Search results for: lung cancer trends

Authors: Hadeer Hegazy, Wael Ewieda, Ranin Soliman, Samah Elway, Asmaa Tawfik, Ragaa Sayed, Sahar Mousa

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The current healthcare system is facing major challenges in terms of cost, quality of care, and access to services. In response, the concept of value-based healthcare has emerged as a new approach to healthcare delivery. This concept puts the focus on patient values rather than on the traditional medical model of care. To achieve this, healthcare organizations must be agile and able to anticipate and respond quickly to changing needs. Agile management is essential for healthcare organizations to achieve value-based care, as it allows them to rapidly adjust their strategies to changing circumstances. Additionally, it is argued that agile management can help healthcare organizations gain a better understanding of the needs of their patients and develop better care delivery models. Besides, it can help healthcare organizations develop new services, innovate, and become more efficient. The authors provide evidence to support their argument, drawing on examples from successful value-based healthcare initiatives at children’s cancer hospital Egypt-57357. The paper offers insight into how agile management can be used to facilitate the shift towards value-based healthcare and how it can be used to maximize value in the healthcare system.

Keywords: value-based healthcare, agility in healthcare, nursing department, patients outcomes

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Authors: H. Fraga, J. A. Santos

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Vitiviniculture in Portugal is a key socio-economic sector, with a strong connection to local traditions and culture. Despite being a relatively small country, with prevailing Mediterranean environments, Portugal comprises an exceptionally large diversity of growth conditions (Terroirs). The vineyard area in Portugal is over 190 thousand hectares, being the eleventh wine producer and ninth wine exporter worldwide. Owing to the strong impact of weather and climate conditions on grapevine physiological development, grape berry quantity and quality show important inter-annual variability. Grapevines are also susceptible to climate change, as their responses will be unavoidably different under future climates. These impacts may change wine typicity of a given region or even its viticultural suitability. The current study reveals that the projected warming and drying trends for Portugal under the Representative Concentration Pathway (RCP) 4.5 and 8.5, are projected to 1) significantly shift current grapevine growing thermal conditions (e.g., heat and chill accumulation), 2) enhance water stress, 3) anticipate phenological timings and 4) modify yields. Moreover, the present study provides some hints regarding the effectiveness of mulching and irrigation as climate change adaptation measures. Our results show that the effectiveness of these adaptation measures will strongly rest on the strength of the climate change signal at a local scale, thus emphasizing the need for local-to-regional climate change assessments.

Keywords: viticulture, climate change, adaptation measures, Portugal

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Authors: Areej Almalkawi, Sameer Hamadna, Parviz Soroushian, Nalin Darsana

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The work on indigenous binders in this paper focused on the following indigenous raw materials: red clay, red lava and pumice (as primary aluminosilicate precursors), wood ash and gypsum (as supplementary minerals), and sodium sulfate and lime (as alkali activators). The experimental methods used for evaluation of these indigenous raw materials included laser granulometry, x-ray fluorescence (XRF) spectroscopy, and chemical reactivity. Formulations were devised for transforming these raw materials into alkali aluminosilicate-based hydraulic cements. These formulations were processed into hydraulic cements via simple heating and milling actions to render thermal activation, mechanochemical and size reduction effects. The resulting hydraulic cements were subjected to laser granulometry, heat of hydration and reactivity tests. These cements were also used to prepare mortar mixtures, which were evaluated via performance of compressive strength tests. The measured values of strength were correlated with the reactivity, size distribution and microstructural features of raw materials. Some of the indigenous hydraulic cements produced in this reporting period yielded viable levels of compressive strength. The correlation trends established in this work are being evaluated for development of simple and thorough methods of qualifying indigenous raw materials for use in production of indigenous hydraulic cements.

Keywords: one-part geopolymer cement, aluminosilicate precursors, thermal activation, mechanochemical

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Authors: A. J. S. P. Nileema, S. Kulatunga , S. H. Palihawadana

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Computer aided detection (CAD) system was developed for the diagnosis of pulmonary tuberculosis using digital chest X-rays with MATLAB image processing techniques using a statistical approach. The study comprised of 200 digital chest radiographs collected from the National Hospital for Respiratory Diseases - Welisara, Sri Lanka. Pre-processing was done to remove identification details. Lung fields were segmented and then divided into four quadrants; right upper quadrant, left upper quadrant, right lower quadrant, and left lower quadrant using the image processing techniques in MATLAB. Contrast, correlation, homogeneity, energy, entropy, and maximum probability texture features were extracted using the gray level co-occurrence matrix method. Descriptive statistics and normal distribution analysis were performed using SPSS. Depending on the radiologists’ interpretation, chest radiographs were classified manually into PTB - positive (PTBP) and PTB - negative (PTBN) classes. Features with standard normal distribution were analyzed using an independent sample T-test for PTBP and PTBN chest radiographs. Among the six features tested, contrast, correlation, energy, entropy, and maximum probability features showed a statistically significant difference between the two classes at 95% confidence interval; therefore, could be used in the classification of chest radiograph for PTB diagnosis. With the resulting value ranges of the five texture features with normal distribution, a classification algorithm was then defined to recognize and classify the quadrant images; if the texture feature values of the quadrant image being tested falls within the defined region, it will be identified as a PTBP – abnormal quadrant and will be labeled as ‘Abnormal’ in red color with its border being highlighted in red color whereas if the texture feature values of the quadrant image being tested falls outside of the defined value range, it will be identified as PTBN–normal and labeled as ‘Normal’ in blue color but there will be no changes to the image outline. The developed classification algorithm has shown a high sensitivity of 92% which makes it an efficient CAD system and with a modest specificity of 70%.

