Search results for: disease duration

Authors: Zia Ul Haq, Saleem Muhammad, Naeem Ullah, Abbas Shah, Abdullah Shah

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Pakistan being the developing country is facing double burden of communicable and non-communicable disease. The aspect of secondary prevention of ischemic heart disease in developing countries is the dire need for public health specialists, clinicians and policy makers. There is some evidence that psychotherapeutic measures, including psychotherapy, recreation, exercise and stress management training have positive impact on secondary prevention of cardiovascular diseases but there are some contradictory findings as well. Cardiac rehabilitation program (CRP) has not yet fully implemented in Pakistan. Psychological, physical and specific health-related quality of life (HRQoL) outcomes needs assessment with respect to its practicality, effectiveness, and success. Objectives: To determine the effect of cardiac rehabilitation program (CRP) on the health-related quality of life (HRQoL) measures of post MI patients compared to the usual care. Hypothesis: Post MI patients who receive the interventions (CRP) will have better HRQoL as compared to those who receive the usual cares. Methods: The randomized control trial was conducted at a Cardiac Rehabilitation Unit of Lady Reading Hospital (LRH), Peshawar. LRH is the biggest hospital of the Province Khyber Pakhtunkhwa (KP). A total 206 participants who had recent first myocardial infarction were inducted in the study. Participants were randomly allocated into two group i.e. usual care group (UCG) and cardiac rehabilitation group (CRG) by permuted-block randomization (PBR) method. CRP was conducted in CRG in two phases. Three HRQoL outcomes i.e. general health questionnaire (GHQ), self-rated health (SRH) and MacNew quality of life after myocardial infarction (MacNew QLMI) were assessed at baseline and follow-up visits among both groups. Data were entered and analyzed by appropriate statistical test in STATA version 12. Results: A total of 195 participants were assessed at the follow-up period due to lost-to-follow-up. The mean age of the participants was 53.66 + 8.3 years. Males were dominant in both groups i.e. 150 (76.92%). Regarding educational status, majority of the participants were illiterate in both groups i.e. 128 (65.64%). Surprisingly, there were 139 (71.28%) who were non-smoker on the whole. The comorbid status was positive in 120 (61.54%) among all the patients. The SRH at follow-up among UCG and CRG was 4.06 (95% CI: 3.93, 4.19) and 2.36 (95% CI: 2.2, 2.52) respectively (p<0.001). GHQ at the follow-up of UCG and CRG was 20.91 (95% CI: 18.83, 21.97) and 7.43 (95% CI: 6.59, 8.27) respectively (p<0.001). The MacNew QLMI at follow-up of UCG and CRG was 3.82 (95% CI: 3.7, 3.94) and 5.62 (95% CI: 5.5, 5.74) respectively (p<0.001). All the HRQoL measures showed strongly significant improvement in the CRG at follow-up period. Conclusion: HRQOL improved in post MI patients after comprehensive CRP. Education of the patients and their supervision is needed when they are involved in their rehabilitation activities. It is concluded that establishing CRP in cardiac units, recruiting post-discharged MI patients and offering them CRP does not impose high costs and can result in significant improvement in HRQoL measures. Trial registration no: ACTRN12617000832370

Keywords: cardiovascular diseases, cardiac rehabilitation, health-related quality of life, HRQoL, myocardial infarction, quality of life, QoL, rehabilitation, randomized control trial

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Authors: Yinglisong, Jingge Chen, Jingxuan Chen, Yan Wang, Hui Huang, Jing Zhnag, Qianqian Zhang, Zhenzhen Zhang, Ji Zhang

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Purpose: The study aims to establish a nomogram prediction model for postpartum hemorrhage (PPH) in vaginal delivery. Patients and Methods: Clinical data were retrospectively collected from vaginal delivery patients admitted to a hospital in Zhengzhou, China, from June 1, 2022 - October 31, 2022. Univariate and multivariate logistic regression were used to filter out independent risk factors. A nomogram model was established for PPH in vaginal delivery based on the risk factors coefficient. Bootstrapping was used for internal validation. To assess discrimination and calibration, receiver operator characteristics (ROC) and calibration curves were generated in the derivation and validation groups. Results: A total of 1340 cases of vaginal delivery were enrolled, with 81 (6.04%) having PPH. Logistic regression indicated that history of uterine surgery, induction of labor, duration of first labor, neonatal weight, WBC value (during the first stage of labor), and cervical lacerations were all independent risk factors of hemorrhage (P <0.05). The area-under-curve (AUC) of ROC curves of the derivation group and the validation group were 0.817 and 0.821, respectively, indicating good discrimination. Two calibration curves showed that nomogram prediction and practical results were highly consistent (P = 0.105, P = 0.113). Conclusion: The developed individualized risk prediction nomogram model can assist midwives in recognizing and diagnosing high-risk groups of PPH and initiating early warning to reduce PPH incidence.

Keywords: vaginal delivery, postpartum hemorrhage, risk factor, nomogram

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Authors: Carla Idely Palencia-Aguilar

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Mining in Colombia represents around 2% of the GDP (USD 8 billion in 2018), with main productions represented by coal, nickel, gold, silver, emeralds, iron, limestone, gypsum, among others. Sand and Gravel had been decreasing its participation of the GDP with a reduction of 33.2 million m3 in 2015, to 27.4 in 2016, 22.7 in 2017 and 15.8 in 2018, with a consumption of approximately 3 tons/inhabitant. However, with the new government policies it is expected to increase in the following years. Mining causes temporary environmental impacts, once restoration and rehabilitation takes place, social, environmental and economic benefits are higher than the initial state. A way to demonstrate how the mining interventions had contributed to improve the characteristics of the region after sand and gravel mining, the NDVI (Normalized Difference Vegetation Index) from MODIS and ASTER were employed. The histograms show not only increments of vegetation in the area (8 times higher), but also topographies similar to the ones before the intervention, according to the application for sustainable development selected: either agriculture, forestry, cattle raising, artificial wetlands or do nothing. The decision was based upon a Multicriteria analysis for optimal land use, with three main variables: geostatistics, evapotranspiration and groundwater characteristics. The use of remote sensing, meteorological stations, piezometers, sunphotometers, geoelectric analysis among others; provide the information required for the multicriteria decision. For cattle raising and agricultural applications (where various crops were implemented), conservation of products were tested by means of nanotechnology. The results showed a duration of 2 years with no chemicals added for preservation and concentration of vitamins of the tested products.

