Search results for: digital media tools and methods

Authors: Hamed Kalhori, Lin Ye

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In this study, an inverse method was developed to reconstruct the magnitude and duration of impact forces exerted to a rectangular carbon fibre-epoxy composite honeycomb sandwich panel. The dynamic signals captured by Piezoelectric (PZT) sensors installed on the panel remotely from the impact locations were utilized to reconstruct the impact force generated by an instrumented hammer through an extended deconvolution approach. Two discretized forms of convolution integral are considered; the traditional one with an explicit transfer function and the modified one without an explicit transfer function. Deconvolution, usually applied to reconstruct the time history (e.g. magnitude) of a stochastic force at a defined location, is extended to identify both the location and magnitude of the impact force among a number of potential impact locations. It is assumed that a number of impact forces are simultaneously exerted to all potential locations, but the magnitude of all forces except one is zero, implicating that the impact occurs only at one location. The extended deconvolution is then applied to determine the magnitude as well as location (among the potential ones), incorporating the linear superposition of responses resulted from impact at each potential location. The problem can be categorized into under-determined (the number of sensors is less than that of impact locations), even-determined (the number of sensors equals that of impact locations), or over-determined (the number of sensors is greater than that of impact locations) cases. For an under-determined case, it comprises three potential impact locations and one PZT sensor for the rectangular carbon fibre-epoxy composite honeycomb sandwich panel. Assessments are conducted to evaluate the factors affecting the precision of the reconstructed force. Truncated Singular Value Decomposition (TSVD) and the Tikhonov regularization are independently chosen to regularize the problem to find the most suitable method for this system. The selection of optimal value of the regularization parameter is investigated through L-curve and Generalized Cross Validation (GCV) methods. In addition, the effect of different width of signal windows on the reconstructed force is examined. It is observed that the impact force generated by the instrumented impact hammer is sensitive to the impact locations of the structure, having a shape from a simple half-sine to a complicated one. The accuracy of the reconstructed impact force is evaluated using the correlation co-efficient between the reconstructed force and the actual one. Based on this criterion, it is concluded that the forces reconstructed by using the extended deconvolution without an explicit transfer function together with Tikhonov regularization match well with the actual forces in terms of magnitude and duration.

Keywords: honeycomb composite panel, deconvolution, impact localization, force reconstruction

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Authors: Abigail Bentley, Audrey Prost, Nayreen Daruwalla, Apoorwa Gupta, David Osrin

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BACKGROUND: Intimate partner violence (IPV) can impact a woman’s physical, reproductive and mental health, including common mental disorders such as anxiety and depression. However, people other than an intimate partner may also perpetrate violence against women in the family, particularly in India. This study aims to investigate the relationship between experiences of violence perpetrated by the husband and other members of the wider household and symptoms of common mental disorders in women residing in informal settlement (slum) areas of Mumbai. METHODS: Experiences of violence were assessed through a detailed cross-sectional survey of 598 women, including questions about specific acts of emotional, economic, physical and sexual violence across different time points in the woman’s life and the main perpetrator of each act. Symptoms of common mental disorders were assessed using the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 scores were divided into four groups and the relationship between experiences of each type of violence in the last 12 months and GHQ-12 score group was analyzed using ordinal logistic regression, adjusted for the woman’s age and clustering. RESULTS: 482 (81%) women consented to interview. On average, they were 28.5 years old, had completed 7 years of education and had been married 9 years. 88% were Muslim and 47% lived in joint and 53% in nuclear families. 44% of women had experienced at least one act of violence in their lifetime (33% emotional, 22% economic, 23% physical, 12% sexual). 7% had a high GHQ-12 score (6 or above). For violence experiences in the last 12 months, the odds of being in the highest GHQ-12 score group versus the lower groups combined were 13.1 for emotional violence, 6.5 for economic, 5.7 for physical and 6.3 for sexual (p<0.001 for all outcomes). DISCUSSION: The high level of violence reported across the lifetime could be due to the detailed assessment of violent acts at multiple time points and the inclusion of perpetrators within the family other than the husband. Each type of violence was associated with greater odds of a higher GHQ-12 score and therefore more symptoms of common mental disorders. Emotional violence was far more strongly associated with symptoms of common mental disorders than physical or sexual violence. However, it is not possible to attribute causal directionality to the association. Further work to investigate the relationship between differing severity of violence experiences and women’s mental health and the components of emotional violence that make it so strongly associated with symptoms of common mental disorders would be beneficial.

Keywords: common mental disorders, family violence, India, informal settlements, mental health, violence against women

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Authors: Ahlem Dhahri, Waleed Omri, Audrey Becuwe, Abdelwahed Omri

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In industrial processes, decision-making ranges across different scales, from process control to supply chain management. The purchasing decision-making process in the supply chain is presently gaining more attention as a critical contributor to the company's strategic success. Given the scarcity of thorough summaries in the prior studies, this bibliometric analysis aims to adopt a meticulous approach to achieve quantitative knowledge on the constantly evolving subject of purchasing decision-making in supply chain management. Through bibliometric analysis, we examine a sample of 358 peer-reviewed articles from the Scopus database. VOSviewer and Gephi software were employed to analyze, combine, and visualize the data. Data analytic techniques, including citation network, page-rank analysis, co-citation, and publication trends, have been used to identify influential works and outline the discipline's intellectual structure. The outcomes of this descriptive analysis highlight the most prominent articles, authors, journals, and countries based on their citations and publications. The findings from the research illustrate an increase in the number of publications, exhibiting a slightly growing trend in this field. Co-citation analysis coupled with content analysis of the most cited articles identified five research themes mentioned as follows integrating sustainability into the supplier selection process, supplier selection under disruption risks assessment and mitigation strategies, Fuzzy MCDM approaches for supplier evaluation and selection, purchasing decision in vendor problems, decision-making techniques in supplier selection and order lot sizing problems. With the help of a graphic timeline, this exhaustive map of the field illustrates a visual representation of the evolution of publications that demonstrate a gradual shift from research interest in vendor selection problems to integrating sustainability in the supplier selection process. These clusters offer insights into a wide variety of purchasing methods and conceptual frameworks that have emerged; however, they have not been validated empirically. The findings suggest that future research would emerge with a greater depth of practical and empirical analysis to enrich the theories. These outcomes provide a powerful road map for further study in this area.

Keywords: bibliometric analysis, citation analysis, co-citation, Gephi, network analysis, purchasing, SCM, VOSviewer

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Authors: Clare Flood, Shareen Forbes

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Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disorder affecting >400,000 people in the UK alone, with the global prevalence expected to double in the next decade. Islet transplant offers a minimally-invasive procedure with very low morbidity and almost no mortality, and is now as effective as whole pancreas transplant. The procedure was introduced to the UK in 2011 for patients with the most severe type 1 diabetes mellitus (T1DM) – those with unstable blood glucose, frequently occurring episodes of severe hypoglycemia and impaired awareness of hypoglycemia (IAH). Objectives: To evaluate the effectiveness of islet transplantation in improving glycemic control, reducing the burden of hypoglycemia and improving awareness of hypoglycemia through a single-centre cohort study at the Royal Infirmary of Edinburgh. Glycemic control and degree of hypoglycemic awareness will be determined and monitored pre- and post-transplantation to determine effectiveness of the procedure. Methods: A retrospective analysis of data collected over three years from the 16 patients who have undergone islet transplantation in Scotland. Glycated haemoglobin (HbA1c) was measured and continuous glucose monitoring systems (CGMS) were utilised to assess glycemic control, while Gold and Clarke score questionnaires tested IAH. Results: All patients had improved glycemic control following transplant, with optimal control seen visually at 3 months post-transplant. Glycemic control significantly improved, as illustrated by percentage time in hypoglycemia in the months following transplant (p=0.0211) and HbA1c (p=0.0426). Improved Clarke (p=0.0034) and Gold (p=0.0001) scores indicate improved glycemic awareness following transplant. Conclusion: While the small sample of islet transplant recipients at the Royal Infirmary of Edinburgh prevents definitive conclusions being drawn, it is indicated that through our retrospective, single-centre cohort study of 16 patients, islet transplant is capable of improving glycemic control, reducing the burden of hypoglycemia and IAH post-transplant. Data can be combined with similar trials at other centres to increase statistical power but from research in Edinburgh, it can be suggested that the minimally invasive procedure of islet transplantation offers selected patients with extremely unstable T1DM the incredible opportunity to regain control of their condition and improve their quality of life.

