Search results for: risk groups

Authors: Jong Yeop Kim, In Kyong Yi, Hyun Jeong Kwak, Sook Young Lee, Sung Yong Park

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Background: Several video laryngoscopes (VLs) were used to facilitate tracheal intubation in the normal and potentially difficult airway, especially by novice personnel. The aim of this study was to compare tracheal intubation performance regarding the time to intubation, glottic view, difficulty, and dental click, by a novice using McGrath VL, Pentax Airway Scope (AWS) and Macintosh laryngoscope in normal and cervical immobilized manikin models. Methods: Thirty-five anesthesia nurses without previous intubation experience were recruited. The participants performed endotracheal intubation in a manikin model at two simulated neck positions (normal and fixed neck via cervical immobilization), using three different devices (McGrath VL, Pentax AWS, and Macintosh direct laryngoscope) at three times each. Performance parameters included intubation time, success rate of intubation, Cormack Lehane laryngoscope grading, dental click, and subjective difficulty score. Results: Intubation time and success rate at the first attempt were not significantly different between the 3 groups in normal airway manikin. In the cervical immobilized manikin, the intubation time was shorter (p = 0.012) and the success rate with the first attempt was significantly higher (p < 0.001) when using McGrath VL and Pentax AWS compared with Macintosh laryngoscope. Both VLs showed less difficulty score (p < 0.001) and more Cormack Lehane grade I (p < 0.001). The incidence of dental clicks was higher with McGrath VL than Macintosh laryngoscope in the normal and cervical immobilized airway (p = 0.005, p < 0.001, respectively). Conclusion: McGrath VL and Pentax AWS resulted in shorter intubation time, higher first attempt success rate, compared with Macintosh laryngoscope by a novice intubator in a cervical immobilized manikin model. McGrath VL could be reduced the risk of dental injury compared with Macintosh laryngoscope in this scenario.

Keywords: intubation, manikin, novice, videolaryngoscope

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Authors: Safoin Aktaou, Aya Al Masri, Kamel Guerchouche, Malorie Martin, Fouad Maaloul

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Introduction: In the ‘Magnetic Resonance Imaging (MRI)’ department, all workers involved in preparing the patient, setting it up, tunnel cleaning, etc. are likely to be exposed to ‘ElectroMagnetic fields (EMF)’ emitted by the MRI device. Exposure to EMF can cause adverse radio-biological effects to workers. The purpose of this study is to propose an organizational process to manage and control EMF risks. Materials and methods: The study was conducted at seven MRI departments using machines with 1.5 and 3 Tesla magnetic fields. We assessed the exposure of each one by measuring the two electromagnetic fields (static and dynamic) at different distances from the MRI machine both inside and around the examination room. Measurement values were compared with British and American references (those of the UK's ‘Medicines and Healthcare Regulatory Agency (MHRA)’ and the ‘American Radiology Society (ACR)’). Results: Following the results of EMF measurements and their comparison with the recommendations of learned societies, a zoning system that adapts to needs of different MRI services across the country has been proposed. In effect, three risk areas have been identified within the MRI services. This has led to the development of a good practice guide related to the magnetic protection of MRI workers. Conclusion: The guide established by our study is a standard that allows MRI workers to protect themselves against the risk of electromagnetic fields.

Keywords: comparison with international references, measurement of electromagnetic fields, magnetic protection of workers, magnetic resonance imaging