Keywords: chest radiographs, computer aided detection, image processing, pulmonary tuberculosis

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Authors: Salamatu Sani

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This study is an investigation of how code-mixing manifests in the language development of a Nigerian child, especially in the Hausa speaking environment. It is hinged on the fact that the environment influences the first language acquired by a child regardless of the cultural and/or linguistic background of the parents. The child under investigation has been subjected to close monitoring on her speech hitherto. It is a longitudinal study covering a period of twelve months (January 2018 to December 2018); that was when the subject was between twenty-four and thirty months of age. The speeches have been recorded by means of a tape recorder, video, and a diary. The study employs as a theoretical framework, emergentism, which is an eclectic of the behaviourist and the mentalist theories to the study of language development, for analysis. This is in agreement with the positions of Skinner and Watson. Sequel to this investigation, it was discovered the environment is a major factor that influences the exposure of a child to a language more than the other factors and that, if a child is exposed to more than one language, there is a great tendency for such a child to code-mix and code-switch in her speech production. The child under investigation, in spite of the linguistic background of her parents, speaks the Hausa Language much better than the other languages around her though with remarkable code-mixing with other languages around her such as English and Ebira languages. The study concludes that although a child is born with the innate ability to acquire a particular language, the environment plays a key role to trigger the innate ability and consequently, the child is exposed to the acquisition of the dominant language around her at a particular given time.

Keywords: bilingual, code-mixing, emergentism, environment, Hausa

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Authors: R. Setino, I. M. Ambe, J. A Badenhorst-Weiss

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The South African government supply chain management system is not adequately implemented in State Owned Enterprises (SOEs). There are weaknesses in the SOEs SCM enablers, strategies and policies. In addition, top management of SOEs still do not see SCM as strategic enough to deserve their attention, and therefore, there is very little support from top management, thus making it even difficult for SCM practitioners to execute their day to day functions, let alone delivering the letter and spirit of the relevant legislations. Supply chain strategies lack buy in from the top, and as a result senior SCM practitioners has not been involved in the corporate strategy. This has resulted in supply chain and corporate strategies being misaligned. Due to service delivery backlog, high level of corruption and continuous strikes across the country for better services it is inevitable that government leaders be more strategic about how South Africa can use SCM as a tool to improve service delivery. Consequently, there is a need to close the gap between the strategic level dealt by top management and the application of operational SCM concepts: the use of SCM concepts and, therefore, supply chain strategies – should be aligned with the corporate and business strategies in order to ensure the achievement of top level business objectives. This paper aims to explore supply chain practices in State Owned Enterprises (SOEs). The paper based on a conceptual review provides the status, trends and development and suggests a framework for aligning supply chain strategies and organizational strategies in an SOE environment.

Keywords: alignment, strategies, state owned enterprises, supply chain management, South Africa

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Authors: Mehran Fadaeinasab, Hamed Karimian, Najihah Mohd Hashim, Hapipah Mohd Ali

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In this study, three indole alkaloids namely; rauvolfine B, macusine B, and isoreserpiline have been isolated from the dichloromethane crude extract of Rauvolfia reflexa bark (Apocynaceae). The structural elucidation of the isolated compounds has been performed using spectral methods such as UV, IR, MS, 1D, and 2D NMR. Rauvolfine B showed anti proliferation activity on HCT-116 cancer cell line, its cytotoxicity induction was observed using MTT assay in eight different cell lines. Annexin-V is serving as a marker for apoptotic cells and the Annexin-V-FITC assay was carried out to observe the detection of cell-surface Phosphatidylserine (PS). Apoptosis was confirmed by using caspase-8 and -9 assays. Cell cycle arrest was also investigated using flowcytometric analysis. rauvolfine B had exhibited significantly higher cytotoxicity against HCT-116 cell line. The treatment significantly arrested HCT-116 cells in the S phase. Together, the results presented in this study demonstrated that rauvolfine B inhibited the proliferation of HCT-116 cells and programmed cell death followed by cell cycle arrest.

Keywords: apocynacea, indole alkaloid, apoptosis, cell cycle arrest

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Authors: Sudeshna Chandra, Christian Gäbler, Christian Schliebe, Heinrich Lang

