of PQ with AUCratio ranging from 0.56-0.8 and 1.64-1.79 for efavirenz and ritonavir respectively over 10-40 gestational weeks, however, a reduction in human serum albumin level reflective of severe malaria resulted in significantly reduced the number of subjects attaining the PQ day 7 concentration in the presence of both DDIs. The model demonstrated that the DDI between PQ and ARV in pregnant women with different malaria severities can alter the pharmacokinetic of PQ.

Keywords: antiretroviral, malaria, piperaquine, pregnancy, physiologically-based pharmacokinetics

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Authors: Carin Lindskog

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Introduction: Long-term success requires an organizational balance between continuity (exploitation) and change (exploration). The problem of balancing exploitation and exploration is a common issue in studies of organizational learning. In order to better face the tough competition in the face of changes, organizations need to exploit their current business and explore new business fields by developing new capabilities. The purpose of this work in progress is to develop a conceptual framework to shed light on the relevance of 'learning activities', i.e., exploitation and exploration, on different levels. The research questions that will be addressed are as follows: What sort of learning activities are found in the Business Process Management (BPM) field? How can these activities be linked to the individual level, group, level, and organizational level? In the work, a literature review will first be conducted. This review will explore the status of learning activities in the BPM field. An outcome from the literature review will be a conceptual framework of learning activities based on the included publications. The learning activities will be categorized to focus on the categories exploitation, exploration or both and into the levels of individual, group, and organization. The proposed conceptual framework will be a valuable tool for analyzing the research field as well as identification of future research directions. Related Work: BPM has increased in popularity as a way of working to strengthen the quality of the work and meet the demands of efficiency. Due to the increase in BPM popularity, more and more organizations reporting on BPM failure. One reason for this is the lack of knowledge about the extended scope of BPM to other business contexts that include, for example, more creative business fields. Yet another reason for the failures are the fact of the employees’ are resistant to changes. The learning process in an organization is an ongoing cycle of reflection and action and is a process that can be initiated, developed and practiced. Furthermore, organizational learning is multilevel; therefore the theory of organizational learning needs to consider the individual, the group, and the organization level. Learning happens over time and across levels, but it also creates a tension between incorporating new learning (feed-forward) and exploiting or using what has already been learned (feedback). Through feed-forward processes, new ideas and actions move from the individual to the group to the organization level. At the same time, what has already been learned feeds back from the organization to a group to an individual and has an impact on how people act and think.

Keywords: business process management, exploitation, exploration, learning activities

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Authors: Gebeyaw Molla Wondim, Damen Haile Mariam, Wubegzier Mekonnen, Catherine Arsenault

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Introduction: Maternal depression is a common psychological disorder that mostly occurs during pregnancy and after childbirth. It affects approximately one in four women worldwide. There is inconsistent evidence regarding the association between anemia and maternal depression. The objective of this systematic review was to examine the association between anemia and depression during pregnancy. Method: A comprehensive search of articles published before March 8, 2024, was conducted in seven databases such as PubMed, Scopus, Web of Science, PsycINFO, CINAHL, Cochrane Library, and Google Scholar. The Boolean operators “AND” or “OR” and “NOT” were used to connect the MeSH terms and keywords. Rayyan software was used to screen articles for final retrieval, and the PRISMA diagram was used to show the article selection process. Data extraction and risk bias assessment were done by two reviewers independently. JBI critical appraisal tool was used to assess the methodological quality of the retrieved articles. Heterogenicity was assessed through visual inspection of the extracted result, and narrative analysis was used to synthesize the result. Result: A total of 2,413 articles were obtained from seven electronic databases. Among these articles, a total of 2,398 were removed due to duplication (702 articles), by title and abstract selection criteria (1,678 articles), and by full-text review (18 articles). Finally, in this systematic review, 15 articles with a total of 628,781 pregnant women were included: seven articles were cohort studies, two were case-control, and six studies were cross-sectional. All included studies were published between 2013 and 2022. Studies conducted in the United States, South Korea, Finland, and one in South India found no significant association between anemia and maternal depression during pregnancy. On the other hand, studies conducted in Australia, Canada, Finland, Israel, Turkey, Vietnam, Ethiopia, and South India showed a significant association between anemia and depression during pregnancy. Conclusion: The overall finding of the systematic review shows the burden of anemia and antenatal depression is much higher among pregnant women in developing countries. Around three-fourths of the studies show that anemia is positively associated with antenatal depression. Almost all studies conducted in LMICs show anemia positively associated with antenatal depression.

