Search results for: remote health monitoring system

Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, burns, FLAMES, scoring systems, outcome

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Authors: F. Pal-Fam, S. Keszthelyi

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Phytosanitary condition of sunflower (Helianthus annuus L.) was endangered by several phytopathogenic agents, mainly microfungi, such as Sclerotinia sclerotiorum, Diaporthe helianthi, Plasmopara halstedtii, Macrophomina phaseolina and so on. There are more agrotechnical and chemical technologies against them, for instance, tolerant hybrids, crop rotations and eventually several in-crop chemical treatments. There are different fungicide treatment methods in sunflower in Hungarian agricultural practice in the quest of obtaining healthy and economic plant products. Besides, there are many choices of useable active ingredients in Hungarian sunflower protection. This study carried out into the examination of the effect of five different fungicide active substances (found on the market) and three different application modes (early; late; and early and late treatments) in a total number of 9 sample plots, 0.1 ha each other. Five successive vegetation periods have been investigated in long term, between 2013 and 2017. The treatments were: 1)untreated control; 2) boscalid and dimoxystrobin late treatment (July); 3) boscalid and dimoxystrobin early treatment (June); 4) picoxystrobin and cyproconazole early treatment; 5) picoxystrobin and cymoxanil and famoxadone early treatment; 6) picoxystrobin and cyproconazole early; cymoxanil and famoxadone late treatments; 7) picoxystrobin and cyproconazole early; picoxystrobin and cymoxanil and famoxadone late treatments; 8) trifloxystrobin and cyproconazole early treatment; and 9) trifloxystrobin and cyproconazole both early and late treatments. Due to the very different yearly weather conditions different phytopathogenic fungi were dominant in the particular years: Diaporthe and Alternaria in 2013; Alternaria and Sclerotinia in 2014 and 2015; Alternaria, Sclerotinia and Diaporthe in 2016; and Alternaria in 2017. As a result of treatments ‘infection frequency’ and ‘infestation rate’ showed a significant decrease compared to the control plot. There were no significant differences between the efficacies of the different fungicide mixes; all were almost the same effective against the phytopathogenic fungi. The most dangerous Sclerotinia infection was practically eliminated in all of the treatments. Among the single treatments, the late treatment realised in July was the less efficient, followed by the early treatments effectuated in June. The most efficient was the double treatments realised in both June and July, resulting 70-80% decrease of the infection frequency, respectively 75-90% decrease of the infestation rate, comparing with the control plot in the particular years. The lowest yield quantity was observed in the control plot, followed by the late single treatment. The yield of the early single treatments was higher, while the double treatments showed the highest yield quantities (18.3-22.5% higher than the control plot in particular years). In total, according to our five years investigation, the most effective application mode is the double in-crop treatment per vegetation time, which is reflected by the yield surplus.

Keywords: fungicides, treatments, phytopathogens, sunflower

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Authors: Tatjana Stefanovic Stanojevic, Milica Tosic Radev, Aleksandra Bogdanovic

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Depression is considered to be a leading cause of death and disability in the female population, and that is the reason why understanding the dynamics of the onset of depressive symptomatology is important. A review of the literature indicates the relationship between depressive symptoms and insecure attachment patterns, but very few studies have examined the mechanism underlying this relation. The aim of the study was to examine the pathway from the preoccupied attachment pattern to depressive symptomatology, as well as to test the mediation effect of mentalization, social anxiety and rumination in this relationship using a serial mediation model. The research was carried out on a geographical cluster sample from the general population of Serbia included within the project ‘Indicators and models of family and work roles harmonization’ funded by the Ministry of Education, Science and Technological Development of the Republic of Serbia. This research was carried out on a subsample of 791 working-age female adults from 37 urban and rural locations distributed through 20 administrative districts of Serbia. The respondents filled in a battery of instruments, including Relationship Questionnaire - Clinical Version (RQ - CV), The Mentalization Scale (MentS), Scale of Social Anxiety (SA), Patient Ruminative Thought Style Questionnaire (RTSQ), Health Questionnaire (PHQ-9). The results confirm our assumption that the total indirect effect of the preoccupied attachment pattern to depressive symptoms is significant across all mediators separately. More importantly, this effect is still present in a model with a sequential mediator relationship, where social anxiety, rumination, and mentalization were perceived as serial mediators of a relationship between preoccupied attachment and depressive symptoms (estimated indirect effect=0.004, boot-strapped 95% CI=0.002 to 0.007). Our findings suggest that there is a significant specific indirect effect of the preoccupied attachment pattern to depressive symptoms, occurring through mentalization, social anxiety and rumination, indicating that preoccupied attachment cause decrease of a self related mentalization, which in turn causes increasing of social anxiety and rumination, concluding in depressive symptoms as a final consequence. The finding that the path from the preoccupied attachment pattern to depressive symptoms is typical in women is understandable from the perspective of both evolutionary and culturally conditioned gender differences. The practical implications of the study are reflected in the recommendations for the prevention and forehand psychotherapy response among preoccupied women with depressive symptomatology. Treatment of this specific group of depressed patients should be focused on strengthening mentalization, learning to accept and to understand herself better, reducing anxiety in situations where mistakes are visible to others, and replacing the rumination strategy with more constructive coping strategies.

Keywords: preoccupied attachment, depression, serial mediation model, mentalization, rumination

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Authors: Aikaterini-Melpomeni Papadopoulou, Kyriaki Apergi, Margarita-Vasiliki Panagopoulou, Olga Malisova

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Introduction: Adequate hydration is a vital factor that enhances concentration, memory, and decision-making abilities throughout the workday. Various factors may affect hydration status in workplace settings, and many variables, such as age, gender and activity level affect hydration needs. Employees frequently overlook their hydration needs amid busy schedules and demanding tasks, leading to dehydration that can negatively affect cognitive function, productivity, and overall well-being In addition, dietary habits, including fluid intake and food choices, can either support or hinder optimal hydration. However, factors that affect hydration balance among workers in Greece have not been adequately studied. Objective: This study aims to evaluate the hydration status of the working population in Greece and investigate the various factors that impact hydration status in workplace settings, considering demographic, dietary, and occupational influences in a Greek sample of employees from diverse working environments Materials & Methods: The study included 212 participants (46.2% women) from the working population in Greece. Water intake from both solid and liquid foods was recorded using a semi-quantified drinking frequency questionnaire the validated Water Balance Questionnaire was used to evaluate hydration status. The calculation of water from solid and liquid foods was based on data from the USDA National Nutrient Database. Water balance was calculated subtracting the total fluid loss from the total fluid intake in the body. Furthermore, the questionnaire including additional questions on drinking habits and work-related factors.volunteers answered questions of different categories such as a) demographic socio-economic b) work style characteristics c) health, d) physical activity, e) food and fluid intake, f) fluid excretion and g) trends on fluid and water intake. Individual and multivariate regression analyses were performed to assess the relationships between demographic, work-related factors, and hydration balance. Results: Analysis showed that demographic factors like gender, age, and BMI, as well as certain work-related factors, had a weak and statistically non-significant effect on hydration balance. However, the use of a bottle or water container during work hours (b = 944.93, p < 0.001) and engaging in intense physical activity outside of work (b = -226.28, p < 0.001) were found to have a significant impact. Additionally, the consumption of beverages other than water (b = -416.14, p = 0.059) could negatively impact hydration balance. On average, the total consumption of the sample is 3410 ml of water daily, with men consuming approximately 440 ml / day more water (3470 ml / day) compared to women (3030 ml / day) with this difference also being statistically significant. Finally, the water balance, defined as the difference between water intake and water excretion, was found to be negative on average for the entire sample. Conclusions: This study is among the first to explore hydration status within the Greek working population. Findings indicate that awareness of adequate hydration and individual actions, such as using a water bottle during work, may influence hydration balance.

Keywords: hydration, working population, water balance, workplace behavior

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Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos

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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.

Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation

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Authors: Ngoc Nguyen

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There is large plantation of Eucalyptus globulus established which has been grown to produce pulpwood. This resource is not suitable for the production of decorative products, principally due to low grades of wood and “dull” appearance but many trials have been already undertaken for the production of veneer and veneer-based engineered wood products, such as plywood and laminated veneer lumber (LVL). The manufacture of veneer-based products has been recently identified as an unprecedented opportunity to promote higher value utilisation of plantation resources. However, many uncertainties remain regarding the impacts of inferior wood quality of young plantation trees on product recovery and value, and with respect to optimal processing techniques. Moreover, the quality of veneer and veneer-based products is far from optimal as trees are young and have small diameters; and the veneers have the significant colour variation which affects to the added value of final products. Developing production methods which would enhance appearance of low-quality veneer would provide a great potential for the production of high-value wood products such as furniture, joinery, flooring and other appearance products. One of the methods of enhancing appearance of low quality veneer, developed in Italy, involves the production of multilaminar veneer, also named “reconstructed veneer”. An important stage of the multilaminar production is colouring the veneer which can be achieved by dyeing veneer with dyes of different colours depending on the type of appearance products, their design and market demand. Although veneer dyeing technology has been well advanced in Italy, it has been focused on poplar veneer from plantation which wood is characterized by low density, even colour, small amount of defects and high permeability. Conversely, the majority of plantation eucalypts have medium to high density, have a lot of defects, uneven colour and low permeability. Therefore, detailed study is required to develop dyeing methods suitable for colouring eucalypt veneers. Brown reactive dye is used for veneer colouring process. Veneers from sapwood and heartwood of two moisture content levels are used to conduct colouring experiments: green veneer and veneer dried to 12% MC. Prior to dyeing, all samples are treated. Both soaking (dipping) and vacuum pressure methods are used in the study to compare the results and select most efficient method for veneer dyeing. To date, the results of colour measurements by CIELAB colour system showed significant differences in the colour of the undyed veneers produced from heartwood part. The colour became moderately darker with increasing of Sodium chloride, compared to control samples according to the colour measurements. It is difficult to conclude a suitable dye solution used in the experiments at this stage as the variables such as dye concentration, dyeing temperature or dyeing time have not been done. The dye will be used with and without UV absorbent after all trials are completed using optimal parameters in colouring veneers.

Keywords: Eucalyptus globulus, veneer colouring/dyeing, multilaminar veneer, reactive dye

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Authors: Tatiana N. Astakhova, Alexander E. Saprygin, Tatyana A. Golovko, Alexander N. Savostyanov, Mikhail S. Vlasov, Natalia V. Borisova, Alexandera G. Karpova, Urana N. Kavai-ool, Elena D. Mokur-ool, Nikolay A. Kolchanov, Lubomir I. Aftanas

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The aim of the study is to compare behaviorally and EEG reactions in Turkic-speaking inhabitants of Siberia (Tuvinians and Yakuts) and Russians during the recognition of syntax errors in native and foreign languages. 63 healthy aboriginals of the Tyva Republic, 29 inhabitants of the Sakha (Yakutia) Republic, and 55 Russians from Novosibirsk participated in the study. All participants completed a linguistic task, in which they had to find a syntax error in the written sentences. Russian participants completed the task in Russian and in English. Tuvinian and Yakut participants completed the task in Russian, English, and Tuvinian or Yakut, respectively. EEG’s were recorded during the solving of tasks. For Russian participants, EEG's were recorded using 128-channels. The electrodes were placed according to the extended International 10-10 system, and the signals were amplified using ‘Neuroscan (USA)’ amplifiers. For Tuvinians and Yakuts EEG's were recorded using 64-channels and amplifiers Brain Products, Germany. In all groups 0.3-100 Hz analog filtering, sampling rate 1000 Hz were used. Response speed and the accuracy of recognition error were used as parameters of behavioral reactions. Event-related potentials (ERP) responses P300 and P600 were used as indicators of brain activity. The accuracy of solving tasks and response speed in Russians were higher for Russian than for English. The P300 amplitudes in Russians were higher for English; the P600 amplitudes in the left temporal cortex were higher for the Russian language. Both Tuvinians and Yakuts have no difference in accuracy of solving tasks in Russian and in their respective national languages (Tuvinian and Yakut). However, the response speed was faster for tasks in Russian than for tasks in their national language. Tuvinians and Yakuts showed bad accuracy in English, but the response speed was higher for English than for Russian and the national languages. With Tuvinians, there were no differences in the P300 and P600 amplitudes and in cortical topology for Russian and Tuvinian, but there was a difference for English. In Yakuts, the P300 and P600 amplitudes and topology of ERP for Russian were the same as Russians had for Russian. In Yakuts, brain reactions during Yakut and English comprehension had no difference and were reflected foreign language comprehension -while the Russian language comprehension was reflected native language comprehension. We found out that the Tuvinians recognized both Russian and Tuvinian as native languages, and English as a foreign language. The Yakuts recognized both English and Yakut as a foreign language, only Russian as a native language. According to the inquirer, both Tuvinians and Yakuts use the national language as a spoken language, whereas they don’t use it for writing. It can well be a reason that Yakuts perceive the Yakut writing language as a foreign language while writing Russian as their native.

Keywords: EEG, language comprehension, native and foreign languages, Siberian inhabitants

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Authors: G. C. Santini, C. Potrich, L. Lunelli, L. Vanzetti, S. Marasso, M. Cocuzza, C. Pederzolli

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The relevance of circulating miRNAs as non-invasive biomarkers for several pathologies is nowadays undoubtedly clear, as they have been found to have both diagnostic and prognostic value able to add fundamental information to patients’ clinical picture. The availability of these data, however, relies on a time-consuming process spanning from the sample collection and processing to the data analysis. In light of this, strategies which are able to ease this procedure are in high demand and considerable effort have been made in developing Lab-on-a-chip (LOC) devices able to speed up and standardise the bench work. In this context, a very promising polydimethylsiloxane (PDMS)-based microdevice which integrates the processing of the biological sample, i.e. purification of extracellular miRNAs, and reverse transcription was previously developed in our lab. In this study, we aimed at the improvement of the miRNA extraction performances of this micro device by increasing the ability of its surface to absorb extracellular miRNAs from biological samples. For this purpose, we focused on the modulation of two properties of the material: roughness and charge. PDMS surface roughness was modulated by casting with several templates (terminated with silicon oxide coated by a thin anti-adhesion aluminum layer), followed by a panel of curing conditions. Atomic force microscopy (AFM) was employed to estimate changes at the nanometric scale. To introduce modifications in surface charge we functionalized PDMS with different mixes of positively charged 3-aminopropyltrimethoxysilanes (APTMS) and neutral poly(ethylene glycol) silane (PEG). The surface chemical composition was characterized by X-ray photoelectron spectroscopy (XPS) and the number of exposed primary amines was quantified with the reagent sulfosuccinimidyl-4-o-(4,4-dimethoxytrityl) butyrate (s-SDTB). As our final end point, the adsorption rate of all these different conditions was assessed by fluorescence microscopy by incubating a synthetic fluorescently-labeled miRNA. Our preliminary analysis identified casting on thermally grown silicon oxide, followed by a curing step at 85°C for 1 hour, as the most efficient technique to obtain a PDMS surface roughness in the nanometric scaleable to trap miRNA. In addition, functionalisation with 0.1% APTMS and 0.9% PEG was found to be a necessary step to significantly increase the amount of microRNA adsorbed on the surface, therefore, available for further steps as on-chip reverse transcription. These findings show a substantial improvement in the extraction efficiency of our PDMS microdevice, ultimately leading to an important step forward in the development of an innovative, easy-to-use and integrated system for the direct purification of less abundant circulating microRNAs.

Keywords: circulating miRNAs, diagnostics, Lab-on-a-chip, polydimethylsiloxane (PDMS)

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Authors: Ananya Pal, Neelakshi Sarkar, Debraj Saha, Dipanwita Das, Subhashish Kamal Guha, Bibhuti Saha, Runu Chakravarty

