Search results for: background mesh

Authors: Sadeq Al Yaari, Muhammad Alkhunayn, Montaha Al Yaari, Ayman Al Yaari, Aayah Al Yaari, Adham Al Yaari, Sajedah Al Yaari, Fatehi Eissa

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Background: In spite of the fact that several language deficits, both internalizing and externalizing, have been documented in comorbidity with Asperger Syndrome (AS) and High Functioning Autism (HFA), there is a paucity of the continuity of these deficits in these individuals’ life span. Furthermore, findings regarding differences in the occurrence of these language deficits both in HFA and AS males and females are mixed. Aims: Systematic Literature Review and meta-analysis (SLR & Meta-analysis) provides a more valid indicator; that is why it has been used here to distinguish HFA and AS individuals in terms of (a) When does language deficits prevails in these individuals’ life and (b) in which gender the prevalence of these language deficits is seen more. Materials and Method: In this SLR & Meta-analysis, PubMed, ScienceDirect, SpringerLink, SAGE journals online, WILEY online library, Google Scholar, CINAHL, EMBASE, Scopus, and ERIC databases in addition to unpublished literature were systematically searched between 1st of January 1980 and 30th of May 2022. Interpretations: Although overall sample sizes were small, the combined results do permit the tentative conclusion that prevalence of language deficits both in AS and HFA children and adults with more prevalence of phonological deficit in HFA male children and pragmatic deficits in AS male children. Further research should be separately undertaken in each linguistic branch to verify the occlusions of this study.

Keywords: high-functioning autism, Asperger syndrome, systematic literature review, meta-analysis

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Authors: Lukman Thalib, Luis Furuya-Kanamori, Rachel Walker, Brigid Gillespie, Suhail Doi

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Background and objectives: There are many topical treatments available for Pressure Injury (PI) treatment, yet there is a lack of evidence with regards to the most effective treatment. The objective of this study was to compare the effect of various topical treatments and identify the best treatment choice(s) for PI healing. Methods: Network meta-analysis of published randomized controlled trials that compared the two or more of the following dressing groups: basic, foam, active, hydroactive, and other wound dressings. The outcome complete healing following treatment and the generalised pair-wise modelling framework was used to generate mixed treatment effects against hydroactive wound dressing, currently the standard of treatment for PIs. All treatments were then ranked by their point estimates. Main Results: 40 studies (1,757 participants) comparing 5 dressing groups were included in the analysis. All dressings groups ranked better than basic (i.e. saline gauze or similar inert dressing). The foam (RR 1.18; 95%CI 0.95-1.48) and active wound dressing (RR 1.16; 95%CI 0.92-1.47) ranked better than hydroactive wound dressing in terms of healing of PIs when the latter was used as the reference group. Conclusion & Recommendations: There was considerable uncertainty around the estimates, yet, the use of hydroactive wound dressings appear to perform better than basic dressings. Foam and active wound dressing groups show promise and need further investigation. High-quality research on clinical effectiveness of the topical treatments are warranted to identify if foam and active wound dressings do provide advantages over hydroactive dressings.

Keywords: Net work Meta Analysis, Pressure Injury, Dresssing, Pressure Ulcer

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Authors: Ying Sun, Yuxuan Lei

Abstract:

Based on the analysis of the current situation of Nantong's comprehensive transportation system, the interactive relationship between the transportation system and the economy and society is clarified, and then the development strategy for the planning and implementation of the "three ports in one" comprehensive transportation system of ocean, land, and airport is proposed for this round of territorial spatial planning. The research findings are as follows: (1) The comprehensive transportation network system of Nantong City is beginning to take shape, but the lack of a unified and complete system planning makes it difficult to establish a "multi-port integration" pattern with transportation hubs. (2) At the Yangtze River Delta level and Nantong City level, a connected transport node integrating ocean, land, and airport should be built in the transportation construction planning to effectively meet the guidance of the overall territorial space planning of Nantong City. (3) Nantong's comprehensive transportation system and economic society have experienced three interactive development relations in different stages: mutual promotion, geographical separation, and high-level driving. Therefore, the current planning of Nantong's comprehensive transportation system needs to be optimized. The four levels of Nantong city, Shanghai metropolitan area, Yangtze River Delta, and each district, county, and city should be comprehensively considered, and the four development strategies of accelerating construction, dislocation development, active docking, and innovative implementation should be adopted.

Keywords: master plan for territorial space, Integrated transportation system, Nantong, sea, land and air, "Three ports in one"

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Authors: Abbas Sedighinejad, Hossein Khoshrang, Mohammad Haghighi, Ali Ashraf, Mostafa Saeedinia, Gelareh Biazar, Zahra Atrkarroushan, Mahdi Ajdadi

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Background: Coronavirus disease 2019 (COVID-19) as an alarming attack broke out in China and spread rapidly worldwide. Objectives: Based on a theory indicating the correlation between some viral diseases and blood types, we investigated the relationship between blood groups and coronavirus infection risk in Guilan Province, Iran. Methods: Retrospectively, all the files of the admitted patients with suspected COVID-19, in peak conditions of the disease between March 1 and May 30, 2020, were reviewed using the Census method. The required data, including epidemiological and clinical information and outcomes, were obtained from electronic records. Results: A total of 249 cases were analyzed, of whom 109 were collected from governmental centers, and the rest were collected from private hospitals. The most common co-morbidity was diabetes with 71 (37.6%) cases and the main symptom at the admission time was dyspnea with 170 (24.5%) cases. Of the total patients, 155 (62.2%) were discharged, and the rest died. The most common blood group among our patients was O Rh-positive with 91 (36.5%) cases. No meaningful correlation was found between outcomes and blood groups in terms of ABO types (P = 0.89) or Rh factor (P = 0.456). The Rh-positive proportion was significantly higher in the COVID-19 cases than in the general population (P = 0.038). Conclusions: We found that the Rh-positive proportion was significantly higher in the COVID-19 cases than in the healthy individuals. However, no correlation was observed between the groups regarding ABO typing.

