Search results for: diversity and tirunesh beijing hospital

Authors: Emmanouil Papavasileiou, Nikos Bozionelos, Liza Howe-Walsh, Sarah Turnbull

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Purpose: The research focuses on women academics’ insecure identity at work and examines its link with generational identity. The aim is to enrich understanding of identities at work as a crucial attribute of managing academics in the context of the proliferation of managerialist controls of audit, accountability, monitoring, and performativity. Methodology: Positivist quantitative methodology was utilized. Data were collected from the Scientific Women's Academic Network (SWAN) Charter. Responses from 155 women academics based in the British Higher Education system were analysed. Findings: Analysis showed high prevalence of strong imposter feelings among participants, suggesting high insecurity at work among women academics in the United Kingdom. Generational identity was related to imposter feelings. In particular, Millennials scored significantly higher than the other generational groups. Research implications: The study shows that imposter feelings are variously manifested among the prevalent generations of women academics, while generational identity is a significant antecedent of such feelings. Research limitations: Caution should be exercised in generalizing the findings to national cultural contexts beyond the United Kingdom. Practical and social implications: Contrary to popular depictions of Millennials as self-centered, narcissistic, materialistic and demanding, women academics who are members of this generational group appear significantly more insecure than the preceding generations. Value: The study provides insightful understandings into women academics’ identity at work as a function of generational identity, and provides a fruitful avenue for further research within and beyond this gender group and profession.

Keywords: academics, generational diversity, imposter feelings, United Kingdom, women, work identity

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Authors: Carol S. Binnekade, Deon Scott, Christina C. Shuttleworth, Annelien A. Van Rooyen

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Higher education institutions are constantly challenged to deliver skilled graduates into the workplace. Employers expect graduates to have the required technical knowledge as well as various pervasive skills. This also applies to accountants who need to know the technical requirements of financial reporting and be able to communicate with individuals, teams and clients at a high level. Accountants need to develop effective business conversational skills and use these skills to communicate up, down and across organizations, taking into consideration cultural and gender diversity. In addition, they need to master business writing and presentation skills. However, providing students with these skills in a distance-learning environment where interaction between students and instructors is limited, is a challenge for academics. The study on which this paper reports, forms part of a larger body of research, which explored the perceptions of accounting practitioners of the communication skills (or lack thereof) of recently qualified accounting students. Feedback (qualitative and quantitative) was obtained from various accounting practitioners in South Africa. Taking into consideration that distance learners communicate mainly with their instructors via email communication and their assignments are submitted using various word processor software, the researchers were of the opinion that the accounting graduates would be capable of communicating effectively once they entered the workplace. However, the research findings, inter alia, suggested that the accounting graduates lacked communication skills and that training was needed to differentiate between business and social communication once they entered the workplace. Recommendations on how these communication challenges may be addressed by higher education institutions are provided.

Keywords: accounting practitioners, communication skills, distance education, pervasive skills

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Authors: Aminu Bashir Mohammad, Agwu Ezera, Abdulrazaq G. Habib, Garba Iliyasu

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Background: Drug resistance tuberculosis (DR-TB) continues to be a challenge in developing countries with poor resources. Routine screening for primary DR-TB before commencing treatment is not done in public hospitals in Nigeria, even with the large body of evidence that shows a high prevalence of primary DR-TB. Data on drug resistance and its genetic determinant among follow up TB patients is lacking in Nigeria. Hence the aim of this study was to determine the prevalence and genetic determinant of drug resistance among follow up TB patients in a tertiary hospital in Nigeria. Methods: This was a cross-sectional laboratory-based study conducted on 384 sputum samples collected from consented follow-up tuberculosis patients. Standard microbiology methods (Zeil-Nielsen staining and microscopy) and PCR (Line Probe Assay)] were used to analyze the samples collected. Person’s Chi-square was used to analyze the data generated. Results: Out of three hundred and eighty-four (384) sputum samples analyzed for mycobacterium tuberculosis (MTB) and DR-TB twenty-five 25 (6.5%) were found to be AFB positive. These samples were subjected to PCR (Line Probe Assay) out of which 18(72%) tested positive for DR-TB. Mutations conferring resistance to rifampicin (rpo B) and isoniazid (katG, and or inhA) were detected in 12/18(66.7%) and 6/18(33.3%), respectively. Transmission dynamic of DR-TB was not significantly (p>0.05) dependent on demographic characteristics. Conclusion: There is a need to strengthened the laboratory capacity for diagnosis of TB and drug resistance testing and make these services available, affordable, and accessible to the patients who need them.

Keywords: drug resistance tuberculosis, genetic determinant, intensive phase, Nigeria

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Authors: Christina Killian, Katie Wall, Séamus Fanning, Guerrino Macori

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Deep-level metagenomics offers a useful technical approach to explore the three dynamic One Health axes: healthcare, domiciliary and veterinary. There is currently limited understanding of the composition of complex biofilms, natural abundance of AMR genes and gene transfer occurrence in these ecological niches. By using a newly established small-scale complex biofilm model, COMBAT has the potential to provide new information on microbial diversity, antimicrobial resistance (AMR)-encoding gene abundance, and their transfer in complex biofilms of importance to these three One Health axes. Shotgun metagenomics has been used to sample the genomes of all microbes comprising the complex communities found in each biofilm source. A comparative analysis between untreated and biocide-treated biofilms is described. The basic steps include the purification of genomic DNA, followed by library preparation, sequencing, and finally, data analysis. The use of long-read sequencing facilitates the completion of metagenome-assembled genomes (MAG). Samples were sequenced using a PromethION platform, and following quality checks, binning methods, and bespoke bioinformatics pipelines, we describe the recovery of individual MAGs to identify mobile gene elements (MGE) and the corresponding AMR genotypes that map to these structures. High-throughput sequencing strategies have been deployed to characterize these communities. Accurately defining the profiles of these niches is an essential step towards elucidating the impact of the microbiota on each niche biofilm environment and their evolution.

