Search results for: rare disease policy

Authors: Ilse Kreme

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To the best of this author’s knowledge, no studies have been identified on the connection between a refusal to engage in health-protective behaviors and a basic understanding of viral biology among community college students, faculty, and staff during the COVID-19 pandemic. Lack of scientific knowledge could prevent understanding of why these behaviors are important to prevent the community spread of COVID-19, even when they are not shown to offer much individual protection. In this study, a possible correlation was examined between a basic knowledge level of viral disease that comes from having taken a college biology course and disease perceptions of COVID-19. In particular, disease risk perception, disease severity percept and mask-wearing behaviors were examined as they correlated with having taken an undergraduate biology course. The effect of covariates of age, gender, and education level were investigated along with the main dependent variables. A representative sample of the population included students, faculty, and staff at Paradise Valley Community College (PVCC) in Phoenix, Arizona. Participants were recruited by an email sent to all students, faculty, and staff at PVCC using an all-college email distribution. Disease risk and severity perception were assessed with the Brief Illness Perception Questionnaire 5 (BIP-Q5), which was modified to include questions measuring participant age, education level, and whether they took or ever took a college biology course. Two additional questions measured compliance of willingness to wear a face mask. The results showed an effect of gender on mask-wearing behavior and a correlation between having taken a biology course and disease severity perception. No differences were seen in mask-wearing behavior and disease risk perception as a result of having taken a biology course. These findings suggest that taking an undergraduate biology course leads to a greater awareness of COVID-19 disease severity through an understanding of the basic biological principles of viral disease transmission. The results can be used to modify existing health education strategies. Further research is needed on how to best reach target audiences in all education brackets.

Keywords: COVID-19, education, gender, mask wearing, disease risk perception, disease severity perception

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Authors: Xue Wang, Liwei Fan

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Renewable energy technology innovation is an important way to realize the energy transformation. Our government has issued a series of policies to guide and support the development of renewable energy. The implementation of these policies will affect the further development, utilization and technological innovation of renewable energy. In this context, it is of great significance to systematically sort out and evaluate the renewable energy technology innovation policy for improving the existing policy system. Taking the 190 renewable energy technology innovation policies issued during 2005-2021 as a sample, from the perspectives of policy issuing departments and policy keywords, it uses text mining and content analysis methods to analyze the current situation of the policies and conduct a semantic network analysis to identify the core issuing departments and core policy topic words; A PMC (Policy Modeling Consistency) index model is built to quantitatively evaluate the selected policies, analyze the overall pros and cons of the policy through its PMC index, and reflect the PMC value of the model's secondary index The core departments publish policies and the performance of each dimension of the policies related to the core topic headings. The research results show that Renewable energy technology innovation policies focus on synergy between multiple departments, while the distribution of the issuers is uneven in terms of promulgation time; policies related to different topics have their own emphasis in terms of policy types, fields, functions, and support measures, but It still needs to be improved, such as the lack of policy forecasting and supervision functions, the lack of attention to product promotion, and the relatively single support measures. Finally, this research puts forward policy optimization suggestions in terms of promoting joint policy release, strengthening policy coherence and timeliness, enhancing the comprehensiveness of policy functions, and enriching incentive measures for renewable energy technology innovation.

Keywords: renewable energy technology innovation, content analysis, policy evaluation, PMC index model

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Authors: Renae McNair

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Subjective well-being levels were assessed in individuals diagnosed with an autoimmune disease. The current exploratory analysis sought to examine two factors that impact subjective well-being in individuals diagnosed with a chronic health condition. The two factors, resilience, and rumination, were assessed as possible moderators in self-reported levels of subjective well-being were measured. The importance of understanding the psychological state of perceived well-being in an individual diagnosed with an autoimmune disease is important given the impact of the level of subjective well-being on life longevity. In previous research, higher levels of subjective well-being are correlated with longer life longevity, including those individuals who have been diagnosed with an autoimmune disease. Conversely, individuals who report higher levels of negative affect have a shorter length of life longevity. According to the Center for Disease Control (CDC) and a report from the National Health Council, currently, 8-10% of individuals in the United States have been diagnosed with at least one autoimmune disease. Although treatment plans are in place to help manage the physical effects of disease, the psychological state of the person impacts life longevity. Resilience and rumination impact subjective well-being as an outcome in individuals diagnosed with an autoimmune disease. Resilience is the ability to adjust or adapt effectively and positively to unfavorable life conditions or events. Resilience acts as a protective factor in life, allowing those who face adversity to successfully adapt, regardless of the health diagnosis. Rumination is the worry or dwelling on the negative aspects of a given situation. Rumination interrupts the adaptive response, leading to a decrease in well-being. The relationship between resilience and subjective well-being were examined correlated with higher levels of resilience and higher levels of self-reported subjective well-being.

