Search results for: pile head department

Authors: Sharda Kumari, Saiman Shetty

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Autonomous trucking is just one of the numerous significant shifts impacting fleet management services. The Society of Automotive Engineers (SAE) has defined six levels of vehicle automation that have been adopted internationally, including by the United States Department of Transportation. On public highways in the United States, organizations are testing driverless vehicles with at least Level 4 automation which indicates that a human is present in the vehicle and can disable automation, which is usually done while the trucks are not engaged in highway driving. However, completely driverless vehicles are presently being tested in the state of California. While autonomous trucking can increase safety, decrease trucking costs, provide solutions to trucker shortages, and improve efficiencies, logistics, too, requires advancements to keep up with trucking innovations. Given that artificial intelligence, machine learning, and automated procedures enable people to do their duties in other sectors with fewer resources, CRM (Customer Relationship Management) can be applied to the autonomous trucking business to provide the same level of efficiency. In a society witnessing significant digital disruptions, fleet management is likewise being transformed by technology. Utilizing strategic alliances to enhance core services is an effective technique for capitalizing on innovations and delivering enhanced services. Utilizing analytics on CRM systems improves cost control of fuel strategy, fleet maintenance, driver behavior, route planning, road safety compliance, and capacity utilization. Integration of autonomous trucks with automated fleet management, yard/terminal management, and customer service is possible, thus having significant power to redraw the lines between the public and private spheres in autonomous trucking logistics.

Keywords: autonomous vehicles, customer relationship management, customer experience, autonomous trucking, digital transformation

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Authors: Emna Ketata, Wafa Farhat

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Introduction: Hyponatremia is defined by a blood sodium level of ≤ 136 mmol/L; it is associated with a high risk of morbidity and mortality in the emergency room. This was explained by transit disorders, including diarrhea and inappropriate antidiuretic hormone secretion (Syndrome of inappropriate antidiuretic hormone secretion). Pneumonia can cause dyspnea, stress-causing SIADH and digestive symptoms (diarrhea and vomiting). Aim: The purpose of this study was to determine the link between pneumonia and hyponatremia as a predictor of patient’s prognosis and intra-hospital mortality. Methodology: This is a prospective observational study over a period of 3 years in the emergency department. Inclusion :patients (age > 14 years), with clinical signs in favor of pneumonia. Natremia was measured. Natremia was classified as mild to moderate with a blood sodium level between 121 and 135 mmol/L and as severe with a blood sodium level ≤ 120 mmol/L. Results: This study showed an average serum sodium value of 135 mmol/L (range 114–159 mmol/L) in these patients. Hyponatremia was observed in 123 patients (43.6%), 115 patients (97,8%) had mild to moderate hyponatremia and 2,8% had severe hyponatremia. The mean age was 65±17 years with a sex ratio of 1.05. The main reason for consultation in patients with hyponatremia was cough in 58 patients (47.2%), and digestive symptoms were present in 25 patients (20.3. An altered state of consciousness was observed in 11 patients (3%). Patients with hyponatremia had greater heart rate (p=0.02),white blood cell count (p=0.009) , plasmatic lactate (p=0.002) and higher rate of pneumonia recurrence (p=0.001) .In addition, 80% of them have a positive CURB65 score (>=2). hyponatremia had higher rates of use of oxygen therapy compared to patients with normo-natremia (54% vs. 45%). The analytical study showed that hyponatremia is significantly associated with intra-hospital mortality with( p=0.01), severe hyponatremia p=0.04. Conclusion: Hyponatremia is a predictor of mortality and worse prognosis. Recognition of the pathophysiological mechanisms of hyponatremia in pneumonia will probably allow better management of it.

Keywords: oxygenotherapy, mortality, recurrence, positif curb65

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Authors: Bahadır Erişti

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Values are the behavioral procedures of society based communication and interaction process that includes social and cultural backgrounds. The policy of learning and teaching in higher education is oriented towards constructing knowledge and skills, based on theorist framework of cognitive and psychomotor aspects. This approach makes people not to develop generosity, empathy, affection, solidarity, justice, equality and so on. But the sensorial gains of education system provide the integrity of society interaction. This situation carries out the necessity of values education’s in higher education. The current study aims to consider values education from the viewpoint of students in higher education. Within the framework of the current study, an open ended survey based scenario of higher education students was conducted with the students’ social, cognitive, affective and moral developments. In line with this purpose, the following situations of the higher education system were addressed based on the higher education students’ viewpoint: The views of higher education students’ regarding values that are tried to be gained at the higher education system; The higher education students’ suggestions regarding values education at the higher education system; The views of the higher education students’ regarding values that are imposed at the higher education system. In this study, descriptive qualitative research method was used. The study group of the research is composed of 20 higher education postgraduate students at Curriculum and Instruction Department of Educational Sciences at Anadolu University. An open-ended survey was applied for the purpose of collecting qualitative data. As a result of the study, value preferences, value judgments and value systems of the higher education students were constructed on prioritizes based on social, cultural and economic backgrounds and statues. Multi-dimensional process of value education in higher education need to be constructed on higher education-community-cultural background cooperation. Thus, the act of judgement upon values between higher education students based on the survey seems to be inherent in the system of education itself. The present study highlights the students’ value priorities and importance of values in higher education. If the purpose of the higher education system gains on values, it is possible to enable society to promote humanity.

Keywords: higher education, value, values education, values in higher education

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Authors: Ankita Sharma, Satish Kumar Meena, Neha Kawatra Madan

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Background and Aims: Pediatric septic shock, a life-threatening condition, is associated with significant morbidity and mortality. Dysregulation of thyroid function, presenting as Non-Thyroidal Illness Syndrome (NTIS), is a common observation in critically ill patients and may impact clinical outcomes. This study investigates the thyroid hormone profile in pediatric septic shock and its correlation with disease outcomes. Methods: A cross-sectional study was conducted in the Pediatric Department of VMMC and Safdarjung Hospital, New Delhi. Ninety-one children, aged 1 month to 12 years, diagnosed with septic shock were included. Thyroid function tests (Total T3, Total T4, Free T3, Free T4, and TSH) were measured upon admission. Outcomes were categorized as favorable (shock reversal within 24 hours, ICU stay <7 days) or unfavorable (prolonged shock, ICU stay >7 days, multiorgan dysfunction syndrome [MODS], or death). Statistical analysis included logistic regression and receiver operating characteristic (ROC) curve evaluation. Results: Thyroid hormone abnormalities were prevalent, with low Total T3 (84.6%), low Total T4 (70.3%), and low Free T3 (76.9%) being the most common findings. Significant associations were observed between low levels of Total T3, Total T4, Free T3, and Free T4 with unfavorable outcomes (p<0.001 for all). ROC analysis identified Free T3 as the strongest predictor of unfavorable outcomes, with an AUROC of 0.842. Conclusions: Thyroid hormone levels, particularly Free T3, are critical prognostic markers in pediatric septic shock. Timely monitoring of thyroid function could aid in risk stratification and therapeutic decision-making. Future research should focus on the potential benefits of thyroid hormone replacement therapy in this population.

