Search results for: team efficacy

Authors: Yu-Shi Ye, Jia-Min Wu, Jhih-Ci Li

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Background: Most orthopedic inpatients and primary caregivers are elderly, and patients are at high risk of falls. We set up a quality control team to analyze the root cause and found the following issues: 1. The nursing staff did not conduct cognitive assessments of patients and their primary caregivers to ensure that health education content was understood. 2. Nurses prefer to use spoken language in health education but lack the skills to use diverse teaching materials. 3. Newly recruited nurses have insufficient awareness of fall prevention. Methods: The study subjects were 16 nurses in the orthopedic ward of a teaching hospital in central Taiwan. We implemented the following strategies: 1. Developed a fall simulation teaching plan and conducted teaching courses and assessments in the morning meeting; 2. Designed and used a "fall prevention awareness card" to improve the prevention awareness of elderly patients; 3. All staff (including new staff) received experiential education training. Results: In 2021, 40% of patients in the orthopedic wards were aged 60-79 years (792/1979) with a high risk of falls. According to data collection, the incidence of falls in hospitalized patients was 0.04% (5/12651), which exceeded the threshold of 0.02% in our ward. After completing the on-the-job education training in October, the nursing staff expressed that they were more aware of the special situation of fall prevention. Through practical sharing and drills, combined with experiential teaching strategies, nurses can reconstruct the safety awareness of fall prevention and deepen their cognitive memory. Participants scored between 30 and 80 on the pretest (16 students, mean: 72.6) and between 90 and 100 on the post-test (16 students, mean: 92.6), resulting in a 73.8% improvement in overall scores. We have a total of 4 new employees who have all completed the first 3 months of compulsory PGY courses. From January to April 2022, the incidence of falls in hospitalized patients was 0.025% (1/3969). We have made good improvements and will continue to track the outcome. Discussion: In addition to enhancing the awareness of falls among nursing staff, how-to guide patients and primary caregivers to prevent falls is also the focus of improvement. The proper way of health education can be better understood through practical exercises and case sharing.

Keywords: experiential teaching strategies, fall prevention, cognitive card, elderly patients, orthopedic wards

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Authors: Dimuthu Manage

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Introduction: The prevalence of obesity and obesity-related non-communicable diseases are becoming a massive health concern in the whole world. Physical activity is recognized as an effective solution for this matter. The published data on the effectiveness of High-Intensity Interval Training (HIIT) in improving health parameters in overweight and obese individuals in Sri Lanka is sparse. Hence this study is conducted. Methodology: This is a quasi-experimental study that was conducted at the Sports medicine clinic, General Hospital, Kalutara. Participants have engaged in a programme of HIIT three times per week for six weeks. Data collection was based on precise measurements by using structured and validated methods. Ethical clearance was obtained. Results: Registered number for the study was 48, and only 52% have completed the study. The mean age was 32 (SD=6.397) years, with 64% males. All the anthropometric measurements which were assessed (i.e. waist circumference(P<0.001), weight(P<0.001) and BMI(P<0.001)), body fat percentage(P<0.001), VO2 max(P<0.001), and lipid profile (ie. HDL(P=0.016), LDL(P<0.001), cholesterol(P<0.001), triglycerides(P<0.010) and LDL: HDL(P<0.001)) had shown statistically significant improvement after the intervention with the HIIT programme. Conclusions: This study confirms HIIT as a time-saving and effective exercise method, which helps in preventing obesity as well as non-communicable diseases. HIIT ameliorates body anthropometry, fat percentage, cardiopulmonary status, and lipid profile in overweight and obese individuals markedly. As with the majority of studies, the design of the current study is subject to some limitations. The first is the study focused on a correlational study. If it is a comparative study, comparing it with other methods of training programs would have given more validity. Although the validated tools used to measure variables and the same tools used in pre and post-exercise occasions with the available facilities, it would have been better to measure some of them using gold-standard methods. However, this evidence should be further assessed in larger-scale trials using comparative groups to generalize the efficacy of the HIIT exercise program.

Keywords: HIIT, lipid profile, BMI, VO2 max

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Authors: Tamara Vagg, Cathy Shortt, Claire Hickey, Joseph A. Eustace, Barry J. Plant, Sabin Tabirca

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Introduction: Paper-based patient passports have been used advantageously for older patients, patients with diabetes, and patients with learning difficulties. However, these passports can experience issues with data security, patients forgetting to bring the passport, patients being over encumbered, and uncertainty with who is responsible for entering and managing data in this passport. These issues could be resolved by transferring the paper-based system to a convenient platform such as a smartphone application (app). Background: Life expectancy for some Cystic Fibrosis (CF) patients are rising and as such new complications and procedures are predicted. Subsequently, there is a need for education and management interventions that can benefit CF adults. This research proposes a CF patient passport to record basic medical information through a smartphone app which will allow CF adults access to their basic medical information. Aim: To provide CF patients with their basic medical information via mobile multimedia so that they can receive care when traveling abroad or between CF centres. Moreover, by recording their basic medical information, CF patients may become more aware of their own condition and more active in their health care. Methods: This app is designed by a CF multidisciplinary team to be a lightweight reflection of a hospital patient file. The passport app is created using PhoneGap so that it can be deployed for both Android and iOS devices. Data entered into the app is encrypted and stored locally only. The app is password protected and includes the ability to set reminders and a graph to visualise weight and lung function over time. The app is introduced to seven participants as part of a stress test. The participants are asked to test the performance and usability of the app and report any issues identified. Results: Feedback and suggestions received via this testing include the ability to reorder the list of clinical appointments via date, an open format of recording dates (in the event specifics are unknown), and a drop down menu for data which is difficult to enter (such as bugs found in mucus). The app is found to be usable and accessible and is now being prepared for a pilot study with adult CF patients. Conclusions: It is anticipated that such an app will be beneficial to CF adult patients when travelling abroad and between CF centres.

Keywords: Cystic Fibrosis, digital patient passport, mHealth, self management

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Authors: S. Yeo, M. Mathur

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Introduction: Obesity, defined as a Body Mass Index (BMI) of more than or equal to 30kg/m, is associated with an increased risk of complications during pregnancy and delivery. During labour, obese mothers often require greater intervention and have higher rates of caesarean section. Despite a low overall rate of serious complications following caesarean section, a high BMI predisposes to a higher risk of postoperative complications. Our study, therefore, aimed to investigate the impact of antenatal obesity on adverse outcomes following caesarean section, particularly wound-related infections. Materials and Methods: A retrospective cohort study of all caesarean deliveries during the first quarter of a chosen year was undertaken in our hospital, which is a tertiary referral centre with > 12,000 deliveries per year. Patients’ health records and data from our hospital’s electronic labour and delivery database were reviewed. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), and odds ratios plus adjusted odd ratios were calculated with 95% confidence intervals (CI). Results: A total of 1829 deliveries were reviewed during our study period. Of these, 180 (9.8%) patients were obese. The rate of caesarean delivery was 48.9% in obese patients versus 28.1% in non-obese patients. Post-operatively, 17% of obese patients experienced wound infection versus 0.2% of non-obese patients. Obese patients were also more likely to experience major postpartum haemorrhage (4.6% vs. 0.2%) and postpartum pyrexia (18.2% vs. 5.0%) in comparison to non-obese patients. Conclusions: Obesity is a significant risk factor in the development of postoperative complications following caesarean section. Wound infection remains a major concern for obese patients undergoing major surgery and results in extensive morbidity during the postnatal period. Postpartum infection can prolong recovery and affect maternal mental health, leading to reduced perinatal bonding with long-term implications on breastfeeding and parenting confidence. This study supports the need for the development of standardized protocols specifically for obese patients undergoing caesarean section. Multidisciplinary team care, in conjunction with anaesthesia, family physicians, and plastic surgery counterparts, early on in the antenatal journey, may be beneficial where wound complications are anticipated and to minimize the burden of postoperative infection in obese mothers.