Keywords: ASTER, Geostatistics, MODIS, Multicriteria

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Authors: Raneem Osama Salem, Ayesha Nuzhat, Fatimah Nasser Al Shehri, Nasser Al Hamdan

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Background: Recently, most medical schools around the globe are using simulation for teaching and assessing students’ clinical skills and competence. There are many obstacles that could face students and faculty when simulation sessions are introduced into undergraduate curriculum. Objective: The aim of this study is to obtain the opinion of undergraduate medical students and our faculty regarding the role of simulation in undergraduate curriculum, the simulation modalities used, and perceived barriers in implementing stimulation sessions. Methods: To address the role of simulation, modalities used, and perceived challenges to implementation of simulation sessions, a self-administered pilot tested questionnaire with 18 items using a 5 point Likert scale was distributed. Participants included undergraduate male medical students (n=125) and female students (n=70) as well as the faculty members (n=14). Result: Various learning outcomes are achieved and improved through the technology enhanced simulation sessions such as communication skills, diagnostic skills, procedural skills, self-confidence, and integration of basic and clinical sciences. The use of high fidelity simulators, simulated patients and task trainers was more desirable by our students and faculty for teaching and learning as well as an evaluation tool. According to most of the students,' institutional support in terms of resources, staff and duration of sessions was adequate. However, motivation to participate in the sessions and provision of adequate feedback by the staff was a constraint. Conclusion: The use of simulation laboratory is of great benefit to the students and a great teaching tool for the staff to ensure students learning of the various skills.

Keywords: simulators, medical students, skills, simulated patients, performance, challenges, skill laboratory

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Authors: Gary J. Pickering, Sarah Lucas, Catherine E. Klodnicki, Nicole J. Gaudette

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Two taste pheno types that are of interest in the study of habitual diet-related risk factors and disease are 6-n-propylthiouracil (PROP) responsiveness and thermal tasting. Individuals differ considerable in how intensely they experience the bitterness of PROP, which is partially explained by three major single nucleotide polymorphisms associated with the TAS2R38 gene. Importantly, this variable responsiveness is a useful proxy for general taste responsiveness, and links to diet-related disease risk, including body mass index, in some studies. Thermal tasting - a newly discovered taste phenotype independent of PROP responsiveness - refers to the capacity of many individuals to perceive phantom tastes in response to lingual thermal stimulation, and is linked with TRPM5 channels. Thermal tasters (TTs) also experience oral sensations more intensely than thermal non-tasters (TnTs), and this was shown to associate with differences in self-reported food preferences in a previous survey from our lab. Here we report on two related studies, where we sought to determine whether PROP responsiveness and thermal tasting would associate with perceptual differences in the oral sensations elicited by sampled energy-dense foods, and whether in turn this would influence liking. We hypothesized that hyper-tasters (thermal tasters and individuals who experience PROP intensely) would (a) rate sweet and high-fat foods more intensely than hypo-tasters, and (b) would differ from hypo-tasters in liking scores. (Liking has been proposed recently as a more accurate measure of actual food consumption). In Study 1, a range of energy-dense foods and beverages, including table cream and chocolate, was assessed by 25 TTs and 19 TnTs. Ratings of oral sensation intensity and overall liking were obtained using gVAS and gDOL scales, respectively. TTs and TnTs did not differ significantly in intensity ratings for most stimuli (ANOVA). In a 2nd study, 44 female participants sampled 22 foods and beverages, assessing them for intensity of oral sensations (gVAS) and overall liking (9-point hedonic scale). TTs (n=23) rated their overall liking of creaminess and milk products lower than did TnTs (n=21), and liked milk chocolate less. PROP responsiveness was negatively correlated with liking of food and beverages belonging to the sweet or sensory food grouping. No other differences in intensity or liking scores between hyper- and hypo-tasters were found. Taken overall, our results are somewhat unexpected, lending only modest support to the hypothesis that these taste phenotypes associate with energy-dense food liking and consumption through differences in the oral sensations they elicit. Reasons for this lack of concordance with expectations and some prior literature are discussed, and suggestions for future research are advanced.

Keywords: taste phenotypes, sensory evaluation, PROP, thermal tasting, diet-related health risk

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Authors: Daniel Adjei, Mesfin Getachew Ayele, Przemyslaw Wachulak, Andrzej Bartnik, Luděk Vyšín, Henryk Fiedorowicz, Inam Ul Ahad, Lukasz Wegrzynski, Anna Wiechecka, Janusz Lekki, Wojciech M. Kwiatek

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Laser produced plasma light sources, emitting high intensity pulses of X-rays, delivering high doses are useful to understand the mechanisms of high dose effects on biological samples. In this study, a desk-top laser plasma soft X-ray source, developed for radio biology research, is presented. The source is based on a double-stream gas puff target, irradiated with a commercial Nd:YAG laser (EKSPLA), which generates laser pulses of 4 ns time duration and energy up to 800 mJ at 10 Hz repetition rate. The source has been optimized for maximum emission in the “water window” wavelength range from 2.3 nm to 4.4 nm by using pure gas (argon, nitrogen and krypton) and spectral filtering. Results of the source characterization measurements and dosimetry of the produced soft X-ray radiation are shown and discussed. The high brightness of the laser produced plasma soft X-ray source and the low penetration depth of the produced X-ray radiation in biological specimen allows a high dose rate to be delivered to the specimen of over 28 Gy/shot; and 280 Gy/s at the maximum repetition rate of the laser system. The source has a unique capability for irradiation of cells with high pulse dose both in vacuum and He-environment. Demonstration of the source to induce DNA double- and single strand breaks will be discussed.

