Search results for: nutrition therapy guide
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3732

Search results for: nutrition therapy guide

1272 Child Feeding Practices of Mothers (Childbearing) and Exploration of Their Household Food Insecurity in a Coastal Region of Bangladesh

Authors: Md Abdullah Al Mamun

Abstract:

Background: The current situation of Ensuring WHO recommended feeding practices for infant and young children which is becoming a challenge nowadays in many developing countries, especially in areas where household food security is at risk. Because many households of the developing countries often encounter severe food insecurity hence provision of adequate child nutrition is threatened. Aim: The study aimed to assess the child feeding practices of 0-24 months childbearing mothers and explore their household food insecurity in a coastal region of Bangladesh. Methods: This study was conducted in Suborno Char (one of the coastal suburbs in Noakhali District in Bangladesh) from October 2019 to April 2020. A total of 400 mothers were selected with their children of 0-24 months following a cross sectional study sampling procedure of the population. Data were collected through a standard questionnaire and analyzed using statistical tests in SPSS version 20.0.0. Results: The frequency of exclusive breastfeeding, timely initiation of complementary feeding, and giving foods from four food groups to the children were 53.5%, 75.5%, and 22.2%, respectively. Mother's level of education showed a strong association with the child feeding practices of the mothers. Mothers of severely food insecure households showed lower odds in exclusive breastfeeding practice (COR 0.233 at 95% CI 0.083, 0.655; and AOR 0.478 at 95% CI 0.133, 1.713) than mothers of food secured households. Similar results have also been found in case of timely initiation of complementary feeding and minimum dietary diversity of the children.

Keywords: household food insecurity, exclusive breastfeeding, complementary feeding, maternal education, mothers age, household income

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1271 Associations Between Positive Body Image, Physical Activity and Dietary Habits in Young Adults

Authors: Samrah Saeed

Abstract:

Introduction: This study considers a measure of positive body image and the associations between body appreciation, beauty ideals internalization, dietary habits, and physical activity in young adults. Positive body image is assessed by Body Appreciation Scale 2. It is used to assess a person's acceptance of the body, the degree of positivity, and respect for the body.Regular physical activity and healthy eating arebasically important for the body, and they play an important role in creating a positive image of the body. Objectives: To identify the associations between body appreciation and beauty ideals internalization. To compare body appreciation and body ideals internalization among students of different physical activity. To explore the associations between dietary habits (unhealthy, healthy), body appreciation and body ideals internalization. Research methods and organization: Study participants were young adult students, aged 18-35, both male and female.The research questionnaire consisted of four areas: body appreciation, beauty ideals internalization, dietary habits, and physical activity.The questionnaire was created in Google Forms online survey platform.The questionnaire was filled out anonymously Result and Discussion: Physical dissatisfaction, diet, eating disorders and exercise disorders are found in young adults all over the world.Thorough nutrition helps people understand who they are by reassuring them that they are okay without judging or accepting themselves. Social media can positively influence body image in many ways.A healthy body image is important because it affect self-esteem, self-acceptance, and your attitude towards food and exercise.

Keywords: pysical activity, dietary habits, body image, beauty ideals internalization, body appreciation

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1270 Flow: A Fourth Musical Element

Authors: James R. Wilson

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Music is typically defined as having the attributes of melody, harmony, and rhythm. In this paper, a fourth element is proposed -"flow". "Flow" is a new dimension in music that has always been present but only recently identified and measured. The Adagio "Flow Machine" enables us to envision this component and even suggests a new approach to music theory and analysis. The Adagio was created specifically to measure the underlying “flow” in music. The Adagio is an entirely new way to experience and visualize the music, to assist in performing music (both as a conductor and/or performer), and to provide a whole new methodology for music analysis and theory. The Adagio utilizes musical “hit points”, such as a transition from one musical section to another (for example, in a musical composition utilizing the sonata form, a transition from the exposition to the development section) to help define the compositions flow rate. Once the flow rate is established, the Adagio can be used to determine if the composer/performer/conductor has correctly maintained the proper rate of flow throughout the performance. An example is provided using Mozart’s Piano Concerto Number 21. Working with the Adagio yielded an unexpected windfall; it was determined via an empirical study conducted at Nova University’s Biofeedback Lab that watching the Adagio helped volunteers participating in a controlled experiment recover from stressors significantly faster than the control group. The Adagio can be thought of as a new arrow in the Musicologist's quiver. It provides a new, unique way of viewing the psychological impact and esthetic effectiveness of music composition. Additionally, with the current worldwide access to multi-media via the internet, flow analysis can be performed and shared with others with little time and/or expense.

Keywords: musicology, music analysis, music flow, music therapy

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1269 A Development of Community Participation in Developing Healthy Religion Places in Narathiwat Province, Thailand

Authors: Waepa Wanhussen

Abstract:

The Ministry of Public Health has established policies accelerating health promotion to prevent public health problems in five border provinces of Thailand. One of these policies employs the religion to guide the community development and solve health issues consistent with the lifestyle and culture of those people. This policy is an important strategy to solve the problems due to the unrest and conflicts in the southern border provinces. This participatory action research aimed to develop mosques as healthy religion places in Narathiwat Province. In the development, the participatory action, consisting of 5 stages, was conducted from October 2012 - May 2013. Stage I: Conducting a survey for problems and needs for developing healthy religion places by employing community participation. Stage II: Analyzing problems and situations at a workshop containing informal interviews and group conversations with 200 participants (health providers at district level, Imams (the Muslim leaders), and community leaders). Stage III: Planning for developing healthy religion places by health providers, Imams, community leaders. Stage IV: Implementing the plan according to the conditions of problems and needs of the community in order to develop healthy religion places. Stage V: Evaluating the implementation by using the instrument, a criteria of being healthy religion place, for collecting data. Data were analyzed by using percentage. It was found that out of 630 mosques 575 (90.12%) passed the criteria of being a healthy religion place. Among these mosques, 190 mosques (30.15%) were in good and very good level, in which, after the implementation, the number of being good and very good healthy mosques increased by 22.58%. The researcher suggested that the developing sustainably healthy religion places require the participation of residences in the community and agencies such as local government, the Islamic Council of Narathiwat Province, and Council of Culture of Narathiwat Province. The healthy religion places can be used to strengthen and sustain health promotion and disease prevention in the community as health learning centers.