Keywords: pediatric septic shock, thyroid function, non-thyroidal illness syndrome, prognostic markers, free T3

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Authors: S. Hammoudeh, S. Ghuloum, A. Abdelhakam, A. AlMujalli, M. Opler, Y. Hani, A. Yehya, S. Mari, R. Elsherbiny, Z. Mahfoud, H. Al-Amin

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Introduction: Suicidal ideation and attempts are very common in patients with schizophrenia and still contributes to the high mortality in this population. The InterSePT Scale for Suicidal Thinking (ISST) is a validated tool used to assess suicidal ideation in patients with schizophrenia. This research aims to validate the Arabic version of the ISST among the Arabs residing in Qatar. Methods: Patients diagnosed with schizophrenia were recruited from the department of Psychiatry, Rumailah Hospital, Doha, Qatar. Healthy controls were recruited from the primary health care centers in Doha, Qatar. The validation procedures including professional and expert translation, pilot survey and back translation of the ISST were implemented. Diagnosis of schizophrenia was confirmed using the validated Arabic version of Mini International Neuropsychiatric Interview (MINI 6, module K) for schizophrenia. The gold standard was the module B on suicidality from MINI 6 also. This module was administered by a rater who was blinded to the results of ISST. Results: Our sample (n=199) was composed of 98 patients diagnosed with schizophrenia (age 36.03 ± 9.88 years; M/F is 2/1) and 101 healthy participants (age 35.01 ± 8.23 years; M/F is 1/2). Among patients with schizophrenia: 26.5% were married, 17.3% had a college degree, 28.6% were employed, 9% had committed suicide once, and 4.4% had more than 4 suicide attempts. Among the control group: 77.2% were married, 57.4% had a college degree, and 99% were employed. The mean score on the ISST was 2.36 ± 3.97 vs. 0.47 ± 1.44 for the schizophrenia and control groups, respectively. The overall Cronbach’s alpha was 0.91. Conclusions: This is the first study in the Arab world to validate the ISST in an Arabic-based population. The psychometric properties indicate that the Arabic version of the ISST is a valid tool to assess the severity of suicidal ideation in Arabic speaking patients diagnosed with schizophrenia.

Keywords: mental health, Qatar, schizophrenia, suicide

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Authors: Mawong R., Bussracumpakorn C.

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Millions of young people around the world have been affected by COVID-19 to their psychological and social effects. Millennials’ stresses have been shaped by a few global issues, including climate change, political instability, and financial crisis. In particular, the spread of COVID-19 has become laying psychological and socioeconomic scars on them. When end-of-life planning turns into more widely discussed, the stigma and taboos around this issue are greatly lessened. End-of-life planning is defined as a future life plan, such as financial, legacy, funeral, and memorial planning. This plan would help millennials to discover the value and meaning of life. This study explores the attitudes of Thai Millennials toward end-of-life planning as a new normal awareness of life in order to initiate an innovative service concept to fit with their value and meaning. The study conducts an in-depth interview with 12 potential participants who have awareness or action on the plan. The framework of the customer journey map is used to analyze the responses to examine trigger points, barriers, beliefs, and expectations. The findings pointed to a service concept that is suggested for a new end-of-life planning service that is suited to Thai Millennials in 4 different groups, which are 1. Social -Conscious as a socially aware who to donate time and riches to make the world and society a better place, their end-of-life planning value is inspired by the social impact of giving something or some action that they will be able to do after life or during life which provides a variety of choice based on their preference to give to society, 2. Life Fulfillment who make a life goal for themselves and attempt to achieve it before the time comes to their value will be to inspire life value with a customized plan and provide guidance to suggest, 3. Prevention of the After-Death Effect who want to plan to avoid the effects of their death as patriarch, head of the family, and anchor of someone, so they want to have a plan that brings confidence and feel relief while they are still alive and they want to find some reliable service that they can leave the death will or asset, and 4. No Guilty Planning who plan for when they wish to be worry-free as a self-responsible they want to have the plan which is easy to understand and easy to access. The overall finding of the study is to understand the new service concept of end-of-life planning which to improve knowledge of significant life worth rather than death planning, encouraging people to reassess their lives in a positive way, leading to higher self-esteem and intrinsic motivation for this generation in this time of global crisis.

Keywords: design management, end-of-life planning, millennial generation, service design solution

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Authors: Kalsoom Rani

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Tobacco contains nicotine, which causes addiction to many toxic chemicals. In the world, people consume it in the form of smoke, chew, and sniffing, smoke of it is composed of almost 7000 active chemicals, which are very harmful to human health as well as for eye health, inhalation of tobacco smoke and fumes can accelerate and cause many blinding eye diseases. Dry eye and smoking have not been covered extensively in researches; more studies are required to unveil the relationship between smoking and dry eye. This study was conducted to determine the quantity and quality of tears in smokers. 60 subjects participated in the study, which was divided into two groups on the basis of consumption of cigarettes per day with age matched non smokers of 15-50 years. All participants have gone through a study based questioner, eye examination, and diagnostic 'Dry Eye Tests' for evaporative tears evaluation and measurement of basal tear secretion. Subjects were included in the criteria of 10 cigarettes per day with a minimum duration of 1 year; passive smokers for control groups were excluded. The study was carried out in a Medina Teaching Hospital, Faisalabad, Pakistan, ophthalmology department for the duration of 8 months. Mean values for tear break up time (TBUT), was reported 10sec with SD of +3.74 in controlled group, 5sec with SD + 2.32 in smokers and 4sec SD +3.77 heavy smokers in right eye (RE) and left eye (LE) 10.35sec with SD of +3.88 in controlled 5sec with SD + 2.3 in smokers and much reduced TBUT in heavy smokers was 3.85sec SD+2.20. Smoking has a very strong association with TRUT with a significance of P=.00 both eyes. Mean Schirmer-I value of the subjects was reported 12.6mm with SD + 8.37 in RE and 12.59mm with SD + 8.96 LE. The mean Schirmer-II test value was reported in the right, and left eye with a mean value for control was 20.23mm with SD + 8.93, 20.75mm with SD + 8.84 respectively, and in Smokers 9.90mm with SD + 5.74, and 10.07mm with SD + 6.98, and in heavy smokers 7.7mm, SD + 3.22 and 6.9, SD + 3.50 mm, association with smoking showed p=.001 in RE and .003 in LE. Smoking has deteriorated effect on both evaporative tear and aqueous tear secretion and causing symptoms of dry eye burning, itching, redness, and watering with epithelial cell damage.