Keywords: diabetes, islet, transplant, CGMS

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Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.

Keywords: hospital acquired infection, intensive care unit, mortality, risk factors

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Authors: B. Petrović, M. Petrović, L. Rutonjski, I. Djan, V. Ivanović

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Objective: Cardiac pacemakers are very sensitive to radiotherapy treatment from two sources: electromagnetic influence from the medical linear accelerator producing ionizing radiation- influencing electronics within the pacemaker, and the absorption of dose to the device. On the other hand, patients with cardiac pacemakers at the place of a tumor are rather rare, and single clinic hardly has experience with the management of such patients. The widely accepted international guidelines for management of radiation oncology patients recommend that these patients should be closely monitored and examined before, during and after radiotherapy treatment by cardiologist, and their device and condition followed up. The number of patients having both cancer and pacemaker, is growing every year, as both cancer incidence, as well as cardiac diseases incidence, are inevitably growing figures. Materials and methods: Female patient, age 69, was diagnozed with valvular cardiomyopathy and got implanted a pacemaker in 2005 and prosthetic mitral valve in 1993 (cancer was diagnosed in 2012). She was stable cardiologically and came to radiation therapy department with the diagnosis of right breast cancer, with the tumor in upper lateral quadrant of the right breast. Since she had all lymph nodes positive (28 in total), she had to have irradiated the supraclavicular region, as well as the breast with the tumor bed. She previously received chemotherapy, approved by the cardiologist. The patient was estimated to be with the high risk as device was within the field of irradiation, and the patient had high dependence on her pacemaker. The radiation therapy plan was conducted as 3D conformal therapy. The delineated target was breast with supraclavicular region, where the pacemaker was actually placed, with the addition of a pacemaker as organ at risk, to estimate the dose to the device and its components as recommended, and the breast. The targets received both 50 Gy in 25 fractions (where 20% of a pacemaker received 50 Gy, and 60% of a device received 40 Gy). The electrode to the heart received between 1 Gy and 50 Gy. Verification of dose planned and delivered was performed. Results: Evaluation of the patient status according to the guidelines and especially evaluation of all associated risks to the patient during treatment was done. Patient was irradiated by prescribed dose and followed up for the whole year, with no symptoms of failure of the pacemaker device during, or after treatment in follow up period. The functionality of a device was estimated to be unchanged, according to the parameters (electrode impedance and battery energy). Conclusion: Patient was closely monitored according to published guidelines during irradiation and afterwards. Pacemaker irradiated with the full dose did not show any signs of failure despite recommendations data, but in correlation with other published data.

Keywords: cardiac pacemaker, breast cancer, radiotherapy treatment planning, complications of treatment

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Authors: Warsi A. Ibrahim, Qureshi A. Ambrina, Younus M. Anjum

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Introduction: Oral lesions related to commercially available Smokeless Tobacco (ST), such as, Pan, Gutka, Mahwa, Naswar is considered a serious challenge for dental health care providers in Pakistan. Majority of labored Pakistani population consume ST, where public transporters and drivers are no exception. It was necessary to identify individuals of this particular population group and screen their oral health and early signs of pre-cancerous lesions so that appropriate preventive measures could be taken to reduce the burden on health providers. Aim of Study: To estimate Prevalence of ST consumption and perception of use, and to evaluate Oral Health status among public drivers of Karachi. Material & methods: A cross-sectional study survey was conducted over duration of 2 months, through convenient sampling. Sample size (n=615) of public drivers (age > 18 years) all over Karachi was gathered. A structured proforma was used to record socio-demographics, addiction profile, perception of use and oral health status (oral lesions, oral sub-mucosal fibrosis and dental caries) of study participants. Data was entered and analyzed using SPSS version 16.0 using descriptive statistics only. Results: Prevalence of ST consumption among the study participants was figured to 92.5%. Out of these almost 70% suffered from one or the other form of oral lesion(s). Four major types of ST consumption were observed out of which 60 % of oral lesion were related to Gutka chewers showing early signs of oral cancer. In addition, occurrence of Oral sub-mucosal fibrosis (OSF) was found to be significantly high around 54.8%. Overall dental caries status was also high, showing on an average 5 teeth of an individual were decayed, missing or filled deviating from WHO normal criteria (mean < 3). It was thus proven from the study that public drivers relied on oral tobacco consumption because it helps them ‘Improve consciousness’ (p-value: < 0.01; using chi-square test). Multivariate analysis showed that there were higher prevalence of smokeless tobacco among highway drivers versus local drivers (A.O.R: 2.82 [0.83-9.61], p-value: < 0.01) Conclusion: Smokeless tobacco (ST) consumption has a direct effect on oral health. However, the type of ST, the duration of consumption are factors which are directly related to the severity. Moreover, Gutka may be considered as having most lethal effects on oral health which may lead to oral cancer and affect individual’s quality of life. Specific preventive programs must be undertaken to reduce the consumption of Gutka among public transporters and drivers.

Keywords: smokeless tobacco, oral lesions, drivers, public transporters

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Authors: Meriem Taleb, Ghania Tail, Fatma Zohra Kara, Brahim Djedouani, T. Moussa

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Forensic entomology has grown immensely as a discipline in the past thirty years. The main purpose of forensic entomology is to establish the post mortem interval or PMI. Three days after the death, insect evidence is often the most accurate and sometimes the only method of determining elapsed time since death. This work presents the estimation of the PMI in an experiment to test the reliability of the accumulated degree days (ADD) method and the application of this method in a real case. The study was conducted at the Laboratory of Entomology at the National Institute for Criminalistics and Criminology of the National Gendarmerie, Algeria. The domestic rabbit Oryctolagus cuniculus L. was selected as the animal model. On 08th July 2012, the animal was killed. Larvae were collected and raised to adulthood. Estimation of oviposition time was calculated by summing up average daily temperatures minus minimum development temperature (also specific to each species). When the sum is reached, it corresponds to the oviposition day. Weather data were obtained from the nearest meteorological station. After rearing was accomplished, three species emerged: Lucilia sericata, Chrysomya albiceps, and Sarcophaga africa. For Chrysomya albiceps species, a cumulation of 186°C is necessary. The emergence of adults occured on 22nd July 2012. A value of 193.4°C is reached on 9th August 2012. Lucilia sericata species require a cumulation of 207°C. The emergence of adults occurred on 23rd, July 2012. A value of 211.35°C is reached on 9th August 2012. We should also consider that oviposition may occur more than 12 hours after death. Thus, the obtained PMI is in agreement with the actual time of death. We illustrate the use of this method during the investigation of a case of a decaying human body found on 03rd March 2015 in Bechar, South West of Algerian desert. Maggots were collected and sent to the Laboratory of Entomology. Lucilia sericata adults were identified on 24th March 2015 after emergence. A sum of 211.6°C was reached on 1st March 2015 which corresponds to the estimated day of oviposition. Therefore, the estimated date of death is 1st March 2015 ± 24 hours. The estimated PMI by accumulated degree days (ADD) method seems to be very precise. Entomological evidence should always be used in homicide investigations when the time of death cannot be determined by other methods.