Procedia PDF Downloads 169

Authors: Hossein Khara, Mahmoud Sayyadborani, Mohammad Sayyadborani

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In the present study, we examined the effects of different dietary levels of ascorbic acid (vitamin C) and α-tocopherol (vitamin E) and their combinations on growth, survival and some haematological and immunological parameters of Caspian brown trout, Salmo trutta caspius juveniles. 15 experimental treatments and one control group with three replicates were considered for experiment. The experimental treatments were fish fed by experimental diets containing different levels of Vit C and E as follow: T1: Vit E (20 mg.kg diet -1) + Vit C (100 mg.kg diet -1), T2: Vit E (30 mg.kg diet -1) + Vit C (100 mg.kg diet -1), T3: Vit E (40 mg.kg diet -1) + Vit C (100 mg.kg diet -1), T4: Vit E (20 mg.kg diet -1) + Vit C (200 mg.kg diet -1), T5: Vit E (30 mg.kg diet -1) + Vit C (200 mg.kg diet -1), T6: Vit E (40 mg.kg diet -1) + Vit C (200 mg.kg diet -1), T7: Vit E (20 mg.kg diet -1) + Vit C (300 mg.kg diet -1), T8: Vit E (30 mg.kg diet -1) + Vit C (300 mg.kg diet -1), T9: Vit E (40 mg.kg diet -1) + Vit C (300 mg.kg diet -1), T10: Vit C (100 mg.kg diet -1), T11: Vit C (200 mg.kg diet -1), T12: Vit C (300 mg.kg diet -1), T13: Vit E (20 mg.kg diet -1), T14: Vit E (30 mg.kg diet -1) T15: Vit E (40 mg.kg diet -1). Also a non-vitamin supplemented was considered as control group. Growth parameters were measured monthly and serum parameters assayed at the end of the experiment. According to our results, Vit C and E improved survival and growth parameters including specific growth rate (SGR), weight gain percent (WG%) and biomass. The highest values of these parameters obtained in T8, T9 and T8 respectively. The lowest FCR obtained in T8. The haematological parameters including red blood cells (RBCs), white blood cells (WBCs), haematocrit (Hct) and haemoglobin (Hb) were higher in vitamin treated groups than control group with highest values in T8. In T13, WBC values were higher compared to other experimental groups. The immunological parameters including lysozyme activity, Immunoglobulin (IgM) and total immunoglobulin (TIg) were significantly higher in vitamin supplemented groups than in control group. In this regard the highest values of these parameters were found in T12. The lowest values of TIg and lysozyme activity were observed in control group and fish fed by only vitamin E i.e. T13, T14 and T15. In conclusion, our results show that Vit C and E in combination or only can improve growth, survival, haematological and immunological indices of Caspian brown trout.

Keywords: vitamins E, vitamins C, growth, survival, haematological parameters, immunological parameters

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Authors: Hamid Falaki, Roya Kelkanlo, Mojtaba Tabatabaei

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The present study aimed at distinguishing the effects of work type on hand dimensions and investigating the relationship between anthropometric dimensions and occupation. The anthropometric data used in study were collected on 12 hand anthropometric dimensions. The participants included 91 males in two groups, namely manual labor job and office workers. All the data were analyzed using SPSS version 16. All measurements were significantly greater than those of office jobs except for the grip diameter obtained from the manual workers. The hand perimeter was the greatest value among the 12 measured dimensions, while the thickness of the side little finger was the smallest one. In four dimensions, namely width of four fingers together from the central hinge; diameter of thumb to face; diameter of index finger to face; hand thickness from index finger revealed the availability of a significant difference between manual labor jobs and office workers. Moreover, no significant relation was observed between weight and stature with hand dimension, which represents the correlation between occupation and the four dimensions. The results of this study showed that the difference between the two occupational groups was significant in terms of the four dimensions. Therefore, it is suggested that tool designers should consider this finding in their designing process.

Keywords: hand dimensions, occupation, tool design, anthropometry

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Authors: V. Rekha, Rama Pal

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The study examines the degree and magnitude of wealth-based inequalities in child health and its determinants in India. Despite making strides in economic growth, India has failed to secure a better nutritional status for all the children. The country currently faces the double burden of malnutrition as well as the problems of overweight and obesity. Child malnutrition, obesity, unsafe water, sanitation among others are identified as the risk factors for Non-Communicable Diseases (NCDs). Eliminating malnutrition in all its forms will catalyse improved health and economic outcomes. The assessment of the distributive dimension of child health across various segments of the population is essential for effective policy intervention. The study utilises the fourth round of District Level Health Survey for 2012-13 to analyse the inequalities among children in the age group 0-14 years in Maharashtra, a state in the western region of India with a population of 11.24 crores which constitutes 9.3 percent of the total population of India. The study considers the extent of health inequality by state, districts, sector, age-groups, and gender. The z-scores of four child health outcome variables are computed to assess the nutritional status of pre-school and school children using WHO reference. The descriptive statistics, concentration curves, concentration indices, correlation matrix, logistic regression have been used to analyse the data. The results indicate that magnitude of inequality is higher in Maharashtra and child health inequalities manifest primarily among the weaker sections of society. The concentration curves show that there exists a pro-poor inequality in child malnutrition measured by stunting, wasting, underweight, anaemia and a pro-rich overweight inequality. The inequalities in anaemia are observably lower due to the widespread prevalence. Rural areas exhibit a higher incidence of malnutrition, but greater inequality is observed in the urban areas. Overall, the wealth-based inequalities do not vary significantly between age groups. It appears that there is no gender discrimination at the state level. Further, rural-urban differentials in gender show that boys from the rural area and girls living in the urban region experience higher disparities in health. The relative distribution of undernutrition across districts in Maharashtra reveals that malnutrition is rampant and considerable heterogeneity also exists. A negative correlation is established between malnutrition prevalence and human development indicators. The findings of logistic regression analysis reveal that lower economic status of the household is associated with a higher probability of being malnourished. The study recognises household wealth, education of the parent, child gender, and household size as factors significantly related to malnutrition. The results suggest that among the supply-side variables, child-oriented government programmes might be beneficial in tackling nutrition deficit. In order to bridge the health inequality gap, the government needs to target the schemes better and should expand the coverage of services.