Keywords: pregnancy, obesity, caesarean, infection

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Authors: F. O Anugom

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The general functions of the university amongst other things include teaching, research and community service. Universities are recognized as the apex of learning, accumulating and imparting knowledge and skills of all kinds to students to enable them to be productive, earn their living and to make optimum contributions to national development. This is equivalent to the production of human capital in the form of high level manpower needed to administer the educational society, be useful to the society and manage the economy. Quality has become a matter of major importance for university education in Nigeria. Accreditation is the systematic review of educational programs to ensure that acceptable standards of education, scholarship and infrastructure are being maintained. Accreditation ensures that institution maintain quality. The process is designed to determine whether or not an institution has met or exceeded the published standards for accreditation, and whether it is achieving its mission and stated purposes. Ensuring quality assurance in accreditation process falls in the hands of university management which justified the need for this study. This study examined accreditation and quality assurance: the management imperative. Three research questions and three hypotheses guided the study. The design was a correlation survey with a population of 2,893 university administrators out of which 578 Heads of department and Dean of faculties were sampled. The instrument for data collection was titled Programme Accreditation Exercise scale with high levels of reliability. The research questions were answered with Pearson ‘r’ statistics. T-test statistics was used to test the hypotheses. It was found among others that the quality of accredited programme depends on the level of funding of universities in Nigeria. It was also indicated that quality of programme accreditation and physical facilities of universities in Nigeria have high relationship. But it was also revealed that programme accreditation is positively related to staffing in Nigerian universities. Based on the findings of the study, the researcher recommend that academic administrators should be included in the team of those who ensure quality programs in the universities. Private sector partnership should be encouraged to fund programs to ensure quality of programme in the universities. Independent agencies should be engaged to monitor the activities of accreditation teams to avoid bias.

Keywords: accreditation, quality assurance, national universities commission , physical facilities, staffing

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Authors: Genziana Lay

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A wide majority of older children and adolescents who enter the juvenile court system present with an array of problematic symptoms and behaviors including anxiety, depression, aggressive acting out, detachment, and substance abuse. Attachment theory offers a framework for understanding normative and pathological functioning, which during development is influenced by emotional, social and cognitive elements. There is clear evidence that children and adolescents with the highest risk of developing adaptation problems present an insecure attachment profile. Most offending minors have experienced dysfunctional family relationships as well as social and/or economic deprivation. Their maladaptive attachment develops not only through their relationship with caregivers but with the environment at large. Activation of their faulty attachment system leads them to feel emotionally overwhelmed and engage in destructive behaviors and decision-making. A psycho-social intervention with this population conceptualized as attachment therapy is a multi-faceted, practical approach that has shown excellent results in terms of increased psychological well-being and drastically reduced rates of re-offense/ destructive behavior. Through several; components including psychotherapy, monitoring, volunteering, meditation and socialization, the program focuses on seven dimensions: self-efficacy, responsibility, empathy/reparation, autonomy/security, containment/structure, insight building, and relational health. This paper presents the program and illustrates how the framework of attachment theory practically applied to psycho-social intervention has great therapeutic and social reparation potential. Preliminary evidence drawn from the Sassari Juvenile Court is very promising; this paper will illustrate these results and propose an even more comprehensive, applicable approach to psycho-social reparative intervention that leads to greater psychological health and reduced recidivism in the child and adolescent population.

Keywords: attachment, child, adolescent, crime, juvenile, psychosocial

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Authors: Thomas Monahan, Nicolas Gorius, Thanh Nguyen

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Exoplanet atmospheric parameters retrieval is a complex, computationally intensive, inverse modeling problem in which an exoplanet’s atmospheric composition is extracted from an observed spectrum. Traditional Bayesian sampling methods require extensive time and computation, involving algorithms that compare large numbers of known atmospheric models to the input spectral data. Runtimes are directly proportional to the number of parameters under consideration. These increased power and runtime requirements are difficult to accommodate in space missions where model size, speed, and power consumption are of particular importance. The use of traditional Bayesian sampling methods, therefore, compromise model complexity or sampling accuracy. The Atmospheric Retrievals conditional Generative Adversarial Network (ARcGAN) is a deep convolutional generative adversarial network that improves on the previous model’s speed and accuracy. We demonstrate the efficacy of artificial intelligence to quickly and reliably predict atmospheric parameters and present it as a viable alternative to slow and computationally heavy Bayesian methods. In addition to its broad applicability across instruments and planetary types, ARcGAN has been designed to function on low power application-specific integrated circuits. The application of edge computing to atmospheric retrievals allows for real or near-real-time quantification of atmospheric constituents at the instrument level. Additionally, edge computing provides both high-performance and power-efficient computing for AI applications, both of which are critical for space missions. With the edge computing chip implementation, ArcGAN serves as a strong basis for the development of a similar machine-learning algorithm to reduce the downlinked data volume from the Compact Ultraviolet to Visible Imaging Spectrometer (CUVIS) onboard the DAVINCI mission to Venus.

Keywords: deep learning, generative adversarial network, edge computing, atmospheric parameters retrieval

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Authors: S. F. Kanaan, Fatima Al-Kadi, H. Khrais

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Background: Fibromyalgia is a chronic condition that is characterized by chronic pain that limits physical and functional activities. To our best knowledge, there is currently no key physiotherapy approach recommended to reduce pain and improve function. In addition, there are scarce studies that investigated the effect of manual therapy in the management of Fibromyalgia, and no study investigated the efficacy of Mulligan´s mobilization with movement (MWM) in particular. Methods: A 51-year-old female diagnosed with Fibromyalgia for more than a year. The patient was complaining of generalized pain including neck, lower back, shoulders, elbows, hips, and knees. In addition, the patient reported severe limitation in activities and inability to complete her work as a lawyer. The Intervention provided for the patient consisted of 4 sessions (in two weeks) of MWM for neck, lower back, shoulders, elbows, sacroiliac joint, hips, and knees. The Visual Analogue Scale of pain (VAS), Range of Motion (ROM), 10-minute walk test, Roland Morris Low Back Pain and Disability Questionnaire (RMQ), Disability of the Arm, Shoulder and Hand Score (DASH) were collected at the baseline and at the end of treatment. Results: Average improvement of ROM in the neck, lower back, shoulder, elbows, hips, and knees was 45%. VAS scale changed from pre-treatment to post-treatment as the following: neck pain (9 to 0), lower back pain (8 to 1), shoulders pain (8 to 2), elbows pain (7 to 1), and knees pain (9 to 0). The patient demonstrated improvement in all functional scale from pre-intervention to post-intervention: 10-meter walk test (9.8 to 4.5 seconds), RMQ (21 to 11/24), and DASH (88.7% to 40.5%). The patient did not report any side effect of using this approach. Conclusion: Fibromyalgia can cause joint 'faulty position' leading to pain and dysfunction, which can be reversed by using MWM. MWM showed to have clinically significant improvement in ROM, pain, and ability to walk and a clinically significant reduction in disability in only 4 sessions. This work can be expanded in a larger sample.

