Search results for: clinical benefit

Authors: Leila Maleki, Ahmad Esmali Kooraneh, Hossein Taghi Derakhshi

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Neural activity in the human brain starts from the early stages of prenatal development. This activity or signals generated by the brain are electrical in nature and represent not only the brain function but also the status of the whole body. At the present moment, three methods can record functional and physiological changes within the brain with high temporal resolution of neuronal interactions at the network level: the electroencephalogram (EEG), the magnet oencephalogram (MEG), and functional magnetic resonance imaging (fMRI); each of these has advantages and shortcomings. EEG recording with a large number of electrodes is now feasible in clinical practice. Multichannel EEG recorded from the scalp surface provides a very valuable but indirect information about the source distribution. However, deep electrode measurements yield more reliable information about the source locations، Intracranial recordings and scalp EEG are used with the source imaging techniques to determine the locations and strengths of the epileptic activity. As a source localization method, Low Resolution Electro-Magnetic Tomography (LORETA) is solved for the realistic geometry based on both forward methods, the Boundary Element Method (BEM) and the Finite Difference Method (FDM). In this paper, we review The findings EEG- LORETA about epilepsy.

Keywords: epilepsy, EEG, EEG-LORETA

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Authors: Chueh Chi-An, Chan Hui-Ya

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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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Authors: Paul Awolade, Parvesh Singh

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The global threat of pathogenic resistance to available therapeutic agents has become a menace to clinical practice, public health and man’s existence inconsequential. This has therefore led to an exigency in the development of new molecular scaffolds with profound activity profiles. In this vein, a versatile synthetic tool for accessing new molecules by incorporating two or more pharmacophores into a single entity with the unique ability to be recognized by multiple receptors hence leading to an improved bioactivity, known as molecular hybridization, has been explored with tremendous success. Accordingly, aware of the similarity in pharmacological activity spectrum of quinoline and 1,2,3-triazole pharmacophores such as; anti-Alzheimer, anticancer, anti-HIV, antimalarial and antimicrobial to mention but a few, the present study sets out to synthesize hybrids of quinoline and 1,2,3-triazole. The hybrids were accessed via click chemistry using copper catalysed azide-alkyne 1,3-dipolar cycloaddition reaction. All synthesized compounds were evaluated for their pharmaco-potential in an antimicrobial assay out of which the 3-OH derivative emerged as the most active with MIC value of 4 μg/mL against Cryptococcus neoformans; a value superior to standard Fluconazole and comparable to Amphotericin B. Structures of synthesized hybrids were elucidated using appropriate spectroscopic techniques (1H, 13C and 2D NMR, FT-IR and HRMS).

Keywords: bioisostere, click chemistry, molecular hybridization, quinoline, 1, 2, 3-triazole

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Authors: Nicolas Meylan, Eric Tardif

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Many studies have highlighted the links between substance use and school difficulties. However, most of these studies address only the consumption in terms of frequency without considering the different types of behavior (use, abuse, dependence). Moreover, little is known about the associations between substance use and variables such as school engagement and school burnout recently described as a positive state of mind and an exhaustion syndrome related to school, respectively. Through this study, we wish to describe and compare school-related variables in adolescents with different type of substance use. Our study focuses on 402 Swiss adolescents, aged between 14 and 19 years old. They responded collectively and anonymously to a set of scales assessing substance use and several school variables (social support, stress, burnout, engagement and school climate). First, results on frequency and severity of substance use are relatively close to those observed in other studies. Second, it also appears that certain dimensions of stress, burnout, engagement and school climate are associated with the frequency of alcohol and cannabis consumption. Finally, adolescents’ substance abusers show particularly high scores of burnout, cynicism and stress related to workload, which can be understand as self-medication behavior. Additional analyzes are underway to clarify these associations. Results are discussed in terms of implications for research and clinical practice in academic burnout.

Keywords: school burnout, school engagement, adolescence, substance use, self-medication

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Authors: Sakshi Chopra, Ashima Nehra, Sumit Sinha, Harsimarpreet Kaur, Ravindra Mohan Pandey

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Background: Cognitive rehabilitation aims to retrain brain injured individuals with cognitive deficits to restore or compensate lost functions. As illiterates or people with low literacy levels represent a significant proportion of the world, specific rehabilitation modules for such populations are indispensable. Literacy is significantly associated with all neuropsychological measures and retraining programs widely use written or spoken techniques which essentially require the patient to read or write. So, the aim of the study was to develop and standardize a literacy free neuropsychological rehabilitation program for improving cognitive functioning in patients with mild and moderate Traumatic Brain Injury (TBI). Several studies have pointed out to the impairments seen in memory, executive functioning, and attention and concentration post-TBI, so the rehabilitation program focussed on these domains. Visual item memorization, stick constructions, symbol cancellations, and colouring techniques were used to construct the retraining program. Methodology: The development of the program consisted of planning, preparing, analyzing, and revising the different modules. The construction focussed on areas of retraining immediate and delayed visual memory, planning ability, focused and divided attention, concentration, and response inhibition (to control irritability and aggression). A total of 98 home based retraining modules were prepared in the 4 domains (42 for memory, 42 for executive functioning, 7 for attention and concentration, and 7 for response inhibition). The standardization was done on 20 healthy controls to review, select and edit items. For each module, the time, errors made and errors per second were noted down, to establish the difficulty level of each module and were arranged in increasing level of difficulty over a period of 6 weeks. The retraining tasks were then administered on 11 brain injured individuals (5 after Mild TBI and 6 after Moderate TBI). These patients were referred from the Trauma Centre to Clinical Neuropsychology OPD, All India Institute of Medical Sciences, New Delhi, India. Results: The time was taken, errors made and errors per second were analysed for all domains. Education levels were divided into illiterates, up to 10 years, 10 years to graduation and graduation and above. Mean and standard deviations were calculated. Between group and within group analysis was done using the t-test. The performance of 20 healthy controls was analyzed and only a significant difference was observed on the time taken for the attention tasks and all other domains had non-significant differences in performance between different education levels. Comparing the errors, time taken between patient and control group, there was a significant difference in all the domains at the 0.01 level except the errors made on executive functioning, indicating that the tool can successfully differentiate between healthy controls and patient groups. Conclusions: Apart from the time taken for symbol cancellations, the entire cognitive rehabilitation program is literacy free. As it taps the major areas of impairment post-TBI, it could be a useful tool to rehabilitate the patient population with low literacy levels across the world. The next step is already underway to test its efficacy in improving cognitive functioning in a randomized clinical controlled trial.