Keywords: COMBAT, biofilm, metagenomics, high-throughput sequencing

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Authors: Farhad Arian Far, Anjanette Q. Eleazar, Francis Aldrine A. Uy, Mary Joyce Anne V. Uy

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The Unified Philippine Accident Reporting and Database System (UPARDS), is a newly developed system by Dr. Francis Aldrine Uy of the Mapua Institute of Technology. The main purpose is to provide an advanced road accident investigation tool, record keeping and analysis system for stakeholders such as Philippine National Police (PNP), Metro Manila Development Authority (MMDA), Department of Public Works and Highways (DPWH), Department of Health (DOH), and insurance companies. The system is composed of 2 components, the mobile application for road accident investigators that takes advantage of available technology to advance data gathering and the web application that integrates all accident data for the use of all stakeholders. The researchers with the cooperation of PNP’s Vehicle Traffic Investigation Sector of the City of Manila, conducted the field-testing of the application in fifteen (15) accident cases. Simultaneously, the researchers also distributed surveys to PNP, Manila Doctors Hospital, and Charter Ping An Insurance Company to gather their insights regarding the web application. The survey was designed on information systems theory called Technology Acceptance Model. The results of the surveys revealed that the respondents were greatly satisfied with the visualization and functions of the applications as it proved to be effective and far more efficient in comparison with the conventional pen-and-paper method. In conclusion, the pilot study was able to address the need for improvement of the current system.

Keywords: accident, database, investigation, mobile application, pilot testing

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Authors: Ge Sun, Monika Trzpis, Robbert J. de Haas, Paul M. A. Broens

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Introduction: Dynamic magnetic resonance defecography is frequently used to assess defecation disorders. We aimed to investigate the usefulness of dynamic magnetic resonance defecography for assessing the severity of defecation disorder. Methods: We included patients retrospectively from our tertiary referral hospital who had undergone dynamic magnetic resonance defecography, anorectal manometry, and anal electrical sensitivity tests to assess defecation disorders between 2014 and 2020. The primary outcome was the association between the dynamic magnetic resonance defecography variables and the severity of defecation disorders. We assessed the severity of fecal incontinence and constipation with the Wexner incontinence and Agachan constipation scores. Results: Out of the 32 patients included, 24 completed the defecation questionnaire. During defecation, the M line length at magnetic resonance correlated with the Agachan score (r = 0.45, p = 0.03) and was associated with anal sphincter pressure (r=0.39, p=0.03) just before defecation. During rest and squeezing, the H line length at imaging correlated with the Wexner incontinence score (r=0.49, p=0.01 and r=0.69, p< 0.001, respectively). H line length also correlated positively with the anal electrical sensation threshold during squeezing (r=0.50, p=0.004) and during rest (r= 0.42, p=0.02). Conclusions: The M and H line lengths at dynamic magnetic resonance defecography can be used to assess the severity of constipation and fecal incontinence respectively and reflect anatomic changes of the pelvic floor. However, as these anatomic changes are generally late-stage and irreversible, anal manometry seems a better diagnostic approach to assess early and potentially reversible changes in patients with defecation disorders.

Keywords: defecation disorders, dynamic magnetic resonance defecography, anorectal manometry, anal electrical sensitivity tests, H line, M line

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Authors: Wan Liu, Haibo Wang, Cathy Huang, Zhiwu Tan, Zhiwei Chen

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The tremendous diversity of HIV-1 has been a major challenge for an effective AIDS vaccine development. Mosaic approach presents the potential for vaccine design aiming for global protection. The mosaic antigen of HIV-1 Gag allows antigenic breadth for vaccine-elicited immune response against a wider spectrum of viral strains. However, the enhancement of immune response using vaccines is dependent on the strategy used. Heterologous prime/boost regimen has been shown to elicit high levels of immune responses. Here, we investigated whether priming using plasmid DNA with electroporation followed by boosting with the live replication-competent modified vaccinia virus vector TianTan (MVTT) combined with the mosaic antigenic sequence could elicit a greater and broader antigen-specific response against HIV-1 Gag in mice. When compared to DNA or MVTT alone, or MVTT/MVTT group, DNA/MVTT group resulted in coincidentally high frequencies of broadly reactive, Gag-specific, polyfunctional, long-lived, and cytotoxic CD8+ T cells and increased anti-Gag antibody titer. Meanwhile, the vaccination could upregulate PD-1+, and Tim-3+ CD8+ T cell, myeloid-derived suppressive cells and Treg cells to balance the stronger immune response induced. Importantly, the prime/boost vaccination could help control the EcoHIV and mesothelioma AB1-gag challenge. The stronger protective Gag-specific immunity induced by a Mosaic DNA/MVTT vaccine corroborate the promise of the mosaic approach, and the potential of two acceptably safe vectors to enhance anti-HIV immunity and cancer prevention.

Keywords: DNA/MVTT vaccine, EcoHIV, mosaic antigen, mesothelioma AB1-gag

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Authors: Najmeh Jafari, Sona Rostampour Yasouri

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Crimean-Congo hemorrhagic fever (CCHF) is an acute hemorrhagic disease. This disease is one of the common diseases between humans and animals, transmitted through tick bites or contact with the blood and secretions or carcasses of infected animals and humans. CCHF is more common in people who work with livestock, such as ranchers, butchers, farmers, slaughterhouse workers, healthcare workers, etc. Its hospital prevalence is also very high. Considering that CCHF can be transmitted through the consumption of food such as beef and sheep meat, this study aims to quickly identify and diagnose the Crimean-Congo fever virus in suspected patients through real-time PCR technique. In the summer of 1402, 20 blood samples were collected separately from Ahvaz and Gilan hospitals. An extraction kit was used to extract the virus RNA. Primers and probes were designed based on the S genomic region, the conserved region in CCHFV. Then, a real-time PCR technique was performed with specific primers and probes. It should be noted that the mentioned technique was repeated several times. The number of 4 samples from the examined samples was determined positive by real-time PCR. This technique has high sensitivity and specificity and the possibility of rapid detection of CCHFV. Therefore, the above method is a good candidate for quick disease diagnosis. By diagnosing the disease, the treatment process can be done faster, and the best prevention methods can be used to control the disease and prevent the death of patients.