Keywords: child health, inequality, malnutrition, obesity

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Authors: Abdolrasoul Daneshjoo

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The aim of this study was studying the effect of acute creatine supplementation on physiological variables of continuous and intermittent soccer activities of men soccer players. 32 soccer players from Tarbiat Moalem University aged (22/3+-1/6) volunteered for this research and were divided into two groups randomly. Both experimental and control groups after 6 days taking supplementation were tested. For measuring height and weight meter and balance were used. Questionnaire for health background, lactate electro, heart beat measuring polar electro, continuous and intermittent training program and time recorder were used for data collection. For data analysis descriptive statistical techniques, two-way ANOVA and F test were used. The result of this study showed increased significantly in heart rate in control group. For control group heart beat was (71/6 +- 3/5) and for experimental group it was (75/3 +- 4/9). No significant differences were observed in players weight after taking creatine.

Keywords: heartbeat, lactate Blood, creatine, soccer players of Tarbiat Moalem University

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Authors: Sun Woo Lee, Tae Bum Lee, Yoon Hwa Park, Yoo Jeong Kim

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Cervical dentinal hypersensitivity (CDH) affects 8-30% of adults and nearly 85% of perio-treated patients. Various treatment schemes have been applied for treating CDH, among them being fluoride application, laser irradiation, and, recently, bioglass. The purpose of this study was to investigate the influence of bioglass, copper-bromide (Cu-Br) laser irradiation and their combination on dentinal tubule occlusion as a potential dentinal hypersensitivity treatment for CDH. 45 human dentin surfaces were organized into three equal groups: group A received Cu-Br laser only; group B received bioglass only; group C received bioglass followed by Cu-Br laser irradiation. Specimens were evaluated with regard to dentinal tubule occlusion under environmental scanning electron microscope. Treatment modality significantly affected dentinal tubule occlusion (p<0.001). Groups B and C scored higher dentinal tubule occlusion than group A. Binary logistic regression showed that bioglass application significantly (p<0.001) contributed to dentinal tubule occlusion, compared with other variables. Under the conditions used herein and within the limitations of this study, bioglass application, alone or combined with Cu-Br laser irradiation, is a superior method for producing dentinal tubule occlusion, and may lead to an effective treatment modality for CDH.

Keywords: bioglass, Cu-Br laser, cervical dentinal hypersensitivity, dentinal tubule occlusion

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Authors: Yao Huang, Hongjie Yu, Fangrong Xu, Longbiao Cai, Qiqiang He

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The Klotho gene has been found to be involved in cardiovascular health, and epigenetic mechanism has risen as good candidates to understand the role of lifestyle factors in obesity. The aim of this study was to investigate the effect of exercise intervention on the expression and DNA methylation of Klotho gene in high-fat diet induced obese mice. C57BL/6 male mice were fed a normal diet (ND) or a high-fat diet (HFD) for 12 weeks. HFD induced obese mice were divided into secondary group (SED) and exercise group (EX) randomly. The treadmill exercise was performed in EX group for 8 weeks. The expression and DNA methylation of Klotho were evaluated by Western blot, RT-PCR, and Methylation-specific PCR. Results indicated that Klotho protein and mRNA expression were significantly lower in the SED group than those in the ND and EX groups (P<0.01), whereas no significant difference, was found between ND group and EX group (P>0.05). Furthermore, mice in the ND group and SED group showed significantly lower levels of completely methylated Klotho DNA in ND group (0%) and SED group (50%) compared with the EX group (90%), and unmethylated Klotho DNA level in ND group (80%) was significantly higher than those in the SED (0%) and EX (0%) groups. These results suggested that exercise leads to increased Klotho expression and reduced Klotho DNA methylation level in HFD induced obese mice.