Keywords: cognitive rehabilitation, illiterates, India, traumatic brain injury

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Authors: S. O. Ayansina, R. A. Oyeyinka, K. K. Bolarinwa

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There is an increasing demand for a functional extension delivery services in Nigeria with a view to meet up with the food and fiber needs of the ever growing population of human and animal respectively. This study was designed to examine farmers’ involvement in public and private extension services in southwestern Nigeria, specifically to explore the farmers’ participation in the two types of organizations involved. It also evaluates the performances of personnel in the organizations. A multi-stage random sampling technique was used to select 30 respondents from each of the three selected organizations in Ogun, Osun and Oyo states in Southwestern Nigeria. Data was collected with interview schedule and analyzed both at descriptive and inferential levels. Kruskal Wallis one-way Analysis of variance was used to test the differences between the participation of beneficiaries who are farmers under the public and private extension services and the level of benefit accrued to them from the various extension organizations involved in the study. Results revealed that private extension organizations were performing better and were more preferred by the beneficiaries. Results of the tested hypotheses as shown by Kruskal Wallis test of difference (x2 = 0.709) S no significant difference between farmers’ participation in the extension services of public and private organizations but however showed significant difference (X2 =12.074) in the benefits achieved by respondents in the two organizations. These include: increased quantity of crop produced, farm income, skill acquisition, and improved education in private extension organizations. Based on this result, it could be inferred that beneficiaries generally preferred private extension organizations because of their effectiveness and vibrancy in programme administration. Public extension is therefore recommended for general overhauling and possibly privatization in order to cater for teeming population of farmers demanding for efficient and functional extension services to better their lots in production, processing and marketing of agricultural produce.

Keywords: public and private involvement, extension services, farmers' participation

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Authors: Kevin William Taylor

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This work draws upon research in the fields of games development and mental health treatments to assess the influence that interactive entertainment has on the populous, and the potential of technology to affect areas of psychiatric assessment and treatment. It will use studies to establish the evolving direction of interactive media in the development of ‘digital self-identity,’ and how this can be incorporated into treatment to the benefit of psychiatry. It will determine that this approach will require collaborative production between developers and psychiatrists in order to ensure precise goals are met, improving the success of serious gaming for psychiatric assessment and treatment. Analysis documents the reach of video games across a growing global community of gamers, highlighting cases of the positives and negatives of video game usage. The games industry is largely oblivious to the psychological negatives, with psychiatrists encountering new conditions such as gaming addiction, which is now recognized by the World Health Organization. With an increasing amount of gamers worldwide, and an additional time per day invested in online gaming and character development, the concept of virtual identity as a means of expressing the id needs further study to ensure successful treatment. In conclusion, the assessment and treatment of game-related conditions are currently reactionary, and while some mental health professionals have begun utilizing interactive technologies to assist with the assessment and treatment of conditions, this study will determine how the success of these products can be enhanced. This will include collaboration between software developers and psychiatrists, allowing new avenues of skill-sharing in interactive design and development. Outlining how to innovate approaches to engagement will reap greater rewards in future interactive products developed for psychiatric assessment and treatment.

Keywords: virtual reality, virtual identity, interactivity, psychiatry

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Authors: Doaa Hashad, Amany Elbanna, Abeer Ibrahim, Gihan Khedr

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Background: H19 is one of the long non coding RNAs (LncRNA) that is related to the progression of many diseases including cancers. This work was carried out to study the level of the long non-coding RNA; H119, in plasma of patients with gastric cancer (GC) and to assess its significance in their clinical management. Methods: A total of sixty-two participants were enrolled in the present study. The first group included thirty-two GC patients, while the second group was formed of thirty age and sex matched healthy volunteers serving as a control group. Plasma samples were used to assess H19 gene expression using real time quantitative PCR technique. Results: H19 expression was up-regulated in GC patients with positive correlation to TNM cancer stages. Conclusions: Up-regulation of H19 is closely associated with gastric cancer and correlates well with tumor staging. Convenient, efficient quantification of H19 in plasma using real time PCR technique implements its role as a potential noninvasive prognostic biomarker in gastric cancer, that predicts patient’s outcome and most importantly as a novel target in gastric cancer treatment with better performance achieved on using both CEA and H19 simultaneously.

Keywords: biomarker, gastric, cancer, LncRNA

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Authors: Anjan Hazra, Nirjhar Dasgupta, Chandan Sengupta, Sauren Das

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Tea (Camellia sinensis) has received substantial attention from the scientific world time to time, not only for its commercial importance, but also for its demand to the health-conscious people across the world for its extensive use as potential sources of antioxidant supplement. These health-benefit traits primarily rely on some regulatory networks of different metabolic pathways. Development of microsatellite markers from the conserved genomic regions is being worthwhile for studying the genetic diversity of closely related species or self-pollinated species. Although several SSR markers have been reported, in tea the trait-specific Simple Sequence Repeats (SSRs) are yet to be identified, which can be used for marker assisted breeding technique. MicroRNAs are endogenous, noncoding, short RNAs directly involved in regulating gene expressions at the post-transcriptional level. It has been found that diversity in miRNA gene interferes the formation of its characteristic hair pin structure and the subsequent function. In the present study, the precursors of small regulatory RNAs (microRNAs) has been fished out from tea Expressed Sequence Tag (EST) database. Furthermore, the simple sequence repeat motifs within the putative miRNA precursor genes are also identified in order to experimentally validate their existence and function. It is already known that genic-SSR markers are very adept and breeder-friendly source for genetic diversity analysis. So, the potential outcome of this in-silico study would provide some novel clues in understanding the miRNA-triggered polymorphic genic expression controlling specific metabolic pathways, accountable for tea quality.