Keywords: healthy religion places, development of community participation, nursing informatics, health

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1268 Examining the Presence of Heterotrophic Aerobic Bacteria (HAB), and Sulphate Reducing Bacteria (SRB) in Some Types of Water from the City of Tripoli, Libya

Authors: Abdulsalam. I. Rafida, Marwa. F. Elalem, Hasna. E. Alemam

Abstract:

This study aimed at testing the various types of water in some areas of the city of Tripoli, Libya for the presence of Heterotrophic Aerobic Bacteria (HAB), and anaerobic Sulphate Reducing Bacteria (SRB). The water samples under investigation included rainwater accumulating on the ground, sewage water (from the city sewage treatment station, sulphate water from natural therapy swimming sites), and sea water (i.e. sea water exposed to pollution by untreated sewage water, and unpolluted sea water from specific locations). A total of 20 samples have been collected distributed as follows: rain water (8 samples), sewage water (6 samples), and sea water (6 samples). An up-to-date method for estimation has been used featuring readymade solutions i.e. (BARTTM test for HAB and BARTTM test for SRB). However, with the exception of one rain water sample, the results have indicated that the target bacteria have been present in all samples. Regarding HAB bacteria the samples have shown a maximum average of 7.0 x 106 cfu/ml featuring sewage and rain water and a minimum average of 1.8 x 104 cuf/ml featuring unpolluted sea water collected from a specific location. As for SRB bacteria; a maximum average of 7.0 x 105 cfu/ml has been shown by sewage and rain water and a minimum average of 1.8 x 104 cfu/ml by sewage and sea water. The above results highlight the relationship between pollution and the presence of bacteria in water particularly water collected from specific locations, and also the presence of bacteria as the result of the use of water provided that a suitable environment exists for its growth.

Keywords: heterotrophic aerobic bacteria (HAB), sulphate reducing bacteria (SRB), water, environmental sciences

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1267 1D PIC Simulation of Cold Plasma Electrostatic Waves beyond Wave-Breaking Limit

Authors: Prabal Singh Verma

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Electrostatic Waves in plasma have emerged as a new source for the acceleration of charged particles. The accelerated particles have a wide range of applications, for example in cancer therapy to cutting and melting of hard materials. The maximum acceleration can only be achieved when the amplitude of the plasma wave stays below a critical limit known as wave-breaking amplitude. Beyond this limit amplitude of the wave diminishes dramatically as the coherent energy of the wave starts to convert into random kinetic energy. In this work, spatiotemporal evolution of non-relativistic electrostatic waves in a cold plasma has been studied in the wave-breaking regime using a 1D particle-in-cell simulation (PIC). It is found that plasma gets heated after the wave-breaking but a fraction of initial energy always remains with the remnant wave in the form of Bernstein-Greene-Kruskal (BGK) mode in warm plasma. Another interesting finding of this work is that the frequency of the resultant BGK wave is found be below electron plasma frequency which decreases with increasing initial amplitude and the acceleration mechanism after the wave-breaking is also found to be different from the previous work. In order to explain the results observed in the numerical experiments, a simplified theoretical model is constructed which exhibits a good agreement with the simulation. In conclusion, it is shown in this work that electrostatic waves get shower after the wave-breaking and a fraction of initial coherent energy always remains with remnant wave. These investigations have direct relevance in wakefield acceleration experiments.

Keywords: nonlinear plasma waves, longitudinal, wave-breaking, wake-field acceleration

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1266 Endoscopic Treatment of Patients with Large Bile Duct Stones

Authors: Yuri Teterin, Lomali Generdukaev, Dmitry Blagovestnov, Peter Yartcev

Abstract:

Introduction: Under the definition "large biliary stones," we referred to stones over 1.5 cm, in which standard transpapillary litho extraction techniques were unsuccessful. Electrohydraulic and laser contact lithotripsy under SpyGlass control have been actively applied for the last decade in order to improve endoscopic treatment results. Aims and Methods: Between January 2019 and July 2022, the N.V. Sklifosovsky Research Institute of Emergency Care treated 706 patients diagnosed with choledocholithiasis who underwent biliary stones removed from the common bile duct. Of them, in 57 (8, 1%) patients, the use of a Dormia basket or Biliary stone extraction balloon was technically unsuccessful due to the size of the stones (more than 15 mm in diameter), which required their destruction. Mechanical lithotripsy was used in 35 patients, and electrohydraulic and laser lithotripsy under SpyGlass direct visualization system - in 26 patients. Results: The efficiency of mechanical lithotripsy was 72%. Complications in this group were observed in 2 patients. In both cases, on day one after lithotripsy, acute pancreatitis developed, which resolved on day three with conservative therapy (Clavin-Dindo type 2). The efficiency of contact lithotripsy was in 100% of patients. Complications were not observed in this group. Bilirubin level in this group normalized on the 3rd-4th day. Conclusion: Our study showed the efficacy and safety of electrohydraulic and laser lithotripsy under SpyGlass control in a well-defined group of patients with large bile duct stones.

Keywords: contact lithotripsy, choledocholithiasis, SpyGlass, cholangioscopy, laser, electrohydraulic system, ERCP

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1265 Experiences of Military Nurse-Manager: Implication to Clinical Leadership

Authors: Maria Monica D. Espinosa

Abstract:

This study aimed to identify and examine the characteristics of an effective leader in a Hospital institution from the perspectives of military nurse-managers. The researcher extracted the different facets of leadership from the stories of six nurse- managers from a military hospital. The stories which are in pre-reflective stage convey an unbiased perspective from which clinical leadership may be defined. Using Phenomenology as a method of Research, the lived experiences of the military nurse-managers served as empirical data which were reflected upon until the formulation of insights. The information from the co-researchers became gallows from which the characteristics of effective leadership in the clinical area were drawn. These insights were synthesized through layers of reflection that resulted to the knowledge about clinical leadership. The reflections are the following, (a) Clinical leaders develop their skills through experiences and hardwork; (b) Clinical leaders are devoted; (c) Clinical leaders are focused; (d) Clinical leaders are good in interpersonal relationship; (e) Clinical leaders are mentors; (f) Clinical leaders seek affirmation and recognition; and (g) Clinical leaders are responsible and dependable. The common themes that emerged from the nurse manager’s stories showed that clinical leadership maybe attained if leaders possessed the following traits, (a) The gift to establish a steadfast and firm management; (b) The proficiency to guide and encourage others towards the achievement of their goals and objectives; (c) The ability to instigate participative and collaborative work among his/her subordinates and (d) The aptitude and skill to address the institutional concerns in their unit. In the future, Clinical leaders should continually adapt an evaluation program on how they can relate socially with their subordinates, the result of which can be used as a basis in developing strategies on relationship enhancement. Moreover, they should empower the nurses by allowing them to voice out their opinions and concerns regarding assignments, role expectations, and workload issues to improve and strengthen the relationships among nurses. Lastly, they can incorporate a collaborative strategy to promote professional socialization attitudes of nurse managers who work with staff nurses to improve the quality of their proficiencies and enhance a positive clinical environment.