Keywords: DNA methylation, exercise intervention, klotho, obese mice

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Authors: Farida Ibrahim

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Right to information is the public's right to know through having access to public information held by state bodies. Recognized as a cornerstone in transparent, participatory and open democracies, the right to information is increasingly perceived today as an emerging human right on the international level. While this right is conceptualized in a range of different contexts, the paper focuses on its conceptualization as a force for socio-economic change for disadvantaged groups. The paper's goal is study the instrumental capacity of this right in empowering the public to access state-held information pertinent to their socio-economic rights. In this regard, the paper views the right to information as an inclusionary tool that is capable of spurring inclusion for individuals excluded from the ambits of both: public participation and social justice. For exploring this, the paper examines the advocacy role played by civil society groups in furthering this instrumental capacity. In particular, the paper presents a focused account on the Egyptian case. While Egypt has recently adopted its constitutional provision on access to information, doubts arise on Egyptian citizens' genuine ability to access information held by state bodies. The politico-economic environment, long term culture of bureaucratic secrecy, and legal framework do not provide promising outcomes on access to public information. Within the particular context of the Egyptian case, this paper questions the extent to which civil society in Egypt is capable of instrumentally employing the political opportunity offered by the constitutional entitlement to information access for pressuring public authorities to disclose information. Through four lawsuits brought by civil society groups in Egypt, the paper argues that the right to information has instrumentally provided civil society actors with new domains of mobilization for furthering the realization of social and economic rights, and ultimately, for renegotiating a new social order lining the relationship between the Egyptian state and its citizens marginalized by socio-economic imbalances.

Keywords: civil society, Egypt, right to information, socio-economic rights

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Authors: L. Kashyap, S. Jha, D. Shende, V. K. Mohan, P. Khanna, A. Aravindan, S. Kashyap, L. Singh, S. Aggarwal

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Obesity is associated with a chronic inflammatory state. During surgery, there is an interplay between anaesthetic and surgical stress vis-a-vis the already present complex immune state. Moreover, the postoperative period is dictated by inflammation, which is crucial for wound healing and regeneration. An excess of inflammatory response might hamper recovery besides increasing the risk for infection and complications. There is definite evidence of the immunosuppressive role of inhaled anaesthetic agents. This immune modulation may be brought into effect directly by influencing the innate and adaptive immunity cells. The effects of propofol on immune mechanisms in has been widely elucidated because of its popularity. It reduces superoxide generation, elastase release, and chemotaxis. However, there is no unequivocal proof of one’s superiority over the other. Hence, an anaesthetic regimen with lesser inflammatory potential and specific to the obese patient is needed. OBESITA trial protocol (2019) by Sousa and co-workers in progress aims to test the hypothesis that anaesthesia with sevoflurane results in a weaker proinflammatory response compared to propofol, as evidenced by lower IL-6 and other biomarkers and an increased macrophage differentiation into M2 phenotype in adipose tissue. IL-6 was used as the objective parameter to evaluate inflammation as it is regulated by both surgery and anesthesia. It is the most sensitive marker of the inflammatory response to tissue damage since it is released within minutes by blood leukocytes. We hypothesized that maintenance of anaesthesia with propofol would lead to less inflammation than that with desflurane. Aims: The effect of two anaesthetic techniques, total intravenous anaesthesia (TIVA) with propofol and desflurane, on surgical stress response was evaluated. The primary objective was to compare serum interleukin-6 (IL-6) levels before and after surgery. Methods: In this prospective single-blinded randomized controlled trial undertaken, 30 obese patients (BMI>30 kg/m2) undergoing laparoscopic bariatric surgery under general anaesthesia were recruited. Patients were randomized to receive desflurane or TIVA using a target-controlled infusion for maintenance of anaesthesia. As a marker of inflammation, pre-and post-surgery IL-6 levels were compared. Results: After surgery, IL-6 levels increased significantly in both groups. The rise in IL-6 was less with TIVA than with desflurane; however, it did not reach significance. IL-6 rise post-surgery correlated positively with the complexity of procedure and duration of surgery and anaesthesia, rather than anaesthetic technique. Both groups did not differ in terms of intra-operative hemodynamic and respiratory variables, time to awakening, postoperative pulmonary complications, and duration of hospital stay. The incidence of nausea was significantly higher with desflurane than with TIVA. Conclusion: Inflammatory response did not differ as a function of anaesthetic technique when propofol and desflurane were compared. Also, patient and surgical variables dictated post-operative inflammation more than the anaesthetic factors. Further, larger sample size is needed to confirm or refute these findings.