Keywords: tear break-up time, basal tear secretion, smokers, dry eye

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Authors: Sunday Nathaniel Obasi, Chiamak Chinasa Obasi

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Soil characterization and classification provide the basic information necessary to create a functional evaluation and soil classification schemes. Fertility capability classification (FCC) on the other hand is a technical system that groups the soils according to kinds of problems they present for management of soil physical and chemical properties. This research was carried out in Ebonyi state, southeastern Nigeria, which is an agrarian state and a leading rice producing part of southeastern Nigeria. In order to maximize the soil and enhance the productivity of rice in Ebonyi soils, soil classification, and fertility classification information need to be supplied. The state was grouped into three locations according to their agricultural zones namely; Ebonyi north, Ebonyi central and Ebonyi south representing Abakaliki, Ikwo and Ivo locations respectively. Major rice growing areas of the soils were located and two profile pits were sunk in each of the studied zones from which soils were characterized, classified and fertility capability classification (FCC) developed. Soil classification was done using United State Department of Agriculture (USDA) Soil Taxonomy and correlated with World Reference Base for soil resources. Results obtained classified Abakaliki 1 and Abakaliki 2 as Typic Fluvaquents (Ochric Fluvisols). Ikwo 1 was classified as Vertic Eutrudepts (Eutric Vertisols) while Ikwo 2 was classified as Typic Eutrudepts (Eutric Cambisols). Ivo 1 and Ivo 2 were both classified as Aquic Eutrudepts (Gleyic Leptosols). Fertility capability classification (FCC) revealed that all studied soils had mostly loamy topsoils and subsoils except Ikwo 1 with clayey topsoil. Limitations encountered in the studied soils include; dryness (d), low ECEC (e), low nutrient capital reserve (k) and water logging/ anaerobic condition (gley). Thus, FCC classifications were Ldek for Abakaliki 1 and 2, Ckv for Ikwo 1, LCk for Ikwo 2 while Ivo 1 and 2 were Legk and Lgk respectively.

Keywords: soil classification, soil fertility, limitations, modifiers, Southeastern Nigeria

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Authors: Lubna Khondker

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Background: Melasma is a common pigmentary dermatosis, manifested by hyperpigmented macules or patches on the face, commonly occurring in females due to an acquired disorder in the melanogenesis process. Although several treatments are currently used, it remains a great challenge due to recurrence and refractory nature. It was recently reported that tranexamic acid (TA-plasmin inhibitor) is an effective treatment for melasma. Objective: This study aims to compare the efficacy and side effects of intralesional injection of Tranexamic acid with oral Tranexamic acid in the treatment of melasma. Methods: A clinical trial was done in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, for a period of 4 years. A total of 100 patients with melasma who did not respond to topical therapy were included in the study as group A and group B. Group A Patients were administered intralesional injection (10 mg/ml) of Tranexamic acid( TA) weekly for 6 weeks, and group B patients were treated with oral tranexamic acid 250 mg 12 hourly for 12 weeks after taking informed consent. The severity and extent of pigmentation were assessed by the modified melasma area severity index (MASI). The response to treatment was assessed by MASI at 4 weeks, 8 weeks, and 12 weeks after stopping treatment. Results: The study showed the MASI scores at the baseline, 4 weeks, 8 weeks, and 12 weeks in group A were 18.23±1.22, 6.14±3.26, 3.21±2.14 and 2.11±2.01 respectively, and in group B, 17.87±1.12, 11.21±6.25, 6.57±4.26 and 6.41±4.17 respectively. The mean MASI significantly reduced in group A compared to group B in the 4th, 8th, and 12th weeks. The present study showed that among group A patients, 56% rated excellent (>75% reduction) in outcome, 32% good (50-75% reduction), 8% moderate (25-50% reduction) and only 4% (<25% reduction) was unsatisfactory and among group B patients, 14% rated excellent in outcome, 28% good, 36% moderate and 22% was unsatisfactory. Overall improvement in our study in group A was 96% and in group B 78%. Side effects were negligible, and all the patients tolerated the treatment well. Conclusion: Based on our results, intralesional Tranexamic acid (10 mg/ml) is more effective and safer than oral Tranexamic acid in the treatment of melasma.

Keywords: intralesional tranexamic acid, melasma, oral tranexamic acid, MASI score

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Authors: Alicia Greenbank, Efrat Bengio

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The aim of this research was to examine the efficacy of the first course in Israel, whose objective is to train student teachers in the special education department to work cooperatively with parents of children with special needs. Studies often highlight the importance of cooperation between teachers and parents of students with special needs. Israel’s Special Education Law defines parents as complete partners, and the Ministry of Education encourages and even requires that partnership be present. Yet this partnership is difficult to achieve many kindergarten teachers, and teachers have a lot of difficulties establishing and managing a pattern of cooperation with their students’ parents. Often we see different perspectives on the child's development and needs, distrust, lack of appreciation, and communication difficulties on both sides – parents & teachers. The course describes a method of instilling the need for cooperation at an early stage of teacher training-in the teacher training program. 22 students in the special education program for early childhood education in the fourth year of learning took part in the course. The fourth-year is the experiential training year and the first time that students have worked in a school. The course consisted of 14 sessions. Seven parents of students with different disabilities participated at 6 of the sessions. The changes in the students' attitudes towards partnership and their ability to manage this partnership were carried out by examining the reports written by the students before the meetings with the parents and the reflections they wrote after each meeting with the parents and at the end of the course. Three themes emerged from the narrative analysis, corresponding to the three preconditions for joint activities with parents — Approach, Attitude, Appropriate Atmosphere, according to the Four A’s Model. The findings showed that a course combining meetings with parents of children with special needs offers many benefits for teacher training. The course raised student awareness of the question partnership, changed students’ approaches and attitudes towards the parents, stressed the importance of partnership, and provided students with tools for working with parents through the school. Based on the findings of this study, courses in this format can be applied in order to cooperate between teachers and parents, for example, parents of gifted children with special needs.

Keywords: Partnership with parents in special education, parents of children with disabilities, parents of children with special needs, parents’ involvement in special education

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Authors: G. Barański, P. Kacejko, M. Wendeker

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The impact of the ignition advance control algorithms of the ASz-62IR-16X aircraft piston engine on a combustion process has been presented in this paper. This aircraft engine is a nine-cylinder 1000 hp engine with a special electronic control ignition system. This engine has two spark plugs per cylinder with an ignition advance angle dependent on load and the rotational speed of the crankshaft. Accordingly, in most cases, these angles are not optimal for power generated. The scope of this paper is focused on developing algorithms to control the ignition advance angle in an electronic ignition control system of an engine. For this type of engine, i.e. radial engine, an ignition advance angle should be controlled independently for each cylinder because of the design of such an engine and its crankshaft system. The ignition advance angle is controlled in an open-loop way, which means that the control signal (i.e. ignition advance angle) is determined according to the previously developed maps, i.e. recorded tables of the correlation between the ignition advance angle and engine speed and load. Load can be measured by engine crankshaft speed or intake manifold pressure. Due to a limited memory of a controller, the impact of other independent variables (such as cylinder head temperature or knock) on the ignition advance angle is given as a series of one-dimensional arrays known as corrective characteristics. The value of the ignition advance angle specified combines the value calculated from the primary characteristics and several correction factors calculated from correction characteristics. Individual cylinder control can proceed in line with certain indicators determined from pressure registered in a combustion chamber. Control is assumed to be based on the following indicators: maximum pressure, maximum pressure angle, indicated mean effective pressure. Additionally, a knocking combustion indicator was defined. Individual control can be applied to a single set of spark plugs only, which results from two fundamental ideas behind designing a control system. Independent operation of two ignition control systems – if two control systems operate simultaneously. It is assumed that the entire individual control should be performed for a front spark plug only and a rear spark plug shall be controlled with a fixed (or specific) offset relative to the front one or from a reference map. The developed algorithms will be verified by simulation and engine test sand experiments. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: algorithm, combustion process, radial engine, spark plug