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Highly branched dendrimers provide structural homogeneity, controlled composition, comparable size to biomolecules, internal porosity and multiple functional groups for conjugating reactions. Electro-active dendrimers containing multiple redox units have generated great interest in their use as electrode modifiers for development of biosensors. The electron transfer between the redox-active dendrimers and the biomolecules play a key role in developing a biosensor. Ferrocenes have multiple and electrochemically equivalent redox units that can act as electron “pool” in a system. The ferrocenyl-terminated polyamidoamine dendrimer is capable of transferring multiple numbers of electrons under the same applied potential. Therefore, they can be used for dual purposes: one in building a film over the electrode for immunosensors and the other for immobilizing biomolecules for sensing. Electrochemical immunosensor, thus developed, exhibit fast and sensitive analysis, inexpensive and involve no prior sample pre-treatment. Electrochemical amperometric immunosensors are even more promising because they can achieve a very low detection limit with high sensitivity. Detection of the cancer biomarkers at an early stage can provide crucial information for foundational research of life science, clinical diagnosis and prevention of disease. Elevated concentration of biomarkers in body fluid is an early indication of some type of cancerous disease and among all the biomarkers, IgG is the most common and extensively used clinical cancer biomarkers. We present an IgG (=immunoglobulin) electrochemical immunosensor using a newly synthesized redox-active ferrocenyl dendrimer of generation 2 (G2Fc) as glassy carbon electrode material for immobilizing the antibody. The electrochemical performance of the modified electrodes was assessed in both aqueous and non-aqueous media using varying scan rates to elucidate the reaction mechanism. The potential shift was found to be higher in an aqueous electrolyte due to presence of more H-bond which reduced the electrostatic attraction within the amido groups of the dendrimers. The cyclic voltammetric studies of the G2Fc-modified GCE in 0.1 M PBS solution of pH 7.2 showed a pair of well-defined redox peaks. The peak current decreased significantly with the immobilization of the anti-goat IgG. After the immunosensor is blocked with BSA, a further decrease in the peak current was observed due to the attachment of the protein BSA to the immunosensor. A significant decrease in the current signal of the BSA/anti-IgG/G2Fc/GCE was observed upon immobilizing IgG which may be due to the formation of immune-conjugates that blocks the tunneling of mass and electron transfer. The current signal was found to be directly related to the amount of IgG captured on the electrode surface. With increase in the concentration of IgG, there is a formation of an increasing amount of immune-conjugates that decreased the peak current. The incubation time and concentration of the antibody was optimized for better analytical performance of the immunosensor. The developed amperometric immunosensor is sensitive to IgG concentration as low as 2 ng/mL. Tailoring of redox-active dendrimers provides enhanced electroactivity to the system and enlarges the sensor surface for binding the antibodies. It may be assumed that both electron transfer and diffusion contribute to the signal transformation between the dendrimers and the antibody.

Keywords: ferrocenyl dendrimers, electrochemical immunosensors, immunoglobulin, amperometry

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Authors: Nneka Nkechi Uchegbu, Temitope Omolayo Fasuan

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This study investigated how to reduce bio-compounds and amino acids in V. amygdalina leaf during processing as a functional food ingredient. Fresh V. amygdalina leaf was processed using thermal oil-aqueous mixtures (soybean oil: aqueous and palm oil: aqueous) at 1:40 and 130 (v/v), respectively. Results indicated that the hot soybean oil-aqueous mixture was the most effective in preserving the bio-compounds and amino acids with retention potentials of 80.95% of the bio-compounds at the rate of 90-100%. Hot palm oil-aqueous mixture retained 61.90% of the bio-compounds at the rate of 90-100% and hot aqueous retained 9.52% of the bio-compounds at the same rate. During the debittering process, seven new bio-compounds were formed in the leaves treated with hot soybean oil-aqueous mixture, six in palm oil-aqueous mixture, and only four in hot aqueous leaves. The bio-compounds in the treated leaves have potential functions as antitumor, antioxidants, antihistaminic, anti-ovarian cancer, anti-inflammatory, antiarthritic, hepatoprotective, antihistaminic, haemolytic 5-α reductase inhibitor, nt, immune-stimulant, diuretic, antiandrogenic, and anaemiagenic. Alkaloids and polyphenols were retained at the rate of 81.34-98.50% using oil: aqueous mixture while aqueous recorded the rate of 33.47-41.46%. Most of the essential amino acids were retained at a rate above 90% through the aid of oil. The process is scalable and could be employed for domestic and industrial applications.

Keywords: V. amygdalina leaf, bio-compounds, oil-aqueous mixture, amino acids

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Authors: Young Min Kim, Deokyeong Choe, Chul Soo Shin

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Monascus pigments, commonly used as a natural colorant in Asia, have many biological activities, such as cholesterol level control, anti-obesity, anti-cancer, and anti-oxidant, that have recently been elucidated. Especially, amino acid derivatives of Monascus pigments are receiving much attention because they have higher biological activities than original Monascus pigments. Previously, there have been two ways to produce amino acid derivatives: one-step production and two-step production. However, the one-step production has low purity, and the two-step production—precursor(orange pigments) fermentation and derivatives synthesis—has low productivity and growth rate during its precursor fermentation step. In this study, it was verified that pH is a key factor that affects the stability of orange pigments and the growth rate of Monascus. With an optimal pH profile obtained by pH-stat fermentation, we designed a process of precursor(orange pigments) fermentation that is a pH-controlled fed-batch fermentation. The final concentration of orange pigments in this process increased to 5.5g/L which is about 30% higher than the concentration produced from the previously used precursor fermentation step.

Keywords: cultivation process, fed-batch fermentation, monascus pigments, pH stability

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Authors: Basem Kamal Abasakhiroun Farag

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Fashion, like many other areas of design, has undergone numerous developments over the centuries. The aim of the article is to recognize and evaluate the importance of advanced technologies in fashion design and to examine how they are transforming the role of contemporary fashion designers by transforming the creative process. It also discusses how contemporary culture is involved in such developments and how it influences fashion design in terms of conceptualization and production. The methodology used is based on examining various examples of the use of technology in fashion design and drawing parallels between what was feasible then and what is feasible today. Comparison of case studies, examples of existing fashion designs and experiences with craft methods; We therefore observe patterns that help us predict the direction of future developments in this area. Discussing the technological elements in fashion design helps us understand the driving force behind the trend. The research presented in the article shows that there is a trend towards significantly increasing interest and progress in the field of fashion technology, leading to the emergence of hybrid artisanal methods. In summary, as fashion technologies advance, their role in clothing production is becoming increasingly important, extending far beyond the humble sewing machine.