Keywords: ABO blood group, COVID 19, association, personal protection

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Authors: Yi-Fung Lin, Yuan-Mei Liao

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Background: Pain is common among patients with cancer and is also one of the most disturbing symptoms. As this suffering is subjective, if patients proactively participate in their pain self-management, pain could be alleviated effectively. However, not everyone can carry out self-management very well because human behavior is a product of the cognition process. In this process, we can see that "self-efficacy" plays an essential role in affecting human behaviors. Methods: We used the eight steps of concept analysis proposed by Walker and Avant to clarify the concept of “self-efficacy for cancer pain management.” A comprehensive literature review was conducted for relevant publications that were published during the period of 1977 to 2021. We used several keywords, including self-efficacy, self-management, concept analysis, conceptual framework, and cancer pain, to search the following databases: PubMed, CINAHL, Web of Science, and Embase. Results: We identified three defining attributes for the concept of self-efficacy for cancer pain management, including pain management abilities, confidence, and continuous pain monitoring, and recognized six skills related to pain management abilities: problem-solving, decision-making, resource utilization, forming partnerships between medical professionals and patients, planning actions, and self-regulation. Five antecedents for the concept of self-efficacy for cancer pain management were identified: pain experience, existing cancer pain, pain-related knowledge, a belief in pain management, and physical/mental state. Consequences related to self-efficacy for cancer pain management were achievement of pain self-management, well pain control, satisfying quality of life, and containing motivation. Conclusions: This analysis provides researchers with a clearer understanding of the concept of “self-efficacy for cancer pain management.” The findings presented here provide a foundation for future research and nursing interventions to enhance self-efficacy for cancer pain management.

Keywords: cancer pain, concept analysis, self-efficacy, self-management

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Authors: S Eli, DGB Kalio, BOA Altraide, P Kua, DA MacPepple, FE Okonofua

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Background: Anaemia in pregnancy is worrisome morbidity encountered by obstetricians and gynaecologist in the developing countries of the world. It is an indirect cause of maternal mortality and also a cause of perinatal mortality. Aim: The study aimed to ascertain the prevalence of anaemia amongst antenatal clinic (ANC) attendees at booking at The Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Rivers State, Nigeria. Method: The method was a cross-sectional study of ANC attendees at booking at RSUTH. The cut-off for anaemia by the WHO used for this study was packed cell volume (PCV) less than 33%. Simple randomized sampling method was used. Information was analyzed using SPSS version 25. Result: A total of 500 questionnaires were distributed, and 488 questionnaires retrieved. The mean age was of the ANC attendees was 31.44 years, and the modal parity was 0. Three hundred and fifty-seven (73.2%) of the respondents had a tertiary level of education, 126(25.8%) had a secondary level of education while 5 (1%) of the respondents had a primary level of education. Five (1%) of the respondents did not volunteer their educational status. The modal packed cell volume was 32%. Three hundred and eighty-two (78.3%) of the ANC attendees had PCV level less than 33% compared to 106 (21.7%) who had PCV equal or greater than 33%. Conclusion: The study revealed that the prevalence of anaemia in pregnancy amongst ANC attendees at the RSUTH was high, representing 73.3% of the subjects. Anaemia was common amongst multiparas (38.5%). Malaria prophylaxis, as well as encouraging pregnant women to be compliant with their routine antenatal drugs as well as counseling on the right diet, cannot be overemphasized during pregnancy. In addition, women should use family planning for child spacing for them to recover from previous pregnancies.

Keywords: anaemia, ANC attendees, Nigeria, prevalence

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Authors: J. C. Cabanillas-Noris, M. I. Martínez-Hernández, I. León-Monzón

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The selection of diffractive events in the ALICE experiment during the first data taking period (RUN-I) of the Large Hadron Collider (LHC) was limited by the range over which rapidity gaps occur. It would be possible to achieve better measurements by expanding the range in which the production of particles can be detected. For this purpose, the ALICE Diffractive (AD0) detector has been installed and commissioned for the second phase (RUN-II). Any new detector should be able to take the data synchronously with all other detectors and be operated through the ALICE central systems. One of the key elements that must be developed for the AD0 detector is the Detector Control System (DCS). The DCS must be designed to operate safely and correctly this detector. Furthermore, the DCS must also provide optimum operating conditions for the acquisition and storage of physics data and ensure these are of the highest quality. The operation of AD0 implies the configuration of about 200 parameters, from electronics settings and power supply levels to the archiving of operating conditions data and the generation of safety alerts. It also includes the automation of procedures to get the AD0 detector ready for taking data in the appropriate conditions for the different run types in ALICE. The performance of AD0 detector depends on a certain number of parameters such as the nominal voltages for each photomultiplier tube (PMT), their threshold levels to accept or reject the incoming pulses, the definition of triggers, etc. All these parameters define the efficiency of AD0 and they have to be monitored and controlled through AD0 DCS. Finally, AD0 DCS provides the operator with multiple interfaces to execute these tasks. They are realized as operating panels and scripts running in the background. These features are implemented on a SCADA software platform as a distributed control system which integrates to the global control system of the ALICE experiment.