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Authors: Ying Sun, Biao Cheng, Qing Lu, Xuefei Tao, Xiaoyu Lai, Cheng Guo, Dan Wang

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Fibrinogen-like protein 2 (FGL2) has recently been identified to play an important role in inflammatory diseases such as atherosclerosis through a thrombin-dependent manner. Here, a murine monoclonal antibody was raised against the critical residue Ser(89) of FGL2, and the effects of the anti-FGL2 mAb (SPF89) were analyzed in human umbilical vein endothelial cells (HUVECs) and THP-1 cells. Firstly, it was proved that SPF89, which belongs to the IgG1 subtype with a KD value of 44.5 pM, could specifically show the expression levels of protein FGL2 in different cell lines of known target gene status. The lipopolysaccharide (LPS)-mediated endothelial cell proliferation was significantly inhibited with a decline of phosphorylation nuclear factor-κB (NF-κB) in a dose-dependent manner after SPF89 treatment. Furthermore, SPF89 reduced LPS-induced expression of adhesion molecules and inflammatory cytokines such as vascular cell adhesion molecule-1, tumor necrosis factor-α, Matrix metalloproteinase MMP-2, Integrin αvβ3, and interleukin-6 in HUVECs. In macrophage-like THP-1 cells, SPF89 effectively inhibited LPS and low-density lipoprotein-induced foam cell formation. However, these anti-inflammatory and anti-atherosclerotic effects of anti-FGL2 mAb in HUVECs and THP-1 cells were significantly reduced after treatment with an NF-κB inhibitor PDTC. All the above suggest, by efficiently inhibiting LPS-induced pro-inflammatory effects in vascular endothelial cells by attenuating NF-κB dependent pathway, the new anti-FGL2 mAb SPF89 could to be a potential therapeutic candidate for protecting the vascular endothelium against inflammatory diseases such as atherosclerosis. This work was supported by the Program of Sichuan Science and Technology Department (2017FZ0069) and Collaborative Innovation Program of Sichuan for Elderly Care and Health(YLZBZ1511).

Keywords: monoclonal antibody, fibrinogen like protein 2, inflammation, endothelial cells

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Authors: Werner Grommes

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Intelligent wearables (illuminated vests or hand and foot-bands, smart watches with a laser diode, Bluetooth smart glasses) overflow the market today. They are integrated with complex electronics and are worn very close to the body. Optical measurements and limitation of the maximum light density are needed. Smart watches are equipped with a laser diode or control different body currents. Special glasses generate readable text information that is received via radio transmission. Small high-performance batteries (lithium-ion/polymer) supply the electronics. All these products have been tested and evaluated for risk. These products must, for example, meet the requirements for electromagnetic compatibility as well as the requirements for electromagnetic fields affecting humans or implant wearers. Extensive analyses and measurements were carried out for this purpose. Many users are not aware of these risks. The result of this study should serve as a suggestion to do it better in the future or simply to point out these risks. Commercial LED warning vests, LED hand and foot-bands, illuminated surfaces with inverter (high voltage), flashlights, smart watches, and Bluetooth smart glasses were checked for risks. The luminance, the electromagnetic emissions in the low-frequency as well as in the high-frequency range, audible noises, and nervous flashing frequencies were checked by measurements and analyzed. Rechargeable lithium-ion or lithium-polymer batteries can burn or explode under special conditions like overheating, overcharging, deep discharge or using out of the temperature specification. Some risk analysis becomes necessary. The result of this study is that many smart wearables are worn very close to the body, and an extensive risk analysis becomes necessary. Wearers of active implants like a pacemaker or implantable cardiac defibrillator must be considered. If the wearable electronics include switching regulators or inverter circuits, active medical implants in the near field can be disturbed. A risk analysis is necessary.

Keywords: safety and hazards, electrical safety, EMC, EMF, active medical implants, optical radiation, illuminated warning vest, electric luminescent, hand and head lamps, LED, e-light, safety batteries, light density, optical glare effects

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Authors: Mamta Thakur, Dr. Shashi Mawar, Ms. Levis Murry, Dr. D.k.sharma

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Aim: The aim of this study is to develop nephrology nursing procedure protocol after clinical audit of current nephrology nursing practices. Materials and methods: This descriptive observational study was conducted on 40 nurses who were working in Nephrology Department of AIIMS, New Delhi to observe their current practices to assess the existing gaps in the practice. The nurses were enrolled through total enumerative sampling. Sociodemographic profile of nurses and clinical profile for site of procedure was collected. Observation checklist was formed on the basis of standard nursing practices, which included 7 dimensions for hemodialysis procedure and 3 dimensions for procedure of assisting renal biopsy. Based on the gaps identified, nephrology nursing procedure protocol will be developed. Nurses were observed during two shifts, and each nurse was observed once. Scoring of items were done in each dimension, and for acceptable practices, nurses have to score ≥80% in each dimension. Results: Data was analyzed using descriptive statistics. Majority of nurses (73.7%) in nephrology ward and (80.9%) in hemodialysis unit have not undergone any special training in nephrology. Most of nurses (80.9%) followed the acceptable nursing practices for procedure of connection for hemodialysis. None of nurses followed the acceptable level (≥80%) of nursing practices for the procedure of predialysis assessment, the procedure for site preparation, during dialysis assessment and post dialysis assessment. None (100%) showed the acceptable level of nursing practices for all the dimensions of assisting renal biopsy procedure. Nephrology nursing procedure protocol was developed by researcher following a rigorous process, and this will reduce the gaps in the nursing practice. Conclusion: Clinical audit found that there were gaps in the existing nursing practices compared to the standardised nursing practices for procedure of hemodialysis and assisting renal biopsy, and these gaps have been addressed by the development of the protocol.

