Search results for: neonatal death risk

Authors: Andhiani Sharfina Arnellya, Mochammad Indra Permana, Dika Pramita Destiani, Ellin Febrina

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Health Research Data, Ministry of Health of Indonesia in 2007, showed coronary heart disease (CHD) or coronary artery disease (CAD) was the third leading cause of death in Indonesia after hypertension and stroke with 7.2% incidence rate. Antiplatelet is one of the important therapy in management of patients with CHD. In addition to therapeutic effect on patients, quality of life is one aspect of another assessment to see the success of antiplatelet therapy. The purpose of this study was to determine the quality of life of patients on oral antiplatelet therapy in outpatient cardiac department Dr. Hasan Sadikin central general hospital, Bandung, Indonesia. This research is a cross sectional by collecting data through quality of life questionnaire of patients which performed prospectively as primary data and secondary data from medical record of patients. The results of this study showed that 54.3% of patients had a good quality of life, 45% had a moderate quality of life, and 0.7% had a poor quality of life. There are no significant differences in quality of life-based on age, gender, diagnosis, and duration of drug use.

Keywords: antiplatelet, quality of life, coronary artery disease, coronary heart disease

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Authors: Cristina Domínguez, Steven N. Cuadra

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Aims: The aims of this study are: 1) to describe the occurrence and estimate the risk of suffering injuries of any kind, especially work-related injuries, in rural children working in agricultural activities and in urban children working on the street 2) to explore factors that might be associated with the occurrence of work-related injuries among child workers such as gender, school attendance, and performance of household chore. Method: We performed a crossectional study among working children in agricultural activities (120) and on the street (108) and in non-working referents (140) in 2019. We investigated self-reported injuries during the last 12 months, with focus on work-related injuries. Incidence rate, rate ratios, and 95% CI were calculated by Poisson regression. Results: Agricultural workers have a higher incidence of work-related injuries (2.1 per 1000 person-days) than children working on the street (1.8 per 1000 person-days). However, when considering girl’s unpaid work at home, girls had higher occurrence. Girls had a 30% increase on the risk of suffering work related injuries compared to boys. Performing household chore and attending school were the major predictors of injury occurrence. Discussion: Our data suggest If such partial and full-time girl’s housework is taken into account, there would be little or no variation between the sexes with regard to injuries occurrence, and the incidence rate of work related injuries among girls could even exceed that of boys A greater understanding of the interaction of factors related to how child workers spend their time, and its impact on children’s health, is needed in order to identify feasible and appropriate strategies to reduce the negative effect of work on children when elimination of child labor is not reachable in the short term. Clearly, gender aspects on child labor may allow for more effective targeting of prevention efforts.

Keywords: injuries, child labor, agricultural work, gender

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Authors: Mustafa M. Donma, Orkide Donma

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Zinc is a vital element required for growth and development. This fact makes zinc important, particularly for children. It maintains normal cellular structure and functions. This essential element appears to have protective effects against coronary artery disease and cardiomyopathy. Higher serum zinc levels are associated with lower risk of cardiovascular diseases (CVDs). There is a significant association between low serum zinc levels and heart failure. Zinc may be a potential biomarker of cardiovascular health. High sensitive cardiac troponin T (hs-cTnT) and cardiac myosin binding protein C (cMyBP-C) are new generation markers used for prediagnosis, diagnosis, and prognosis of CVDs. The aim of this study is to determine zinc as well as new generation cardiac markers profiles in children with normal body mass index (N-BMI), obese (OB), morbid obese (MO) children, and children with metabolic syndrome (MetS) findings. The association among them will also be investigated. Four study groups were constituted. The study protocol was approved by the institutional Ethics Committee of Tekirdag Namik Kemal University. Parents of the participants filled informed consent forms to participate in the study. Group 1 is composed of 44 children with N-BMI. Group 2 and Group 3 comprised 43 OB and 45 MO children, respectively. Forty-five MO children with MetS findings were included in Group 4. World Health Organization age- and sex-adjusted BMI percentile tables were used to constitute groups. These values were 15-85, 95-99, and above 99 for N-BMI, OB, and MO, respectively. Criteria for MetS findings were determined. Routine biochemical analyses, including zinc, were performed. High sensitive-cTnT and cMyBP-C concentrations were measured by kits based on enzyme-linked immunosorbent assay principle. Appropriate statistical tests within the scope of SPSS were used for the evaluation of the study data. p<0.05 was accepted as statistically significant. Four groups were matched for age and gender. Decreased zinc concentrations were measured in Groups 2, 3, and 4 compared to Group 1. Groups did not differ from one another in terms of hs-cTnT. There were statistically significant differences between cMyBP-C levels of MetS group and N-BMI as well as OB groups. There was an increasing trend going from N-BMI group to MetS group. There were statistically significant negative correlations between zinc and hs-cTnT as well as cMyBP-C concentrations in MetS group. In conclusion, inverse correlations detected between zinc and new generation cardiac markers (hs-TnT and cMyBP-C) have pointed out that decreased levels of this physiologically essential trace element accompany increased levels of hs-cTnT as well as cMyBP-C in children with MetS. This finding emphasizes that both zinc and these new generation cardiac markers may be evaluated as biomarkers of cardiovascular health during severe childhood obesity precipitated with MetS findings and also suggested as the messengers of the future risk in the adulthood periods of children with MetS.