Keywords: AD0, ALICE, DCS, LHC

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Authors: Seyed Fakhreddin Hejazi, Leili Iranirad, Mohammad Sadeghi, Mohsen Talebizadeh

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Background: Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures. We performed this clinical trial to assess the preventive effect of allopurinol against CIN in high-risk patients undergoing coronary angiography. Methods: In this prospective randomized controlled trial, 140 patients with at least two risk factors for CIN undergoing coronary angiography were randomly assigned to either the allopurinol group or the control group. Patients in the allopurinol group received 300 mg allopurinol 24 hours before a procedure and intravenous hydration for 12 hours before and after coronary angiography, whereas patients in the control group received intravenous hydration. Serum creatinine (SCr), blood urea nitrogen (BUN) and uric acid were measured before contrast exposure and at 48 hours. CIN was defined as an increase of 25% in serum creatinine (SCr) or >0.5 mg/dl 48 hours after contrast administration. Results: CIN occurred in 11 out of 70 (7.9%) patients in the control group and in 8 out of 70 (5.7%) patients in the allopurinol group. There was no significant difference in the incidence of CIN between the two groups at 48 hours after administering the radiocontrast agent (p = 0.459). However, there were significant differences between the two groups in SCr, BUN, uric acid, and eGFR 48 hours after radiocontrast administration (p < 0.05). Conclusion: Our findings revealed that allopurinol had no substantial efficacy over hydration protocol in high-risk patients for the development of CIN.

Keywords: contrast-induced nephropathy, allopurinol, coronary angiography, contrast agent

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Authors: Samar Rabah

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Background: Incense woods are special kind of trees called Agarwood, which characterized by good smelling odors and many medical benefits. Incense smoke is heavily used in Saudi Arabia although comprehensive studies of its effects on health are limited. The present study demonstrated lung ultrastructure changes of mice after exposure and cessation to Incense smoke. Eighty mice are divided equally into four groups, three groups are exposed to different concentrations of Incense smoke (2, 4 and 6 gm) for three months, while the fourth group is control one. At the end of each month, lungs of five animals from each group are gathered, while the last five animals from each group are kept for another 60 days without exposure to the Incense smoke to allow for recovery. Results: Transmission electron microscope investigations of all exposed groups showed hypertrophy and hyperplasia in Clara Cells and some an enlargement of the macrophage to the point that it fills a large part of the alveolar lumen. Scanning electron microscope marks presence of mucus materials attached to the epithelial bronchioles. After prevention of exposure to the Incense smoke for 60 days, necrosis and degeneration in some cells of epithelial bronchioles, fibrosis of peribronchial, thickening in alveolar walls and aggregation of lymphoid cells were demonstrated. Conclusion: Based on the above findings and other related studies (not published), we conclude that exposure to Incense smoke causes harmful effects due to sever changes in pulmonary ultrastructure, such effects do not disappear even when Incense smoke inhalation was stopped. Therefore, we recommend that Incense smoke should use only in open places to reduce its harms.

Keywords: Incense smoke, lungs, ultrastructure of lungs, Agarwood

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Authors: Mohammad Abdullah Almalki

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Background: Despite the frequent usage of ankle arthroscopy, there is limited medical literature regarding its indications, patterns of admissions, surgical outcomes, and associated complicated at Saudi Arabia. Hence, this study would highlight the surgical outcomes of such surgical approach that will assist orthopedic surgeons to detect which surgical procedure needs to be done as well as to help them regarding their diagnostic workups. Methods: At the Orthopedic Division of King Abdul‑Aziz Medical City in Riyadh and through a cross‑sectional design and convenient sampling techniques, the present study had recruited 20 subjects who fulfill the inclusion and exclusion criteria between 2016 and 2018. Data collection was carried out by a questionnaire designed and revised by an expert panel of health professionals. Results: Twenty patients were reviewed (11M and 9F) with an average age of 40.1 ± 12.2. Only 30% of the patients (5M, 1F) have no comorbidity, but 70% of patients (7M, 8F) were having at least one comorbidity. The most common indications were osteochondritis dissecans (n = 7, 35%), ankle fracture without dislocation (n = 4, 20%), and tibiotalar impingement (n = 3, 15%). Patients recorded pain in all cases (100%). The top four symptoms after pain were instability (30%, n = 6), muscle weakness (15%, n = 3) swelling (15%, n = 3), and stiffness (5%, n = 1). Two‑third of cases reached to their full healthy status and toe‑touch weight‑bearing was seen in two patients (10%). Conclusion: Ankle arthroscopy improved the rehabilitation rates in our tertiary care center. In addition, the surgical outcomes are favorable in our hospital since it has a very short length of stay, unexpended surgery, and fewest physiotherapy sessions.

Keywords: ankle, arthroscopy, indications, patterns

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Authors: Norazlin Mohamad, Saiful Adli Bukry, Zarina Zahari, Haidzir Manaf, Hanafi Sawalludin

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Background: Deficit in neuromuscular recruitment and decrease force distribution were the common problems among ankle instability patients due to altered joint kinematics that lead to recurrent ankle injuries. Rigid Tape and KT Tape had widely been used as therapeutic and performance enhancement tools in ankle stability. However the difference effect between this two tapes is still controversial. Objective: To investigate the different effect between Rigid Tape and KT Tape on force distribution and muscle activation among ankle instability patients while standing. Study design: Crossover trial. Participants: 27 patients, age between 18 to 30 years old participated in this study. All the subjects were applied with KT Tape & Rigid Tape on their affected ankle with 3 days of interval for each intervention. The subjects were tested with their barefoot (without tape) first to act as a baseline before proceeding with KT Tape, and then with Rigid Tape. Result: There were no significant difference on force distribution at forefoot and back-foot for both tapes while standing. However the mean data shows that Rigid Tape has the highest force distribution at back-foot rather than forefoot when compared with KT Tape that had more force distribution at forefoot while standing. Regarding muscle activation (Peroneus Longus), results showed significant difference between Rigid Tape and KT Tape (p= 0.048). However, there was no significant difference on Tibialis Anterior muscle activation between both tapes while standing. Conclusion: The results indicated that Peroneus longus muscle was more active when applied Rigid Tape rather than KT Tape in ankle instability patients while standing.

