Search results for: clinical interpretation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4535

Search results for: clinical interpretation

1865 Study on the Incidence of Chikungunya Infection in Swat Region

Authors: Nasib Zaman, Maneesha Kour, Muhammad Rizwan, Fazal Akbar

Abstract:

Abstract: Chikungunya fever is a re-emerging rapidly spreading mosquito-borne disease cause by Aedes albopictus and Aedes aegypti mosquito vectors. Currently, it is affecting millions of people globally. Objective: This study's main objective was to find the incidence of chikungunya fever in the Swat region and the factors associated with the spread of this infection. Method: This study was carried out in different areas of Swat. Blood samples and data were collected from selected patients, and a questionnaire was filled for each patient. 3-5ml of the specimen was taken from the patient's vein and serum, or plasma was separated by centrifugation. Chikungunya tests were performed for IgG and IgM antibodies. The data was analyzed by SPSS and Graph Paid Prism 5. Results: A total of 169 patients were included in this study, out of which 103 (60.9%) having age less than 30 years were positive for chikungunya infection and 66 (39.1%) having more than 30 years were negative for this infection. Only 1 (0.6%) were positive for both IgG and IgM antibody. About 15 (8.9%) patients have diagnosed with positive IgG antibodies, and 25 (26.6%) patients were positive for IgM positive antibodies. The infection rate was significantly higher in males compared to females 71 (59.6%) vs. 14 (38%) P value=0.088, OR=1.7. Conclusion: This study concludes clinical knowledge and awareness that are necessary for a diagnosis of chikungunya infection properly. Therefore it is important to educate people for the eradication of this infection. Recommendation: This study also recommends investigating the other risk factors associated with this infection.

Keywords: Chikungunya, risk factor, Incidence, antibodies, mosquito

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1864 PET Image Resolution Enhancement

Authors: Krzysztof Malczewski

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PET is widely applied scanning procedure in medical imaging based research. It delivers measurements of functioning in distinct areas of the human brain while the patient is comfortable, conscious and alert. This article presents the new compression sensing based super-resolution algorithm for improving the image resolution in clinical Positron Emission Tomography (PET) scanners. The issue of motion artifacts is well known in Positron Emission Tomography (PET) studies as its side effect. The PET images are being acquired over a limited period of time. As the patients cannot hold breath during the PET data gathering, spatial blurring and motion artefacts are the usual result. These may lead to wrong diagnosis. It is shown that the presented approach improves PET spatial resolution in cases when Compressed Sensing (CS) sequences are used. Compressed Sensing (CS) aims at signal and images reconstructing from significantly fewer measurements than were traditionally thought necessary. The application of CS to PET has the potential for significant scan time reductions, with visible benefits for patients and health care economics. In this study the goal is to combine super-resolution image enhancement algorithm with CS framework to achieve high resolution PET output. Both methods emphasize on maximizing image sparsity on known sparse transform domain and minimizing fidelity.

Keywords: PET, super-resolution, image reconstruction, pattern recognition

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1863 Effectiveness of Short-Term Cognitive-Behavioral Group Therapy on Binge Eating Disorder in Females

Authors: Saeed Dehnavi, Ismail Asadallahi, Fatemeh Rahmatian, Elahe Rahimian

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Purpose: Due to an increasing prevalence of over eating disorders, this paper aims to investigate the effectiveness of short-term group cognitive-behavioral therapy on reducing binge eating behavior and depression symptoms among females suffered from binge eating disorder (BED) in Qazvin, Iran. Methodology: This is aquasi-experimental study (pre-post testing plan with control group). Using a convenience sampling technique, binge eating scale (BES) and clinical interviews, 30 persons were selected among all clients who had referred to weight loss centers in Qazvin, these persons were randomly placed into two control and experimental groups. The experimental group participated in a seven-session plan on short-term cognitive-behavioral group therapy. Results: The results showed that the short term group cognitive-behavioral therapy results in a significant reduction in binge eating signs and depressive symptoms within the experimental group, compared to the control. Conclusion: Regarding the results, it is known that short-term group cognitive-behavioral therapy is effective in reducing overeating symptoms. Hence, it can be used as an economical and effective treatment method for individuals suffering from BED.

Keywords: cognitive-behavioral group therapy, binge eating disorder, depression

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1862 Azaridachta Indica (Neem) Seed Oil Effect in Experimental Arthritis – Biochemical Parameters Assessment

Authors: Sasan Khademnematolahi, Kevine Kamga Silihe, Katarína Pružinská, Martina Chrastina, Elisabeth Louise Ndjengue Mindang, František Dráfi, Katarína Bauerová

Abstract:

Background: In ethnomedicine, plant parts and compounds are traditionally utilized to treat many disorders. Azadirachta indica, known as Neem, has been traditionally used in medicinal practices. Neem has various pharmaceutical activities, such as antioxidant and anti-inflammatory, due to the content of bioactive compounds like nimbolide, azadirachtin, and gedunin.Through its effect on pathological inflammatory processes, supplementation with it could alleviate the symptoms of rheumatoid arthritis (RA). Methods: This research aimed to assess Neem seed oil's impact on rats with adjuvant arthritis. Three doses in monotherapy and two in combination with methotrexate (MTX) have been studied and their effect was compared. Neem p.o. doses of 100, 200, and 300 mg/kg and MTX p.o. doses of 0.3 mg/kg were examined. After clinical parameters assessment, biochemical analysis was performed in plasma. Results: During the acute phase of the experimental arthritis (Day21), levels of MMP-9, MCP-1 and cytokines IL-1beta and IL-17A were measured. The positive results of inflammatory mediators evaluation in plasma encourage additional analysis also in related tissues to prove if Neem seed oil can be used as an adjuvant therapy for RA. Conclusion: In this study, the combination therapy of Neem with MTX was most effective from all therapies investigated.

Keywords: adjuvant, neem, methotrexate, arthritis

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1861 Nurses’ Views on ‘Effective Nurse Leader’ Characteristics in Iraq

Authors: S. Abed, S. O’Neill

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This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.