Keywords: pregnant, women, anemia, depression

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Authors: Thomas Abraham, Garcia de la Vega Felipe, Lubna Nishath, Nzekwe Nduka, Powell Anne-Marie

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Introduction: The purpose of this paper is to discuss the effectiveness of a peer support network created to provide medical education, pastoral support, and reliable resources to registrars to help them pass the MRCGP exams. This paper will include a description of the network and its purpose, discuss how it has been used by trainees since its creation, and explain how this methodology can be applied to other areas of medical education and primary care. Background: The peer support network was created in February 2021, using Facebook, Telegram, and WhatsApp platforms to facilitate discussion of cases and answer queries about the exams, share resources, and offer peer support from qualified GPs and specialists. The network was created and is maintained by the authors of this paper and is open to anyone who is registered with the General Medical Council (GMC) and is studying for the MRCGP exams. Purpose: The purpose of the network is to provide medical education, pastoral support, and reliable resources to registrars to help them pass the exams. The network is free to use and is designed to take the onus away from a single medical educator and collate a vast amount of information from multiple medical educators/trainers; thereby creating a digital library of information for all trainees - exam related or otherwise. Methodology The network is managed by a team of moderators who respond to queries and facilitate discussion. Smaller study groups are created from the main group and provide a platform for trainees to work together, share resources, and provide peer support. The network has had thousands of trainees using it since February 2021, with positive feedback from all trainees. Results: The feedback from trainees has been overwhelmingly positive. Word of mouth has spread rapidly, growing the groups exponentially. Trainees add colleagues to the groups and often stay after they pass their exams to 'give back' to their fellow trainees. To date, thousands of trainees have passed the MRCGP exams using the resources and support provided by the network. Conclusion The success of this peer support network demonstrates the effectiveness of creating a network of thousands of doctors to provide medical education and support.

Keywords: peer support, medical education, pastoral support, MRCGP exams

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Authors: Naomi Nathan

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Introduction Digitalization of medical education can revolutionize how medical students learn and interact with the medical curriculum across contexts. With the increasing availability of the internet and mobile connectivity in LMICs, online medical education platforms and digital learning tools are becoming more widely available, providing new opportunities for learners to access high-quality medical education and training. However, the adoption and integration of digital technologies in medical education in LMICs is a complex process influenced by various factors, including learners' perceptions and attitudes toward digital learning. In Ethiopia, the adoption of digital platforms for medical education has been slow, with traditional face-to-face teaching methods still being the norm. However, as access to technology improves and more universities adopt digital platforms, it is crucial to understand how medical students perceive this shift. Methodology This study investigated medical students' perception of the digitalization of medical education in relation to their access to the Lecturio Digital Medical Education Platform through a capacity-building project. 740 medical students from over 20 medical universities participated in the study. The students were surveyed using a questionnaire that included their attitudes toward the digitalization of medical education, their frequency of use of the digital platform, and their perceived benefits and challenges. Results The study results showed that most medical students had a positive attitude toward digitalizing medical education. The most commonly cited benefit was the convenience and flexibility of accessing course material/curriculum online. Many students also reported that they found the platform more interactive and engaging, leading to a more meaningful learning experience. The study also identified several challenges medical students faced when using the platform. The most commonly reported challenge was the need for more reliable internet access, which made it difficult for students to access content consistently. Overall, the results of this study suggest that medical students in Ethiopia have a positive perception of the digitalization of medical education. Over 97% of students continuously expressed a need for access to the Lecturio platform throughout their studies. Conclusion Significant challenges still need to be addressed to fully realize the Lecturio digital platform's benefits. Universities, relevant ministries, and various stakeholders must work together to address these challenges to ensure that medical students fully participate in and benefit from digitalized medical education - sustainably and effectively.