Keywords: forensic entomology, accumulated degree days, postmortem interval, diptera, Algeria

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Authors: Daifeng Hao, Guang Feng, Jingfeng Zhao, Tao Li, Xiaoye Tuo

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Objective: To retrospectively analyze the clinical characteristics of incision infection with sternal osteomyelitis sinus tract after cardiac surgery and the operation method and therapeutic effect of filling and repairing with activated PRP gel. Methods: From March 2011 to October 2022, 142 cases of incision infection after cardiac surgery with sternal osteomyelitis sinus were retrospectively analyzed, and the causes of poor wound healing after surgery, wound characteristics, perioperative wound management were summarized. Treatment during operation, collection and storage process of autologous PRP before debridement surgery, PRP filling repair and activation method after debridement surgery, effect of anticoagulant drugs on surgery, postoperative complications and average wound healing time, etc.. Results: Among the cases in this group, 53.3% underwent coronary artery bypass grafting, 36.8% underwent artificial heart valve replacement, 8.2% underwent aortic artificial vessel replacement, and 1.7% underwent allogeneic heart transplantation. The main causes of poor incision healing were suture reaction, fat liquefaction, osteoporosis, diabetes, and metal allergy in sequence. The wound is characterized by an infected sinus tract. Before the operation, 100-150ml of PRP with 4 times the physiological concentration was collected separately with a blood component separation device. After sinus debridement, PRP was perfused to fill the bony defect in the middle of the sternum, activated with thrombin freeze-dried powder and calcium gluconate injection to form a gel, and the outer skin and subcutaneous tissue were sutured freely. 62.9% of patients discontinued warfarin during the perioperative period, and 37.1% of patients maintained warfarin treatment. There was no significant difference in the incidence of postoperative wound hematoma. The average postoperative wound healing time was 12.9±4.7 days, and there was no obvious postoperative complication. Conclusions: Application of activated PRP gel to fill incision infection with sternal osteomyelitis sinus after cardiac surgery has a less surgical injury and satisfactory and stable curative effect. It can completely replace the previously used pectoralis major muscle flap transplantation operation scheme.

Keywords: platelet-rich plasma, negative-pressure wound therapy, sternal osteomyelitis, cardiac surgery

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Authors: Natalia Bustos Sierra, Katrien Tersago

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It is currently proven that both extremes of temperature are associated with increased mortality and that air pollution is associated with temperature. This relationship is complex, and in countries with important seasonal variations in weather such as Belgium, some effects can appear as non-significant when the analysis is done over the entire year. We, therefore, analyzed the effect of short-term outdoor air pollution exposure on cardiovascular mortality during the warmer and colder months separately. We used daily cardiovascular deaths from acute cardiovascular diagnostics according to the International Classification of Diseases, 10th Revision (ICD-10: I20-I24, I44-I49, I50, I60-I66) during the period 2008-2013. The environmental data were population-weighted concentrations of particulates with an aerodynamic diameter less than 10 µm (PM₁₀) and less than 2.5 µm (PM₂.₅) (daily average), nitrogen dioxide (NO₂) (daily maximum of the hourly average) and ozone (O₃) (daily maximum of the 8-hour running mean). A Generalized linear model was applied adjusting for the confounding effect of season, temperature, dew point temperature, the day of the week, public holidays and the incidence of influenza-like illness (ILI) per 100,000 inhabitants. The relative risks (RR) were calculated for an increase of one interquartile range (IQR) of the air pollutant (μg/m³). These were presented for the four hottest months (June, July, August, September) and coldest months (November, December, January, February) in Belgium. We applied both individual lag model and unconstrained distributed lag model methods. The cumulative effect of a four-day exposure (day of exposure and three consecutive days) was calculated from the unconstrained distributed lag model. The IQR for PM₁₀, PM₂.₅, NO₂, and O₃ were respectively 8.2, 6.9, 12.9 and 25.5 µg/m³ during warm months and 18.8, 17.6, 18.4 and 27.8 µg/m³ during cold months. The association with CV mortality was statistically significant for the four pollutants during warm months and only for NO₂ during cold months. During the warm months, the cumulative effect of an IQR increase of ozone for the age groups 25-64, 65-84 and 85+ was 1.066 (95%CI: 1.002-1.135), 1.041 (1.008-1.075) and 1.036 (1.013-1.058) respectively. The cumulative effect of an IQR increase of NO₂ for the age group 65-84 was 1.066 (1.020-1.114) during warm months and 1.096 (1.030-1.166) during cold months. The cumulative effect of an IQR increase of PM₁₀ during warm months reached 1.046 (1.011-1.082) and 1.038 (1.015-1.063) for the age groups 65-84 and 85+ respectively. Similar results were observed for PM₂.₅. The short-term effect of air pollution on cardiovascular mortality is greater during warm months for lower pollutant concentrations compared to cold months. Spending more time outside during warm months increases population exposure to air pollution and can, therefore, be a confounding factor for this association. Age can also affect the length of time spent outdoors and the type of physical activity exercised. This study supports the deleterious effect of air pollution on cardiovascular mortality (CV) which varies according to season and age groups in Belgium. Public health measures should, therefore, be adapted to seasonality.

Keywords: air pollution, cardiovascular, mortality, season

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Authors: Rehan Mohammad

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Background: Improved Water, Sanitation and Hygiene (WASH) practices in schools ensure children’s health, well-being and cognitive performance. In India under various WASH interventions in schools, teachers, and other staff make every possible effort to educate children about personal hygiene, sanitation practices and harms of open defecation. However, once children get back to their families, they see other practicing inappropriate WASH behaviors, and they consequently start following them. This show disconnect between school behavior and family behavior, which needs to be bridged to achieve desired WASH outcomes. Aims and Objectives: The aim of this study is to assess the factors causing disconnect of WASH-related behaviors between school and the family of children. It also suggests behavior change interventions to bridge the gap. Methodology: The present study has chosen a mixed- method approach. Both quantitative and qualitative methods of data collection have been used in the present study. The purposive sampling for data collection has been chosen. The data have been collected from 20% children in each age group of 04-08 years and 09-12 years spread over three primary schools and 20% of households to which they belong to which is spread over three slum communities in south district of Delhi. Results: The present study shows that despite of several behavior change interventions at school level, children still practice inappropriate WASH behaviors due to disconnect between school and family behaviors. These behaviors show variation from one age group to another. The inappropriate WASH behaviors being practiced by children include open defecation, wrong disposal of garbage, not keeping personal hygiene, not practicing hand washing practices during critical junctures and not washing fruits and vegetables before eating. The present study has highlighted that 80% of children in the age group of 04-08 years still practice inappropriate WASH behaviors when they go back to their families after school whereas, this percentage has reduced to 40% in case of children in the age group 09-12 years. Present study uncovers association between school and family teaching which creates a huge gap between WASH-related behavioral practices. The study has established that children learn and de-learn the WASH behaviors due to the evident disconnect between behavior change interventions at schools and household level. The study has also made it clear that children understand the significance of appropriate WASH practices but owing to the disconnect the behaviors remain unsettled. The study proposes several behavior change interventions to sync the behaviors of children at school and family level to ensure children’s health, well-being and cognitive performance.

Keywords: behavioral interventions, child health, family behavior, school behavior, WASH

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Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: Head and neck cancers (HNC) are often associated with the development of non-HNC primaries, as the risk factors that predispose patients to HNC are often risk factors for other cancers. Aim: We sought to evaluate whether there was an increased risk of smoking and alcohol-related cancers and also other cancers in HNC patients and to evaluate whether there is a difference between the rates of non-HNC primaries in Aboriginal compared with non-Aboriginal HNC patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single center in Western Australia, identifying 80 Aboriginal and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, treatments, outcomes, and past and subsequent HNCs and non-HNC primaries. Results: In the overall study population, there were 86 patients (26.9%) with a metachronous or synchronous non-HNC primary. Non-HNC primaries were actually significantly more common in the non-Aboriginal population compared with the Aboriginal population (30% vs. 17.5%, p=0.02); however, half of these were patients with cutaneous squamous or basal cell carcinomas (cSCC/BCC) only. When cSCC/BCCs were excluded, non-Aboriginal patients had a similar rate as Aboriginal patients (16.7% vs. 15%, p=0.73). There were clearly more cSCC/BCCs in non-Aboriginal patients compared with Aboriginal patients (16.7% vs. 2.5%, p=0.001) and more patients with melanoma (2.5% vs. 0%, p value not significant (p=NS). Rates of most cancers were similar between non-Aboriginal and Aboriginal patients, including prostate (2.9% vs. 3.8%), colorectal (2.9% vs. 2.5%), kidney (1.2% vs. 1.2%), and these rates appeared comparable to Australian Age Standardised Incidence Rates (ASIR) in the general community. Oesophageal cancer occurred at double the rate in Aboriginal patients (3.8%) compared with non-Aboriginal patients (1.7%), which was far in excess of ASIRs which estimated a lifetime risk of 0.59% in the general population. Interestingly lung cancer rates did not appear to be significantly increased in our cohort, with 2.5% of Aboriginal patients and 3.3% of non-Aboriginal patients having lung cancer, which is in line with ASIRs which estimates a lifetime risk of 5% (by age 85yo). Interestingly the rate of Glioma in the non-Aboriginal population was higher than the ASIR, with 0.8% of non-Aboriginal patients developing Glioma, with Australian averages predicting a 0.6% lifetime risk in the general population. As these are small numbers, this finding may well be due to chance. Unsurprisingly, second HNCs occurred at an increased incidence in our cohort, in 12.5% of Aboriginal patients and 11.2% of non-Aboriginal patients, compared to an ASIR of 17 cases per 100,000 persons, estimating a lifetime risk of 1.70%. Conclusions: Overall, 26.9% of patients had a non-HNC primary. When cSCC/BCCs were excluded, Aboriginal and non-Aboriginal patients had similar rates of non-HNC primaries, although non-Aboriginal patients had a significantly higher rate of cSCC/BCCs. Aboriginal patients had double the rate of oesophageal primaries; however, this was not statistically significant, possibly due to small case numbers.