Keywords: ahvaz, crimean-congo hemorrhagic fever, gilan, real time PCR

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Authors: Cheng-Yu Tsai, Wen-Te Liu, Yin-Tzu Lin, Chen-Chen Lo, Kang Lo

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Background: Driving drowsiness related to inadequate or disordered sleep accounts for a major percentage of traffic accidents. Sleep-disordered breathing (SDB) syndrome is a common respiratory disorder during sleep. However, the effects of SDB syndrome on driving fatigue remain unclear. Objective: This study aims to investigate the relationship between SDB pattern and driving drowsiness. Methodologies: The physical condition while driving was obtained from the questionnaires to classify the state of driving fatigue. SDB syndrome was quantified as the polysomnography, and the air flow pattern was collected by the thermistor and nasal pressure cannula. To evaluate the desaturation, the mean hourly number of greater than 3% dips in oxygen saturation was sentenced by reregistered technologist during examination in a hospital in New Taipei City (Taiwan). The independent T-test was used to investigate the correlations between sleep disorders related index and driving drowsiness. Results: There were 880 subjects recruited in this study, who had been done polysomnography for evaluating severity for obstructive sleep apnea syndrome (OSAS) as well as completed the driver condition questionnaire. Four-hundred-eighty-four subjects (55%) were classified as fatigue group, and 396 subjects (45%) were served as the control group. Significantly higher values of snoring index (242.14 ± 205.51 /hours) were observed in the fatigue group (p < 0.01). The value of respiratory disturbance index (RDI) (31.82 ± 19.34 /hours) in fatigue group were significantly higher than the control group (p < 0.01). Conclusion: We observe the considerable association between SDB syndrome and driving drowsiness. To promote traffic safety, SDB syndrome should be controlled and alleviated.

Keywords: driving drowsiness, sleep-disordered breathing syndrome, snoring index, respiratory disturbance index.

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Authors: Mona Afifi, Yara Al Qahtani, Afnan Al Dosari, Amnah Hamdi

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Background: First aid is the care provided outside the hospital. It is important in saving lives. Delay in helping the victims may result in serious complication or even death. Many people die in Saudi Arabia because they don’t get proper first aid interventions. According to Traffic Safety council in KSA (2012), in the year of 2011 there was 7153 deaths from car accident in KAS. Subjects and method: Quasi-experimental research design was utilized to assess the effect of a structured 45-minute educational session on 82 undergraduate nursing students’ knowledge about first aid. Two tools were developed for the purpose of the current study. First tool containing the sociodemographic data including age, gender, level, and previous participation in a first aid course, and 55 statements specific to different situations that requires first aid. Concept and Knowledge of First Aid has 9 questions, cardiopulmonary resuscitation has 12 questions, Bleeding and Shock have 7 questions, Road Traffic Accidents has 5 questions, Fracture and Trauma have 4 questions, wound has 5 questions, sunstroke has 4 questions, bits and stings has 4 questions and burn has 5 questions. The second tool was to evaluate the campaign session. Result: The overall knowledge score showed significant difference between the pre and post awareness session (59.58 and 93.00 respectively, p=.000). Mean score shows significant difference in pre-tests between third and fourth year nursing students indicating that knowledge of fourth year students is higher compared to third year students with the mean knowledge scores of 69.56 and 60.88 respectively (p=0.006). Conclusion: Results of the current study indicate that the level of the knowledge in the post test session was higher than in the pre session. Also results showed that the fourth year student`s knowledge in pre-test was better compared to previous year.

Keywords: first aid, awareness campaign, undergraduate nursing students, knowledge

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Authors: Kgaugelo Lekota, Ayesha Hassim, Henriette Van Heerden

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Bacillus anthracis is the causative agent of anthrax that is composed of three genetic groups, namely A, B, and C. Clade-A is distributed world-wide, while sub-clades B has been identified in Kruger National Park (KNP), South Africa. KNP is one of the endemic anthrax regions in South Africa with distinctive genetic diversity. Genomic surveillance of KNP B. anthracis strains was employed on the historical culture collection isolates (n=67) dated from the 1990’s to 2015 using a whole genome sequencing approach. Whole genome single nucleotide polymorphism (SNPs) and pan-genomics analysis were used to define the B. anthracis genetic population structure. This study showed that KNP has heterologous B. anthracis strains grouping in the A-clade with more prominent ABr.005/006 (Ancient A) SNP lineage. The 2012 and 2015 anthrax isolates are dispersed amongst minor sub-clades that prevail in non-stabilized genetic evolution strains. This was augmented with non-parsimony informative SNPs of the B. anthracis strains across minor sub-clades of the Ancient A clade. Pan-genomics of B. anthracis showed a clear distinction between A and B-clade genomes with 11 374 predicted clusters of protein coding genes. Unique accessory genes of B-clade genomes that included biosynthetic cell wall genes and multidrug resistant of Fosfomycin. South Africa consists of diverse B. anthracis strains with unique defined SNPs. The sequenced B. anthracis strains in this study will serve as a means to further trace the dissemination of B. anthracis outbreaks globally and especially in South Africa.

Keywords: bacillus anthracis, whole genome single nucleotide polymorphisms, pangenomics, kruger national park

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Authors: Berna Yaylalı, Isin Can Traunmüller

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This paper explores the emergent bottom-up practices in the fields of architecture and urban design within comparative perspectives of two cities. As a temporary, easily affordable intervention that gives the possibility of transforming neglected spaces into vibrant public spaces, tactical urbanism, together with creative place-making strategies, presents alternative ways of creating sustainable developments in derelict and underused areas. This study examines the potential of social and physical developments through a reading of case studies of two creative spatial practices: a pop-up garden transformed from an unused derelict space in Favoriten, Vienna, and an urban community garden in Kuzguncuk, Istanbul. Two cities are chosen according to their multicultural population and diversity. Istanbul was selected as a design city by UNESCO Creative Cities Network in 2017, and Vienna was declared an open and livable city by its local government. This research will use media archives and reports, interviews with locals and local governments, site observations, and visual recordings as methods to provide a critical reading on creative public spaces from the view of local users in these neighborhoods. Reflecting on these emergent ways, this study aims at discussing the production process of tactile urbanism with the practices of locals and the decision-making process with cases from İstanbul and Vienna. The comparison between their place-making strategies in tactical urbanism will give important insights for future developments.