Keywords: digital medical education, EdTech, LMICs, e-learning

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Authors: Il-Ho Kim, Samuel Noh, Kwame McKenzie, Cyu-Chul Choi

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Introduction: The ‘stress of higher status’ hypothesis suggests that workers with higher-status occupations are more likely to experience work-to-family conflict (WFC) than those with lower-status occupations. Yet, the occupational difference in WFC and its mechanisms have not been explicitly explored within Asian culture. This present study examines (a) the association between occupational status and WFC and (b) the mediating roles of work-related stressors and resources, focused on gender perspectives using a sample of Korean immigrants. Methods: Data were derived from a cross-sectional survey of foreign born Korean immigrants who were currently working at least two years in the Greater Area of Toronto or surrounding towns. The sample was stratified for equivalent presentations of micro-business owners (N=555) and paid employees in diverse occupational categories (N=733). Results: We found gender differences and similarities in the link between occupational status and WFC and the mediating roles of work-related variables. Compared to skilled/unskilled counterparts, male immigrants in professional, service, and microbusiness jobs reported higher levels of WFC, whereas female immigrants in higher-status occupations were more likely to have WFC with the exception of the highest levels of WFC among microbusiness owners. Regardless of gender, both male and female immigrants who have longer weekly work hours, shift work schedule, and high emotional and psychological demands were significantly associated with high levels of WFC. However, skill development was related to WFC only among male immigrants. Regarding the mediating roles of work-related factors, among female immigrants, the occupational difference in WFC was fully mediated by weekly work hours, shift work schedule, and emotional and psychological demands with the exception of the case of microbusiness workers. Among male immigrants, the occupational differences remained virtually unchanged after controlling for these mediators. Conclusions: Our results partially confirmed the ‘stress of higher status’ hypothesis among female immigrants. Additionally, work-related stressors seem to be critical mediators of the link between occupations and WFC only for female immigrants.

Keywords: work-to-family conflict, gender, work conditions, job demands, job resources

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Authors: Mancho Manev

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The concept of almost paracontact Riemannian manifolds (abbr., apcR manifolds) was introduced by I. Sato in 1976 as an analogue of almost contact Riemannian manifolds. The notion of an apcR manifold of type (p,q) was defined by S. Sasaki in 1980, where p and q are respectively the numbers of the multiplicity of the structure eigenvalues 1 and -1. It also has a simple eigenvalue of 0. In our work, we consider (2n+1)-dimensional apcR manifolds of type (n,n), i.e., the paracontact distribution of the studied manifold can be considered as a 2n-dimensional almost paracomplex Riemannian distribution with almost paracomplex structure and structure group O(n) × O(n). The aim of the present study is to introduce a new class of apcR manifolds. Such a manifold is obtained using the construction of a certain Riemannian cone over it, and the resulting manifold is a paraholomorphic paracomplex Riemannian manifold (abbr., phpcR manifold). We call it a para-Sasaki-like Riemannian manifold (abbr., pSlR manifold) and give some explicit examples. We study the structure of pSlR spaces and find that the paracontact form η is closed and each pSlR manifold locally can be considered as a certain product of the real line with a phpcR manifold, which is locally a Riemannian product of two equidimensional Riemannian spaces. We also obtain that the curvature of the pSlR manifolds is completely determined by the curvature of the underlying local phpcR manifold. Moreover, the ξ-directed Ricci curvature is equal to -2n, while in the Sasaki case, it is 2n. Accordingly, the pSlR manifolds can be interpreted as the counterpart of the Sasaki manifolds; the skew-symmetric part of ∇η vanishes, while in the Sasaki case, the symmetric part vanishes. We define a hyperbolic extension of a (complete) phpcR manifold that resembles a certain warped product, and we indicate that it is a (complete) pSlR manifold. In addition, we consider the hyperbolic extension of a phpcR manifold and prove that if the initial manifold is a complete Einstein manifold with negative scalar curvature, then the resulting manifold is a complete Einstein pSlR manifold with negative scalar curvature. In this way, we produce new examples of a complete Einstein Riemannian manifold with negative scalar curvature. Finally, we define and study para contact conformal/homothetic deformations by deriving a subclass that preserves the para-Sasaki-like condition. We then find that if we apply a paracontact homothetic deformation of a pSlR space, we obtain that the Ricci tensor is invariant.