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Presently, tenofovir disoproxil fumurate (TDF) is the most effective anti-viral agent for the treatment of hepatitis B virus (HBV) in individuals co-infected with HIV and HBV as TDF has activity to suppress both wild-type and lamivudine (3TC)-resistant HBV. However, suboptimal response to TDF was reported in HIV-HBV co-infected individuals with prior 3TC therapy from different countries recently. The incidence of 3TC-resistant HBV strains is quite high in HIV-HBV co-infected patients experiencing long-term anti-retroviral therapy (ART) in eastern India. In spite of this risk, most of the patients with long-term 3TC treatment are continued with the same anti-viral agent in this country. Only a few have received TDF in addition to 3TC in the ART regimen since TDF has been available in India for the treatment of HIV-infected patients in 2012. In this preliminary study, we investigated the virologic and biochemical parameters among HIV-HBV co-infected patients who are non-responders to 3TC treatment during the continuation of 3TC or TDF add-on to 3TC in their ART regimen. Fifteen HIV-HBV co-infected patients who experienced long-term 3TC (mean duration months 36.87 ± 24.08 months) were identified with high HBV viremia ( > 20,000 IU/ml) or harbouring 3TC-resistant HBV. These patients receiving ART from School of Tropical Medicine Kolkata, the main ART centre in eastern India were followed-up semi-annually for next three visits. Different virologic parameters including quantification of plasma HBV load by real-time PCR, detection of hepatitis B e antigen (HBeAg) by commercial ELISA and anti-viral resistant mutations by sequencing were studied. During three follow-up among study subjects, 86%, 47%, and 43% had 3TC-mono-therapy (mean treatment-duration 41.54±18.84, 49.67±11.67, 54.17±12.37 months respectively) whereas 14%, 53%, and 57% experienced TDF in addition to 3TC (mean treatment duration 4.5±2.12, 16.56±11.06, and 23±4.07 months respectively). Mean CD4 cell-count in patients receiving 3TC was tended to be lower during third follow-up as compared to the first and the second [520.67±380.30 (1st), 454.8±196.90 (2nd), and 397.5±189.24 (3rd) cells/mm3) and similar trend was seen in patients experiencing TDF in addition to 3TC [334.5±330.218 (1st), 476.5±194.25 (2nd), and 461.17±269.89 (3rd) cells/mm3]. Serum HBV load was increased during successive follow-up of patients with 3TC-mono-therapy. Initiation of TDF lowered serum HBV-load among 3TC-non-responders at the time of second visit ( < 2,000 IU/ml), interestingly during third follow-up, mean HBV viremia increased >1 log IU/ml (mean 3.56±2.84 log IU/ml). Persistence of 3TC-resistant double and triple mutations was also observed in both the treatment regimens. Mean serum alanine aminotransferase remained elevated in these patients during this follow-up study. Persistence of high HBV viraemia and 3TC-resistant mutation in HBV during the continuation of 3TC might lead to major public health threat in India. The inclusion of TDF in the ART regimen of 3TC non-responder HIV-HBV co-infected patients showed adverse treatment response in terms of virologic and biochemical parameters. Therefore, serious attention is necessary for proper management of long-term 3TC experienced HIV-HBV co-infected patients with high HBV viraemia or 3TC-resistant HBV mutants in India.

Keywords: HBV, HIV, TDF, 3TC-resistant

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Authors: Mohammad Idrees Yusofzai, Hirobata Yasuhiro, Matsuo Kojiro

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Kabul is the capital of Afghanistan. It is the focal point of educational, industrial, etc. of Afghanistan. Additionally, the population of Kabul has grown recently and will increase because of return of refugees and shifting of people from other province to Kabul city. However, this increase in population, the issues of urban congestion and other related problems of urban transportation in Kabul city arises. One of the problems is public transport (large buses) service and needs to be modified and enhanced especially large bus routes that are operating in each zone of the 22 zone of Kabul City. To achieve the above mentioned goal of improving public transport, Spatial Accessibility Analysis is one of the important attributes to assess the effectiveness of transportation system and urban transport policy of a city, because accessibility indicator as an alternative tool to support public policy that aims the reinforcement of sustainable urban space. The case study of this research compares the present model (present bus route) and the modified model of public transport. Furthermore, present model, the bus routes in most of the zones are active, however, with having low frequency and unpublished schedule, and accessibility result is analyzed in four cases, based on the variables of accessibility. Whereas in modified model all zones in Kabul is taken into consideration with having specified origin and high frequency. Indeed the number of frequencies is kept high; however, this number is based on the number of buses Millie Bus Enterprise Authority (MBEA) owns. The same approach of cases is applied in modified model to figure out the best accessibility for the modified model. Indeed, the modified model is having a positive impact in congestion level in Kabul city. Besides, analyses of person trip and trip distribution have been also analyzed because how people move in the study area by each mode of transportation. So, the general aims of this research are to assess the present movement of people, identify zones in need of public transport and assess equity level of accessibility in Kabul city. The framework of methodology used in this research is based on gravity analysis model of accessibility; besides, generalized cost (time) of travel and travel mode is calculated. The main data come from person trip survey, socio-economic characteristics, demographic data by Japan International Cooperation Agency, 2008, study of Kabul city and also from the previous researches on travel pattern and the remaining data regarding present bus line and routes have been from MBEA. In conclusion, this research explores zones where public transport accessibility level is high and where it is low. It was found that both models the downtown area or central zones of Kabul city is having high level accessibility. Besides, the present model is the most unfavorable compared with the modified model based on the accessibility analysis.

Keywords: accessibility, bus generalized cost, gravity model, public transportation network

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Authors: Haidy Weliam Megaly Gouda

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Dermatology is often a neglected specialty in low-resource settings despite the high morbidity associated with skin disease. This becomes even more significant when associated with HIV infection, as dermatological conditions are more common and aggressive in HIV-positive patients. African countries have the highest HIV infection rates, and skin conditions are frequently misdiagnosed and mismanaged because of a lack of dermatological training and educational material. The frequent lack of diagnostic tests in the African setting renders basic clinical skills all the more vital. This project aimed to improve the diagnosis and treatment of skin disease in the HIV population in a district hospital in Malawi. A basic dermatological clinical tool was developed and produced in collaboration with local staff and based on available literature and data collected from clinics. The aim was to improve diagnostic accuracy and provide guidance for the treatment of skin disease in HIV-positive patients. A literature search within Embassy, Medline and Google Scholar was performed and supplemented through data obtained from attending 5 Antiretroviral clinics. From the literature, conditions were selected for inclusion in the resource if they were described as specific, more prevalent, or extensive in the HIV population or have more adverse outcomes if they develop in HIV patients. Resource-appropriate treatment options were decided using Malawian Ministry of Health guidelines and textbooks specific to African dermatology. After the collection of data and discussion with local clinical and pharmacy staff, a list of 15 skin conditions was included, and a booklet was created using the simple layout of a picture, a diagnostic description of the disease and treatment options. Clinical photographs were collected from local clinics (with full consent of the patient) or from the book ‘Common Skin Diseases in Africa’ (permission granted if fully acknowledged and used in a not-for-profit capacity). This tool was evaluated by the local staff alongside an educational teaching session on skin disease. This project aimed to reduce uncertainty in diagnosis and provide guidance for appropriate treatment in HIV patients by gathering information into one practical and manageable resource. To further this project, we hope to review the effectiveness of the tool in practice.

Keywords: prevalence and pattern of skin diseases, impact on quality of life, rural Nepal, interventions, quality switched ruby laser, skin color river blindness, clinical signs, circularity index, grey level run length matrix, grey level co-occurrence matrix, local binary pattern, object detection, ring detection, shape identification

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Authors: Hafsa Kamran, Asma Afreen, Zaheer Ahmed

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Internet addiction, an emerging mental health disorder from last two decades, is manifested by the inability in the controlled use of internet leading to academics, social, physiological and/or psychological difficulties. The present study aimed to assess the levels of internet addiction among university students in Lahore and to explore the effects of internet addiction on their dietary behavior and lifestyle. It was an analytical cross-sectional study. Data was collected from October to December 2016 from students of four universities selected through two-stage sampling method. The numbers of participants were 500 and 13 questionnaires were rejected due to incomplete information. Levels of Internet Addiction (IA) were calculated using Young Internet Addiction Test (YIAT). Data was also collected on students’ demographics, lifestyle factors and dietary behavior using self-reported questionnaire. Data was analyzed using SPSS (version 21). Chi-square test was applied to evaluate the relationship between variables. Results of the study revealed that 10% of the population had severe internet addiction while moderate Internet Addiction was present in 42%. High prevalence was found among males (11% vs. 8%), private sector university students (p = 0.008) and engineering students (p = 0.000). The lifestyle habits of internet addicts were significantly of poorer quality than normal users (p = 0.05). Internet addiction was found associated with lesser physically activity (p = 0.025), had shorter duration of physical activity (p = 0.016), had more disorganized sleep pattern (p = 0.023), had less duration of sleep (p = 0.019), reported being more tired and sleepy in class (p = 0.033) and spending more time on internet as compared to normal users. Severe and moderate internet addicts also found to be more overweight and obese than normal users (p = 0.000). The dietary behavior of internet addicts was significantly poorer than normal users. Internet addicts were found to skip breakfast more than a normal user (p = 0.039). Common reasons for meal skipping were lack of time and snacking between meals (p = 0.000). They also had increased meal size (p = 0.05) and habit of snacking while using the internet (p = 0.027). Fast food (p = 0.016) and fried items (p = 0.05) were most consumed snacks, while carbonated beverages (p = 0.019) were most consumed beverages among internet addicts. Internet Addicts were found to consume less than recommended daily servings of dairy (p = 0.008) and fruits (p = 0.000) and more servings of meat group (p = 0.025) than their no internet addict counterparts. In conclusion, in this study, it was demonstrated that internet addicts have unhealthy dietary behavior and inappropriate lifestyle habits. University students should be educated regarding the importance of balanced diet and healthy lifestyle, which are critical for effectual primary prevention of numerous chronic degenerative diseases. Furthermore, it is necessary to raise awareness concerning adverse effects of internet addiction among youth and their parents.