Keywords: clinical leadership, experiences, implications, military nurse - managers, phenomenology

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1264 The Possible Double-Edged Sword Effects of Online Learning on Academic Performance: A Quantitative Study of Preclinical Medical Students

Authors: Atiwit Sinyoo, Sekh Thanprasertsuk, Sithiporn Agthong, Pasakorn Watanatada, Shaun Peter Qureshi, Saknan Bongsebandhu-Phubhakdi

Abstract:

Background: Since the SARS-CoV-2 virus became extensively disseminated throughout the world, online learning has become one of the most hotly debated topics in educational reform. While some studies have already shown the advantage of online learning, there are still questions concerning how online learning affects students’ learning behavior and academic achievement when each student learns in a different way. Hence, we aimed to develop a guide for preclinical medical students to avoid drawbacks and get benefits from online learning that possibly a double-edged sword. Methods: We used a multiple-choice questionnaire to evaluate the learning behavior of second-year Thai medical students in the neuroscience course. All traditional face-to-face lecture classes were video-recorded and promptly posted to the online learning platform throughout this course. Students could pick and choose whatever classes they wanted to attend, and they may use online learning as often as they wished. Academic performance was evaluated as summative score, spot exam score and pre-post-test improvement. Results: More frequently students used online learning platform, the less they attended lecture classes (P = 0.035). High proactive online learners (High PO) who were irregular attendee (IrA) had significantly lower summative scores (P = 0.026), spot exam score (P = 0.012) and pre-post-test improvement (P = 0.036). In the meanwhile, conditional attendees (CoA) who only attended classes with attendance check had significantly higher summative score (P = 0.025) and spot exam score (P = 0.001) if they were in the High PO group. Conclusions: The benefit and drawbacks edges of using an online learning platform were demonstrated in our research. Based on this double-edged sword effect, we believe that online learning is a valuable learning strategy, but students must carefully plan their study schedule to gain the “benefit edge” meanwhile avoiding its “drawback edge”.

Keywords: academic performance, assessment, attendance, online learning, preclinical medical students

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1263 Designing Mobile Application to Motivate Young People to Visit Cultural Heritage Sites

Authors: Yuko Hiramatsu, Fumihiro Sato, Atsushi Ito, Hiroyuki Hatano, Mie Sato, Yu Watanabe, Akira Sasaki

Abstract:

This paper presents a mobile phone application developed for sightseeing in Nikko, one of the cultural world heritages in Japan, using the BLE (Bluetooth Low Energy) beacon. Based on our pre-research, we decided to design our application for young people who walk around the area actively, but know little about the tradition and culture of Nikko. One solution is to construct many information boards to explain; however, it is difficult to construct new guide plates in cultural world heritage sites. The smartphone is a good solution to send such information to such visitors. This application was designed using a combination of the smartphone and beacons, set in the area, so that when a tourist passes near a beacon, the application displays information about the area including a map, historical or cultural information about the temples and shrines, and local shops nearby as well as a bus timetable. It is useful for foreigners, too. In addition, we developed quizzes relating to the culture and tradition of Nikko to provide information based on the Zeigarnik effect, a psychological effect. According to the results of our trials, tourists positively evaluated the basic information and young people who used the quiz function were able to learn the historical and cultural points. This application helped young visitors at Nikko to understand the cultural elements of the site. In addition, this application has a function to send notifications. This function is designed to provide information about the local community such as shops, local transportation companies and information office. The application hopes to also encourage people living in the area, and such cooperation from the local people will make this application vivid and inspire young visitors to feel that the cultural heritage site is still alive today. This is a gateway for young people to learn about a traditional place and understand the gravity of preserving such areas.

Keywords: BLE beacon, smartphone application, Zeigarnik effect, world heritage site, school trip

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1262 Clustering and Modelling Electricity Conductors from 3D Point Clouds in Complex Real-World Environments

Authors: Rahul Paul, Peter Mctaggart, Luke Skinner

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Maintaining public safety and network reliability are the core objectives of all electricity distributors globally. For many electricity distributors, managing vegetation clearances from their above ground assets (poles and conductors) is the most important and costly risk mitigation control employed to meet these objectives. Light Detection And Ranging (LiDAR) is widely used by utilities as a cost-effective method to inspect their spatially-distributed assets at scale, often captured using high powered LiDAR scanners attached to fixed wing or rotary aircraft. The resulting 3D point cloud model is used by these utilities to perform engineering grade measurements that guide the prioritisation of vegetation cutting programs. Advances in computer vision and machine-learning approaches are increasingly applied to increase automation and reduce inspection costs and time; however, real-world LiDAR capture variables (e.g., aircraft speed and height) create complexity, noise, and missing data, reducing the effectiveness of these approaches. This paper proposes a method for identifying each conductor from LiDAR data via clustering methods that can precisely reconstruct conductors in complex real-world configurations in the presence of high levels of noise. It proposes 3D catenary models for individual clusters fitted to the captured LiDAR data points using a least square method. An iterative learning process is used to identify potential conductor models between pole pairs. The proposed method identifies the optimum parameters of the catenary function and then fits the LiDAR points to reconstruct the conductors.

Keywords: point cloud, LİDAR data, machine learning, computer vision, catenary curve, vegetation management, utility industry

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1261 Knowledge and Utilization of Mammography among Undergraduate Female Students in a Nigerian University

Authors: Ali Arazeem Abdullahi, Mariam Seedat-Khan, Bamidele S. Akanni

Abstract:

Background: Like the rest of the world, cancer of the breast is a life-threatening disease to Nigerian women. The utilization of mammography is however very poor among the general population. Whereas, there strong indications that women who engage in the regular screening of breast cancer using mammography are more likely to have a lower risk of developing and dying from advanced breast cancer compared to unscreened women. This study examined knowledge of breast cancer and utilization of mammography among undergraduate female students at the University of Ilorin, Nigeria. Health Belief Model (HBM) was deployed to guide the conduct of the study. Method: Self-administered questionnaire was used to collect data from 292 undergraduate female students from the faculties of Social and Management Sciences of the University. A simple random sampling technique was used to select the respondents. Data was analyzed using both descriptive and inferential statistics. Results: The study found that apart from high knowledge of breast cancer and mammography, perceived threat, perceived susceptibility and perceived seriousness of breast cancer were equally high. However, the uptake of mammography was very poor largely due to perceived barriers including being single and young and poor history of breast cancer in families (cues to action). The test of hypotheses showed that there is a weak relationship of about 6.8% between knowledge of breast cancer and utilization of mammography (p-value= 0.244) at 0.05 level of significance. However, 64.4% of the respondents were willing to utilize mammography in the future if the opportunity arises. While the study found a significant statistical relationship between the perceived benefits of mammography and its utilization among the respondents, no significant statistical association was found between the socio-demographic characteristics of the respondents and the uptake of mammography. Recommendations: Findings highlight the need for health education interventions to promote breast cancer screening and the utilization mammography, while addressing barriers to the uptake of mammography among female undergraduate students of the University of Ilorin and Nigeria in general.