Keywords: micro RNA, simple sequence repeats, tea quality, trait specific marker

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Authors: Nadilla Saskia, Octoria Nur, Assegaf Zareeva

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Mass transport infrastructures are essential to enhance the connectivity between regions and regional equity in Indonesia. Indonesia’s capital city, Jakarta, ranked the 10th highest congestion rate in the world based on the 2019 traffic index, contributing to air pollution and energy consumption. Other than that, the World Air Quality Report in 2019 depicted Jakarta’s air pollutant concentration at 49.4 mg, the 5th highest in the world. Issues of severe traffic congestion, lack of sufficient urban infrastructure in Jakarta, and greenhouse gas emissions have to be addressed through mass transportation. Indonesia’s government is currently constructing The Greater Jakarta LRT (Light Rapid Transit) as convenient, efficient, and environmentally friendly transportation connecting Jakarta with Bekasi and Cibubur areas and plans to serve the passengers in August 2023. Greater Jakarta LRT is operated with Grade of Automation (GoA) No.3, Driverless Train Operation (DTO). Hence, the automated technology used in rail infrastructure is anticipated to address these issues with greater results. The paper will be validated and establish the extent to which the automation system would increase energy efficiency, help reduce carbon emissions, and benefit the environment. Based on the calculated CO2 emissions and fuel consumption for the existing condition (2015) during the feasibility study of the LRT Project and the predicted condition in 2030, it is obtained that Greater Jakarta LRT with GoA3 operation will reduce the CO2 emissions and fuel consumption by more than 50% in 2030. In the bigger picture, Greater Jakarta LRT supports the government's goal of achieving Jakarta Net-Zero Emissions (NZE) 2050.

Keywords: LRT, Grade of Automation (GoA), energy efficiency, carbon emissions, railway infrastructure, DKI Jakarta

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Authors: Chun Hsien Wu, Guan Xuan Wu, Hsia Ying Cheng, Shyh Ming Kuo

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Articular cartilage is composed of chondrocytes and extracellular matrix, such as collagen fibers, glycosaminoglycans, etc., which play an important role in lubricating and cushion joint activities. The phenotypic expression and metabolic activity of chondrocytes are extremely important in maintaining the functions of articular cartilage. In in vitro passaged culture of chondrocytes, chondrocytes gradually lose their original cell phenotype and morphology, which is called dedifferentiation. After continuous passaged culture of chondrocytes or induction by inflammatory factor IL-1, chondrocytes changed their phenotype and morphology. Also, the extracellular matrix type II collagen and GAG secretion were significantly reduced, while type I and X collagen were synthesized. Farnesol is an anti-inflammatory and antioxidant sesquiterpene compound that has the specific property of promoting collagen production. The purpose of this study was to investigate whether farnesol could restore the original type II collagen synthesis and, furthermore, the mechanisms of farnesol on the synthesis of type II collagen from the de-differentiated chondrocytes. The obtained results showed that the de-differentiated chondrocytes significantly restored to secret type II collagen and GAG (2.5-folds increases), and the secretion of collagen I and X and PGE2 synthesis were also significantly reduced after being treated with farnesol, indicating that farnesol had a restoration/re-differentiation effect on de-differentiated chondrocytes. The de-differentiated chondrocytes exhibited decreased expression of PPAR-γ and upregulated TGF-β expression to increase the MMP-13 expression. Higher expression of MMP-13 caused chondrocytes to secret type X collagen. On the contrary, increasing the expression of PPAR-γ would benefit the production of type II collagen. As shown, the PPAR-γ expression increased, and MMP-13 expression decreased after being treated with farnesol, indicating a possible signal pathway of farnesol to restore the production of type II collagen. However, more detailed mechanisms still need to evaluate.

Keywords: chondrocytes, de-differentiation, farnesol, re-differentiation

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Authors: Vijay Samuel, Tina Thekkekkara, Shoma Ganguly