Keywords: mobilization, fibromyalgia, dysfunction, manual therapy

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Authors: Hamza A. Pantami, Khozizah Shaari, Intan S. Ismail, Chong C. Min

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Introduction: Tilapia is the second-highest harvested freshwater fish species in Malaysia, available in almost all fish farms and markets. Unfortunately, tilapia culture in Malaysia is highly affected by Aeromonas hydrophila and Streptococcus agalactiae, which affect the production rate and consequently pose a direct negative economic impact. Reliance on drugs to control or reduce bacterial infections has been led to contamination of water bodies and development of drug resistance, as well as gave rise to toxicity issues in downstream fish products. Resorting to vaccines have helped curb the problem to a certain extent, but a more effective solution is still required. Using microalgae-based feed to enhance the fish immunity against bacterial infection offers a promising alternative. Objectives: This study aims to evaluate the efficacy of Chlorella vulgaris at lower percentage incorporation in feeds for an immune boost of tilapia in a shorter time. Methods: The study was in two phases. The safety concentration studies at 500 mg/kg-1 and the administration of cultured C. vulgaris biomass via incorporation into fish feed for five different groups in three weeks. Group 1 was the control (0% incorporation), whereas group 2, 3, 4 and 5 received 0.625%, 1.25%, 2.5% and 5% incorporation respectively. The parameters evaluated were the blood profile, serum lysozyme activity (SLA), serum bactericidal activity (SBA), phagocytosis activity (PA), respiratory burst activity (RBA), and lymphoproliferation activity (LPA). The data were analyzed via ANOVA using SPSS (version 16). Further testing was done using Tukey’s test. All tests were performed at the 95% confidence interval (p < 0.05). Results: There were no toxic signs in tilapia fish at 500 mg/kg-1. Treated groups showed significantly better immune parameters compared to the control group (p < 0.05). Conclusions: C. vulgaris crude biomass in a fish meal at a lower incorporation level of 5% can increase specific and non-specific immunity in tilapia fish in a shorter time duration.

Keywords: Chlorella vulgaris, hematology profile, immune boost, lymphoproliferation

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Authors: Michelle W. T. Cheng, Yau Y.

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Hong Kong continues to be ranked as the least affordable housing market in the world, making co-living a feasible alternative in this high-density city. Although the number of co-living residences has increased in Hong Kong, co-living as a housing typology is still a new concept for many. Little research has been conducted on this new housing typology, let alone the co-living experience. To address this gap, this study targeted student residents in university residential halls as it is a more controlled environment (e.g., with established rules and guidelines regarding the use of communal facilitates and housing management) for studying co-living experiences in Hong Kong. To date, no research study has systematically identified anti-social behavior (ASB) in co-living spaces. Since ASB can be influenced by factors such as social norms and individual interpretation, it has an elastic definition that results in different levels of acceptance. Unlike other types of housing, co-living spaces can be potentially more influenced by the neighborhood as residents share more time and space. As a pilot study, this research targeted one university residential hall to examine student co-living experiences. To clarify, the research question is focused on identifying the social factors that impact the residential satisfaction of those who co-living in residential halls. Quantitative data (n=100) were collected via a structured questionnaire to measure the residential environment, including ASB, social neighboring, community attachment, and perceived hall management efficacy. The survey was distributed at the end of the academic year to ensure that respondents had at least one year of first-hand experience living in a co-living space. To gather qualitative data, follow-up focus group interviews were conducted with 16 participants who completed the survey. The semi-structured interviews aimed to elicit the participants' perspectives on their co-living experience. Through analyzing their co-living experiences, the researcher identified factors that affected their residential satisfaction and provided recommendations to enhance their co-living experience.

Keywords: co-living, university residential hall, anti-social behabiour, neighbour relationship, community attachement

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Authors: Basma Hassabo, Sarah Ahmed, Aisha Hameed

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Aims and Objectives: To determine the incidence of maternal mortality amongst pregnant women with sickle cell disease (SCD) in the United Kingdom and to determine exact cause of death in these women. Background: SCD is caused by the ‘sickle’ gene and is characterized by episodes of severe bone pain and other complications like acute chest syndrome, chronic pulmonary hypertension, stroke, retinopathy, chronic renal failure, hepato-splenic crises, avascular bone necrosis, sepsis and leg ulcers. SCD is a continual cause of maternal mortality and fetal complications, and it comprises 1.5% of all Direct and Indirect deaths in the UK. Sepsis following premature rupture of membranes with ascending infection, post-partum infection and pre-labour overwhelming septic shock is one of its leading causes of death. Over the last fifty years of maternal mortality reports in UK, between 1 to 4 pregnant women died in each triennium. Material and Method: This is a retrospective study that involves pregnant women who died from SCD complications in the UK between 1952-2012. Data were collected from the UK Confidential Enquiries into Maternal Death and its causes between 1952–2012. Prior to 1985, exact cause of death in this cohort was not recorded. Results: 33 deaths reported between 1964 and 1984. 17 deaths were reported due to sickle cell disease between 1985 and 2012. Five women in this group died of sickle cell crisis, one woman had liver sequestration crisis, two women died of venous thromboembolism, two had myocardial fibrosis and three died of sepsis. Remaining women died of amniotic fluid embolism, SUDEP, myocardial ischemia and intracranial haemorrhage. Conclusion: The leading causes of death in sickle cell sick pregnant women are sickle cell crises, sepsis, venous thrombosis and thromboembolism. Prenatal care for women with SCD should be managed by a multidisciplinary team that includes an obstetrician, nutritionist, primary care physician, and haematologist. In every sick Sickle Cell woman Sickle Cell crises should be on the top of the list of differential diagnosis. Aggressive treatment of complications with low threshold to commence broad-spectrum antibiotics and LMWH contribute to better outcomes.

Keywords: incidence, maternal mortality, sickle cell disease (SCD), uk

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Authors: W. L. Tsang, H. Y. Li, S. L. Wong, T. Y. Kwok, S. C. Yuen, S. S. Kwok, P. S. Ko, S. Y. Lau

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Introduction: Palliative care is no doubt necessary in surgery. When one looks at studies of what patients with life-threatening illness want and compares to what they experience in surgical units, the gap is huge. Surgical nurses, being patient advocates, should engage with patients and families sooner rather than later in their illness trajectories to consider how to manage the illness, not just their capacity to survive. Objective: This clinical practice guide aims to fill the service gap of palliative care in surgery by producing a quality-driven, evidence-based yet straightforward clinical practice guide based on a focus strategy. Methodology: In line with Guide to Good Nursing Practice: End-of-Life Care recommended by Nursing Council of Hong Kong and the strategic goal of improving quality of palliative care proposed in HA Strategic Plan 2017-2022, multiple phases of work were undertaken from July 2015 to December 2017. A pragmatic clinical practice guide for surgical patients facing life-threatening conditions was developed based on assessments on knowledge of and attitudes towards end-of-life care of surgical nurses. Key domains, including preparation for bereavement, nursing care for imminently dying patients and at the dying scene were crystallized according to the results of the assessments and the palliative care checklist formulated by UCH Palliative Care Team. After a year of rollout, its content was refined through analyses of implementation in routine practice and consensus opinions from frontline nurses. Results and Outcomes: This clinical practice guide inspires surgical nurses with the art of care to provide for patients’ comfort, function, and longevity. It provides practical directions and assists nurses to master the skills on advance care planning and learn how to be clear with patients, families and themselves about the realities of the disease pictures. Through the implementation, patients and families are included in the decision process, and their wishes are honored. The delivery of explicit and high-quality palliative care maintains good nurse-to-patient relations and enhances satisfaction of hospital care of patients and families. Conclusion: Surgical nursing has always been up to the unique challenges of the era. This clinical practice guide has become an island of credibility for our nurses as they traverse the often stormy waters of life-limiting illness.