Keywords: cancer of the breast, mammography, female undergraduate students, health belief model, University of Ilorin

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1260 Analysis of Policy Issues on Computer-Based Testing in Nigeria

Authors: Samuel Oye Bandele

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A policy is a system of principles to guide activities and strategic decisions of an organisation in order to achieve stated objectives and meeting expected outcomes. A Computer Based Test (CBT) policy is therefore a statement of intent to drive the CBT programmes, and should be implemented as a procedure or protocol. Policies are hence generally adopted by an organization or a nation. The concern here, in this paper, is the consideration and analysis of issues that are significant to evolving the acceptable policy that will drive the new CBT innovation in Nigeria. Public examinations and internal examinations in higher educational institutions in Nigeria are gradually making a radical shift from Paper Based or Paper-Pencil to Computer-Based Testing. The need to make an objective and empirical analysis of Policy issues relating to CBT became expedient. The following are some of the issues on CBT evolution in Nigeria that were identified as requiring policy backing. Prominent among them are requirements for establishing CBT centres, purpose of CBT, types and acquisition of CBT equipment, qualifications of staff: professional, technical and regular, security plans and curbing of cheating during examinations, among others. The descriptive research design was employed based on a population consisting of Principal Officers (Policymakers), Staff (Teaching and non-Teaching-Policy implementors), and CBT staff ( Technical and Professional- Policy supports) and candidates (internal and external). A fifty-item researcher-constructed questionnaire on policy issues was employed to collect data from 600 subjects drawn from higher institutions in South West Nigeria, using the purposive and stratified random sampling techniques. Data collected were analysed using descriptive (frequency counts, means and standard deviation) and inferential (t-test, ANOVA, regression and Factor analysis) techniques. Findings from this study showed, among others, that the factor loadings had significantly weights on the organizational and National policy issues on CBT innovation in Nigeria.

Keywords: computer-based testing, examination, innovation, paper-based testing, paper pencil based testing, policy issues

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1259 The Effectiveness of Concept Mapping as a Tool for Developing Critical Thinking in Undergraduate Medical Education: A BEME Systematic Review: BEME Guide No. 81

Authors: Marta Fonseca, Pedro Marvão, Beatriz Oliveira, Bruno Heleno, Pedro Carreiro-Martins, Nuno Neuparth, António Rendas

Abstract:

Background: Concept maps (CMs) visually represent hierarchical connections among related ideas. They foster logical organization and clarify idea relationships, potentially aiding medical students in critical thinking (to think clearly and rationally about what to do or what to believe). However, there are inconsistent claims about the use of CMs in undergraduate medical education. Our three research questions are: 1) What studies have been published on concept mapping in undergraduate medical education? 2) What was the impact of CMs on students’ critical thinking? 3) How and why have these interventions had an educational impact? Methods: Eight databases were systematically searched (plus a manual and an additional search were conducted). After eliminating duplicate entries, titles, and abstracts, and full-texts were independently screened by two authors. Data extraction and quality assessment of the studies were independently performed by two authors. Qualitative and quantitative data were integrated using mixed-methods. The results were reported using the structured approach to the reporting in healthcare education of evidence synthesis statement and BEME guidance. Results: Thirty-nine studies were included from 26 journals (19 quantitative, 8 qualitative and 12 mixed-methods studies). CMs were considered as a tool to promote critical thinking, both in the perception of students and tutors, as well as in assessing students’ knowledge and/or skills. In addition to their role as facilitators of knowledge integration and critical thinking, CMs were considered both teaching and learning methods. Conclusions: CMs are teaching and learning tools which seem to help medical students develop critical thinking. This is due to the flexibility of the tool as a facilitator of knowledge integration, as a learning and teaching method. The wide range of contexts, purposes, and variations in how CMs and instruments to assess critical thinking are used increase our confidence that the positive effects are consistent.

Keywords: concept map, medical education, undergraduate, critical thinking, meaningful learning

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1258 Leading Virtual Project Teams in the Post Pandemic Era: Trust and Conflict Management Strategies

Authors: Vidya Badrinarayanan, Appa Iyer Sivakumar

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The coronavirus pandemic has sent an important message that future project teams need to be trained to work under virtual conditions, which has already become the new norm in organizations across the world. As organizations increasingly rely on virtual teams to achieve project objectives, it is essential to comprehend how leadership functions in virtual project teams. The purpose of this research is to analyze the leadership behaviors exhibited by project managers for building trust and managing conflicts effectively in virtual project teams. This convergent parallel mixed method research was conducted by surveying 185 virtual leaders and conducting a semi-structured interview with 13 senior virtual leaders involved in managing projects across the industry sectors. The research findings indicate that establishing trust and managing conflicts were ranked as significant challenges in leading virtual project teams in the post-pandemic era. In contrast to earlier findings, our research findings suggest that productivity was not ranked as a significant challenge in leading virtual project teams. This indeed is a positive finding for organizations to consider adopting virtual project teams in the long run. Additionally, the research findings recommend that virtual leaders need to strive to build a high-trust environment and develop effective conflict resolution skills to improve the effectiveness of virtual project teams. As the project management profession struggles with low project success rates, mixed-method research aims to contribute to the knowledge in the growing research area of virtual project leadership. This research contributes to the knowledge by offering first-person accounts from senior virtual leaders on the innovative strategies they had implemented for building trust and resolving conflicts effectively in the virtual project when there were limited opportunities for face-to-face interaction on account of the pandemic. In addition, the leadership framework created as a part of this research for trust development and conflict management in virtual project teams will guide project managers to improve virtual project team effectiveness.