Keywords: bariatric, biomarkers, inflammation, laparoscopy

Procedia PDF Downloads 126

Authors: Jason Maffia, Maria D’urso, Robert Crupi, Margaret Cartmell

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The emotional aspects of traumatic events such as workplace violence are often ignored, causing low productivity, disillusionment, and resentment within an organization. As a result, if workplace violence, particularly in healthcare settings, is not adequately addressed, it will become a phenomenon, undermining the peace and stability among the active communities while also posing a risk to the population's health and well-being. This review intends to identify the risk factors and the implications of workplace violence in healthcare settings and highlight the collaborative efforts needed in sustaining control and prevention measures against workplace violence. It is essential that health care organizations are prepared physically and emotionally for traumatic situations. This study explores the theoretical nature of addressing work-related violence in healthcare settings as well as traumatic stress reactivity and the context within which reactions occur and recovery takes place. Cognitive, social, and organizational influences on response are identified and used to tentatively offer explanations for identifying security risks, development, and implementation of de-escalation teams, CISM programs and training staff in violence prevention are among strategies hospitals are employing to keep workers and patients safe. General conclusion regarding the implications for intervention effectiveness and design are discussed.

Keywords: healthcare settings, stress reactions, traumatic events, workplace violence

Procedia PDF Downloads 78

Authors: Erva Kaygun

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The purpose of this research is to investigate the effects of positive psychology interventions on college students' positive-negative emotions, coronavirus anxiety, and career stress. 4 groups of college students are compared in terms of the level of exposure to PP constructs ( Non-Psychology, Psychology, Positive Psychology Course, and Positive Psychology Boot Camp). In this research, Pearson Correlation, independent t-tests, ANOVA, and Post-Hoc tests are conducted. Without being significant, the groups exposed to PP constructs showed higher positive emotions and total PERMA scores, whereas negative emotions, career stress, and coronavirus stress remained similar. It is crucial to indicate that career stress is higher among all psychology students when compared to non-psychology students. The results showed that the highest exposure group (PP Boot Camp) showed no difference in negative emotions, whereas higher PERMA scores and positive emotion scores were on the Positive and Negative Affect Schedule (PANAS) scale.

Keywords: positive psychology, college students, well being, anxiety

Procedia PDF Downloads 199

Authors: Mohamed M. Zaki, Maha M. Hady

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Salmonella spp. have been categorized as the world’s biggest threats to human health and poultry products are mostly incriminated sources. In Egypt, it was found that S. enteritidis and S. typhimurium are the most prevalent ones in poultry farms. It is recommended to eliminate salmonella from living bird by competing for salmonella contamination in feed in order to establish a healthy gut. The Feed acidifiers are the group of feed additives containing low-molecular-weight organic acids and/ or their salts which act as performance promoters by lowering the pH in the gut, optimizes digestion and inhibit bacterial growth. The inclusion of organic acid in pure form nonetheless effective in feed, yet, it is difficult to handle in feed mills as it is corrosive and produce more losses during pelleting process. The current study aimed at to evaluate the impact of incorporation of sodium diformate (SDF) and a commercial acidifier, CA (a mixture of butyric and propionic acids and their ammonium salts) at 0.4% dietary levels on broilers performance and the control S. enteritidis infection. Two hundreds and seventy unsexed cobb chickens were allotted in one of three treatments (90/ group) which were, the control (no acidifier, C- &C+), the 0.4% SDF (SDF- & SDF +) and the 0.4% CA (CA- & CA +) dietary levels for 35 days. Before the allocation of the groups, ten extra birds and a diet sample were bacteriologically examined to ensure negative contamination with salmonella. The birds were raised on deep-litter separated pens and had free access to feed and water all the time. The experimentally formulated diets were kept at 40C. After 24h access to the different dietary treatments, all the birds in the positive groups (n=15/ replicate) were inoculated intra-crop with 0.2 ml of 24 h broth culture of S. entertidis containing 1X 107 organisms while the negative-treated groups were inoculated with the same amount of the negative broth and second inoculation was done at 22 d of age. Colocal swabs were collected individually from all birds 2 h pre-inoculation to assure the absence of salmonella, then 1, 3, 5, 7, 21 days post-inoculation to recover salmonella. Performance parameter (body weight gain and feed efficiency) were calculated. Mortalities were recorded and reisolation of the salmonella was adopted to ensure it was the inoculated ones. The results revealed that the dietary acidification with sodium diformate significantly improved broilers performance and tends to produce heavier birds as compared to the negative control and CA groups. Moreover, the dietary inclusion of both acidifiers at level of 0.4% was able to eliminate mortalities completely at the relevant inoculation time. Regarding the shedding of S. enteritidius in positive groups, the SDF treatment resulted in significant (p<0.05) cessation of the shedding at 3 days post-inoculation compared to 7 days post-inoculation for the CA-group. In conclusion, sodium diformate at 0.4% dietary level in broiler diets has a valuable effect not only on broilers performance but also by eliminating S. enteritidis the main source of salmonella contamination in poultry farms which is feed.