Keywords: head and neck cancer, synchronous and metachronous primaries, other primaries, Aboriginal

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Authors: Zeytu G. Asfaw, Serkalem K. Abrha, Demisew G. Degefu

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Background: HIV/AIDS remains a major public health problem in Ethiopia and heavily affecting people of productive and reproductive age. We aimed to compare the performance of Parametric Survival Analysis and Bayesian Survival Analysis using simulations and in a real dataset application focused on determining predictors of HIV patient survival. Methods: A Parametric Survival Models - Exponential, Weibull, Log-normal, Log-logistic, Gompertz and Generalized gamma distributions were considered. Simulation study was carried out with two different algorithms that were informative and noninformative priors. A retrospective cohort study was implemented for HIV infected patients under Highly Active Antiretroviral Therapy in Alamata General Hospital, North Ethiopia. Results: A total of 320 HIV patients were included in the study where 52.19% females and 47.81% males. According to Kaplan-Meier survival estimates for the two sex groups, females has shown better survival time in comparison with their male counterparts. The median survival time of HIV patients was 79 months. During the follow-up period 89 (27.81%) deaths and 231 (72.19%) censored individuals registered. The average baseline cluster of differentiation 4 (CD4) cells count for HIV/AIDS patients were 126.01 but after a three-year antiretroviral therapy follow-up the average cluster of differentiation 4 (CD4) cells counts were 305.74, which was quite encouraging. Age, functional status, tuberculosis screen, past opportunistic infection, baseline cluster of differentiation 4 (CD4) cells, World Health Organization clinical stage, sex, marital status, employment status, occupation type, baseline weight were found statistically significant factors for longer survival of HIV patients. The standard error of all covariate in Bayesian log-normal survival model is less than the classical one. Hence, Bayesian survival analysis showed better performance than classical parametric survival analysis, when subjective data analysis was performed by considering expert opinions and historical knowledge about the parameters. Conclusions: Thus, HIV/AIDS patient mortality rate could be reduced through timely antiretroviral therapy with special care on the potential factors. Moreover, Bayesian log-normal survival model was preferable than the classical log-normal survival model for determining predictors of HIV patients survival.

Keywords: antiretroviral therapy (ART), Bayesian analysis, HIV, log-normal, parametric survival models

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Authors: Akbarova Gulnozakhon

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Relevance. Physical exercises can prolong the function of the growth zones of long tubular bones, delay the fusion of the epiphyses and diaphyses of bones and, thus, increase the growth of the body. At the same time, intensive strength exercises can accelerate the process of ossification of bone growth zones and slow down their growth in length. The influence of physical exercises on the process of biological maturation is noted. Gymnastics, which requires intense speed and strength loads, delays puberty. On the other hand, it is indicated that the relatively slow puberty of gymnasts is associated with the selection of girls with a special somatotype in this sport. It was found that the later onset of menstruation in female athletes does not have a negative effect on the maturation process and fertility (the ability to procreate). Observations are made about the normalizing influence of sports on the puberty of girls. The purpose of the study. Our goal is to study physical activity of varying intensity on the formation of secondary sexual characteristics and hormonal status of girls in adolescence. Each biological process peculiar to a given organism is not in a stationary state, but fluctuates with a certain frequency. According to the duration, there are, for example, circadian cycles, and infradian cycles, a typical example of which is the menstrual cycle. Materials and methods, results. Violations of menstrual function in athletes were detected by applying a questionnaire survey that contains several paragraphs and sub-paragraphs where passport data, anthropometric indicators, taking into account anthropometric indices, information about the menstrual cycle are indicated. Of 135 female athletes aged 1-3 to 16 years engaged in various sports - gymnasts, menstrual function disorders were noted in 86.7% (primary or secondary amenorrhea, irregular MC), in swimming-in 57.1%. The general condition also changes during the menstrual cycle. In a large percentage of cases, athletes indicate an increase in irritability in the premenstrual (45%) and menstrual (36%) phases. During these phases, girls note an increase in fatigue of 46.5% and 58% (respectively). In girls, secondary sexual characteristics continue to form during puberty and the clearest indicator of the onset of puberty is the age of the onset of the first menstruation - menarche. Conclusions. 1. Physical exercise has a positive effect on all major systems of the body and thus promotes health.2. Along with a beneficial effect on human health, physical exercise, if the requirements of sports are not observed, can be harmful.

Keywords: girls health, anthropometric, physical development, reproductive health

Procedia PDF Downloads 90

Authors: Reenu Yadav, Abhay Asthana, S. K. Yadav

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Purpose: The aim of the present work was to develop an oral gel for brushing with an antimicrobial activity which will cure/protect from various periodontal diseases such as periodontitis, gingivitis, and pyorrhea. Methods: Plant materials procured from local suppliers, extracted and standardized. Screening of antimicrobial activity was carried out with the help of disk diffusion method. The gel was formulated by dried extracts of Beautea monosperma and Cordia obliquus. Gels were evaluated on various parameters and standardization of the formulation was performed. The release of drugs was studied in pH 6.8 using a mastication device.Total phenolic and flavonoid contents were estimated by folin-Ciocalteu and aluminium chloride method, and stability studies were performed (40°C and RH 75% ± 5% for 90 days) to assess the effect of temperature and humidity on the concentration of phenolic and flavonoid contents. The results of accelerated stability conditions were compared with that of samples kept at controlled conditions (RT). The control samples were kept at room temperature (25°C, 35% RH for 180 days). Results: Results are encouraging; extracts possess significant antimicrobial activity at very low concentration (15µg/disc, 20µg/disc and 15 µg/ disc) on oral pathogenic bacteria. The formulation has optimal characteristics, as well as has a pleasant appearance, fragrance, texture, and taste, is highly acceptable by the volunteers. The diffusion coefficient values ranged from 0.6655 to 0.9164. Since the R values of korsmayer papas were close to 1, Drug release from formulation follows matrix diffusion kinetics. Hence, diffusion was the mechanism of the drug release. Formulation follows non-Fickian transport mechanism. Most Formulations released 50 % of their contents within 25-30 minutes. Results obtained from the accelerated stability studies are indicative of a slight reduction in flavonoids and phenolic contents with time on long time storage. When measured degradation under ambient conditions, degradation was significantly lower than in accelerated stability study. Conclusion: Plant extracts possess compounds with antimicrobial properties can be used as. Developed formulation will cure/protect from various periodontal diseases. Further development and evaluations oral gel including the isolated compounds on the commercial scale and their clinical and toxicological studies are the future challenges.