Keywords: ankle instability, kinematic, muscle activation, force distribution, Rigid Tape, KT tape

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Authors: Victor Emery David Jr., Jiang Wenchao, Yasinta John, Md. Sahadat Hossain

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Sludge originates from the process of treatment of wastewater. It is the byproduct of wastewater treatment containing concentrated heavy metals and poorly biodegradable trace organic compounds, as well as potentially pathogenic organisms (viruses, bacteria, etc.) which are usually difficult to treat or dispose of. China, like other countries, is no stranger to the challenges posed by an increase of wastewater. Treatment and disposal of sludge have been a problem for most cities in China. However, this problem has been exacerbated by other issues such as lack of technology, funding, and other factors. Suitable methods for such climatic conditions are still unavailable for modern cities in China. Against this background, this paper seeks to describe the methods used for treatment and disposal of sludge from industries and suggest a suitable method for treatment and disposal in Chongqing/China. From the research conducted, it was discovered that the highest treatment rate of sludge in Chongqing was 10.08%. The industrial waste piping system is not separated from the domestic system. Considering the proliferation of industry and urbanization, there is a likelihood that the production of sludge in Chongqing will increase. If the sludge produced is not properly managed, this may lead to adverse health and environmental effects. Disposal costs and methods for Chongqing were also included in this paper’s analysis. Research showed that incineration is the most expensive method of sludge disposal in China/Chongqing. Subsequent research, therefore, considered optional alternatives such as composting. Composting represents a relatively cheap waste disposal method considering the vast population, current technology and economic conditions of Chongqing, as well as China at large.

Keywords: Chongqing/China, disposal, industrial, sludge, treatment

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Authors: S. Zith Dey Babu, S. Kour, S. Verma, C. Verma, V. Pathania, A. Agrawal, V. Chaudhary, A. Manoj Puthur, R. Goyal, A. Pal, T. Danti Dey, A. Kumar, K. Wadhwa, O. Ved

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Background: Skin cancer is now is the buzzing button in the field of medical science. The cyst's pandemic is drastically calibrating the body and well-being of the global village. Methods: The extracted image of the skin tumor cannot be used in one way for diagnosis. The stored image contains anarchies like the center. This approach will locate the forepart of an extracted appearance of skin. Partitioning image models has been presented to sort out the disturbance in the picture. Results: After completing partitioning, feature extraction has been formed by using genetic algorithm and finally, classification can be performed between the trained and test data to evaluate a large scale of an image that helps the doctors for the right prediction. To bring the improvisation of the existing system, we have set our objectives with an analysis. The efficiency of the natural selection process and the enriching histogram is essential in that respect. To reduce the false-positive rate or output, GA is performed with its accuracy. Conclusions: The objective of this task is to bring improvisation of effectiveness. GA is accomplishing its task with perfection to bring down the invalid-positive rate or outcome. The paper's mergeable portion conflicts with the composition of deep learning and medical image processing, which provides superior accuracy. Proportional types of handling create the reusability without any errors.

Keywords: computer-aided system, detection, image segmentation, morphology

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Authors: Inemesit Akpan Umoren, Aniekan James Akpan

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Media practitioners and information managers have often erroneously operated on the premise that media messages are received as disseminated to the extent that audiences of whatever background assimilate the content uniformly. This does not subsist since media audiences are often segmented in terms of educational level, social category, place of residence, gender, among others. While those who are highly educated, live in urban areas and are of highest standing are more likely to have direct access to the media, those in the rural areas and of low education and standing, may not have direct or easy access. These, therefore, informed the study to establish the consumption patterns of mass media products by residents of rural communities in south-south, Nigeria. The study, which was anchored on the multi-step flow and social categories theories, adopted a survey research design and a sample of 383 using Mayer’s 1979 guide drawn from nine rural communities in the south-south, Nigeria states of Akwa Ibom, Rivers and Edo. Findings among others showed that while a negligible percentage is highly exposed to media messages of all types, a greater member depend on opinion leaders, social groups, drinking joints, among other such for filtered content. It was concluded that since rural or community media organizations are very vital in ensuring media content get to all audience without necessarily being passing through intermediaries. Among the recommendations was that information managers and media organizations should always have in mind the ruralites while packaging their contents even in the mainstream media.

Keywords: consumption, media, media product, pattern

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Authors: Ashit Syngle, Nidhi Garg, Pawan Krishan

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Background: Endothelial Progenitor Cells (EPCs) are depleted and contribute to increased cardiovascular (CV) risk in rheumatoid arthritis (RA). Statins exert a protective effect in CAD partly by promoting EPC mobilization. This vasculoprotective effect of statin has not yet been investigated in RA. We aimed to investigate the effect of rosuvastatin on EPCs in RA. Methods: 50 RA patients were randomized to receive 6 months of treatment with rosuvastatin (10 mg/day, n=25) and placebo (n=25) as an adjunct to existing stable antirheumatic drugs. EPCs (CD34+/CD133+) were quantified by Flow Cytometry. Inflammatory measures included DAS28, CRP and ESR were measured at baseline and after treatment. Lipids and pro-inflammatory cytokines (TNF-α, IL-6, and IL-1) were estimated at baseline and after treatment. Results: At baseline, inflammatory measures and pro-inflammatory cytokines were elevated and EPCs depleted among both groups. At baseline, EPCs inversely correlated with DAS28 and TNF-α in both groups. EPCs increased significantly (p < 0.01) after treatment with rosuvastatin but did not show significant change with placebo. Rosuvastatin exerted positive effect on lipid spectrum: lowering total cholesterol, LDL, non HDL and elevation of HDL as compared with placebo. At 6 months, DAS28, ESR, CRP, TNF-α and IL-6 improved significantly in rosuvastatin group. Significant negative correlation was observed between EPCs and DAS28, CRP, TNF-α, and IL-6 after treatment with rosuvastatin. Conclusion: First study to show that rosuvastatin improves inflammation and EPC biology in RA possibly through its anti-inflammatory and lipid lowering effect. This beneficial effect of rosuvastatin may provide a novel strategy to prevent cardiovascular events in RA.