Keywords: fashion, identity, such, textiles ambient intelligence, proximity sensors, shape memory materials, sound sensing garments, wearable technology bio textiles, fashion trends, nano textiles, new materials, smart textiles, techno textiles fashion design, functional aesthetics, 3D printing.

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Authors: M. Abou-Amouna, A. Radwan, L. Al-kuwari, A. Hammuda, K. Al-Khalifa

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There is growing concern over increasing incidences of road accidents and consequent loss of human life in Qatar. In light to the future planned event in Qatar, World Cup 2022; Qatar should put into consideration the future deaths caused by road accidents, and past trends should be considered to give a reasonable picture of what may happen in the future. Qatar roads should be arranged and paved in a way that accommodate high capacity of the population in that time, since then there will be a huge number of visitors from the world. Qatar should also consider the risk issues of road accidents raised in that period, and plan to maintain high level to safety strategies. According to the increase in the number of road accidents in Qatar from 1995 until 2012, an analysis of elements affecting and causing road accidents will be effectively studied. This paper aims to identify and criticize the factors that have high effect on causing road accidents in the state of Qatar, and predict the total number of road accidents in Qatar 2022. Alternative methods are discussed and the most applicable ones according to the previous researches are selected for further studies. The methods that satisfy the existing case in Qatar were the multiple linear regression model (MLR) and artificial neutral network (ANN). Those methods are analyzed and their findings are compared. We conclude that by using MLR the number of accidents in 2022 will become 355,226 accidents, and by using ANN 216,264 accidents. We conclude that MLR gave better results than ANN because the artificial neutral network doesn’t fit data with large range varieties.

Keywords: road safety, prediction, accident, model, Qatar

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Authors: Jay Mar D. Quevedo, Fernando P. Siringan, Cesar L. Villanoy

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The influence of the Younger Dryas (YD) event on primary production off the northeast shelf of Luzon, Philippines is examined using sediment cores from two deep sea sites north of the Bicol shelf and with varying relative influence from terrestrial sediment input and the Kuroshio Current. Core A is immediately west of the Kuroshio feeder current and is off the slope while Core B is from a bathymetric high located almost west of Core A. XRF-, CHN- and LOI- derived geochemical proxies are utilized for reconstruction. A decrease in sediment input from ~12.9 to ~11.6 kyr BP corresponding to the YD event is indicated by the proxies, Ti, Al, and Al/Ti, in both cores. This is consistent with the drier climate during this period. Primary productivity indicators in the cores show opposing trends during the YD; Core A shows an increasing trend while Core B shows a decreasing trend. The decreasing trend in Core B can be due to a decrease in terrestrial nutrient input due to a decrease in precipitation. On the other hand, the increasing trend in Core A can be due to a swifter Kuroshio Current caused by a swifter and more southerly NEC bifurcation which in turn is due to a southerly shift of the ITCZ during YD. A stronger Kuroshio feeder would have enhanced upwelling induced by steeper sea surface across the current and by more intense cyclonic gyres due to flow separation where the shelf width suddenly decreases north of the Bicol Shelf.

Keywords: paleoproductivity, younger dryas, Philippines, northeastern Luzon

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Authors: D. Garg, S. Luthra, A. Haleem

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Due to growing concern about environmental and social consequences throughout the world, a need has been felt to incorporate sustainability concepts in conventional manufacturing. This paper is an attempt to identify and evaluate drivers in implementing sustainable manufacturing in Indian context. Nine possible drivers for successful implementation of sustainable manufacturing have been identified from extensive review. Further, Decision Making Trial and Evaluation Laboratory (DEMATEL) approach has been utilized to evaluate and categorize these identified drivers for implementing sustainable manufacturing in to the cause and effect groups. Five drivers (Societal Pressure and Public Concerns; Regulations and Government Policies; Top Management Involvement, Commitment and Support; Effective Strategies and Activities towards Socially Responsible Manufacturing and Market Trends) have been categorized into the cause group and four drivers (Holistic View in Manufacturing Systems; Supplier Participation; Building Sustainable culture in Organization; and Corporate Image and Benefits) have been categorized into the effect group. “Societal Pressure and Public Concerns” has been found the most critical driver and “Corporate Image and Benefits” as least critical or the most easily influenced driver to implementing sustainable manufacturing in Indian context. This paper may surely help practitioners in better understanding of these drivers and their priorities towards effective implementation of sustainable manufacturing.

Keywords: drivers, decision making trial and evaluation laboratory (DEMATEL), India, sustainable manufacturing

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Authors: Erica Lima

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In Brazil, considering the (little) age of translation studies, it can be argued that the University of Campinas is traditionally an important place for graduate studies in translation. The story is told from the accreditation for the Masters, in 1987, and the Doctoral program, in 1993, within the Graduate Program in Applied Linguistics. Since the beginning, the program boasted cutting-edge research, with theoretical reflections on various aspects, and with different methodological trends. However, on the one hand, the graduate studies development was continuously growing, but on the other, it is not what was observed in the undergraduate degree program. Currently, there are only a few disciplines of Translation Theory and Practice, which does not seem to respond to student aspirations. The objective of this paper is to present the characteristics of the university’s graduate program as something profitable, considering the concern in relating the research to the historical moment in which we are living, with research conducted in a socially compromised environment and committed to the impact that it will cause ethically and socially, as well as to question the undergraduate program paths. The objective is also to discuss and propose changes, considering the limited scope currently achieved. In light of the information age, in which we have an avalanche of information, we believe that the training of translators in the undergraduate degree should be reviewed, with the goal of retracing current paths and following others that are consistent with our historical period, marked by virtual and real, by the shuffling of borders and languages, the need for new language policies, greater inclusion, and more acceptance of others. We conclude that we need new proposals for the development of the translator in an undergraduate program, and also present suggestions to be implemented in the graduate program.