Keywords: health care, nurse education, nursing in Iraq, nurse leadership

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1860 Intraosseous Urography by Iodixanol in Persian Squirrels

Authors: Mehdi Tavana, Seyedeh Zeinab Peighambarzadeh

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Excretory urography is used for morphologic and especially functional studies of the urinary tracts. There are many indications for excretory urography in humans and animals. Intravenous urography is the most practical method, other urography techniques were manipulated because of difficulties for finding veins in small size of the patients. At the best of times, the combination of small veins and abundant subcutaneous tissue make vascular access difficult or impossible, therefore, another methods of administration of contrast media is desired. This study was performed to evaluate the feasibility of intraosseous injection of iodixanol in providing a safe and diagnostic urogram in Persian squirrel. Fourteen hundreds mg iodine per kilogram body weight of iodixanol were injected subcutaneously over tibial tuberosity on ten clinically healthy adult Persian squirrels with no signs of urinary system disorder. Lateral and ventrodorsal radiographs were taken every 2 minutes until the pyelogram was finished. Intraosseous injection of iodixanol was successful to show nephrogram, pyelogram, uretrogram and cystogram clearly. There were no abnormal clinical signs after one week of experiments. Biochemical and hematological profiles were in normal ranges. It is concluded that intraosseous urography is an effective and reliable method for urography studies in squirrel. Microscopic examinations of the kidneys and the site of injection after one week were normal.

Keywords: intraosseous urography, iodixanol, Persian squirrel, morphologic

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1859 18F-Fluoro-Ethyl-Tyrosine-Positron Emission Tomography in Gliomas: Comparison with Magnetic Resonance Imaging and Computed Tomography

Authors: Habib Alah Dadgar, Nasim Norouzbeigi

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The precise definition margin of high and low-grade gliomas is crucial for treatment. We aimed to assess the feasibility of assessment of the resection legions with post-operative positron emission tomography (PET) using [18F]O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET). Four patients with the suspicion of high and low-grade were enrolled. Patients underwent post-operative [18F]FET-PET, pre-operative magnetic resonance imaging (MRI) and CT for clinical evaluations. In our study, three patients had negative response to recurrence and progression and one patient indicated positive response after surgery. [18F]FET-PET revealed a legion of increased radiotracer uptake in the dura in the craniotomy site for patient 1. Corresponding to the patient history, the study was negative for recurrence of brain tumor. For patient 2, there was a lesion in the right parieto-temporal with slightly increased uptake in its posterior part with SUVmax = 3.79, so the study was negative for recurrence evaluation. In patient 3 there was no abnormal uptake with negative result for recurrence of brain tumor. Intense radiotracer uptake in the left parietal lobe where in the MRI there was a lesion with no change in enhancement in the post-contrast image is indicated in patient 4. Assessment of the resection legions in high and low-grade gliomas with [18F]FET-PET seems to be useful.

Keywords: FET-PET, CT, glioma, MRI

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1858 The Significance of Childhood in Shaping Family Microsystems from the Perspective of Biographical Learning: Narratives of Adults

Authors: Kornelia Kordiak

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The research is based on a biographical approach and serves as a foundation for understanding individual human destinies through the analysis of the context of life experiences. It focuses on the significance of childhood in shaping family micro-worlds from the perspective of biographical learning. In this case, the family micro-world is interpreted as a complex of beliefs and judgments about elements of the ‘total universe’ based on the individual's experiences. The main aim of the research is to understand the importance of childhood in shaping family micro-worlds from the perspective of reflection on biographical learning. Additionally, it contributes to a deeper understanding of the familial experiences of the studied individuals who form these family micro-worlds and the course of the biographical learning process in the subjects. Biographical research aligns with an interpretative paradigm, where individuals are treated as active interpreters of the world, giving meaning to their experiences and actions based on their own values and beliefs. The research methods used in the project—narrative interview method and analysis of personal documents—enable obtaining a multidimensional perspective on the phenomenon under study. Narrative interviews serve as the main data collection method, allowing researchers to delve into various life contexts of individuals. Analysis of these narratives identifies key moments and life patterns, as well as discovers the significance of childhood in shaping family micro-worlds. Moreover, analysis of personal documents such as diaries or photographs enriches the understanding of the studied phenomena by providing additional contexts and perspectives. The research will be conducted in three phases: preparatory, main, and final. The anticipated schedule includes preparation of research tools, selection of research sample, conducting narrative interviews and analysis of personal documents, as well as analysis and interpretation of collected research material. The narrative interview method and document analysis will be utilized to capture various contexts and interpretations of childhood experiences and family relations. The research will contribute to a better understanding of family dynamics and individual developmental processes. It will allow for the identification and understanding of mechanisms of biographical learning and their significance in shaping identity and family relations. Analysis of adult narratives will enable the identification of factors determining patterns of behavior and attitudes in adult life, which may have significant implications for pedagogical practice.

Keywords: childhood, adulthood, biographical learning, narrative interview, analysis of personal documents, family micro-worlds

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1857 First Year Experience of International Students in Malaysian Universities

Authors: Nur Hidayah Iwani Mohd Kamal

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The higher education institutions in Malaysia is challenged with a more socially and culturally diverse student population than ever before, especially with the increasing number of international students studying in Malaysia in the recent years. First year university is a critical time in students’ lives. Students are not only developing intelectually, they are also establishing and maintaining personal relationships, developing an identity, deciding about career and lifestyle, maintaining personal health and wellness, and developing an integrated philosohy of life. The higher education institutions work as a diverse community of learners to provide a supportive environment for these first year students in assisting them in their transition from high school to university. Although many universities are taking steps to improve the first year experience for their new local and international students, efforts must be taken to ensure organized and coordinated manner in order for the initiatives to be successful. The objectives of the study are to examine the international students’ perceptions and interpretation of their first year experiences in shaping and determining their attitudes toward study and the quality of their entire undergraduate academic career; and identify an appropriate mechanism to encounter the international students’ adjustment in the new environment in order to facilitate cross-functional communication and create a coherent and meaningful first year experience. A key construct in this study is that if universities wish to recruiting and retaining international students, it is their ethical responsibility to determine how they can best meet their needs at the academic and social level, create a supportive ‘learning community’ as a foundation of their educational experience, hence facilitate cross-cultural communication and create a coherent and meaningful first year experience. This study is simultaneously frames in relation to focus on the factors that influence a successful and satisfying transition to university life by the first year international students. The study employs a mixed-method data collection involving semi-structured interviews, questionnaire, classroom observation and document analysis. This study provides valuable insight into the struggles that many international students face as they attempt to make the adjustment not only to a new educational system but factors such as psychosocial and cultural problems. It would discuss some of the factors that impact the international students during their first year in university in their quest to be academically successful. It concludes with some recommendations on how Malaysian universities provide these students with a good first year experience based on some the best practices of universities around the world.