Keywords: subjective well-being, rumination, resilience, autoimmune disease

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Authors: Muhammad Faisal Khilji, Rana Shoaib Hamid

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Subdural hematoma (SDH) is an extremely rare complication of immune thrombocytopenic purpura (ITP). We present a case of a 34 years old female who presented to the Emergency department of a tertiary care hospital with complaints of headache, on and off gums bleeding and upper respiratory tract symptoms for the last two weeks. Examination was unremarkable except some purpura over limbs. Investigations revealed zero platelets and peripheral film suggestive of ITP. Computerized tomography (CT) brain revealed bilateral SDH in the frontal areas extending into Falx cerebri. Impression of ITP with SDH was made. Patient was treated with intravenous immunoglobulin (IVIg), methyl prednisolone and initial Platelets transfusion. Patient recovered uneventfully with platelets reaching normal levels within a few days and resolution of SDH without surgery.

Keywords: headache, immune thrombocytopenia, purpura, subdural hematoma

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Authors: Farah Amalina Mohamed Affandi, Redhwan Ahmad Al-Naggar, Seok Mui Wang, Thanikasalam Kathiresan

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Gestational choriocarcinoma is a condition in which there is an abnormal growth or a tumor inside the women’s uterus after conception. It is a type of gestational trophoblastic disease which is relatively rare and malignant. The current epidemiological data of this disease are inadequate. The purposes of this study are to examine the epidemiology of choriocarcinoma and their risk factors based on all available population-based and hospital-based data of the disease. In this study, we searched The MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases using the keywords ‘choriocarcinoma’, ‘gestational’, ‘gestational choriocarcinoma’ and ‘epidemiology’. We included only human studies published in English between 1995 and 2015 to ensure up to date evidence. Case studies, case reports, animal studies, letters to the editor, news, and review articles were excluded. Retrieved articles were screened in three phases. In the first phase, any articles that did not match the inclusion criteria based solely on titles were excluded. In the second phase, the abstracts of remaining articles were screened thoroughly; any articles that did not meet our inclusion criteria were excluded. In the final phase, full texts of the remaining articles were read and assessed to exclude articles that did not meet the inclusion criteria or any articles that fulfilled the exclusion criteria. Duplicates articles were also removed. Systematic reviews and meta-analysis were excluded. Extracted data were summarized in table and figures descriptively. The reference lists of included studies were thoroughly reviewed in search for other relevant studies. A total of ten studies met all the selection criteria. Nine were retrospective studies and one was cohort study. Total numbers of 4563 cases of choriocarcinoma were reviewed from several countries which are Korea, Japan, South Africa, USA, New Mexico, Finland, Turkey, China, Brazil and The Netherlands. Different studies included different range of age with their mean age of 28.5 to 30.0 years. All studies investigated on the disease’s incidence rate, only two studies examined on the risk factors or associations of the disease. Approximately 20% of the studies showed a reduction in the incidence of choriocarcinoma while the other 80% showed inconsistencies in rate. Associations of age, fertility age, occupations and socio-demographic with the status remains unclear. There is limited information on the epidemiological aspects of gestational choriocarcinoma. The observed results indicated there was a decrease in the incidence rate of gestational choriocarcinoma globally. These could be due to the reduction in the incidence of molar pregnancy and the efficacy of the treatment, mainly by chemotherapy.

Keywords: epidemiology, gestational choriocarcinoma, incidence, prevalence, risk factor

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Authors: Awais Naeem, Osama Shakeel, Faizan Ullah, Abdul Wahid Anwer

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Introduction: To study the clinic-pathological factors, diagnostic factors and survival of extra-pulmonary small cell carcinoma. Methodology: From 1995 to 2017 all patients with a diagnosis of extra-pulmonary small cell carcinoma were included in the study. Demographic variables and clinic-pathological factors were collected. Management of disease was recorded. Short and long term oncological outcomes were recorded. All data was entered and analyzed in SPSS version 21. Results: A total of 14 patients were included in the study. Median age was 53.42 +/- 16.1 years. There were 5 male and 9 female patients. Most common presentation was dysphagia in 16 patient among esophageal small cell carcinoma and while other patient had pain in abdomen. Mean duration of symptoms was 4.23+/-2.91 months .Most common site is esophagus (n=6) followed by gall bladder(n=3). Almost all of the patients received chemo-radiotherapy. Majority of the patient presented with extensive disease. Five patients (35.7%) died during the follow up period, two (14.3%) were alive and rest of the patients were lost to follow up. Mean follow up period was 22.92 months and median follow up was 15 months. Conclusion: Extra-pulmonary small cell carcinoma is rare and needs to be managed aggressively. All patients should be treated with both systemic and local therapies.

Keywords: small cell carcinoma of esophagus, extrapulmonary small cell carcinoma, small cell carcinoma of gall bladder, small cell carcinoma of rectum, small cell carcinoma of stomach

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Authors: Mary Rose Eunice S. Gundayao, Manolo M. Fernandez

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Metachromatic leukodystrophy (MLD) is a rare lysosomal storage disorder with an autosomal recessive inheritance pattern. Lysosomal storage disorders are often severe, follow a progressively neurodegenerative path, and may result in multi-organ failure, potentially leading to death within 5 to 6 years in cases of early-onset forms. There are limited data regarding cases of MLD in Filipino children. This is the case of a 2-year-old Filipino girl who presented with progressive neurological deterioration and was diagnosed with metachromatic leukodystrophy by molecular genetic testing. This case report aims to present this patient’s clinical history, neurological findings, diagnosis and novel genetic mutations causing MLD. A concise review of updated literature on MLD will be discussed.