Keywords: palliative care delivery, palliative care in surgery, hospice care, end-of-life care

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Authors: Min-Chien Su, Tzu-Hsuan Hsu, Guan-Xuan Wu, Shyh-Ming Kuo

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Lung cancer is one of the clinically challenging malignant diseases worldwide. For efficient therapeutics in cancer, combination therapy has developed to acquire a better outcome. PLK-1 was one of the major factors affecting cell mitosis in cancer cells, its inhibitor Bi6727 was proven effective in treating several different cancers namely oral cancer, colon cancer and lung cancer. Despite its low toxicity toward normal cells compared to traditional chemotherapy, it is still yet to be evaluated in detail. Livistona Chinensis (LC) is a Chinese herb that used as a traditional prescription to treat lung cancer. Due to the uncertainty of the efficacy of LC, we utilized a water extraction method to extract the Livistona Chinensis and then lyophilized into powder for further study. In this study we investigated the antiproliferation activities of Bi6727 and LC extracts (LCE) on A549 non-small lung cancer cells. The IC50 of Bi6727 and LCE on A549 are 60 nM and 0.8 mg/mL, respectively. The fluorescent staining images shown nucleolus damage in cells treated with Bi6727 and mitochondrial damage after treated with LCE. A549 cells treated with Bi6727 and LCE showed increased expression of Bax, Caspase-3 and Caspase-9 proteins from Western blot assay. LCE also inhibited A549 cells growth keeping cells at G2-M phase from cell cycle assay. Apoptosis assay results showed that LCE induced late apoptosis of A549 cells. JC-1 assay showed that the mitochondria damaged at the LCE concentration of 0.4 mg/mL. In our preliminary anti-proliferation test of combined LCE and Bi-6727 on A549 cells, we found a dramatically decrease in proliferation after treated with LCE first for 24-h and then Bi-6727 for extra 24-h. This was an important finding regarding synergistic anti-proliferation effect of these drugs, However, the usage, the application sequence of LCE and Bi-6727 on A549 cells and their related mechanisms still need to be evaluated. In summary, the drugs exerted anti-proliferation effect on A549 cells independently. We hopefully combine the usage of these two drugs will bring a different and potential outcome in treating lung cancer.

Keywords: anti-proliferation, A549, Livistona Chinensis fruit extracts, PLK-1 inhibitor

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Authors: Sebastian van Delden, Matthew Anuszkiewicz, Jayse White, Scott Stolarski

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Industrial robotic manipulators have been commonplace in the manufacturing world since the early 1960s, and unmanned aerial vehicles (drones) have only begun to realize their full potential in the service industry and the military. The omnipresence of these technologies in their respective fields will only become more potent in coming years. While these technologies have greatly evolved over the years, the typical approach to human interaction with these robots has not. In the industrial robotics realm, a manipulator is typically jogged around using a teach pendant and programmed using a networked computer or the teach pendant itself via a proprietary software development platform. Drones are typically controlled using a two-handed controller equipped with throttles, buttons, and sticks, an app that can be downloaded to one’s mobile device, or a combination of both. This application-oriented work offers a novel approach to human interaction with both unmanned aerial vehicles and industrial robotic manipulators via hand gestures and movements. Two systems have been implemented, both of which use a Myo™ armband to control either a drone (DJI Spark™) or a robotic arm (Stäubli™ TX40). The methodologies developed by this work present a mapping of armband gestures (fist, finger spread, swing hand in, swing hand out, swing arm left/up/down/right, etc.) to either drone or robot arm movements. The findings of this study present the efficacy and limitations (precision and ergonomic) of hand gesture control of two distinct types of robotic technology. All source code associated with this project will be open sourced and placed on GitHub. In conclusion, this study offers a framework that maps hand and arm gestures to drone and robot arm control. The system has been implemented using current ubiquitous technologies, and these software artifacts will be open sourced for future researchers or practitioners to use in their work.

Keywords: human robot interaction, drones, gestures, robotics

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Authors: Krishna Dahiya, Esha Charaya

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Induction of labour is a common obstetrical intervention. Around 1 in every 4 patient undergo induction of labour for different indications Purpose: To study the efficacy of the combination of Foley bulb and vaginal misoprostol in comparison to vaginal misoprostol alone for cervical ripening and induction of labour. Methods: A prospective randomised study was conducted on 150 patients with term singleton pregnancy admitted for induction of labour. Seventy-five patients were induced with both Foley bulb, and vaginal misoprostol and another 75 were given vaginal misoprostol alone for induction of labour. Both groups were then compared with respect to change in Bishop score, induction to the active phase of labour interval, induction delivery interval, duration of labour, maternal complications and neonatal outcomes. Data was analysed using statistical software SPSS version 11.5. Tests with P,.05 were considered significant. Results: The two groups were comparable with respect to maternal age, parity, gestational age, indication for induction, and initial Bishop scores. Both groups had a significant change in Bishop score (2.99 ± 1.72 and 2.17 ± 1.48 respectively with statistically significant difference (p=0.001 S, 95% C.I. -0.1978 to 0.8378). Mean induction to delivery interval was significantly lower in the combination group (11.76 ± 5.89 hours) than misoprostol group (14.54 ± 7.32 hours). Difference was of 2.78 hours (p=0.018,S, 95% CI -5.1042 to -0.4558). Induction to delivery interval was significantly lower in nulliparous women of combination group (13.64 ± 5.75 hours) than misoprostol group (18.4±7.09 hours), and the difference was of 4.76 hours (p=0.002, S, 95% CI 1.0465 to 14.7335). There was no difference between the groups in the mode of delivery, infant weight, Apgar score and intrapartum complications. Conclusion: From the present study it was concluded that addition of Foley catheter to vaginal misoprostol have the synergistic effect and results in early cervical ripening and delivery. These results suggest that the combination may be used to achieve timely and safe delivery in the presence of an unfavorable cervix. A combination of the Foley bulb and vaginal misoprostol resulted in a shorter induction-to-delivery time when compared with vaginal misoprostol alone without increasing labor complications.