Keywords: first year experience, Malaysian universities, international students, education

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1856 The Effects of Vitamin D Supplementation on Anthropometric Indicators of Adiposity and Fat Distribution in Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Simin Zarea Karizi, Somaye Fatahi, Amirhossein Hosseni

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Background: There are conflicting findings regarding the effect of vitamin D supplementation on obesity-related factors. This study aimed to investigate the effect of vitamin D supplementation on changes in anthropometric indicators of adiposity and fat distribution in children and adolescents. Methods: Original databases were searched using standard keywords to identify all controlled trials investigating the effects of vitamin D supplementation on obesity-related factors in children and adolescents. Pooled weighted mean difference and 95% confidence intervals were achieved by random-effects model analysis. Results: Fourteen treatment arms were included in this systematic review and meta-analysis. The quantitative meta-analysis revealed no significant effect of vitamin D supplement on BMI (-0.01 kg/m2; 95% CI: -0.09, 0.12; p= 0.74; I2=0.0%), BMI z score (0.02; 95% CI: -0.04, 0.07; p= 0.53; I2=0.0%) and fat mass (0.07%; 95% CI: -0.09 to 0.24; p= 0.38; I2=31.2%). However, the quantitative meta-analysis displayed a significant effect of vitamin D supplementation on WC compared with the control group (WMD=-1.17 cm, 95% CI: -2.05, -0.29, p=0.009; I2=32.0 %). It seems that this effect was greater in healthy children with duration>12 weeks, dose<=400 IU and baseline less than 50 nmol/l vitamin D than others. Conclusions: Our findings suggest that vitamin D supplementation may be a protective factor of abdominal obesity and should be evaluated on an individual basis in clinical practice.

Keywords: weight loss, vitamin D, anthropometry, children, adolescent

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1855 Genetic and Non-Genetic Factors Affecting the Response to Clopidogrel Therapy

Authors: Snezana Mugosa, Zoran Todorovic, Zoran Bukumiric, Ivan Radosavljevic, Natasa Djordjevic

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Introduction: Various studies have shown that the frequency of clopidogrel resistance ranges from 4-40%. The aim of this study was to provide in depth analysis of genetic and non-genetic factors that influence clopidogrel resistance in cardiology patients. Methods: We have conducted a prospective study in 200 hospitalized patients hospitalized at Cardiology Centre of the Clinical Centre of Montenegro. CYP2C19 genetic testing was conducted, and the PREDICT score was calculated in 102 out of 200 patients treated with clopidogrel in order to determine the influence of genetic and non-genetic factors on outcomes of interest. Adverse cardiovascular events and adverse reactions to clopidogrel were assessed during 12 months follow up period. Results: PREDICT score and CYP2C19 enzymatic activity were found to be statistically significant predictors of expressing lack of therapeutic efficacy of clopidogrel by multivariate logistic regression, without multicollinearity or interaction between the predictors (p = 0.002 and 0.009, respectively). Conclusions: Pharmacogenetics analyses that were done in the Montenegrin population of patients for the first time suggest that these analyses can predict patient response to the certain therapy. Stepwise approach could be used in assessing the clopidogrel resistance in cardiology patients, combining the PREDICT score, platelet aggregation test, and genetic testing for CYP2C19 polymorphism.

Keywords: clopidogrel, pharmacogenetics, pharmacotherapy, PREDICT score

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1854 The Admitting Hemogram as a Predictor for Severity and in-Hospital Mortality in Acute Pancreatitis

Authors: Florge Francis A. Sy

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Acute pancreatitis (AP) is an inflammatory condition of the pancreas with local and systemic complications. Severe acute pancreatitis (SAP) has a higher mortality rate. Laboratory parameters like the neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), and mean platelet volume (MPV) have been associated with SAP but with conflicting results. This study aims to determine the predictive value of these parameters on the severity and in-hospital mortality of AP. This retrospective, cross-sectional study was done in a private hospital in Cebu City, Philippines. One-hundred five patients were classified according to severity based on the modified Marshall scoring. The admitting hemogram, including the NLR, RDW, and MPV, was obtained from the complete blood count (CBC). Cut-off values for severity and in-hospital mortality were derived from the ROC. Association between NLR, RDW, and MPV with SAP and mortality were determined with a p-value of < 0.05 considered significant. The mean age for AP was 47.6 years, with 50.5% being male. Most had an unknown cause (49.5%), followed by a biliary cause (37.1%). Of the 105 patients, 23 patients had SAP, and 4 died. Older age, longer in-hospital duration, congestive heart failure, elevated creatinine, urea nitrogen, and white blood cell count were seen in SAP. The NLR was associated with in-hospital mortality using a cut-off of > 10.6 (OR 1.133, 95% CI, p-value 0.003) with 100% sensitivity, 70.3% specificity, 11.76% PPV and 100% NPV (AUC 0.855). The NLR was not associated with SAP. The RDW and MPV were not associated with SAP and mortality. The admitting NLR is, therefore, an easily accessible parameter that can predict in-hospital mortality in acute pancreatitis. Although the present study did not show an association of NLR with SAP nor RDW and MPV with both SAP and mortality, further studies are suggested to establish their clinical value.