Keywords: nursing practice, nephrology nursing procedure, nursing protocol, renal biopsy, hemodialysis

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Authors: Stefaan Carpentier, Aya Al Masri, Fabrice Leroy, Thibault Julien, Safoin Aktaou, Malorie Martin, Fouad Maaloul

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Introduction: During an 'Interventional Radiology (IR)' procedure, the patient's skin-dose may become very high for a burn, necrosis, and ulceration to appear. In order to prevent these deterministic effects, a prediction of the peak skin-dose for the patient is important in order to improve the post-operative care to be given to the patient. The objective of this study is to estimate, before the intervention, the patient dose for ‘Chronic Total Occlusion (CTO)’ procedures by selecting relevant clinical indicators. Materials and methods: 103 procedures were performed in the ‘Interventional Cardiology (IC)’ department using a Siemens Artis Zee image intensifier that provides the Air Kerma of each IC exam. Peak Skin Dose (PSD) was measured for each procedure using radiochromic films. Patient parameters such as sex, age, weight, and height were recorded. The complexity index J-CTO score, specific to each intervention, was determined by the cardiologist. A correlation method applied to these indicators allowed to specify their influence on the dose. A predictive model of the dose was created using multiple linear regressions. Results: Out of 103 patients involved in the study, 5 were excluded for clinical reasons and 2 for placement of radiochromic films outside the exposure field. 96 2D-dose maps were finally used. The influencing factors having the highest correlation with the PSD are the patient's diameter and the J-CTO score. The predictive model is based on these parameters. The comparison between estimated and measured skin doses shows an average difference of 0.85 ± 0.55 Gy for doses of less than 6 Gy. The mean difference between air-Kerma and PSD is 1.66 Gy ± 1.16 Gy. Conclusion: Using our developed method, a first estimate of the dose to the skin of the patient is available before the start of the procedure, which helps the cardiologist in carrying out its intervention. This estimation is more accurate than that provided by the Air-Kerma.

Keywords: chronic total occlusion procedures, clinical experimentation, interventional radiology, patient's peak skin dose

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Authors: Y. Abdul Aziz, E. L. K. Osafo, S. O. Apori, A. Osman

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A sixteen week trial was conducted at the Research Farm (Technology Village) of the Department of Animal Science, School of Agriculture, University of Cape Coast, Cape Coast, Ghana. This study sought to investigate the effects of Probiotic (RE3) on growth performance, diarrhea incidence and blood parameters of N’dama calves. Sixteen N’dama calves aged 3 months of an average initial weight of 44.2 kg were randomly assigned to one of four dietary treatments according to their body weight, age, and sex. Treatment 1 (T1) serve as a control animal (No RE3 supplementation). Treatment 2 (T2) receives 0.03 ml RE3 per kg body weight. Treatment 3 (T3) receives 0.06 ml RE3 per kg body weight, and Treatment 4 (T4) also receives 0.09 ml RE3 per kg body weight in a Completely Randomize Design (CRD). There were 4 replicates per treatment. The calves were allowed access to feed and water ad libitum. The body weight of the calves was recorded at the start of the experiment and thereafter regularly at two weeks interval. Weighing was done early morning before the calves are allowed to access feed and water and were also observed in their pens for occurrence of diarrhea and faecal scores recorded. Blood samples were obtained from each calf at the end of the study through jugular vein puncture. Supplementation of RE3 to calves had showed a beneficial effect by reducing the incidence of diarrhea. The highest faecal score was recorded in T1 and the least faecal score was recorded in T3. There was significant difference (P < 0.05) in the faecal score between the treatment group and the control after two weeks of the experiment. There was no significant difference (P > 0.05) in the average daily gain of the animals. Hematological and biochemical indices of calves were all within the normal range except in treatments (1, 3 and 4) which recorded high White Blood Cell (WBC) count with no significant difference (P > 0.05).

Keywords: probiotics (RE3), diarrhea incidence, blood parameters, N’dama calves

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Authors: Prachi Sharma, B. V. Ramkumar

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In current days, autism is a well-known neurodevelopmental disorder that may restrict child development globally. Ignorance or delayed identification or incorrect diagnosis of autism is a major challenge in controlling such an incurable disorder. This may lead to various behavioural complications followed by mental illness in adulthood. Autism is an incurable disorder that is progressive and negatively affects our development globally. This may vary in degree in different skills. However, a deviation from the normal range creates a complex outcome in social and communication areas and restricts or deviates cognitive ability. The primary goal of the present research is to identify and understand the deviations in cognitive, social communication, and behaviour in children during their growing age, with a focus on autism. In this study, five children with mild autism were taken. All the children had achieved normal developmental milestones until the age of one year. The maximum age of observation of children’s development was four years to see the difference in their developmental rates in the areas of cognitive, social communication, and behaviour. The study is based on the parental report about their children from 1 year to 4 years. Videos and pictures of children during their development were also seen as a reference to verify information received by the parents of the children. This research is qualitative, with samples for which were selected using a purposive sampling technique. The data was collected from the OPD, NIEPID RC, NOIDA, India. The data was collected in the form of parental reports based on their observations about their kids. Videos were also seen to verify the information reported by the parents (just shown to verify the facts, not shared). In results, we observed a significant difference in the rate of development in all five children taken for this research. The children having mild autism, at present, showed variations in all three domains (cognitive, social communication, and behaviour). These variations were seen in terms of restricted development in global areas. The result revealed that typical features of ASD had created more cognitive restrictions as compared to the children having ASD features with hyperactivity. Behavioral problems were observed with different levels of severity in the children having ASD with hyperactivity, whereas children with typical ASD are found with some typical problem behaviours like head banging, body rocking, self-biting, etc., with different levels of severity. The social-communication area was observed as equally affected in all children, as no major difference was found in the information received from each parent.

Keywords: autism/ASD, behaviour, cognitive skill, hyperactivity, social-communication skill

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Authors: Tumelo Jaquiline Ntsopi

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This study explored the academic writing challenges of first-year students who use English as an Additional Language (EAL) registered in the EAW101 module at an ODeL institution. Research shows that academic writing is a challenge for EAL teaching and learning contexts across the globe in higher education institutions (HEIs). Academic writing is an important aspect of academic literacy in any institution of higher learning, more so in an ODeL institution. This has probed research that shows that academic writing is and continues to pose challenges for EAL teaching and learning contexts in higher education institutions. This study stems from the researcher’s experience in teaching academic writing to first-year students in the EAW101 module. The motivation for this study emerged from the fact that EAW101 is a writing module that has a high number of students in the Department of English Studies with an average of between 50-80 percent pass rate. These statistics elaborate on the argument that most students registered in this module struggle with academic writing, and they need intervention to assist and support them in achieving competence in the module. This study is underpinned by Community of Inquiry (CoI) framework and Transactional distance theory. This study adopted a qualitative research methodology and utilised a case study approach as a research design. Furthermore, the study gathered data from first year students and the EAW101 module’s student support initiatives. To collect data, focus group discussions, structured open-ended evaluation questions, and an observation schedule were used to gather data. The study is vital towards exploring academic writing challenges that first-year students in EAW101 encounter so that lecturers in the module may consider re-evaluating their methods of teaching to improve EAL students’ academic writing skills. This study may help lecturers towards enhancing academic writing in a ODeL context by assisting first year students through using student support interventions.