Keywords: graduate Brazilian program, undergraduate Brazilian program, translator’s education, Unicamp

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Authors: Dauda G., Bila Ha Sani Y. M., Magaji M. G., Musa A. M., Hassan H. S.

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Introduction: Globimetula oreophila is a parasitic plant with a known therapeutic value that is widely used in the treatment of various ailments, including malaria, hypertension, cancer, diabetes, epilepsy and as a diuretic agent. Objectives: The present study is aimed at analyzing and documenting the level of trace and toxic metals in the crude ethanol leaf extract of G. oreophila. Methods: After collection and authentication, the leaves were air-dried, mashed into powder, weighed and extracted using aqueous ethanol (70%). The crude extract (0.5g) was digested with HNO₃: HCl (3:1); then heated to 2000C and analyzed for its metal content by atomic absorption spectroscopy (AAS). Results: Fe had the highest concentration (32.73mg/kg), while Pb was not detected. The concentrations of Co, Cu, Ni, Zn and Cd detected were 5.97, 10.8, 8.01 and 0.9mg/kg, respectively. The concentration of Cd, Fe and Ni were above the permissible limit of FAO/WHO. Conclusion: The results also show that the analyzed plant is a beneficial source of appropriate and essential trace metals. However, the leaf of G. oreophila in the present study was probably unsafe for long-term use because of the level of Fe, Ni, and Cd concentration.

Keywords: Globimetula oreophila, minerals, trace element, crude extract

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Authors: Francis Jegede

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This paper examines essential issues relating to the rise and nature of violent extremism involving non-state actors and groups in the early 21^st century. The global trends in terrorism and violent extremism are examined in relation to Western governments’ counter terror operations. The paper analyses the existing legal framework for fighting violent extremism and terrorism and highlights the inherent limitations of the current International Law of War in dealing with the growing challenges posed by terrorists and violent extremist groups. The paper discusses how terrorist groups use civilians, women and children as tools and weapon of war to fuel their campaign of terror and suggests ways in which the international community could deal with the challenge of fighting terrorist groups without putting civilians, women and children in harm way. The paper emphasises the need to uphold human rights values and respect for the law of war in our response to global terrorism. The paper poses the question as to whether the current legal framework for dealing with terrorist groups is sufficient without contravening the essential provisions and ethos of the International Law of War and Human Rights. While the paper explains how terrorist groups flagrantly disregard the rule of law and disrespect human rights in their campaign of terror, it also notes instances in which the current Western strategy in fighting terrorism may be viewed or considered as conflicting with human rights and international law.

Keywords: terrorism, law of war, international law, violent extremism

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Authors: D. Densenbal, Ts. Naidansuren, M. Oyunchimeg, Ts. Manaljav, D. Udval, L. Khosbayar, Kh. Solongo, D. Ichinnorov, B. Solongo

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Background: The rapid economic growth and to the common use of smoky fuel such as coal in the small traditional houses (Ger) in Mongolia is worsening its air pollution problem. In addition, the smoking rate is considered to be high. Despite these conditions, few prevalence studies of COPD epidemiology and diagnose have been performed in Mongolia. The spirometric test is a widely used diagnose for COPD. Aims: Healthy and over the 40 aged adults were evaluated of Pulmonary function test in Ulaanbaatar. Methods: Healthy, over the 40 aged residences were admitted for this study from II sub-district, in Khan-Uul district of Ulaanbaatar city. In this cross-sectional study. Health information was collected 184 subjects between 01-03 July in 2013; spirometry device was named Hichest–105 Japan that was employed for this study. Studies were using the acceptability standards outlined, and data were compared with personal reference data generated on Asian subjects which were performed abnormally to evaluated by global initiative obstructive lung decreases (GOLD). Data were analyzed using SPSS 20 software. Results: A total of 134 subjects (age 52.9±9.8, man 32.8%) were performed PFT which were interpreted normal 73.9% (sum of man 65.0% and woman 79.4% ), abnormal 26.1% which were typed obstruction 17.2% (23), restriction 6% (8), mixed 3% (4). Airflow obstruction were determined in all man 25% (11), woman 13.3% (12) which were classified mild 43.4% (man 54.5%, woman 33.3%), moderate 52.2% (36.3% vs. 66.7%) and severe 4.3% man 1 GOLD degree. Undetermined a very severe obstruction. Normal PFT subjects were compared a group of gender and age group which man was significantly higher than the women (p<0.05). Age group of PFT decrease was no difference in gender (p>0.05) also no difference in BMI (p>0.05). Normal PFT subjects were compared with predicted values were used to Asian population which was significantly lower than FEV1 (0.15±0.36 l), PEF (1.92±1.31 l) and same deference occurred man (FEV1 0.19±0.42 l, PEF 2.04±1.64), women (0.14±0.33 l vs. 1.86±1.15 l). The decrease of FEV1 was defined in over the 60 age group higher than other age groups. Conclusion: Not only observed an air flow limitation prevalence dominance in all case but also COPD prevalence diagnosed man were higher than women. Normal PFT subjects were compared with predicted values were used to Asian population which was significant air flow limitation started early.