Keywords: laser produced plasma, soft X-rays, radio biology experiments, dosimetry

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Authors: Hamil Uribe, Cristian Arancibia

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In Chile, the water for irrigation and hydropower generation is delivery essentially through unlined channels on earth, which have high seepage losses. Traditional seepage-abatement technologies are very expensive. The goals of this work were to quantify water loss in unlined channels and select reaches to evaluate the use of linear anionic polyacrylamide (LA-PAM) to reduce seepage losses. The study was carried out in Maule Region, central area of Chile. Water users indicated reaches with potential seepage losses, 45 km of channels in total, whose flow varied between 1.07 and 23.6 m³ s⁻¹. According to seepage measurements, 4 reaches of channels, 4.5 km in total, were selected for LA-PAM application. One to 4 LA-PAM applications were performed at rates of 11 kg ha⁻¹, considering wet perimeter area as basis of calculation. Large channels were used to allow motorboat moving against the current to carry-out LA-PAM application. For applications, a seeder machine was used to evenly distribute granulated polymer on water surface. Water flow was measured (StreamPro ADCP) upstream and downstream in selected reaches, to estimate seepage losses before and after LA-PAM application. Weekly measurements were made to quantify treatment effect and duration. In each case, water turbidity and temperature were measured. Channels showed variable losses up to 13.5%. Channels showing water gains were not treated with PAM. In all cases, LA-PAM effect was positive, achieving average loss reductions of 8% to 3.1%. Water loss was confirmed and it was possible to reduce seepage through LA-PAM applications provided that losses were known and correctly determined when applying the polymer. This could allow increasing irrigation security in critical periods, especially under drought conditions.

Keywords: canal seepage, irrigation, polyacrylamide, water management

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Authors: Reem Alajmi, Hind Al Harbi, Tahany Ayaad, Zainab Al Musawi

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Hard ticks Hyalomma spp. (family: Ixodidae) are obligate ectoparasite in their all life stages on some domestic animals mainly camels and cattle. Ticks may lead to many economic and public health problems because of their blood feeding behavior. Also, they act as vectors for many bacterial, viral and protozoan agents which may cause serious diseases such as tick-born encephalitis, Rocky-mountain spotted fever, Q-fever and Lyme disease which can affect human and/or animals. In the present study, molecular identification of ticks that attack camels in Riyadh region, Saudi Arabia based on the partial sequence of mitochondrial 16s rRNA gene was applied. Also, the present study aims to detect natural infections of collected camel ticks with Rickessia spp. and Borelia spp. using PCR/hybridization of Citrate synthase encoding gene present in bacterial cells. Hard ticks infesting camels were collected from different camels located in a farm in Riyadh region, Saudi Arabia. Results of the present study showed that the collected specimens belong to two species: Hyalomma dromedari represent 99% of the identified specimens and Hyalomma marginatum which account for 1 % of identified ticks. The molecular identification was made through blasting the obtained sequence of this study with sequences already present and identified in GeneBank. All obtained sequences of H. dromedarii specimens showed 97-100% identity with the same gene sequence of the same species (Accession # L34306.1) which was used as a reference. Meanwhile, no intraspecific variations of H. marginatum mesured because only one specimen was collected. Results also had shown that the intraspecific variability between individuals of H. dromedarii obtained in 92 % of samples ranging from 0.2- 6.6%, while the remaining 7 % of the total samples of H. dromedarii showed about 10.3 % individual differences. However, the interspecific variability between H. dromedarii and H. marginatum was approximately 18.3 %. On the other hand, by using the technique of PCR/hybridization, we could detect natural infection of camel ticks with Rickettsia spp. and Borrelia spp. Results revealed the natural presence of both bacteria in collected ticks. Rickettsial spp. infection present in 29% of collected ticks, while 35% of collected specimen were infected with Borrelia spp. The valuable results obtained from the present study are a new record for the molecular identification of camel ticks in Riyadh, Saudi Arabia and their natural infection with both Rickettsia spp. and Borrelia spp. These results may help scientists to provide a good and direct control strategy of ticks in order to protect one of the most important economic animals which are camels. Also results of this project spotlight on the disease that might be transmitted by ticks to put out a direct protective plan to prevent spreading of these dangerous agents. Further molecular studies are needed to confirm the results of the present study by using other mitochondrial and nuclear genes for tick identification.

Keywords: Camel ticks, Rickessia spp. , Borelia spp. , mitochondrial 16s rRNA gene

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Authors: Fakhrosadat Sajjadian

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In the USA, about 5% of women diagnosed with breast cancer annually are affected by Inflammatory Breast Cancer (IBC), which is a highly aggressive type of Locally Advanced Breast Cancer (LABC). It is a type of LABC that is clinically and pathologically different, known for its rapid growth, invasiveness, and ability to promote the growth of blood vessels. Almost all women are found to have lymph nodes affected upon diagnosis, while around 36% show obvious distant metastases. Even with the latest improvements in multimodality therapies, the outlook for patients with IBC remains bleak, as the average disease-free survival time is less than 2.5 years. Recent research on the genetic factors responsible for the IBC phenotype has resulted in the discovery of genes that play a role in the advancement of this illness. The development of primary human cell lines and animal models has assisted in this research. These advancements offer new possibilities for future actions in identifying and treating IBC.

Keywords: breast cancer, inflammation, diagnosis, IBC, LABC

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Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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Effective management of hypertension remains a critical public health challenge, particularly among racially and ethnically diverse populations. This study employs sophisticated statistical models to rigorously investigate the predictors of poor blood pressure (BP) control, with a specific focus on demographic, socioeconomic, and clinical risk factors. Leveraging a large sample of 19,253 adults drawn from the National Health and Nutrition Examination Survey (NHANES) across three distinct time periods (2013-2014, 2015-2016, and 2017-2020), we applied multivariable logistic regression and generalized estimating equations (GEE) to account for the clustered structure of the data and potential within-subject correlations. Our multivariable models identified significant associations between poor BP control and several key predictors, including race/ethnicity, age, gender, body mass index (BMI), prevalent diabetes, and chronic kidney disease (CKD). Non-Hispanic Black individuals consistently exhibited higher odds of poor BP control across all periods (OR = 1.99; 95% CI: 1.69, 2.36 for the overall sample; OR = 2.33; 95% CI: 1.79, 3.02 for 2017-2020). Younger age groups demonstrated substantially lower odds of poor BP control compared to individuals aged 75 and older (OR = 0.15; 95% CI: 0.11, 0.20 for ages 18-44). Men also had a higher likelihood of poor BP control relative to women (OR = 1.55; 95% CI: 1.31, 1.82), while BMI ≥35 kg/m² (OR = 1.76; 95% CI: 1.40, 2.20) and the presence of diabetes (OR = 2.20; 95% CI: 1.80, 2.68) were associated with increased odds of poor BP management. Further analysis using GEE models, accounting for temporal correlations and repeated measures, confirmed the robustness of these findings. Notably, individuals with chronic kidney disease displayed markedly elevated odds of poor BP control (OR = 3.72; 95% CI: 3.09, 4.48), with significant differences across the survey periods. Additionally, higher education levels and better self-reported diet quality were associated with improved BP control. College graduates exhibited a reduced likelihood of poor BP control (OR = 0.64; 95% CI: 0.46, 0.89), particularly in the 2015-2016 period (OR = 0.48; 95% CI: 0.28, 0.84). Similarly, excellent dietary habits were associated with significantly lower odds of poor BP control (OR = 0.64; 95% CI: 0.44, 0.94), underscoring the importance of lifestyle factors in hypertension management. In conclusion, our findings provide compelling evidence of the complex interplay between demographic, clinical, and socioeconomic factors in predicting poor BP control. The application of advanced statistical techniques such as GEE enhances the reliability of these results by addressing the correlated nature of repeated observations. This study highlights the need for targeted interventions that consider racial/ethnic disparities, clinical comorbidities, and lifestyle modifications in improving BP control outcomes.