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There is no reported Hanta Seoul virus infection in children in the UK so far, making it quite challenging for clinicians in diagnosing, predicting and prognosticating the outcome of the infection to patients and parents. We report a case of a ten-year-old girl who presented with pyrexia associated with headache, photophobia and abdominal pain. The family had recently acquired two pet rats six weeks ago. She appeared flushed with peri-oral pallor, coated the strawberry tongue, inflamed tonsils and bilateral cervical lymphadenopathy. Her liver and splenic edges were palpable. Investigations showed that she was thrombocytopenic with deranged renal and liver functions. An ultrasound abdomen demonstrated a mildly enlarged spleen, peripancreatic lymph node and an acalculous cholecystitis. In view of her clinical presentation, a diagnosis of leptospirosis was considered and she was commenced on intravenous benzylpenicillin. The following day she became oliguric, developed significant proteinuria and her renal function deteriorated. Following conservative management, her urine output gradually improved along with her renal function, proteinuria and thrombocytopaenia. Serology for leptospirosis and various other viruses were negative. Following discussion with the Rare and Imported Pathogens Laboratory at Porton hanta virus serology was requested and found to be strongly positive for Seoul hanta virus. Following discharge she developed palpitations, fatigue, severe headache and cognitive difficulties including memory loss and difficulties in spelling, reading and mathematics. Extensive investigations including ECG, MRI brain and CSF studies were performed and revealed no significant abnormalities. Since 2012, there have been six cases of acute kidney injury due to Hantavirus infection in the UK. Two cases were from the Humber region and were exposure to wild rats and the other four were exposed to specially bred pet fancy rats. Hanta virus infections can cause mild flu like symptoms but two clinical syndromes are associated with severe disease including haemorrhagic fever with renal syndrome, which may be associated with thrombocytopenia and Hantavirus cardiopulmonary syndrome. Neuropsychological impairments reported following hantavirus pulmonary syndrome and following Puumala virus infection have been reported. Minor white matter lesions were found in about half of the patients investigated with MRI brain. Seoul virus has a global distribution owing to the dispersal of its carrier host rats, through global trade. Several ports in the region could explain the possible establishment of Seoul virus in local populations of rats in the Yorkshire and Humber region. The risk of infection for occupationally exposed groups is 1-3% compared to 32.9% for specialist pet rat owners. The report highlight’s the importance of routinely asking about pets in the family. We hope to raise awareness of the emergence of hantavirus infection in the UK, particularly in the Yorkshire and Humber region. Clinicians should consider hantavirus infection as a potential cause of febrile illness causing renal impairment in children. Awareness of the possible neuro-cognitive sequele would help the clinicians offer appropriate information and support to children and their families. Contacting Rare and Imported Pathogens Laboratory at Porton is a useful resource for clinicians in UK when they consider unusual infections.

Keywords: Seoul hantavirus in child Porton, UK Acute kidney injury

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Authors: A. Hayrapetyan, A. Simon, P. Marques, G. Renart

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Business survival is a question of greatest interest for any economy. Firm characteristics that can explain or predict performance and, ultimately, business survival become of the greatest significance, as the sustainable longevity of any business can mean health for the future of the country. Family Firms (FFs) are one of the most ubiquitous forms of business worldwide, as more than half of European firms (60%) are considered as family firms. Therefore, the inherent characteristics of FFs are one of the possible explanatory variables for firm survival because FFs have strategic goals that differentiate them from other types of businesses. Although there is literature on the performance of FFs across generations, there are fewer studies on the factors that impact the survival of family and non-family FFs, as there is a lack of data on failed firms. To address this gap, this paper explores the differential survival of family firms versus non-family firms with a representative sample of companies of the region of Catalonia (Northeast of Spain) that were adhoc classified as family or nonfamily firms, as well as classified as failed or surviving, since no census data for family firms or for failed firms is available in Spain. By using the COX regression model on a representative sample of 629 family and non-family firms, this study investigates to what extent financial ratios, such as Liquidity, Solvency Rate can impact business survival, taking into consideration the socioemotional side of family firms, as well as revealing the differences between family and non-family firms. The findings show that the liquidity rate is significant for non-family firm survival, whereas not for family firms. On the other hand, FFs can benefit while having a higher solvency rate. Ultimately, this paper discovers that FFs increase their chances of survival when they are small, as the growth in size starts negatively impacting the socioemotional objectives of the firm. This study proves the existence of significant differences between family and non-family firms’ survival during economic crises, suggesting that the prioritization of emotional wealth creates distinct conditions for both types of firms.

Keywords: COX regression, economy crises, family firm, non-family firm, survival

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Authors: Abdelkarim Mahdhi, Fdhila Kais, Faouzi Lamari, Zeineb Hmila, Fathi Kamoun, Maria Ángeles Esteban, Amina Bakhrouf

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Aquaculture is the world’s fastest growing food-production sector. However, one of the most serious problems regarding the culture of marine fishes is the mortality associated with pathogenic bacteria that occurs in the critical phases of larval development. Conventional approaches, such as the use of antimicrobial drugs to control diseases, have had limited success in the prevention or cure of aquatic diseases. Promising alternatives to antibiotics are probiotics, which are food supplements consisting of live microorganisms that benefit the host organism. In the search for more effective and environmentally friendly treatments with probionts against pathogenic species in shrimp larval culture, the probiotic properties of Bacillus strains isolated from Artemia culture such as antibacterial activity, adhesion, pathogenicity, toxicity and the effect of marine stress on viability and survival were investigated, as well as the changes occurring in their properties. Analyses showed that these bacteria corresponded to the genus Bacillus sp. Antagonism and adherence assays revealed that these strains have an inhibitory effect against pathogenic bacteria in vitro and in vivo conditions and are fairly adherent. Challenge tests performed with Artemia larvae provided evidence that the tested Bacillus strains were neither pathogenic nor toxic to the host. The tested strains maintained their viability and their probiotic properties during the period of study. The results suggest that the tested strains have suffered changes allowing them to survive in seawater in the absence of nutrients and outside their natural host, identifying them as potential probiotic candidates for Artemia culture.