Keywords: metachromatic leukodystrophy, ARSA gene, peripheral neuropathy, case report, demyelinating disease

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Authors: Eithan Hourie, Miki Malul, Raphael Bar-El

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To investigate the relationship between various welfare policies and the value of job security, we conducted a study with 201 people regarding their assessments of the value of job security with respect to three elements: income stability, assurance of continuity of employment, and security in the job. The experiment simulated different welfare policy scenarios, such as the amount and duration of unemployment benefits, workfare, and basic income. The participants evaluated the value of job security in various situations. We found that the value of job security is approximately 22% of the starting salary, which is distributed as follows: 13% reflects income security, 8.7% reflects job security, and about 0.3% is for being able to keep their current employment in the future. To the best of our knowledge, this article is one of the pioneers in trying to quantify the value of job security in different market scenarios and at varying levels of welfare policy. Our conclusions may help decision-makers when deciding on a welfare policy.

Keywords: job security value, employment protection legislation, status quo bias, expanding welfare policy

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Authors: Junnile Romero, Ilhwan Park, Vannie Joy Resabal, Carlito Tabelin, Richard Alorro, Leaniel Silva, Joshua Zoleta, Takunda Mandu, Kosei Aikawa, Mayumi Ito, Naoki Hiroyoshi

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Rare earth elements (REE) play a vital role in technological advancement due to their unique physical and chemical properties essential for various renewable energy applications. However, this increasing demand represents a challenging task for sustainability that corresponds to various research interests relating to the development of various extraction techniques, particularly on the extractant being used. In this study, TK221 (a modified polymer resin containing diglycolamide, carbamoyl methyl phosphine oxide (CMPO), and diglycolamide (DGA-N)) has been investigated as a conjugate extractant. FTIR and SEM analysis results confirmed the presence of CMPO and DGA-N being coated onto the PS-DVB support of TK221. Moreover, the kinetic rate law and adsorption isotherm batch test was investigated to understand the corresponding adsorption mechanism. The results show that REEs’ (Nd, Y, Ce, and Er) obtained pseudo-second-order kinetics and Langmuir isotherm, suggesting that the adsorption mechanism undergoes a single monolayer adsorption site via a chemisorption process. The Qmax values of Nd, Ce, Er, Y, and Fe were 45.249 mg/g, 43.103 mg/g, 35.088 mg/g, 15.552 mg/g, and 12.315 mg/g, respectively. This research further suggests that TK221 polymer resin can be used as an alternative absorbent material for an effective REE extraction.

Keywords: rare earth element, diglycolamide, characterization, extraction resin

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Authors: Ramuel Spirituel Mattathiah A. San Juan, Neil Ambasing

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Background: Reversal of vision metamorphopsia is a transient form of metamorphopsia described as an upside-down alteration of the visual field in the coronal plane. Patients would describe objects, such as cups, upside down, but the tea would not spill, and people would walk on their heads. It is extremely rare as a stable finding, lasting days or weeks. We report a case wherein this type of metamorphopsia occurred only in written words and lasted for six months. Objective: To the best of our knowledge, we report the first rare occurrence of reversal of vision metamorphopsia described as inverted words as the sole initial presentation of an underlying stroke. Case Presentation: We report a 59-year-old male with poorly controlled hypertension and diabetes mellitus who presented with a 3-day history of difficulty reading, described as the words were turned upside down as if the words were inverted horizontally then with the progression of deficits such as right homonymous hemianopia and achromatopsia, prosopagnosia. Cranial magnetic resonance imaging (MRI) revealed an acute infarct on the left posterior cerebral artery territory. Follow-up after six months revealed improvement of the visual field cut but with the persistence of the higher cortical function deficits. Conclusion: We report the first rare occurrence of metamorphopsia described as purely inverted words as the sole initial presentation of an underlying stroke. The differential diagnoses of a patient presenting with text reversal metamorphopsia should include stroke in the occipitotemporal areas. It further expands the landscape of metamorphopsias due to its exclusivity to written words and prolonged duration. Knowing these clinical features will help identify the lesion locus and improve subsequent stroke care, especially in time-bound management like intravenous thrombolysis.

Keywords: rare presentation, text reversal metamorphopsia, ischemic stroke, stroke

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Authors: Magdalena Barbara Kaziuk, Ilona Hubner, Jacek Hubner, Slawomir Kroczka

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Background: The motor neuron disease is a progressive neurodegenerative disease causing malfunction. Irrespective of the form of the disease and its onset always leads to the worsening of the quality of life, with patients usually depending on the family. Materials and methods: The study included 20 persons (5 females, 15 males, aged 65,5 ± 20 years) with clinically certain or probable diagnosis of the motor neuron disease. Patients were examined three times in the period of six months. The diagnosis was established based on the criteria of El Escorial. Manual dexterity was assessed using the test of the card Rene Zazzo and the test of shading in with lines Mira Stambak. Results: All patients achieved unsatisfactory results in Rene Zazzo’s test of the card and most of the patients (60%) in Mira Stambak’s test of shading with lines. Significantly higher test results were achieved for Rene Zazzo’s test and lower test results for Mira Stambak’s test in consecutive measurements. Conclusions: Impairment of manual dexterity is present already at the moment of diagnosing the disease and is growing significantly during its course. The quality of life for MND patients undergoes gradual deterioration as a result of the malfunction.