Keywords: almost paracontact Riemannian manifolds, Einstein manifolds, holomorphic product manifold, warped product manifold

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Authors: A. Kherraf, M. Bouziane, L. Azzouzi, R. Habbal

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Introduction: Hypocalcaemia is a rare cause of heart failure. We report the clinical case of a young patient with reversible dilated cardiomyopathy secondary to hypocalcaemia in the context of hyperparathyroidism. Clinical case: We report the clinical case of a 23-year-old patient with a history of thyroidectomy for papillary thyroid carcinoma 3 years previously, who presented to the emergency room with a progressive onset dyspnea and edema of the lower limbs. Clinical examination showed hypotension at 90/70 mmHg, tachycardia at 102 bpm, and edema of the lower limbs. The ECG showed a regular sinus rhythm with a prolonged corrected QT interval to 520ms. The chest x-ray showed cardiomegaly. Echocardiography revealed dilated cardiomyopathy with biventricular dysfunction and a left ventricular ejection fraction of 45%, as well as moderate mitral insufficiency by restriction of the posterior mitral leaflet, moderate tricuspid insufficiency, and a dilated inferior vena cava with a pulmonary arterial pressure estimated at 46 mmHg. Blood tests revealed severe hypocalcemia at 38 mg / l with normal albumin and thyroxine levels, as well as hyperphosphatemia and increased TSH. The patient received calcium intake and vitamin D supplementation and was treated with beta blockers, ACE inhibitors, and diuretics with good progress and progressive normalization of cardiac function. Discussion: The cardiovascular manifestations of hypocalcaemia usually appear with deeply low serum calcium levels. This can lead to hypotension, arrhythmias, ventricular fibrillation, prolonged QT interval, or even heart failure. Heart failure is a rare and serious complication of hypocalcemia but most often characterized by complete normalization of myocardial function after treatment. The etiology of the hypocalcaemia, in this case, was probably related to accidental parathyroid removal during thyroidectomy. This is why careful monitoring of calcium levels is recommended after surgery. Conclusion: Hypocalcemic heart failure is rare but reversible heart disease. Systematic monitoring of serum calcium should be performed in all patients after thyroid surgery to avoid any complications related to hypoparathyroidism.

Keywords: hypocalcemia, heart failure, thyroid surgery, hypoparathyroidism

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Authors: Manuela Caciula, Luis Torres, Simion Tomoiaga

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Introduction: The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), more commonly referred to as COVID-19, has wreaked havoc on all facets of higher education since its inception in late 2019. College students, in particular, significantly reduced their daily energy expenditure and increased the time spent sitting to listen to online classes and complete their studies from home. This change, in combination with the associated COVID-19 lockdown, presumably decreased physical activity levels, increased mental health symptoms, and led to the promotion of unhealthy eating habits. Objectives: The main objective of this study was to determine the current self-reported physical activity levels, mental health symptoms, and body composition of college students after the COVID-19 lockdown in order to develop future interventions for the overall improvement of health. Methods: All participants completed pre-existing, well-validated surveys for both physical activity (International Physical Activity Questionnaire - long form) and mental health (Hospital Anxiety and Depression Scale). Body composition was assessed in person with the use of an Inbody 570 device. Results: Of the 90 American college students (M age = 22.52 ± 4.54, 50 females) who participated in this study, depressive and anxious symptom scores consistent with 58% (N = 52) heightened symptomatology, 17% (N = 15) moderate borderline symptomatology, and 25% (N = 23) asymptomatology were reported. In regard to physical activity, 79% (N = 71) of the students were highly physically active, 18% (N = 16) were moderately active, and 3% (N = 3) reported low levels of physical activity. Additionally, 46% (N = 41) of the students maintained an unhealthy body fat percentage based on World Health Organization recommendations. Strong, significant relationships were found between anxiety and depression symptomatology and body fat percentage (P = .003) and skeletal muscle mass (P = .015), with said symptomatology increasing with added body fat and decreasing with added skeletal muscle mass. Conclusions: Future health interventions for American college students should be focused on strategies to reduce stress, anxiety, and depressive characteristics, as well as nutritional information on healthy eating, regardless of self-reported physical activity levels.