Keywords: acute pancreatitis, mean platelet volume, neutrophil-lymphocyte ratio, red cell distribution width

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1853 The Relationship between Environmental Factors and Purchasing Decisions in the Residential Market in Sweden

Authors: Agnieszka Zalejska-Jonsson

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The Swedish Green Building Council (SGBC) was established in 2009. Since then, over 1000 buildings have been certified, of which approximately 600 are newly produced and 340 are residential buildings. During that time, approximately 2000 apartment buildings have been built in Sweden. This means that over a five- year period 17% of residential buildings have been certified according to the environmental building scheme. The certification of the building is not a guarantee of environmental progress but it gives us an indication of the extent of the progress. The overarching aim of this study is to investigate the factors behind the relatively slow evolution of the green residential housing market in Sweden. The intention is to examine stated willingness to pay (WTP) for green and low energy apartments, and to explore which factors have a significant effect on stated WTP among apartment owners. A green building was defined as a building certified according to the environmental scheme and a low energy building as a building designed and constructed with high energy efficiency goals. Data for this study were collected through a survey conducted among occupants of comparable apartment buildings: two green and one conventional. The total number of received responses was 429: green A (N=160), response rate 42%; green B (N=138) response rate 35%, and conventional (N=131) response rate 43%. The study applied a quasi-experimental method. Survey responses regarding factors affecting purchase of apartment, stated WTP and environmental literacy have been analysed using descriptive statistics, the Mann–Whitney (rank sum) test and logistic models. Comments received from respondents have been used for further interpretation of results. Results indicate that environmental education has a significant effect on stated WTP. Occupants who declared higher WTP showed a higher level of environmental literacy and indicated that energy efficiency was one of the important factors that affected their decision to buy an apartment. Generally, the respondents were more likely to pay more for low energy buildings than for green buildings. This is to a great extent a consequence of rational customer behaviour and difficulty in apprehending the meaning of green building certification. The analysis shows that people living in green buildings indicate higher WTP for both green and low energy buildings, the difference being statistically significant. It is concluded that growth in the green housing market in Sweden might be achieved if policymakers and developers engage in active education in the environmental labelling system. The demand for green buildings is more likely to increase when the difference between green and conventional buildings is easily understood and information is not only delivered by the estate agent, but is part of an environmental education programme.

Keywords: consumer, environmental education, housing market, stated WTP, Sweden

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1852 Application of ATP7B Gene Mutation Analysis in Prenatal Diagnosis of Wilson’s Disease

Authors: Huong M. T. Nguyen, Hoa A. P. Nguyen, Chi V. Phan, Mai P. T. Nguyen, Ngoc D. Ngo, Van T. Ta, Hai T. Le

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Wilson’s disease is an autosomal recessive disorder of copper metabolism, which is caused by mutation in copper- transporting P-type ATPase (ATP7B). The mechanism of this disease is a failure of hepatic excretion of copper to the bile, and it leads to copper deposits in the liver and other organs. Most clinical symptoms of Wilson’s disease can present as liver disease and/or neurologic disease. Objective: The goal of the study is prenatal diagnosis for pregnant women at high risk of Wilson’s disease in Northern Vietnam. Material and method: Three probands with clinically diagnosed liver disease were detected in the mutations of 21 exons and exon-intron boundaries of the ATP7B gene by direct Sanger-sequencing. Prenatal diagnoses were performed by amniotic fluid sampling from pregnant women in the 16th-18th weeks of pregnancy after the genotypes of parents with the probands were identified. Result: A total of three different mutations of the probands, including of S105*, P1052L, P1273G, were detected. Among three fetuses which underwent prenatal genetic testing, one fetus was homozygote; two fetuses were carriers. Conclusion: Genetic testing provided a useful method for prenatal diagnosis, and is a basis for genetic counseling.

Keywords: ATP7B gene, genetic testing, prenatal diagnosis, pedigree, Wilson disease

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1851 Gut-Microbiota-Brain-Axis, Leaky Gut, Leaky Brain: Pathophysiology of Second Brain Aging and Alzheimer’s Disease- A Neuroscientific Riddle

Authors: Bilal Ahmad

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Alzheimer’s disease (AD) is one of the most common neurodegenerative illnesses. However, how Gut-microbiota plays a role in the pathogenesis of AD is not well elucidated. The purpose of this literature review is to summarize and understand the current findings that may elucidate the gut microbiota's role in the development of AD. Methods: A literature review of all the relevant papers known to the author was conducted. Relevant articles, abstracts and research papers were collected from well-accepted web sources like PubMed, PMC, and Google Scholar. Results: Recent studies have shown that Gut-microbiota has an important role in the progression of AD via Gut-Microbiota-Brain Axis. The onset of AD supports the ‘Hygiene Hypothesis’, which shows that AD might begin in the Gut, causing dysbiosis, which interferes with the intestinal barrier by releasing pro-inflammatory cytokines and making its way up to the brain via the blood-brain barrier (BBB). Molecular mechanisms lipopolysaccharides and serotonin kynurenine (tryptophan) pathways have a direct association with inflammation, the immune system, neurodegeneration, and AD. Conclusion: The studies helped to analyze the molecular basis of AD, other neurological conditions like depression, autism, and Parkinson's disease and how they are linked to Gut-microbiota. Further, studies to explore the therapeutic effects of probiotics in AD and cognitive enhancement should be warranted to provide significant clinical and practical value.