Keywords: creative city, tactical urbanism, neglected area, public space

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Authors: Eda Yakit Ak, Ergül Aslan

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The study was conducted using the quasi-experimental design to determine the influence of the nursing support program prepared according to the Health Belief Model on reproductive health behaviors of orthopedically disabled women in the physical therapy and rehabilitation clinic at a university hospital between August 2019-October, 2020. The research sample included 50 women (35 in the control group and 15 in the experimental group with orthopedic disability). A 3-week nursing support program was applied to the experimental group of women. To collect the data, Introductory Information Form and Scale for Determining the Protective Attitudes of Married Women towards Reproductive Health (SDPAMW) were applied. The evaluation was made with a follow-up form for four months. In the first evaluation, the total SDPAMW scores were 119.93±20.59 for the experimental group and 122.20±16.71 for the control group. In the final evaluation, the total SDPAMW scores were 144.27±11.95 for the experimental group and 118.00±16.43 for the control group. The difference between the groups regarding the first and final evaluations for the total SDPAMW scores was statistically significant (p<0.01). In the experimental group, between the first and final evaluations regarding the sub-dimensions of SDPAMW, an increase was found in the behavior of seeing the doctor on reproductive health issues, protection from reproductive organ and breast cancer, general health behaviors to protect reproductive health, and protection from genital tract infections (p<0.05). Consequently, the nursing support program based on the Health Belief Model applied to orthopedically disabled women positively affected reproductive health behaviors.

Keywords: orthopedically disabled, woman, reproductive health, nursing support program, health belief model

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Authors: Khalid Al Saleh, Najlaa AlSayed

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Background: Palliative care is changing from just ‘end of life care’ to care delivered earlier in the disease course. Metanalysis showed that Palliative Performance Scale (PPS) is associated with increased length of survival. The Palliative Care Center (PCC) in Kuwait is the only stand-alone center in Eastern Mediterranean Region with a capacity of 92 beds. We compared clinical characteristics between patients referred from the Specialized Cancer Center and general hospitals in Kuwait to PCC. Method: A cross Sectional survey was conducted since the opening of PCC in January 2011 to June 2013. Patients’ data on demographics, type of the cancer, PPS score and referring hospital were collected and analyzed. Results: Total number of the patients was 142. Mean age was 61.05±14.79 years, 66 patients (47.1%) were males and 74 (52.9%) were females. The most common cancers in males were lung (n=18, 27.3%) followed by head and neck cancers (n=8, 12.1%) and brain tumors (n=7, 10.6%) while in females, the most common cancers were breast cancer (n=12, 16.7%) followed by ovarian cancer (n=10, 13.9%) and Cancer Colon (n=8, 11.1%). Patients with PPS score 30% were 27.9% (n=39), 40% in 40.7% (n=57), and 50% in 17.1% (n=24) respectively. Patients referred from the Specialized Cancer Center had significantly higher portion of patients with PPS score > 30% (73.4%, n=94), compared to patients coming from general hospitals (33.3%, n=4), P value= 0.007. Conclusion: There is significant difference in PPS scores between patients referred from the Specialized Cancer Center compared to patients referred from general hospitals. We encourage that all cancer patients should be treated in Specialized Cancer Centers and earlier involvement of Palliative Care Centers to achieve better survival. Training workshops are needed for health care professionals working in general hospitals to raise awareness about earlier referral of patients to palliative care services.

Keywords: palliative care, kuwait, performance scale differences, pps score, specialized hospitals

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Authors: M. A. Abdel-Wahed, Nayera Elmorsi Hassan, Safaa Shafik Imam, Ola G. El-Farghali, Khadija M. Alian

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Low-birth-weight is a challenging public health problem. Aim: to clarify role of zinc on enhancing catch-up growth of low-birth-weight and find out a proposed relationship between zinc effect on growth and the main growth hormone mediator, IGF-1. Methods: Study is a double-blind-randomized-placebo-controlled trial conducted on low-birth-weight-neonates delivered at Ain Shams University Maternity Hospital. It comprised 200 Low-birth-weight-neonates selected from those admitted to NICU. Neonates were randomly allocated into one of the following two groups: group I: low-birth-weight; AGA or SGA on oral zinc therapy at dose of 10 mg/day; group II: Low-birth-weight; AGA or SGA on placebo. Anthropometric measurements were taken including birth weight, length; head, waist, chest, mid-upper arm circumferences, triceps and sub-scapular skin-fold thicknesses. Results: At 12-month-old follow-up visit, mean weight, length; head (HC), waist, chest, mid-upper arm circumferences and triceps; also, infant’s proportions had values ≥ 10th percentile for weight, length and HC were significantly higher among infants of group I when compared to those of group II. Oral zinc therapy was associated with 24.88%, 25.98% and 19.6% higher proportion of values ≥ 10th percentile regarding weight, length and HC at 12-month-old visit, respectively [NNT = 4, 4 and 5, respectively]. Median IGF-1 levels measured at 6 months were significantly higher in group I compared to group II (median (range): 90 (19 – 130) ng/ml vs. 74 (21 – 130) ng/ml, respectively, p=0.023). Conclusion: Oral zinc therapy in low-birth-weight neonates was associated with significantly more catch-up growth at 12-months-old and significantly higher serum IGF-1 at 6-month-old.