Keywords: physical activity, mental health, body composition, COVID-19

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Authors: Huang Hao, Li Weiwen

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Global biodiversity continues to decline as a result of global climate change and various human activities, such as habitat destruction, pollution, introduction of alien species and overfishing. Although there are connections between global marine organisms more or less, it is better to have clear geographical boundaries in order to facilitate the assessment and management of different biogeographical zones. And so area based management tools (ABMT) are considered as the most effective means for the conservation and sustainable use of marine biodiversity. On a large scale, the geographical gap (or barrier) is the main factor to influence the connectivity, diffusion, ecological and evolutionary process of marine organisms, which results in different distribution patterns. On a small scale, these factors include geographical location, geology, and geomorphology, water depth, current, temperature, salinity, etc. Therefore, the analysis on geographic and environmental factors is of great significance in the study of biodiversity characteristics. This paper summarizes the marine spatial classification and ABMTs used in coastal area, open oceans and deep sea. And analysis principles and methods of marine spatial classification based on biogeographic related factors, and take China Near Sea (CNS) area as case study, and select key biogeographic related factors, carry out marine spatial classification at biological region scale, ecological regionals scale and biogeographical scale. The research shows that CNS is divided into 5 biological regions by climate and geographical differences, the Yellow Sea, the Bohai Sea, the East China Sea, the Taiwan Straits, and the South China Sea. And the bioregions are then divided into 12 ecological regions according to the typical ecological and administrative factors, and finally the eco-regions are divided into 98 biogeographical units according to the benthic substrate types, depth, coastal types, water temperature, and salinity, given the integrity of biological and ecological process, the area of the biogeographical units is not less than 1,000 km². This research is of great use to the coastal management and biodiversity conservation for local and central government, and provide important scientific support for future spatial planning and management of coastal waters and sustainable use of marine biodiversity.

Keywords: spatial classification, marine biodiversity, bio-geographical, conservation

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Authors: O. Yu Shchelkova, E. B. Usmanova

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Introduction: Last decades scientific research of quality of life (QoL) is developing fast worldwide. QoL concept pays attention to emotional experience of disease in patients, particularly to personal sense of possibility to satisfy actual needs and possibility of full social functioning in spite of disease limitations. QoL in oncological patients is studied intensively. Nevertheless, the issue of QoL in patients with bone tumors focused on psychological factors of QoL and relation to disease impact on QoL is not discussed. The aim of the study was to reveal the basic aspects and personality factors of QoL in patients with bone tumor. Results: Study participants were 139 patients with bone tumors. The diagnoses were osteosarcoma (n=42), giant cell tumor (n=32), chondrosarcoma (n=32), Ewing sarcoma (n=10) and bone metastases (n=23). The study revealed that patients with bone metastases assess their health significantly worse than other patients. Besides patients with osteosarcoma evaluate their general health higher than patients with giant cell tumors. Social functioning in patients with chondrosarcoma is higher than in patients with bone metastases and patients with giant cell tumor. Patients with chondrosarcoma have higher physical functioning and less restricted in daily activities than patients with bone metastases. Patients with bone metastases characterize their pain as more widespread than patients with primary bone tumors and have more functional restrictions due to bone incision. Moreover, the study revealed personality significant influence on QoL related to bone tumors. Such characteristics in structure of personality as high degree of self-consciousness, personal resources, cooperation and disposition to positive reappraisal in difficult situation correspond to higher QoL. Otherwise low personal resources and slight problem solving behaviour, low degree of self-consciousness and high social dependence correspond to decrease of QoL in patients with bone tumors. Conclusion: Patients with bone metastasis have lower QoL compared to patients with primary bone tumors. Patients with giant cell tumor have the worth quality of life among patients with primary bone tumors. Furthermore, the results revealed differences in QoL parameters associated with personality characteristics in patients with bone tumors. Such psychological factors as future goals, interest in life and emotional saturation, besides high degree of personal resources and cooperation influence on increasing QoL in patients with bone tumors.

Keywords: quality of life, psychological factors, bone tumor, personality

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Authors: L. Musak, J. Valachova, T. Vasicko, O. Osina