Keywords: cardiac myosin binding protein-C, cardiovascular diseases, children, high sensitive cardiac troponin T, obesity

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Authors: Ghazal Mortazavi, S. M. J. Mortazavi

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Electricians, power line engineers and power station workers, welders, aluminum reduction workers, MRI operators and railway workers are occupationally exposed to different levels of electromagnetic fields. Mercury is among the most toxic metals. Dental amalgam fillings cause significant exposure to elemental mercury vapour in the general population. Today, substantial evidence indicates that mercury even at low doses may lead to toxicity. Increased release of mercury from dental amalgam fillings after exposure to MRI or microwave radiation emitted by mobile phones has been previously shown by our team. Moreover, our recent studies on the effects of stronger magnetic fields entirely confirmed our previous findings. From the other point of view, we have also shown that papers which reported no increased release of mercury after MRI, may have some methodological flaws. Over the past several years, our lab has focused on the health effects of exposure of laboratory animals and humans to different sources of electromagnetic fields such as mobile phones and their base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons, and MRI. As a strong association between exposure to electromagnetic fields and mercury level has been found in our studies, our findings lead us to this conclusion that occupational exposure to electromagnetic fields in workers with dental amalgam fillings can lead to elevated levels of mercury. Studies which reported that exposure to mercury can be a risk factor of Alzheimer’s disease (AD) due to the accumulation of amyloid beta protein (Aβ) in the brain and those reported that long-term occupational exposure to high levels of electromagnetic fields can increase the risk of Alzheimer's disease and dementia in male workers support our concept and confirm the significant role of the occupational exposure to electromagnetic fields in increasing the mercury level in workers with amalgam fillings.

Keywords: occupational exposure, electromagnetic fields, workers, mercury release, dental amalgam, restorative dentistry

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Authors: Nursel Koyuncu, Nihal Ata Tutkun

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Frailty model is a survival model that takes into account the unobserved heterogeneity for exploring the relationship between the survival of an individual and several covariates. In the recent years, proposed survival models become more complex and this feature causes convergence problems especially in large data sets. Therefore selection of sample from these big data sets is very important for estimation of parameters. In sampling literature, some authors have defined new sampling schemes to predict the parameters correctly. For this aim, we try to see the effect of sampling design in semi-parametric frailty model. We conducted a simulation study in R programme to estimate the parameters of semi-parametric frailty model for different sample sizes, censoring rates under classical simple random sampling and ranked set sampling schemes. In the simulation study, we used data set recording 17260 male Civil Servants aged 40–64 years with complete 10-year follow-up as population. Time to death from coronary heart disease is treated as a survival-time and age, systolic blood pressure are used as covariates. We select the 1000 samples from population using different sampling schemes and estimate the parameters. From the simulation study, we concluded that ranked set sampling design performs better than simple random sampling for each scenario.

Keywords: frailty model, ranked set sampling, efficiency, simple random sampling

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Authors: Baiyeri R. M, Oloriegbe Y. A., Saad A. O., Yusuf, K. O.

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Most farmers that produce food crops in Nigeria live in rural areas where potable water is not available. The farmers in some areas have problem of water borne diseases which could affect their health and could lead to death. This study was conducted to determine the impact of incorporating Granular Activated Carbon(GAC) and Magnetic Field(MF) in Slow Sand Filter(SSF) on the purification of water for rural dwellers. The SSF was developed using PVC pipe with diameter 152.4 mm and 1100 mm long, with layers of fine sand with size 0.25 mm and 350 mm depth, followed by GAC 10 mm size and 100 mm depth, fine sand 0.25mm with 500 mm depth and gravel grain size 10-14 mm and 100 mm depth. The SSF was kept moist for 21 days for biofilm layer (schmutzdecke) to fully develop, which is essential for trapping bacteria. Two SSFs fabricated consist of SSF+GAC as Filter 1, SSF+GAC+MF as Filter 2 and Control (Raw water without passing through filter. Water samples were collected from the filter and analyzed. The flow rate of Filter was 25 litres/h Total bacteria counts(TBC) for Filter 1 and Filter 2 and control were 2.4, 4.6 and 8.1 cfu/mg, respectively. Total coliform count for Filter 1 and Filter 2 and control were 1.7, 3.0 and 6.4 cfu/100mL, respectively. The filters reduced water hardness, turbidity, lead, copper, electrical conductivity and TBC by 53.13-73.44% but increased pH from 5.8 to 7.1-7.3. SSF is recommended for water purification in the rural areas.

Keywords: magnetised water, sow sand filter, portable water, activated carbon

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Authors: A. R. Shakura, A. B. Elistina, M. S. Aini, S. Norhasmah, A. Fakhru’l-Razi

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Tsunami 2004 was an unforeseeable event that caught Malaysia of guard resulting with 68 losses of lives and with an estimated economic loss of about 55.15billion US dollar. Scientists predict that if the earthquake epicentre originates from the Andaman-Nicobar region, the coastal population of Penang will have about 30 minutes to evacuate to safety. Thus, a study was conducted to enhance resiliency of Penang community as the area was the worst affected region during 2004 tsunami disaster. This paper is intended to examine the factors that influence intention to prepare for future tsunami among the coastal residence in Penang. The differences in the level of intention to prepare were also examined between those who experience and did not experience the 2004 tsunami. This study utilized a cross-sectional research design using a survey method. A total of 503 respondents were chosen systematically and data gathered were analysed using SPSS. Both genders, male and female were equally represented with a mean age of 44 years. Data indicated that the level of intention to prepare for tsunami disaster was moderate (M=3.72) with no significant difference in intention to prepare between those who had experienced or had not experienced the 2004 tsunami. Subsequently, results from a multiple regression analysis found that sense of community to be the most influential factor followed by subjective norm, trust, positive outcome expectancy and risk perception, explaining the 57% variance in intention to prepare. These factors reflect the influence of the collectivistic culture in Malaysia whereby households plus communities have a central role in encouraging each other. Therefore, the findings highlights the potential of adopting a community based disaster risk management as recommended by the United Nations International Strategy Disaster Reduction (UNISDR) which encompasses the cooperation between the local community and relevant stakeholders in preparing for future tsunami disaster.