Keywords: gut-microbiota, Alzheimer’s disease, second brain aging, lipopolysaccharides, short-chain fatty acids

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1850 Features of Formation and Development of Possessory Risk Management Systems of Organization in the Russian Economy

Authors: Mikhail V. Khachaturyan, Inga A. Koryagina, Maria Nikishova

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The study investigates the impact of the ongoing financial crisis, started in the 2nd half of 2014, on marketing budgets spent by Fast-moving consumer goods companies. In these conditions, special importance is given to efficient possessory risk management systems. The main objective for establishing and developing possessory risk management systems for FMCG companies in a crisis is to analyze the data relating to the external environment and consumer behavior in a crisis. Another important objective for possessory risk management systems of FMCG companies is to develop measures and mechanisms to maintain and stimulate sales. In this regard, analysis of risks and threats which consumers define as the main reasons affecting their level of consumption become important. It is obvious that in crisis conditions the effective risk management systems responsible for development and implementation of strategies for consumer demand stimulation, as well as the identification, analysis, assessment and management of other types of risks of economic security will be the key to sustainability of a company. In terms of financial and economic crisis, the problem of forming and developing possessory risk management systems becomes critical not only in the context of management models of FMCG companies, but for all the companies operating in other sectors of the Russian economy. This study attempts to analyze the specifics of formation and development of company possessory risk management systems. In the modern economy, special importance among all the types of owner’s risks has the risk of reduction in consumer activity. This type of risk is common not only for the consumer goods trade. Study of consumer activity decline is especially important for Russia due to domestic market of consumer goods being still in the development stage, despite its significant growth. In this regard, it is especially important to form and develop possessory risk management systems for FMCG companies. The authors offer their own interpretation of the process of forming and developing possessory risk management systems within owner’s management models of FMCG companies as well as in Russian economy in general. Proposed methods and mechanisms of problem analysis of formation and development of possessory risk management systems in FMCG companies and the results received can be helpful for researchers interested in problems of consumer goods market development in Russia and overseas.

Keywords: FMCG companies, marketing budget, risk management, owner, Russian economy, organization, formation, development, system

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1849 The Concept of the Family and Its Principles from the Perspective of International Human Rights Instruments

Authors: Mahya Saffarinia

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The family has existed as a natural unit of human relations from the beginning of creation and life of human society until now and has been the core of the relationship between women, men, and children. However, in the field of human relations, the definition of family, related rights and duties, principles governing the family, the impact of the family on other individual or social phenomena and various other areas have changed over time, especially in recent decades, and the subject has now become one of the important categories of studies including interdisciplinary studies. It is difficult to provide an accurate and comprehensive definition of the family, and in the context of different cultures, customs, and legal systems, different definitions of family are presented. The meaning of legal principles governing the family is the general rules of law that determine the organization of different dimensions of the family, and dozens of partial rules are inferred from it or defined in the light of these general rules. How each of these principles was formed has left its own detailed history. In international human rights standards, which have been gradually developed over the past 72 years, numerous data can be found that in some way represent a rule in the field of family law or provide an interpretation of existing international rules which also address obligations of governments in the field of family. Based on a descriptive-analytical method and by examining human rights instruments, the present study seeks to explain the effective elements in defining and the principles governing the family. This article makes it clear that international instruments do not provide a clear definition of the family and that governments are empowered to define the family in terms of the cultural context of their community. But at the same time, it has been stipulated that governments do not have the exclusive authority to provide this definition, and certain principles should be considered as essential elements. Also, 7 principles have been identified as general legal rules governing all international human rights instruments related to the family, such as the principle of voluntary family formation and the prohibition of forced marriage, and the principle of respecting human dignity for all family members. Each of these 7 principles has led to different debates, and the acceptance or non-acceptance of each of them has different consequences in the rights and duties related to the family and the relations between its members and even the family's interactions with others and society. One of the consequences of the validity of these principles in family-related human rights standards is that many of the existing legal systems of countries in some cases need to be amended and their regulations revised, and some established cultural traditions in societies that are considered inhumane in terms of these principles need to be modified and changed. Of course, this process of governing the principles derived from human rights standards over the family also has vulnerabilities and misinterpretations that should not be neglected.

Keywords: family, human rights, international instruments, principles

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1848 Attitudes Towards the Supernatural in Benjamin Britten’s The Turn of the Screw

Authors: Yaou Zhang

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Background: Relatively little scholarly attention has been paid to the production of Benjamin Britten’s chamber opera The Turn of the Screw. As one of Britten’s most remarkable operas. The story of the libretto was from Henry James’s novella of the same name. The novella was created in 1898 and one of the primary questions addressed to people in the story is “how real the ghosts are,” which leads the story to a huge ambiguity in readers’ minds. Aims: This research focuses on the experience of seeing the opera on stage over several decades. This study of opera productions over time not only provides insight into how stage performances can alter audience members' perceptions of the opera in the present but also reveals a landscape of shifting aesthetics and receptions. Methods: To examine the hypotheses in interpretation and reception, the qualitative analysis is used to examine the figures of ghosts in different productions across the time from 1954 to 2021 in the UK: by accessing recordings, newspapers, and reviews for the productions that are sourced from online and physical archives. For instance, the field research is conducted on the topic by arranging interviews with the creative team and visiting Opera North in Leeds and Britten-Pears Foundation. The collected data reveals the “hidden identity” in creative teams’ interpretations, social preferences, and rediscover that have previously remained unseen. Results: This research presents an angle of Britten’s Screw by using the third position; it shows how the attention moved from the stage of “do the ghosts really exist” to “traumatised children.” Discussion: Critics and audiences have debated whether the governess hallucinates the ghosts in the opera for decades. While, in recent years, directors of new productions have given themselves the opportunity to go deeper into Britten's musical structure and offer the opera more space to be interpreted, rather than debating if "ghosts actually exist" or "the psychological problems of the governess." One can consider and reflect that the questionable actions of the children are because they are suffering from trauma, whether the trauma comes from the ghosts, the hallucinating governess, or some prior experiences: various interpretations cause one result that children are the recipients of trauma. Arguably, the role of the supernatural is neither simply one of the elements of a ghost story nor simply one of the parts of the ambiguity between the supernatural and the hallucination of the governess; rather, the ghosts and the hallucinating governess can exist at the same time - the combination of the supernatural’s and the governess’s behaviours on stage generates a sharper and more serious angle that draws our attention to the traumatized children.