Keywords: academic writing, academic writing challenge, ODeL, EAL

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Authors: Bunjirtluk Jintaridth

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Utilization of silicon for sustainable rice cultivation in acid sulfate soils was studied for 2 years. The study was conducted on Rungsit soils in Amphoe Tanyaburi, Pathumtani Province. The objectives of this study were to assess the effect of high quality organic fertilizer in combination with silicon and chemical fertilizer on rice yield, chemical soil properties after using soil amendments, and also to assess the economic return. A Randomized Complete Block Design (RCBD) with 10 treatments and 3 replications were employed. The treatments were as follows: 1) control 2) chemical fertilizer (recommended by Land Development Department, LDD 3) silicon 312 kg/ha 4) high quality organic fertilizer at 1875 kg/ha (the recommendation rate by LDD) 5) silicon 156 kg/ha in combination with high quality organic fertilizer 1875 kg/ha 6) silicon at the 312 kg/ha in combination with high quality organic fertilizer 1875 kg/ha 7) silicon 156 kg/ha in combination with chemical fertilizer 8) silicon at the 312 kg/ha in combination with chemical fertilizer 9) silicon 156 kg/ha in combination with ½ chemical fertilizer rate, and 10) silicon 312 kg/ha in combination with ½ chemical fertilizer rate. The results of 2 years indicated the treatment tended to increase soil pH (from 5.1 to 4.7-5.5), percentage of organic matter (from 2.43 to 2.54 - 2.94%); avail. P (from 7.5 to 7-21 mg kg-1 P; ext. K (from 616 to 451-572 mg kg-1 K), ext Ca (from 1962 to 2042.3-4339.7 mg kg-1 Ca); ext Mg (from 1586 to 808.7-900 mg kg-1 Mg); but decrease the ext. Al (from 2.56 to 0.89-2.54 cmol kg-1 Al. Two years average of rice yield, the highest yield was obtained from silicon 156 kg/ha application in combination with high quality organic fertilizer 300 kg/rai (3770 kg/ha), or using silicon at the 312 kg/ha combination with high quality organic fertilizer 300 kg/rai. (3,750 kg/ha). It was noted that chemical fertilizer application with 156 and 312 kg/ha silicon gave only 3,260 และ 3,133 kg/ha, respectively. On the other hand, half rate of chemical fertilizer with 156 and 312 kg/ha with silicon gave the yield of 2,934 และ 3,218 kg/ha, respectively. While high quality organic fertilizer only can produce 3,318 kg/ha as compare to rice yield of 2,812 kg/ha from control. It was noted that the highest economic return was obtained from chemical fertilizer treated plots (886 dollars/ha). Silicon application at the rate of 156 kg/ha in combination with high quality organic fertilizer 1875 kg/ha gave the economic return of 846 dollars/ha, while 312 kg/ha of silicon with chemical fertilizer gave the lowest economic return (697 dollars/ha).

Keywords: rice, high quality organic fertilizer, acid sulfate soil, silicon

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Authors: Mrinal Kanti Bhowmik, Usha Rani Gogoi Jr., Anjan Kumar Ghosh, Debotosh Bhattacharjee

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In the last few decades, breast thermography has achieved an average sensitivity and specificity of 90% for breast tumor detection. Breast thermography is a non-invasive, cost-effective, painless and radiation-free breast imaging modality which makes a significant contribution to the evaluation and diagnosis of patients, suspected of having breast cancer. An abnormal breast thermogram may indicate significant biological risk for the existence or the development of breast tumors. Breast thermography can detect a breast tumor, when the tumor is in its early stage or when the tumor is in a dense breast. The infrared breast thermography is very sensitive to environmental changes for which acquisition of breast thermography should be performed under strictly controlled conditions by undergoing some standard protocols. Several factors like air, temperature, humidity, etc. are there to be considered for characterizing thermal images as an imperative tool for detecting breast cancer. A detailed study of various breast thermogram acquisition protocols adopted by different researchers in their research work is provided here in this paper. After going through a rigorous study of different breast thermogram acquisition protocols, a new standard breast thermography acquisition setup is proposed here in this paper for proper and accurate capturing of the breast thermograms. The proposed breast thermogram acquisition setup is being built in the Radiology Department, Agartala Government Medical College (AGMC), Govt. of Tripura, Tripura, India. The breast thermograms are captured using FLIR T650sc thermal camera with the thermal sensitivity of 20 mK at 30 degree C. The paper is an attempt to highlight the importance of different critical parameters of breast thermography like different thermography views, patient preparation protocols, acquisition room requirements, acquisition system requirements, etc. This paper makes an important contribution by providing a detailed survey and a new efficient approach on breast thermogram capturing.

Keywords: acquisition protocol, breast cancer, breast thermography, infrared thermography

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Authors: Parsa Keyvani, Alistair Phillips, David Warwick

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Background: The current process for gaining patient consent for hand and wrist surgery at University Hospital Southampton (UHS) is paper-based and makes use of generic forms provided by the NHS and no patient information leaflet is available relating to hand and wrist surgery. Aims: To evaluate the process of obtaining clinical consent and suggest ways in which the service can be improved. Methods: A log-book review of four orthopaedic surgeons at UHS was carried out over a three-month period in order to identify the 10 most common types of elective hand and wrist surgeries performed. A literature review was carried out to identify the complications of these surgeries. The surgeries were then divided into 6 types: nerve, bone, ligament, joint, tendon and dupuytren’s surgery. A digitised consent form was created covering the complications of all 6 surgery types. Finally, the surgeons at the orthopaedic department of UHS were asked whether they prefer the old paper-based or the digitised consent form. Results: All of the surgeons felt that the procedure type-based form was easier to read, use and understand. Conclusion: This research highlights a number of problems related to the use of current NHS consent forms. The proposed solution is to use a set of digitised, procedure type-based consent forms. Digital consent forms can be filled in in advance and sent to the patient electronically along with any relevant information leaflets, thus giving them time to absorb the information and come up with any questions before they have their pre-procedure discussion with their doctor. This would allow the doctor to focus the consultation on the patient rather than writing out the consent form and would ultimately be a step forward in making the NHS a global digital leader and fully embrace the opportunity offered by technology.

Keywords: digitised consent form, elective surgery, hand surgery complications, informed consent, procedure type-based consent form

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Authors: Nabil Mohammed Nasser Salem

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International advertisements targeting the Arab world are usually modified to be compatible with the conservative culture in many Arab countries. The portrayal of female models in international advertisements in Arab magazines avoids direct sexual representation. Arab culture is guided by religious teachings and social restrictions that prohibit the display of many parts of the female body. Exposure of shoulders, arms, armpits, cleavage, legs, thighs, etc., of the female body is usually avoided in international advertisements published in Arab magazines. Exposure to parts of the female body other than the face and hands may be considered offensive in many parts of Arab countries. Although extensive research has been conducted on Arabic advertisements, to our best knowledge, there are no publications in the literature that address the recent changes in the visual sign system in international advertisements in Arab magazines using semiotics as a research method. The present study aims to analyze the changes in the visual sign system of international advertisements published in Arab magazines that promote female fragrances. It tries to analyze the differences in the sexual representations of the same female models in some selected advertisements during different periods. The magazines are randomly selected from the period between 2000 and 2019. The selection of magazines is based on their availability and popularity. The study focuses on the Dior Jadore ads because they reflect important changes in the appearance of the same female model between 2000 to 2019. The result of the study shows important changes in the sexual representation of the same female body. The Dior Jadore advertisement in 2000 shows only the head of the female model. The model is modestly portrayed and shows clear cultural and religious restrictions on the sexual representation of the female body. The result shows that the same female model is portrayed differently in the Dior Jadore advertisement from the period 2005 to 2019. These versions of advertisements show more parts of the female body that are covered in the older versions and show stronger sexual representations. The study is an important contribution as it fills an important gap in the literature by extending semiotic research to the study of recent visual changes in the sign system of international advertisements published in Arab magazines during an important period in the history of international advertisement targeting the Arab world, as they reflect changes in the sexual representation of female models.