Keywords: bacillus, probiotic, cell viability, stress response

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Authors: Jelena Maletkovic

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Background: Endogenous Cushing’s syndrome is a rare disease, but iatrogenic or drug related Cushing syndrome from glucocorticoid products is commonly seen in clinical practice. With high dose and long term use of glucocorticoids, patients can develop isolated hypothalamic-pituitary-adrenal (HPA) suppression, or HPA axis suppression can be accompanied by overt iatrogenic Cushing’s syndrome. This is a rare case where severe Cushing’s syndrome developed from an unknown medication and was followed by severe and prolonged adrenal insufficiency and multiple potentially fatal complications. Case: This is a 37-year-old woman who is presented to Emergency Room (ER) with shortness of breath and chest pain. Four months prior to this presentation the patient was a generally healthy woman who was looking for improvement in her appearance and visited local Rejuvenation Clinic. After initial consultation with a nurse, she was contacted by a physician over the phone and was advised to start taking multiple injectable medications that will arrive by mail. Medications without any labels on bottles were delivered and the patient started daily intramuscular injections. Over the next two months, she noticed rounding of her face and swelling around her eyes. She gained 20 pounds, mostly abdominal fat and became extremely fatigued. Her muscles on legs were visibly decreasing in size and she felt significant muscle weakness. Unexplained bruising occurred. She started growing hair on face and developed secondary amenorrhea. New severe back pain started. She developed depression and headaches. Finally, over a few days, a number of red-purple stretch marks that were sensitive and painful appeared over her abdomen, upper part of arms and legs. She then became suspicious that these dramatic symptoms are caused by injectable medication and she discontinued injections. Over the next few days she presented to ER with low blood pressure and oxygen saturation of 75%. Studies revealed extensive pneumonia as well as multiple pulmonary emboli. Her white blood count was elevated with 32 000 and she also had acute kidney failure on admission. She was treated for sepsis and was also given stress dose steroids. Steroids were tapered over 48 hours and discontinued. After being discharged to home, on her first visit to endocrinology clinic she had undetectable ACTH of < 2pg/mL and undetectable 8am cortisol of < 0.2mcg/dL. She did not respond to an intramuscular injection of cosyntropin 250mcg and her repeated cortisol after 60 minutes was only 1mcg/dL. The patient was diagnosed with adrenal insufficiency and was started on hydrocortisone 20mg+10mg. It took close to 2 years of slow tapering for recovery of this patient’s HPA axis and resolve all the sequelae from Cushing’s syndrome. Conclusion: Misuse and abuse of glucocorticoids have been present almost since these medications were discovered. This is a rare case where not only severe Cushing’s syndrome in full clinical picture developed but also the patient suffered multiple potentially fatal complications and prolonged adrenal insufficiency. Visits to herbal, rejuvenation, esthetic, and similar clinics are becoming more and more popular and physicians need to be aware of possible non-benign nature of medications that their patients may be using.

Keywords: iatrogenic, Cushing's syndrome, adrenal crisis, steroid abuse

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Authors: S. J. Higgs, E. Van Eck, K. Heynis, S. H. Broadberry

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Engagement with non-human animals is a rapidly-growing field of study within the animal science and social science sectors, with human-interactions occurring in many forms; interactions, encounters and animal-assisted therapy. To our knowledge, there has been a wide array of research published on domestic and livestock human-animal interactions, however, there appear to be fewer publications relating to zoo animals and the effect these interactions have on the animal, human and establishment. The aim of this study was to identify if there were any perceivable benefits from the human-animal interaction for the cheetah, the human and the establishment. Behaviour data were collected before, during and after the interaction on the behaviour of the cheetah and the human participants to highlight any trends with nine interactions conducted. All 35 participants were asked to fill in a questionnaire prior to the interaction and immediately after to ascertain if their perceptions changed following an interaction with the cheetah. An online questionnaire was also distributed for three months to gain an understanding of the perceptions of human-animal interactions from members of the public, gaining 229 responses. Both questionnaires contained qualitative and quantitative questions to allow for specific definitive answers to be analysed, but also expansion on the participants perceived perception of human-animal interactions. In conclusion, it was found that participants’ perceptions of human-animal interactions saw a positive change, with 64% of participants altering their opinion and viewing the interaction as beneficial for the cheetah (reduction in stress assumed behaviours) following participation in a 15-minute interaction. However, it was noted that many participants felt the interaction lacked educational values and therefore this is an area in which zoological establishments can work to further improve upon. The results highlighted many positive benefits for the human, animal and establishment, however, the study does indicate further areas for research in order to promote positive perceptions of human-animal interactions and to further increase the welfare of the animal during these interactions, with recommendations to create and regulate legislation.

Keywords: Acinonyx jubatus, encounters, human-animal interactions, perceptions, zoological establishments

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Authors: Ashkan Ebadi, Adam Krzyzak

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Recommender systems, also known as recommender engines, have become an important research area and are now being applied in various fields. In addition, the techniques behind the recommender systems have been improved over the time. In general, such systems help users to find their required products or services (e.g. books, music) through analyzing and aggregating other users’ activities and behavior, mainly in form of reviews, and making the best recommendations. The recommendations can facilitate user’s decision making process. Despite the wide literature on the topic, using multiple data sources of different types as the input has not been widely studied. Recommender systems can benefit from the high availability of digital data to collect the input data of different types which implicitly or explicitly help the system to improve its accuracy. Moreover, most of the existing research in this area is based on single rating measures in which a single rating is used to link users to items. This paper proposes a highly accurate hotel recommender system, implemented in various layers. Using multi-aspect rating system and benefitting from large-scale data of different types, the recommender system suggests hotels that are personalized and tailored for the given user. The system employs natural language processing and topic modelling techniques to assess the sentiment of the users’ reviews and extract implicit features. The entire recommender engine contains multiple sub-systems, namely users clustering, matrix factorization module, and hybrid recommender system. Each sub-system contributes to the final composite set of recommendations through covering a specific aspect of the problem. The accuracy of the proposed recommender system has been tested intensively where the results confirm the high performance of the system.