Keywords: dietary behavior, internet addiction, lifestyle, university students

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Authors: Kaitlyn O'Mara, Michele Burford

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Estuaries and coastal bays can receive large quantities of sediment from surrounding catchments during flooding or high flow periods. Large river systems that feed freshwater into estuaries can flow through several catchments of varying geology. Human modification of catchments for agriculture, industry and urban use can contaminate soils with excess nutrients, trace metals and other pollutants. Land clearing, especially clearing of riparian vegetation, can accelerate erosion, mobilising, transporting and depositing soil particles into rivers, estuaries and coastal bays. In this study, a flood simulation experiment was used to study the flux of nutrients between soil particles and water during this erosion, transport and deposition process. Granite, sedimentary and basalt surface soils (as well as sub-soils of granite and sedimentary) were collected from eroding areas surrounding the Brisbane River, Australia. The <63 µm size fraction of each soil type was tumbled in freshwater for 3 days, to simulation flood erosion and transport, followed by stationary exposure to seawater for 4 weeks, to simulate deposition into estuaries. Filtered water samples were taken at multiple time points throughout the experiment and analysed for water nutrient concentrations. The highest rates of nutrient release occurred during the first hour of exposure to freshwater and seawater, indicating a chemical reaction with seawater that may act to release some nutrient particles that remain bound to the soil during turbulent freshwater transport. Although released at a slower rate than the first hour, all of the surface soil types showed continual ammonia, nitrite and nitrate release over the 4-week seawater exposure, suggesting that these soils may provide ongoing supply of these nutrients to estuarine waters after deposition. Basalt surface soil released the highest concentrations of phosphates and dissolved organic phosphorus. Basalt soils are found in much of the agricultural land surrounding the Brisbane River and contributed largely to the 2011 Brisbane River flood plume deposit in Moreton Bay, suggesting these soils may be a source of phosphate enrichment in the bay. The results of this study suggest that erosion of catchment soils during storm and flood events may be a source of nutrient supply in receiving waterways, both freshwater and marine, and that the amount of nutrient release following these events may be affected by the type of soil deposited. For example, flooding in different catchments of a river system over time may result in different algal and food web responses in receiving estuaries.

Keywords: flood, nitrogen, nutrient, phosphorus, sediment, soil

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Authors: Lukasz Szymanski, Zbigniew Kolacinski, Grzegorz Raniszewski, Slawomir Wiak, Lukasz Pietrzak, Dariusz Koza, Karolina Przybylowska-Sygut, Ireneusz Majsterek, Zbigniew Kaminski, Justyna Fraczyk, Malgorzata Walczak, Beata Kolasinska, Adam Bednarek, Joanna Konka

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The aim of this work is to investigate the influence of electromagnetic field from the range of radio frequencies on the desired nanoparticles for cancer therapy. In the article, the development and demonstration of the method and the model device for hyperthermic selective destruction of cancer cells are presented. This method was based on the synthesis and functionalization of carbon nanotubes serving as ferromagnetic material nanocontainers. The methodology of the production carbon - ferromagnetic nanocontainers (FNCs) includes: The synthesis of carbon nanotubes, chemical, and physical characterization, increasing the content of a ferromagnetic material and biochemical functionalization involving the attachment of the key addresses. The ferromagnetic nanocontainers were synthesised in CVD and microwave plasma system. Biochemical functionalization of ferromagnetic nanocontainers is necessary in order to increase the binding selectively with receptors presented on the surface of tumour cells. Multi-step modification procedure was finally used to attach folic acid on the surface of ferromagnetic nanocontainers. Pristine ferromagnetic carbon nanotubes are not suitable for application in medicine and biotechnology. Appropriate functionalization of ferromagnetic carbon nanotubes allows to receiving materials useful in medicine. Finally, a product contains folic acids on the surface of FNCs. The folic acid is a ligand of folate receptors – α which is overexpressed on the surface of epithelial tumours cells. It is expected that folic acids will be recognized and selectively bound by receptors presented on the surface of tumour cells. In our research, FNCs were covalently functionalized in a multi-step procedure. Ferromagnetic carbon nanotubes were oxidated using different oxidative agents. For this purpose, strong acids such as HNO3, or mixture HNO3 and H2SO4 were used. Reactive carbonyl and carboxyl groups were formed on the open sides and at the defects on the sidewalls of FNCs. These groups allow further modification of FNCs as a reaction of amidation, reaction of introduction appropriate linkers which separate solid surface of FNCs and ligand (folic acid). In our studies, amino acid and peptide have been applied as ligands. The last step of chemical modification was reaction-condensation with folic acid. In all reaction as coupling reagents were used derivatives of 1,3,5-triazine. The first trials in the device for hyperthermal RF generator have been done. The frequency of RF generator was in the ranges from 10 to 14Mhz and from 265 to 621kHz. Obtained functionalized nanoparticles enabled to reach the temperature of denaturation tumor cells in given frequencies.

Keywords: cancer colon cells, carbon nanotubes, hyperthermia, ligands

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Authors: S. H. Gasa, L. Singh, B. Pillay, A. O. Olaniran

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Wastewater treatment plants (WWTPs) have been implicated as the leading reservoir for antibiotic resistant bacteria (ARB), including Enterococci spp. and antibiotic resistance genes (ARGs), worldwide. Enterococci are a group of clinically significant bacteria that have gained much attention as a result of their antibiotic resistance. They play a significant role as the principal cause of nosocomial infections and dissemination of antimicrobial resistance genes in the environment. The main objective of this study was to ascertain the role of WWTPs in Durban, South Africa as potential reservoirs for antibiotic resistant Enterococci (ARE) and their related ARGs. Furthermore, the antibiogram and resistance gene profile of Enterococci species recovered from treated wastewater effluent and receiving surface water in Durban were also investigated. Using membrane filtration technique, Enterococcus selective agar and selected antibiotics, ARE were enumerated in samples (influent, activated sludge, before chlorination and final effluent) collected from two WWTPs, as well as from upstream and downstream of the receiving surface water. Two hundred Enterococcus isolates recovered from the treated effluent and receiving surface water were identified by biochemical and PCR-based methods, and their antibiotic resistance profiles determined by the Kirby-Bauer disc diffusion assay, while PCR-based assays were used to detect the presence of resistance and virulence genes. High prevalence of ARE was obtained at both WWTPs, with values reaching a maximum of 40%. The influent and activated sludge samples contained the greatest prevalence of ARE with lower values observed in the before and after chlorination samples. Of the 44 vancomycin and high-level gentamicin-resistant isolates, 11 were identified as E. faecium, 18 as E. faecalis, 4 as E. hirae while 11 are classified as “other” Enterococci species. High-level aminoglycoside resistance for gentamicin (39%) and vancomycin (61%) was recorded in species tested. The most commonly detected virulence gene was the gelE (44%), followed by asa1 (40%), while cylA and esp were detected in only 2% of the isolates. The most prevalent aminoglycoside resistance genes were aac(6')-Ie-aph(2''), aph(3')-IIIa, and ant(6')-Ia detected in 43%, 45% and 41% of the isolates, respectively. Positive correlation was observed between resistant phenotypes to high levels of aminoglycosides and presence of all aminoglycoside resistance genes. Resistance genes for glycopeptide: vanB (37%) and vanC-1 (25%), and macrolide: ermB (11%) and ermC (54%) were detected in the isolates. These results show the need for more efficient wastewater treatment and disposal in order to prevent the release of virulent and antibiotic resistant Enterococci species and safeguard public health.