Keywords: disaster management, experience, intention to prepare, tsunami

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Authors: Maryam Kheirollahpour, Mahmoud Danaee, Amir Faisal Merican, Asma Ahmad Shariff

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Background: The presence of nonlinearity among the risk factors of eating behavior causes a bias in the prediction models. The accuracy of estimation of eating behaviors risk factors in the primary prevention of obesity has been established. Objective: The aim of this study was to explore the potential of a hybrid model of structural equation modeling (SEM) and Artificial Neural Networks (ANN) to predict eating behaviors. Methods: The Partial Least Square-SEM (PLS-SEM) and a hybrid model (SEM-Artificial Neural Networks (SEM-ANN)) were applied to evaluate the factors affecting eating behavior patterns among university students. 340 university students participated in this study. The PLS-SEM analysis was used to check the effect of emotional eating scale (EES), body shape concern (BSC), and body appreciation scale (BAS) on different categories of eating behavior patterns (EBP). Then, the hybrid model was conducted using multilayer perceptron (MLP) with feedforward network topology. Moreover, Levenberg-Marquardt, which is a supervised learning model, was applied as a learning method for MLP training. The Tangent/sigmoid function was used for the input layer while the linear function applied for the output layer. The coefficient of determination (R²) and mean square error (MSE) was calculated. Results: It was proved that the hybrid model was superior to PLS-SEM methods. Using hybrid model, the optimal network happened at MPLP 3-17-8, while the R² of the model was increased by 27%, while, the MSE was decreased by 9.6%. Moreover, it was found that which one of these factors have significantly affected on healthy and unhealthy eating behavior patterns. The p-value was reported to be less than 0.01 for most of the paths. Conclusion/Importance: Thus, a hybrid approach could be suggested as a significant methodological contribution from a statistical standpoint, and it can be implemented as software to be able to predict models with the highest accuracy.

Keywords: hybrid model, structural equation modeling, artificial neural networks, eating behavior patterns

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, John Beatty, Aakash Pai

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Introduction: The development of robotic surgery has accelerated centralisation to tertiary centres, where robotic radical prostatectomy (RP) is offered. The purpose of concentrating treatment in high volume specialist centres is to improve the quality of care and patient outcomes. The aim of this study was to assess the impact on clinical outcomes of centralisation for locally diagnosed patients undergoing RP. Methods: Clinical outcomes for 169 consecutive laparoscopic & open RP pre-centralisation were retrospectively compared with 50 consecutive robotic RP conducted over a similar period post-centralisation. Preoperative risk stratification and time to surgery were collected. Perioperative outcomes, including length of stay (LOS) and complications, were collated. Post-operative outcomes, including erectile dysfunction (ED), biochemical recurrence (BCR), and urinary continence, were assessed. Results: Preoperative risk stratification showed no difference between the two groups. The median time from diagnosis to treatment was similar between the two groups (pre-centralisation, 121 days, post-centralisation, 117 days). The mean length of stay (pre-centralisation, 2.1 days, post-centralisation, 1.6 days) showed no significant difference (p=0.073). Proportion of overall complications (pre-centralisation, 11.4%, post-centralisation, 8.7%) and complications, above Clavien-Dindo 2, were similar between the two groups (pre-centralisation1.2%, post-centralisation 2.2%). Post operative functional parameters, including continence and ED, were comparable. Five-year BCR free rate was 78% for the pre-centralisation group and 79% for the post centralisation group. Conclusion: For our cohort of patients, clinical outcomes have remained static during centralisation. It is imperative that centralisation is accompanied by increased capacity, streamlining of pathways, and training to ensure that improved quality of care is achieved. Our institution has newly acquired a robot, and prospectively studying this data may support the reversal of centralisation for RP surgery.

Keywords: prostate, cancer, prostatectomy, clinical

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Authors: Rosemary I. Eneji, Stephen Adi Odey, Edem Carole, Eucharia Nwagbara

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Sexual and reproductive health behaviors are the main causes of death, disability, and disease among adolescents in Nigeria. In this study, we determined the accessibility of youth-friendly sexual and reproductive health services to secondary school adolescents in southern Cross River state, Nigeria. Nineteen randomly selected public secondary schools across the seven local government areas in the zone were used. The respondents were four hundred senior secondary (classes SSI - SS3) students aged 15-19 years, comprising 63.7% females and 36.3% males. A 50-item structured questionnaire was used for the study. There was a strong influence of age and sex of adolescents, income and occupation of parents, knowledge and awareness of adolescents, and tradition on the accessibility and use of youth-friendly sexual and reproductive health services (YFSRHS) to the adolescents. The attitude of health workers towards accessibility was of little effect. Overall, youth-friendly sexual and reproductive health services were not easily accessible to adolescents in the study area. Thus, there is need to enforce adolescent reproductive health policies in the area. Training and use of trained caregivers and peer educators to attend to adolescents and the inclusion of adolescent reproductive health as a subject in the curriculum are strongly recommended.