Keywords: tourism, hotel recommender system, hybrid, implicit features

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Authors: Alex Knighton, Roba Khundkar, Michael Dunn

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Neo-colonialism is defined as the use of economic, political, cultural, or other pressures to control or influence other countries, especially former dependencies, and concerns have been raised about its presence in surgical missions. Surgical missions aim to rectify the huge disparity in surgical access worldwide, but their ethics must be carefully considered. This is especially in light of colonial history which affects international relations and global health today, to ensure that colonial attitudes are not influencing efforts to promote equity. This review examines the history of colonial global health, demonstrating that global health initiatives have consistently been used to benefit those providing them, and then asks whether elements of colonialism are still pervasive in surgical missions today. Data was collected from the literature using specified search terms and snowball searching, as well as from international expert web-based conferences on global surgery ethics. A thematic analysis was then conducted on this data, resulting in the identification of six themes which are identifiable in both past and present global health initiatives. These six themes are power, lack of understanding or respect, feelings of superiority, exploitation, enabling of dependency, and acceptance of poorer standards of care. An ethical analysis follows, concluding that the concerns of power and neo-colonialism in global surgery would be addressed by adopting a framework of procedural justice that promotes a refined governance process in which stakeholders are able to propose and reject decisions that affect them. The paper argues that adopting this model would address concerns of the power disparity in the field directly, as well as promoting an ethical framework to enable the other concerns of power disparity and neo-colonialism identified in the present analysis to be addressed.

Keywords: medical ethics, global surgery, global health, neocolonialism, surgical missions

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Authors: Asnate Kirse, Daina Karklina, Sandra Muizniece-Brasava, Ruta Galoburda

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Pulses are high in plant protein and dietary fiber, and contain slowly digestible starches. Innovative products from pulses could increase their consumption and benefit consumer health. This study was conducted to evaluate physicochemical stability of processed cowpea (Vigna unguiculata (L.) Walp. cv. Fradel) and maple pea (Pisum sativum var. arvense L. cv. Bruno) spreads at 5 °C temperature during 62-day storage. Physicochemical stability of pulse spreads was compared after sous vide treatment (80 °C/15 min) and high pressure processing (700 MPa/10 min/20 °C). Pulse spreads were made by homogenizing cooked pulses in a food processor together with salt, citric acid, oil, and bruschetta seasoning. A total of four different pulse spreads were studied: Cowpea spread without and with seasoning, maple pea spread without and with seasoning. Transparent PA/PE and light proof PET/ALU/PA/PP film pouches were used for packaging of pulse spreads under vacuum. The parameters investigated were pH, water activity and mass losses. Pulse spreads were tested on days 0, 15, 29, 42, 50, 57 and 62. The results showed that sous-vide treatment and high pressure processing had an insignificant influence on pH, water activity and mass losses after processing, irrespective of packaging material did not change (p>0.1). pH and water activity of sous-vide treated and high pressure processed pulse spreads in different packaging materials proved to be stable throughout the storage. Mass losses during storage accounted to 0.1% losses. Chosen sous-vide treatment and high pressure processing regimes and packaging materials are suitable to maintain consistent physicochemical quality of the new products during 62-day storage.

Keywords: cowpea, flexible packaging, maple pea, water activity

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Authors: M. Samsami, A. Hekmatdoost, N. Ebrahimi Daryani, P. Rezanejad Asl

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Ulcerative colitis (UC) is an inflammatory bowel disease in which immune and inflammatory factors are thought to be effective in this disease. Resveratrol is an antioxidant and anti-inflammatory compound. This study determined the effects of resveratrol compound on inflammatory factors in patients with ulcerative colitis. This study was a double-blind randomized clinical trial conducted on 50 patients with UC. Subjects received one capsule daily for 6 wk of either resveratrol (500 mg) or a placebo. Inflammatory factors, anthropometric measures, and IBDQ-9 (Inflammatory Bowel Disease Questionnaire-9) scores were assessed at baseline and at the end of the study. STATA12 software was used for data analysis. No significant differences were found in the background variables between the two groups at baseline. The results indicated that resveratrol supplementation for 6 week significantly decreased plasma levels of TNF-a and hs-CRP and the activity of NF-κB over the placebo group (p<0.001). Significant differences remained after adjustment for vitamin C (p<0.0001). The IBDQ-9 scores increased significantly in the resveratrol group over the placebo group (p<0.001). The findings of this study showed that resveratrol supplementation can be useful in patients with ulcerative colitis.

Keywords: IBD, inflammation, resveratrol, ulcerative colitis

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Authors: Jonathan A. Mikhail, Arsenio Paez

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It is not uncommon for a viral infection to cause hearing loss. Many viral infections are associated with sudden-onset, often unilateral, idiopathic sensorineural hearing loss. We conducted an exploratory study with thirty patients with pre-existing hearing loss between 50 and 64 to evaluate if COVID-19 was associated with exacerbated hearing loss. We hypothesized that hearing loss would be exacerbated by COVID-19 infection in patients with pre-existing hearing loss. A statistically significant paired T-test between pure tone averages (PTAs) at the patient’s original diagnosis and a current, updated audiometric assessment indicated a regression in hearing (p-value < .001) sensitivity following the contraction of COVID-19. Speech reception thresholds (SRTs) and word recognition scores (WRSs) were also considered, as well as the participants' gender. SRTs between each ear exhibited a statistically significant change (p-value of .002 and p-value < .001). WRSs did not show statistically significant differences (p-value of .290 and p-value of .098). A non-statistically significant Two-Way ANOVA was performed to evaluate gender’s potential role in exacerbated hearing loss and proved to be statistically insignificant (p-value of .214). This study discusses practical implications for clinical and educational pursuits in understanding COVID-19's effect on the auditory system and the need to evaluate the deadly virus further.

Keywords: audiology, COVID-19, sensorineural hearing loss, otology, auditory research

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Authors: Levylee Bautista, Dawn Grace Santos, Aishwarya Veluchamy, Jesusa Santos, Ghafoor Haque, Jr. I, Rodolfo Rafael

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Sesbania grandiflora is widely used in traditional medicine to treat a wide range of ailments. Assessment of its toxic properties is hence crucial when considering public health protection because exposure to plant extracts may pose adverse effects on consumers. This study aimed to investigate the acute intraperitoneal toxicity of S. grandiflora flower methanolic extract (SGFME) in Swiss albino mice. Four different concentrations (11.25, 22.5, 40, and 90 mg/kg) of SGFME were administered intraperitoneally and immediate behavioral and clinical signs were observed. All concentrations of SGFME-treated mice exhibited gasping and faster respiratory rate, writhing, reddening and fanning of the ears, paralysis of the hind leg, and mortality. Such reactions may be attributed to the histamine and saponin content of S. grandiflora. Results of this study suggests that intraperitoneal administration of SGFME produced significant adverse effect in mice, therefore, caution should be exercised in using it as herbal remedy since there is little control over its quality.