Keywords: hypertension, blood pressure, NHANES, generalized estimating equations

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Authors: Rafeza Begum, Mohammad Mokhlesur Rahman, Safikul Moula, Rafiqul Islam

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Potassium (K) is crucial for healthy soil and plant growth. However, K fertilization is either disregarded or poorly underutilized in Bangladesh agriculture, despite the great demand for crops. This could eventually result in a significant depletion of the soil's potassium reserves, irreversible alteration of the minerals that contain potassium, and detrimental effects on crop productivity. Soil K mining in Bangladesh is a worrying problem, and we need to evaluate it thoroughly and find remedies. A pot culture experiment was conducted in the greenhouse of Bangladesh Institute of Nuclear Agriculture (BINA) using eleven soil series of Bangladesh in order to see the depletion behaviour of potassium (K) by continuous cropping using rice (var. Iratom-24) as the test crop. The soil series were Ranishankhail, Kaonia. Sonatala, Silmondi, Gopalpur, Ishurdi, Sara, Kongsha, Nunni, Lauta and Amnura on which four successive rice plants (45 days duration) were raised with (100 ppm K) or without addition of potassium. Nitrogen, phosphorus, sulfur and zinc were applied as basal to all pots. Potassium application resulted in higher dry matter yield, increased K concentration and uptake in all the soils compared with no K treatment; which gradually decreased in the subsequent harvests. Furthermore, plant takes up K not only from exchangeable pool but also from non-exchangeable sites and a minimum replenishment of K from the soil reserve was observed. Continuous cropping has resulted in the depletion of available K of the soil. The result indicated that in order to sustain higher crop yield under intensive cultivation, the addition of potash fertilizer is necessary.

Keywords: potassium, exchangeable pool, depletion behavior., Soil series

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Authors: Mustafa Cam, Nedim Ongun, Ufuk Kutluana

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Introduction: Restless LegsSyndrome (RLS) is a common, under-recognized disorder disrupts sleep and diminishes quality of life (1). The most common conditions highly associated with RLS include renalfailure, iron and folic acid deficiency, peripheral neuropathy, pregnancy, celiacdisease, Crohn’sdiseaseandrarelymalignancy (2).Despite a clear relation between low peripheral iron and increased prevalence and severity of RLS, the prevalence and clinical significance of RLS in iron-deficientanemic populations is unknown (2). We report here a case of RLS due to iron deficiency in the setting of neuroendocrinetumor. Report of Case: A 35 year-old man was referred to our clinic with general weakness, weight loss (10 kg in 2 months)and 2-month history of uncomfortable sensations in his legs with urge to move, partially relieved by movement. The symptoms were presented very day, worsening in the evening; the discomfort forced the patient to getup and walk around at night. RLS was severe, with a score of 22 at the International RLS ratingscale. The patient had no past medical history. The patient underwent a complete set of blood analyses and the following ab normal values were found (normal limitswithinbrackets): hemoglobin 9.9 g/dl (14-18), MCV 70 fL (80-94), ferritin 3,5 ng/mL (13-150). Brain and spinemagnetic resonance imaging was normal. The patient consultated with gastroenterology clinic and gastointestinal systemendoscopy was performed for theetiology of the iron deficiency anemia. After the gastricbiopsy, results allowed us to reach the diagnosis of neuroen docrine tumor and the patient referred to oncology clinic. Discussion: The first important consideration from this case report is that the patient was referred to our clinic because of his severe RLS symptoms dramatically reducing his quality of life. However, our clinical study clearly demonstrated that RLS was not the primary disease. Considering the information available for this patient, we believe that the most likely possibility is that RLS was secondary to iron deficiency, a very well-known and established cause of RLS in theliterature (3,4). Neuroendocrine tumors (NETs) are rare epithelial neoplasms with neuroendocrine differentiation that most commonly originate in the lungs and gastrointestinal tract (5). NETs vary widely in their clinical presentation; symptoms are often nonspecific and can be mistaken for those of other more common conditions (6). 50% of patients with reported disease stage have either regional or distant metastases at diagnosis (7). Accurate and earlier NET diagnosis is the first step in shortening the time to optimal care and improved outcomes for patients (8). The most important message from this case report is that RLS symptoms can sometimes be thesign of a life-threatening condition. Conclusion: Careful and complete collection of clinical and laboratory data should be carried out in RLS patients. Inparticular, if RLS onset coincides with weight loss and iron deficieny anemia, gastricendos copy should be performed. It is known about that malignancy is a rare etiology in RLS patients and to our knowledge; it is the first case with neuro endocrine tumor presenting with RLS.