Keywords: antibiogram, enterococci, gentamicin, vancomycin, virulence signatures

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Authors: Robby Y. Tallar, Nikodemus L., Yuri S., Jian P. Suen

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Research in the subject of ecological water resources management is full of trivial questions addressed and it seems, today to be one branch of science that can strongly contribute to the study of complexity (physical, biological, ecological, socio-economic, environmental, and other aspects). Existing literature available on different facets of these studies, much of it is technical and targeted for specific users. This study offered the combination all aspects in evaluation methodology for aquaculture lakes with its paradigm refer to hierarchical theory and to the effects of spatial specific arrangement of an object into a space or local area. Therefore, the process in developing a conceptual framework represents the more integrated and related applicable concept from the grounded theory. A design of integrated evaluation methodology for aquaculture lakes is presented. The method is based on the identification of a series of attributes which can be used to describe status of aquaculture lakes using certain indicators from aquaculture water quality index (AWQI), aesthetic aquaculture lake index (AALI) and rapid appraisal for fisheries index (RAPFISH). The preliminary preparation could be accomplished as follows: first, the characterization of study area was undertaken at different spatial scales. Second, an inventory data as a core resource such as city master plan, water quality reports from environmental agency, and related government regulations. Third, ground-checking survey should be completed to validate the on-site condition of study area. In order to design an integrated evaluation methodology for aquaculture lakes, finally we integrated and developed rating scores system which called Integrated Aquaculture Lake Index (IALI).The development of IALI are reflecting a compromise all aspects and it responds the needs of concise information about the current status of aquaculture lakes by the comprehensive approach. IALI was elaborated as a decision aid tool for stakeholders to evaluate the impact and contribution of anthropogenic activities on the aquaculture lake’s environment. The conclusion was while there is no denying the fact that the aquaculture lakes are under great threat from the pressure of the increasing human activities, one must realize that no evaluation methodology for aquaculture lakes can succeed by keeping the pristine condition. The IALI developed in this work can be used as an effective, low-cost evaluation methodology of aquaculture lakes for developing countries. Because IALI emphasizes the simplicity and understandability as it must communicate to decision makers and the experts. Moreover, stakeholders need to be helped to perceive their lakes so that sites can be accepted and valued by local people. For this site of lake development, accessibility and planning designation of the site is of decisive importance: the local people want to know whether the lake condition is safe or whether it can be used.

Keywords: aesthetic value, AHP, aquaculture lakes, integrated lakes, RAPFISH

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Authors: Angelis P. Barlampas

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Introduction: The term phantom lung mass describes the ovoid collection of fluid within the interlobular fissure, which initially creates the impression of a mass. The problem of correct differential diagnosis is great, especially in plain radiography. A case is presented with three nodular pulmonary foci, the shape, location, and density of which, as well as the presence of chronic loculated pleural effusions, suggest the presence of multiple phantom tumors of the lung. Purpose: The aim of this paper is to draw the attention of non-experienced and non-specialized physicians to the existence of benign findings that mimic pathological conditions and vice versa. The careful study of a radiological examination and the comparison with previous exams or further control protect against quick wrong conclusions. Methods: A hospitalized patient underwent a non-contrast CT scan of the chest as part of the general control of her situation. Results: Computed tomography revealed pleural effusions, some of them loculated, increased cardiothoracic index, as well as the presence of three nodular foci, one in the left lung and two in the right with a maximum density of up to 18 Hounsfield units and a mean diameter of approximately five centimeters. Two of them are located in the characteristical anatomical position of the major interlobular fissure. The third one is located in the area of the right lower lobe’s posterior basal part, and it presents the same characteristics as the previous ones and is likely to be a loculated fluid collection, within an auxiliary interlobular fissure or a cyst, in the context of the patient's more general pleural entrapments and loculations. The differential diagnosis of nodular foci based on their imaging characteristics includes the following: a) rare metastatic foci with low density (liposarcoma, mucous tumors of the digestive or genital system, necrotic metastatic foci, metastatic renal cancer, etc.), b) necrotic multiple primary lung tumor locations (squamous epithelial cancer, etc. ), c) hamartomas of the lung, d) fibrotic tumors of the interlobular fissures, e) lipoid pneumonia, f) fluid concentrations within the interlobular fissures, g) lipoma of the lung, h) myelolipomas of the lung. Conclusions: The collection of fluid within the interlobular fissure of the lung can give the false impression of a lung mass, particularly on plain chest radiography. In the case of computed tomography, the ability to measure the density of a lesion, combined with the provided high anatomical details of the location and characteristics of the lesion, can lead relatively easily to the correct diagnosis. In cases of doubt or image artifacts, comparison with previous or subsequent examinations can resolve any disagreements, while in rare cases, intravenous contrast may be necessary.

Keywords: phantom mass, chest CT, pleural effusion, cancer

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Authors: Riya Bose, Ashok Bera, Manas R. Parida, Anirudhha Adhikari, Basamat S. Shaheen, Erkki Alarousu, Jingya Sun, Tom Wu, Osman M. Bakr, Omar F. Mohammed

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This work reports visualization of charge carrier dynamics on the surface of copper indium gallium selenide (CIGSe) nanocrystals in real space and time using four-dimensional scanning ultrafast electron microscopy (4D S-UEM) and correlates it with the optoelectronic properties of the nanocrystals. The surface of the nanocrystals plays a key role in controlling their applicability for light emitting and light harvesting purposes. Typically for quaternary systems like CIGSe, which have many desirable attributes to be used for optoelectronic applications, relative abundance of surface trap states acting as non-radiative recombination centre for charge carriers remains as a major bottleneck preventing further advancements and commercial exploitation of these nanocrystals devices. Though ultrafast spectroscopic techniques allow determining the presence of picosecond carrier trapping channels, because of relative larger penetration depth of the laser beam, only information mainly from the bulk of the nanocrystals is obtained. Selective mapping of such ultrafast dynamical processes on the surfaces of nanocrystals remains as a key challenge, so far out of reach of purely optical probing time-resolved laser techniques. In S-UEM, the optical pulse generated from a femtosecond (fs) laser system is used to generate electron packets from the tip of the scanning electron microscope, instead of the continuous electron beam used in the conventional setup. This pulse is synchronized with another optical excitation pulse that initiates carrier dynamics in the sample. The principle of S-UEM is to detect the secondary electrons (SEs) generated in the sample, which is emitted from the first few nanometers of the top surface. Constructed at different time delays between the optical and electron pulses, these SE images give direct and precise information about the carrier dynamics on the surface of the material of interest. In this work, we report selective mapping of surface dynamics in real space and time of CIGSe nanocrystals applying 4D S-UEM. We show that the trap states can be considerably passivated by ZnS shelling of the nanocrystals, and the carrier dynamics can be significantly slowed down. We also compared and discussed the S-UEM kinetics with the carrier dynamics obtained from conventional ultrafast time-resolved techniques. Additionally, a direct effect of the state trap removal can be observed in the enhanced photoresponse of the nanocrystals after shelling. Direct observation of surface dynamics will not only provide a profound understanding of the photo-physical mechanisms on nanocrystals’ surfaces but also enable to unlock their full potential for light emitting and harvesting applications.

Keywords: 4D scanning ultrafast microscopy, charge carrier dynamics, nanocrystals, optoelectronics, surface passivation, trap states

Procedia PDF Downloads 293

Authors: Lívia Pinheiro Carvalho, Luciana Di Thommazo-Luporini, Rafael Luís Luporini, José Carlos Bonjorno Junior, Renata Pedrolongo Basso Vanelli, Manoel Carneiro de Oliveira Junior, Rodolfo de Paula Vieira, Renata Trimer, Renata G. Mendes, Mylène Aubertin-Leheudre, Audrey Borghi-Silva

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Rationale: Cardiorespiratory fitness (CRF) and functional capacity in young obese and normal-weight people are associated with metabolic and cardiovascular diseases and mortality. However, it remains unclear whether their metabolically healthy (MH) or at risk (AR) phenotype influences cardiorespiratory fitness in this vulnerable population such as obese adults but also in normal-weight people. HOMA insulin resistance index (HI) and leptin-adiponectin ratio (LA) are strong markers for characterizing those phenotypes that we hypothesized to be associated with physical fitness. We also hypothesized that an easy and feasible exercise test could identify a subpopulation at risk to develop metabolic and related disorders. Methods: Thirty-nine sedentary men and women (20-45y; 18.530 kg.m-2) underwent a clinical evaluation, including the six-minute step test (ST), a well-validated and reliable test for young people. Body composition assessment was done by a tetrapolar bioimpedance in a fasting state and in the folicular phase for women. A maximal cardiopulmonary exercise testing, as well as the ST, evaluated the oxygen uptake at the peak of the test (VO2peak) by an ergospirometer Oxycon Mobile. Lipids, glucose, insulin were analysed and the ELISA method quantified the serum leptin and adiponectin from blood samples. Volunteers were divided in two groups: AR or MH according to a HI cutoff of 1.95, which was previously determined in the literature. T-test for comparison between groups, Pearson´s test to correlate main variables and ROC analysis for discriminating AR from up-and-down cycles in ST (SC) were applied (p<0.05). Results: Higher LA, fat mass (FM) and lower HDL, SC, leg lean mass (LM) and VO2peak were found in AR than in MH. Significant correlations were found between VO2peak and SC (r= 0.80) as well as between LA and FM (r=0.87), VO2peak (r=-0.73), and SC (r=-0.65). Area under de curve showed moderate accuracy (0.75) of SC <173 to discriminate AR phenotype. Conclusion: Our study found that at risk obese and normal-weight subjects showed an unhealthy metabolism as well as a poor CRF and functional daily activity capacity. Additionally, a simple and less costly functional test associated with above-mentioned aspects is able to identify ‘at risk’ subjects for primary intervention with important clinical and health implications.