Keywords: low-birth-weight, zinc, catch-up growth, neonates

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Authors: Pedro Gomes, Lia Ferreira, Sofia Garcia, Jaime Babulal, Luís Costa, Luís Castelo, José Muras, Isabel Gonçalves, Rui Carvalho

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Introduction: Foot ulcers and their complications are an important cause of morbidity and mortality in diabetes. Objectives: The present study aims to evaluate the outcomes in terms of need for hospitalization, amputation, healing time and mortality in patients with new-onset diabetic foot ulcers in subgroups stratified by etiology. Methods: A retrospective study based on clinical assessment of patients presenting with new ulcers to a multidisciplinary diabetic foot consult during 2012. Outcomes were determined until September 2014, from hospital registers. Baseline clinical examination was done to classify ulcers as neuropathic, ischemic or neuroischemic. Results: 487 patients with new diabetic foot ulcers were observed; 36%, 15% and 49% of patients had neuropathic, ischemic and neuroischemic ulcers, respectively. For analysis, patients were classified as having predominantly neuropathic (36%) or ischemic foot (64%). The mean age was significantly higher in the group with ischemic foot (70±12 vs 63±12 years; p <0.001), as well as the duration of diabetes (18±10 vs 16 ± 10years, p <0.05). A history of previous amputation was also significantly higher in this group (24.7% vs 15.6%, p <0.05). The evolution of ischemic ulcers was significantly worse, with a greater need for hospitalization (27.2% vs 18%, p <0.05), amputation (11.5% vs 3.6% p <0.05) mainly major amputation (3% vs. 0%; p <0.001) and higher mean healing time (151 days vs 89 days, p <0.05). The mortality rate at 18 months, was also significantly higher in the ischemic foot group (7.3% vs 1.8%, p <0.05). Conclusions: All types of diabetic foot ulcers are associated with high morbidity and mortality, however, the presence of arterial disease confers a poor prognosis. Diabetic foot can be successfully treated only by the multidisciplinary team which can provide more comprehensive and integrated care.

Keywords: diabetes, foot ulcers, etiology, outcome

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Authors: Haibin Zhou, Pingping Yao, Kunyang Fan

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Copper-based sintered friction materials are widely used in the brake system of different applications such as engineering machinery or high-speed train, due to the excellent mechanical, thermal and tribological performance. Considering the diversity of the working conditions of brake system, it is necessary to identify well and understand the tribological performance and wear mechanisms of friction materials for different conditions. Fe has been a preferred reinforcement for copper-based friction materials, due to its ability to improve the wear resistance and mechanical properties of material. Wear map is well accepted as a useful research method for evaluation of wear performances and wear mechanisms over a wider range of working conditions. Therefore, it is significantly important to construct a wear map which can give out the effects of work condition and Fe reinforcement on tribological performance of Cu-based friction materials. In this study, the copper-based sintered friction materials with the different addition of Fe reinforcement (0-20 vol. %) were studied. The tribological tests were performed against stainless steel in a ring-on-ring braking tester with varying braking energy density (0-5000 J/cm2). The linear wear and friction coefficient were measured. The worn surface, cross section and debris were analyzed to determine the dominant wear mechanisms for different testing conditions. On the basis of experimental results, the wear map and wear mechanism map were established, in terms of braking energy density and the addition of Fe. It was found that with low contents of Fe and low braking energy density, adhesive wear was the dominant wear mechanism of friction materials. Oxidative wear and abrasive wear mainly occurred under moderate braking energy density. In the condition of high braking energy density, with both high and low addition of Fe, delamination appeared as the main wear mechanism.

Keywords: Cu-based friction materials, Fe reinforcement, wear map, wear mechanism

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Authors: Julianne Macmullen

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Due to advances in technology and early detection and treatment of cancer, many cancer patients are surviving longer than five years post-diagnosis. Most cancer patients suffer from depression, anxiety, and post-traumatic stress disorder (PTSD) at some point during diagnosis, treatment, and survivorship. A subgroup of patients will continue to suffer from depression and PTSD and require early intervention. Support groups provide patients with the emotional and informational support they require while also giving survivors a sense of community, friendship, and purpose. This type of support is recognized by researchers to improve the quality of life while also decreasing depression and PTSD symptoms. The gaps in the literature include cultural diversity, minorities, and support groups involving cancer types other than breast cancer. Another gap in the literature includes the perceptions of cancer patients as well as longitudinal studies to determine the relationships between support groups and decreased depression and PTSD rates over time. Future research is required to fill the gaps in the literature mentioned previously. Future research is also needed to analyze the difference in age groups and different types of support groups such as professionally-led, peer-led, and online. Implications for practice involve providers assessing for the symptoms of depression and PTSD in order to offer prompt treatment and support services to those patients. In conclusion, social support by way of support groups improves the quality of life, gives survivors a sense of purpose to help others while also gaining the support they need, and reduces the rate of depressive episodes related to PTSD.

Keywords: cancer survivor, survivorship, post-traumatic stress disorder (PTSD), depression, support groups

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Authors: Balakrishna Valluru, Ruth Suckling

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A 16 year old male was found collapsed on the road following stab injuries to the chest and abdomen and was transported to the emergency department by ambulance. On arrival in the emergency department the patient was breathless and appeared pale. He was maintaining his airway with spontaneous breathing and had a heart rate of 122 beats per minute with a blood pressure of 83/63 mmHg. He was resuscitated initially with three units of packed red cells. Clinical examination identified three incisional wounds each measuring 2 cm. These were in the left para-sternal region, right infra-scapular region and left upper quadrant of the abdomen. The chest wound over the left parasternal area at the level of 4tth intercostal space was bleeding intermittently on leaning forwards and was relieving his breathlessness intermittently. CT imaging was performed to characterize his injuries and determine his management. CT scan of chest and abdomen showed moderate size haemopericardium with left sided haemopneumothorax. The patient underwent urgent surgical repair of the left ventricle and left anterior descending artery. He recovered without complications and was discharged from the hospital. This case highlights the fact that the potential to develop a life threatening cardiac tamponade was mitigated by the left parasternal stab wound. This injury fortuitously provided a pericardial window through which the bleeding from the injured left ventricle and left anterior descending artery could drain into the left hemithorax providing an opportunity for timely surgical intervention to repair the cardiac injuries.