Keywords: manual dexterity, motor neuron disease, quality of life, malfunction

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Authors: Tewele Gerlase Haile

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Like any other country, Ethiopia's state government has reached today by undergoing many political changes. Until the last quarter of the 19th century, the aristocratic regimes of Ethiopia were using their infinite mystical power to shape the traditional public administrative institutions of the country. Mystical, feudal, social, and revolutionary political systems were used as sources of ruling power to the long-lasted monarchical, military and dictatorial regimes. For a country that is struggling to escape from the vicious cycle of poverty, famines, and civil wars, understanding how political regimes reform public policies and institutions is necessary for several reasons. A retrospective policy analysis approach is employed to determine how public policies are shaped by institutional factors and why the traditional public administration paradigm of Ethiopia continues to date despite regime changes. Using the experiences of political reforms practiced in four successive regimes (1916-2023), this retrospective analysis reveals a causal relationship among policy, institutional, and political failures. Moreover, Ethiopia's law-making and policy-making background significantly reflects the behavior of governments and their institutions. With a macro-level policy analysis in mind, the paper analyzes why the recent policy and institutional reforms twisted the country into unresolved military catastrophes.

Keywords: public administration, public policy, institutional reform, political structure

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Authors: Bidisha Chatterjee, Sonal Grover, Rekha Gurung

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Postpartum dissection of the internal carotid artery is a relatively rare condition and is considered as an underlying aetiology in 5% to 25% of strokes under the age of 30 to 45 years. However, 86% of these cases recover completely and 14% have mild focal neurological symptoms. Prognosis is generally good with early intervention. The risk quoted for a repeat carotid artery dissection in subsequent pregnancies is less than 2%. 36-year Caucasian primipara presented on postnatal day one of forceps delivery with tachycardia. In the intrapartum period she had a history of prolonged rupture of membranes and developed intrapartum sepsis and was treated with antibiotics. Postpartum ECG showed septal inferior T wave inversion and a troponin level of 19. Subsequently Echocardiogram ruled out post-partum cardiomyopathy. Repeat ECG showed improvement of the previous changes and in the absence of symptoms no intervention was warranted. On day 4 post-delivery, she had developed symptoms of droopy right eyelid, pain around the right eye and itching in the right ear. On examination, she had developed right sided ptosis, unequal pupils (Rt miotic pupil). Cranial nerve examination, reflexes, sensory examination and muscle power was normal. Apart from migraine, there was no medical or family history of note. In view of Horner’s on the right, she had a CT Angiogram and subsequently MR/MRA and was diagnosed with dissection of the cervical portion of the right internal carotid artery. She was discharged on a course of Aspirin 75mg. By 6 week post-natal follow up patient had recovered significantly with occasional episodes of unequal pupils and tingling of right toes which resolved spontaneously. Cervical artery dissection, including VAD and carotid artery dissection, are rare complications of pregnancy with an estimated annual incidence of 2.6–3 per 100,000 pregnancy hospitalizations. Aetiology remains unclear though trauma during straining at labour, underlying arterial disease and preeclampsia have been implicated. Hypercoagulable state during pregnancy and puerperium could also be an important factor. 60-90% cases present with severe headache and neck pain and generally precede neurological symptoms like ipsilateral Horner’s syndrome, retroorbital pain, tinnitus and cranial nerve palsy. Although rare, the consequences of delayed diagnosis and management can lead to severe and permanent neurological deficits. Patients with a strong index of suspicion should undergo an MRI or MRA of head and neck. Antithrombotic and antiplatelet therapy forms the mainstay of therapy with selected cases needing endovascular stenting. Long term prognosis is favourable with either complete resolution or minimal deficit if treatment is prompt. Patients should be counselled about the recurrence risk and possibility of stroke in future pregnancy. Coronary artery dissection is rare and treatable but needs early diagnosis and treatment. Post-partum headache and neck pain with neurological symptoms should prompt urgent imaging followed by antithrombotic and /or antiplatelet therapy. Most cases resolve completely or with minimal sequelae.

Keywords: postpartum, dissection of internal carotid artery, magnetic resonance angiogram, magnetic resonance imaging, antiplatelet, antithrombotic

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Authors: Pınar Yardımcı

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This paper tries to answer to the questions whether or not trade openness cause economic growth and trade policy changes is good for Turkey as a developing country in global economy before and after 1980. We employ Johansen cointegration and Granger causality tests with error correction modelling based on vector autoregressive. Using WDI data from the pre-1980 and the post-1980, we find that trade openness and economic growth are cointegrated in the second term only. Also the results suggest a lack of long-run causality between our two variables. These findings may imply that trade policy of Turkey should concentrate more on extra complementary economic reforms.