Keywords: Arab magazine, female body, international advertisements, semiotics, sexual representation

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Authors: Rutcher M. Lacaza, Stephen Jun V. Villejo

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This paper investigated the patterns of private transfers in the Philippines using the Family Income Expenditure Survey (FIES) 2009, conducted by the Philippine government’s National Statistics Office (NSO) every three years. The paper performed bivariate analysis on net transfers, using the identified determinants for a household to be either a net receiver or a net giver. The household characteristics considered are the following: age, sex, marital status, employment status and educational attainment of the household head, and also size, location, pre-transfer income and the number of employed members of the household. The variables net receiver and net giver are determined by computing the net transfer, subtracting total gifts from total receipts. The receipts are defined as the sum of cash received from abroad, cash received from domestic sources, total gifts received and inheritance. While gifts are defined as the sum of contributions and donations to church and other religious institutions, contributions and donations to other institutions, gifts and contributions to others, and gifts and assistance to private individuals outside the family. Both in kind and in cash transfers are considered in the analysis. It also performed a multiple regression analysis on transfers received and income including other household characteristics to examine the motives for giving transfers – whether altruism or exchanged. It also used the binary logistic regression to estimate the probability of being a net receiver or net giver given the household characteristics. The study revealed that receiving tends to be universal – both the non-poor and the poor benefit although the poor receive substantially less than the non-poor. Regardless of whether households are net receivers or net givers, households in the upper deciles generally give and receive more than those in the lower deciles. It also appears that private transfers may just flow within economic groups. Big amounts of transfers are, therefore, directed to the non-poor and the small amounts go to the poor. This was also supported by the increasing function of gross transfers received and the income of households – the poor receiving less and the non-poor receiving more. This is contrary to the theory that private transfers can help equalize the distribution of income. This suggested that private transfers in the Philippines are not altruistically motivated but exchanged. However, bilateral data on transfers received or given is needed to test this theory directly. The results showed that transfers are much needed by the poor and it is important to understand the nature of private transfers, to ensure that government transfer programs are properly designed and targeted so as to prevent the duplication of private safety nets already present among the non-poor.

Keywords: private transfers, net receiver, net giver, altruism, exchanged.

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Authors: Nelly S. Aggangan, Julieta A. Anarna

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Indigenous tree species are priority planting materials for the National Greening Program of the Department of Environment and Natural Resources. Areas for reforestation are marginal grasslands where plant growth is stunted and seedling survival is low. This experiment was conducted to compare growth rates and seedling survival of seven indigenous reforestation species. Narra (Pterocarpus indicus), salago (Wikstroemia lanceolata), kisubeng (Sapindus saponaria), tuai (Biscofia javanica), batino (Alstonia macrophylla), bani (Pongamina pinnata) and ipil (Intsia bijuga) were inoculated with Mykovam® (mycorrhizal fungi) and Bio-N® (N2-fixing bacteria) during pricking. After five months in the nursery, the treated seedlings were planted in degraded upland acidic red soil in Cavinti, Laguna (Luzon). During outplanting, all mycorrhiza inoculated seedlings had 50-80% mycorrhizal roots while the control ones had 5-10% mycorrhizal roots. Mykovam increased height of narra, salago and kisubeng. Stem diameter was bigger in mycorrhizal salago than the control. After two years in the field, Mykovam®+Bio-N® inoculated narra, salago and bani gave 95% survival while non-mycorrhizal tuai gave the lowest survival (25%). Inoculated seedlings grew faster than the control. Highest height increase was in batino (103%), followed by bani (95%), ipil (59%), narra (58%), tuai (53%) and kisubeng was the lowest (10%). Stem diameter was increased by Mykovam® from 13-39% over the control. Highest stem diameter was obtained from narra (50%), followed by bani (40%), batino (36%), ipil (33%), salago (28%), kisubeng and tuai (12%) had the lowest. In conclusion, Mykovam® inoculated batino, bani, narra, salago and ipil can be selected to restore degraded upland acidic red soil in the Philippines.

Keywords: Azospirillum spp., Bio-N®, Mykovam®, nitrogen fixing bacteria, acidic red soil

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Authors: Jasbir Arora, Indu Talwar, Daisy Sahni, Vidya Rattan

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Introduction: Age estimation is a crucial step to build the identity of a person, both in case of deceased and alive. In adults, age can be estimated on the basis of six regressive (Attrition, Secondary dentine, Dentine transparency, Root resorption, Cementum apposition and Periodontal Disease) changes in teeth qualitatively using scoring system and quantitatively by micrometric method. The present research was designed to establish the reliability of qualitative (method 1) and quantitative (method 2) of age estimation among North Indians and to compare the efficacy of these two methods. Method: 250 single-rooted extracted teeth (18-75 yrs.) were collected from Department of Oral Health Sciences, PGIMER, Chandigarh. Before extraction, periodontal score of each tooth was noted. Labiolingual sections were prepared and examined under light microscope for regressive changes. Each parameter was scored using Gustafson’s 0-3 point score system (qualitative), and total score was calculated. For quantitative method, each regressive change was measured quantitatively in form of 18 micrometric parameters under microscope with the help of measuring eyepiece. Age was estimated using linear and multiple regression analysis in Gustafson’s method and Kedici’s method respectively. Estimated age was compared with actual age on the basis of absolute mean error. Results: In pooled data, by Gustafson’s method, significant correlation (r= 0.8) was observed between total score and actual age. Total score generated an absolute mean error of ±7.8 years. Whereas, for Kedici’s method, a value of correlation coefficient of r=0.5 (p<0.01) was observed between all the eighteen micrometric parameters and known age. Using multiple regression equation, age was estimated, and an absolute mean error of age was found to be ±12.18 years. Conclusion: Gustafson’s (qualitative) method was found to be a better predictor for age estimation among North Indians.

