Search results for: dominant period
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6762

Search results for: dominant period

4602 Bacteriological Spectrum and Resistance Patterns of Common Clinical Isolates from Infections in Cancer Patients

Authors: Vivek Bhat, Rohini Kelkar, Sanjay Biswas

Abstract:

Introduction: Cancer patients are at increased risk of bacterial infections. This may due to the disease process itself, the effect of chemotherapeutic drugs or invasive procedures such as catheterization. A wide variety of bacteria including some emerging pathogens are increasingly being reported from these patients. The incidence of multidrug-resistant organisms particularly in the Gram negative group is also increasing, with higher resistance rates seen to cephalosporins, β-lactam/β-lactam inhibitor combinations, and the carbapenems. This study documents the bacteriological spectrum of infections and their resistance patterns in cancer patients. Methods: This study includes all bacterial isolates recovered from infections cancer patients over a period of 18 months. Samples included Blood cultures, Pus/wound swabs, urine, tissue biopsies, body fluids, catheter tips and respiratory specimens such as sputum and bronchoalveolar lavage (BAL). All samples were processed in the microbiology laboratory as per standard laboratory protocols. Organisms were identified to species level and antimicrobial susceptibility testing was performed manually by the disc diffusion technique or in the Vitek-2 (Biomereux, France) instrument. Interpretations were as per Clinical laboratory Standards Institute (CLSI) guidelines. Results: A total of 1150 bacterial isolates were cultured from 884 test samples during the study period. Of these 227 were Gram-positive and 923 were Gram-negative organisms. Staphylococcus aureus (99 isolates) was the commonest Gram-positive isolate followed by Enterococcus (79) and Gr A Streptococcus (30). Among the Gram negatives, E. coli (304), Pseudomonas aeruginosa (201) and Klebsiella pneumoniae (190) were the most common. Of the Staphylococcus aureus isolates 27.2% were methicillin resistant. Only 5.06% enterococci were vancomycin resistant. High rates of resistance to cefotaxime and ciprofloxacin were seen amongst E. coli (84.8% & 83.55%) and Klebsiella pneumoniae (71 & 62.1%) respectively. Resistance to carbapenems (meropenem) was high at 70% in Acinetobacter spp.; however all isolates were sensitive to colistin. Among the aminoglycosides, amikacin retained good efficacy against Escherichia coli (82.9%) and Pseudomonas aeruginosa (78.1%). Occasional isolates of emerging pathogens such as Chryseobacterium indologens, Roseomonas, and Achromobacter xyloxidans were also recovered. Conclusion: The common infections in cancer patients include respiratory, wound, tract infections and sepsis. The commonest isolates include Staphylococcus aureus, Enterococci, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. There is a high level of resistance to the commonly used antibiotics among Gram-negative organisms.

Keywords: bacteria, resistance, infection, cancer

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4601 Game of Funds: Efficiency and Policy Implications of the United Kingdom Research Excellence Framework

Authors: Boon Lee

Abstract:

Research publication is an essential output of universities because it not only promotes university recognition, it also receives government funding. The history of university research culture has been one of ‘publish or perish’ and universities have consistently encouraged their academics and researchers to produce research articles in reputable journals in order to maintain a level of competitiveness. In turn, the United Kingdom (UK) government funding is determined by the number and quality of research publications. This paper aims to investigate on whether more government funding leads to more quality papers. To that end, the paper employs a Network DEA model to evaluate the UK higher education performance over a period. Sources of efficiency are also determined via second stage regression analysis.

Keywords: efficiency, higher education, network data envelopment analysis, universities

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4600 High Speed Rail vs. Other Factors Affecting the Tourism Market in Italy

Authors: F. Pagliara, F. Mauriello

Abstract:

The objective of this paper is to investigate the relationship between the increase of accessibility brought by high speed rail (HSR) systems and the tourism market in Italy. The impacts of HSR projects on tourism can be quantified in different ways. In this manuscript, an empirical analysis has been carried out with the aid of a dataset containing information both on tourism and transport for 99 Italian provinces during the 2006-2016 period. Panel data regression models have been considered, since they allow modelling a wide variety of correlation patterns. Results show that HSR has an impact on the choice of a given destination for Italian tourists while the presence of a second level hub mainly affects foreign tourists. Attraction variables are also significant for both categories and the variables concerning security, such as number of crimes registered in a given destination, have a negative impact on the choice of a destination.

Keywords: tourists, overnights, high speed rail, attractions, security

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4599 Monitoring CO2 and H2S Emission in Live Austrian and UK Concrete Sewer Pipes

Authors: Anna Romanova, Morteza A. Alani

Abstract:

Corrosion of concrete sewer pipes induced by sulfuric acid is an acknowledged problem and a ticking time-bomb to sewer operators. Whilst the chemical reaction of the corrosion process is well-understood, the indirect roles of other parameters in the corrosion process which are found in sewer environment are not highly reflected on. This paper reports on a field studies undertaken in Austria and United Kingdom, where the parameters of temperature, pH, H2S and CO2 were monitored over a period of time. The study establishes that (i) effluent temperature and pH have similar daily pattern and peak times, When examined in minutes scale, (ii) H2S and CO2 have an identical hourly pattern, (iii) H2S instant or shifted relation to effluent temperature is governed by the root mean square value of CO2.