Keywords: conflict management, trust building, virtual leadership, virtual teams

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1257 The Comparison of the Effect of Mindfulness-Based Relaxation Training and Trans Cranial Electrical Stimulation and Their Combination on Decreasing Physiological Distress in Patients with Type-2 Diabetes

Authors: Gholam Hossein Javanmard, Roghayeh Mohammadi Garegozlo

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The present study was a randomized three-group double-blind clinical trial with repeated measures designs which aimed to determine the pure effect and combined effect of mindfulness based-relaxation (MBR) technique and Transcranial Electrical Simulation (tCES) on psychological distress decreasing of patients with type-2 diabetes. The sample of the study consisted of 30 patients with type-2 diabetes who were selected from the Diabetes Association of Bonab city in Iran. The participants were matched and then randomly assigned to the three groups of 10 subjects (MBR, CES, MBR+CES). The subjects received interventions related to their group in 10 individual sessions. Pre-test, post-test, and one-month follow-up were conducted using DASS-42. Analysis of variance with repeated measures showed a significant change in psychological distress. Multivariate covariance analysis and the paired interpersonal comparative test of Ben Foruni indicated that both interventions of MBR and CES have a similar effect on psychological distress decreasing in the post-test and follow-up phase. But, the combined therapy of MBR+CES was more efficient, and it had a more stable effect. However, all three interventions, especially combined intervention of MBR+CES, as efficient and stable treatment, are suggested for improving the psychological status of diabetic patients.

Keywords: mindfulness based-relaxation, transcranial electrical simulation, type 2 diabetes, psychological distress

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1256 Customised Wellness Solutions Using Health Technological Platforms: An Exploratory Research Protocol

Authors: Elaine Wong Yee-Sing, Liaw Wee Tong

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Rapid transformations in demographic and socioeconomic shifts are leading to a growing global demand for health and beauty products and services that demands holistic concepts of well-being. In addition, technological breakthroughs such as internet of things make it convenient and offer innovative solutions for well-being and engage consumers to track their own health conditions and fitness goals. This 'new health economy' encompasses three key concepts: well-being, well-conditioned and well-shaped; which are shaped by wellness segments and goals that influence purchasing decisions of consumers. The research protocol aims to examine the feasibility, challenges, and capabilities in provision for each customer with an ecosystem, or platform, that organizes data and insights to create an individual health and fitness, nutrition, and beauty profile. Convenience sampling of 100 consumers residing in private housing within five major districts in Singapore will be selected to participate in the study. Statistical Package for Social Science 25 will be used to conduct descriptive statistics for quantitative data while qualitative data results using focus interviews, will be translated and transcribed to identify improvements in provision of these services. Rising income in emerging global markets is fuelling the demand for these general wellbeing products and services. Combined with technological advances, it is imperative to understand how these highly personalized services with integrated technology can be designed better to support consumer preferences; provide greater flexibility and high-quality service, and generate better health awareness among consumers.

Keywords: beauty, consumers, health, technology, wellness

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1255 Isolation, Characterization and Myogenic Differentiation of Synovial Mesenchymal Stem Cells

Authors: Fatma Y. Meligy

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Objectives: The objectives of this study aimed to isolate and characterize mesenchymal stem cells (MSCs) derived from synovial membrane. Then to assess the potentiality of myogenic differentiation of these isolated MSCs. Methods: The MSCs were isolated from synovial membrane by digestion method. Three adult rats were used. The 5 -azacytidine was added to the cultured cells for one day. The isolated cells and treated cells are assessed using immunoflouresence, flowcytometry, PCR and real time PCR. Results: The isolated stem cells showed morphological aspect of stem cells they showed strong positivity to CD44 and CD90 in immunoflouresence while in CD34 and CD45 showed negative reaction. The treated cells with 5-azacytidine was shown to have positive reaction for desmin. Flowcytometric analysis showed that synovial MSCs had strong positive percentage for CD44(%98)and CD90 (%97) and low percentage for CD34 & CD45 while the treated cells showed positive percentage for myogenic marker myogenin (85%). As regard the PCR and Real time PCR, the treated cells showed positive reaction to the desmin primer. Conclusion: The adult MSCs were isolated successfully from synovial membrane and characterized with stem cell markers. The isolated cells could be differentiated in vitro into myogenic cells. These differentiated cells could be used in auto-replacement of diseased or traumatized muscle cells as a regenerative therapy for muscle disorders and trauma.

Keywords: mesenchymal stem cells, synovial membrane, myogenic differentiation

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1254 Assessment of the Role of Plasmid in Multidrug Resistance in Extended Spectrum βEtalactamase Producing Escherichia Coli Stool Isolates from Diarrhoeal Patients in Kano Metropolis Nigeria

Authors: Abdullahi Musa, Yakubu Kukure Enebe Ibrahim, Adeshina Gujumbola

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The emergence of multidrug resistance in clinical Escherichia coli has been associated with plasmid-mediated genes. DNA transfer among bacteria is critical to the dissemination of resistance. Plasmids have proved to be the ideal vehicles for dissemination of resistance genes. Plasmids coding for antibiotic resistance were long being recognized by many researchers globally. The study aimed at determining the antibiotic susceptibility pattern of ESBL E. coli isolates claimed to be multidrug resistance using disc diffusion method. Antibacterial activity of the test isolates was carried out using disk diffusion methods. The results showed that, majority of the multidrug resistance among clinical isolates of ESBL E. coli was as a result of acquisition of plasmid carrying antibiotic-resistance genes. Production of these ESBL enzymes by these organisms which are normally carried by plasmid and transfer from one bacterium to another has greatly contributed to the rapid spread of antibiotic resistance amongst E. coli isolates, which lead to high economic burden, increase morbidity and mortality rate, complication in therapy and limit treatment options. To curtail these problems, it is of significance to checkmate the rate at which over the counter drugs are sold and antibiotic misused in animal feeds. This will play a very important role in minimizing the spread of resistance bacterial strains in our environment.