Keywords: forensic odontology, age estimation, North India, teeth

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Authors: Duduzile Dlamini-Boemah, Haretsebe Manwa, Lisebo Tseane-Gumbi

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The demands and expectations of twenty-first century tourists have changed, and they continue to have an impact on tour guiding in cultural and natural tourist attractions. The traditional communicative role of the tour guide as a mere presenter is not sufficient anymore; instead, there are expectations from the tourists of guides who provide effective interpretive guiding. It is always questionable if tour guides in South Africa are equipped with the skills for effective interpretation, yet limited research has been conducted to investigate the continuing professional education of tour guides in South Africa. Instead, much attention has been given to aspects of registration and certification of tour guides in South Africa. Concerns have been raised about tour guiding and have led to the development of a strategy by the Department of Tourism to professionalise tourists guiding that includes training. However, the necessity for tourism training in tour guiding in South Africa was raised as early as in the 1980s, the paper argues that there is a further need to emphasise continuing professional education in interpretive guiding in South Africa. In this study, continuing education and training are considered to involve the upgrading of the skills and knowledge of interpretation of those who are already working as tour guides at the cultural and natural attractions. The study is guided by the empowerment theory. The aim of this paper is to present issues of effective interpretive guiding and continuing professional education in interpretive guiding in South Africa. This study is based on the literature survey of secondary sources such as academic journal articles, government documents, and reports and books. The conclusions indicate that there is a need for training in interpretive delivery techniques in South Africa. The need for interpretive training in interpretive delivery techniques is attributed by the call to allow people to use indigenous knowledge, rather than formal education as a basis for becoming a field guide as well as affording the previously disadvantaged individuals to access training opportunities as tourist guides.

Keywords: continuing education, interpretive delivery skills, interpretive guiding, tour guide

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Authors: Walid Ibrahim, Abdul Kasem, Sudeendra Doddi, Ilaria Giono, Tareq Sabagh, Muhammad Ammar, Nermin Osman

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Background: wire-guided localization (WL) is the most widely used method for the localization of non-palpable breast lesions. SAVI SCOUT occult lesion localization (SSL) is a new technique in breast-conservative surgery. SSL has the potential benefit of improving radiology workflow as well as accurate localization. Purpose: The purpose of this study is to compare the breast tissue specimen volume and weight and margin excision between WL and SSL. Materials and methods: A single institution retrospective analysis of 377 female patients who underwent wide local breast excision with SAVI SCOUT and or wire-guided technique between 2018 and 2021 in a UK University teaching hospital. Breast department. Breast tissue specimen volume and weight, and margin excision have been evaluated in the three groups of different localization. Results: Three hundred and seventy-seven patients were studied. Of these, 261 had wire localization, 88 had SCOUT and 28 had dual localization techniques. Tumor size ranged from 1 to 75mm (Median 20mm). The pathology specimen weight ranged from 1 to 466gm (Median 46.8) and the volume ranged from 1.305 to 1560cm³ (Median 106.32 cm³). SCOUT localization was associated with a significantly low specimen weight than wire or the dual technique localization (Median 41gm vs 47.3gm and 47gm, p = 0.029). SCOUT was not associated with better specimen volume with a borderline significance in comparison to wire and combined techniques (Median 108cm³ vs 105cm³ and 105cm³, p = 0.047). There was a significant correlation between tumor size and pathology specimen weight in the three groups. SCOUT showed a better >2mm safety margin in comparison to the other 2 techniques (p = 0.031). Conclusion: Preoperative SCOUT localization is associated with better specimen weight and better specimen margin. SCOUT did not show any benefits in terms of specimen volume which may be due to difficulty in getting the accurate specimen volume due to the irregularity of the soft tissue specimen.

Keywords: scout, wire, localization, breast

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Authors: Conchita Martin de Bustamante, Christopher S. Kung, Brianne Lacy, Eunsol Park, Hien Piotrowski, Mustafa Husain, Waseem Ahmed

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Objective: To explore the comorbidity of mental health conditions (major depressive disorder, borderline personality disorder, generalized anxiety disorder, and schizophrenia) with opioid use disorder in people incarcerated at a large urban jail. Background Schizophrenia, depression, bipolar disorder, and anxiety are all serious mental health conditions that are highly prevalent amongst incarcerated patients. However, it is seldom the only disorder these patients are suffering from. According to the US Department of Justice, about half of US prisoners, both at the state and federal level, suffer from substance use disorders. Although the opioid epidemic has been studied greatly in the recent years amongst the general population, little has been explored on how the opioid crisis has affected incarcerated patients in local jails, particularly regarding which of these patients are most susceptible. Method The cohort consisted of 507 people incarcerated at a large county jail who were evaluated by mental health providers in December 2020. A retrospective review was performed to evaluate associations between mental health diagnoses, substance use disorder, and other demographic variables. Results Participants had been diagnosed with various mental health conditions, including MDD (22.6%, n = 115), GAD (33.7%, n = 171), Schizophrenia (15.2%, n = 77) and BPD (27%, n = 137). Preliminary Chi square tests were conducted for these conditions against marijuana, alcohol, cocaine, opioid, methamphetamine, benzodiazepines, and sedative use disorders. The results showed significant associations between Schizophrenia (p = 0.013), GAD (p M 0.001), and MDD (p = 0.029) with opioid use disorders. Conclusions Determining the extent of these comorbid substance use and mental health disorders within an incarcerated population can help influence treatment plans for future incarcerated patients. Many federal and state jail systems lack pharmacological substance use intervention and the prevalence of these co-morbid conditions can shed light on the importance of treating conditions concurrently upon intake.

Keywords: mental health conditions, opioids, substance use disorder, comorbidity

Procedia PDF Downloads 154

Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud

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Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.

Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors

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Authors: Busra Ekinci

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Urban heat island term becomes one of the most important problem in urban areas as a reflection of global warming in local scale last years. Many communities and governments are taking action to reduce heat island effects on urban areas where the half of the world's population live today. At this point, urban design turned out to be an important practice and research area for providing an environmentally sensitive urban development. In this study, mitigating strategies of urban heat island effects by urban design are investigated in Aksaray Square and surroundings in Istanbul. Aksaray is an important historical and commercial center of Istanbul, which has an increasing density due to be the node of urban transportation. Also, Istanbul Metropolitan Municipality prepared an urban design project to respond the needs of growing population in the area for 2018. The purpose of the study is emphasizing the importance of urban design objectives and strategies that are developed to reduce the heat island effects on urban areas. Depending on this, the urban heat island effect of the area was examined based on the albedo (reflectivity) parameter which is the most effective parameter in the formation of the heat island effect in urban areas. Albedo values were calculated by Albedo Viewer web application model that was developed by Energy and Environmental Engineering Department of Kyushu University in Japan. Albedo parameter had examined for the present situation and the planned situation with urban design project. The results show that, the current area has urban heat island potential. With the Aksaray Square Project, the heat island effect on the area can be reduced, but would not be completely prevented. Therefore, urban design strategies had been developed to reduce the island effect in addition to the urban design project of the area. This study proves that urban design objectives and strategies are quite effective to reduce the heat island effects, which negatively affect the social environment and quality of life in urban areas.

Keywords: Albedo, urban design, urban heat island, sustainable design

Procedia PDF Downloads 580