Keywords: globalization, trade policy, economic growth, openness, cointegration, Turkey

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Authors: Yafa Haron, Hanna Adami

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Background: World Health Organization emphasizes the contribution of nurses in planning and implementing health policies and reforms. Aim: To evaluate nursing students’ attitudes towards nurses’ involvement in health policy issues. Methods: Mixed-methods; qualitative and quantitative – a descriptive study. Participants - nursing students who were enrolled in their last year in the undergraduate program (BSN). Qualitative data included two open-ended questions: What is health policy and what is the importance of studying health policy, and 18 statements on the Likert Scale range 1-5. Results: Qualitativeanalysisrevealed that the majority of students defined health policy as a set of rules and regulations that defined procedures, borders, and proper conduct. 73% of students responded that nurses should be active in policymaking, but only 22% thought that nurses were currently involved in political issues. 28% thought that nurses do not have the knowledge and the time needed (60%) for political activity. 77% thought that the work environment did not encourage nurses to be politically active. Nursing students are aware of the importance towards nurses’ involvement in health policy issues, however, they do not have role models based on their low evaluation regarding nurses’ involvement in the health policy decision making process at the local or national level. Conclusions: Results emphasize the importance and the need of implementation the recommendation to include “advance policy changes” as core competency in nursing education and practice.

Keywords: health policy, nursing education, health systems, student perceptions

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Authors: Elidrissi Laila, El Rhaoussi Fatima-Zahra, Haddad Fouad, Tahiri Mohamed, Hliwa Wafaa, Bellabah Ahmed, Badre Wafaa

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Introduction: Metabolic Dysfunction Associated with Non-Alcoholic Fatty Liver Disease (MASLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), is the leading cause of chronic liver disease. The cardiometabolic risk factors associated with MASLD represent common health issues and significant public health challenges. Medical students, being active participants in the healthcare system and a young demographic, are particularly relevant for understanding this entity to prevent its occurrence on a personal and collective level. The objective of our study is to assess the level of knowledge among medical students regarding MASLD, its risk factors, and its long-term consequences. Materials and Methods: We conducted a descriptive cross-sectional study using an anonymous questionnaire distributed through social media over a period of 2 weeks. Medical students from various faculties in Morocco answered 22 questions about MASLD, its etiological factors, diagnosis, complications, and principles of treatment. All responses were analyzed using the Jamovi software. Results: A total of 124 students voluntarily provided complete responses. 59% of our participants were in their 3rd year, with a median age of 21 years. Among the respondents, 27% were overweight, obese, or diabetic. 83% correctly answered more than half of the questions, and 77% believed they knew about MASLD. However, 84% of students were unaware that MASLD is the leading cause of chronic liver disease, and 12% even considered it a rare condition. Regarding etiological factors, overweight and obesity were mentioned in 93% of responses, and type 2 diabetes in 84%. 62% of participants believed that type 1 diabetes could not be implicated in MASLD. For 83 students, MASLD was considered a diagnosis of exclusion, while 41 students believed that a biopsy was mandatory for diagnosis. 12% believed that MASLD did not lead to long-term complications, and 44% were unaware that MASLD could progress to hepatocellular carcinoma. Regarding treatment, 85% included weight loss, and 19% did not consider diabetes management as a therapeutic approach for MASLD. At the end of the questionnaire, 89% of the students expressed a desire to learn more about MASLD and were invited to access an informative sheet through a hyperlink. Conclusion: MASLD represents a significant public health concern due to the prevalence of its risk factors, notably the obesity pandemic, which is widespread among the young population. There is a need for awareness about the seriousness of this emerging and long-underestimated condition among young future physicians.

Keywords: MASLD, medical students, obesity, diabetes

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Authors: Eliud Kiprop, Kenichi Matsui, Joseph Karanja, Hesborn Ondiba

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To double the share of renewable energy in the global energy mix by 2030 as part of actions for the Paris Agreement, policymakers in each ratifying country must accelerate their efforts within the next few years by implementing their own renewable energy strategies. Kenya has increased its funding for research and development in renewable energy sources largely because it intends to reduce greenhouse gas GHG emissions by 30% from business as usual (BAU) levels (143 MtCO₂eq) by 2030. In 2013, the Kenyan government launched an ambitious plan to increase the installed power generation capacity from 1,768MW to more than 5,000MW by the end of 2017. This paper examines the formulation and implementation process of this plan and shows how this plan will affect Kenya’s renewable energy industry and national policy implementation in general. Results demonstrate that, despite having a well- documented policy in place, the Kenyan government cannot meet its target of 5000MW by the end of 2017. Among other factors, we find that the main reason is attributable to the failure in adhering to the main principles of the policy plan. We also find that the government has failed to consider the future energy demand. Had the policy been implemented on time, we argue that there would have been excess power.