Keywords: concrete corrosion, carbon dioxide, hydrogen sulphide, sewer pipe, sulfuric acid

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4598 The Evloution of LGBTQ Right in the U. S.: The Vaugries of Presidential Leadership and Followership

Authors: Michael A. Genovese

Abstract:

The struggle for LGBTQ rights in the United States began in Greenwich Village, New York, in 1967, when police tried to break up a gathering of mostly gay men who were partying at the Stonewall Bar in NYC. As unlikely as it may sound, this “riot” proved to be consequential in raising the political consciousness of gay men in America. From that point on, gays engaged in a political battle to achieve the rights to which they were entitled. This essay examines changes in popular opinion regarding LGBTQ rights from the late 1960s through the Trump administration, and examines the role public pressure played on presidential politics. For most of this period, presidents “followed” public opinion. This was true even during the administration of Barack Obama when gay Americans finally achieved some clearly spelled out rights (e.g. same-sex marriage). The findings of this paper call into question certain assumptions about presidential leadership, and underline the power of public opinion in shaping policy.

Keywords: presidential leadership, gay rights, LGBTQ, popular opinion

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4597 Examining the Impact of Degrees of Slag Replacement on the Carbonation Process of Slag-Blended Cement

Authors: Geta Bekalu Belayneh, Solmoi Park

Abstract:

This study examines the role of slag in the process of hydration and carbonation of carbonation-cured slag cement. Carbonation-cured slag-blended cement paste samples were prepared with varying slag percentages of 0%, 10%, 30%, and 50%. The curing process lasted for a maximum of 28 days. The findings demonstrated that the carbonation depth increased as the curing period was extended, and a larger slag percentage promoted a more extensive penetration of carbonation. The degree of belite reaction was greatly enhanced in the slag-blended cement, resulting in an increased ability to bind CO₂ in the blended cement. These findings enhance comprehension of the behaviour of blended cement produced through carbonation-curing, facilitating the advancement of more environmentally friendly and long-lasting concrete constructions.

Keywords: carbonation curing, blast furnace slag, characterization, Portland cement

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4596 The Impact of Diversification Strategy on Leverage and Accrual-Based Earnings Management

Authors: Safa Lazzem, Faouzi Jilani

Abstract:

The aim of this research is to investigate the impact of diversification strategy on the nature of the relationship between leverage and accrual-based earnings management through panel-estimation techniques based on a sample of 162 nonfinancial French firms indexed in CAC All-Tradable during the period from 2006 to 2012. The empirical results show that leverage increases encourage managers to manipulate earnings management. Our findings prove that the diversification strategy provides the needed context for this accounting practice to be possible in highly diversified firms. In addition, the results indicate that diversification moderates the relationship between leverage and accrual-based earnings management by changing the nature and the sign of this relationship.

Keywords: diversification, earnings management, leverage, panel-estimation techniques

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4595 Testing the Validity of Feldstein-Horioka Puzzle in BRICS Countries

Authors: Teboho J. Mosikari, Johannes T. Tsoku, Diteboho L. Xaba

Abstract:

The increase of capital mobility across emerging economies has become an interesting topic for many economic policy makers. The current study tests the validity of Feldstein–Horioka puzzle for 5 BRICS countries. The sample period of the study runs from 2001 to 2014. The study uses the following parameter estimates well known as the Fully Modified OLS (FMOLS), and Dynamic OLS (DOLS). The results of the study show that investment and savings are cointegrated in the long run. The parameters estimated using FMOLS and DOLS are 0.85 and 0.74, respectively. These results imply that policy makers within BRICS countries have to consider flexible monetary and fiscal policy instruments to influence the mobility of capital with the bloc.

Keywords: Feldstein and Horioka puzzle, saving and investment, panel models, BRICS countries

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4594 Bending and Shear Characteristics of Hollowcore Slab with Polystyrene Forms

Authors: Kang Kun Lee

Abstract:

New I-slab system with polystyrene forms and precast concrete deck is proposed to reduce the construction period and the self-weight of the slab. This paper presents experimental works on the bending and shear of the I-slabs. Five specimens were tested. The main parameters of experiments are diameters of the holes made by polystyrene form and the thickness of slab. Structural performance of I-slab is evaluated on the basis of failure mode, load-displacement curve, and ultimate strengths. Based on the test results, it is found that the critical punching shear sections are changed as the test variables are different, hence resulting in the varied punching shear strengths. Test results indicate that the developed I-slab is very effective to increase the strength due to self-weight reduction.

Keywords: hollowcore slab, section force-deformation response, precast concrete deck

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4593 Mechanism of Cathodic Protection to Minimize Corrosion Caused by Chloride in Reinforcement Concrete

Authors: Mohamed A. Deyab, Omnia El-Shamy

Abstract:

The main objective of this case study is to integrate the advantages of cathodic protection technologies in order to lessen chloride-induced corrosion in reinforced concrete. This research employs potentiodynamic polarisation, impedance spectroscopy (EIS), and surface characteristics. The results showed how effectively the new cathodic control strategy is preventing corrosion of the concrete iron rods. Over time, the protective system becomes more reliable and effective. The potentials of the zinc electrode persist still more negative after 30 days, implying that the zinc electrode can maintain powerful electrocatalytic behavior for a long period of time. As per the electrochemical impedance spectroscopy (EIS), using the CP technique reduces the rate of corrosion of rebar iron in cementitious materials over time.