Keywords: youth, reproductive health, cross river state, secondary schools, Nigeria

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Authors: Anastasios Manos, Despina Elisabeth Filippidou

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Introduction: Historical buildings are an inte-gral part of the cultural heritage of every place, and beyond the obvious need for protection against risks, they have specific requirements regarding the handling of hazards and disasters such as fire, floods, earthquakes, etc. Ensuring high levels of protection and safety for these buildings is impera-tive for two distinct but interconnected reasons: a) they themselves constitute cultural heritage, and b) they are often used as museums/cultural spaces, necessitating the protection of both human life (vis-itors and workers) and the cultural treasures they house. However, these buildings present serious constraints in implementing the necessary measures to protect them from destruction due to their unique architecture, construction methods, and/or the structural materials used in the past, which have created an existing condition that is sometimes challenging to reshape and operate within the framework of modern regulations and protection measures. One of the most devastating risks that threaten historical buildings is fire. Catastrophic fires demonstrate the need for timely evaluation of fire safety measures in historical buildings. Recog-nizing the criticality of protecting historical build-ings from the risk of fire, the Confederation of Fire Protection Associations in Europe (CFPA E) issued specific guidelines in 2013 (CFPA-E Guideline No 30:2013 F) for the fire protection of historical buildings at the European level. However, until now, few actions have been implemented towards leveraging modern technologies in the field of con-struction and maintenance of buildings, such as Building Information Modeling (BIM) and the Inter-net of Things (IoT), for the protection of historical buildings from risks like fires, floods, etc. The pro-ject BIM4Cult has bee developed in order to fill this gap. It is a tool for timely assessing and monitoring of the fire safety level of historical buildings using BIM and IoT technologies in an integrated manner. The tool serves as a decision support expert system for improving the fire safety of historical buildings by continuously monitoring, controlling and as-sessing critical risk factors for fire.

Keywords: Iot, fire, BIM, expert system

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Authors: Raymond Puijk, Rachid Rassir, Inger N. Sierevelt, Anneke Spekenbrink-Sporen, Bart G. C. W. Pijls, Rob G. H. H. Nelissen, Peter A. Nolte

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Background: Among uncemented total knee arthroplasty (TKA), a wide variety of metal surface structures (MSS) and coatings exist to enhance implants' biological properties (i.e., bone ingrowth). This study explores the variety of MSS-coating combinations and compares their mid-long-term survivorships with cemented TKAs, by using data from the Dutch Arthroplasty Register. Methods: A total of 235,500 cemented and 11,132 uncemented primary TKAs with a median follow-up of 5.1 years were included. MSS-coating combinations were (1) Porous-uncoated (n=8986), (2) Beaded-hydroxyapatite (HA)(n=1093), (3) Matte-uncoated (n=846), (4) Matte-Titanium-nitride (TiN) (n=207). Five- and 10-year revision-free survival for all-cause revisions, and aseptic loosening of the tibial component, were calculated and compared by using Kaplan-Meier, Log-rank tests, and multivariable Cox proportional hazard regression analyses. Results: Ten-year survival rates with all-cause revisions as an endpoint, were 94.2% for cement, and 94.7%, 96.3%, 92.1%, and 79.0% for porous-uncoated, beaded-HA, matte-uncoated, and Matte-TiN, respectively (p<0.01). Rates for aseptic loosening were 98.8% for cemented, and 98.7%, 99.8%, 97.2%, and 94.9% for the uncemented, respectively (p<0.01).The beaded-HA implants were half the risk for an all-cause revision compared to cemented implants (p<0.01). Matte-uncoated and matte-TiN implants were at more risk of an all-cause revision than cemented implants (p=0.01, p<0.01). Proportions of revisions for aseptic loosening were comparable among most groups. Conclusion: Based on Dutch registry data, four main MSS-coating combinations among uncemented TKAs were found. survivorships for all-cause revisions and aseptic release differed widely between groups. Beaded-HA and porous-uncoated implants had the best survival rates among the uncemented TKAs and were non-inferior to the cemented TKAs.

Keywords: total knee arthroplasty, cement, uncemented, cementless;, metal surface structure, coating

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Authors: Bahareh Khakifirooz, Arian Shojaei, Amirhossein Hajialigol, Bahare Abdolahi

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Laceration of the inner layer of the myometrium can cause massive bleeding during and after childbirth, which can lead to the death of the mother if it is not diagnosed in time. We studied a rare case of massive intrapartum bleeding following myometrial laceration that was diagnosed correctly, and the patient survived with in-time treatments. The patient was a 26 years-old woman who was under observation for term pregnancy and complaint of rupture of membranes (ROM) and vaginal bleeding. Following the spontaneous course of labor and without receiving oxytocin, during the normal course of labor, she had an estimated total blood loss of 750 mL bleeding, which, despite the normal fetal heart rate and with the mother's indication for cesarean section, was transferred to the operating room and underwent cesarean section. During the cesarean section, the amniotic fluid was clear; after the removal of the placenta, severe and clear bleeding was flowing from the posterior wall of the uterus, which was caused by the laceration of the inner layer of the myometrium in the posterior wall of the lower segment of the uterus. The myometrial laceration was repaired with absorbable continuous locked sutures, and hemostasis was established, then, the patient used uterotonic drugs, and after monitoring, the patient was discharged from the hospital in good condition.