Keywords: policy implementation, policy plan, renewable energy, sustainable development

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Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova, Anna Khelkovskaya-Sergeeva

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Objectives: The duration of the disease could be one of the leading factors in the effectiveness of therapy in systemic sclerosis (SSc). The aim of the study was to assess how the duration of the disease affects the changes of lung function in patients(pts) with interstitial lung disease (ILD) associated with SSc during long-term RTX therapy. Methods: We prospectively included 113pts with SSc in this study. 85% of pts were female. Mean age was 48.1±13years. The diffuse cutaneous subset of the disease had 62pts, limited–40, overlap–11. The mean disease duration was 6.1±5.4years. Pts were divided into 2 groups depending on the disease duration - group 1 (less than 5 years-63pts) and group 2 (more than 5 years-50 pts). All pts received prednisolone at mean dose of 11.5±4.6 mg/day and 53 of them - immunosuppressants at inclusion. The parameters were evaluated over the periods: at baseline (point 0), 13±2.3mo (point 1), 42±14mo (point 2) and 79±6.5mo (point 3) after initiation of RTX therapy. Cumulative mean dose of RTX in group 1 at point 1 was 1.7±0.6 g, at point 2 = 3.3±1.5g, at point 3 = 3.9±2.3g; in group 2 at point 1 = 1.6±0.6g, at point 2 = 2.7±1.5 g, at point 3 = 3.7±2.6 g. The results are presented in the form of mean values, delta(Δ), median(me), upper and lower quartile. Results. There was a significant increase of forced vital capacity % predicted (FVC) in both groups, but at points 1 and 2 the improvement was more significant in group 1. In group 2, an improvement of FVC was noted with a longer follow-up. Diffusion capacity for carbon monoxide % predicted (DLCO) remained stable at point 1, and then significantly improved by the 3rd year of RTX therapy in both groups. In group 1 at point 1: ΔFVC was 4.7 (me=4; [-1.8;12.3])%, ΔDLCO = -1.2 (me=-0.3; [-5.3;3.6])%, at point 2: ΔFVC = 9.4 (me=7.1; [1;16])%, ΔDLCO =3.7 (me=4.6; [-4.8;10])%, at point 3: ΔFVC = 13 (me=13.4; [2.3;25.8])%, ΔDLCO = 2.3 (me=1.6; [-5.6;11.5])%. In group 2 at point 1: ΔFVC = 3.4 (me=2.3; [-0.8;7.9])%, ΔDLCO = 1.5 (me=1.5; [-1.9;4.9])%; at point 2: ΔFVC = 7.6 (me=8.2; [0;12.6])%, ΔDLCO = 3.5 (me=0.7; [-1.6;10.7]) %; at point 3: ΔFVC = 13.2 (me=10.4; [2.8;15.4])%, ΔDLCO = 3.6 (me=1.7; [-2.4;9.2])%. Conclusion: Patients with an early SSc have more quick response to RTX therapy already in 1 year of follow-up. Patients with a disease duration more than 5 years also have response to therapy, but with longer treatment. RTX is effective option for the treatment of ILD-SSc, regardless of the duration of the disease.

Keywords: interstitial lung disease, systemic sclerosis, rituximab, disease duration

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Authors: Purnima Pandit

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Malaria remains one of the world’s most deadly infectious disease and arguably, the greatest menace to modern society in terms of morbidity and mortality. To choose the right treatment and to ensure a quality of life suitable for a specific patient condition, early and accurate diagnosis of malaria is essential. It reduces transmission of disease and prevents deaths. Our work focuses on designing an efficient, accurate fuzzy inference system for malaria diagnosis.

Keywords: fuzzy inference system, fuzzy logic, malaria disease, triangular fuzzy number

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Authors: M. J. Pourvaghar, M. E. Bahram, Sh. Khoshemehry

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Hyperlipidemia or an increase in blood lipids is a condition that has been rising, especially during the last decade, with the advancement of the life-span of the car, as an important disease. In fact, it is one of the complications of industrial life and semi-industrial. Hyperlipidemia alone is not a disease, but it is recognized as an important risk factor for coronary artery disease. The methodology of this review article is the use of research to provide the best solution for physical activity and exercise in relation to lowering blood lipids and lowering blood pressure. Also, factors that contribute to improving the health status of humans should be introduced. Research findings in this article show that physical activity with a specific duration and severity can keep a person away from the cardiovascular disease. The result shows that regular physical activity with low intensity and long periods of time is essential for human health. Physical mobility reduces blood pressure, reduces the harmful fats and does not cause cardiovascular disease. More than half of the patients suffering from cardiovascular problems are afflicted with blood lipids. On the other hand, high blood pressure is one of the serious health hazards in the world today, which causes a large number of cardiovascular problems and mortality in the world. Undoubtedly, the second most common risk factor for heart disease is high blood pressure after cigarette smoking.

Keywords: blood pressure, cardiovascular, hyperlipidemia, risk factor

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Authors: Veronique Jubera, Guillaume Salek, Manuel Gaudon, Alain Garcia, Alain Demourgues

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Luminescence of transition metal and rare earth elements cover ultraviolet to far infrared wavelengths. Applications of phosphors are numerous. One can cite lighting, sensing, laser, energy, medical or military applications. But regarding each domain, specific criteria are required and they can be achieved with a strong control of the chemical composition. Emission of doped materials can be tailored with modifications of the local environment of the cations. For instance, the increase of the crystal field effect shifts the divalent manganese radiative transitions from the green to the red color. External factor as heat-treatment can induce changes of the doping element location or modify the unit cell crystalline symmetry. By controlling carefully the synthesis route, it is possible to initiate emission shift and to establish the thermal history of a compound. We propose to demonstrate through the luminescence of divalent manganese and trivalent rare earth doped oxide, that it is possible to follow the thermal history of a material. After optimization of the synthesis route, structural and optical properties are discussed. Finally, thermal calibration graphs are successfully established on these doped compounds. This makes these materials promising probe for thermal sensing.