Keywords: cathodic protection, corrosion, reinforced concrete, chloride

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4592 The Political Economy of Green Trade in the Context of US-China Trade War: A Case Study of US Biofuels and Soybeans

Authors: Tonghua Li

Abstract:

Under the neoliberal corporate food regime, biofuels are a double-edged sword that exacerbates tensions between national food security and trade in green agricultural products. Biofuels have the potential to help achieve green sustainable development goals, but they threaten food security by exacerbating competition for land and changing global food trade patterns. The U.S.-China trade war complicates this debate. Under the influence of different political and corporate coordination mechanisms in China and the US, trade disputes can have different impacts on sustainable agricultural practices. This paper develops an actor-centred ‘network governance framework’ focusing on trade in soybean and corn-based biofuels to explain how trade wars can change the actions of governmental and non-governmental actors in the context of oligopolistic competition and market concentration in agricultural trade. There is evidence that the US-China trade decoupling exacerbates the conflict between national security, free trade in agriculture, and the realities and needs of green and sustainable energy development. The US government's trade policies reflect concerns about China's relative gains, leading to a loss of trade profits, making it impossible for the parties involved to find a balance between the three objectives and, consequently, to get into a biofuels and soybean industry dilemma. Within the setting of prioritizing national security and strategic interests, the government has replaced the dominant position of large agribusiness in the neoliberal food system, and the goal of environmental sustainability has been marginalized by high politics. In contrast, China faces tensions in the trade war between food security self-sufficiency policy and liberal sustainable trade, but the state-capitalist model ensures policy coordination and coherence in trade diversion and supply chain adjustment. Despite ongoing raw material shortages and technological challenges, China remains committed to playing a role in global environmental governance and promoting green trade objectives.

Keywords: food security, green trade, biofuels, soybeans, US-China trade war

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4591 Corruption and Income: Case of Independent Turkish Republic

Authors: Rahime Hülya Öztürk

Abstract:

Along with the development of globalization, the relationship between economic, politic and commercial behaviors became unlimited. The liberalization of capital has many advantages for countries, but it also has some disadvantages. In these disadvantages the most important one is corruption. Especially in Developing Countries and Underdeveloped countries, corruption is very extensive. Corruption causes inefficient use of resources and promotes income inequality. Especially in the transition period of economies corruption increases and sometimes governments don’t interfere. To fight against corruption domestic and international measures are taken. Corruption is an economic problem, but it also has social and moral effects. The aim of this study is to define the relationship between corruption and income in Independent Turkish State. In the first part of the study, the concept of corruption is examined. In the second part of the study, information about The Independent Turkish Republic is given. In the third part of the study, country’s relationship between corruption and income is analyzed with panel data analysis.

Keywords: corruption, income, independent Turkish Republic, distribution of income

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4590 Sustainable Underground Structures Through Soil-Driven Bio-Protection of Concrete

Authors: Abdurahim Abogdera, Omar Hamza, David Elliott

Abstract:

The soil bacteria can be affected by some factors such as pH, calcium ions and Electrical conductivity. Fresh concrete has high pH value, which is between 11 and 13 and these values will be prevented the bacteria to produce CO₂ to participate with Calcium ions that released from the concrete to get calcite. In this study we replaced 15% and 25% of cement with Fly ash as the fly ash reduce the value of the pH at the concrete. The main goal of this study was investigated whether bacteria can be used on the soil rather than in the concrete to avoid the challenges and limitations of containing bacteria inside the concrete. This was achieved by incubating cracked cement mortar specimens into fully saturated sterilized and non-sterilized soil. The crack sealing developed in the specimens during the incubation period in both soil conditions were evaluated and compared. Visual inspection, water absorption test, scanning electron microscopy (SEM), and Energy Dispersive X-ray (EDX) were conducted to evaluate the healing process.

Keywords: pH, calcium ions, MICP, salinity

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4589 Effect of Minimalist Footwear on Running Economy Following Exercise-Induced Fatigue

Authors: Jason Blair, Adeboye Adebayo, Mohamed Saad, Jeannette M. Byrne, Fabien A. Basset

Abstract:

Running economy is a key physiological parameter of an individual’s running efficacy and a valid tool for predicting performance outcomes. Of the many factors known to influence running economy (RE), footwear certainly plays a role owing to its characteristics that vary substantially from model to model. Although minimalist footwear is believed to enhance RE and thereby endurance performance, conclusive research reports are scarce. Indeed, debates remain as to which footwear characteristics most alter RE. The purposes of this study were, therefore, two-fold: (a) to determine whether wearing minimalist shoes results in better RE compared to shod and to identify relationships with kinematic and muscle activation patterns; (b) to determine whether changes in RE with minimalist shoes are still evident following a fatiguing bout of exercise. Well-trained male distance runners (n=10; 29.0 ± 7.5 yrs; 71.0 ± 4.8 kg; 176.3 ± 6.5 cm) partook first in a maximal O₂ uptake determination test (VO₂ₘₐₓ = 61.6 ± 7.3 ml min⁻¹ kg⁻¹) 7 days prior to the experimental sessions. Second, in a fully randomized fashion, an RE test consisting of three 8-min treadmill runs in shod and minimalist footwear were performed prior to and following exercise induced fatigue (EIF). The minimalist and shod conditions were tested with a minimum of 7-day wash-out period between conditions. The RE bouts, interspaced by 2-min rest periods, were run at 2.79, 3.33, and 3.89 m s⁻¹ with a 1% grade. EIF consisted of 7 times 1000 m at 94-97% VO₂ₘₐₓ interspaced with 3-min recovery. Cardiorespiratory, electromyography (EMG), kinematics, rate of perceived exertion (RPE) and blood lactate were measured throughout the experimental sessions. A significant main speed effect on RE (p=0.001) and stride frequency (SF) (p=0.001) was observed. The pairwise comparisons showed that running at 2.79 m s⁻¹ was less economic compared to 3.33, and 3.89 m s⁻¹ (3.56 ± 0.38, 3.41 ± 0.45, 3.40 ± 0.45 ml O₂ kg⁻¹ km⁻¹; respectively) and that SF increased as a function of speed (79 ± 5, 82 ± 5, 84 ± 5 strides min⁻¹). Further, EMG analyses revealed that root mean square EMG significantly increased as a function of speed for all muscles (Biceps femoris, Gluteus maximus, Gastrocnemius, Tibialis anterior, Vastus lateralis). During EIF, the statistical analysis revealed a significant main effect of time on lactate production (from 2.7 ± 5.7 to 11.2 ± 6.2 mmol L⁻¹), RPE scores (from 7.6 ± 4.0 to 18.4 ± 2.7) and peak HR (from 171 ± 30 to 181 ± 20 bpm), expect for the recovery period. Surprisingly, a significant main footwear effect was observed on running speed during intervals (p=0.041). Participants ran faster with minimalist shoes compared to shod (3:24 ± 0:44 min [95%CI: 3:14-3:34] vs. 3:30 ± 0:47 min [95%CI: 3:19-3:41]). Although EIF altered lactate production and RPE scores, no other effect was noticeable on RE, EMG, and SF pre- and post-EIF, except for the expected speed effect. The significant footwear effect on running speed during EIF was unforeseen but could be due to shoe mass and/or heel-toe-drop differences. We also cannot discard the effect of speed on foot-strike pattern and therefore, running performance.

Keywords: exercise-induced fatigue, interval training, minimalist footwear, running economy

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4588 Act Local, Think Global: Superior Institute of Engineering of Porto Campaign for a Sustainable Campus

Authors: R. F. Mesquita Brandão

Abstract:

Act Local, Think Global is the name of a campaign implemented at Superior Institute of Engineering of Porto (ISEP), one of schools of Polytechnic of Porto, with the main objective of increase the sustainability of the campus. ISEP has a campus with 52.000 m2 and more than 7.000 students. The campaign started in 2019 and the results are very clear. In 2019 only 16% of the waste created in the campus was correctly separate for recycling and now almost 50% of waste goes to the correct waste container. Actions to reduce the energy consumption were implemented with significantly results. One of the major problems in the campus are the water leaks. To solve this problem was implemented a methodology for water monitoring during the night, a period of time where consumptions are normally low. If water consumption in the period is higher than a determinate value it may mean a water leak and an alarm is created to the maintenance teams. In terms of energy savings, some measurements were implemented to create savings in energy consumption and in equivalent CO₂ produced. In order to reduce the use of plastics in the campus, was implemented the prohibition of selling 33 cl plastic water bottles and in collaboration with the students association all meals served in the restaurants changed the water plastic bottle for a glass that can be refilled with water in the water dispensers. This measures created a reduction of use of more than 75.000 plastic bottles per year. In parallel was implemented the ISEP water glass bottle to be used in all scientific meetings and events. Has a way of involving all community in sustainability issues was developed and implemented a vertical garden in aquaponic system. In 2019, the first vertical garden without soil was installed inside a large campus building. The system occupies the entire exterior façade (3 floors) of the entrance to ISEP's G building. On each of these floors there is a planter with 42 positions available for plants. Lettuces, strawberries, peppers are examples of some vegetable produced that can be collected by the entire community. Associated to the vertical garden was developed a monitoring system were some parameters of the system are monitored. This project is under development because it will work in a stand-alone energy feeding, with the use of photovoltaic panels for production of energy necessities. All the system was, and still is, developed by students and teachers and is used in class projects of some ISEP courses. These and others measures implemented in the campus, will be more developed in the full paper, as well as all the results obtained, allowed ISEP to be the first Portuguese high school to obtain the certification “Coração Verde” (Green Heart), awarded by LIPOR, a Portuguese company with the mission of transform waste into new resources through the implementation of innovative and circular practices, generating and sharing value.

Keywords: aquaponics, energy efficiency, recycling, sustainability, waste separation

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4587 The Role of Meaningful Work in Transformational Leadership and Work Outcomes Relationship

Authors: Zainur Rahman

Abstract:

Meaningful work is the topic that will be discussed in this article, especially in changing period. It has an important role because by reaching meaningful work, it will drive to be positive in the workplace. Therefore, task performance will be increased and cynicism about organizational change (CAOC) will be reduced. Moreover, it is influenced by situational factor, which is transformational leadership. In this conceptual paper, the author discusses how the construct of meaningful work influenced by transformational leadership that will have impact on the follower’ work outcomes in the organizational change. It is proposed that the construct of meaningful work are susceptible with situational variable. Transformational leaders who are respectful on the process of humanizing the followers affect task performance and reduce CAOC in organizational change.