Keywords: RA, Endothelial Progenitor Cells, rosuvastatin, cytokines

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Authors: Saleh N. Maodaa

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Background: Lead (Pb) is an environmental pollutant causing serious health problems, including impairment of reproduction. Visnagin (VIS) is a furanochromone with promising antioxidant and anti-inflammatory effects; however, its protective efficacy against Pb toxicity has not been investigated. Objective: This study evaluated the protective effect of VIS on Pb reproductive toxicity, impaired steroidogenesis and spermatogenesis, oxidative stress and inflammation. Methods: Rats received VIS (30 or 60 mg/kg) and 50 mg/kg lead acetate for 3 weeks, and blood and testes samples were collected. Results: Pb intoxication impaired the pituitary-testicular axis (PTA), manifested by the decreased serum levels of gonadotropins and testosterone. Pb decreased sperm count, motility and viability, increased sperm abnormalities, and downregulated the steroidogenesis markers StAR, CYP17A1, 3β-HSD and 17β-HSD in the testis of rats. VIS significantly increased serum gonadotropins and testosterone, alleviated sperm parameters and upregulated steroidogenesis. In addition, VIS decreased pro-inflammatory cytokines, testicular lipid peroxidation and DNA fragmentation, downregulated Bax, and enhanced antioxidants and Bcl-2 Conclusion: These results demonstrate the protective effect of VIS against Pb reproductive toxicity in rats. VIS improved serum gonadotropins and testosterone, enhanced steroidogenesis and spermatogenesis, and attenuated oxidative injury, inflammation and apoptosis. Therefore, VIS is a promising candidate for the protection against Pb-induced reproduction impairment.

Keywords: pituitary-gonadal axis, cytokines, DNA damage, apoptosis

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Authors: Carl van Walraven, Meltem Tuna

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Background: Network meta-analysis (NMA) quantifies the relative efficacy of 3 or more interventions from studies containing a subgroup of interventions. This study applied the analytical approach of NMA to quantify the relative accuracy of prediction models with distinct inclusion criteria that are evaluated on a common population (‘concurrent external validation’). Methods: We simulated binary events in 5000 patients using a known risk function. We biased the risk function and modified its precision by pre-specified amounts to create 15 prediction models with varying accuracy and distinct patient applicability. Prediction model accuracy was measured using the Scaled Brier Score (SBS). Overall prediction model accuracy was measured using fixed-effects methods that accounted for model applicability patterns. Prediction model accuracy was summarized as the Network Relative Model Accuracy (NeRMA) Score which ranges from -∞ through 0 (accuracy of random guessing) to 1 (accuracy of most accurate model in concurrent external validation). Results: The unbiased prediction model had the highest SBS. The NeRMA score correctly ranked all simulated prediction models by the extent of bias from the known risk function. A SAS macro and R-function was created to implement the NeRMA Score. Conclusions: The NeRMA Score makes it possible to quantify the accuracy of binomial prediction models having distinct inclusion criteria in a concurrent external validation.

Keywords: prediction model accuracy, scaled brier score, fixed effects methods, concurrent external validation

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Authors: Abha Cherkani Hassani, Imane Ghanname, Nezha Mouane

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Background: This is the first systematic review summarizing 43 years of research from 36 countries in the assessment of cadmium in breast milk; a suitable matrix in human biomonitoring. Objectives: To report from the published literature the levels of cadmium in breast milk and the affecting factors causing the increase of cadmium concentrations; also to gather several quantitative data which might be useful to evaluate the international degrees of maternal and infant exposure. Methods: We reviewed the literature for studies reporting quantitative data about cadmium levels in human breast milk in the world that have been published between 1971 and 2014 and that are available on Pubmed, Science direct and Google scholar. The aim of the study, country, period of samples collection, size of samples, sampling method, time of lactation, mother’s age, area of residence, cadmium concentration and other information were extracted. Results: 67 studies were selected and included in this systematic review. Some concentrations greatly exceed the limit of the WHO, However about 50% of the studies had less than 1 µg/l cadmium concentration (the recommendation of the WHO); as well many factors have shown their implication in breast milk contamination by Cadmium as lactation stage, smoking, diet, supplement intake, interaction with other mineral elements, age of mothers, parity and other parameters. Conclusion: Breast milk is a pathway of maternal excretion of cadmium. It is also a biological indicator of the degree of environmental pollution and cadmium exposure of the lactating women and the nourished infant. Therefore preventive measures and continuous monitoring are necessary.

Keywords: breast milk, cadmium level, factors, systematic review

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Authors: Anna Gramza-Michałowska, Dominik Kmiecik, Justyna Bilon, Joanna Skręty, Joanna Kobus-Cisowska, Józef Korczak, Andrzej Sidor

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Background: Hypertension is one of the civilization diseases with a global scope. Many research showed that every day diet influences significantly our health, helping with the prophylaxis and diseases treatment. The key factor here is the presence of plant origin natural bio active components. Aim: The following research describes snack health-oriented products for hypertension sufferers enriched with selected plant ingredients. Various analytical methods have been applied to determine product’s basic composition and their antioxidant activity. Methods: Snack products was formulated from a composition of different flours, oil, yeast, plant particles and extracts. Basic composition of a product was evaluated as content of protein, lipids, fiber, ash and caloricity. Antioxidant capacity of snacks was evaluated with use radical scavenging methods (DPPH, ABTS) and ORAC value. Proposed snacks as new product was also characterized with sensory analysis. Results and discussion: Results showed that addition of phyto nutrients allowed to improve nutritional and antioxidative value of examined products. Also the anti radical potential was significantly increased, with no loss of sensory value of a snacks. Conclusions: Designed snack is rich in polyphenolics, that express high antioxidant activity, helpful in hypertension and as low calories product obesity prophylaxis.