Keywords: emission, thermal sensing, transition metal, rare eath element

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Authors: E. Kharaishvili

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The paper shows the necessity of farm diversification in accordance with the current trends in agricultural sector of Georgia. The possibilities for the diversification and the corresponding economic policy are suggested. The causes that hinder diversification of farms are revealed, possibilities of diversification are suggested and the ability of increasing employment through diversification is proved. Index of harvest diversification is calculated based on the areas used for cereals and legumes, potatoes and vegetables and other food crops. Crop and livestock production indexes are analyzed, correlation between crop capacity index and value-added per one worker and one ha is studied. Based on the research farm diversification strategies and priorities of corresponding economic policy are presented. Based on the conclusions relevant recommendations are suggested.

Keywords: farm diversification, diversification index, agricultural development policy

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Authors: Ghoul Rachid Brahim

Abstract:

Introduction: Degenerative disc disease is a process of premature and accelerated deterioration of the intervertebral disc; it is of multifactorial origin and is responsible for chronic low back pain. Objectives: Determine an epidemiological profile of patients with painful lumbar degenerative disc disease. Patients and methods: We performed a prospective study of 104 patients operated on for degenerative painful lumbar disc disease over a period of 25 months. The parameters analyzed were: age, sex, Body Mass Index (BMI), comorbidities, family history of low back pain, and difficulty with professional activity. Results: The average age was 43.3 years, with a clear predominance of men: 72 men for 32 women, the average BMI was 26.80Kg / m2, and 63.5% of the patients were overweight. The occurrence of disc degeneration in pathological conditions was noted in 14.4% of cases. The notion of familial low back pain was found in 49% of cases. The majority of patients perform more or less arduous work (51%) in the cases. Conclusion: In our series, degenerative painful lumbar disc disease predominates in the male subject, active obese who performs more or less painful work, in whom we find a family history of low back pain.

Keywords: degenerative disc disease, low back pain, body mass index, disque intervertebrale

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Authors: Tzuli Lin

Abstract:

This paper aims to explore that the EU and Member State (UK) converges on cultural diplomacy to constitute an influential European external relations. It will address the development of EU cultural diplomacy and practice at Member state level. It also discusses the EU and Member States suffering in cultural resource overlapped. In contrast to the literature on the EU external relations, studies of the cultural dimension are rare. Thus, this paper will utilise the broad policy papers to explore how the cultural diversity among the Member States and the EU has a constructive progress at European level but not at Member State level. It can be argued that cultural component is the pivotal strategy for the stagnated EU external relations since the Euro crisis. The EU recognises that if it wants to promote the trade relations from the inside of Europe to outside, it requires the broad culture context among its traditional diplomacy, which brings the cultural component into a significant role. Even though in the area of Member State level, they share the fundamental value and idea, it does not elaborate Member States regarding the EU as a representative of European cultural diplomacy. In theory and practice, the discourse of Normative Power Europe (NPE) can be the analytic framework to construct the research of cultural diplomacy in Europe. NPE is an idea of the EU’s global role and spreading its norms to others. Moreover, Member States’ national interest has supreme priority rather than the EU. Therefore, this paper will utilise the UK as a case study to explore that cultural diplomacy shows fragmentation at European level. In the result, this paper will illustrate that the EU and the UK have mutual recognised each other as a partner not a leader.

Keywords: EU cultural diplomacy, cultural policy, cultural diversity, normative power

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Authors: EMMANUEL DWAMENA SASU

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International climate policy actions require countries under Paris Agreement to design instruments, provide support (financial and technical), and strengthen institutional capacity with tendency to transcending policy formulation to implementation and sustainability. Changes associated with moisture depletion has been a growing phenomenon; especially in developing countries with projected global GDP drop from 7% to 2% between 2005 and 2050. These developments have potential to adversely affect food production in feeding the growing world population, with corresponding rise in global hunger. Incongruously, there is global absence of a harmonized policy direction; capable of providing the required indicators on climate policies for monitoring sustainability of international agricultural development projects. We conduct extensive review and synthesis on existing limitations on global climate policy governance, agricultural food security and sustainability of international agricultural development projects, and conjecture the role of non-state and sub-national climate stakeholder engagements, and monitoring and evaluation strategies for improved climate policy action for sustaining international agricultural development projects.

Keywords: climate policy, agriculture, development projects, sustainability

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Authors: Simon Tsipis

Abstract:

In this study, we propose to analyze Russian foreign policy conduct by applying the theory of Political Realism and the qualitative comparative method of analysis. We find that the paradigm of Political Realism supplies us with significant insights into the sources of contemporary Russian foreign policy conduct since the power factor was and remains an integral element in Russian foreign policies, especially when we apply comparative analysis and compare it with the behavior of its Soviet predecessor. Through the lens of the Realist theory, a handful of Russian foreign policy-making becomes clearer and much more comprehensible.