Keywords: PFT, obstruction, FEV1, COPD

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Authors: Ramón Cruzat, Sergio F. Ochoa, Ignacio Casas, Luis A. Guerrero, José Bravo

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Patients under health treatments that involve long stays at a hospital or health centre (e.g. cancer, organ transplants and severe burns), tend to get bored or depressed because of the lack of social interaction with family and friends. Such a situation also affects the evolution and effectiveness of their treatments. In many cases, the solution to this problem involves extra challenges, since many patients need to rest quietly (or remain in bed) to their being contagious. Considering the weak health condition in which usually are these kinds, keeping them motivated and quiet represents an important challenge for nurses and caregivers. This article presents a mobile ubiquitous game called MagicRace, which allows hospitalized kinds to interact socially with one another without putting to risk their sensitive health conditions. The game does not require a communication infrastructure at the hospital, but instead, it uses a mobile ad hoc network composed of the handheld devices used by the kids to play. The usability and performance of this application was tested in two different sessions. The preliminary results show that users experienced positive feelings from this experience.

Keywords: ubiquitous game, children's emotional support, social isolation, mobile collaborative interactions

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Authors: C. Scurr, J. Jeans, S. Srivastava

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Introduction: Acute type two respiratory failure (T2RF) has become a common presentation over the last two decades primarily due to an increase in the prevalence of chronic lung disease. Acute exacerbations can be managed either medically or in combination with non-invasive ventilation (NIV) which should be monitored with regular arterial blood gas samples (ABG). Arterial lines allow more frequent arterial blood sampling with less patient discomfort. We present the experience from a teaching hospital emergency department (ED) and level 2 medical high-dependency unit (HDU) that together form the pathway for management of acute type 2 respiratory failure. Methods: Patients acutely presenting to Charing Cross Hospital, London, with T2RF requiring non-invasive ventilation (NIV) over 14 months (2011 to 2012) were identified from clinical coding. Retrospective data collection included: demographics, co-morbidities, blood gas numbers and timing, if arterial lines were used and who performed this. Analysis was undertaken using Microsoft Excel. Results: Coding identified 107 possible patients. 69 notes were available, of which 41 required NIV for type 2 respiratory failure. 53.6% of patients had an arterial line inserted. Patients with arterial lines had 22.4 ABG in total on average compared to 8.2 for those without. These patients had a similar average time to normalizing pH of (23.7 with arterial line vs 25.6 hours without), and no statistically significant difference in mortality. Arterial lines were inserted by Foundation year doctors, Core trainees, Medical registrars as well as the ICU registrar. 63% of these were performed by the medical registrar rather than ICU, ED or a junior doctor. This is reflected in that the average time until an arterial line was inserted was 462 minutes. The average number of ABGs taken before an arterial line was 2 with a range of 0 – 6. The average number of gases taken if no arterial line was ever used was 7.79 (range of 2-34) – on average 4 times as many arterial punctures for each patient. Discussion: Arterial line use was associated with more frequent arterial blood sampling during each inpatient admission. Additionally, patients with an arterial line have less individual arterial punctures in total and this is likely more comfortable for the patient. Arterial lines are normally sited by medical registrars, however this is normally after some delay. ED clinicians could improve patient comfort and monitoring thus allowing faster titration of NIV if arteral lines were regularly inserted in the ED. We recommend that ED doctors insert arterial lines when indicated in order improve the patient experience and facilitate medical management.

Keywords: non invasive ventilation, arterial blood gas, acute type, arterial line

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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: Sally Shepherd, Richard De Boer, Craig Murphy

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Background: Invasive lobular carcinoma (ILC) can metastasize to atypical sites within the peritoneal cavity, gastrointestinal, or genitourinary tract. Management varies depending on the symptom presentation, extent of disease burden, particularly if the primary disease is occult, and patient wishes. Case Series: 6 patients presented with general surgical presentations of ILC, including incomplete large bowel obstruction, cholecystitis, persistent lower abdominal pain, and faecal incontinence. 3 were diagnosed with their primary and metastatic disease in the same presentation, whilst 3 patients developed metastasis from 5 to 8 years post primary diagnosis of ILC. Management included resection of the metastasis (laparoscopic cholecystectomy), excision of the primary (mastectomy and axillary clearance), followed by a combination of aromatase inhibitors, biologic therapy, and chemotherapy. Survival post diagnosis of metastasis ranged from 3 weeks to 7 years. Conclusion: Metastatic ILC must be considered with any gastrointestinal or genitourinary symptoms in patients with a current or past history of ILC. Management may not be straightforward to chemotherapy if the acute pathology is resulting in a surgically resectable disease.

Keywords: breast cancer, gastrointestinal metastasis, invasive lobular carcinoma, metastasis

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Authors: Blessing A. Aderibigbe

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Combination therapy is a treatment approach that is used to prevent the emergence of drug resistance. This approach is used for the treatment of many chronic and infectious diseases. Potentiating agents are currently explored in combination therapy, resulting in excellent therapeutic outcomes. Breast cancer and malaria are two chronic conditions responsible globally for high death rates. In this research, a class of polymer-drug conjugates containing potentiating agents with either antimalarial or anticancer drugs were prepared by Michael Addition Polymerization reaction and ring-opening polymerization reaction. Conjugation of potentiating agents with bioactive compounds into the polymers resulted in conjugates with good water solubility, highly selective and non-toxic. In vitro cytotoxicity and in vitro antiplasmodial evaluation on the conjugates revealed that the conjugates were more effective when compared to the free drugs. The drug release studies further showed that the release profile of the drugs from the conjugates was sustained. The findings revealed the potential of polymer-drug conjugates to overcome drug toxicity and drug resistance, which is common with the currently used antimalarial and anticancer drugs.