Keywords: benjamin britten, chamber opera, production, reception, staging, the turn of the screw

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1847 Oral Toxicity of Low Doses of Fungicides, Propinebe, Propiconazole and Their Mixtures in the Male Rat

Authors: Mallem Leila, Aiche Mohamed Amine, Boulakoud Mohamed Salah

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A number of chemical compounds are being used to protect agricultural crops from diseases. Residues of these chemicals lead to environmental pollution and pose some threat to non target organisms, human and animal. The aim of this study is to detect the toxicity of these fungicides and their mixtures in the fertility and biochemical’s parameters in the rat. The male of rats (28) were used, they were divided in four groups (7 rats of each group) and one group was used as control. Rats were dosed orally with propiconazole (60 mg/kg body weight/day), propinebe (100 mg/Kg body weight/day) and their mixture (50:50) for 4 weeks. Animals were observed for clinical toxicity. At the end of treatment period, animals of all groups were scarified and samples of different organs were fixed in the formol 10% for histopathological study, and blood was collected for hematological and biochemical’s analysis. The results indicated that the fungicide and their mixture of fungicides were toxic in the treated animals. The semen study showed a decrease in the count, mobility and speed of spermatozoa in all treated group especially those dosed with the mixture and Propiconazole, it was also a decrease in the weight of the testis and epidydimis in the treated group as compared with control. Remarquable histological changes were observed in the testis and epidydimis and liver in the group treated with mixture.

Keywords: fungicides, mixture, fertility, hematological, biochemical's parameters

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1846 Understanding Lacan’s ‘Name of the Father’ Concept, the Original Introject, and Personality Functioning

Authors: Chloe T. Cohen, Sarah Johnson

Abstract:

Psychoanalytic literature has traditionally focused on the theoretical explanations of psychological phenomena rather than empirical research to support those ideas. Many clinicians assume a lack of empirical verification of the theories that underpin psychoanalytic treatment disqualifies psychoanalytic psychotherapy as an effective clinical technique. One such theory is Lacan’s ‘Name of the Father’, which extended Freud’s idea of the importance of a successful resolution of the Oedipal problem, situating it even earlier in psychological development. Lacan posited that the Name of the Father construct (establishing psychological structure and preventing psychosis) was best represented in language use, metaphor, and linguistic structure. However, no study to date has empirically examined the Name of the Father construct. The current study attempts to measure Lacan’s ‘Name of the Father’ construct through linguistic structure and metaphor use and to compare it with Freud’s ‘original introject’. We will then investigate whether they relate to adult personality functioning (measured using the Rorschach Inkblot Test). We aim to contribute to the empirical study of psychoanalytic concepts by operationalizing and validating the Name of the Father empirically. We also aim to examine the relationship of the Name of the Father construct to Freud’s concept of the original introject and to adult pathology. We hypothesize that measures of the original introject will mediate the pathway between linguistic indicators of Lacan’s Name of the Father construct and personality functioning.

Keywords: Lacan, Name of the Father, original introject, personality functioning, psychoanalysis

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1845 Craniopharyngiomas: Surgical Techniques: The Combined Interhemispheric Sub-Commissural Translaminaterminalis Approach to Tumors in and Around the Third Ventricle: Neurological and Functional Outcome

Authors: Pietro Mortini, Marco Losa

Abstract:

Objective: Resection of large lesions growing into the third ventricle remains a demanding surgery, sometimes at risk of severe post-operative complications. Transcallosal and transcortical routes were considered as approaches of choice to access the third ventricle, however neurological consequences like memory loss have been reported. We report clinical results of the previously described combined interhemispheric sub-commissural translaminaterminalis approach (CISTA) for the resection of large lesions located in the third ventricle. Methods: Authors conducted a retrospective analysis on 10 patients, who were operated through the CISTA, for the resection of lesions growing into the third ventricle. Results: Total resection was achieved in all cases. Cognitive worsening occurred only in one case. No perioperative deaths were recorded and, at last follow-up, all patients were alive. One year after surgery 80% of patients had an excellent outcome with a KPS 100 and Glasgow Outcome score (GOS) Conclusion: The CISTA represents a safe and effective alternative to transcallosal and transcortical routes to resect lesions growing into the third ventricle. It allows for a multiangle trajectory to access the third ventricle with a wide working area free from critical neurovascular structures, without any section of the corpus callosum, the anterior commissure and the fornix.

Keywords: craniopharingioma, surgery, sub-commissural translaminaterminalis approach (CISTA),

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1844 Nursing Care Experience for a Patient with Type2 Diabetes Mellitus and Hyperglycemic Hyperosmolar State

Authors: Yen-Hsia Lin, Ya-Fang Cheng, Hui-Zhu Chen, Chi-Hui Tiao

Abstract:

This is a case study of a 70-year-old man suffering from Type 2 diabetes mellitus and hyperglycemia hyperosmolarity state. He was admitted into the intensive care unit from the 20th to 26th of October, 2015. After receiving relevant information through open-ended conversations, observation, and physical assessment, as well as the psychological, social and spiritual holistic nursing assessment, several clinical health problems such as unstable blood sugar, impaired skin integrity and lack of self-care management knowledge were identified by the author. During the period of care, the patient was encouraged to share and express his feelings, an active listening and initiating approach from the nursing team had led to the understanding of why the patient refused to use insulin. This knowledge enabled the nursing team to manage patient care by educating the patient with self-care management skills, such as foot wound care and insulin injection skills to slow the deterioration of complications. Also, the implementation of appropriate diet and exercise routine to improve patients’ style. By enhancing self-care ability in diabetic patients, they are able to return home with the skill to improve better quality life style.

Keywords: hyperglycemia hyperosmolar state, type2 diabetes Mellitu, diabetes Mellitu foot care, intensive care

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1843 Artificial Intelligence-Based Chest X-Ray Test of COVID-19 Patients

Authors: Dhurgham Al-Karawi, Nisreen Polus, Shakir Al-Zaidi, Sabah Jassim

Abstract:

The management of COVID-19 patients based on chest imaging is emerging as an essential tool for evaluating the spread of the pandemic which has gripped the global community. It has already been used to monitor the situation of COVID-19 patients who have issues in respiratory status. There has been increase to use chest imaging for medical triage of patients who are showing moderate-severe clinical COVID-19 features, this is due to the fast dispersal of the pandemic to all continents and communities. This article demonstrates the development of machine learning techniques for the test of COVID-19 patients using Chest X-Ray (CXR) images in nearly real-time, to distinguish the COVID-19 infection with a significantly high level of accuracy. The testing performance has covered a combination of different datasets of CXR images of positive COVID-19 patients, patients with viral and bacterial infections, also, people with a clear chest. The proposed AI scheme successfully distinguishes CXR scans of COVID-19 infected patients from CXR scans of viral and bacterial based pneumonia as well as normal cases with an average accuracy of 94.43%, sensitivity 95%, and specificity 93.86%. Predicted decisions would be supported by visual evidence to help clinicians speed up the initial assessment process of new suspected cases, especially in a resource-constrained environment.