Keywords: Escherichia coli, plasmid, multidrug resistance, ESBL, pan drug resistance

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1253 Role of Moderate Intensity Exercises in the Amelioration of Oxidant-Antioxidant Status and the Levels of Inflammatory Cytokines in Rheumatoid Arthritis Patients

Authors: Somaiya Mateen, Shagufta Moin, Abdul Qayyum, Atif Zafar

Abstract:

Cytokines and reactive species play an important role in the pathophysiology of rheumatoid arthritis (RA). This study was done to determine the levels of reactive oxygen and nitrogen species (ROS and RNS), inflammatory cytokines and the markers of protein, DNA and lipid oxidation in the blood of RA patients, with the aim to study the antioxidant and anti-inflammatory role of moderate intensity exercises in the management of RA. RA patients were subdivided into two groups- first group (n=30) received treatment with conventional RA drugs while the second group (n=30) received moderate exercise therapy along with the conventional drugs for a period of 12 weeks. The levels of ROS, RNS, inflammatory cytokines and markers of biomolecule oxidation were monitored before and after 12 weeks of treatment. RA patients showed a marked increase in the levels of ROS, RNS, inflammatory cytokines, lipid, protein and DNA oxidation as compared to the healthy controls. These parameters were ameliorated after treatment with drugs alone and exercise combined with drugs, with the amelioration being more significant in patients given drugs along with the moderate intensity exercise treatment. In conclusion, the role of ROS, RNS and inflammatory cytokines in the pathogenesis of RA has been confirmed by this study. These may also serve as potential biomarker for assessing the disease severity. Finally, the addition of moderate intensity exercises in the management of RA may be of great value.

Keywords: rheumatoid arthritis, reactive oxygen species, inflammatory cytokines, moderate intensity exercises

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1252 Metagenomic Identification of Cave Microorganisms in Lascaux and Other Périgord Caves

Authors: Lise Alonso, Audrey Dubost, Patricia Luis, Thomas Pommier, Yvan Moënne-Loccoz

Abstract:

The Lascaux Cave in South-Est France is an archeological landmark renowned for its Paleolithic paintings dating back c.18.000 years. Extensive touristic frequenting and repeated chemical treatments have resulted in the development of microbial stains on cave walls, which is a major issue in terms of art conservation. Therefore, it is of prime importance to better understand the microbiology specific to the Lascaux Cave, in comparison to regional situations. To this end, we compared the microbial community (i.e. both prokaryotic and eukaryotic microbial populations) of Lascaux Cave with three other anthropized Périgord caves as well as three pristine caves from the same area. We used state-of-the-art metagenomic analyses of cave wall samples to obtain a global view of the composition of the microbial community colonizing cave walls. We measured the relative abundance and diversity of four DNA markers targeting different fractions of the ribosomal genes of bacteria (i.e. eubacteria), archaea (i.e. archeobacteria), fungi and other micro-eukaryotes. All groups were highly abundant and diverse in all Périgord caves, as several hundred genera of microorganisms were identified in each. However, Lascaux Cave displayed a specify microbial community, which differed from those of both pristine and anthropized caves. Comparison of stains versus non-stained samples from the Passage area of the Lascaux Cave indicated that a few taxa (e.g. the Sordiaromycetes amongst fungi) were more prevalent within than outside stains, yet the main difference was in the relative proportion of the different microbial taxonomic groups and genera, which supposedly supports the biological origin of the stains. Overall, metagenomic sequencing of cave wall samples was effective to evidence the large colonization of caves by a diversified range of microorganisms. It also showed that Lascaux Cave represented a very particular situation in comparison with neighboring caves, probably in relation to the extent of disturbance it had undergone. Our results provide key baseline information to guide conservation efforts in anthropized caves such as Lascaux and pave the way to modern monitoring of ornamented caves.

Keywords: cave conservation, Lascaux cave, microbes, paleolithic paintings

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1251 Ultrasound-Assisted Extraction of Carotenoids from Tangerine Peel Using Ostrich Oil as a Green Solvent and Optimization of the Process by Response Surface Methodology

Authors: Fariba Tadayon, Nika Gharahgolooyan, Ateke Tadayon, Mostafa Jafarian

Abstract:

Carotenoid pigments are a various group of lipophilic compounds that generate the yellow to red colors of many plants, foods and flowers. A well-known type of carotenoids which is pro-vitamin A is β-carotene. Due to the color of citrus fruit’s peel, the peel can be a good source of different carotenoids. Ostrich oil is one of the most valuable foundations in many branches of industry, medicine, cosmetics and nutrition. The animal-based ostrich oil could be considered as an alternative and green solvent. Following this study, wastes of citrus peel will recycle by a simple method and extracted carotenoids can increase properties of ostrich oil. In this work, a simple and efficient method for extraction of carotenoids from tangerine peel was designed. Ultrasound-assisted extraction (UAE) showed significant effect on the extraction rate by increasing the mass transfer rate. Ostrich oil can be used as a green solvent in many studies to eliminate petroleum-based solvents. Since tangerine peel is a complex source of different carotenoids separation and determination was performed by high-performance liquid chromatography (HPLC). In addition, the ability of ostrich oil and sunflower oil in carotenoid extraction from tangerine peel and carrot was compared. The highest yield of β-carotene extracted from tangerine peel using sunflower oil and ostrich oil were 75.741 and 88.110 (mg/L), respectively. Optimization of the process was achieved by response surface methodology (RSM) and the optimal extraction conditions were tangerine peel powder particle size of 0.180 mm, ultrasonic intensity of 19 W/cm2 and sonication time of 30 minutes.

Keywords: β-carotene, carotenoids, citrus peel, ostrich oil, response surface methodology, ultrasound-assisted extraction

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1250 The Association between Antimicrobial Usage and Biosecurity Practices on Commercial Chicken Farms in Bangladesh

Authors: Tasneem Imam, Justine S. Gibson, Mohammad Foysal, Shetu B. Das, Rashed Mahmud, Suman D. Gupta, Ahasanul Hoque, Guillaume Fournie, Joerg Henning

Abstract:

Commercial chicken production is an import livestock industry in Bangladesh. Antimicrobials are commonly used to control and prevent infectious diseases. It was hypothesized that inadequate biosecurity practices might promote antimicrobial usage on commercial chicken farms. A cross-sectional study was carried out to evaluate antimicrobial usage and farm biosecurity practices implemented on 57 layer and 83 broiler farms in eight sub-districts of the Chattogram district in Bangladesh. A questionnaire was used to collect data on antimicrobial usage and biosecurity practices on these farms. A causal framework was used to guide the development of a multi-level mixed-effects logistic regression analysis to evaluate the total and direct effects of practiced biosecurity management on prophylactic and therapeutic administration of antimicrobials. A total of 24 antimicrobials were administered in the current production cycle at the time of the survey. The most administered antimicrobials on layer farms were ciprofloxacin (37.0% of farms), amoxicillin (33.3%), and tiamulin (31.5%); however, on broiler farms, colistin (56.6% of farms), doxycycline (50.6%), and neomycin (38.6%) were most used. Only 15.3% of commercial farmers used antimicrobials entirely for therapeutic purposes, whereas 84.7% administered antimicrobials prophylactically. Inadequate biosecurity practices were more common among commercial broiler farmers compared to layer farmers. For example, only 2.4% of broiler farmers used footbaths before entering sheds compared to 22.2% of the layer farmers (p < 0.001). Farms that used antimicrobials only for therapeutic purposes (vs prophylactic) implemented more frequently adequate disease control measures, such as separating sick birds from healthy birds. This research highlighted that the prophylactic application of antimicrobials is often conducted to substitute poor biosecurity practices on commercial chicken farms. Awareness programs for farmers are crucial to inform them about the risk associated with antimicrobial usage and to highlight the economic benefits of implementing cost-effective biosecurity measures to control infectious poultry diseases.