Keywords: Bishop score, Foley catheter, induction of labor, misoprostol

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Authors: Shanza Akram, Samir Salah, Imran Saleem, Ashraf Alzaabi, Jassim Abdou

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Introduction: 300 million people worldwide are affected by asthma .In UAE, prevalence is around 10% (900,000 people).Patients with persistent symptoms despite using high dose ICS plus a second controller +/- OCS are considered to have severe asthma. Omalizumab (Xolaire) an IgE monoclonal antibody is approved as add on therapy for severe allergic asthma. Objective: To determine the efficacy of omalizumab based on clinical outcomes in our cohort of patient pre and post 52 weeks of treatment to assess safety and tolerability of treatment. Methods: Medical records of patients receiving omalizumab therapy for asthma at ZMH ,Abu Dhabi were retrospectively analyzed.Patients fulfilling the criteria of severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months prior to and 12 months after commencement of omalizumab therapy was analysed by taking into account the number of exacerbations and hospitalizations in addition to maintenance of medication dosages, need for rescue reliever therapy and pulmonary function testing. Results: Total cohort of 21 patient (5 females), average age 41 years and av length of therapy 22 months were included. Seven patients (total 11/52%) managed to stop steroids on treatment while four were able to decrease the dosage. Mean exacerbation rate decreased from five/ year pre treatment to 1.36 while on treatment. Number of hospitalizations decreased from mean of two per year to 0.9 per year. Rescue reliever inhaler usage decreased from mean of 40 puffs to 15 puffs per week. 2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects including local irritation, severe limb and joint pains after 6 months. Conclusion: Treatment with omalizumab showed effect in terms of reduced number of exacerbations, maintenance therapy and reliever medications. However, no improvement was seen in PFTs.There is room for improved documentation in terms of symptom recording and use of rescue medicationas as well as for better patient education and counselling in order to improve compliance.

Keywords: asthma, omalizumab, severe allergic asthma, UAE

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Authors: Yen Ling Liu, Shu-Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Chia-Yu Chen

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Purpose: Nurse anesthetists are confronting extraordinarily high job stress in their daily practice, deriving from the fast-track anesthesia care, risk of perioperative complications, routine rotating shifts, teaching programs and interactions with the surgical team in the operating room. This study investigated the influence of work stress on the burnout and turnover intention of nurse anesthetists in a regional general hospital in Southern Taiwan. Methods: This was a descriptive correlational study carried out in 66 full-time nurse anesthetists. Data was collected from March 2017 to June 2017 by in-person interview, and a self-administered structured questionnaire was completed by the interviewee. Outcome measurements included the Practice Environment Scale of the Nursing Work Index (PES-NWI), Maslach Burnout Inventory (MBI) and nursing staff turnover intention. Numerical data were analyzed by descriptive statistics, independent t test, or one-way ANOVA. Categorical data were compared using the chi-square test (x²). Datasets were computed with Pearson product-moment correlation and linear regression. Data were analyzed by using SPSS 20.0 software. Results: The average score for job burnout was 68.7916.67 (out of 100). The three major components of burnout, including emotional depletion (mean score of 26.32), depersonalization (mean score of 13.65), and personal(mean score of 24.48). These average scores suggested that these nurse anesthetists were at high risk of burnout and inversely correlated with turnover intention (t = -4.048, P < 0.05). Using linear regression model, emotional exhaustion and depersonalization were the two independent factors that predicted turnover intention in the nurse anesthetists (19.1% in total variance). Conclusion/Implications for Practice: The study identifies that the high risk of job burnout in the nurse anesthetists is not simply derived from physical overload, but most likely resulted from the additional emotional and psychological stress. The occurrence of job burnout may affect the quality of nursing work, and also influence family harmony, in turn, may increase the turnover rate. Multimodal approach is warranted to reduce work stress and job burnout in nurse anesthetists to enhance their willingness to contribute in anesthesia care.

Keywords: anesthesia nurses, burnout, job, turnover intention

Procedia PDF Downloads 291

Authors: Ali Alshumrani, Nathan Clarke, Bogdan Ghite, Stavros Shiaeles

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Digital forensics has become an essential tool in the investigation of cyber and computer-assisted crime. Arguably, given the prevalence of technology and the subsequent digital footprints that exist, it could have a significant role across almost all crimes. However, the variety of technology platforms (such as computers, mobiles, Closed-Circuit Television (CCTV), Internet of Things (IoT), databases, drones, cloud computing services), heterogeneity and volume of data, forensic tool capability, and the investigative cost make investigations both technically challenging and prohibitively expensive. Forensic tools also tend to be siloed into specific technologies, e.g., File System Forensic Analysis Tools (FS-FAT) and Network Forensic Analysis Tools (N-FAT), and a good deal of data sources has little to no specialist forensic tools. Increasingly it also becomes essential to compare and correlate evidence across data sources and to do so in an efficient and effective manner enabling an investigator to answer high-level questions of the data in a timely manner without having to trawl through data and perform the correlation manually. This paper proposes a Unified Forensic Analysis Tool (U-FAT), which aims to establish a common language for electronic information and permit multi-source forensic analysis. Core to this approach is the identification and development of forensic analyses that automate complex data correlations, enabling investigators to investigate cases more efficiently. The paper presents a systematic analysis of major crime categories and identifies what forensic analyses could be used. For example, in a child abduction, an investigation team might have evidence from a range of sources including computing devices (mobile phone, PC), CCTV (potentially a large number), ISP records, and mobile network cell tower data, in addition to third party databases such as the National Sex Offender registry and tax records, with the desire to auto-correlate and across sources and visualize in a cognitively effective manner. U-FAT provides a holistic, flexible, and extensible approach to providing digital forensics in technology, application, and data-agnostic manner, providing powerful and automated forensic analysis.

Keywords: digital forensics, evidence correlation, heterogeneous data, forensics tool

Procedia PDF Downloads 191

Authors: Vivek Anand, Rainer Naegele

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Industry 4.0 is a global mega-trend revolutionizing the world of advanced manufacturing, but also bringing up challenges for SMEs. In response, many regional, as well as digital Industry 4.0 Platforms, have been set up to boost the competencies of established enterprises as well as SMEs. The concept of 'Clusters' is a policy tool that aims to be a starting point to establish sustainable and self-supporting structures in industries of a region by identifying competencies and supporting cluster actors with services that match their growth needs. This paper is motivated by the idea that Clusters have the potential to enable firms, particularly SMEs, to accelerate the innovation process and transition to digital technologies. In this research, the efficacy of Industry 4.0 platforms as Cluster ecosystems is evaluated, especially for SMEs. Focusing on the Baden Wurttemberg region in Germany, an action research method is employed to study how SMEs leverage other actors on Industry 4.0 Platforms to further their Industry 4.0 journeys. The aim is to evaluate how such Industry 4.0 platforms stimulate innovation, cooperation and competitiveness. Additionally, the barriers to these platforms fulfilling their promise to serve as capacity building cluster ecosystems for SMEs in a region will also be identified. The findings will be helpful for academicians and policymakers alike, who can leverage a ‘cluster policy’ to enable Industry 4.0 ecosystems in their regions. Furthermore, relevant management and policy implications stem from the analysis. This will also be of interest to the various players in a cluster ecosystem - like SMEs and service providers - who benefit from the cooperation and competition. The paper will improve the understanding of how a dialogue orientation, a bottom-up approach and active integration of all involved cluster actors enhance the potential of Industry 4.0 Platforms. A strong collaborative culture is a key driver of digital transformation and technology adoption across sectors, value chains and supply chains; and will position Industry 4.0 Platforms at the forefront of the industrial renaissance. Motivated by this argument and based on the results of the qualitative research, a roadmap will be proposed to position Industry 4.0 Platforms as effective clusters ecosystems to support Industry 4.0 adoption in a region.