Keywords: antioxidant, well-being, hypertension, bioactive compounds

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Authors: Yuanhong Zhao, Qingping Yang, Andrew Fox, Tao Zhang

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Post-occupancy evaluation (POE) is a systematic approach to assess the actual building performance after the building has been occupied for some time. In this paper, a structured POE assessment was conducted using the building use survey (BUS) methodology in two higher educational buildings in the United Kingdom. This study aims to help close the building performance gap, provide optimized building operation suggestions, and to improve occupants’ satisfaction level. In this research, the questionnaire survey investigated the influences of environmental factors on user satisfaction from the main aspects of building overall design, thermal comfort, perceived control, indoor environment quality for noise, lighting, ventilation, and other non-environmental factors, such as the background information about age, sex, time in buildings, workgroup size, and so on. The results indicate that the occupant satisfaction level with the main aspects of building overall design, indoor environment quality, and thermal comfort in summer and winter on both two buildings, which is lower than the benchmark data. The feedback of this POE assessment has been reported to the building management team to allow managers to develop high-performance building operation plans. Finally, this research provided improvement suggestions to the building operation system to narrow down the performance gap and improve the user work experience satisfaction and productivity level.

Keywords: building performance assessment systems, higher educational buildings, post-occupancy evaluation, user satisfaction

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Authors: Upasana Bhumbla

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Background: Hepatitis C virus is a major cause of chronic hepatitis, which can further lead to cirrhosis of the liver and hepatocellular carcinoma. Worldwide the burden of Hepatitis C infection has become a serious threat to the human race. Hepatitis C virus (HCV) has population-specific genotypes and provides valuable epidemiological and therapeutic information. Genotyping and assessment of viral load in HCV patients are important for planning the therapeutic strategies. The aim of the study is to study the changing trends of prevalence and genotypic distribution of hepatitis C virus in a tertiary care hospital in Western India. Methods: It is a retrospective study; blood samples were collected and tested for anti HCV antibodies by ELISA in Dept. of Microbiology. In seropositive Hepatitis C patients, quantification of HCV-RNA was done by real-time PCR and in HCV-RNA positive samples, genotyping was conducted. Results: A total of 114 patients who were seropositive for Anti HCV were recruited in the study, out of which 79 (69.29%) were HCV-RNA positive. Out of these positive samples, 54 were further subjected to genotype determination using real-time PCR. Genotype was not detected in 24 samples due to low viral load; 30 samples were positive for genotype. Conclusion: Knowledge of genotype is crucial for the management of HCV infection and prediction of prognosis. Patients infected with HCV genotype 1 and 4 will have to receive Interferon and Ribavirin for 48 weeks. Patients with these genotypes show a poor sustained viral response when tested 24 weeks after completion of therapy. On the contrary, patients infected with HCV genotype 2 and 3 are reported to have a better response to therapy.

Keywords: hepatocellular, genotype, ribavarin, seropositive

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Authors: Ihab Saad Ahmed

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Background For Siewert type I and II gastroesophageal junction tumor (GEJ) laparoscopic proximal gastrectomy can be performed. It is associated with several perioperative benefits compared with open proximal gastrectomy. The use of laparoscopic proximal gastrectomy (LPG) has become an increasingly popular approach for select tumors Methods We describe our technique for LPG, including the preoperative work-up, illustrated images of the main principle steps of the surgery, and our postoperative course. Results Thirteen pts (nine males, four female) with type I, II (GEJ) adenocarcinoma had laparoscopic radical proximal gastrectomy and D2 lymphadenectomy. All of our patient received neoadjuvant chemotherapy, eleven patients had intrathoracic anastomosis through mini thoracotomy (two hand sewn end to end anastomoses and the other 9 patient end to side using circular stapler), two patients with intrathoracic anastomosis had flap and wrap technique, two patients had thoracoscopic esophageal and mediastinal lymph node dissection with cervical anastomosis The mean blood loss 80ml, no cases were converted to open. The mean operative time 250 minute Average LN retrieved 19-25, No sever complication such as leakage, stenosis, pancreatic fistula ,or intra-abdominal abscess were reported. Only One patient presented with empyema 1.5 month after discharge that was managed conservatively. Conclusion For carefully selected patients, LPG in GEJ tumour type I and II is a safe and reasonable alternative for open technique , which is associated with similar oncologic outcomes and low morbidity. It showed less blood loss, respiratory infections, with similar 1- and 3-year survival rates.

Keywords: LPG(laparoscopic proximal gastrectomy, GEJ( gastroesophageal junction tumour), d2 lymphadenectomy, neoadjuvant cth

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Authors: Kexin Tan

Abstract:

The Silk Road is a concept idiosyncratic in nature. Western scholars co-created and conceptualized in its early days, transliterated into the countries along the Silk Road, redefined, reimagined, and reconfigured by the public in the second half of the twentieth century. Therefore, the image is not only a mirror of the discursive interactions between East and West but Self and Other. The travel narrative of Sven Hedin, through which the Silk Road was enriched in meanings and popularized, is the focus of this study. This article examines how the Silk Road was imagined in three key texts of Sven Hedin: The Silk Road, The Wandering Lake, and The Flight of “Big Horse”. Three recurring themes are extracted and analyzed: the Silk Road, the land of enigmas, the virgin land, and the reconnecting road. Ideas about ethnotypes and images drawn from theorists such as Joep Leerssen have been deployed in the analysis. This research tracks how the images were configured, concentrating on China’s ethnotypes, travel writing tropes, and the Silk Road discourse that preceded Sven Hedin. Hedin’s role in his expedition, his geopolitical viewpoints, and the commercial considerations of his books are also discussed in relation to the intellectual construct of the Silk Road. It is discovered that the images of the Silk Road and the discursive traditions behind it are mobile rather than static, inclusive than antithetical. The paradoxical characters of the Silk Road reveal the complexity of the socio-historical background of Hedin’s time, as well as the collision of discursive traditions and practical issues. While it is true that Hedin’s discursive construction of the Silk Road image embodies the bias of Self-West against Other-East, its characteristics such as fluidity and openness could probably offer a hint at its resurgence in the postcolonial era.