Keywords: antimicrobial, biosecurity, broiler, layer

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1249 Distributing Complementary Food Supplement - Yingyangbao Reducing the Anemia in Young Children in a County of Sichuan Province after Wenchuan Earthquake

Authors: Lijuan Wang, Junsheng Huo, Jing Sun, Wenxian Li, Jian Huang, Lin Ling, Yiping Zhou, Chengyu Huang, Jifang Hu

Abstract:

Backgrounds and Objective: This study aimed to evaluate the impact of highly nutrient-dense complementary food supplement-Yingyangbao, at the time of 3 months after Wenchuan earthquake, on the anemia of young children in a county in Sichuan province. Methods: The young children aged 6-23 months in the county were fed one sachet Yingyangbao per day. Yingyangbao were distributed for 15 months for free. The children entering 6 months age would be included. The length, weight and hemoglobin of the children aged 6-29 months were assessed at baseline (n=257) and Yingyangbao intervention for 6 (n=218) and 15 months (n=253) by cluster sampling. Growth status has not been described in the paper. The analysis was conducted based on 6-11, 12-17, 18-23 and 24-29 months. Results: It showed that the hemoglobin concentration in each group among the 4 groups increased by 4.9, 6.4, 8.0, 9.5 g/L after 6 months and 12.7, 11.4, 16.7, 15.7 g/L after 15 months compared to the baseline, respectively. The total anemia prevalence in each group was significantly lower after 6 and 15 months than the baseline (P<0.001), except the 6-11 months group after 6 months because of fewer Yingyangbao consumption. Total moderate anemia rate decreased from 18.3% to 5.5% after 6 months, and kept decreasing to 0.8% after another 9 months. The hemoglobin concentration was significantly correlated with the amount of Yingyangbao consumption(P<0.001) The anemia rate was significantly different based on the Yingyangbao compliance (P<0.001). Conclusion: It was concluded that Yingyangbao which contains quality protein, vitamins and micronutrients intervened 15 months could be effective for the improvement of anemia of young children. The study provides the support that the application of the complementary food supplements to reduce the anemia of young children in the emergency of natural disaster.

Keywords: young children, anemia, nutrition intervention, complementary food supplements, Yingyangbao

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1248 Ab-initio Calculations on the Mechanism of Action of Platinum and Ruthenium Complexes in Phototherapy

Authors: Eslam Dabbish, Fortuna Ponte, Stefano Scoditti, Emilia Sicilia, Gloria Mazzone

Abstract:

The medical techniques based on the use of light for activating the drug are occupying a prominent place in the cancer treatment due to their selectivity that contributes to reduce undesirable side effects of conventional chemotherapy. Among these therapeutic treatments, photodynamic therapy (PDT) and photoactivated chemotherapy (PACT) are emerging as complementary approaches for selective destruction of neoplastic tissue through direct cellular damage. Both techniques rely on the employment of a molecule, photosensitizer (PS), able to absorb within the so-called therapeutic window. Thus, the exposure to light of otherwise inert molecules promotes the population of excited states of the drug, that in PDT are able to produce the cytotoxic species, such as 1O2 and other ROS, in PACT can be responsible of the active species release or formation. Following the success of cisplatin in conventional treatments, many other transition metal complexes were explored as anticancer agents for applications in different medical approaches, including PDT and PACT, in order to improve their chemical, biological and photophysical properties. In this field, several crucial characteristics of candidate PSs can be accurately predicted from first principle calculations, especially in the framework of density functional theory and its time-dependent formulation, contributing to the understanding of the entire photochemical pathways involved which can ultimately help in improving the efficiency of a drug. A brief overview of the outcomes on some platinum and ruthenium-based PSs proposed for the application in the two phototherapies will be provided.

Keywords: TDDFT, metal complexes, PACT, PDT

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1247 Fusion Neutron Generator Dosimetry and Applications for Medical, Security, and Industry

Authors: Kaouther Bergaui, Nafaa Reguigui, Charles Gary

Abstract:

Characterization and the applications of deuterium-deuterium (DD) neutron generator developed by Adelphie technology and acquired by the National Centre of Nuclear Science and Technology (NCNST) were presented in this work. We study the performance of the neutron generator in terms of neutron yield, production efficiency, and the ionic current as a function of the acceleration voltage at various RF powers. We provide the design and optimization of the PGNAA chamber and thus give insight into the capabilities of the planned PGNAA facility. Additional non-destructive techniques were studied employing the DD neutron generator, such as PGNAA and neutron radiography: The PGNAA is used for determining the concentration of 10B in Si and SiO2 matrices by using a germanium detector HPGe and the results obtained are compared with PGNAA system using a Sodium Iodide detector (NaI (Tl)); Neutron radiography facility was tested and simulated, using a camera device CCD and simulated by the Monte Carlo code; and the explosive detection system (EDS) also simulated using the Monte Carlo code. The study allows us to show that the new models of DD neutron generators are feasible and that superior-quality neutron beams could be produced and used for various applications. The feasibility of Boron neutron capture therapy (BNCT) for cancer treatment using a neutron generator was assessed by optimizing Beam Shaping Assembly (BSA) on a phantom using Monte-Carlo (MCNP6) simulations.