Keywords: transformational leadership, meaningful work, task performance, CAOC

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4586 The Pioneering Model in Teaching Arabic as a Mother Tongue through Modern Innovative Strategies

Authors: Rima Abu Jaber Bransi, Rawya Jarjoura Burbara

Abstract:

This study deals with two pioneering approaches in teaching Arabic as a mother tongue: first, computerization of literary and functional texts in the mother tongue; second, the pioneering model in teaching writing skills by computerization. The significance of the study lies in its treatment of a serious problem that is faced in the era of technology, which is the widening gap between the pupils and their mother tongue. The innovation in the study is that it introduces modern methods and tools and a pioneering instructional model that turns the process of mother tongue teaching into an effective, meaningful, interesting and motivating experience. In view of the Arabic language diglossia, standard Arabic and spoken Arabic, which constitutes a serious problem to the pupil in understanding unused words, and in order to bridge the gap between the pupils and their mother tongue, we resorted to computerized techniques; we took texts from the pre-Islamic period (Jahiliyya), starting with the Mu'allaqa of Imru' al-Qais and other selected functional texts and computerized them for teaching in an interesting way that saves time and effort, develops high thinking strategies, expands the literary good taste among the pupils, and gives the text added values that neither the book, the blackboard, the teacher nor the worksheets provide. On the other hand, we have developed a pioneering computerized model that aims to develop the pupil's ability to think, to provide his imagination with the elements of growth, invention and connection, and motivate him to be creative, and raise level of his scores and scholastic achievements. The model consists of four basic stages in teaching according to the following order: 1. The Preparatory stage, 2. The reading comprehension stage, 3. The writing stage, 4. The evaluation stage. Our lecture will introduce a detailed description of the model with illustrations and samples from the units that we built through highlighting some aspects of the uniqueness and innovation that are specific to this model and the different integrated tools and techniques that we developed. One of the most significant conclusions of this research is that teaching languages through the employment of new computerized strategies is very likely to get the Arabic speaking pupils out of the circle of passive reception into active and serious action and interaction. The study also emphasizes the argument that the computerized model of teaching can change the role of the pupil's mind from being a store of knowledge for a short time into a partner in producing knowledge and storing it in a coherent way that prevents its forgetfulness and keeping it in memory for a long period of time. Consequently, the learners also turn into partners in evaluation by expressing their views, giving their notes and observations, and application of the method of peer-teaching and learning.

Keywords: classical poetry, computerization, diglossia, writing skill

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4585 An Intervention Method on Improving Teamwork Competence for Business Studies Undergraduates

Authors: Silvia Franco, Marcos Sarasola

Abstract:

The Faculty of Business Administration at the Catholic University of Uruguay is performing an important educational innovation, unique in the country. In preparing future professionals in companies, teamwork competence is very important. However, there is no often a systematic and specific training in the acquisition of this competence in undergraduate students. For this reason, we have designed and implemented an educational innovation through an intervention method to improve teamwork competence for undergraduate students of business studies. Students’ teams are integrated according to the complementary roles of Belbin; changes in teamwork competence during training period are measured with CCSAC tool; classroom methodology in the prio-border teamwork by Team-Based Learning. Methodology also integrates coaching and support team performance during the first two semesters.

Keywords: business students, teamwork, learning, competences

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4584 A New Mathematical Model for Scheduling Preventive Maintenance and Renewal Projects of Multi-Unit Systems; Application to Railway Track

Authors: Farzad Pargar

Abstract:

We introduce the preventive maintenance and renewal scheduling problem for a multi-unit system over a finite and discretized time horizon. Given the latest possible time for carrying out the next maintenance and renewal projects after the previous ones and considering several common set-up costs, the introduced scheduling model tries to minimize the cost of projects by grouping them and simultaneously finding the optimal balance between doing maintenance and renewal. We present a 0-1 pure integer linear programming that determines which projects should be performed together on which location and in which period (e.g., week or month). We consider railway track as a case for our study and test the performance of the proposed model on a set of test problems. The experimental results show that the proposed approach performs well.

Keywords: maintenance, renewal, scheduling, mathematical programming model

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4583 Real-world Characterization of Treatment Intensified (Add-on to Metformin) Adults with Type 2 Diabetes in Pakistan: A Multi-center Retrospective Study (Converge)

Authors: Muhammad Qamar Masood, Syed Abbas Raza, Umar Yousaf Raja, Imran Hassan, Bilal Afzal, Muhammad Aleem Zahir, Atika Shaheer

Abstract:

Background: Cardiovascular disease (CVD) is a major burden among people with type 2 diabetes (T2D) with 1 in 3 reported to have CVD. Therefore, understanding real-world clinical characteristics and prescribing patterns could help in better care. Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real world with GLP-1RAs) study characterized demographics and medication usage patterns in T2D intensified (add-on to metformin) overall population. The data were further divided into subgroups {dipeptidyl peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), insulins, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is)}, according to the latest prescribed antidiabetic agent (ADA) in India/Pakistan/Thailand. Here, we report findings from Pakistan. Methods: A multi-center retrospective study utilized data from medical records between 13-Sep-2008 (post-market approval of GLP-1RAs) and 31-Dec-2017 in adults (≥18-year-old). The data for this study were collected from 05 centers / institutes located in major cities of Pakistan, including Karachi, Lahore, Islamabad, and Multan. These centers included National Hospital, Aga Khan University Hospital, Diabetes Endocrine Clinic Lahore, Shifa International Hospital, Mukhtar A Sheikh Hospital Multan. Data were collected at start of medical record and at 6 or 12-months prior to baseline based on variable type; analyzed descriptively. Results: Overall, 1,010 patients were eligible. At baseline, overall mean age (SD) was 51.6 (11.3) years, T2D duration was 2.4 (2.6) years, HbA1c was 8.3% (1.9) and 35% received ≥1CVD medications in the past 1-year (before baseline). Most frequently prescribed ADAs post-metformin were DPP-4is and SUs (~63%). Only 6.5% received GLP-1RAs and SGLT-2is were not available in Pakistan during the study period. Overall, it took a mean of 4.4 years and 5 years to initiate GLP-1RAs and SGLT-2is, respectively. In comparison to other subgroups, more patients from GLP-1RAs received ≥3 types of ADA (58%), ≥1 CVD medication (64%) and had higher body mass index (37kg/m2). Conclusions: Utilization of GLP-1RAs and SGLT-2is was low, took longer time to initiate and not before trying multiple ADAs. This may be due to lack of evidence for CV benefits for these agents during the study period. The planned phase 2 of the CONVERGE study can provide more insights into utilization and barriers to prescribe GLP-1RAs and SGLT-2is post 2018 in Pakistan.

Keywords: type 2 diabetes, GLP-1RA, treatment intensification, cardiovascular disease

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4582 Surgical Management of Cystic Lesions in the Sellar and Suprasellar Region

Authors: Hakim Derradji, Abdelkader Yahi, Abdelmalek Sabrou, Nacer Tabet

Abstract:

Introduction: Cystic lesions located in the sellar and suprasellar region cause a diagnostic and therapeutic problem, given their location and their impact on neighboring structures. The patient's symptomatology varies from a simple headache to serious visual and endocrine disorders, involving the functional prognosis, sometimes even the vital prognosis. Surgery in this region remains a therapeutic challenge, and several surgical techniques have been described and used. Material and Methods: We treated 15 patients during the period from 2015 to 2022, whose clinical, biological, radiological, and therapeutic characteristics will be presented in detail in this work, and in whom the surgical technique differs from one case to another. Conclusion: We will discuss in this work the different techniques used to treat these lesions and the different objectives to be achieved for each case, as well as the complications and our conduct to be taken per and post-operative.

Keywords: cystic lesions, adenomas, sellar and suprasellar region, neuroendoscopy

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4581 The Leaching Kinetics of Zinc from Industrial Zinc Slag Waste

Authors: Hilary Rutto

Abstract:

The investigation was aimed at determining the extent at which the zinc will be extracted from secondary sources generated from galvanising process using dilute sulphuric acid under controlled laboratory conditions of temperature, solid-liquid ratio, and agitation rate. The leaching experiment was conducted for a period of 2 hours and to total zinc extracted calculated in relation to the amount of zinc dissolved at a unit time in comparison to the initial zinc content of the zinc ash. Sulphuric acid was found to be an effective leaching agent with an overall extraction of 91.1% when concentration is at 2M, and solid/liquid ratio kept at 1g/200mL leaching solution and temperature set at 65ᵒC while slurry agitation is at 450rpm. The leaching mechanism of zinc ash with sulphuric acid was conformed well to the shrinking core model.

Keywords: leaching, kinetics, shrinking core model, zinc slag

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4580 Reproductive Biology of Chirruh Snowtrout (Schizothorax Esocinus) from River Swat, Pakistan

Authors: Waheed Akhtar

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In the current study, we aim to access the different month-wise reproductive biology of S. esocinus. Samples were collected from Rive Swat in the period of March 2022 to March 2023. Samples were collected using different gills nets of different sizes. Gonado Somatic Index and fecundity were studied using gravimetric to identify the breeding season and reproductive potential. The highest GSI was recorded in the month of April and November. Male to female ratio was in balance. The weight of the fish, size of the fish and ovary were parallel to the fecundity. This is the baseline study for the breeding biology of S. esocinus and further molecular study is required to identify the internal and external factors associated with the breeding biology of S. esocinus.

Keywords: snow trout, length and weight relationship, fecundity, river Swat

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4579 Application of EEG Wavelet Power to Prediction of Antidepressant Treatment Response

Authors: Dorota Witkowska, Paweł Gosek, Lukasz Swiecicki, Wojciech Jernajczyk, Bruce J. West, Miroslaw Latka

Abstract:

In clinical practice, the selection of an antidepressant often degrades to lengthy trial-and-error. In this work we employ a normalized wavelet power of alpha waves as a biomarker of antidepressant treatment response. This novel EEG metric takes into account both non-stationarity and intersubject variability of alpha waves. We recorded resting, 19-channel EEG (closed eyes) in 22 inpatients suffering from unipolar (UD, n=10) or bipolar (BD, n=12) depression. The EEG measurement was done at the end of the short washout period which followed previously unsuccessful pharmacotherapy. The normalized alpha wavelet power of 11 responders was markedly different than that of 11 nonresponders at several, mostly temporoparietal sites. Using the prediction of treatment response based on the normalized alpha wavelet power, we achieved 81.8% sensitivity and 81.8% specificity for channel T4.