Keywords: herbal gel, dental care, ambient conditions, commercial scale

Procedia PDF Downloads 427

Authors: Alexander A. Osmolovskiy, Anastasia V. Orekhova, Daria M. Bednenko, Yelyzaveta Boiko

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Micromycetes from Aspergillus genus can produce proteases capable of promoting proteolysis of hemostasis proteins or, along with hydrolytic activity, to show the ability to convert proenzymes of this system activating them into an active form. At the same time, practical medicine needs specific activators for quantitation of the level of some plasma enzymes, especially protein C and factor X, the lack of which leads to the development of thromboembolic diseases. Thus, some micromycetes of the genus Aspergillus were screened for the ability to synthesize extracellular proteases with promising activity for designing anti-thrombotic and diagnostic preparations. Such standard methods like salting out, electrophoresis, isoelectrofocusing were used for isolation, purification and study of physicochemical properties of proteases. Enzyme activity was measured spectrophotometrically fibrin as a substrate of the reaction and chromogenic peptide substrates of different proteases of the human hemostasis system. As a result of the screening, four active producers were selected: Aspergillus janus 301, A. flavus 1, A. terreus 2, and A. ochraceus L-1. The enzyme of A. janus 301 showed the greatest fibrinolytic activity (around 329.2 μmol Tyr/(ml × min)). The protease produced by A. terreus 2 had the highest plasmin-like activity (54.1 nmol pNA/(ml × min)), but fibrinolytic activity was lower than A. janus 301 demonstrated (25.2 μmol Tyr/(ml × min)). For extracellular protease of micromycete A. flavus a high plasmin-like activity was also shown (39.8 nmol pNA / (ml × min)). Moreover, according to our results proteases one of the fungi - A. terreus 2 were able to activate protein C of human plasma - the key factor of the human anticoagulant hemostasis system. This type of activity was 39.8 nmol pNA/(ml × min)). It was also shown that A. ochraceus L-1 could produce extracellular proteases with protein C and factor X activator activities (65.9 nmol pNA/(ml × min) and 34.6 nmol pNA/(ml × min) respectively). The maximum accumulation of the proteases falls on the 4th day of cultivation. Using isoelectrofocusing was demonstrated that the activation of both proenzymes might proceed via limited proteolysis induced by proteases of A. ochraceus L-1. The activatory activity of A. ochraceus L-1 proteases toward essential hemostatic proenzymes, protein C and X factor may be useful for practical needs. It is well known that similar enzymes, activators of protein C and X factor isolated from snake venom, South American copperhead Agkistrodon contortrix contortrix and Russell’s viper Daboia russelli russeli, respectively, are used for the in vitro diagnostics of the functional state of these proteins in blood plasma. Thus, the proteases of Aspergillus genus can be used as cheap components for enzyme thrombolytic preparations.

Keywords: anti-trombotic drugs, fibrinolysis, diagnostics, proteases, micromycetes

Procedia PDF Downloads 119

Authors: T. Schmitt, J. Rosin, C. Butenweg

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Seismic design of buried pipeline systems for energy and water supply is not only important for plant and operational safety, but in particular for the maintenance of supply infrastructure after an earthquake. Past earthquakes have shown the vulnerability of pipeline systems. After the Kobe earthquake in Japan in 1995 for instance, in some regions the water supply was interrupted for almost two months. The present paper shows special issues of the seismic wave impacts on buried pipelines, describes calculation methods, proposes approaches and gives calculation examples. Buried pipelines are exposed to different effects of seismic impacts. This paper regards the effects of transient displacement differences and resulting tensions within the pipeline due to the wave propagation of the earthquake. Other effects are permanent displacements due to fault rupture displacements at the surface, soil liquefaction, landslides and seismic soil compaction. The presented model can also be used to calculate fault rupture induced displacements. Based on a three-dimensional Finite Element Model parameter studies are performed to show the influence of several parameters such as incoming wave angle, wave velocity, soil depth and selected displacement time histories. In the computer model, the interaction between the pipeline and the surrounding soil is modeled with non-linear soil springs. A propagating wave is simulated affecting the pipeline punctually independently in time and space. The resulting stresses mainly are caused by displacement differences of neighboring pipeline segments and by soil-structure interaction. The calculation examples focus on pipeline bends as the most critical parts. Special attention is given to the calculation of long-distance heat pipeline systems. Here, in regular distances expansion bends are arranged to ensure movements of the pipeline due to high temperature. Such expansion bends are usually designed with small bending radii, which in the event of an earthquake lead to high bending stresses at the cross-section of the pipeline. Therefore, Karman's elasticity factors, as well as the stress intensity factors for curved pipe sections, must be taken into account. The seismic verification of the pipeline for wave propagation in the soil can be achieved by observing normative strain criteria. Finally, an interpretation of the results and recommendations are given taking into account the most critical parameters.

Keywords: buried pipeline, earthquake, seismic impact, transient displacement

Procedia PDF Downloads 171

Authors: I. Irska, S. Paszkiewicz, D. Pawlikowska, E. Piesowicz, A. Linares, T. A. Ezquerra

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Due to the number of advantages such as high tensile strength, sensitivity to hydrolytic degradation, and biocompatibility poly(lactic acid) (PLA) is one of the most common polyesters for biomedical and pharmaceutical applications. However, PLA is a rigid, brittle polymer with low heat distortion temperature and slow crystallization rate. In order to broaden the range of PLA applications, it is necessary to improve these properties. In recent years a number of new strategies have been evolved to obtain PLA-based materials with improved characteristics, including manipulation of crystallinity, plasticization, blending, and incorporation into block copolymers. Among the other methods, synthesis of aliphatic-aromatic copolyesters has been attracting considerable attention as they may combine the mechanical performance of aromatic polyesters with biodegradability known from aliphatic ones. Given the need for highly flexible biodegradable polymers, in this contribution, a series of aromatic-aliphatic based on poly(butylene terephthalate) and poly(lactic acid) (PBT-b-PLA) copolyesters exhibiting superior mechanical properties were copolymerized with an additional poly(tetramethylene oxide) (PTMO) soft block. The structure and properties of both series were characterized by means of attenuated total reflectance – Fourier transform infrared spectroscopy (ATR-FTIR), nuclear magnetic resonance spectroscopy (¹H NMR), differential scanning calorimetry (DSC), wide-angle X-ray scattering (WAXS) and dynamic mechanical, thermal analysis (DMTA). Moreover, the related changes in tensile properties have been evaluated and discussed. Lastly, the viscoelastic properties of synthesized poly(ester-ether) copolymers were investigated in detail by step cycle tensile tests. The block lengths decreased with the advance of treatment, and the block-random diblock terpolymers of (PBT-ran-PLA)-b-PTMO were obtained. DSC and DMTA analysis confirmed unambiguously that synthesized poly(ester-ether) copolymers are microphase-separated systems. The introduction of polyether co-units resulted in a decrease in crystallinity degree and melting temperature. X-ray diffraction patterns revealed that only PBT blocks are able to crystallize. The mechanical properties of (PBT-ran-PLA)-b-PTMO copolymers are a result of a unique arrangement of immiscible hard and soft blocks, providing both strength and elasticity.

Keywords: aliphatic-aromatic copolymers, multiblock copolymers, phase behavior, thermoplastic elastomers

Procedia PDF Downloads 124

Authors: Murad A. Channa, Mehdi Khiadani. Yasir Al-Abdeli

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Considering the severity of water scarcity around the world and its widening at an alarming rate, practical improvements in desalination techniques need to be engineered at the earliest. Atomization is the major aspect of flashing phenomena, yet it has been paid less attention to until now. There is a need to test efficient ways of atomization for the flashing process. Flash evaporation together with reverse osmosis is also a commercially matured desalination technique commonly famous as Multi-stage Flash (MSF). Even though reverse osmosis is massively practical, it is not economical or sustainable compared to flash evaporation. However, flashing evaporation has its drawbacks as well such as lower efficiency of water production per higher consumption of power and time. Flash evaporation is simply the instant boiling of a subcooled liquid which is introduced as droplets in a well-maintained negative environment. This negative pressure inside the vacuum increases the temperature of the liquid droplets far above their boiling point, which results in the release of latent heat, and the liquid droplets turn into vapor which is collected to be condensed back into an impurity-free liquid in a condenser. Atomization is the main difference between pool and spray flash evaporation. Atomization is the heart of the flash evaporation process as it increases the evaporating surface area per drop atomized. Atomization can be categorized into many levels depending on its drop size, which again becomes crucial for increasing the droplet density (drop count) per given flow rate. This review comprehensively summarizes the selective results relating to the methods of atomization and their effectiveness on the evaporation rate from earlier works to date. In addition, the reviewers propose using centrifugal atomization for the flashing application, which brings several advantages viz ultra-fine droplets, uniform droplet density, and the swirling geometry of the spray with kinetically more energetic sprays during their flight. Finally, several challenges of using rotary bell atomizer (RBA) and RBA Sprays inside the chamber have been identified which will be explored in detail. A schematic of rotary bell atomizer (RBA) integration with the chamber has been designed. This powerful centrifugal atomization has the potential to increase potable water production in commercial multi-stage flash evaporators, where it would be preferably advantageous.