Keywords: stab, incisional, haemo-pericardium, haemo-pneumothorax

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Authors: Inosha Bimali, Shambhu P. Adhikari, Sumana Baidya, Nishchal R. Shakya

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Background: An earthquake of 7.8 magnitudes with an epicenter in Gorkha on 25th April 2015 and second earthquake of 6.5 magnitudes with an epicenter at Sindhupalchwok on 12th May 2015 struck the beautiful country of Nepal, killing more than 8,500 people and over 18,500 individuals were left injured with various forms of disabilities. Objectives: To explore number, type and level of disability among post earthquake victims. A door to door physiotherapy rehabilitation program will be conducted at the community level as a continuation of this study. Methods: A survey was carried out in the catchment area of Bahunepati and Manekharka outreach centers of Sindhupalchowk district and Gaurishankar outreach center of Dolakha district of Dhulikhel Hospital. Physical disability was identified using a disability survey form given by Ministry of women, children and social welfare Nepal Government. World health organization disability assessment schedule-2 was used to identify the level of disability. Results: Twenty-nine person with disabilities at Bahunepati, four person with disabilities at Manekharkha and two person with disabilities at Gaurishankar and its catchment area were identified. Level of disability was an average of 56% with majority of survivors having upper extremities fractures followed by lower extremities fractures and miscellaneous injury. Few spinal cord injuries and head injuries were also identified. Conclusion: Though number of person with disabilities was found relatively less, disability level is high; hence an urgent need of physiotherapy rehabilitation is reflected to improve the quality of life of the affected people.

Keywords: community, disability, Nepal earthquake, physiotherapy

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Authors: Jolanta Jonak, Sylvia Tolczyk

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Students demonstrate various learning preferences and learning styles that range from visual, auditory to kinesthetic preferences. These learning preferences are further impacted by individual cognitive make up that characterizes itself in linguistic strengths, logical- special, inter-or intra- personal, just to name a few. Students from culturally and linguistically diverse backgrounds (CLD) have an increased risk of being misunderstood by many school systems and even medical personnel. CLD students are influenced by many factors (like acculturation and experience) that may impact their achievements and functioning levels. CLD students who develop initial or basic interpersonal communication proficiency skills in the target language are even at a higher risk for being suspected of learning disability when they are underachieving academically. Research indicates that large numbers of students arenot provided the type of education and types of supports they need in order to be successful in an academicenvironment. Multiple research findings indicate that significant numbers of school staff self-reports that they do not feel adequately prepared to work with CLD students. It is extremely important for the school staff, especially school psychologists, who often are the first experts that are consulted, to be educated about overlapping symptoms and settle differences between learning difference and disability. It is equally important for medical personnel, mainly pediatricians, psychologists, and psychiatrists, to understand the subtle differences to avoid inaccurate opinions. Having the knowledge, school staff can avoid unnecessary referrals for special education evaluations and avoid inaccurate decisions about the presence of a disability. This presentation will illustrate distinctions based on research between learning differences and disabilities, how to recognize them, and how to assess for them.

Keywords: special education, learning disability, differentiation, differences

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Authors: Mohammed T. Shabeer

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Hoary moorlands of Tibet bear bundle of religious traditions. Vajrayana tradition of Tibetan Buddhism is one of the deep rooted religious orders of the area. It demands the homage to a variety of gods and diverse worships, especially to manifestations like the Dalai Lamas. This divine diversity has been conceptualized by remoteness of the area and transcontinental intrusion of Asiatic philosophies like Indian Buddhism, Mongolian Shamanism and Hindu Tantrism. This study reveals the role of Hindu Tantrism in conceptualizing the manifestations in Vajrayana Tradition of Tibetan Buddhism in a comparative way. Nowadays, the academic explorations and researches in the field of ‘Tibetology’ are widely tolerable in east and west alike. International community concerns such studies supportive of the restless campaigns for ‘free Tibet’. Moreover, the scientific sources on the topic are rarest and precious in the field of comparative religion. This study reveals a clear account of god concept of Vajrayana tradition and insists that the god concept of the tradition is conceptualized from the amalgamation of Indian Hindu Tantrism, Mongolian Shamanism, and Indian Buddhism. Primly, it sheds the light upon the mysterious similarities between Indian and Tibetan concepts of manifestation of gods. The scientific examination of this problem lasts in the conclusion that the transcontinental transmission of Hindu Tantrism in the special occasion of Buddhist Diaspora of 12th century in consequence of the invasion of Muslim Ghorid Sultanate had paved a vital role in shaping the Vajrayana tradition especially conceptualizing the manifestation of Tibetan gods.

Keywords: Buddhist diaspora, Hindu tantrism, manifestation of god, Vajrayana tradition of Tibetan Buddhism

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Authors: Ahmad Esmaillzadeh, Javad Anjom-Shoae, Omid Sadeghi,

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Background: Although considerable research has been devoted to the link between consumption of legume and nuts and metabolic abnormalities, few studies have examined legume and nuts consumption in relation to psychological disorders. Objective: The current study aimed to examine the association of legume and nuts consumption with depression, anxiety and psychological distress in Iranian adults. Methods: This cross-sectional study was carried out among 3172 adult participants aged 18-55 years. Assessment of legume and nuts consumption was conducted using a validated dish-based 106-item semi-quantitative food frequency questionnaire. The Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was used to examine psychological health. Scores of 8 or more on either subscale in the questionnaire were considered to indicate the presence of depression or anxiety. Data on psychological distress were collected through the use of General Health Questionnaire (GHQ), in which the score of 4 or more was considered as having psychological distress. Results: Mean age of participants was 36.5±7.9 years. Compared with the lowest quintile, men in the highest quintile of legume and nuts consumption had lower odds of anxiety; such that after adjusting for potential confounding variables, men in the top quintile of legume and nuts consumption were 66% less likely to be anxious than those in the bottom quintile (OR: 0.34; 95% CI: 0.14-0.82). Such relationship was not observed among women. We failed to find any significant association between legume plus nuts consumption and depression or psychological distress after adjustment for potential confounders. Conclusion: We found that consumption of legume and nuts was associated with lower odds of anxiety in men, but not in women. No significant association was seen between consumption of legume and nuts and odds of depression or psychological disorder. Further prospective studies are required to confirm these findings.