Keywords: cluster policy, digital transformation, industry 4.0, innovation clusters, innovation policy, SMEs and startups

Procedia PDF Downloads 219

Authors: Hang T. T. Truong, Ronald S. Laura, Kylie Shaw

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Within Vietnam's system of higher education, its schools of business play a vital role in supporting the country’s economic objectives. However, the crucial contribution of soft skills for maximal success within the business sector has to date not been adequately recognized by its business schools. This being so, the development of the business school curriculum in Vietnam has not been able to 'catch up', so to say, with the burgeoning need of students for a comprehensive soft skills program designed to meet the national and global business objectives of their potential employers. The burden of the present paper is first to reveal the results of our survey in Vietnam which make explicit the extent to which major Vietnamese industrial employers’ value the potential role that soft skill competencies can play in maximizing business success. Our final task will be to determine which soft skills employers discern as best serving to maximize the economic interests of Vietnam within the global marketplace. Semi-structured telephone interviews have been conducted with the 15 representative Head Employers of Vietnam's reputedly largest and most successful of the diverse business enterprises across Vietnam. The findings of the study indicate that all respondents highly value the increasing importance of soft skills in business success. Our critical analysis of respondent data reveals that 19 essential soft skills are deemed by employers as integral to business workplace efficacy and should thus be integrated into the formal business curriculum. We are confident that our study represents the first comprehensive and specific survey yet undertaken within the business sector in Vietnam which accesses and analyses the opinions of representative employers from major companies across the country in regard to the growing importance of 19 specific soft skills essential for maximizing overall business success. Our research findings also reveal that the integration into business school curriculums nationwide of the soft skills we have identified is of paramount importance to advance the national and global economic interests of Vietnam.

Keywords: business curriculum, business graduates, employers’ perception, soft skills

Procedia PDF Downloads 315

Authors: Moses Mwangi, Geert Verbeke, Geert Molenberghs

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Cross-over designs are commonly used in randomized clinical trials to estimate efficacy of a new treatment with respect to a reference treatment (placebo or standard). The main advantage of using cross-over design over conventional parallel design is its flexibility, where every subject become its own control, thereby reducing confounding effect. Jones & Kenward, discuss in detail more recent developments in the analysis of cross-over trials. We revisit the simple piecewise linear mixed-effects model, proposed by Mwangi et. al, (in press) for its first application in the analysis of cross-over trials. We compared performance of the proposed piecewise linear mixed-effects model with two commonly cited statistical models namely, (1) Grizzle model; and (2) Jones & Kenward model, used in estimation of the treatment effect, in the analysis of randomized cross-over trial. We estimate two performance measurements (mean square error (MSE) and coverage probability) for the three methods, using data simulated from the proposed piecewise linear mixed-effects model. Piecewise linear mixed-effects model yielded lowest MSE estimates compared to Grizzle and Jones & Kenward models for both small (Nobs=20) and large (Nobs=600) sample sizes. It’s coverage probability were highest compared to Grizzle and Jones & Kenward models for both small and large sample sizes. A piecewise linear mixed-effects model is a better estimator of treatment effect than its two competing estimators (Grizzle and Jones & Kenward models) in the analysis of cross-over trials. The data generating mechanism used in this paper captures two time periods for a simple 2-Treatments x 2-Periods cross-over design. Its application is extendible to more complex cross-over designs with multiple treatments and periods. In addition, it is important to note that, even for single response models, adding more random effects increases the complexity of the model and thus may be difficult or impossible to fit in some cases.

Keywords: Evaluation, Grizzle model, Jones & Kenward model, Performance measures, Simulation

Procedia PDF Downloads 119

Authors: Awadh O. Al-Anazi

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As part of the organizational needs toward successful maintaining activities, a proper management system need to be put in place, ensuring the effectiveness of maintenance activities. The management system shall clearly describes the process of identifying, prioritizing, planning, scheduling, execution, and providing valuable feedback for all maintenance activities. Completion and accuracy of the system with proper implementation shall provide the organization with a strong platform for effective maintenance activities that are resulted in efficient outcomes toward business success. The purpose of this research was to introduce a practical tool for measuring the maintenance efficiency level within Saudi organizations. A comprehensive study was launched across many maintenance professionals throughout Saudi leading organizations. The study covered five main categories: work process, identification, planning and scheduling, execution, and performance monitoring. Each category was evaluated across many dimensions to determine its current effectiveness through a five-level scale from 'process is not there' to 'mature implementation'. Wide participation was received, responses were analyzed, and the study was concluded by highlighting major gaps and improvement opportunities within Saudi organizations. One effective implementation of the efficiency enhancement efforts was deployed in Saudi Kayan (one of Sabic affiliates). Below details describes the project outcomes: SK overall maintenance wrench time was measured at 20% (on average) from the total daily working time. The assessment indicates the appearance of several organizational gaps, such as a high amount of reactive work, poor coordination and teamwork, Unclear roles and responsibilities, as well as underutilization of resources. Multidiscipline team was assigned to design and implement an appropriate work process that is capable to govern the execution process, improve the maintenance workforce efficiency, and maximize wrench time (targeting > 50%). The enhanced work process was introduced through brainstorming and wide benchmarking, incorporated with a proper change management plan and leadership sponsorship. The project was completed in 2018. Achieved Results: SK WT was improved to 50%, which resulted in 1) reducing the Average Notification completion time. 2) reducing maintenance expenses on OT and manpower support (3.6 MSAR Actual Saving from Budget within 6 months).

Keywords: efficiency, enhancement, maintenance, work force, wrench time

Procedia PDF Downloads 142

Authors: Iftikhar Tayubi, Tabrej Khan, Rayan Alsulmi, Abdulrahman Labban

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Spider produces a special kind of substance. This special kind of substance is called a toxin. The toxin is composed of many types of protein, which differs from species to species. Spider toxin consists of several proteins and non-proteins that include various categories of toxins like myotoxin, neurotoxin, cardiotoxin, dendrotoxin, haemorrhagins, and fibrinolytic enzyme. Protein Sequence information with references of toxins was derived from literature and public databases. From the previous findings, the Spider toxin would be the best choice to treat different types of tumors and cancer. There are many therapeutic regimes, which causes more side effects than treatment hence a different approach must be adopted for the treatment of cancer. The combinations of drugs are being encouraged, and dramatic outcomes are reported. Spider toxin is one of the natural cytotoxic compounds. Hence, it is being used to treat different types of tumors; especially its positive effect on breast cancer is being reported during the last few decades. The efficacy of this database is that it can provide a user-friendly interface for users to retrieve the information about Spiders, toxin and toxin protein of different Spiders species. SPIDTOXD provides a single source information about spider toxins, which will be useful for pharmacologists, neuroscientists, toxicologists, medicinal chemists. The well-ordered and accessible web interface allows users to explore the detail information of Spider and toxin proteins. It includes common name, scientific name, entry id, entry name, protein name and length of the protein sequence. The utility of this database is that it can provide a user-friendly interface for users to retrieve the information about Spider, toxin and toxin protein of different Spider species. The database interfaces will satisfy the demands of the scientific community by providing in-depth knowledge about Spider and its toxin. We have adopted the methodology by using A MySQL and PHP and for designing, we used the Smart Draw. The users can thus navigate from one section to another, depending on the field of interest of the user. This database contains a wealth of information on species, toxins, and clinical data, etc. This database will be useful for the scientific community, basic researchers and those interested in potential pharmaceutical Industry.