Keywords: acidifier, broilers, Salmonalla spp, sodium diformate

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Authors: Farhad Ghorbandordinejad, Shamsoddin Aref

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Wikis and blogs, defined as educational tools in line with the objectives of collaborative writing, are regarded as innovative ways of writing addressing the problems of conventional types of writing. Although writing in wikis and blogs step in different contexts, they are both aiming at betterment of collaborative writing procedures. It is believed that due to certain reasons bringing in wikis and blogs to learners' life can lead to better performance of writing. This study aimed at dipping into pedagogical aspects of wikis and blogs in the hope of eliminating prior traditional mistakes and bringing students together in a more constructive L2 context. To this end, three groups of intermediate students were experimented in three settings of wiki-group, blog-group and conventional (control) group. Despite conventional group learners, participants in both experimental groups experienced L2 writing in a new telecollaborative context. An achievement test was administered after the treatment to check learners’ degree of improvement in EFL writing. The results of this study provide a deep insight towards the effectiveness of writing in the contexts of wikis and blogs compared with conventional writing procedures. The overall conclusion drawn from the distinction of conventional writing, on one hand, and wikis and blogs, on the other hand, indicates that the latter channels of writing are more constructive for learners’ writing improvements.

Keywords: collaborative writing, wikis, blogs, writing achievement

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Authors: Beverly Komen

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Online crimes have been on the rise in the recent days, especially with the hit of the covid-19 pandemic. The coronavirus pandemic has led to an unprecedented rise in screen time, this means more families are relying on technology and digital solutions to keep children learning, spending more time on the virtual platforms can leave children vulnerable to online abuse and exploitation. With ease access of affordable phones, internet, and increased online activities, all children are at risk of being abused online hence making the digital space unsafe for children. With these increased use of technology and its accessibility, children are at risk of facing challenges such as access to inappropriate content, online grooming, identity theft, cyber bullying, among other risks. The big question is; as we enjoy the benefits brought in by technology, how do we ensure that our children are save in this digital space? With the analysis of the current trends, there is a gap in knowledge on people’s understanding on child online protection and safety measures when using the digital space. A survey conducted among 50 parents in Nairobi in Kenya indicated that there is a gap in knowledge on online protection of children and over 50 % of the participants shared that for sure they have no idea on how to protect children online. This paper seeks to address the concept of child protection in the digital space and come up with viable solutions in protecting children from online vices.

Keywords: child protection, digital space, online risks, online grooming, cyber bulying, online child sexual exploitation, and abuse

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Authors: María Isabel Núñez-Peña, Macarena Suárez Pellicioni

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In the present study, we used event-related potentials (ERP) to address the question of whether high (HMA) and low math-anxious (LMA) individuals differ on a complex addition verification task, which involved both carrying and non-carrying additions. ERPs were recorded while seventeen HMA and seventeen LMA individuals performed the verification task. Groups did not differ in trait anxiety or gender distribution. Participants were presented with two-digit additions and were asked to decide whether the proposed solution was correct or incorrect. Behavioral data showed a significant Carrying x Proposed solution x Group interaction for accuracy, showing that carrying additions were more error prone than non-carrying ones for both groups, although the difference non-carrying minus carrying was larger for the HMA group. As for ERPs, a P2 component larger in HMA individuals than in their LMA peers was found both for carrying and non-carrying additions. The P2 was followed by a sustained negative slow wave at parietal positions. Because the negative slow waves are thought to reflect the updating of working memory, these results give support to the relationship among working memory, math performance and math anxiety.