Keywords: anxiety, depression, legumes, nuts, psychological distress

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Authors: Yongxin Chen, Min Zhang

Abstract:

As industrial enterprises are the primary source of national pollution, environmental information disclosure is a crucial way to demonstrate to stakeholders the work they have done in fulfilling their environmental responsibilities and accepting social supervision. In the era of the digital economy, many companies, actively embracing the opportunities that come with digital transformation, have begun to apply digital technology to information collection and disclosure within the enterprise. However, less is known about the relationship between digital transformation and environmental disclosure. This study investigates how enterprise digital transformation affects environmental disclosure in 643 Chinese industrial companies, according to information processing theory. What is intriguing is that the depth (size) and breadth (diversity) of environmental disclosure linearly increase with the rise in the collection, processing, and analytical capabilities in the digital transformation process. However, the volume of data will grow exponentially, leading to a marginal increase in the economic and environmental costs of utilizing, storing, and managing data. In our empirical findings, linearly increasing benefits and marginal costs create a unique inverted U-shaped relationship between the degree of digital transformation and environmental disclosure in the Chinese industrial sector. Besides, based on the upper echelons theory, we also propose that the top management team with high stability and managerial capabilities will invest more effort and expense into improving environmental disclosure quality, lowering the carbon footprint caused by digital technology, maintaining data security etc. In both these contexts, the increasing marginal cost curves would become steeper, weakening the inverted U-shaped slope between DT and ED.

Keywords: digital transformation, environmental disclosure, the top management team, information processing theory, upper echelon theory

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Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

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Bile spillage occurs frequently during laparoscopic cholecystectomy yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact, might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visits, with subsequent readmission and additional procedures. While some authors found no increase in SSI following bile spillage (BS) compared to non-bile spillage cases, others found bile spillage to be associated with SSI. Therefore we sought to examine whether bile spillage is indeed associated with an increased risk of postoperative wound infections after laparoscopic cholecystectomy. I hypothesize that patients who experience BS during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing Laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per CDC-defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non-bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and was absent in the rest i.e.92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in nonbile spillage cases, SSI was found in 8 cases (8.7%). However, it was statistically not significant (p-value>0.05). Eleven (92%) cases were superficial SSI and one was an organ-space infection. No mortality or 30-day readmission. Spillage of Gallbladder content does not lead to an increase in SSIs. However as the rate of SSI is still higher, Surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage thorough peritoneal irrigation with normal saline should be done.

Keywords: organ space infection, Laparoscopic cholecystectomy, biliary spillage, surgical site infection

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Authors: Keiko Naito, Y. Nakashima, S. Yamauchi, Y. Kunitani, Y. Ishigami, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

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Background: A presence of severe acidemia, defined as pH < 7.2, is common during endotracheal intubation for critically ill patients in the emergency department (ED). Severe acidemia is widely recognized as a predisposing factor for intubation failure. However, it is unclear that acidemic condition itself actually makes endotracheal intubation more difficult. We aimed to evaluate if a presence of severe acidemia before intubation is associated with the lower first attempt intubation success rate in the ED. Methods: This is a retrospective observational cohort study in the ED of an urban hospital in Japan. The collected data included patient demographics, such as age, sex, and body mass index, presence of one or more factors of modified LEMON criteria for predicting difficult intubation, reasons for intubation, blood gas levels, airway equipment, intubation by emergency physician or not, and the use of the rapid sequence intubation technique. Those with any of the following were excluded from the analysis: (1) no blood gas drawn before intubation, (2) cardiopulmonary arrest, and (3) under 18 years of age. The primary outcome was the first attempt intubation success rates between a severe acidemic patients (SA) group and a non-severe acidemic patients (NA) group. Logistic regression analysis was used to test the first attempt success rates for intubations between those two groups. Results: Over 5 years, a total of 486 intubations were performed; 105 in the SA group and 381 in the NA group. The univariate analysis showed that the first attempt intubation success rate was lower in the SA group than in the NA group (71.4% vs 83.5%, p < 0.01). The multivariate logistic regression analysis identified that severe acidemia was significantly associated with the first attempt intubation failure (OR 1.9, 95% CI 1.03-3.68, p = 0.04). Conclusions: A presence of severe acidemia before endotracheal intubation lowers the first attempt intubation success rate in the ED.

Keywords: acidemia, airway management, endotracheal intubation, first-attempt intubation success rate

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Authors: Siwarak Kitchanapaibul, Warren Gillibrand, Rob Burton

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The prevalence of diabetes mellitus has been rising all over the world. Self-management is required for diabetes mellitus patients. The objective of this study is to explore the self-management among the ethnic groups with type 2 diabetes mellitus in Thailand, an upper middle-income country which is located in South East Asia. The ethnic groups in Thailand are a minority group which has limited education and a different culture, language, costume and lifestyle from Thai people. The qualitative exploratory study was used in this study. In-depth interviews with semi-structured open questions were conducted by 20 participants from purposive sampling. These participants were the ethnic groups who have type 2 diabetes mellitus, received the services from a region hospital, understood Thai and were willing to participate. Content analysis was adopted for the study. The results showed that all of the participants controlled their diet before the appointment day and never miss their appointment. Only 3 participants did their exercise while 2 participants stated that they occasionally forgot to take medicine. 10 participants use the herbs for reducing the sugar level. 12 participants drank a lot of water after a lapse in the diet because they believed that water could dilute the sugar. The findings identified 5 themes; ‘controlling diet before appointment day’; ‘drinking water after a lapse in diet’; ‘medication being a vital importance’; ‘exercise is unimportant’; and ‘taking herbs for sugar reduction’. The results of this study are important to the health professionals to understand the self-management of Ethnic groups and use the data to create the appropriate intervention for promoting health among the ethnic groups with type 2 diabetes mellitus in Thailand. The findings will lead to the revision of health policy and the procedure for promoting health in this special ethnic groups.