Keywords: neurology, neuroendocrine tumor, restless legs syndrome, sleep

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Authors: Ching-Ling Lin, Li-Chi Huang, Yao-Tsung Chang, Ruey-Yu Chen, Shwu-Huey Yang

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Introduction & Purpose: Diabetes and its related complications always been a major part of medical cost in Taiwan. To patient with diabetes, self-management blood sugar, improving a healthy lifestyle are the most important thing to avoid getting worse. The aim of this study was to explore the trend of the changing in blood glucose within intervention and followed-up periods of patients who participated in the health coaching program between 2017 and 2020. Design & Methods: The data was combined from two diabetes health coaching program. The intervention group had health coaching and usual care for 6 months, whereas the control had usual care only. The main outcome variables were HbA1c level at baseline, 3, 6, 9, and 12 months. Results: In total, the data were available for 99 patients in the coaching intervention group and for 88 patients in the control group, the dropout rate during the follow-up period is about 18%. Of 187 participants, 54% were female, mean age was 61.5 years (SD=10.19), only 32.1% had a bachelor’s degree or higher, and the mean duration of diabetes treatment at Cathay General Hospital was 9.9 years. Within 12 months, the intervention group had a significant decrease of 0.65% (SD=1.05) in HbA1c level, and a non-significant decrease of 0.13%(SD=0.96) was observed in the control group. The figure showed the effect was the most significant in the first three months of the intervention and can be maintained for up to six months after the intervention was over. The HbA1c values of the two groups at each follow-up point are significantly different. In addition, there were non-significant correlation between HbA1c and gender, age, and educational level. Conclusion: Health coaching might be an effective way to enhance self-management for patients with diabetes and improving their blood sugar control in Taiwan.

Keywords: diabetes, health coaching, HbA1c, self-management

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Authors: Seyedeh Faranak Baniahmad, Soroor Yousefi

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Osteoporosis is a bone disease which increases the bone fracture risk, reduces the bone mineral density (BMD) and alters the amount and variety of proteins in bones. Antiresorptive therapy is one the most popular Osteoporosis treatment methods. In this method the bisphosphonates, hormones, calcitonin or the selective estrogen receptor modulators is replaced. In order to reduce undesirable effects and to increase the bioavailability of drug agents, the controlled drug delivery systems have been utilized. In current study, the controlled release of Alendronate from LDH-PCL with (0, 5, 10, 15 % wt. of LDH) was investigated. The results showed that the release of alendronate from the lamellar LDH incorporated into the PCL matrix is much slower than the release of alendronate from the PCL. Therefore such systems are very promising, in which the antiresorptive drug has to remain in the matrix for longer time and can be released in controlled manner.

Keywords: osteoporosis, alendronate, poly (ε–caprolactone), layered double hydroxide

Procedia PDF Downloads 398

Authors: Ibrahim A. Alhammad, Suleiman A. Al-Otaibi, Khalid S. Al-Gahtani, Naïf Al-Otaibi, Abdulaziz A. Bubshait

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In the last decade, the use of project delivery system of design build engineering contracts is increasing in North America due to the reasons of reducing the project duration and minimizing costs. The shift from traditional approach of Design-Bid-Build to Design-Build contracts have been attributed to many factors such as evolution of the regulatory and legal frameworks governing the engineering contracts and improvement in integrating design and construction. The aforementioned practice of contracting is more appropriate in North America; yet, it may not be the case in Saudi Arabia where the traditional approach of construction contracting remains dominant. The authors believe there are number of factors related to the gaps in the level of sophistication of the engineering and management of the construction projects in both countries. A step towards improving the Saudi construction practice by adopting the new trend of construction contracting, this paper identifies the reasons why Design/Build form of contracting are not frequently utilized. A field survey, which includes the questionnaire addressing the research problem, is distributed to three main parties of the construction contracts: clients, consultants, and contractors. The analyzed collected data were statistically sufficient to finding the reasons of not adopting the new trend of good practice of deign build approach in Saudi Arabia. In addition, the reasons are: (1) lack of regulation and legal framework; (2) absence of clear criteria of the owner for the trade-off between competing contractors, (3) and lack of experience, knowledge and skill.

Keywords: design built projects, Saudi Arabia, GCC, mega projects

Procedia PDF Downloads 223

Authors: Hirokatsu Kawashima

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In an attempt to elucidate relationships between listening to music and pronunciation learning, a classroom-based investigation was conducted with Japanese EFL learners (n=45). The subjects were instructed to listen to English songs they liked on YouTube, especially paying attention to phonologically similar vowel and consonant minimal pair words (e.g., live and leave). This kind of activity, which included taking notes, was regularly carried out in the classroom, and the same kind of task was given to the subjects as homework in order to reinforce the in-class activity. The duration of these activities was eight weeks, after which the program was evaluated on a 9-point scale (1: the lowest and 9: the highest) by learners’ self-evaluation. The main questions for this evaluation included 1) how good the learners had been at pronouncing vowel and consonant minimal pair words originally, 2) how often they had listened to songs good for pronouncing vowel and consonant minimal pair words, 3) how frequently they had moved their mouths to vowel and consonant minimal pair words of English songs, and 4) how much they thought the program would support and enhance their pronunciation learning of phonologically similar vowel and consonant minimal pair words. It has been found, for example, A) that the evaluation of this program is by no means low (Mean: 6.51 and SD: 1.23), suggesting that listening to music may support and enhance pronunciation learning, and B) that listening to consonant minimal pair words in English songs and moving the mouth to them are more related to the program’s evaluation (r =.69, p=.00 and r =.55, p=.00, respectively) than listening to vowel minimal pair words in English songs and moving the mouth to them (r =.45, p=.00 and r =.39, p=.01, respectively).

Keywords: minimal pair, music, pronunciation, song

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Authors: M. Kuzhko, M. Gumeniuk, D. Butov, T. Tlustova, O. Denysov, T. Sprynsian

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Background: The aim of the research was to determine the effectiveness of chemotherapy using intravenous antituberculosis drugs compared with their oral administration during the intensive phase of treatment. Methods: 152 tuberculosis patients were randomized into 2 groups: Main (n=65) who received isoniazid, ethambutol and sodium rifamycin intravenous + pyrazinamide per os and control (n=87) who received all the drugs (isoniazid, rifampicin, ethambutol, pyrazinamide) orally. Results: After 2 weeks of treatment symptoms of intoxication disappeared in 59 (90.7±3.59 %) of patients of the main group and 60 (68.9±4.9 %) patients in the control group, p<0.05. The mean duration of symptoms of intoxication in patients main group was 9.6±0.7 days, in control group – 13.7±0.9 days. After completing intensive phase sputum conversion was found in all the patients main group and 71 (81.6±4.1 %) patients control group p < 0.05. The average time of sputum conversion in main group was 1.6±0.1 months and 1.9±0.1 months in control group, p > 0.05. In patients with destructive pulmonary tuberculosis time to sputum conversion was 1.7±0.1 months in main group and 2.2±0.2 months in control group, p < 0.05. The average time of cavities healing in main group was 2.9±0.2 months and 3.9±0.2 months in the control group, p < 0.05. Conclusions: In patients with newly diagnosed destructive pulmonary tuberculosis use of isoniazid, ethambutol and sodium rifamycin intravenous in the intensive phase of chemotherapy resulted in a significant reduction in terms of the disappearance of symptoms of intoxication and sputum conversion.