Keywords: realism, Russia, cold war, Soviet Union, European security

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Authors: C. Gallottini, W. Di Mari, A. Amaddeo, K. Barbaro, A. Dolci, G. Dolci, L. Gallottini, G. Barraco, S. Eramo

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A group of 10 dogs (group A) with Periodontal Disease in the third stage, were subjected to regenerative therapy of periodontal tissues, by use of nano hydroxy apatite (NHA). These animals induced by general anesthesia, where treated by ultrasonic scaling, root planning, and at the end by a mucogingival flap in which it was applied NHA. The flap was closed and sutured with simple steps. Another group of 10 dogs (group B), control group, was treated only by scaling and root planning. No patient was subjected to antibiotic therapy. After three months, a check was made by inspection of the oral cavity, radiography and bone biopsy at the alveolar level. Group A showed a total restitutio ad integrum of the periodontal structures, and in group B still mild gingivitis in 70% of cases and 30% of the state remains unchanged. Numerous experimental studies both in animals and humans have documented that the grafts of porous hydroxyapatite are rapidly invaded by fibrovascular tissue which is subsequently converted into mature lamellar bone tissue by activating osteoblast. Since we acted on the removal of necrotic cementum and rehabilitating the root tissue by polishing without intervention in the ligament but only on anatomical functional interface of cement-blasts, we can connect the positive evolution of the clinical-only component of the cement that could represent this perspective, the only reason that Periodontal Disease become a Cement Disease, while all other clinical elements as nothing more than a clinical pathological accompanying.

Keywords: nanoidroxiaphatite, parodontal disease, cement disease, regenerative therapy

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Authors: Chenhong Peng

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Beijing, the capital city of China, is running out of water. The water resource per capita in Beijing is only 106 cubic meter, accounts for 5% of the country’s average level and less than 2% of the world average level. The tension between water supply and demand is extremely serious. For one hand, the surface and ground water have been over-exploited during the last decades; for the other hand, water demand keep increasing as the result of population and economic growth. There is a massive gap between water supply and demand. This paper will focus on addressing the water shortage in Beijing city by increasing water use efficiency in domestic sector. First, we will emphasize on the changing structure of water supply and demand in Beijing under the economic development and restructure during the last decade. Second, by analyzing the water use efficiency in agriculture, industry and domestic sectors in Beijing, we identify that the key determinant for addressing the water crisis is to increase the water use efficiency in domestic sector. Third, this article will explore the two primary causes for the water use inefficiency in Beijing: The ineffective water pricing policy and the poor water education and communication policy. Finally, policy recommendation will offered to improve the water use efficiency in domestic sector by making and implementing an effective water pricing policy and people-engaged water education and communication policy.

Keywords: Beijing, water use efficiency, domestic sector, water pricing policy, water education policy

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Authors: Dylan Yanano Mangani, Theodore Nkadimeng Mahosi

Abstract:

Soon after independence on 18th April 1980, Zimbabwe’s foreign policy was shaped by the realities on the ground, which saw the country managing a sound relationship with both the Capitalist West and the Communist Eastern blocs. The post-independence foreign policy was therefore premised on security concerns illuminated by the Cold War era. This was one the reasons President Robert Mugabe adopted a policy of reconciliation and this earned his government recognition on the international platform. However, in Southern Africa apartheid South Africa was still the vanguard of capitalism and oppression such that she posed a serious threat to the newly born Zimbabwean nation which necessitated that Zimbabwe position herself both in the region and the continent to counter potential internal stability from within. Irrespective of how the international community viewed the country’s foreign policy Zimbabwe has continued to influence regional, continental and world geo-politics, especially on behalf of the developing nations. This raises a question why as a result of its foreign policy the country is now regarded a pariah state, especially some Western countries which used to applaud its political economic policies immediately after independence. Therefore, this study argues that the political economy of Zimbabwe had a far-reaching bearing on its foreign policy. For this reason, the problem necessitates the investigation of Zimbabwe’s foreign policy perspectives in Southern Africa since the turn of the 1990s. Two main theories which are Realism, Afro-centrism inform the study as an attempt to understand Zimbabwe’s foreign policy paradigm shift and perhaps provide answers to the objectives raised. The research therefore employs a qualitative approach where the conceptual nature of the study into the foreign policy of Zimbabwe is largely desktop research. However, the nature of the study will also require that oral interviews are conducted to substantiate some of the arguments advanced.

Keywords: cold war set up, foreign policy, look east policy, pan-africanism, post 2000 period, Southern Africa, Zimbabwe

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Authors: Jamil Ahmed

Abstract:

Access control models aim to decide whether a user should be denied or granted access to the user‟s requested activity. Various access control models have been established and proposed. The most prominent of these models include role-based, attribute-based, policy based access control models as well as role-centric attribute based access control model. In this paper, a novel access control model is presented called “Role centric Attribute based Policy Driven Access Control (RAPDAC) model”. RAPDAC incorporates the concept of “policy” in the “role centric attribute based access control model”. It leverages the concept of "policy‟ by precisely combining the evaluation of conditions, attributes, permissions and roles in order to allow authorization access. This approach allows capturing the "access control policy‟ of a real time application in a well defined manner. RAPDAC model allows making access decision at much finer granularity as illustrated by the case study of a real time library information system.

Keywords: authorization, access control model, role based access control, attribute based access control

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