Keywords: self-management, diabetes, ethnic groups, Thailand

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Authors: Meng-Chyi Wu, Bonn Lin, Jyun-Hao Liao, Chein-Ju Chen, Yu-Cheng Jhuang, Mau-Phon Houng, Fang-Hsing Wang, Min-Chu Liu, Cheng-Fu Yang, Cheng-Shong Hong

Abstract:

Since the use of wireless communications has become critical nowadays, the available RF spectrum has become limited. Ultraviolet (UV) communication system can alleviate the spectrum constraint making UV communication system a potential alternative to future communication demands. Also, UV links can provide faster communication rate and can be used in combination with existing RF communication links, providing new communications diversity with higher user capacity. The UV region of electromagnetic spectrum has been of interest to detector, imaging and communication technologies because the stratospheric ozone layer effectively absorbs some solar UV radiation from reaching the earth surface. The wavebands where most of UV radiation is absorbed by the ozone are commonly known as the solar blind region. By operating in UV-C band (200-280 nm) the communication system can minimize the transmission power consumption since it will have less radiation noise. UV communication uses the UV ray as the medium. Electric signal is carried on this band after being modulated and then be transmitted within the atmosphere as channel. Though the background noise of UV-C communication is very low owing to the solar-blind feature, it leads to a large propagation loss. The 370 nm UV provides a much lower propagation loss than that the UV-C does and the recent device technology for UV source on this band is more mature. The fabricated 370 nm AlGaN light-emitting diodes (LEDs) with an aperture size of 45 m exhibit a modulation bandwidth of 165 MHz at 30 mA and a high power of 7 W/cm2 at 230 A/cm2. In order to solve the problem of low power in single UV LED, a UV LED array is presented in.

Keywords: ultraviolet (UV) communication, light-emitting diodes (LEDs), modulation bandwidth, LED array, 370 nm

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Authors: Laila Almulla, Narayana Bhat, Majda Suleiman, Sheena Jacob

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Biodiversity conservation has become one of the challenging priorities to combat species extinction for many countries, including the state of Kuwait. Since native plants are better adapted to the local environment, can endure long spells of drought, withstand high soil salinity levels and provide a more natural effect to landscape projects, their use will both conserve natural resources and produce sustainable greenery. When native plants are properly blended with naturalized exotic ornamental plants in a landscape, they can improve social and cultural benefits. Screening of exotic and native plants in Kuwait during the past two decades has led to the selection of some very promising plants. Continuation of evaluation of additional native and exotic plants is essential to increase diversity of plant resources for greenery projects. Therefore, an effort was made to evaluate further native plants for their suitability for greenery applications. In the present study, various treatments were used to mass multiply selected plants using seeds to secure maximum germination. Seeds were subjected to nine treatments, and each treatment was replicated five times with ten seeds per treatment unit. After the treatment, the seeds of Zygophyllum qatarense were incubated at 30 °C, three lights for 12 h, at 40% humidity; where as the seeds of Haloxylon salicornicum were incubated at 22 °C with continuous light, at 40% humidity. Soaking in 250-ppm GA3 resulted in highest germination percentage of 20% in Zygophyllum qatarense and, Soaking in 500-ppm GA3 resulted in 6% germination in Haloxylon salicornicum. Germination of the viable seeds is influenced by various external and internal factors, seed must not be in a state of dormancy and the environmental requirements for germination of that seed must be met, before germination can occur.

Keywords: landscape, native plants, revegetation, seed germination

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Authors: John Zacharias, Bin Wang

Abstract:

Travel comfort is increasingly seen as crucial to effecting the switch from private motorized modes to public transit. Surveys suggest that travel comfort is closely related to perceived crowding, that may involve lack of available seating, difficulty entering and exiting, jostling and other physical contacts with strangers. As found in studies on environmental stress, other factors may moderate perceptions of crowding–in this case, we hypothesize that the ambient environment may play a significant role. Travel comfort was measured by applying a structured survey to randomly selected passengers (n=369) on 3 lines of the Beijing metro on workdays. Respondents were standing with all seats occupied and with car occupancy at 14 levels. A second research assistant filmed the metro car while passengers were interviewed, to obtain the total number of passengers. Metro lines 4, 6 and 10 were selected that travel through the central city north-south, east-west and circumferentially. Respondents evaluated the following factors: crowding, noise, smell, air quality, temperature, illumination, vibration and perceived safety as they experienced them at the time of interview, and then were asked to rank these 8 factors according to their importance for their travel comfort. Evaluations were semantic differentials on a 7-point scale from highly unsatisfactory (-3) to highly satisfactory (+3). The control variables included age, sex, annual income and trip purpose. Crowding was assessed most negatively, with 41% of the scores between -3 and -2. Noise and air quality were also assessed negatively, with two-thirds of the evaluations below 0. Illumination was assessed most positively, followed by crime, vibration and temperature, all scoring at indifference (0) or slightly positive. Perception of crowding was linearly and positively related to the number of passengers in the car. Linear regression tested the impact of ambient environmental factors on perception of crowding. Noise intensity accounted for more than the actual number of individuals in the car in the perception of crowding, with smell also contributing. Other variables do not interact with the crowding variable although the evaluations are distinct. In all, only one-third of the perception of crowding (R2=.154) is explained by the number of people, with the other ambient environmental variables accounting for two-thirds of the variance (R2=.316). However, when ranking the factors by their importance to travel comfort, perceived crowding made up 69% of the first rank, followed by noise at 11%. At rank 2, smell dominates (25%), followed by noise and air quality (17%). Commuting to work induces significantly lower evaluations of travel comfort with shopping the most positive. Clearly, travel comfort is particularly important to commuters. Moreover, their perception of crowding while travelling on metro is highly conditioned by the ambient environment in the metro car. Focussing attention on the ambient environmental conditions of the metro is an effective way to address the primary concerns of travellers with overcrowding. In general, the strongly held opinions on travel comfort require more attention in the effort to induce ridership in public transit.

Keywords: ambient environment, mass rail transit, public transit, travel comfort

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