Keywords: intravenous chemotherapy, tuberculosis, treatment efficiency, tuberculosis drugs

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Authors: Fadzil Ahmad, Noor Ashidi Mat Isa

Abstract:

This study introduces an improved genetic algorithm procedure that focuses search around near optimal solution corresponded to a group of elite chromosome. This is achieved through a novel crossover technique known as Segmented Multi Chromosome Crossover. It preserves the highly important information contained in a gene segment of elite chromosome and allows an offspring to carry information from gene segment of multiple chromosomes. In this way the algorithm has better possibility to effectively explore the solution space. The improved GA is applied for the automatic and simultaneous parameter optimization and feature selection of artificial neural network in pattern recognition of medical problem, the cancer and diabetes disease. The experimental result shows that the average classification accuracy of the cancer and diabetes dataset has improved by 0.1% and 0.3% respectively using the new algorithm.

Keywords: genetic algorithm, artificial neural network, pattern clasification, classification accuracy

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Authors: A. Amidah Amrawaty, M. Saleh S. Ali, Darmawan Salman

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The aim of this study was to identify local and non local knowledge in Bali cattle development, to analyze the contestation between local and non-local knowledge. The paradigm used was constructivism paradigm with a qualitative approach. descriptive type of research using case study method. The study was conducted in four villages subjected to Agropolitan Program, i.e. Palakka, Tompo, Galung and Anabanua in Barru District, province of South Sulawesi. The results indicated that the local knowledge of the farmers were: a) knowledge of animal housing, b) knowledge of the prevention and control disease, c) knowledge of the feed, d) knowledge of breed selection, e) knowledge of sharing arrangement, f) knowledge of marketing, Generally, there are three patterns of knowledge contestation namely coexistence, ‘zero sum game’ and hybridization but in this research only coexistence and zero sum game patterns took place, while the pattern of hybridization did not occur.

Keywords: contestation, local knowledge, non-local knowledge, developing of Bali cattle

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Authors: Violina Angelova, Stefan Krustev

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The aim of this work was to evaluate the effectiveness of different soil test extractants for the determination of available soil phosphorus in five internationally certified standard soils, sludge and clay (NCS DC 85104, NCS DC 85106, ISE 859, ISE 952, ISE 998). The certified samples were extracted with the following methods/extractants: CaCl₂, CaCl₂ and DTPA (CAT), double lactate (DL), ammonium lactate (AL), calcium acetate lactate (CAL), Olsen, Mehlich 3, Bray and Kurtz I, and Morgan, which are commonly used in soil testing laboratories. The phosphorus in soil extracts was measured colorimetrically using Spectroquant Pharo 100 spectrometer. The methods used in the study were evaluated according to the recovery of available phosphorus, facility of application and rapidity of performance. The relationships between methods are examined statistically. A good agreement of the results from different soil test was established for all certified samples. In general, the P values extracted by the nine extraction methods significantly correlated with each other. When grouping the soils according to pH, organic carbon content and clay content, weaker extraction methods showed analogous trends; also among the stronger extraction methods, common tendencies were found. Other factors influencing the extraction force of the different methods include soil: solution ratio, as well as the duration and power of shaking the samples. The mean extractable P in certified samples was found to be in the order of CaCl₂ < CAT < Morgan < Bray and Kurtz I < Olsen < CAL < DL < Mehlich 3 < AL. Although the nine methods extracted different amounts of P from the certified samples, values of P extracted by the different methods were strongly correlated among themselves. Acknowledgment: The financial support by the Bulgarian National Science Fund Projects DFNI Н04/9 and DFNI Н06/21 are greatly appreciated.

Keywords: available soil phosphorus, certified samples, determination, soil test extractants

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Authors: Joel Mintz, Kyle Huntley, Waseem Wahood, Samuel Raine, Farzanna Haffizulla

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The effect of different state government interventions on COVID-19 health outcomes is currently unknown. Stay at home (SAH) orders, all non-essential business closures and school closures in the Northeastern US were examined. A linear correlation between the peak number of new daily COVID-19 positive tests, hospitalizations and deaths per capita and the elapsed time between government issued guidance and a fixed number of COVID-19 deaths in each state was performed. Earlier government interventions were correlated with lower peak healthcare burden. Statewide closures of schools and non-essential businesses showed significantly greater (p<.001) correlation to peak COVID-19 disease burden as compared to a statewide SAH. The implications of these findings require further study to determine the effectiveness of these interventions.

Keywords: Coronavirus, epidemiology, government intervention, public health, social distancing

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Authors: Chang Liu, Hanwen Zhang, Vikash Sharma, Don Eliseo Lucerno-Prisno III, Emmanuel Yujuico, Maulik Chokshi, Prashanthi Krishnakumar, Bach Xuan Tran, Giang Thu Vu, Kamilla Anna Pinter, Shenglan Tang

Abstract:

Background and Aims: Globally, many health systems focus on hospital-based healthcare models targeting acute care and disease treatment, which are not effective in addressing the challenges of ageing populations, chronic conditions, multi-morbidities, and increasingly unhealthy lifestyles. Recently, integrated care programs on chronic diseases have been developed, piloted, and implemented to meet such challenges. However, integrated care programs in the Asia-Pacific region vary in the levels of integration from linkage to coordination to full integration. This study aims to identify and analyze existing cases of integrated care in the Asia-Pacific region and identify the facilitators and barriers in order to improve existing cases and inform future cases. Methods: The study is a comparative study, with a combination approach of desk-based research and key informant interviews. The selected countries included in this study represent a good mix of lower-middle income countries (the Philippines, India, Vietnam, and Fiji), upper-middle income country (China), and high-income country (Singapore) in the Asia-Pacific region. Existing integrated care programs were identified through the scoping review approach. Trigger, history, general design, beneficiaries, and objectors were summarized with barriers and facilitators of integrated care based on key informant interviews. Representative case(s) in each country were selected and comprehensively analyzed through deep-dive case studies. Results: A total of 87 existing integrated care programs on chronic diseases were found in all countries, with 44 in China, 21 in Singapore, 12 in India, 5 in Vietnam, 4 in the Philippines, and 1 in Fiji. 9 representative cases of integrated care were selected for in-depth description and analysis, with 2 in China, the Philippines, and Vietnam, and 1 in Singapore, India, and Fiji. Population aging and the rising chronic disease burden have been identified as key drivers for almost all the six countries. Among the six countries, Singapore has the longest history of integrated care, followed by Fiji, the Philippines, and China, while India and Vietnam have a shorter history of integrated care. Incentives, technologies, education, and performance evaluation would be crucial for developing strategies for implementing future programs and improve already existing programs. Conclusion: Integrated care is important for addressing challenges surrounding the delivery of long-term care. To date, there is an increasing trend of integrated care programs on chronic diseases in the Asia-Pacific region, and all six countries in our study set integrated care as a direction for their health systems transformation.