Keywords: COVID-19, chest x-ray scan, artificial intelligence, texture analysis, local binary pattern transform, Gabor filter

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1842 Vibrational Spectra and Nonlinear Optical Investigations of a Chalcone Derivative (2e)-3-[4-(Methylsulfanyl) Phenyl]-1-(3-Bromophenyl) Prop-2-En-1-One

Authors: Amit Kumar, Archana Gupta, Poonam Tandon, E. D. D’Silva

Abstract:

Nonlinear optical (NLO) materials are the key materials for the fast processing of information and optical data storage applications. In the last decade, materials showing nonlinear optical properties have been the object of increasing attention by both experimental and computational points of view. Chalcones are one of the most important classes of cross conjugated NLO chromophores that are reported to exhibit good SHG efficiency, ultra fast optical nonlinearities and are easily crystallizable. The basic structure of chalcones is based on the π-conjugated system in which two aromatic rings are connected by a three-carbon α, β-unsaturated carbonyl system. Due to the overlap of π orbitals, delocalization of electronic charge distribution leads to a high mobility of the electron density. On a molecular scale, the extent of charge transfer across the NLO chromophore determines the level of SHG output. Hence, the functionalization of both ends of the π-bond system with appropriate electron donor and acceptor groups can enhance the asymmetric electronic distribution in either or both ground and excited states, leading to an increased optical nonlinearity. In this research, the experimental and theoretical study on the structure and vibrations of (2E)-3-[4-(methylsulfanyl) phenyl]-1-(3-bromophenyl) prop-2-en-1-one (3Br4MSP) is presented. The FT-IR and FT-Raman spectra of the NLO material in the solid phase have been recorded. Density functional theory (DFT) calculations at B3LYP with 6-311++G(d,p) basis set were carried out to study the equilibrium geometry, vibrational wavenumbers, infrared absorbance and Raman scattering activities. The interpretation of vibrational features (normal mode assignments, for instance) has an invaluable aid from DFT calculations that provide a quantum-mechanical description of the electronic energies and forces involved. Perturbation theory allows one to obtain the vibrational normal modes by estimating the derivatives of the Kohn−Sham energy with respect to atomic displacements. The molecular hyperpolarizability β plays a chief role in the NLO properties, and a systematical study on β has been carried out. Furthermore, the first order hyperpolarizability (β) and the related properties such as dipole moment (μ) and polarizability (α) of the title molecule are evaluated by Finite Field (FF) approach. The electronic α and β of the studied molecule are 41.907×10-24 and 79.035×10-24 e.s.u. respectively, indicating that 3Br4MSP can be used as a good nonlinear optical material.

Keywords: DFT, MEP, NLO, vibrational spectra

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1841 Prototyping the Problem Oriented Medical Record for Connected Health Based on TypeGraphQL

Authors: Sabah Mohammed, Jinan Fiaidhi, Darien Sawyer

Abstract:

Data integration of health through connected services can save lives in the event of a medical emergency or provide efficient and effective interventions for the benefit of the patients through the integration of bedside and bench side clinical research. Such integration will support all wind of change in healthcare by being predictive, pre-emptive, personalized, problem-oriented and participatory. Prototyping a healthcare system that enables data integration has been a big challenge for healthcare for a long time. However, an innovative solution started to emerge by focusing on problem lists where everything can connect the problem list forming a growing graph. This notion was introduced by Dr. Lawrence Weed in early 70’s, but the enabling technologies weren’t mature enough to provide a successful implementation prototype. In this article, we are describing our efforts in prototyping Dr. Lawrence Weed's problem-oriented medical record (POMR) and his patient case schema (SOAP) to shape a prototype for connected health. For this, we are using the TypeGraphQL API and our enterprise-based QL4POMR to describe a Web-Based gateway for healthcare services connectivity. Our prototype has reported success in connecting to the HL7 FHIR medical record and the OpenTarget biomedical repositories.

Keywords: connected health, problem-oriented healthcare record, SOAP, QL4POMR, typegraphQL

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1840 Application of Applied Behavior Analysis Treatment to Children with Down Syndrome

Authors: Olha Yarova

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This study is a collaborative project between the American University of Central Asia and parent association of children with Down syndrome ‘Sunterra’ that took place in Bishkek, Kyrgyzstan. The purpose of the study was to explore whether principles and techniques of applied behavior analysis (ABA) could be used to teach children with Down syndrome socially significant behaviors. ABA is considered to be one of the most effective treatment for children with autism, but little research is done on the particularity of using ABA to children with Down syndrome. The data for the study was received during clinical observations; work with children with Down syndrome and interviews with their mothers. The results show that many ABA principles make the work with children with Down syndrome more effective. Although such children very rarely demonstrate aggressive behavior, they show a lot of escape-driven and attention seeking behaviors that are reinforced by their parents and educators. Thus functional assessment can be done to assess the function of problem behavior and to determine appropriate treatment. Prompting and prompting fading should be used to develop receptive and expressive language skills, and enhance motor development. Even though many children with Down syndrome work for praise, it is still relevant to use tangible reinforcement and to know how to remove them. Based on the results of the study, the training for parents of children with Down syndrome will be developed in Kyrgyzstan, country, where children with Down syndrome are not accepted to regular kindergartens and where doctors in maternity hospitals tell parents that their child will never talk, walk and recognize them

Keywords: down syndrome, applied behavior analysis, functional assessment, problem behavior, reinforcement

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1839 An Information Matrix Goodness-of-Fit Test of the Conditional Logistic Model for Matched Case-Control Studies

Authors: Li-Ching Chen

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The case-control design has been widely applied in clinical and epidemiological studies to investigate the association between risk factors and a given disease. The retrospective design can be easily implemented and is more economical over prospective studies. To adjust effects for confounding factors, methods such as stratification at the design stage and may be adopted. When some major confounding factors are difficult to be quantified, a matching design provides an opportunity for researchers to control the confounding effects. The matching effects can be parameterized by the intercepts of logistic models and the conditional logistic regression analysis is then adopted. This study demonstrates an information-matrix-based goodness-of-fit statistic to test the validity of the logistic regression model for matched case-control data. The asymptotic null distribution of this proposed test statistic is inferred. It needs neither to employ a simulation to evaluate its critical values nor to partition covariate space. The asymptotic power of this test statistic is also derived. The performance of the proposed method is assessed through simulation studies. An example of the real data set is applied to illustrate the implementation of the proposed method as well.