Keywords: anticancer, antimalarials, combination therapy, polymer-drug conjugates

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Authors: Matthew Olanrewaju Ibiyomi

Abstract:

The study examined the abundance of free-range natural inhabitants of the Federal University of Agriculture, Abeokuta (FUNAAB) Zoo Park. A baseline data of free-ranging inhabitants of the Park is essential to monitor trends and institute conservation plans through unsustainable natural resources exploitation and habitat destruction. Four transects were selected across the study area. Each transect was traversed for a period of four months and observations was carried out twice a day. The Four existing tracks explored during the study were the aviary, reptile, carnivore and primate tracks. Data were analyzed using descriptive statistics. The findings from this study revealed that 8 species of natural inhabitants were identified, which were the Vervet monkey (Chlorocebuspygerythrus), Maxwell duiker(Philantombamaxwellii), Mongoose (Herpestidaespp), Bushbuck(Tragelaphusscriptus), Cobra (Najanaja), Ground squirrel (Marmotinispp), Senegal coucal(Centropus senegalensis), Black kite (Milvus migrans). The result further showed that a total of 115 animals were encountered in the primate transect, 77 animals in the carnivores transect, 46 animals in the aviary transect and 34 animals in the ungulates transect by the representative of 43.3%, 28.3%, 15.8% and 12.5% respectively. Human activities and level of disturbance were observed to have affected the abundance and distribution of animals at Funaab Zoo Park. Continuous field inventory is recommended to ascertain the dynamics of animals observed as free-range inhabitants in this study.

Keywords: abundance, ecosystem, extinction, free-range

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Authors: Libing Zhu, Waichung Chen, Kwaicing Lo, Lei Li

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Background: Tian Jiu Therapy (a medicinal vesiculation therapy according to traditional Chinese medicine theory) in San Fu Days (the three hottest days in a year is calculated by the Chinese ancient calendar) is widely used by patients with chronic asthma in China although from modern medicine perspective there is insufficient evidence of its effectiveness and safety issues. We investigated the efficacy and safety of Tian Jiu Therapy compared with placebo in patients with chronic asthma. Methods: Patients with chronic asthma were randomly assigned to Tian Jiu treatment group (n=165), placebo control group (n=158). Registered Chinese Medicine practitioners, in Orthopedics-Traumatology, Acupuncture, and Tui-na Clinical Centre for Teaching and Research, School of Chinese Medicine, The University of Hong Kong, administered Tian Jiu Therapy and placebo treatment in 3 times over 2 months. Patients completed questionnaires and lung function test before treatment and after treatment, 3, 6, 9, and 11 months, respectively. The primary outcome was the no of asthma-related sub-healthy symptoms and the percentage of patients with twenty-three symptoms. Results: 451 patients were recruited totally, 111 patients refused or did not participate according the appointment time and 17 did not meet the inclusion criteria. Consequently, 323 of eligible patients were enrolled. There was nothing difference between Tian Jiu Therapy group and placebo control group at the end of all treatments neither primary nor secondary outcomes. While Tian Jiu Therapy as compared with placebo significantly reduced the percentage of participants who are susceptible waken up by asthma symptoms from 27% to 14% at 2nd follow-up (P < 0.05). Similarly, Tian Jiu Therapy significantly reduced the proportion of participants who had the symptom of running nose and sneezing before onset from 18% to 8% at 2nd follow-up (P < 0.05). Additionally, Tian Jiu Therapy significantly reduced the level of asthma, the proportion of participants who don’t need to processed during asthma attack increased from 6% to 15% at 1st follow-up and 0% to 7% at 3rd follow-up (P < 0.05). Improvements also occurred with Tian Jiu Therapy group, it reduced the proportion of participants who were spontaneously sweating at 3rd follow up and diarrhea after intake of oily food at 4th follow-up (P < 0.05). Conclusion: When added to a regimen of foundational therapy for chronic asthma participants, Tian Jiu Therapy further reduced the need for medications to control asthma, improved the quality of participants’ life, and significantly reduced the level of asthma. What is more, this benefit seems to have an accumulative effect over time was in accordance with the TCM theory of 'winter disease is being cured in summer'.

Keywords: asthma, Tian Jiu Therapy, San Fu Days, triaditional Chinese medicine, clinical trial

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Authors: Walid Moudani

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The healthcare environment is generally perceived as being information rich yet knowledge poor. However, there is a lack of effective analysis tools to discover hidden relationships and trends in data. In fact, valuable knowledge can be discovered from application of data mining techniques in healthcare system. In this study, a proficient methodology for the extraction of significant patterns from the coronary heart disease warehouses for heart attack prediction, which unfortunately continues to be a leading cause of mortality in the whole world, has been presented. For this purpose, we propose to enumerate dynamically the optimal subsets of the reduced features of high interest by using rough sets technique associated to dynamic programming. Therefore, we propose to validate the classification using Random Forest (RF) decision tree to identify the risky heart disease cases. This work is based on a large amount of data collected from several clinical institutions based on the medical profile of patient. Moreover, the experts’ knowledge in this field has been taken into consideration in order to define the disease, its risk factors, and to establish significant knowledge relationships among the medical factors. A computer-aided system is developed for this purpose based on a population of 525 adults. The performance of the proposed model is analyzed and evaluated based on set of benchmark techniques applied in this classification problem.