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Introduction: Stainless steel is resistant to electrochemical corrosion by passivation. Welders are greatly exposed to welding fumes of toxic metals, which added to this steel. The content of chromium (Cr) in steel was above 11.5%, Ni and Mo from 2 to 6.5%. The aim of the study was the evaluation of occupational exposure to Cr, chromosome analysis and valuation of individual susceptibility polymorphism of gene CCND1 c.870 G>A. Materials and Methods: The exposed group was consisted from 117 welders of stainless steels. The average age was 38.43 years and average exposure time 7.14 years. Smokers represented 40.17%. The control group consisted of 123 non-exposed workers with an average age of 39.74 years and time employment 16.67 years. Smokers accounted for 22.76%. Analysis of Cr in blood and urine was performed by atomic absorption spectrophotometry (AAS Varian SpectraAA 30P) with electrothermal decomposition of the sample in the graphite furnace. For the evaluation of chromosomal aberrations (CA) was used cytogenetic analysis of peripheral blood lymphocytes, gene polymorphism was determined by PCR-RFLP reaction using appropriate primers and restriction enzymes. For statistical analysis was used the Mann-Whitney U-test. Results: The mean Cr level in exposed group was 0.095 mmol/l (0.019 min-max 0.504). No value does exceed the average normal value. The average value Cr in urine was 7.9 mmol/mol creatinine (min 0.026 to max 19.26). The total number of CA was 1.86% in compared to 1.70% controls. (CTA-type 0.90% vs 0.80% and CSA-type 0.96% vs 0.90%). In the number of total CA was observed statistical difference between smokers and non-smokers of exposed group (S-1.57% vs. NS-2.04%, P<0.05). In CCND1 gene polymorphisms was observed the increasing of the total CA with wild-type allele (WT) via heterozygous to the VAR genotype (1.44%<1.82%<2.13%). There was observed a statistically higher incidence of CTA-type aberrations in variant genotypes between exposed and control groups (1.22% vs. 0.59%, P<0.05). Discussion and conclusions: The work place is usually higher source of exposure to harmful factors. Workers need consistently and checked frequently health control. In assessing the risk of adverse effects of metals is important to consider their persistence, behavior and bioavailability. Prolonged exposure to carcinogens may not manifest symptoms of poisoning, but delayed effects may occur, which resulted in a higher incidence of malignant tumors.

Keywords: genotoxicity, chromium, stainless steels, welders

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Authors: Piotr Tylec, Julia Wierzbicka, Natalia Gajewska, Krzysztof Przeczek, Grzegorz Torbicz, Alicja Dudek, Magdalena Pisarska-Adamczyk, Mateusz Wierdak, Michal Pedziwiatr

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Introduction: Many patients have described changes in taste perception after weight loss surgery. However, little data is available about short term changes in taste after surgery. Aim: We aimed to evaluate short-term changes in taste preference after bariatric surgeries in comparison to colorectal surgeries. Material and Methods: Between April 2018 and April 2019, a total of 121 bariatric patients and 63 controls participated. Bariatric patients underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric by-pass. Controls underwent oncological colorectal surgeries. Patients who developed clinical complications requiring restriction of oral intake after surgery or withdraw their consent were excluded from the study. In the end, 85 bariatric patients and 44 controls were included. In all of them, the 16-item ERAS Protocol was applied. Using 10-points Numeric Rating Scale (1-10) patients completed questionnaire and rated their appetite and thirst (1 - no appetite/not thirsty, 10 – normal appetite/very thirsty) and flavoured standardized liquids' taste (1- horrible, 10-very tasty) and food images for the 6 group of taste (sweet, umami, sour, spicy, bitter and salty) (1 - not appetizing, 10 - very appetizing) preoperatively and on the first postoperative day. Data were analysed with Statistica 13.0 PL. Results: Analysed group consist of 129 patients (85 bariatric, 44 controls). Mean age and BMI in a research group was 44.91 years old, 46.22 kg/m² and in control group 62.09 years old, 25.87 kg/m², respectively. Our analysis revealed significant differences in changes of appetite between both groups (research: -4.55 ± 3.76 vs. control: -0.85 ± 4.37; p < 0.05), ratings bitter (research: 0.60 ± 2.98 vs. control: -0.88 ± 2.58; p < 0.05) and salty (research: 1.20 ± 3.50 vs. control: -0.52 ± 2.90; p < 0.05) flavoured liquids and ratings for sweet (research: 1.62 ± 3.31 vs. control: 0.01 ± 2.63; p < 0.05) and bitter (research: 1.21 ± 3.15 vs. control: -0.09 ± 2.25; p < 0.05) food images. There were statistically significant results in the ratings of other images, but in comparison to the control group, they were not statistically significant. Conclusion: The study showed that bariatric surgeries quickly decreases appetite and desire to eat certain types of food, such as salty. Moreover, the bitter taste was more desirable in the research group in comparison to control group. Nevertheless, the sweet taste was more appetible in the bariatric group than in control.

Keywords: bariatric surgery, general surgery, obesity, taste preference

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