Keywords: the silk road, Sven Hedin, imagology, ethnotype, travelogue

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Authors: K. M. Shahunja, Peter D. Sly, Tahmina Begum, Tuhin Biswas, Abdullah Mamun

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Background: Various associations between different environmental exposures and asthma have been reported in different countries and populations. We aimed to investigate the associations between family, neighbourhood, and psychosocial environmental factors and asthma in Australia by conducting a systematic review and meta-analysis. Methods: We analysed the primary research studies conducted in Australia across multiple databases, including PubMed, EMBASE, and Scopus, and published between 2000 and 2020. The reviews and analyses focused on the overall association of different environmental exposures with the development or exacerbation of asthma symptoms or asthma-related hospital visits. Quality-effect meta-analysis was done to estimate the pooled odds ratio for different environmental exposures for asthma symptoms. Findings: Among the 4,799 unique published articles found, 46 were included here for systematic review and 28 for meta-analysis. Our review found that psychosocial factors, including low socioeconomic condition, maternal depression, mental stress, ethnicity, and discrimination, are associated with asthma symptoms. Pooled analysis was conducted on family and neighbourhood environmental factors and revealed that environmental tobacco smoking (ETS) (OR 1·69, 95% CI 1·19–2.38), synthetic bedding (OR 1·91, 95% CI 1·48–2·47) and gas heaters (OR 1·40, 95% CI 1·12–1·76) had significant overall associations with asthma-symptoms in Australia. Conclusion: Although the studies were heterogeneous, both systematic review and meta-analysis found several psychosocial and family environmental exposures to be significantly associated with asthma symptoms. Further study to identify their causal relationship and modification may reduce asthma symptoms in the Australian population.

Keywords: asthma, Australia, environment, systematic review

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Authors: Abhijit Trailokya, Kamlesh Patel

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Background: Hypertension is a common disease seen in clinical practice and is associated with high morbidity and mortality. Many patients require combination therapy for the management of hypertension. Objective: To evaluate co-morbidities, risk factors and management practices of hypertension in Indian population. Material and methods: A total of 1596 hypertensive adult patients received anti-hypertensive medications were studied in a cross-sectional, multi-centric, non-interventional, observational registry. Statistical analysis: Categories or nominal data was expressed as numbers with percentages. Continuous variables were analyzed by descriptive statistics using mean, SD, and range Chi square test was used for in between group comparison. Results: The study included 73.50% males and 26.50% females. Overweight (50.50%) and obesity (30.01%) was common in the hypertensive patients (n=903). A total of 54.76% patients had history of smoking. Alcohol use (33.08%), sedentary life style (32.96%) and history of tobacco chewing (17.92%) were the other lifestyle habits of hypertensive patients. Diabetes (36.03%) and dyslipidemia (39.79%) history was common in these patients. Family history of hypertension and diabetes was seen in 82.21% and 45.99% patients respectively. Most (89.16%) patients were treated with combination of antihypertensive agents. ARBs were the by far most commonly used agents (91.98%) followed by calcium channel blockers (68.23%) and diuretics (60.21%). ARB was the most (80.35%) preferred agent as monotherapy. ARB was also the most common agent as a component of dual therapy, four drug and five drug combinations. Conclusion: Most of the hypertensive patients need combination treatment with antihypertensive agents. ARBs are the most preferred agents as monotherapy for the management of hypertension. ARBs are also very commonly used as a component of combination therapy during hypertension management.

Keywords: antihypertensive, hypertension, management, ARB

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Authors: Lise Retat, Maria Carmen Huerta, Laura Webber, Franco Sassi

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Background: Intra-generational social mobility (ISM) can be defined as the extent to which individuals change their socio-economic position over a period of time or during their entire life course. The relationship between poor health and ISM is established. Therefore, quantifying the impact that potential health policies have on ISM now and into the future would provide evidence for how social inequality could be reduced. This paper takes the condition of overweight and obesity as an example and estimates the mean earning change per individual if the UK were to introduce policies to effectively reduce overweight and obesity. Methods: The HealthLumen individual-based model was used to estimate the impact of obesity on social mobility measures, such as earnings, occupation, and wealth. The HL tool models each individual's probability of experiencing downward ISM as a result of their overweight and obesity status. For example, one outcome of interest was the cumulative mean earning per person of implementing a policy which would reduce adult overweight and obesity by 1% each year between 2020 and 2030 in the UK. Results: Preliminary analysis showed that by reducing adult overweight and obesity by 1% each year between 2020 and 2030, the cumulative additional mean earnings would be ~1,000 Euro per adult by 2030. Additional analysis will include other social mobility indicators. Conclusions: These projections are important for illustrating the role of health in social mobility and for providing evidence for how health policy can make a difference to social mobility outcomes and, in turn, help to reduce inequality.