Keywords: integrated healthcare, integrated care delivery, chronic diseases, Asia-Pacific region

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Authors: Abdu Zakari, Said Jibrin, Fatope Majekodunmi Oladeji, Mohammed Hassan Shagga, Andrew Sule

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From the Stems of Bark of Echinaceae angustifolia DC three known triterpenes 3a,5,5b,8,8,11a-hexamethyl-1-(prop-1-en-2-yl)icosahydro-1H-cyclopenta[a]chrysene-9-yl acetate (lupeol acetate), 4,4,6a,6b,8a,10,11,14b,octamethyl1,1,2,3,4,4a,5,6,6a,6b,7,8,8a, 9,10, 11,12,12a,14,14a,14b-icosahydropicen-3-yl acetate (derivative of β-amyrin and 9- hydroxy-1-isopropenyl-5a,5b,8,8,11a-pentamethyl-icosahydro-cyclopenta[a]chrysene- 3a-carboxylic acid (betulinic acid), labelled as Ea-7-38, Ea-9-10 and Ea-12-85) were isolated and characterized. All isolates were tested for their cytotoxicities against Artemia salina (brine shrimp larvae). Compound Ea-12-85 exhibited potent cytotoxic activity against the Artemia salina, Ea-7-38, Ea-9-10 were found to be non-toxic in the cytotoxicity test. The result of the study has justified the claim of the traditional medicine practitioners in Girei for the treatment of complicated malaria disease using the stem bark of E. angustifolia DC.

Keywords: cytotoxic, terpenes, Echinaceae angustifolia, brine shrimp, artemia salina

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Authors: Dilek Zorlu Kaya, Sena Çenesiz, Utku Duran

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Infectious pancreatic necrosis virus is a disease of great concern in aquaculture, causing mortality of 80 - 90% of the stocks in salmonid production. We aimed to investigate the efficacy of quercetin on oxidant and antioxidant parameters of infectious pancreatic necrosis virus, which is important for fish farming and economy in vitro. Quercetin experimental model was used in the cell culture of Oncorhynchus mykiss infected with infectious pancreatic necrosis virus. Malondialdehyde, ceruloplasmin, total oxidant capacity, total antioxidant levels, and glutathione-peroxidase were measured in the samples. As a result of the study, it was observed that quercetin can minimize the damage caused by scavenging free radicals in cells infected with infectious pancreatic necrosis virus. Thus, we think that an important development can be achieved for fish farming and the economy.

Keywords: IPNV, oncorhynchus mykiss, TAS, TOS, quercetin

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Authors: Yan Lyu

Abstract:

Japanese degree adverbs can be explained in different ways, which is hard for Japanese learners to comprehend. For instance, when ‘tyotto’ is used as a degree word, it can be interpreted literally or not. In the sentence ‘Ano mise, tyotto oishi yo. zehi iku to ii yo.’, ‘tyotto’ can be interpreted as a high degree contextually. Despite pragmatic factors, phonetics factors can also affect the interpretation of such ‘tyotto’. Concentrating on the pattern of ‘tyotto +adjective’, the paper aims to investigate the correlation between the interpretation of ‘tyotto’ and the phonetic factors in some specific contexts based on a listening experiment via PRAAT. It is also investigated that how the phonetic factors affect the interpretation of high degree adverbs, including ‘soutou’ , ‘totemo’ , ‘kanari’ and ‘sugoku’. In the experiment, Japanese speakers listened to sentences which were composed of degree adverbs and adjectives in different intonations and judged which degree the sentences expressed. Two conclusions can be drawn from the experiment results. Firstly, for adverbs expressing a high degree, in the pattern of ‘degree adverb + adjective’, either degree adverb or adjective is pronounced in a higher pitch, or both are highly pronounced, a higher degree can be expressed. Besides, with the insertion of geminate consonant and the extension of the vowel, the longer the duration of the degree adverb becomes, the higher degree can be expressed. Secondly, for ‘tyotto’, which expresses a low degree, the interpretation will be influenced by both phonetic and contextual factors. Phonetically, there are three factors causing ‘tyotto’ to be interpreted as a common degree or a high degree. The three factors are the high pitch of the modified adjective, the extended silence period of the geminate consonant and the change in the intonations of ‘tyotto’. In some contexts just like the comparison sentences, no matter how ‘tyotto + adjective’ is pronounced, ‘tyotto’ tends to be interpreted as a low degree literally.

Keywords: contextual interpretation, Japanese degree adverbs, phonetic interpretation, PRAAT

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Authors: Kibbeum Na

Abstract:

Previous gamification research has produced mixed results regarding the effectiveness of gamified learning. One possible explanation for this is that individuals perceive the game elements differently. Cognitive Evaluation Theory posits that external rewards can boost or undermine intrinsic motivation, depending on whether the rewards are perceived as informational or controlling. This research tested the hypothesis that game elements can be perceived as either informational feedback or external reward, and the motivational impact differ accordingly. An experiment was conducted using an educational math puzzle to compare the motivation and performance as a result of different perceived affordances game elements. Participants were primed to perceive the game elements as either informational feedback or external reward, and the duration of an attempt to solve the unsolvable puzzle – amotivation indicator – and the puzzle score – a performance indicator–were measured with the game elements incorporated and then without the game elements. Badges and points were deployed as the main game elements. Results showed that, regardless of priming, a significant decrease in performance occurred when the game elements were removed, whereas the control group who solved non-gamified math puzzles maintained their performance. The undermined performance with gamification removal indicates that learners may perceive some game elements as controlling factors irrespective of the way they are presented. The results of the current study also imply that some game elements are better not being implemented to preserve long-term performance. Further research delving into the extrinsic reward-like nature of game elements and its impact on learning motivation is called for.