Keywords: conditional logistic model, goodness-of-fit, information matrix, matched case-control studies

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1838 Public-Private Partnership for Community Empowerment and Sustainability: Exploring Save the Children’s 'School Me' Project in West Africa

Authors: Gae Hee Song

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This paper aims to address the evolution of public-private partnerships for mainstreaming an evaluation approach in the community-based education project. It examines the distinctive features of Save the Children’s School Me project in terms of empowerment evaluation principles introduced by David M. Fetterman, especially community ownership, capacity building, and organizational learning. School Me is a Save the Children Korea funded-project, having been implemented in Cote d’Ivoire and Sierra Leone since 2016. The objective of this project is to reduce gender-based disparities in school completion and learning outcomes by creating an empowering learning environment for girls and boys. Both quasi-experimental and experimental methods for impact evaluation have been used to explore changes in learning outcomes, gender attitudes, and learning environments. To locate School Me in the public-private partnership framework for community empowerment and sustainability, the data have been collected from School Me progress/final reports, baseline, and endline reports, fieldwork observations, inter-rater reliability of baseline and endline data collected from a total of 75 schools in Cote d’Ivoire and Sierra Leone. The findings of this study show that School Me project has a significant evaluation component, including qualitative exploratory research, participatory monitoring, and impact evaluation. It strongly encourages key actors, girls, boys, parents, teachers, community leaders, and local education authorities, to participate in the collection and interpretation of data. For example, 45 community volunteers collected baseline data in Cote d’Ivoire; on the other hand, three local government officers and fourteen enumerators participated in the follow-up data collection of Sierra Leone. Not only does this public-private partnership improve local government and community members’ knowledge and skills of monitoring and evaluation, but the evaluative findings also help them find their own problems and solutions with a strong sense of community ownership. Such community empowerment enables Save the Children country offices and member offices to gain invaluable experiences and lessons learned. As a result, empowerment evaluation leads to community-oriented governance and the sustainability of the School Me project.

Keywords: community empowerment, Cote d’Ivoire, empowerment evaluation, public-private partnership, save the children, school me, Sierra Leone, sustainability

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1837 Rare Case of Pyoderma Gangrenosum of the Upper Limb

Authors: Karissa A. Graham

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Pyoderma gangrenosum (PG) is a prototypic autoinflammatory neutrophilic dermatosis that is a rare disorder. It presents a diagnostic challenge owing to its variable presentation, clinical overlap with other conditions, it is often associated with other systemic conditions, and there is no definitive histological or laboratory characteristic. The Delphai consensus for PG includes the presence of at least one ulcer on the anterior lower limb. Systemic corticosteroids and immunosuppressive therapies are the mainstay treatment for PG. We describe a case report of delayed diagnosis of ulcerative pyoderma gangrenosum in a 44-year-old male on his forearm. The patient presented with an infected ulcer on his right forearm that had been present for over three years. The patient was a Type 2 Diabetic with no personal or family history of inflammatory bowel disease or other autoimmune diseases. The patient was initially investigated for malignancy, but biopsies returned as chronic inflammatory tissue with neutrophilic infiltrate and no malignancy. The patient was commenced on systemic prednisone for the treatment of pyoderma gangrenosum. The diagnosis of ulcerative PG poses a challenge given the vast differential diagnosis for a cutaneous ulcer (i.e., malignant, vascular, autoimmune, trauma, infective, etc.). Diagnostic accuracy is important given that the treatment for PG with steroids does not go without risks and indeed may be contraindicated in other potential causes of the ulcer. Indeed, more common and more sinister causes of ulcers should be investigated first, as death from PG is quite rare.

Keywords: dermatological diagnosis, dermatosis, pyoderma gangrenosum, rare presentation

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1836 Investigation of Carbapenem-Resistant Genes in Acinetobacter spp. Isolated from Patients at Tertiary Health Care Center, Northeastern Thailand

Authors: S. J. Sirima, C. Thirawan, R.Puntharikorn, K. Ungsumalin, J. Kaemwich

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Acinetobacter spp. is a gram negative bacterium causing the high incidence of multi-drug resistance in patients admitted to an intensive care unit. A hundred isolates of Imipenem-resistant Acinetobacter spp. isolated from patients admitted at tertiary health care center, Northeastern region, Ubon Ratchathani, Thailand, were subjected to modified Hodge test and combined disc test in order to evaluate the production of carbapenemases. The results revealed that about 35% of isolates were found to be carbapenemases producers. In addition, multiplex polymerase chain reactions were performed to detect blaOXA-like genes. It showed that 92% of isolates possess blaOXA-51-like and blaOXA-23-like genes. However, blaOXA-58-like gene was detected in only 8 isolates. No detection of blaOXA-24-like gene was observed in all isolates. In conclusion, an ability to produce carbepenemases would be an important mechanism of multi-drug resistance among clinical isolates of Acinetobacter spp. at tertiary health care center, Northeastern region, Ubon Ratchathani, Thailand. Furthermore, it was likely that the class D carbapenemases genes, blaOXA-51-like and blaOXA-23-like, might contribute to imipenem-resistance exhibiting among isolates.

Keywords: Acinetobacter spp., blaOXA-like genes, carbapenemases, tertiary health care center

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