Keywords: intrapartum hemorrhage, inner myometrial laceration, labor, Increased intrauterine pressure

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Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

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Authors: Hanan Algarni

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Background: Impairment of walking and balance skills has negative impact on functional independence and community participation after stroke. Gait recovery is considered a primary goal in rehabilitation by both patients and physiotherapists. Treadmill training coupled with virtual reality technology is a new emerging approach that offers patients with feedback, open and random skills practice while walking and interacting with virtual environmental scenes. Objectives: To synthesize the evidence around the effects of the VR treadmill training on gait speed and balance primarily, functional independence and community participation secondarily in stroke patients. Methods: Systematic review was conducted; search strategy included electronic data bases: MEDLINE, AMED, Cochrane, CINAHL, EMBASE, PEDro, Web of Science, and unpublished literature. Inclusion criteria: Participant: adult >18 years, stroke, ambulatory, without severe visual or cognitive impartments. Intervention: VR treadmill training alone or with physiotherapy. Comparator: any other interventions. Outcomes: gait speed, balance, function, community participation. Characteristics of included studies were extracted for analysis. Risk of bias assessment was performed using Cochrane's ROB tool. Narrative synthesis of findings was undertaken and summary of findings in each outcome was reported using GRADEpro. Results: Four studies were included involving 84 stroke participants with chronic hemiparesis. Interventions intensity ranged (6-12 sessions, 20 minutes-1 hour/session). Three studies investigated the effects on gait speed and balance. 2 studies investigated functional outcomes and one study assessed community participation. ROB assessment showed 50% unclear risk of selection bias and 25% of unclear risk of detection bias across the studies. Heterogeneity was identified in the intervention effects at post training and follow up. Outcome measures, training intensity and durations also varied across the studies, grade of evidence was low for balance, moderate for speed and function outcomes, and high for community participation. However, it is important to note that grading was done on few numbers of studies in each outcome. Conclusions: The summary of findings suggests positive and statistically significant effects (p<0.05) of VR treadmill training compared to other interventions on gait speed, dynamic balance skills, function and participation directly after training. However, the effects were not sustained at follow up in two studies (2 weeks-1 month) and other studies did not perform follow up measurements. More RCTs with larger sample sizes and higher methodological quality are required to examine the long term effects of VR treadmill effects on function independence and community participation after stroke, in order to draw conclusions and produce stronger robust evidence.

Keywords: virtual reality, treadmill, stroke, gait rehabilitation

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Authors: Ikumapayi Catherine Mayowa

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The well-being of humans on a construction site is critical; abundant manpower had been lost through accidents which kill or make workers physically unfit to carry out construction activities, these, in turn, have multiple effects on the whole economy. Thus, it is necessary to put all safety items and regulations in place before construction activities can commence. This study was carried out in the Ondo state of Nigeria to investigate and analyze the state of health and safety of construction workers in the state. The study was done using first-hand observations, 50 construction project sites were visited in ten major towns of Ondo state, questionnaires were distributed, and the results were analyzed. The result shows that construction workers are being exposed to many construction site hazards due to lack of inadequate safety programs and lack of appropriate safety equipment for workers on site. From the data gotten from each site visited and the statistical analysis, it can be concluded that occurrences of an accident on construction sites depend significantly on the available safety facilities on the sites. The result of the regression statistics shows that the dependence of the frequency of occurrence of an accident on the availability of safety items on the site is 0.0362 which is less than 0.05 maximum significant level allowed. Therefore, a vital way of sustaining our building strategy is given a detail attention to the provision of adequate health and safety items on construction sites which will reduce the occurrence of accident, loss of manpower and death of skilled workers.

Keywords: construction sites, health, safety, welfare

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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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Authors: Nasreen Abdulmannan

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Fetal abnormalities are categorized as a structural abnormality, non-structural abnormality, or a combination of both. Fetal structural abnormalities (FSA) include, but are not limited, to Down syndrome, congenital diaphragmatic hernia, and cleft lip and palate. These abnormalities can be detected in the first weeks of pregnancy, which is almost around 9 - 20 weeks gestational. Etiological factors for FSA are unknown; however, transmitted genetic risk can be one of these factors. Consanguineous marriage often referred to as inbreeding, represents a significant risk factor for FSA due to the increased likelihood of deleterious genetic traits shared by both biological parents. In a country such as the Kingdom of Saudi Arabia (KSA), consanguineous marriage is high, which creates a significant risk of children being born with congenital abnormalities. Historically, the practice of consanguinity occurred commonly among European royalty. For example, Great Britain’s Queen Victoria married her German first cousin, Prince Albert of Coburg. Although a distant blood relationship, the United Kingdom’s Queen Elizabeth II married her cousin, Prince Philip of Greece and Denmark—both of them direct descendants of Queen Victoria. In Middle Eastern countries, a high incidence of consanguineous unions still exists, including in the KSA. Previous studies indicated that a significant gap exists in understanding the lived experiences of Saudi women dealing with an FSA-complicated pregnancy. Eleven participants were interviewed using a semi-structured interview format for this qualitative phenomenological study investigating the lived experiences of pregnant Saudi women carrying a child with FSA. This study explored the gaps in current literature regarding the lived experiences of pregnant Saudi women whose pregnancies were complicated by FSA. In addition, the researcher acquired knowledge about the available support and resources as well as the Saudi cultural perspective on FSA. This research explored the lived experiences of pregnant Saudi women utilizing Giorgi’s (2009) approach to data collection and data management. Findings for this study cover five major themes: (1) initial maternal reaction to the FSA diagnosis per ultrasound screening; (2) strengthening of the maternal relationship with God; (3) maternal concern for their child’s future; (4) feeling supported by their loved ones; and (5) lack of healthcare provider support and guidance. Future research in the KSA is needed to explore the network support for these mothers. This study recommended further clinical nursing research, nursing education, clinical practice, and healthcare policy/procedures to provide opportunities for improvement in nursing care and increase awareness in KSA society.