Keywords: aerobic capacity, exercise, fitness, metabolism, obesity, 6MST

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Authors: Jian Wu

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Since a few years, some French companies have integrated CRS (corporate social responsibility) criteria in their variable remuneration plans to ‘restore a good working atmosphere’ and ‘preserve the natural environment’. These CSR criteria are based on concerns on environment protection, social aspects, and corporate governance. In June 2012, a report on this practice has been made jointly by ORSE (which means Observatory on CSR in French) and PricewaterhouseCoopers. Facing this initiative from the business world, we need to examine whether it has a real economic utility. We adopt a theoretical approach for our study. First, we examine the debate between the ‘orthodox’ point of view in economics and the CSR school of thought. The classical economic model asserts that in a capitalist economy, exists a certain ‘invisible hand’ which helps to resolve all problems. When companies seek to maximize their profits, they are also fulfilling, de facto, their duties towards society. As a result, the only social responsibility that firms should have is profit-searching while respecting the minimum legal requirement. However, the CSR school considers that, as long as the economy system is not perfect, there is no ‘invisible hand’ which can arrange all in a good order. This means that we cannot count on any ‘divine force’ which makes corporations responsible regarding to society. Something more needs to be done in addition to firms’ economic and legal obligations. Then, we reply on some financial theories and empirical evident to examine the sound foundation of CSR. Three theories developed in corporate governance can be used. Stakeholder theory tells us that corporations owe a duty to all of their stakeholders including stockholders, employees, clients, suppliers, government, environment, and society. Social contract theory tells us that there are some tacit ‘social contracts’ between a company and society itself. A firm has to respect these contracts if it does not want to be punished in the form of fine, resource constraints, or bad reputation. Legitime theory tells us that corporations have to ‘legitimize’ their actions toward society if they want to continue to operate in good conditions. As regards empirical results, we present a literature review on the relationship between the CSR performance and the financial performance of a firm. We note that, due to difficulties in defining these performances, this relationship remains still ambiguous despite numerous research works realized in the field. Finally, we are curious to know whether the integration of CSR criteria in variable remuneration plans – which is practiced so far in big companies – should be extended to other ones. After investigation, we note that two groups of firms have the greatest need. The first one involves industrial sectors whose activities have a direct impact on the environment, such as petroleum and transport companies. The second one involves companies which are under pressures in terms of return to deal with international competition.

Keywords: corporate social responsibility, corporate governance, variable remuneration, stakeholder theory

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Authors: Abhijit Trailokya

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Background: Cardiovascular diseases (CVD’s) are the major cause of morbidity and mortality in both developed and developing countries. Many clinical trials have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, reduces the incidence of coronary and cerebrovascular events across a broad spectrum of patients at risk. Guidelines for the management of patients at risk have been established in Europe and North America. The guidelines have advocated progressively lower LDL-C targets and more aggressive use of statin therapy. In Indian patients, comprehensive data on dyslipidemia management and its treatment outcomes are inadequate. There is lack of information on existing treatment patterns, the patient’s profile being treated, and factors that determine treatment success or failure in achieving desired goals. Purpose: The present study was planned to determine the lipid control status in high-risk dyslipidemic patients treated with lipid-lowering therapy in India. Methods: This cross-sectional, non-interventional, single visit program was conducted across 483 sites in India where male and female patients with high-risk dyslipidemia aged 18 to 65 years who had visited for a routine health check-up to their respective physician at hospital or a healthcare center. Percentage of high-risk dyslipidemic patients achieving adequate LDL-C level (< 70 mg/dL) on lipid-lowering therapy and the association of lipid parameters with patient characteristics, comorbid conditions, and lipid lowering drugs were analysed. Results: 3089 patients were enrolled in the study; of which 64% were males. LDL-C data was available for 95.2% of the patients; only 7.7% of these patients achieved LDL-C levels < 70 mg/dL on lipid-lowering therapy, which may be due to inability to follow therapeutic plans, poor compliance, or inadequate counselling by physician. The physician’s lack of awareness about recent treatment guidelines also might contribute to patients’ poor adherence, not explaining adequately the benefit and risks of a medication, not giving consideration to the patient’s life style and the cost of medication. Statin was the most commonly used anti-dyslipidemic drug across population. The higher proportion of patients had the comorbid condition of CVD and diabetes mellitus across all dyslipidemic patients. Conclusion: As per the European Society of Cardiology guidelines the ideal LDL-C levels in high risk dyslipidemic patients should be less than 70%. In the present study, 7.7% of the patients achieved LDL-C levels < 70 mg/dL on lipid lowering therapy which is very less. Most of high risk dyslipidemic patients in India are on suboptimal dosage of statin. So more aggressive and high dosage statin therapy may be required to achieve target LDLC levels in high risk Indian dyslipidemic patients.

Keywords: cardiovascular disease, diabetes mellitus, dyslipidemia, LDL-C, lipid lowering drug, statins

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Authors: Frank Dorrian, Aniket Adhikari

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The placenta accreta spectrum (PAS), which includes placenta accreta, increta, and percreta, is characterized by the abnormal implantation of placental chorionic villi beyond the decidua basalis. Key risk factors include placenta previa, prior cesarean sections, advanced maternal age, uterine surgeries, multiparity, pelvic radiation, and in vitro fertilization (IVF). The incidence of PAS has increased tenfold over the past 50 years, largely due to rising cesarean rates. PAS is associated with significant peripartum and postpartum hemorrhage. Magnetic resonance imaging (MRI) and ultrasound assist in the evaluation of PAS, enabling a multidisciplinary approach to mitigate morbidity and mortality. This study retrospectively analyzed PAS cases at Royal Prince Alfred Hospital, Sydney, Australia. Using the SAR-ESUR joint consensus statement, seven imaging signs were reassessed for their sensitivity and specificity in predicting PAS, with histopathological correlation. The standardized MRI protocols for PAS at the institution were also reviewed. Data were collected from the picture archiving and communication system (PACS) records from 2010 to July 2024, focusing on cases where MR imaging and confirmed histopathology or operative notes were available. This single-center, observational study provides insights into the reliability of MRI for PAS detection and the optimization of imaging protocols for accurate diagnosis. The findings demonstrate that intraplacental dark bands serve as highly sensitive markers for diagnosing PAS, achieving sensitivities of 88.9%, 85.7%, and 100% for placenta accreta, increta, and percreta, respectively, with a combined specificity of 42.9%. Sensitivity for abnormal vascularization was lower (33.3%, 28.6%, and 50%), with a specificity of 57.1%. The placenta bulge exhibited sensitivities of 55.5%, 57.1%, and 100%, with a specificity of 57.1%. Loss of the T2 hypointense interface had sensitivities of 66.6%, 85.7%, and 100%, with 42.9% specificity. Myometrial thinning showed high sensitivity across PAS conditions (88.9%, 71.4%, and 100%) and a specificity of 57.1%. Bladder wall thinning was sensitive only for placenta percreta (50%) but had a specificity of 100%. Focal exophytic mass displayed variable sensitivity (22.9%, 42.9%, and 100%) with a specificity of 85.7%. These results highlight the diagnostic variability among markers, with intraplacental dark bands and myometrial thinning being useful in detecting abnormal placentation, though they lack high specificity. The literature and the results of our study highlight that while no single feature can definitively diagnose PAS, the presence of multiple features -especially when combined with elevated clinical risk- significantly increases the likelihood of an underlying PAS. A thorough understanding of the range of MRI findings associated with PAS, along with awareness of the clinical significance of each sign, helps the radiologist more accurately diagnose the condition and assist in surgical planning, ultimately improving patient care.