Keywords: atomization, desalination, flash evaporation, rotary bell atomizer

Procedia PDF Downloads 64

Authors: Siti Nur Syazni Mohd Zuki, Tan Ling Ling, Nina Suhaity Azmi, Chong Kwok Feng, Lee Yook Heng

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Nitrite (NO2-) ion is used prevalently as a preservative in processed meat. Elevated levels of nitrite also found in edible bird’s nests (EBNs). Consumption of NO2- ion at levels above the health-based risk may cause cancer in humans. Spectrophotometric Griess test is the simplest established standard method for NO2- ion detection, however, it requires careful control of pH of each reaction step and susceptible to strong oxidants and dyeing interferences. Other traditional methods rely on the use of laboratory-scale instruments such as GC-MS, HPLC and ion chromatography, which cannot give real-time response. Therefore, it is of significant need for devices capable of measuring nitrite concentration in-situ, rapidly and without reagents, sample pretreatment or extraction step. Herein, we constructed a microspheres-based microbial optode for visual quantitation of NO2- ion. Raoutella planticola, the bacterium expressing NAD(P)H nitrite reductase (NiR) enzyme has been successfully extracted by microbial technique from EBN collected from local birdhouse. The whole cells and the lipophilic Nile Blue chromoionophore were physically absorbed on the photocurable poly(n-butyl acrylate-N-acryloxysuccinimide) [poly (nBA-NAS)] microspheres, whilst the reduced coenzyme NAD(P)H was covalently immobilized on the succinimide-functionalized acrylic microspheres to produce a reagentless biosensing system. Upon the NiR enzyme catalyzes the oxidation of NAD(P)H to NAD(P)+, NO2- ion is reduced to ammonium hydroxide, and that a colour change from blue to pink of the immobilized Nile Blue chromoionophore is perceived as a result of deprotonation reaction increasing the local pH in the microspheres membrane. The microspheres-based optosensor was optimized with a reflectance spectrophotometer at 639 nm and pH 8. The resulting microbial bio-optode membrane could quantify NO2- ion at 0.1 ppm and had a linear response up to 400 ppm. Due to the large surface area to mass ratio of the acrylic microspheres, it allows efficient solid state diffusional mass transfer of the substrate to the bio-recognition phase, and achieve the steady state response as fast as 5 min. The proposed optical microbial biosensor requires no sample pre-treatment step and possesses high stability as the whole cell biocatalyst provides protection to the enzymes from interfering substances, hence it is suitable for measurements in contaminated samples.

Keywords: acrylic microspheres, microbial bio-optode, nitrite ion, reflectometric

Procedia PDF Downloads 422

Authors: Victoria L. Nkosi, Parvaneh Farhangpour

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Often a Grade 12 certificate is perceived as a passport to tertiary education and the minimum requirement to enter the world of work. In spite of its importance, many students do not make this milestone in South Africa. It is important to find out why so many students still fail in spite of transformation in the education system in the post-apartheid era. Given the complexity of education and its context, this study adopted a case study design to examine one historically underperforming high school in Bushbuckridge, Mpumalanga Province, South Africa in 2013. The aim was to gain a understanding of the inner and outer school contextual factors associated with the high failure rate among Grade 12 students.  Government documents and reports were consulted to identify factors in the district and the village surrounding the school and a student survey was conducted to identify school, home and student factors. The randomly-sampled half of the population of Grade 12 students (53) participated in the survey and quantitative data are analyzed using descriptive statistical methods. The findings showed that a host of factors is at play. The school is located in a village within a municipality which has been one of the poorest three municipalities in South Africa and the lowest Grade 12 pass rate in the Mpumalanga province.   Moreover, over half of the families of the students are single parents, 43% are unemployed and the majority has a low level of education. In addition, most families (83%) do not have basic study materials such as a dictionary, books, tables, and chairs. A significant number of students (70%) are over-aged (+19 years old); close to half of them (49%) are grade repeaters. The school itself lacks essential resources, namely computers, science laboratories, library, and enough furniture and textbooks. Moreover, teaching and learning are negatively affected by the teachers’ occasional absenteeism, inadequate lesson preparation, and poor communication skills. Overall, the continuous low performance of students in this school mirrors the vicious circle of multiple negative conditions present within and outside of the school. The complexity of factors associated with the underperformance of Grade 12 students in this school calls for a multi-dimensional intervention from government and stakeholders. One important intervention should be the placement of over-aged students and grade-repeaters in suitable educational institutions for the benefit of other students.

Keywords: inner context, outer context, over-aged students, vicious cycle

Procedia PDF Downloads 191

Authors: Mónika Ditta Tóth, Ádám Fritz, Balázs Hankó, György Purebl

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Communication training about depression and suicide prevention for pharmacists – A Hungarian pilot study Mónika Ditta Tóth1, Ádám Fritz2, Balázs Hankó2, György Purebl1 1: Semmelweis University, Institute of Behavioural Sciences 2: Semmelweis University, University Pharmacy Department of Pharmacy Administration Background: Suicide rates in Hungary have been one of the highest in the European Union. Depression is one of the main risk factors for suicide and recognizing and treating depression is an effective way to prevent suicidal behaviour. In their daily practice, pharmacists meet patients with high risk of mental health problems. Therefore they have a key role in the prevention of depression and suicide. Aim: The main aim of this study is to raise pharmacists’ awareness about depression and suicide to enable better recognation of verbal and non-verbal signs of these deseases. Another important objective is to reduce their stigma about depression and increase their confidence in communication with depressed and/or suicidal patients. Methods: A 3-hour communication workshop has been delivered in this pilot study about the reasons, trigger factors, verbal and non-verbal signs of depression and suicide. The training includes communication techniques which have been developed to patients needs, as well as role-playing scenarios. Depression Stigma and Morris Confidence Scales were applied before, after and 6 weeks following the training. The results of the training group are then compared with two of the following pharmacist groups: 1. written material only (N=15), 2. no material (N=15). Results: One-way ANOVA revealed significant differences in the training group regarding the level of confidence in treating and communicating with patients with depression and/or suicide following the training, and after 6 weeks (F(2, 24)= 7,135, p=,004; baseline: 20,37, after training: 30,00, follow up: 27,66). After the 3-hour workshop the personal stigma about depression decreased (baselin: 19,75 after training: 17,00, p=0,075) in the training group (N=9), whilst the perceived stigma did not change (before: 33.54, after: 33,44, p=NS). Trainees assessed the workshop as ‘useful’ and ‘gap filling’. No significant differences was found in the group of pharmacisists who got written material only. Conclusions: Despite the high rates of depression and suicide in Hungary, pharmacists do not receive lectures or seminars about mental health during their university studies. Such half-day workshops could fill this gap and give practical help to recognize and communicate with depressed and/or suicidal patients in a more effective way. This way pharmacists, as community gate-keepers, could contribute to a more effective suicide prevention program in Hungary.

Keywords: communication training, pharmacists, depression, suicide

Procedia PDF Downloads 169

Authors: Yufeng Wu, Yifan Gu, Bin Li, Wei Wang

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Resource recycling process contains a subsystem with interactions of three dimensions including coupling allocation of primary and secondary resources, responsibility coordination of stakeholders in forward and reverse supply chains, and trans-boundary transfer of hidden resource and environmental responsibilities between regions. Overlap or lack of responsibilities is easy to appear at the intersection of the three management dimensions. It is urgent to make an overall design of the policy system for recycling resources. From theoretical perspective, this paper analyzes the unique external differences of resource and environment in various dimensions and explores the reason why the effects of trans-dimensional policies are strongly correlated. Taking the example of the copper resources contained in the waste electrical and electronic equipment, this paper constructs reduction effect accounting model of resources recycling and set four trans-dimensional policy scenarios including resources tax and environmental tax reform of the raw and secondary resources, application of extended producer responsibility system, promotion of clean development mechanism, and strict entry barriers of imported wastes. In these ways, the paper simulates the impact effect of resources recycling process on resource deduction and emission reduction of waste water and gas, and constructs trans-dimensional policy mix scenario through integrating dominant strategy. The results show that combined application of various dimensional policies can achieve incentive compatibility and the trans-dimensional policy mix scenario can reach a better effect. Compared with baseline scenario, this scenario will increase 91.06% copper resources reduction effect and improve emission reduction of waste water and gas by eight times from 2010 to 2030. This paper further analyzes the development orientation of policies in various dimension. In resource dimension, the combined application of compulsory, market and authentication methods should be promoted to improve the use ratio of secondary resources. In supply chain dimension, resource value, residual functional value and potential information value contained in waste products should be fully excavated to construct a circular business system. In regional dimension, it should give full play to the comparative advantages of manufacturing power to improve China’s voice in resource recycling in the world.