Keywords: math anxiety, carrying, working memory, P2

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Authors: Nyimas Annissa Mutiara Andini

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There are 325,000 children younger than age 15 in the U.S. have epilepsy. In Indonesia, 40% of 3,5 millions cases of epilepsy happens in children. The most common type of epilepsy, which affects 6 out of 10 people with the disorder, is called idiopathic epilepsy and which has no identifiable cause. One of the most commonly used medications in the treatment of this childhood epilepsy is sodium valproate. Administration of sodium valproat in children has a problem to fail. Nearly 60% of pediatric patients known were mildly, moderately, or severely non-adherent with therapy during the first six months of treatment. Many parents or caregiver took far less medication than prescribed, and the treatment-adherence pattern for the majority of patients was established during the first month of treatment. 42% of the patients were almost always given their medications as prescribed but 13% had very poor adherence even in the early weeks and months of treatment. About 7% of patients initially gave the medication correctly 90% of the time, but adherence dropped to around 20% within six months of starting treatment. Over the six months of observation, the total missing of administration is about four out of 14 doses in any given week. This fail can cause the epilepsy to relapse. Whereas, current reported epilepsy disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P< 0.05). They had a greater risk of limitation in the ability to do things (relative risk: 9.22; 95% CI: 7.56–11.24), repeating a school grade (relative risk: 2.59; CI: 1.52–4.40), and potentially having unmet medical and mental health needs. In the other side, technology can help to make our life easier. One of the technology, that we can use is a mobile application. A mobile app is a software program we can download and access directly using our phone. Indonesians are highly mobile centric. They use, on average, 6.7 applications over a 30 day period. This paper is aimed to describe an application that could help to control a sodium valproat administration in children; we call it as D-Epi app. D-Epi app is a downloadable application that can help parents or caregiver alert by a timer-related application to warn whether it is the time to administer the sodium valproat. It works not only as a standard alarm, but also inform important information about the drug and emergency stuffs to do to children with epilepsy. This application could help parents and caregiver to take care a child with epilepsy in Indonesia.

Keywords: application, children, D-Epi, epilepsy

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Authors: Hind Bouami, Patrick Millot

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Medication dispensing system is a life-critical system whose failure may result in preventable adverse events leading to longer patient stays in hospitals or patient death. Automation has led to great improvements in life-critical systems as it increased safety, efficiency, and comfort. However, critical risks related to medical organization complexity and automated solutions integration can threaten drug dispensing security and performance. Knowledge about the system’s complexity aspects and human machine parameters to control for automated equipment’s security and performance will help operators to secure their automation process and to optimize their system’s reliability. In this context, this study aims to document the operator’s situation awareness about automation risks and parameters involved in automation security and performance. Our risk management approach has been deployed in the North Luxembourg hospital center’s pharmacy, which is equipped with automated drug dispensing systems since 2009. With more than 4 million euros of gains generated, North Luxembourg hospital center’s success story was enabled by the management commitment, pharmacy’s involvement in the implementation and improvement of the automation project, and the close collaboration between the pharmacy and Sinteco’s firm to implement the necessary innovation and organizational actions for automated solutions integration security and performance. An analysis of the actions implemented by the hospital and the parameters involved in automated equipment’s integration security and performance has been made. The parameters to control for automated equipment’s integration security and performance are human aspects (6.25%), technical aspects (50%), and human-machine interaction (43.75%). The implementation of an anthropocentric analysis system before automation would have prevented and optimized the control of risks related to automation.

Keywords: Automated drug delivery systems, Hospitals, Human-centered automated system, Risk management

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Authors: Fayaz Moosavi, Saeid Moradyfard

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One of the methods in avoiding management fraud and increasing the quality of financial information, is the notification of qualitative features of financial information, including conservatism characteristic. Although taking a conservatism approach, while boosting the quality of financial information, is able to reduce the informational risk and the cost of capital stock of commercial department, by presenting an improper image about the situation of the commercial department, raises the risk of failure in returning the main and capital interest, and consequently the cost of capital of the commercial department. In order to know if conservatism finally leads to the increase or decrease of the cost of capital or does not have any influence on it, information regarding accepted companies in Tehran stock exchange is utilized by application of pooling method from 2007 to 2012 and it included 124 companies. The results of the study revealed that there is an opposite and meaningful relationship between conditional conservatism and the cost of capital of the company. In other words, if bad and unsuitable news and signs are reflected sooner than good news in accounting profit, the cost of capital of the company increases. In addition, there is a positive and meaningful relationship between the cost of capital and lack of information asymmetry.