Keywords: neutron generator deuterium-deuterium, Monte Carlo method, radiation, neutron flux, neutron activation analysis, born, neutron radiography, explosive detection, BNCT

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1246 Effectiveness of the Model in the Development of Teaching Materials for Malay Language in Primary Schools in Singapore

Authors: Salha Mohamed Hussain

Abstract:

As part of the review on the Malay Language curriculum and pedagogy in Singapore conducted in 2010, some recommendations were made to nurture active learners who are able to use the Malay Language efficiently in their daily lives. In response to the review, a new Malay Language teaching and learning package for primary school, called CEKAP (Cungkil – Elicit; Eksplorasi – Exploration; Komunikasi – Communication; Aplikasi – Application; Penilaian – Assessment), was developed from 2012 and implemented for Primary 1 in all primary schools from 2015. Resources developed in this package include the text book, activity book, teacher’s guide, big books, small readers, picture cards, flash cards, a game kit and Information and Communication Technology (ICT) resources. The development of the CEKAP package is continuous until 2020. This paper will look at a model incorporated in the development of the teaching materials in the new Malay Language Curriculum for Primary Schools and the rationale for each phase of development to ensure that the resources meet the needs of every pupil in the teaching and learning of Malay Language in the primary schools. This paper will also focus on the preliminary findings of the effectiveness of the model based on the feedback given by members of the working and steering committees. These members are academicians and educators who were appointed by the Ministry of Education to provide professional input on the soundness of pedagogical approach proposed in the revised syllabus and to make recommendations on the content of the new instructional materials. Quantitative data is derived from the interviews held with these members to gather their input on the model. Preliminary findings showed that the members provided positive feedback on the model and that the comprehensive process has helped to develop good and effective instructional materials for the schools. Some recommendations were also gathered from the interview sessions. This research hopes to provide useful information to those involved in the planning of materials development for teaching and learning.

Keywords: Malay language, materials development, model, primary school

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1245 Effect of Post and Pre Induced Treatment with Hesperidin in N-Methyl N-Nitrosourea Induced Mammary Gland Cancer in Female Sprague-Dawley Rats

Authors: Vinay Kumar Theendra

Abstract:

The main objective of the study is to evaluate the effectiveness of hesperidin in the treatment of breast cancer and causing less (or) no bone marrow depression which is the major side effect of the present anticancer drugs treating breast cancer, also to evaluate the mechanisms through which these compounds are exerting their effect. Breast cancer is induced by administering N-methyl N-Nitrosourea (MNU) at a dose of 50mg/kg body weight. Upon the termination of the experiment, the animals were sacrificed by the method of cervical dislocation. The animals were dissected along the ventral midline and were grossly examined for the presence of tumors. Then the tumours were removed along with the stroma. Vascular endothelial growth factor (VEGF) levels were estimated by using ELISA method. The first occurrence of palpable tumors was eight weeks after carcinogen treatment and the final tumour incidence was 100% in the MNU alone and topical treated rats. Whereas in rats of other treatment groups there is decreased tumour incidence which might be due to their antitumour activity. Hesperidin therapy inhibited angiogenesis which can be evident from the significant reduction in serum as well as tumour VEGF concentrations in comparison to the untreated mammary carcinoma bearing rats. Hesperidin is promising agents that exert direct antitumor and also antiangiogenic, antiproliferative and anti-inflammatory activities. Even though the potency is little lesser than standard drug vincristine, it has been proved to be safe without effecting haematological count.

Keywords: hesperidin, VEGF, COX 2, N-methyl N-nitrosourea

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1244 Investigation of Contact Pressure Distribution at Expanded Polystyrene Geofoam Interfaces Using Tactile Sensors

Authors: Chen Liu, Dawit Negussey

Abstract:

EPS (Expanded Polystyrene) geofoam as light-weight material in geotechnical applications are made of pre-expanded resin beads that form fused cellular micro-structures. The strength and deformation properties of geofoam blocks are determined by unconfined compression of small test samples between rigid loading plates. Applied loads are presumed to be supported uniformly over the entire mating end areas. Predictions of field performance on the basis of such laboratory tests widely over-estimate actual post-construction settlements and exaggerate predictions of long-term creep deformations. This investigation examined the development of contact pressures at a large number of discrete points at low and large strain levels for different densities of geofoam. Development of pressure patterns for fine and coarse interface material textures as well as for molding skin and hot wire cut geofoam surfaces were examined. The lab testing showed that I-Scan tactile sensors are useful for detailed observation of contact pressures at a large number of discrete points simultaneously. At low strain level (1%), the lower density EPS block presents low variations in localized stress distribution compared to higher density EPS. At high strain level (10%), the dense geofoam reached the sensor cut-off limit. The imprint and pressure patterns for different interface textures can be distinguished with tactile sensing. The pressure sensing system can be used in many fields with real-time pressure detection. The research findings provide a better understanding of EPS geofoam behavior for improvement of design methods and performance prediction of critical infrastructures, which will be anticipated to guide future improvements in design and rapid construction of critical transportation infrastructures with geofoam in geotechnical applications.

Keywords: geofoam, pressure distribution, tactile pressure sensors, interface

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1243 Early Versus Delayed Antiretroviral Therapy in HIV‐positive People with Tuberculosis

Authors: Mohhamed El Habib Labdouni

Abstract:

Introduction: Co-infection with VIH and tuberculosis poses one of the major ongoing challenges for global TB and AIDS prevention and control. The objective of this study is to raise the issue of the resurgence of TB, in People living with VIH supported in a referent center in western Algeria. Its epidemiological, clinical, biological and radiological new trends, and to compare the mortality rate between early and delayed ART. Methods: It was a prospective study, during 36 months from the 01st/01/2012 to 31st/12/2014, by identifying and analyzing cases of TB-VIH co-infection. Our population was devised in two groups/ early ART and delayed ART. The primary and secondary endpoints were analyzed with Kaplan-Meier curves and log-rank test the period of follow up, which was fixed at 300 weeks. Results: Sixty cases of co-infection TB -VIH were enrolled in our study: 78.3% had pulmonary tuberculosis associated with extra-pulmonary, 13.3% had only pulmonary tuberculosis and 08.3% presented strictly extra-pulmonary TB. The clinical particularity of this co-infection is the frequency of serious localization such us: pleural 23.3%, peritoneal 31.7%, and meningeal suffusion 13.3%.y-.biologicaly we notice the predominance both of pancytopenia and leucoanemia, hyponatremia in 38,6% and hypokalemia in 19,3%. By analyzing Kaplan-Meier survival curves, we notice that early ART initiation is associated with a significant reduction of all-cause mortality (p = 0,000), and we have identified several prognostic factors such as hypokalemia hyponatremia, leukocytosis thrombopenemia leucothrombopenia (p = 0,005). Conclusion: Our study confirms most of the results reported in the literature. Early ART initiation reduces the rate of all-cause mortality, despite the probability of the occurrence of TB-IRIS.

Keywords: TB-HIV co-infection, early ART, hyponatremia, extrapulmonary tuberculosis

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