Keywords: resource recycling, trans-dimension, policy design, incentive compatibility, life cycle

Procedia PDF Downloads 110

Authors: A. H. Taghdisi, M. Mirmohammadi, S. Kamali

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Evening primrose (Oenothera biennis L.) is a biennial and herbaceous and one of the most important species of medicinal plants in the world. due to the production of unsaturated fatty acids such as linoleic acid, alpha-linolenic acid, etc. in its seeds and roots, and compounds such as kaempferol in its leaves, Evening primrose has important medicinal efficiency such as reducing premenstrual problems, acceleration of wound healing, inhibiting platelet aggregation, sedation of cardiovascular diseases, and treatment of viral infections. The sap of the plant is used to treat warts, and the plant itself is used as a charm against mental and spiritual diseases and poisonous animals. Its leaves have significant antibacterial activity against yellow staphylococci. It is also used in the treatment of poisoning, especially the toxication caused by the consumption of alcoholic beverages, in the treatment of arteriosclerosis and diseases caused by liver cell insufficiency. Low germination and production speed are the problems of evening primrose growth and propagation. In the present study, extracts were obtained from four components (flowers, stems, seeds, leaves) of the evening primrose plant using the Soxhlet apparatus. To measure the antibacterial properties against MDR bacteria, microbial methods, including dilution, cultivation on a plate containing nutrient agar culture medium, and disc diffusion in agar, were performed using Staphylococcus aureus and Escherichia coli bacteria on all four extracts. The maximum antibacterial activity related to the dilution method was obtained in all extracts. In the plate culture method, antibacterial activity was obtained for all extracts in the nutrient agar medium. The maximum diameter of the non-growth halo was obtained in the disc diffusion method in agar in the leaf extract. The statistical analysis of the microbial part was done by one-way ANOVA test (SPSS). By comparing the amount of omega-3 in extracts of Iranian and foreign oils available in the market and the extracts extracted from evening primrose plant samples with gas chromatography, it is shown that the stem extract had the most omega-3 (oleic acid) and compared to the extract of the mentioned oils, it had the highest amount of omega-3 overall. Also, the amount of omega-3 in the extract of Iranian oils was much higher than in the extract of foreign oils. It should be noted that the extract of foreign oils had a more complete composition of omega-3 than the extract of Iranian oils.

Keywords: antibacterial activity, MDR bacteria, evening primrose, omega-3

Procedia PDF Downloads 82

Authors: Perpetual Onyejelem, Kenichi Matsui

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Solid waste management is one essential area for urban administration to achieve environmental sustainability. Proper solid waste management (SWM) improves the environment by reducing diseases and increasing public health. On the other way, improper SWM practices negatively impact public health and environmental sustainability. This article evaluates SWM in Port Harcourt, Nigeria, with the goal of determining the current solid waste management practices and their health implications. This study used secondary data, which relies on existing published literature and official documents. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and its four-stage inclusion/exclusion criteria were utilized as part of a systematic literature review technique to locate the literature that concerns SWM practices and the implementation of solid waste management policies between 2014-2023 in PortHarcourt and its health effects from specific databases (Scopus and Google Scholar). The results found that despite the existence and implementation of the Rivers State Waste Management Policy and the formulation of the National Policy on Solid Waste Management in Port Harcourt, residents continued to dump waste in drainages. They were unaware of waste sorting and dumped waste haphazardly. This trend has persisted due to a lack of political commitment to the effective implementation and monitoring of policies and strategies and a lack of training provided to waste collectors regarding the SWM approach, which involves sorting and separating waste. In addition, inadequate remuneration for waste collectors, the absence of community participation in policy formulation, and insufficient awareness among residents regarding the 3R approach are also contributory factors. This caused the emergence of vector-borne diseases such as malaria, lassa fever, and cholera in Port Harcourt, increasing the expense of healthcare for locals, particularly low-income households. The study urges the government to prioritize protecting the health of its citizens by studying the methods other nations have taken to address the problem of solid waste management and adopting those that work best for their region. The bottom-up strategy should be used to include locals in developing solutions. However, citizens who are always the most impacted by this issue should launch initiatives to address it and put pressure on the government to assist them when they have limitations.

Keywords: health effects, solid waste management practices, environmental pollution, Port-Harcourt

Procedia PDF Downloads 45

Authors: Qian Mao, Xiaozan Wang, Jiarong Zhong, Xiaolin Zou

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Introduction: As a result of the decline of students' physical health level and the increase of study pressure, students’ academic performance is not so good. Objective: This study aims to verify whether the Brain-Break intervention in the fourth-grade classroom of primary school can improve students' physical health and academic performance. Methods: According to the principle of no difference in pre-test data, students from two classes of grade four in Fuhai Road Primary School, Fushan district, Yantai city, Shandong province, were selected as experimental subjects, including 50 students in the experimental class (25 males and 25 females) and 50 students in the control class (24 males and 26 females). The content of the experiment was that the students were asked to perform a 4-minute Brain-Berak program designed by the researcher in the second class in the morning and the afternoon, and the intervention lasted for 12 weeks. In addition, the lung capacity, 50-meter run, sitting body forward bend, one-minute jumping rope and one-minute sit-ups stipulated in the national standards for physical fitness of students (revised in 2014) were selected as the indicators of physical health. The scores of Chinese, Mathematics, and English in the unified academic test of the municipal education bureau were selected as the indicators of academic performance. The independent-sample t-test was used to compare and analyze the data of each index between the two classes. The paired-sample t-test was used to compare and analyze the data of each index in the two classes. This paper presents only results with significant differences. Results: in terms of physical health, lung capacity (P=0.002, T= -2.254), one-minute rope skipping (P=0.000, T=3.043), and one-minute sit-ups (P=0.045, T=6.153) were significantly different between the experimental class and the control class. In terms of academic performance, there is a significant difference between the Chinese performance of the experimental class and the control class (P=0.009, T=4.833). Conclusion: Adding Brain-Berak intervention in the classroom can effectively improve the cardiorespiratory endurance (lung capacity), coordination (jumping rope), and abdominal strength (sit-ups) of fourth-grade students. At the same time, it can also effectively improve their Chinese performance. Therefore, it is suggested to promote micro-sports in the classroom of primary schools throughout the country so as to help students improve their physical health and academic performance.

Keywords: academic performance, brain break, fourth grade, physical health

Procedia PDF Downloads 91

Authors: Rostyslav Horbay, Nick Korolis, Vahid Anvari, Rostyslav Stoika

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Introduction: Giant cancer cells (GCC) are common in all types of cancer, especially after poor therapy. Some specific features of such cells include ~10-fold enlargement, drug resistance, and the ability to propagate similar daughter cells. We used murine NK/Ly lymphoma, an aggressive and fast growing lymphoma model that has already shown drastic changes in GCC comparing to parental cells (chromatin condensation, nuclear fragmentation, tighter OXPHOS/cellular respiration coupling, multidrug resistance). Materials and methods: In this study, we compared morpho-functional changes of GCC that predominantly show either a cytostatic or a cytotoxic effect after treatment with drugs. We studied the effect of a combined cytostatic/cytotoxic drug treatment to determine the correlation of drug efficiency and GCC formation. Doses of G1/S-specific drug paclitaxel/PTX (G2/M-specific, 50 mg/mouse), vinblastine/VBL (50 mg/mouse), and DNA-targeting agents doxorubicin/DOX (125 ng/mouse) and cisplatin/CP (225 ng/mouse) on C57 black mice. Several tests were chosen to estimate morphological and physiological state (propidium iodide, Rhodamine-123, DAPI, JC-1, Janus Green, Giemsa staining and other), which included cell integrity, nuclear fragmentation and chromatin condensation, mitochondrial activity, and others. A single and double factor ANOVA analysis were performed to determine correlation between the criteria of applied drugs and cytomorphological changes. Results: In all cases of treatment, several morphological changes were observed (intracellular vacuolization, membrane blebbing, and interconnected mitochondrial network). A lower gain in ascites (49.97% comparing to control group) and longest lifespan (22+9 days) after tumor injection was obtained with single VBL and single DOX injections. Such ascites contained the highest number of GCC (83.7%+9.2%), lowest cell count number (72.7+31.0 mln/ml), and a strong correlation coefficient between increased mitochondrial activity and percentage of giant NK/Ly cells. A high number of viable GCC (82.1+9.2%) was observed compared to the parental forms (15.4+11.9%) indicating that GCC are more drug resistant than the parental cells. All this indicates that the giant cell formation and its ability to obtain drug resistance is an expanding field in cancer research.