Keywords: placenta, accreta, spectrum, MRI

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Authors: Rakelane A. Mendes, Sandro T. M. Goncalves, Raphaella L. R. Silva

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The concepts of energy harvesting and wireless energy transfer have been widely discussed in recent times. There are some ways to create autonomous systems for collecting ambient energy, such as solar, vibratory, thermal, electromagnetic, radiofrequency (RF), among others. In the case of the RF it is possible to collect up to 100 μW / cm². To collect and/or transfer energy in RF systems, a device called rectenna is used, which is defined by the junction of an antenna and a rectifier circuit. The rectenna presented in this work is resonant at the frequencies of 1.8 GHz and 2.45 GHz. Frequencies at 1.8 GHz band are e part of the GSM / LTE band. The GSM (Global System for Mobile Communication) is a frequency band of mobile telephony, it is also called second generation mobile networks (2G), it came to standardize mobile telephony in the world and was originally developed for voice traffic. LTE (Long Term Evolution) or fourth generation (4G) has emerged to meet the demand for wireless access to services such as Internet access, online games, VoIP and video conferencing. The 2.45 GHz frequency is part of the ISM (Instrumentation, Scientific and Medical) frequency band, this band is internationally reserved for industrial, scientific and medical development with no need for licensing, and its only restrictions are related to maximum power transfer and bandwidth, which must be kept within certain limits (in Brazil the bandwidth is 2.4 - 2.4835 GHz). The rectenna presented in this work was designed to present efficiency above 50% for an input power of -15 dBm. It is known that for wireless energy capture systems the signal power is very low and varies greatly, for this reason this ultra-low input power was chosen. The Rectenna was built using the low cost FR4 (Flame Resistant) substrate, the antenna selected is a microfita antenna, consisting of a Meandered dipole, and this one was optimized using the software CST Studio. This antenna has high efficiency, high gain and high directivity. Gain is the quality of an antenna in capturing more or less efficiently the signals transmitted by another antenna and/or station. Directivity is the quality that an antenna has to better capture energy in a certain direction. The rectifier circuit used has series topology and was optimized using Keysight's ADS software. The rectifier circuit is the most complex part of the rectenna, since it includes the diode, which is a non-linear component. The chosen diode is the Schottky diode SMS 7630, this presents low barrier voltage (between 135-240 mV) and a wider band compared to other types of diodes, and these attributes make it perfect for this type of application. In the rectifier circuit are also used inductor and capacitor, these are part of the input and output filters of the rectifier circuit. The inductor has the function of decreasing the dispersion effect on the efficiency of the rectifier circuit. The capacitor has the function of eliminating the AC component of the rectifier circuit and making the signal undulating.

Keywords: dipole antenna, double-band, high efficiency, rectenna

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Authors: Rakesh Mishra, Rajni Singh, Mukunda Upadhyay

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Since the last few decades, the prima facie of development has shifted towards the working population in India. There has been a paradigm shift in the development approach with the realization that the present demographic dividend has to be harnessed for sustainable development. Rapid urbanization and improved socioeconomic characteristics experienced within its territory has catalyzed various forms of migration into it, resulting in massive transference of workforce between its states. Workforce in any country plays a very crucial role in deciding development of both the places, from where they have out-migrated and the place they are residing currently. In India, people are found to be migrating from relatively less developed states to a well urbanized and developed state for satisfying their neediness. Linking migration to HDI at place of destination, the regression coefficient (β ̂) shows affirmative association between them, because higher the HDI of the place would be, higher would be chance of earning and hence likeliness of the migrants would be more to choose that place as a new destination and vice versa. So the push factor is compromised by the cost of rearing and provides negative impulse on the in migrants letting down their numbers to metro cities or megacities of the states but increasing their mobility to the suburban areas and vice versa. The main objective of the study is to check the role of migration in deciding the dividend of the place of destination as well as people at the place of their usual residence with special focus to highly urban states in India. Idealized scenario of Indian migrants refers to some new theories in making. On analyzing the demographic dividend of the places we got to know that Uttar Pradesh provides maximum dividend to Maharashtra, West Bengal and Delhi, and the demographic divided of migrants are quite comparable to the native’s shares in the demographic dividend in these places. On analyzing the data from National Sample Survey 64th round and Census of India-2001, we have observed that for males in rural areas, the share of unemployed person declined by 9 percentage points (from 45% before migration to 36 % after migration) and for females in rural areas the decline was nearly 12 percentage points (from 79% before migration to 67% after migration. It has been observed that the shares of unemployed males in both rural and urban areas, which were significant before migration, got reduced after migration while the share of unemployed females in the rural as well as in the urban areas remained almost negligible both for before and after migration. So increase in the number of employed after migration provides an indication of changes in the associated cofactors like health and education of the place of destination and arithmetically to the place from where they have migrated out. This paper presents the evidence on the patterns of prevailing migration dynamics and corresponding demographic benefits in India and its states, examines trends and effects, and discusses plausible explanations.

Keywords: migration, demographic shift, human development index, multilevel analysis

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Authors: Raja Lahiani

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'Locksley Hall' is a poem that Lord Alfred Tennyson (1809-1892) published in 1842. It is believed to be his first attempt to face as a poet some of the most painful of his experiences, as it is a study of his rising out of sickness into health, conquering his selfish sorrow by faith and hope. So far, in Victorian scholarship as in modern criticism, 'Locksley Hall' has been studied and approached as a canonical Victorian English poem. The aim of this project is to prove that some strategies of translation were used in this poem in such a way as to guarantee its assimilation into the English canon and hence efface to a large extent its Arabic roots. In its relationship with its source text, 'Locksley Hall' is at the same time mimetic and imitative. As part of the terminology used in translation studies, ‘imitation’ means almost the exact opposite of what it means in ordinary English. By adopting an imitative procedure, a translator would do something totally different from the original author, wandering far and freely from the words and sense of the original text. An imitation is thus aimed at an audience which wants the work of the particular translator rather than the work of the original poet. Hallam Tennyson, the poet’s biographer, asserts that 'Locksley Hall' is a simple invention of place, incidents, and people, though he notes that he remembers the poet claiming that Sir William Jones’ prose translation of the Mu‘allaqat (pre-Islamic poems) gave him the idea of the poem. A comparative work would prove that 'Locksley Hall' mirrors a great deal of Tennyson’s biography and hence is not a simple invention of details as asserted by his biographer. It would be challenging to prove that 'Locksley Hall' shares so many details with the Mu‘allaqat, as declared by Tennyson himself, that it needs to be studied as an imitation of the Mu‘allaqat of Imru’ al-Qays and ‘Antara in addition to its being a poem in its own right. Thus, the main aim of this work is to unveil the imitative and mimetic strategies used by Tennyson in his composition of 'Locksley Hall.' It is equally important that this project researches the acculturating assimilative tools used by the poet to root his poem in its Victorian English literary, cultural and spatiotemporal settings. This work adopts a comparative methodology. Comparison is done at different levels. The poem will be contextualized in its Victorian English literary framework. Alien details related to structure, socio-spatial setting, imagery and sound effects shall be compared to Arabic poems from the Mu‘allaqat collection. This would determine whether the poem is a translation, an adaption, an imitation or a genuine work. The ultimate objective of the project is to unveil in this canonical poem a new dimension that has for long been either marginalized or ignored. By proving that 'Locksley Hall' is an imitation of classical Arabic poetry, the project aspires to consolidate its literary value and open up new gates of accessing it.

Keywords: comparative literature, imitation, Locksley Hall, Lord Alfred Tennyson, translation, Victorian poetry

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Authors: Mustafa M. Donma, Orkide Donma

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Metabolic syndrome (MetS) is a severe health problem which is common among obese individuals. The components of MetS are rather stable in adults compared to the components discussed for children. Due to the ambiguity in this group of the population, how to diagnose MetS in morbid obese (MO) children still constitutes a matter of discussion. For this purpose, a formula, which facilitates the diagnosis of MetS in MO children, was investigated. The aim of this study was to develop a formula which was capable of discriminating MO children with and without MetS findings. Study population comprised MO children. Age and sex-dependent body mass index (BMI) percentiles of the children were above 99. Metabolic syndrome components were also determined. Elevated systolic and diastolic blood pressures (SBP and DBP), elevated fasting blood glucose (FBG), elevated triglycerides (TRG), and/or depressed high density lipoprotein cholesterol (HDL-C) in addition to central obesity were listed as MetS components for each child. Presence of at least two of these components confirmed that the case was MetS. Two groups were constituted. In the first group, there were forty-two MO children without MetS components. Second group was composed of forty-four MO children with at least two MetS components. Anthropometric measurements, including weight, height, waist, and hip circumferences, were performed following physical examination. Body mass index and homeostatic model assessment of insulin resistance values were calculated. Informed consent forms were obtained from the parents of the children. Institutional Non-Interventional Ethics Committee approved the study design. Blood pressure values were recorded. Routine biochemical analysis, including FBG, insulin (INS), TRG, HDL-C were performed. The performance and the clinical utility of the Diagnostic Obesity Notation Model Assessment Metabolic Syndrome Index (DONMA MetS index) [(INS/FBG)/(HDL-C/TRG)*100] was tested. Appropriate statistical tests were applied to the study data. p value smaller than 0.05 was defined as significant. Metabolic syndrome index values were 41.6±5.1 in MO group and 104.4±12.8 in MetS group. Corresponding values for HDL-C values were 54.5±13.2 mg/dl and 44.2±11.5 mg/dl. There were statistically significant differences between the groups (p<0.001). Upon evaluation of the correlations between MetS index and HDL-C values, a much stronger negative correlation was found in MetS group (r=-0.515; p=0.001) in comparison with the correlation detected in MO group (r=-0.371; p=0.016). From these findings, it was concluded that the statistical significance degree of the difference between MO and MetS groups was highly acceptable for this recently introduced MetS index as expected. This was due to the involvement of all of the biochemically defined MetS components into the index. This is particularly important because each of these four parameters used in the formula is cardiac risk factor. Aside from discriminating MO children with and without MetS findings, MetS index introduced in this study is important from the cardiovascular risk point of view in MetS group of children.