Keywords: cognitive Evaluation Theory, game elements, gamification, motivation, motivational affordance, performance

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Authors: Narin Salehiyan, Ramin Ghasemi Shayan

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The largest genus of plant viruses, the potyvirus, is responsible for significant crop losses. Potyviruses are aphid sent in a nonpersistent way, and some of them are likewise seed communicated. As significant microorganisms, potyviruses are substantially more examined than other plant infections having a place with different genera, and their review covers numerous parts of plant virology, like utilitarian portrayal of viral proteins, sub-atomic communication with hosts and vectors, structure, scientific classification, development, the study of disease transmission, and determination. Biotechnological utilizations of potyviruses are likewise being investigated. During this last ten years, significant advances have been made in the comprehension of the sub-atomic science of these infections and the elements of their different proteins. Potyvirus multiplication, movement, and transmission, as well as potyvirus/plant compatible interactions, including pathogenicity and symptom determinants, are updated following a general overview of the family Potyviridae and the potyviral proteins. it end the survey giving data on biotechnological uses of potyviruses.

Keywords: virology, poty, virus, genome, genetic

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Authors: Nam Sze Cheng, P. C. Janita Chau

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Background: Eczema is a chronic inflammatory disease with high global prevalence rates in many childhood populations. It is also the most common paediatric skin problem. Although eczema education and proper skin care were effective in controlling eczema symptoms, the lack of both sufficient time for patient consultation and structured eczema education programme hindered the transferability of knowledge to patients and their parents. As a result, these young patients and their families suffer from a significant physical disability and psychological distress, which can substantially impair their quality of life. Objectives: This integrative review is to examine the effects of educational interventions for children with eczema and identify the core elements associated with an effective intervention. Methods: This integrative review targeted all articles published in 10 databases between May 2016 and February 2017 that reported the outcomes of disease interventions of any format for children and adolescents with the clinical diagnosis of eczema who were under 18 years of age. Five randomized controlled trials (RCT) and one systematic review of 10 RCTs were identified for review. All these publications had high methodological quality, except one study of web-based eczema education that was limited by selection bias and poor subject blinding. Findings: This review found that most studies adopted nurse-led or multi-disciplinary parental eczema education programme at the outpatient clinic setting. The format of these programmes included individual lectures, demonstration and group sharing, and the educational materials covered basic eczema knowledge and management as well as methods to interrupt itch-scratch cycle. The main outcome measures of these studies included severity of eczema symptoms, treatment adherence and quality of life of both patients and their families. Nine included studies reported statistically significant improvement in the primary outcome of symptom severity of these eczematous children. On the other hand, all these reviews failed to identify an effective dosage of intervention under these educational programmes that was attributed to the heterogeneity of the interventions. One study that was designed based on the social cognitive theory to guide the interventional content yielded statistically significant results. The systematic review recommended the importance of measuring parental self-efficacy. Implication: This integrative review concludes that structured educational programme can help nurses understand the theories behind different health interventions. They can then deliver eczema education to their patients in a consistent manner. These interventions also result in behavioral changes through patient education. Due to the lack of validated educational programmes in Chinese, it is imperative to conduct an RCT of eczema educational programme to investigate its effects on eczema severity, quality of life and treatment adherence in Hong Kong children as well as to promote the importance of parental self-efficacy.

Keywords: children, eczema, education, intervention

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Authors: Mohd Yussni Hashim, Mohd Nazrul Roslan, Shahruddin Mahzan Mohd Zin, Saparudin Ariffin

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Fiber cross-sectional area value is a crucial factor in determining the strength properties of natural fiber. Furthermore, unlike synthetic fiber, a diameter and cross-sectional area of natural fiber has a large variation along and between the fibers. This study aims to determine the main and interaction effects of alkali treatment conditions that influence kenaf bast fiber mean cross-sectional area. Three alkali treatment conditions at two different levels were selected. The conditions setting were alkali concentrations at two and ten w/v %; fiber immersed temperature at room temperature and 1000C; and fiber immersed duration for 30 and 480 minute. Untreated kenaf fiber was used as a control unit. Kenaf bast fiber bundle mounting tab was prepared according to ASTM C1557-03. The cross-sectional area was measured using a Leica video analyzer. The study result showed that kenaf fiber bundle mean cross-sectional area was reduced 6.77% to 29.88% after alkali treatment. From the analysis of variance, it shows that the interaction of alkali concentration and immersed time has a higher magnitude at 0.1619 compared to alkali concentration and immersed temperature interaction that was 0.0896. For the main effect, alkali concentration factor contributes to the higher magnitude at 0.1372 which indicated the decrease pattern of variability when the level changed from lower to the higher level. Then, it was followed by immersed temperature at 0.1261 and immersed time at 0.0696 magnitudes.

Keywords: natural fiber, kenaf bast fiber bundles, alkali treatment, cross-sectional area

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Authors: Rubaiyea Uddin

Abstract:

The hippocampus, located in the limbic system, is most commonly known for its role in memory and spatial navigation (as cited in Brain Reward and Pathways). It maintains an especially important role in specifically episodic and declarative memory. The hippocampus has also recently been linked to dopamine, the reward pathway’s primary neurotransmitter. Since research has found that dopamine also contributes to memory consolidation and hippocampal plasticity, this neurotransmitter is potentially responsible for contributing to the hippocampus’s role in memory formation. In this experiment we tested to see the effect of tactile cues on spatial navigation for eight different mice. We used a radial arm that had one designated 'reward' arm containing sucrose. The presence or absence of bedding was our tactile cue. We attempted to see if the memory of that cue would enhance the mice’s memory of having received the reward in that arm. The results from our study showed there was no significant response from the use of tactile cues on spatial navigation on our 129 mice. Tactile cues therefore do not influence spatial navigation.

Keywords: mice, radial arm maze, memory, spatial navigation, tactile cues, hippocampus, reward, sensory skills, Alzheimer’s, neurodegnerative disease

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