Keywords: ANOVA, cisplatin, doxorubicin, drug resistance, giant cancer cells, NK/Ly lymphoma, paclitaxel, vinblastine

Procedia PDF Downloads 201

Authors: Safar Ghaedrahmati, Leila Soltani

Abstract:

Population centralization in urban area and metropolitans, especially in developing countries such as Iran increase metropolitan's problems. For few decades, the population of cities in developing countries, including Iran had a higher growth rate than the total growth rate of countries’ population. While in developed countries, the development of the big cities began decades ago and generally allowed for controlled and planned urban expansion, the opposite is the case in developing countries, where rapid urbanization process is characterized by an unplanned existing urban expansion. The developing metropolitan cities have enormous difficulties in coping both with the natural population growth and the urban physical expansion. Iranian cities are usually the heart of economic and cultural changes that have occurred after the Islamic revolution in 1979. These cities are increasingly having impacts via political–economical arrangement and chiefly by urban management structures. Structural features have led to the population growth of cities and urbanization (in number, population and physical frame) and the main problems in them. On the other hand, the lack of birth control policies and the deceptive attractions of cities, particularly big cities, and the birth rate has shot up, something which has occurred mainly in rural regions and small cities. The population of Iran has increased rapidly since 1956. The 1956 and 1966 decennial censuses counted the population of Iran at 18.9 million and 25.7 million, respectively, with a 3.1% annual growth rate during the 1956–1966 period. The 1976 and 1986 decennial censuses counted Iran’s population at 33.7 and 49.4 million, respectively, a 2.7% and 3.9% annual growth rate during the 1966–1976 and 1976–1986 periods. The 1996 count put Iran’s population at 60 million, a 1.96% annual growth rate from 1986–1996 and the 2006 count put Iran population at 72 million. A recent major policy of urban economic and industrial decentralization is a persistent program of the government. The policy has been identified as a result of the massive growth of Tehran in the recent years, up to 9 million by 2010. Part of the growth of the capitally resulted from the lack of economic opportunities elsewhere and in order to redress the developing primacy of Tehran and the domestic pressures which it is undergoing, the policy of decentralization is to be implemented as quickly as possible. Type of research is applied and method of data collection is documentary and methods of analysis are; population analysis with urban system analysis and urban distribution system

Keywords: population centralization, cities of Iran, urban centralization, urban system

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Authors: Paulo Sérgio Ribeiro de Araújo Bogas

Abstract:

Although several studies have assumed (at least implicitly) that learners' approaches to learning develop into deeper approaches to higher education, there appears to be no clear theoretical basis for this assumption and no empirical evidence. As a scientific contribution to this discussion, a pedagogical intervention of a quasi-experimental nature was developed, with a mixed methodology, evaluating the intervention within a single curricular unit of Marketing, using cases based on real challenges of brands, business simulation, and customer projects. Primary and secondary experiences were incorporated in the intervention: the primary experiences are the experiential activities themselves; the secondary experiences result from the primary experience, such as reflection and discussion in work teams. A diversified learning relationship was encouraged through the various connections between the different members of the learning community. The present study concludes that in the same context, the student's responses can be described as students who reinforce the initial deep approach, students who maintain the initial deep approach level, and others who change from an emphasis on the deep approach to one closer to superficial. This typology did not always confirm studies reported in the literature, namely, whether the initial level of deep processing would influence the superficial and the opposite. The result of this investigation points to the inclusion of pedagogical and didactic activities that integrate different motivations and initial strategies, leading to the possible adoption of deep approaches to learning since it revealed statistically significant differences in the difference in the scores of the deep/superficial approach and the experiential level. In the case of real challenges, the categories of “attribution of meaning and meaning of studied” and the possibility of “contact with an aspirational context” for their future professional stand out. In this category, the dimensions of autonomy that will be required of them were also revealed when comparing the classroom context of real cases and the future professional context and the impact they may have on the world. Regarding the simulated practice, two categories of response stand out: on the one hand, the motivation associated with the possibility of measuring the results of the decisions taken, an awareness of oneself, and, on the other hand, the additional effort that this practice required for some of the students.

Keywords: experiential learning, higher education, mixed methods, reflective learning, marketing

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Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

Abstract:

The improvement of surgical techniques in recent years has reduced the frequency of postoperative complications in kidney transplant recipients. Novel immunosuppressive agents have reduced rates of graft loss due to acute rejection to less than 1%. However, surgical complications may still lead graft loss and morbidity in recipients. Because of potent immunosuppression, impaired wound healing and complications are frequent after transplantation. We compared the frequency of post-operative surgical complications in diabetic and non-diabetic patients after kidney transplantation. Materials and Methods: This retrospective study conducted in consecutive patients (213 females, 285 males, median age 39 years) who underwent kidney transplant surgery at our center between December 2005 and October 2015. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). Characteristics of both groups were obtained from medical records. Results: We performed 225 living and 273 deceased donor transplantations. Renal replacement type was hemodialysis in 60.8%, peritoneal dialysis in 17.3% and preemptive in 12%. The mean body mass indexes of the recipients were 24 ± 4.6 kg/m², donor age was 48.6 ± 14.3 years, cold ischemic time was 11.3 ± 6.1 hours, surgery time was 4.9 ± 1.2 hours, and recovery time was 54±31 min. The mean hospitalization duration was 19.1 ± 13.5 days. The frequency of postoperative surgical complications was 43.8%. There was no significant difference between the ratios of post-operative surgical complications in non-diabetic (43.5%) and diabetic (47.4%) groups (p=0.648). Post-operative surgical complications were lymphocele (24.6% vs. 23.7%), delayed wound healing (13.2% vs. 7.6%), hematoma (7.8% vs.15.8 %), urinary leak (4.6% vs. 5.3%), hemorrhage (5.1% vs. 0%), hydronephrosis (2.2% vs. 0%), renal artery thrombosis (1.5% vs. 0%), renal vein thrombosis (1% vs. 2.6%), urinoma (0.7% vs. 0%), urinary obstruction (0.5% vs. 0%), ureteral stenosis (0.5% vs. 0%) and ureteral reflux (0.2% vs. 0%) in non-diabetic and diabetic groups, respectively (p > 0.05). Mean serum creatinine levels in non-diabetics and diabetics were 1.43 ± 0.81 and 1.61 ± 0.96 mg/dL at 1st month (p=0.198). At the 6th month, the mean graft and patient survival times in patients with post-operative surgical complications were significantly lower than in those who did not (162.9 ± 3.4 vs. 175.6 ± 1.5 days, p=0.008, and 171 ± 2.9 vs. 176.1 ± 1.6 days, p=0.047, respectively). However, patient survival durations of non-diabetic (173 ± 27) and diabetic (177 ± 13 day) groups were comparable (p=0.396). Conclusion: As a result, we concluded that surgical complications such as lymphocele and delayed wound healing were common and that frequency of these complications in diabetic recipients did not differ from non-diabetic one. All persons involved in the postoperative care of kidney transplant recipients be aware of the potential surgical complications for rapid diagnosis and treatment.

Keywords: kidney transplantation, diabetes mellitus, surgery, complication

Procedia PDF Downloads 167