Keywords: acute toxicity test, histamine, medicinal plants, Sesbania grandiflora

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Authors: Shaoyi Lu

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Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

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Authors: Hsi-Chuan Wang, Hongxi Yin

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Compactness has been proposed as a type of sustainable urban form globally. However, the meanings and the measurements might diverse in regarding to the varying interpretation; moreover, since compactness was proposed to eliminate auto culture and urban sprawl in the developed countries, voices have emerged asking to rethink the suitability of compactness in the developing countries – based upon such understanding, Quality of Life (QOL) has been suggested as a good way to show the overall benefit of compactness. In regarding to such background, two subjects were targeted for discussion in this paper: (I) the meaning and feasibility of compactness between the developing and developed countries, and (II) the interaction between compactness and QOL. This paper argues that compactness should not be considered a universal principle for cities of all kind, but rather an ideal concept for urban designer and planner to consider throughout local practices. It firstly reviewed the benefits of both compactness and sprawl to uncover the features behind these urban forms, and later addressed the meaning and difficulty of adopting compactness in both the developing and developed countries. Secondly, arguing compactness to be positioned as a ‘process’ along the transition from the developing countries to the developed ones, this paper applied both cross-sectional and longitudinal analysis to uncover (I) the relationship between compactness and QOL in regarding to 30 American cities and (II) the impact of ‘becoming compact’ on QOL in regarding to 8 identified American Urbanized Areas (UZAs). The findings indicated that higher compactness could link to lower QOL among the compact cities, but with higher QOL among the sprawl cities. In addition, based upon the comparison between 2000 and 2010 on 8 UZAs, their QOL have escalated during the transition from the sprawl areas into the compact ones, but the extent of improvement in QOL could differ greatly among areas. In regarding to our findings, compact development should be proposed as a general guideline leading the contemporary sprawl cities in transition with sustainable urbanism; however, to prevent the externalities from damaging QOL with over-compactness, the compact policy should be flexible to adjust a long-term roadmap for sustainable development.

Keywords: compactness, quality of life, sprawl, sustainable urbanism

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Authors: Gopalu Karunakaran, Matheswaran Jagathambal, Nguyen Van Minh, Evgeny Kolesnikov, Denis Kuznetsov

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This work investigated the use of Beijerinckia indica extracellular extract for the synthesis of silver nanoparticles using AgNO₃. The formation of nanoparticles was confirmed by different methods, such as UV-Vis absorption spectroscopy, XRD, FTIR, EDX, and TEM analysis. The formation of silver nanoparticles (AgNPs) was confirmed by the change in color from light yellow to dark brown. The absorbance peak obtained at 430 nm confirmed the presence of silver nanoparticles. The XRD analysis showed the cubic crystalline phase of the synthesized nanoparticles. FTIR revealed the presence of groups that acts as stabilizing and reducing agents for silver nanoparticles formation. The synthesized silver nanoparticles were generally found to be spherical in shape with size ranging from 5 to 20 nm, as evident by TEM analysis. These nanoparticles were found to inhibit pathogenic bacterial strains. This work proved that the bacterial extract is a potential eco-friendly candidate for the synthesis of silver nanoparticles with promising antibacterial and antioxidant properties. 

Keywords: antioxidant activity, antimicrobial activity, Beijerinckia indica, characterisation, extracellular extracts, silver nanoparticles

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Authors: Faruk Aras, Melih Inal, Tansel Cinar

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The coordination of airport staff especially in the operations and maintenance departments is important for the airport operation. As a result, this coordination will increase the efficiency in all operation. Therefore, a Collaborative Decision-Making (CDM) system targets on improving the overall productivity of all operations by optimizing the use of resources and improving the predictability of actions. Enlarged productivity can be of major benefit for all airport operations. It also increases cost-efficiency. This study explains how predictive maintenance using IoT (Internet of Things), predictive operations and the statistical data such as Mean Time To Failure (MTTF) improves airport terminal operations and utilize airport terminal equipment in collaboration with collaborative decision making system/Airport Operation Control Center (AOCC). Data generated by the predictive maintenance methods is retrieved and analyzed by maintenance managers to predict when a problem is about to occur. With that information, maintenance can be scheduled when needed. As an example, AOCC operator would have chance to assign a new gate that towards to this gate all the equipment such as travellator, elevator, escalator etc. are operational if the maintenance team is in collaboration with AOCC since maintenance team is aware of the health of the equipment because of predictive maintenance methods. Applying predictive maintenance methods based on analyzing the health of airport terminal equipment dramatically reduces the risk of downtime by on time repairs. We can classify the categories as high priority calls for urgent repair action, as medium priority requires repair at the earliest opportunity, and low priority allows maintenance to be scheduled when convenient. In all cases, identifying potential problems early resulted in better allocation airport terminal resources by AOCC.