Keywords: siptoxd, php, mysql, toxin

Procedia PDF Downloads 175

Authors: Sarah Holdren, Laura Crook, Anne Drapkin Lyerly

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Objective: The COVID-19 Pandemic has drawn new attention to long-existing bioethical questions around pregnancy, childbirth, and parenthood. Due to the increased risk of severe COVID-19, pregnant individuals may experience anxiety regarding medical decision-making. Especially in the case of hospital births, questions around the ethics of bringing healthy pregnant individuals into a high-risk environment for viral transmission illuminate gaps in the American maternal and child healthcare system. Limited research has sought to understand the experiences of those who gave birth outside hospitals during this time. This study aims to understand pregnant individuals’ conceptualization of risk during the COVID-19 pandemic. Methods: Individuals who gave birth after March 2020 were recruited through advertisements on social media. Participants completed a 1-hour semi-structured interview and a demographic questionnaire. Interviews were transcribed and coded by members of the research team using thematic narrative analysis. Results: A total of 18 participants were interviewed and completed the demographic questionnaire. The language of risk was utilized in birth narratives in three different ways, which highlighted the multileveled and nuanced ways in which risk is understood and mitigated by pregnant and birthing individuals. These included: 1. The risk of contracting COVID-19 before, during, and after birth, 2. The risk of birth complications requiring medical interventions dependent on selected birthing space (home, birthing center, hospital), and 3. The overall risk of creating life in the middle of a pandemic. The risk of contracting COVID-19 and risk of birth complications were often weighed in paradoxical ways throughout each individual’s pregnancy, while phrases such as “pandemic baby” and “apocalypse” appeared throughout narratives and highlighted the broader implications of pregnancy and childbirth during this momentous time. Conclusions: Healthcare professionals should consider the variety of ways that pregnant and birthing individuals understand the risk when counseling patients on healthcare decisions, especially during times of healthcare crisis such as COVID-19. Future work should look to understand how the language of risk fits into a broader understanding of the human experience of growing life in times of crisis.

Keywords: maternal and child health, thematic narrative analysis, COVID-19, risk mitigation

Procedia PDF Downloads 160

Authors: Susana Silva, Dora Martins

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The recent political, economic, social technological and employment changes significantly affect the tourism organizations and consequently the changing nature of the employment experience of the tourism workforce. Such scene leads several researchers and labor analysts to reflect about what kinds of jobs, knowledge and competences are need to ensure the success to teach, to learning and to work on this sector. In recent years the competency-based approach in high education level has become of significant interest. On the one hand, this approach could leads to the forming of the key students’ competences which contribute their better preparation to the professional future and on the other hand could answer better to practical demands from tourism job market. The goals of this paper are (1) to understand the expectations of university tourism students in relation to the present and future tourism competences demands, (2) to identify the importance put on the soft skills, (3) to know the importance of high qualification to their future professional activity and (4) to explore the students perception about present and future tourist sector specificities. To this proposal, a questionnaire was designed and distributed to every students who participate on classes of Hospitality Management under degree and master from one public Portuguese university. All participants were invited, during December 2014 and September 2015, to answer the questionnaire at the moment and on presence of one researcher of this study. Fulfilled the questionnaire 202 students (72, 35,6% male and 130, 64.4% female), the mean age was 21,64 (SD=5,27), 91% (n=86) were undergraduate and 18 (9%) were master students. 80% (n=162) of our participants refers as a possibility to look for a job outside the country.42% (n=85) prefers to work in a medium-sized tourism units (with 50-249 employees). According to our participants the most valued skills in tourism are the domain of foreign languages (87.6%, n=177), the ability to work as a team (85%), the personal persistence (83%, n=168), the knowledge of the product/services provided (73.8%, n=149), and assertiveness (66.3%, n=134). 65% (n=131) refers the availability to look for a job in a home distance of 1000 kilometers and 59% (n=119) do not consider the possibility to work in another area than tourism. From the results of this study we are in the position of confirming the need for universities to maintain a better link with the professional tourism companies and to rethink some competences into their learning course model. Based on our results students, universities and companies could understand more deeply the motivations, expectations and competences need to build the future career who study and work on the tourism sector.

Keywords: human capital, employability, students’ competencies perceptions, soft skills, tourism

Procedia PDF Downloads 268

Authors: Danielle A. Walker, Kyle L. Johnson, Tara B. Thomas, Sandor Dorgo, Jacen S. Moore

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Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa. The relationship existing between HIV incidence and socioeconomic inequity confirms the critical need for programs promoting HIV education, prevention and treatment access. This literature review analyzed 36 sources with a specific focus on the Democratic Republic of Congo, whose critically low socioeconomic status and education rate have resulted in a drastically high HIV rates. Relationships between HIV testing and treatment and barriers to care were explored. Cultural and religious considerations were found to be vital when creating and implementing HIV education and testing programs. Partnerships encouraging active support from community-based spiritual leaders to implement HIV educational programs were also key mechanisms to reach communities and individuals. Gender roles were highlighted as a key component for implementation of effective community trust-building and successful HIV education programs. The efficacy of added support by hospitals and clinics in rural areas to facilitate access to HIV testing and care for people living with HIV/AIDS (PLWHA) was discussed. This review highlighted the need for healthcare providers to provide a network of continued education for PLWHA in clinical settings during disclosure and throughout the course of treatment to increase retention in care and promote medication adherence for viral load suppression. Implementation of culturally sensitive models that rely on community familiarity with HIV educators such as ‘train-the-trainer’ were also proposed as efficacious tools for educating rural communities about HIV. Further research is needed to promote community partnerships for HIV education, understand the cultural context of gender roles as barriers to care, and empower local health care providers to be successful within the HIV Continuum of Care.

Keywords: cultural sensitivity, Democratic Republic of the Congo, education, HIV

Procedia PDF Downloads 271

Authors: Chakrapani Pullagummi, Arun Jyothi Bheemagani, B. Chandra Sekhar Singh, Prem Kumar, A. Roja Rani

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Diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion and its action. The objective of present study was alloxan induced diabetes in S.D (Sprague Dawley) rats, treated with leaf extract of Andrographis paniculata and bark extract of Erythrina indica. Plant extract treated rats were analyzed biochemically and molecularly. on normal and diabetic rats. The changes in MDA (lipid peroxidation) and glucose (by GOD method) levels in blood of both normal and diabetic rat were analyzed. Diabetes induced rats were treated with methanolic extracts of Andrographis paniculata leaf and Erythrina indica bark which are of medicinal importance. Later after inducing diabetes the rats were treated with medicinal plant extracts, Andrographis paniculata leaf and Erythrina indica bark which are well known for their anti diabetic and antioxidative property in order to control the glucose and MDA levels. The blood plasma of diabetic and normal rats was analyzed for the levels of MDA (lipid peroxidation) and glucose levels. Results of this study suggested that the Andrographis paniculata leaf and Erythrina indica can be used as a potential natural antidiabetic agent for treating and postponing the appearance of complications that arise due to Diabetes. Molecular study deals with the analysis of binding mechanism of 2 selected natural compounds from Andrographis and Erythrina extracts against the novel target for type T2D namely PPAR-γ compared with Rosiglitazone (standard compound). The results revealed that most of the selected herbal lead compounds were effective targets against the receptors. These compounds showed favorable interactions with the amino acid residues thereby substantiating their proven efficacy as anti-diabetic compounds.