Keywords: modelling, social mobility, obesity, health

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Authors: Bhavana V. Mohite, Satish V. Patil

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Bacterial cellulose (BC) is an alternative for plant cellulose (PC) that prevents global warming leads to preservation of nature. Although PC and BC have the same chemical structure, BC is superior with its properties like its size, purity, porosity, degree of polymerization, crystallinity and water holding capacity, thermal stability etc. On this background the present study focus production and applications of BC as antimicrobial wound dressing material. BC was produced by Gluconoacetobacter hansenii (strain NCIM 2529) under shaking condition and statistically enhanced upto 7.2 g/l from 3.0 g/l. BC was analyzed for its physico mechanical, structural and thermal characteristics. BC produced at shaking condition exhibits more suitable properties in support to its high performance applications. The potential of nano silver impregnated BC was determined for sustained release modern antimicrobial wound dressing material by swelling ratio, mechanical properties and antimicrobial activity against Staphylococcus aureus. BC in nanocomposite form with other synthetic polymer like PVA shows improvement in its properties such as swelling ratio (757% to 979%) and sustainable release of antibacterial agent. The high drug loading and release potential of BC was evidenced in support to its nature as antimicrobial wound dressing material. The nontoxic biocompatible nature of BC was confirmed by MTT assay on human epidermal cells with 90% cell viability that allows its application as a regenerative biomaterial. Thus, BC as a promising new generation antimicrobial wound dressing material was projected.

Keywords: agitated culture, biopolymer, gluconoacetobacter hansenii, nanocomposite

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Authors: Emmanuel Ademola Anigilaje, Ibraheem Ishola

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Background: Childhood steroid-sensitive idiopathic nephrotic syndrome (SSINS) is plagued with relapses that contribute to its morbidity and the cost of treatment. Materials and Methods: This is a retrospective review of relapses among children with SSINS at the University of Abuja Teaching Hospital from January 2016 to July 2020. Triggers related to relapse incidents were noted. Chi-square test was deployed for predictors (factors at the first clinical presentations that associate with subsequent relapses) of relapses. Predictors with p-values of less than 0.05 were considered significant and 95% confidence intervals (CI) and odd ratio (OR) were described. Results: Sixty SSINS comprising 52 males (86.7%), aged 23 months to 18 years, with a mean age of 7.04±4.16 years were studied. Thirty-eight (63.3%) subjects had 126 relapses including infrequent relapses in 30 (78.9%) and frequent relapses in 8 (21.1%). The commonest triggers were acute upper respiratory tract infections (68, 53.9%) and urinary tract infections (UTIs) in 25 (19.8%) relapses. In 4 (3.2%) relapses, no trigger was identified. The time-to-first relapse ranged 14 days to 365 days with a median time of 60 days. The significant predictors were hypertension (OR=3.4, 95% CI; 1.04-11.09, p=0.038), UTIs (OR=9.9, 95% CI; 1.16-80.71, p= 0.014), malaria fever (OR=8.0, 95% CI; 2.45-26.38, p˂0.001), micro-haematuria (OR=4.9, 95% CI; 11.58-15.16, p=0.004), elevated serum creatinine (OR=12.3, 95%CI; 1.48-101.20, p=0.005) and hypercholesterolaemia (OR=4.1, 95%CI; 1.35-12.63, p=0.011). Conclusion: While the pathogenesis of relapses remains unknown, it is prudent to consider relapse-specific preventive strategies against triggers and predictors of relapses in our setting.

Keywords: Patterns, triggers, predictors, steroid-sensitive idiopathic nephrotic syndrome, relapses, Nigeria

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Authors: G. Erkomaishvili, M. Kobalava, T. Lazariashvili, N. Damenia

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Current state of foreign direct investment (FDI) in Georgia is analyzed and evaluated in the paper, the existing legislative background for regulating investments and stimulating policies to attract investments are shown. It is noted that in developing countries encouragement of investment activity, support and implementation are of the most important tasks, implying a consistent investment policy, investor-friendly tax regime and the legal system, reducing administrative barriers and restrictions, fare competitive conditions and business development infrastructure. The work deals with the determining factor of FDIs and the main directions of stimulation, as well as prospective industries where new investments are needed. Contributing and hindering factors and stimulating measures are analyzed. As a result of the research, the direct and indirect factors attracting FDI have been identified. Facilitating factors to FDI inflow are as follows: simplicity of starting business, geopolitical location, low taxes, access to credit, ease of ownership registration, natural resources, low burden of regulations, low level of corruption and low crime rates. Hindering factors to FDI inflow are as follows: small market, lack of policy for attracting investments, low qualification of the workforce (despite the large number of unemployed people it is difficult to find workers with necessary special skills and qualifications), high interest rates, instability of national currency exchange rate, presence of conflict zones within the country and so forth.

Keywords: foreign direct investment, investor, investment attracting marketing policies, reinvestment

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Authors: Claudia Patricia Beltran Miranda, Mónica López Anaya, Mónica Navarro Meza, Maria Leonor Valderrama Chairez

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Background: Mexico occupies the second world-wide place of morbid obese people (10- 12 million). Factors that predispose the development of MO are genetic, environmental, physiological, psycho-social and behavioral (nourishing habits). Objective: Associate Gln223Arg polymorphism of gene LEPR, levels of leptina and nourishing habits with the presence of morbid obesity in adolescents of the south of Jalisco (México). Methods: In 41 adolescents (18 normal weight and 23 morbid obesity) of 12 to 19 years of age, both sexes that were measure size and weight with tanita scale and stadimeter to determine IMC. Morbid obesity was determined by tables of the WHO and was established with a standard deviation >3. The Gln223Arg polymorphism have been identify by PCR and leptina levels by ELISA. Nourishing habits were evaluate by the questionnaire the Adolescent Food Habits Checklist. The statistical analysis was performed to compare mean scores obtained from the questionnaire when we compare morbid obesity vs. normal weight adolescents with p=0.03 and a significance of 95%. Results: frequencies alellics and genics were not stadistics significatives p= 0,011 and p=0,279 respectly when were compared between normal weight adolescents and morbib obesity Leptin levels and nourishing habits were associated with morbid obesity. The polymorphism not shown significance with morbid obesity. Conclusions: Dietary habits and leptin levels in adolescents are important factor that predisposes the development of obesity in adolescents. The presence of the polymorphism are not associated with morbid obesity in these subjects.

Keywords: leptin, nourishing habits, morbid obesity, polymorphism

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