Keywords: fetal structural abnormalities, psychological distress, health provider, health care

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Authors: Iman Nezamzadeh, Ali Faghih, Behnam Oveisi

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In order to reduce earthquake hazards in urban areas, it is necessary to perform comprehensive studies to understand the dynamics of the active faults and identify potentially high risk areas. The fault slip-rates in Late Quaternary sediment are critical indicators of seismic hazard and also provide valuable data to recognize young crustal deformations. To measure slip-rates accurately, is needed to displacement of geomorphic markers and ages of quaternary sediment samples of alluvial deposit that deformed by movements on fault. In this study we produced information about Intermediate term slip rate of Sabzpushan Fault Zone (SPF) within the central part of the Zagros Mountains of Iran using OSL dating technique to make better analysis of seismic hazard and seismic risk reduction for Shiraz city. For this purpose identifiable geomorphic fluvial surfaces help us to provide a reference frame to determine differential or absolute horizontal and vertical deformation. Optically stimulated luminescence (OSL) is an alternative and independent method of determining the burial age of mineral grains in Quaternary sediments. Field observation and satellite imagery show geomorphic markers that deformed horizontally along the Sabzpoushan Fault. Here, drag folds is forming because of evaporites material of Miocen Formation. We estimate 2.8±0.5 mm/yr (mm/y) horizontal slip rate along the Sabzpushan fault zone, where ongoing deformation is involve with drug folding. The Soltan synclinal structure, close to the Sabzpushan fault, shows slight uplift rate due to active core-extrousion.

Keywords: slip rate, active tectonics, OSL, geomorphic markers, Sabzpushan Fault Zone, Zagros, Iran

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Authors: Hala M. Abdelkarem, Abeer H. Gafeer

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The metabolic syndrome (Mts) is a constellation of risk factors. The main objective of this study is to compare the ameliorating effect of metformin, lipitor, orilstate, lipoic acid and carnitin on insulin, lipid profile, leptin, adenonectin levels in metabolic syndrom (high fructose fed rats HF). Seventy male albino rats were divided into seven groups. G1: normal control. G2: G7 rats fed HF for 8wks. After four wk HF feeding, G3, G4, G5, G6, and G7 were orally administered (200 mg/kg daily) metformin, lipitor, orilstate, lipoic acid and carnitin respectively. All drugs were adminiseterd once daily. After 8 weeks of feeding, a significant increase in blood glucose level was observed in HF fed rats compared to normal rats, but this increase was significantly decreased after administration of metformin and lipitor. The raised of serum insulin level in HF fed rats was significantly decreased after administration of lipoic, carnitin, metformin. Significant higher concentrations of triglycerides (TG), total cholesterol & low density lipoprotein cholesterol (LDL- C) were observed in HF fed rats and these increases were significantly lowered after the administration of all the previous drugs. There was a significant decrease in serum high density lipoprotein cholesterol (HDL-C) in HF group administration of all drugs alleviates this reduction. The increased of serum leptin level in HF group was decreased significantly in met and orilstate groups. Whereas the reduction of serum adiponectin level in HF fed rats was increased in Lipitor, carnitin, orilstate groups. These data suggested that benefial effect of metformin, lipitor, orilstate, lipoic acid carnitin in reducing risk for people with decreased insulin sensitivity, increased oxidative stress and hyperlipidemia such as those with the metabolic syndrome or type 2 diabetes.

Keywords: metabolic syndrome, diabetes, proinflammation, antioxidants

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Authors: Nasrin Hosseinzad

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Troxerutin, a trihydroxyethylated derived of rutin, is a flavonoid existing in tea, coffee, cereal grains, various fruits and vegetables have been conveyed to display radioprotective, antithrombotic, nephron-protective and hepato-protective possessions. Troxerutin, has been well-proved to utilize hepatoprotective assets. Troxerutin could upturn the resistance of hippocampal neurons alongside apoptosis by lessening the action of AChE and oxidative stress. Consequently, troxerutin may have advantageous properties in the administration of Alzheimer's disease and cancer. Troxerutin has been testified to have several welfares and medicinal stuffs. It could shelter the mouse kidney against d-gal-induced damage by refining renal utility, decreasing histopathologic changes, dropping ROS construction, reintroducing the activities of antioxidant enzymes and reducing DNA oxidative destruction. The DNA cleavage study clarifies that troxerutin showed DNA protection against hydroxyl radical persuaded DNA mutilation. Troxerutin uses anti-cancer effect in HuH-7 hepatocarcinoma cells conceivably through synchronized regulation of the molecular signalling pathways, Nrf2 and NF-κB. DNA binding at slight channel by troxerutin may have donated to feature breaks leading to improved radiation brought cell death. Furthermore, the mechanism principal the observed variance in the antioxidant activities of troxerutin and its esters was qualified to equally their free radical scavenging capabilities and dissemination on the cell membrane outward.

Keywords: troxerutin, DNA, oxidative stress, antioxidant, free radical

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Authors: Barsha Saha, Shouvik Chakravarty, Sukanta Ray, Kshaunish Das, Nidhan K. Biswas, Srikanta Goswami

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Pancreatic Ductal Adenocarcinoma is a well-recognised cause of cancer death with a five-year survival rate of about 9%, and its incidence in India has been found to be increased manifold in recent years. Due to delayed detection, this highly metastatic disease has a poor prognosis. Several molecular alterations happen during the progression of the disease from pre-cancerous conditions, and many such alterations could be investigated for their biomarker potential. MicroRNAs have been shown to be prognostic for PDAC patients in a variety of studies. We hereby used NGS technologies to evaluate the role of small RNA changes during pancreatic cancer development from chronic pancreatitis. Plasma samples were collected from pancreatic cancer patients (n=16), chronic pancreatitis patients (n=8), and also from normal individuals (n=16). Pancreatic tumour tissue (n=5) and adjacent normal tissue samples (n=5) were also collected. Sequencing of small RNAs was carried out after small RNAs were isolated from plasma samples and tissue samples. We find that certain microRNAs are highly deregulated in pancreatic cancer patients in comparison to normal samples. A combinatorial analysis of plasma and tissue microRNAs and subsequent exploration of their targets and altered molecular pathways could not only identify potential biomarkers for disease diagnosis but also help to understand the underlying mechanism.