Keywords: andrographis paniculata, erythrina indica, alloxan, lipid peroxidation, blood glucose level, PPAR-γ

Procedia PDF Downloads 473

Authors: Erwin Geroleo, Higinio Mappala

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Introduction Overt Hepatic Encephalopathy (OHE) is the most dreaded outcome of liver cirrhosis. Aside from the triggering factors which are already known to precipitate OHE, there is growing evidence that an altered gut microbiota profile (dysbiosis) can also trigger OHE. MHE is the mildest form of hepatic encephalopathy(HE), affecting about one-third of patients with cirrhosis, and close 80% of patients with cirrhosis and manifests as abnormalities in central nervous system function. Since these symptoms are subclinical most patients are not being treated to prevent OHE. The gut microbiota have been evaluated by several studies as a therapeutic option for MHE, especially in decreasing the levels of ammonia, thus preventing progression to OHE Objectives This study aims to evaluate the efficacy of probiotics in terms of reduction of ammonia levels in patient with minimal hepatic encephalopathies and to determine if Probiotics has role in the prevention of progression to overt hepatic encephalopathy in adult patients with minimal hepatic encephalopathy (MHE) Methods and Analysis The literature search strategy was restricted to human studies in adults subjects from 2004 to 2022. The Jadad Score Calculation was utilized in the assessment of the final studies included in this study. Eight (8) studies were included. Cochrane’s Revman Web, the Fixed Effects model and the Ztest were all used in the overall analysis of the outcomes. A p value of less than 0.0005 was statistically significant. Results. These results show that Probiotics significantly lowers the level of Ammonia in Cirrhotic patients with OHE. It also shows that the use of Probiotics significantly prevents the progression of MHE to OHE. The overall risk of bias graph indicates low risk of publication bias among the studies included in the meta-analysis. Main findings This research found that plasma ammonia concentration was lower among participants treated with probiotics (p<0.00001).) Ammonia level of the probiotics group is lower by 13.96 μmol/ on the average. Overall risk of developing overt hepatic encephalopathy in the probiotics group is shown to be decreased by 15% as compared to the placebo group Conclusion The analysis showed that compared with placebo, probiotics can decrease serum ammonia, may improve MHE and may prevent OHE.

Keywords: minimal hepatic encephalopathy, probiotics, liver cirrhosis, overt hepatic encephalopathy

Procedia PDF Downloads 39

Authors: Obadire F. O., Obadire, S. O., Adeoti R. F., Pirgozliev V.

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An experiment was conducted to determine the efficacy of utilizing African black plum seed nut (ABPNBD) meal on hematological and biochemical indices of broiler chicken ration formulated to substitute wheat offal. A total of 150- 1day-old, male Agrited birds were reared for 28 days of the experiment. The birds were assigned to five dietary treatments, with ten birds per treatment replicated 3 times. Experimental diets were formulated by supplementing the milled African black plum nut at (0, 5, 10, 12.5, and 15%) inclusion levels in the starter broiler’s ratio designated as T1 (control diet containing no ABPBD), Treatments (T2, 3,4 and 5) contained ABPNBD at 5, 10, 12.5, and 15%, respectively, in a completely randomized design. The hematological and biochemical indices of the birds were determined. The result revealed that all hematological parameters measured were significant (P <0.05) except for WBC. Increasing inclusion levels of ABPNBD decreased the PCV, HB, and RBC of the birds across the treatment groups. Birds fed 12.5 and 15% ABPNBD diets recorded the least of the parameters. The result of the serum biochemical indices showed significant (P < 0.05) influence for all parameters measured except for alanine transaminase (ALT), (AST), and creatinine. The total protein (TP), albumin, globulin, and glucose values were reduced across the treatment group as ABPNBD inclusion increased. Birds fed above 10% ABPNBD recorded the lowest value of TP, albumin, globulin, and glucose when compared with birds on a control diet and other treatments. The uric acid ranged from 3.85 to 2 .13 mmol/L, while creatinine ranged from 62.00 to 53.50 mmol/l. AST ranged between 8.50 u/l (5%) to 7.90 u/l (10%). ALT ranged between 7.50 u/l (12.5%) to 5.50 u/l (5 and 10%). In conclusion, dietary inclusion of African black plum up to 10% has no detrimental effect on the health of the starter chickens. Meanwhile, inclusion above 10% revealed a negative effect on some blood parameters measured. Therefore, African black plum should be supplemented with probable probiotics or subjected to different processing methods if to be used at a 15% inclusion level for optimal results.

Keywords: African black plum seed, starter broiler chickens, hematological and serum biochemical indices, (Vitex doniana)

Procedia PDF Downloads 46

Authors: Ibrahim M. I. Hamoda, Ahmed R. Z. Baghdadi, Mohammed K. Mohamed, Nawal A. Abu-Shady

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Background: Most of patients with vestibular dysfunction suffering from balance disorders, Abnormality in balance increase effort and exertion which affect the independency, so this study might be a guide in managing balance problem and consequently improve walking with less exertion and maximum function. Purpose: to analyze and discuss the effect of transcranial magnetic therapy on balance in patients with vestibular dysfunction. Methods: forty subjects from both sexes were classified to divided randomly into two equal groups; Group I study group: this group received transcranial magnetic therapy, with a selected physical therapy program for improving balance and vestibular disorders (Balance training, Cawthorne-Cooksey Exercises) and group II (control group): this group received a selected physical therapy program as group I without transcranial magnetic therapy. This treatment procedure will be applied three times weekly for three months. The mean age was 54.53±3.44 and 55.33±2.32 years and BMI 35.7±3.03 and 35.73±1.03 kg/m2 for group I and II respectively. The Biodex Balance System, Berge balances scale (BBS) and brain MRI were used for assessment. Assessments were conducted before and after treatment. The treatment program for group I included balance training, Cawthorne-Cooksey Exercises and pulsed magnetic therapy (Parameters used in the program of 20 minutes, Intensity 2 gausses, Frequency 1 Hz). This selected program was done in approximately one hour every other day for three month. The treatment program group II Patients received the same program as group A without transcranial magnetic therapy. Results: The One-way ANOVA revealed that there were no significant differences in BBS scores, overall balance index, Anterior / posterior balance index, Medial / lateral balance index and dynamic limits of stability between both groups. Moreover, the BBS scores increased and overall balance index, Anterior / posterior balance index, Medial / lateral balance index and dynamic limits of stability decreased significantly after treatment in group I and II compared with before treatment. Interpretation/Conclusion: Adding pulsed magnetic therapy to balance training, Cawthorne-Cooksey Exercises has no effect on static and dynamic balance in patients with balance problems due to benign positional paroxysmal vertigo.

Keywords: balance, transcranial magnetic therapy, vestibular dysfunction, biomechanic

Procedia PDF Downloads 478