Keywords: multi-classifier decisions tree, features reduction, dynamic programming, rough sets

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Authors: Jeonghun Lee

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In this study, we investigated the relationship between stress and thyroid dysfunction in such patients who underwent thyroidectomy. This study included 101 patients who underwent thyroidectomy from January 2015 to June 2020 and experienced hypothyroidism. The included patients had good drug compliance with the same dosage of levothyroxine (LT4). The male-to-female ratio was 1:4.6, and the mean age was 45.4 years at surgery and 50.2 years at stressful events. Eighteen patients underwent lobectomies and, of these, 12 did not take LT4. The mean follow-up period was 49(8-93) months. Statistical analyses were performed using the paired t-test, Wilcoxon signed-rank test, and McNemer test using PROC MIXED with SAS 9.4. Forty-five patients (44.6%) had hypothyroidism with thyroid-stimulating hormone (TSH) >10 μIU/mL. There was distress in 81 patients and eustress in 10 patients. TSH levels increased during a mean 5.8 months (min 1, max 12) in 24 patients who specified the date of their life events. Even though each patient took the same dose of LT4, when the patients were under stress, both the free T4 and T3 decreased and TSH increased, regardless of whether the patient experienced distress or eustress (P <0.001). While adjusting for the effect of the free T4 and T3, TSH increased significantly in the patients after stress (P <0.001). For patients with thyroid cancer who are simultaneously experiencing life events, TSH may be used as a stress biomarker to enable the implementation of appropriate treatment and counseling strategies.

Keywords: endocrine, thyroid, thyroid function, biomarker, stress

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Authors: N. Saki, S. Nalbantoglu, M. Akin, G. Arabaci

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Walnut has a great range of phenolic profile and it is used in Asia and Africa for treatment of many diseases and cancer. Phenolic compounds play a number of crucial roles in complex metabolism of plants and of also fruit trees. Consumption of certain phenolics in the food is considered beneficial for human nutrition. Phenolic compounds known as anti-radical inactivators with their high antioxidant activities and these activities play an important role in inhibition of multi-metal corrosion. Many common corrosion inhibitors that are still in use today are health hazards. Therefore, there is still an increased attention directed towards the development of environmentally compatible, nonpolluting corrosion inhibitors. The present study reports the total phenols content, antioxidant potentials and tyrosinase inhibitory activity of the walnut (Juglans regia L.) produced in Turkey. The anti-tyrosinase activity was investigated for walnut at 2 h extraction time and all extracts exhibited tyrosinase activity. The results of this study suggested that walnut can be used as an excellent, easily accessible source of natural antioxidant.

Keywords: antioxidant activity, Juglans Regia, total phenols, tyrosinase activity

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Authors: Mohamed Wahba

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Objective: To build a comparative arm for product (X) in specific gene mutated advanced gastrointestinal cancer using real world evidence to fulfill HTA requirements in drug evaluation. Methods: Data for product (X) were collected from phase II clinical trial while real world data for (Y) and (Z) were collected from US database. Real-world (RW) cohorts were matched to clinical trial base line characteristics using weighting by odds method. Outcomes included progression-free survival (PFS) and overall survival (OS) rates. Study location and participants: Internationally (product X, n=80) and from USA (Product Y and Z, n=73) Results: Two comparisons were made: trial cohort 1 (X) versus real-world cohort 1 (Z), trial cohort 2 (X) versus real-world cohort 2 (Y). For first line, the median OS was 9.7 months (95% CI 8.6- 11.5) and the median PFS was 5.2 months (95% CI 4.7- not reached) for real-world cohort 1. For second line, the median OS was 10.6 months (95% CI 4.7- 27.3) for real-world cohort 2 and the median PFS was 5.0 months (95% CI 2.1- 29.3). For OS analysis, results were statistically significant but not for PFS analysis. Conclusion: This study provided the clinical comparative outcomes needed for HTA evaluation.

Keywords: real world evidence, pharmacoeconomics, HTA agencies, oncology

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Authors: A. Fordham, A. Hudson

Abstract:

Background: Studies have suggested 16-25% of normotensive trauma patients with no clinical signs of shock have abnormal lactate and BD readings evidencing shock; a phenomenon known as occult hypoperfusion (OH). In light of the scarce quantity of evidence currently documenting OH, this study aimed to identify the prevalence of OH in the pre-hospital setting and explore ways to improve its identification and management. Methods: A quantitative retrospective data analysis was carried out on 75 sets of patient records for trauma patients treated by Kent Surrey Sussex Air Ambulance Trust between November 2013 and October 2014. The KSS HEMS notes and subsequent ED notes were collected. Trends between patients’ SBP on the scene, whether or not they received PRBCs on the scene as well as lactate and BD readings in the ED were assessed. Patients’ KSS HEMS notes written by the HEMS crew were also reviewed and recorded. Results: -Suspected OH was identified in 7% of the patients who did not receive PRBCs in the pre-hospital phase. -SBP heavily influences the physicians’ decision of whether or not to transfuse PRBCs in the pre-hospital phase. Preliminary conclusions: OH is an under-studied and underestimated phenomenon. We suggest a prospective trial is carried out to evaluate whether detecting trauma patients’ tissue perfusion status in the pre-hospital phase using portable devices capable of measuring serum BD and/or lactate could aid more accurate detection and management of all haemorrhaging trauma patients, including patients with OH.

Keywords: occult hypoperfusion, PRBC transfusion, point of care testing, pre-hospital emergency medicine, trauma

Procedia PDF Downloads 348