Keywords: small RNA sequencing, pancreatic cancer, biomarkers, tissue sample

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Authors: Mahmudjon Kuchkarov, Marufjon Kuchkarov, Mukhayyo Sobirjanova

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The origins of human language remain a profound scientific mystery, characterized by speculative theories often lacking empirical support. This study presents findings that may illuminate the genesis of human language, emphasizing its roots in natural, systematic, and repetitive sound patterns. Also, this paper presents the phonosignological and semantic analysis of linguistic elements across various languages and cultures. By utilizing the principles of the "Human Language" theory, we analyze the symbolic, phonetic, and semantic characteristics of elements such as "A", "L", "I", "F", and "四" (pronounced /si/ in Chinese and /shi/ in Japanese). Our findings reveal that natural sounds and their symbolic representations form the foundation of language, with significant implications for understanding religious and secular myths. This paper explores the intricate relationships between these elements and their cultural connotations, particularly focusing on the concept of "descent" in the context of the phonetic sequence "A, L, I, F," and the symbolic associations of the number four with death.

Keywords: empirical research, human language, phonosignology, semantics, sound patterns, symbolism, body shape, body language, coding, Latin alphabet, merging method, natural sound, origin of language, pairing, phonetics, sound and shape production, word origin, word semantic

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Authors: Mukondi Nethavhakone

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The high prevalence of violence against women is a global public health problem. Our societies have become dangerous places for women. Women during their child-bearing ages are at a higher risk of experiencing emotional, physical, and sexual violence. What makes it more concerning is that these violent acts are perpetrated by family members or partners, or ex-partners. Intimate Partner Violence (IPV) is associated with long-lasting physical, reproductive, sexual, mental, and maternal health implications. Expectedly women’s mental health would dimmish as a result of experiencing IPV. The burden of violence against women is seen to be heavier in low- and middle-income countries (LMICs) compared to the rest of the world. Countries have committed to eliminating all forms of violence against women through the sustainable development goal, aiming to see changes by the year 2030. As such, various countries have implemented psychosocial interventions of different levels of impact. However, little is known, especially in low- and middle-income countries, with regard to the potential of psychosocial interventions for IPV to improve the mental health outcomes for the survivors and/or victims of IPV. Analysing the risk for IPV through a social-ecological theoretical approach, low- and middle-income countries still readdressing gender inequality which is the cause of intimate partner violence. That is why it is taking time for these countries to shift psychosocial interventions to focus more on the improvement of the mental health of the survivors. It is, therefore, against this backdrop that the researcher intends to undertake a scoping review to understand the nature and characteristics of psychosocial interventions that have been implemented in low- and middle-income countries. With the findings from the scoping review, the researcher aims to develop a conceptual framework that may be a useful resource for healthcare practitioners and researchers in low- and middle-income countries. As this area of research has not been thoroughly reviewed, the results from this scoping will determine whether a systematic review will be justifiable. Additionally, the researcher will identify gaps and opportunities for future research in this area.

Keywords: mental health improvement, psychosocial interventions, intimate partner violence, LMICs

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Authors: Jessica Hemberg, Anna K. Forsman, Johanna Nordmyr

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With a considerable increase in the aging population in the Nordic countries there is a call for a deeper understanding of healthy aging and its underlying mechanisms. The aim of this study is to uncover health and well-being for older adults according to their own views and understand what role the existential dimension play? The study uses a hermeneutical approach. Material was collected through focus group interviews with 18 older adults. The texts were interpreted through hermeneutical reading. The underlying mechanisms of health among older adults are described, illustrating the key prerequisites for health as being in the present. This implies ‘living on the continuums of life and death’ and in this field of forces also ‘living on the continuum of the past and the future’. Important aspects for being in the present was balancing ambivalent emotions, considering existential issues, and being in connectedness. Health for older adults may be understood in the light of the metaphor of taking it one day at a time. Being in the present was emphasized as a health potential for older adults highlighting the existential health dimension. From a societal point of view, this implies that health promotion should focus on highlighting the importance of the existential dimension of health since it holds health-promoting potentials for older adults. Optimal health for older adults requires awareness of one’s attitude to life through being in the present as a basis for a positive and healthy outlook on life.

Keywords: focus group interviews, hermeneutics, life experiences, older adults

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Authors: Muhammad Ali, Zeeshan Afzal, Giampaolo Ferraioli, Gilda Schirinzi, Muhammad Saleem Mughal, Vito Pascazio

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On 24 September 2019, an earthquake with 5.6 Mw and 10 km depth stroke in Mirpur. The Mirpur area was highly affected by this earthquake, with the death of 34 people. This study aims to estimate the surface deformation associated with this earthquake. The interferometric synthetic aperture radar (InSAR) technique is applied to study earthquake induced surface motion. InSAR data using 9 Sentinel-1A SAR images from 11 August 2019 to 22 October 2019 is used to investigate the pre, co-, and post-seismic deformation trends. Time series investigation reveals that there was not such deformation in pre-seismic time period. In the co-seismic time period, strong displacement was observed, and in post-seismic results, small displacement is seen due to aftershocks. Our results show the existence of a previously unpublished blind fault in Mirpur and help to locate the fault line. Previous this fault line was triggered during the 2005 earthquake, and now it’s activated on 24 September 2019. Study area is already facing many problems due to natural hazards where additional surface deformations, particularly because of an earthquake with an activated blind fault, have increased its vulnerability.