Keywords: children, fasting blood glucose, high density lipoprotein cholesterol, index, insulin, metabolic syndrome, morbid obesity, triglycerides.

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Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

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The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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Authors: Shiao-Wei Chu

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In order to enhance the ability of their graduates to compete in an increasingly globalized economy, the majority of universities in Taiwan require students to pass Freshman English in order to earn a bachelor's degree. However, many college students show low motivation in English class for several important reasons, including exam-oriented lessons, unengaging classroom activities, a lack of opportunities to use English in authentic contexts, and low levels of confidence in using English. Students’ lack of motivation in English classes is evidenced when students doze off, work on assignments from other classes, or use their phones to chat with others, play video games or watch online shows. Cooperative learning aims to address these problems by encouraging language learners to use the target language to share individual experiences, cooperatively complete tasks, and to build a supportive classroom learning community whereby students take responsibility for one another’s learning. This study includes approximately 50 student participants in a low-proficiency Freshman English class. Each week, participants will work together in groups of between 3 and 4 students to complete various in-class interactive tasks. The instructor will employ a reward system that incentivizes students to be responsible for their own as well as their group mates’ learning. The rewards will be based on points that team members earn through formal assessment scores as well as assessment of their participation in weekly in-class discussions. The instructor will record each team’s week-by-week improvement. Once a team meets or exceeds its own earlier performance, the team’s members will each receive a reward from the instructor. This cooperative learning approach aims to stimulate EFL freshmen’s learning motivation by creating a supportive, low-pressure learning environment that is meant to build learners’ self-confidence. Students will practice all four language skills; however, the present study focuses primarily on the learners’ reading comprehension. Data sources include in-class discussion notes, instructor field notes, one-on-one interviews, students’ midterm and final written reflections, and reading scores. Triangulation is used to determine themes and concerns, and an instructor-colleague analyzes the qualitative data to build interrater reliability. Findings are presented through the researcher’s detailed description. The instructor-researcher has developed this approach in the classroom over several terms, and its apparent success at motivating students inspires this research. The aims of this study are twofold: first, to examine the possible benefits of this cooperative approach in terms of students’ learning outcomes; and second, to help other educators to adapt a more cooperative approach to their classrooms.

Keywords: freshman English, cooperative language learning, EFL learners, learning motivation, zone of proximal development

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Authors: Agne Jucyte Cicine, Vytautas Abromaitis, Zita Rasuole Gasiunaite, I. Vybernaite-Lubiene, D. Overlinge, K. Vilke

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Pharmaceutical pollution in aquatic environments has become a growing concern. Various active pharmaceutical ingredient (API) residues, hormones, antibiotics, or/and psychiatric drugs, have already been discovered in different environmental compartments. Due to existing ineffective wastewater treatment technologies to remove APIs, an underestimated amount can enter the ecosystem by discharged treated wastewater. Especially, psychiatric compounds, such as carbamazepine (CBZ) and venlafaxine (VNX), persist in effluent even post-treatment. Therefore, these pharmaceuticals usually exceed safe environmental levels and pose risks to the aquatic environment, particularly to sensitive ecosystems such as the Baltic Sea. CBZ, known for its chemical stability and long biodegradation time, accumulates in the environment, threatening aquatic life and human health through the food chain. As the use of medication rises, there is an urgent need for advanced wastewater treatment to reduce pharmaceutical contamination and meet future regulatory requirements. In this study, we tested advanced oxidation technology using ozone to remove two commonly used psychiatric drugs (carbamazepine and venlafaxine) from biologically treated wastewater effluent. Additionally, general water quality parameters (suspended matter (SPM), dissolved organic carbon (DOC), chemical oxygen demand (COD), and bacterial presence were analyzed. Three wastewater treatment plants (WWTPs) representing different anthropogenic pressures were selected: 1) resort, 2) resort and residential, and 3) residential, industrial, and resort. Wastewater samples for the experiment were collected during the summer season after mechanical and biological treatment and ozonated for 5, 10, and 15 minutes. The initial dissolved ozone concentration of 7,3±0,7 mg/L was held constant during all the experiments. Pharmaceutical levels in this study exceeded the predicted no-effect concentration (PNEC) of 500 and 90 ng L⁻¹ for CBZ and VNX, respectively, in all WWTPs, except CBZ in WWTP 1. Initial CBZ contamination was found to be lower in WWTP 1 (427.4 ng L⁻¹), compared with WWTP 2 (1266.5 ng L⁻¹) and 3 (119.2 ng L⁻¹). VNX followed a similar trend with concentrations of 341.2 ng L⁻¹, 361.4 ng L⁻¹, and 390.0 ng L⁻¹, respectively, for WWTPs 1, 2, and 3. It was determined that CBZ was not detected in the effluent after 5 minutes of ozonation in any of the WWTPs. Contrarily, VNX was still detected after 5, 10, and 15 minutes of treatment with ozone, however, under the limits of quantification (LOD) (<5ng L⁻¹). Additionally, general pollution of SPM, DOC, COD, and bacterial contamination was reduced notably after 5 minutes of treatment with ozone, while no bacterial growth was obtained. Although initial pharmaceutical levels exceeded PNECs, indicating ongoing environmental risks, ozonation demonstrated high efficiency in reducing pharmaceutical and general contamination in wastewater with different pollution matrices.

Keywords: Baltic Sea, ozonation, pharmaceuticals, wastewater treatment plants

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Authors: Diana Mitova, Krassimir Mitrev

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To prepare the current generation for the future, education systems need to change. It implies a way of learning that meets the demands of the times and the environment in which we live. Productive interaction in the educational process implies an interactive learning environment and the possibility of personal development of learners based on communication and mutual dialogue, cooperation and good partnership in decision-making. Students need not only theoretical knowledge, but transferable skills that will help them to become inventors and entrepreneurs, to implement ideas. STEM education , is now a real necessity for the modern school. Through learning in a "learning company", students master examples from classroom practice, simulate real life situations, group activities and apply basic interactive learning strategies and techniques. The learning company is the subject of this study, reduced to entrepreneurship training in STEM - technologies that encourage students to think outside the traditional box. STEM learning focuses the teacher's efforts on modeling entrepreneurial thinking and behavior in students and helping them solve problems in the world of business and entrepreneurship. Learning based on the implementation of various STEM projects in extracurricular activities, experiential learning, and an interdisciplinary approach are means by which educators better connect the local community and private businesses. Learners learn to be creative, experiment and take risks and work in teams - the leading characteristics of any innovator and future entrepreneur. This article presents some European policies on STEM and entrepreneurship education. It also shares best practices for training company training , with the integration of STEM in the learning company training environment. The main results boil down to identifying some advantages and problems in STEM entrepreneurship education. The benefits of using integrative approaches to teach STEM within a training company are identified, as well as the positive effects of project-based learning in a training company using STEM. Best practices for teaching entrepreneurship through extracurricular activities using STEM within a training company are shared. The following research methods are applied in this research paper: Theoretical and comparative analysis of principles and policies of European Union countries and Bulgaria in the field of entrepreneurship education through a training company. Experiences in entrepreneurship education through extracurricular activities with STEM application within a training company are shared. A questionnaire survey to investigate the motivation of secondary vocational school students to learn entrepreneurship through a training company and their readiness to start their own business after completing their education. Within the framework of learning through a "learning company" with the integration of STEM, the activity of the teacher-facilitator includes the methods: counseling, supervising and advising students during work. The expectation is that students acquire the key competence "initiative and entrepreneurship" and that the cooperation between the vocational education system and the business in Bulgaria is more effective.

Keywords: STEM, entrepreneurship, training company, extracurricular activities

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