Keywords: airport, predictive maintenance, collaborative decision-making system, Airport Operation Control Center (AOCC)

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Authors: Mads Kirk Larsen

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Strict air pollution control is today high on the agenda world-wide. By reducing the particular emission, not only the mg/Nm3 will be reduced – also parts of mercury and other hazardous matters attached to the particles will be reduced. Furthermore, it is possible to catch the fine particles (PM2.5). For particulate control, the precipitators are still the preferred choice and much efforts have been done to improve the efficiencies. Many ESP’s have seen electrical upgrading by changing the traditional 1 phase power system into either 3 phase or SMPS (High Frequency) units. However, there exist a 4th type of power supply – the pulse type. This is unfortunately widely unknown, but may be of great benefit to power plants. The FLSmidth type is called COROMAX® and it is a high voltage pulse generator for precipitators using a semiconductor switch operating at medium potential. The generated high voltage pulses have rated amplitude of 80 kV and duration of 75 μs and are superimposed on a variable base voltage of 60 kV rated voltage. Hereby, achieving a peak voltage of 140 kV. COROMAX® has the ability to increase the voltage beyond the natural spark limit inside the precipitator. Voltage levels may often be twice as high after installation of COROMAX®. Hereby also the migration velocity increases and thereby the efficiency. As the collection efficiency is proportional to the voltage peak and mean values, this also increases the collection efficiency of the fine particles where test has shown 80% removal of particles less than 0.07 micron. Another great advantage is the indifference to back-corona. Simultaneously with emission reduction, the power consumption will also be reduced. Another great advantage of the COROMAX® system is that the emission can be improved without the need to change the internal parts or enlarge the ESP. Recently, more than 150 units have been installed in China, where emissions have been reduced to ultra-low levels.

Keywords: eleectrostatic precipitator, high resistivity dust, micropulse energization, particulate removal

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Authors: Ying-Ming Su, Mei-Shu Huang

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To mitigate the urban heat island effect has become a global issue facing the challenge of climate change. Through literature reviews, plant photosynthesis can reduce the carbon dioxide and mitigate the urban heat island effect relatively. Because there are not enough open space and park, green roof has become an important policy in Taiwan. We selected elementary school buildings in northern New Taipei City as research subjects since elementary school is asked priority to build green roof and important educational place to promote green roof concept. Testo 175-H1 recording device was used to record the temperature and humidity difference between roof surface and interior space below roof with and without green roof for the long-term. We also use questionnaire to investigate the awareness of comfort level of green roof and sensation of teachers and students of the elementary school. The results indicated the temperature of roof without greening was higher than that with greening about 2°C. But sometimes during noontime, the temperature of green roof was higher than that of non-green roof related to the character of the accumulation and dissipation of heat of greening probably. The temperature of interior space below green roof was normally lower than that without green roof about 1°C showed that green roof could lower the temperature. The humidity of the green roof was higher than the one without greening also indicated that green roof retained water better. Teachers liked to combine green roof concept in the curriculum, students wished all classes can take turns to maintain the green roof. Teachers and students that school had integrated green roof concept in the curriculum were more willing to participate in the maintenance work of green roof. Teachers and students who may access and touch the green roof can be more aware of the green roof benefit. We suggest architect to increase the accessibility and visibility of green roof, such as a part of the activity space. This idea can be a reference of the green roof curriculum design.

Keywords: comfort level, elementary school, green roof, heat island effect

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Authors: Hongmei Gu, Shaobo Liang, Richard Bergman

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With current worldwide trend in designs to have net-zero emission buildings to mitigate climate change, widespread use of mass timber products, such as Cross Laminated Timber (CLT), or Nail Laminated Timber (NLT) or Dowel Laminated Timber (DLT) in buildings have been proposed as one approach in reducing Greenhouse Gas (GHG) emissions. Consequentially, mass timber building designs are being adopted more and more by architectures in North America, especially for mid- to high-rise buildings where concrete and steel buildings are currently prevalent, but traditional light-frame wood buildings are not. Wood buildings and their associated wood products have tended to have lower environmental impacts than competing energy-intensive materials. It is common practice to conduct life cycle assessments (LCAs) and life cycle cost analyses on buildings with traditional structural materials like concrete and steel in the building design process. Mass timber buildings with lower environmental impacts, especially GHG emissions, can contribute to the Net Zero-emission goal for the world-building sector. However, the economic impacts from CLT mass timber buildings still vary from the life-cycle cost perspective and environmental trade-offs associated with GHG emissions. This paper quantified the Total Life Cycle Cost and cradle-to-grave GHG emissions of a pre-designed CLT mass timber building and compared it to a functionally-equivalent concrete building. The Total life cycle Eco-cost-efficiency is defined in this study and calculated to discuss the trade-offs for the net-zero emission buildings in a holistic view for both environmental and economic impacts. Mass timber used in buildings for the United States is targeted to the materials from the nation’s sustainable managed forest in order to benefit both national and global environments and economies.

Keywords: GHG, economic impact, eco-cost-efficiency, total life-cycle costs

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Authors: Ana M. Korol, Bibiana Riquelme, Osvaldo A. Rosso

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Since erythrocyte deformability analysis is mostly qualitative, the development of quantitative nonlinear methods is crucial for restricting subjectivity in the study of cell behaviour. An electro-optic mechanic system called erythrodeformeter has been developed and constructed in our laboratory in order to evaluate the erythrocytes' viscoelasticity. A numerical method formulated on the basis of fractal approximation for ordinary (OBM) and fractionary Brownian motion (FBM), as well as wavelet transform analysis, are proposed to distinguish chaos from noise based on the assumption that diffractometric data involves both deterministic and stochastic components, so it could be modelled as a system of bounded correlated random walk. Here we report studies on 25 donors: 4 alpha thalassaemic patients, 11 beta thalassaemic patients, and 10 healthy controls non-alcoholic and non-smoker individuals. The Correlation Coefficient, a nonlinear parameter, showed evidence of the changes in the erythrocyte deformability; the Wavelet Entropy could quantify those differences which are detected by the light diffraction patterns. Such quantifiers allow a good deal of promise and the possibility of a better understanding of the rheological erythrocytes aspects and also could help in clinical diagnosis.

Keywords: red blood cells, deformability, nonlinear dynamics, chaos theory, wavelet trannsform

Procedia PDF Downloads 45