Keywords: surface deformation, InSAR, earthquake, sentinel-1, mirpur

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Authors: M. Medrano, M. D. M. S., L. Younes, M. D.

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Introduction: Incidence of tibial hemimelia is 1:1,000,000. Due to pre-existing case studies and literature, there is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia, but an underlying cause is generally unknown. This presentation aims to discuss a rare, congenital lower limb deficiency observed in a patient in order to identify potential prenatal risk factors and future considerations for the patient’s well-being. Observation: A newborn female child, born full term via spontaneous vaginal delivery after induction of labor to unaffected and non-consanguineous parents. The prenatal course was notable for limited and disjointed prenatal care as well as maternal tobacco and marijuana use, anemia of pregnancy, and inadequate weight gain. Prenatal imaging showed lower extremity deformity with the inability to visualize tibia and bilateral clubfeet in the setting of Intrauterine Growth Restriction (IUGR). The patient presented with right equino varus deformity of the foot and right knee joint deformity. Radiological imaging showed the absence of the right tibia and varus angulation of the right foot with dislocation of the tibiotalar joint. Normal femur with lateral and mild anterior displacement of a wide fibula (Weber Type VIIa). Due to the absence of the patient’s tibia and knee extensor mechanism, the patient was not a candidate for reconstructive surgery and ultimately underwent successful right knee disarticulation. Discussion and Conclusion: By utilizing a retrospective chart review of this case, possible risk factors in prenatal care may be identified and add to existing knowledge on etiology. Hopefully, a cause can be clearly identified in the future and, thus, addressed in the prenatal period. In addition, we can investigate the patient’s well-being and adjustment post-operatively to support outpatient management of an uncommon anomaly.

Keywords: Tibial hemimelia, prenatal care, pediatric orthopedics, congenital deformity

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Authors: Madhav Khadilkar

Abstract:

Construction of a large standby reservoir was required to provide secure water supply. The new reservoir was required to be constructed at the same location of an abandoned old open pond due to space constraints. Some investigations were carried out earlier to improvise and re-commission the existing pond. But due to a lack of quantified risk of settlement from voids in the underlying limestone, the shallow foundations were not found feasible. Since the reservoir was resting on hard strata for about three-quarter of plan area and one quarter was resting on soil underlying with limestone and considerably low subgrade modulus. Further investigations were carried out to ascertain the locations and extent of voids within the limestone. It was concluded that the risk due to lime dissolution was acceptably low, and the site was found geotechnically feasible. The hazard posed by limestone dissolution was addressed through the integrated structural and geotechnical analysis and design approach. Finite Element Analysis was carried out to quantify the stresses and differential settlement due to various probable loads and soil-structure interaction. Walls behaving as cantilever under operational loads were found undergoing in-plane bending and tensile forces due to soil-structure interaction. Sensitivity analysis for varying soil subgrade modulus was carried out to check the variation in the response of the structure and magnitude of stresses developed. The base slab was additionally checked for the loss of soil contact due to lime pocket formations at random locations. The expansion and contraction joints were planned to receive minimal additional forces due to differential settlement. The reservoir was designed to sustain the actions corresponding to allowable deformation limits per code, and geotechnical measures were proposed to achieve the soil parameters set in structural analysis.

Keywords: differential settlement, limestone dissolution, reservoir, soil structure interaction

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Authors: A. Khan, I. Khan, M. Younus, S. E. Haque, U. Waheed, H. Neubauer, A. A. Anjum, S. A. Muhammad, A. Idrees T. Abbas, S. Raza, M. A. Ali, M. Farooq, M. Mahmood, A. Hussain, H. Danish, U. Tayyab, M. Zafar, M. Aslam.

Abstract:

Brucellosis is one of the major problems of milk producing animals in our country which deteriorate the health of livestock. It is a disease of zoonotic significance which is capable of producing disease in humans leading to infertility, orchitis, abortions, and synovitis. In this particular study, milk and serum samples of cattle and buffalo (n=402) were collected from different districts of Punjab including Narowal, Gujranwala and Gujrat. Milk samples were analyzed by Milk Ring Test (MRT), while serum samples were tested through Rose Bengal Plate agglutination Test (RBPT) and Indirect Enzyme Linked Immunosorbant Assay (i-ELISA). The sample tested with MRT were 9.5% positive, including cattle 9.6% and buffalo 9.3%. While using the RBPT test for the detection of serum samples and for screening purpose it was observed that 16.4% animals were seropositive, cattle were 18.8% and buffalo were 13.9% seropositive. The higher prevalence of brucellosis indicates the danger of the disease to human population. The serum samples positive by RBPT were further confirmed by the use of most specific and sensitive serological test known as i-ELISA. 11.4% animals were confirmed as seropositive by i-ELISA including cattle 13.5% seropositive and buffalo 9.3%. The results indicated high seroprevalence of brucellosis in cattle as compared to buffalos. Different risk factors were also studied to know the association between disease and their spread. Advanced age, larger herds, history of abortion and pregnancy of the animals is considered to be the important factors for the prevalence and spread of the hazardous zoonotic disease. It is a core issue of developing countries like Pakistan and has major public health impact.

Keywords: humans, bovines, infertility, orchitis, abortions, seroprevalence, brucellosis

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Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

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Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

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