Keywords: alpha waves, antidepressant, treatment outcome, wavelet

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4578 Customer Segmentation Revisited: The Case of the E-Tailing Industry in Emerging Market

Authors: Sanjeev Prasher, T. Sai Vijay, Chandan Parsad, Abhishek Banerjee, Sahakari Nikhil Krishna, Subham Chatterjee

Abstract:

With rapid rise in internet retailing, the industry is set for a major implosion. Due to the little difference among competitors, companies find it difficult to segment and target the right shoppers. The objective of the study is to segment Indian online shoppers on the basis of the factors – website characteristics and shopping values. Together, these cover extrinsic and intrinsic factors that affect shoppers as they visit web retailers. Data were collected using questionnaire from 319 Indian online shoppers, and factor analysis was used to confirm the factors influencing the shoppers in their selection of web portals. Thereafter, cluster analysis was applied, and different segments of shoppers were identified. The relationship between income groups and online shoppers’ segments was tracked using correspondence analysis. Significant findings from the study include that web entertainment and informativeness together contribute more than fifty percent of the total influence on the web shoppers. Contrary to general perception that shoppers seek utilitarian leverages, the present study highlights the preference for fun, excitement, and entertainment during browsing of the website. Four segments namely Information Seekers, Utility Seekers, Value Seekers and Core Shoppers were identified and profiled. Value seekers emerged to be the most dominant segment with two-fifth of the respondents falling for hedonic as well as utilitarian shopping values. With overlap among the segments, utilitarian shopping value garnered prominence with more than fifty-eight percent of the total respondents. Moreover, a strong relation has been established between the income levels and the segments of Indian online shoppers. Web shoppers show different motives from being utility seekers to information seekers, core shoppers and finally value seekers as income levels increase. Companies can strategically use this information for target marketing and align their web portals accordingly. This study can further be used to develop models revolving around satisfaction, trust and customer loyalty.

Keywords: online shopping, shopping values, effectiveness of information content, web informativeness, web entertainment, information seekers, utility seekers, value seekers, core shoppers

Procedia PDF Downloads 195
4577 The Emerging Multi-Species Trap Fishery in the Red Sea Waters of Saudi Arabia

Authors: Nabeel M. Alikunhi, Zenon B. Batang, Aymen Charef, Abdulaziz M. Al-Suwailem

Abstract:

Saudi Arabia has a long history of using traps as a traditional fishing gear for catching commercially important demersal, mainly coral reef-associated fish species. Fish traps constitute the dominant small-scale fisheries in Saudi waters of Arabian Gulf (eastern seaboard of Saudi Arabia). Recently, however, traps have been increasingly used along the Saudi Red Sea coast (western seaboard), with a coastline of 1800 km (71%) compared to only 720 km (29%) in the Saudi Gulf region. The production trend for traps indicates a recent increase in catches and percent contribution to traditional fishery landings, thus ascertaining the rapid proliferation of trap fishing along the Saudi Red Sea coast. Reef-associated fish species, mainly groupers (Serranidae), emperors (Lethrinidae), parrotfishes (Scaridae), scads and trevallies (Carangidae), and snappers (Lutjanidae), dominate the trap catches, reflecting the reef-dominated shelf zone in the Red Sea. This ongoing investigation covers following major objectives (i) Baseline studies to characterize trap fishery through landing site visit and interview surveys (ii) Stock assessment by fisheries and biological data obtained through monthly landing site monitoring using fishery operational model by FLBEIA, (iii) Operational impacts, derelict traps assessment and by-catch analysis through bottom-mounted video camera and onboard monitoring (iv) Elucidation of fishing grounds and derelict traps impacts by onboard monitoring, Remotely Operated underwater Vehicle and Autonomous Underwater Vehicle surveys; and (v) Analysis of gear design and operations which covers colonization and deterioration experiments. The progress of this investigation on the impacts of the trap fishery on fish stocks and the marine environment in the Saudi Red Sea region is presented.

Keywords: red sea, Saudi Arabia, fish trap, stock assessment, environmental impacts

Procedia PDF Downloads 350
4576 Evaluation of Salivary Nickel Level During Orthodontic Treatment

Authors: Mudafara S. Bengleil, Juma M. Orfi, Iman Abdelgader

Abstract:

Since nickel is a known toxic and carcinogenic metal, the present study was designed to evaluate the level of nickel released into the saliva of orthodontic patients. Non-stimulated saliva was collected from 18 patients attending The Orthodontic Clinic of Dental Faculty of Benghazi University. Patients were divided into two groups and level of nickel was determined by atomic absorption spectrophotometry. Nickel concentration values (mg/L) in first group prior to starting treatment was 0.097± 0.071. An increase in level of nickel was followed by decrease 4 and 8 weeks after applying the arch wire (0.208± 0.112) and (0.077±0.056 mg/L) respectively. Nickel levels in saliva of the second group were showed minimal variation and ranged from 0.061± 0.044mg/L to 0.083±0.054 throughout period of study. It may be concluded that there could be a release of nickel from the appliance used in first group but it doesn't reach toxic level in saliva.

Keywords: atomic absorption spectrophotometry, nickel, orthodontic treatment, saliva, toxicity

Procedia PDF Downloads 350
4575 A Case Study on Quantitatively and Qualitatively Increasing Student Output by Using Available Word Processing Applications to Teach Reluctant Elementary School-Age Writers

Authors: Vivienne Cameron

Abstract:

Background: Between 2010 and 2017, teachers in a suburban public school district struggled to get students to consistently produce adequate writing samples as measured by the Pennsylvania state writing rubric for measuring focus, content, organization, style, and conventions. A common thread in all of the data was the need to develop stamina in the student writers. Method: All of the teachers used the traditional writing process model (prewrite, draft, revise, edit, final copy) during writing instruction. One teacher taught the writing process using word processing and incentivizing with publication instead of the traditional pencil/paper/grading method. Students did not have instruction in typing/keyboarding. The teacher submitted resulting student work to real-life contests, magazines, and publishers. Results: Students in the test group increased both the quantity and quality of their writing over a seven month period as measured by the Pennsylvania state writing rubric. Reluctant writers, as well as students with autism spectrum disorder, benefited from this approach. This outcome was repeated consistently over a five-year period. Interpretation: Removing the burden of pencil and paper allowed students to participate in the writing process more fully. Writing with pencil and paper is physically tiring. Students are discouraged when they submit a draft and are instructed to use the Add, Remove, Move, Substitute (ARMS) method to revise their papers. Each successive version becomes shorter. Allowing students to type their papers frees them to quickly and easily make changes. The result is longer writing pieces in shorter time frames, allowing the teacher to spend more time working on individual needs. With this additional time, the teacher can concentrate on teaching focus, content, organization, style, conventions, and audience. S/he also has a larger body of works from which to work on whole group instruction such as developing effective leads. The teacher submitted the resulting student work to contests, magazines, and publishers. Although time-consuming, the submission process was an invaluable lesson for teaching about audience and tone. All students in the test sample had work accepted for publication. Students became highly motivated to succeed when their work was accepted for publication. This motivation applied to special needs students, regular education students, and gifted students.

Keywords: elementary-age students, reluctant writers, teaching strategies, writing process

Procedia PDF Downloads 176
4574 Nutritional Evaluation of Sea Buckthorn “Hippophae rhamnoides” Berries and the Pharmaceutical Potential of the Fermented Juice

Authors: Sobhy A. El-Sohaimy, Mohamed G. Shehata, Ashwani Mathur, Amira G. Darwish, Nourhan M. Abd El-Aziz, Pammi Gauba, Pooja Upadhyay

Abstract:

Sea buckthorn is a temperate bush plant native to Asian and European countries, explored across the world in traditional medicine to treat various diseases due to the presence of an exceptionally high content of phenolics, flavonoids and antioxidants. In addition to the evaluation of nutrients and active compounds, the focus of the present work was to assess the optimal levels for L. plantarum RM1 growth by applying response surface methodology (RSM), and to determine the impact of juice fermentation on antioxidant, anti-hypertension and anticancer activity, as well as on organoleptic properties. Sea buckthorn berries were shown to contain good fiber content (6.55%, 25 DV%), high quality of protein (3.12%, 6.24 DV%) containing: histidine, valine, threonine, leucine and lysine (with AAS 24.32, 23.66, 23.09, 23.05 and 21.71%, respectively), and 4.45% sugar that pro- vides only 79 calories. Potassium was shown to be the abundant mineral content (793.43%, 22.66 DV), followed by copper and phosphorus (21.81 and 11.07 DV%, respectively). Sea buckthorn juice exhibited a rich phenolic, flavonoid and carotenoid content (283.58, 118.42 and 6.5 mg/g, respec- tively), in addition to a high content of vitamin C (322.33 mg/g). The HPLC profile indicated that benzoic acid is the dominant phenolic compound in sea buckthorn berries (3825.90 mg/kg). Antiox- idant potentials (DPPH and ABTS) of sea buckthorn showed higher inhibition than ascorbic acid. Antimicrobial potentials were most pronounced against Escherichia coli BA12296 (17.46 mm). The probiotic growth was 8.5 log cfu/mL, with juice concentration, inoculum size and temperature as the main contributors to probiotic growth with a 95% confidence level. Fermentation of sea buck- thorn juice with L. plantarum RM1 enhanced the functional phenolic and flavonoid content, as well as antioxidant and antimicrobial activities. The fermentation with L. plantarum RM1 enhanced the anti-hypertension and anticancer properties of the sea buckthorn juice and gained consumers’ sensorial overall acceptance.

Keywords: sea buckthorn juice, L. plantarum RM1, fermentation, antioxidant, antimicrobial, angiotensin converting enzyme inhibition

Procedia PDF Downloads 99
4573 Walking in the Steps of Poets: Evoking Past Poets in Sufi Poetry

Authors: Bilal Orfali

Abstract:

It is common practice in modern times to read mystical poetry and apply it to our mundane lives and loves. Sufis in the early period did the opposite. Their mystical hymns often spun out of the courtly poetic ghazal, panegyric, and wine songs. This paper highlights the relation of the Arabic courtly poetic canon to early Sufism. Sufi akhbār and poetry evoke past poets and their poetic heritage. They tend to quote or refer to eminent poets whose poetry must have been widely circulated and memorized. However, Sufism places this readily recognizable poetry in a new context that deliberately changes the past. It is a process of a metaphorization in which the reality of the pre-Islamic, Umayyad, and Abbasid models now acts as a device or metaphor for the Sufi poetics.

Keywords: Sufism, Arabic poetry, literature, Islamic literature, Abbasid

Procedia PDF Downloads 313