Keywords: conditional conservatism, lack of information asymmetry, the cost of capital, stock exchange

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Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

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Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

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Authors: Zakieh Rostamzadeh, Zahra Shirmohammadi

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Human cytomegalovirus is a species of the cytomegalovirus family of viruses, which in turn is a member of the viral family known as herpesviridae or herpesviruses. Although they may be found throughout the body, HCMV infections are frequently associated with the salivary glands. HCMV infection is typically unnoticed in healthy people, but can be life-threatening for the immunocompromised such as HIV-infected persons, organ transplant recipients, or newborn infants. After infection, HCMV has an ability to remain latent within the body over long periods. Cytomegalovirus (CMV) causes infection in immunocompromised, hemophilia patients and those who received blood transfusion frequently. This study aimed at determining the prevalence of cytomegalovirus (CMV) antibodies in hemophilia patients. Materials and Methods: A retrospective observational study was carried out in Urmia, North West of Iran. The study population comprised a sample of 50 hemophilic patients born after 1985 and have received blood factors in West Azerbaijan. The exclusion criteria include: drug abusing, high risk sexual contacts, vertical transmission of mother to fetus and suspicious needling. All samples were evaluated with the method of ELISA, with a certain kind of kit and by a certain laboratory. Results: Fifty hemophiliacs from 250 patients registered with Urmia Hemophilia Society were enrolled in the study including 43 (86%) male, and 7 (14%) female. The mean age of patients was 10.3 years, range 3 to 25 years. None of patients had risk factors mentioned above. Among our studied population, 34(68%) had hemophilia A, 1 (2%) hemophilia B, 8 (16%) VWF, 3(6%) factor VII deficiency, 1 (2%) factor V deficiency, 1 (2%) factor X deficiency, 1 (2%). Sera of 50 Hemodialysis patients were investigated for CMV-specific immunoglobulin G (IgG) and IgM. % 91.89 patients were anti-CMV IgG positive and %40.54 was seropositive for anti-CMV IgM. 37.8% patient had serological evidence of reactivation and 2.7% of patients had the primary infection. Discussion: There was no relationship between the antibody titer and: drug abusing, high risk sexual contacts, vertical transmission of mother to fetus and suspicious needling.

Keywords: bioinformatics, biomedicine, cytomegalovirus, immunocompromise

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Authors: A. Barratt, M. H. Granat, S. Buttress, B. Roy

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Introduction: Physiotherapy is an essential part of the treatment of patients with shoulder problems. The focus of treatment is usually centred on addressing specific physiotherapy goals, ultimately resulting in the improvement in pain and function. This study investigates if computerised physiotherapy using gamification principles are as effective as standard physiotherapy. Methods: Physiotherapy exergames were created using a combination of commercially available hardware, the Microsoft Kinect, and bespoke software. The exergames used were validated by mapping physiotherapy goals of physiotherapy which included; strength, range of movement, control, speed, and activation of the kinetic chain. A multicenter, randomised prospective controlled trial investigated the use of exergames on patients with Shoulder Impingement Syndrome who had undergone Arthroscopic Subacromial Decompression surgery. The intervention group was provided with the automated sensor-based technology, allowing them to perform exergames and track their rehabilitation progress. The control group was treated with standard physiotherapy protocols. Outcomes from different domains were used to compare the groups. An important metric was the assessment of shoulder range of movement pre- and post-operatively. The range of movement data included abduction, forward flexion and external rotation which were measured by the software, pre-operatively, 6 weeks and 12 weeks post-operatively. Results: Both groups show significant improvement from pre-operative to 12 weeks in elevation in forward flexion and abduction planes. Results for abduction showed an improvement for the interventional group (p < 0.015) as well as the test group (p < 0.003). Forward flexion improvement was interventional group (p < 0.0201) with the control group (p < 0.004). There was however no significant difference between the groups at 12 weeks for abduction (p < 0.118067) , forward flexion (p < 0.189755) or external rotation (p < 0.346967). Conclusion: Exergames may be used as an alternative to standard physiotherapy regimes; however, further analysis is required focusing on patient engagement.

Keywords: shoulder, physiotherapy, exergames, gamification

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Authors: Mhuji Kilonzo

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Acute oral toxicity of Mystroxylon aethiopicum root bark aqueous was evaluated in albino mice of either sex. In this study, five groups of mice were orally treated with doses of 1000, 2000, 3000, 4000 and 5000 mg/kg body weight of the crude extract. The mortality, signs of toxicity and body weights were observed individually for two weeks. At the end of the two weeks study, all animals were sacrificed, and the hematological and biochemical parameters, as well as organ weights relative to body weight of each animal, were determined. No mortality, signs of toxicity and abnormalities in vital organs were observed in the entire period of study for both treated and control groups of mice. Additionally, there were no significant changes (p > 0.05) in the blood hematology and biochemical analysis. However, the body weights of all mice increased significantly. The Mystroxylon aethiopicum root bark aqueous extract were found to have a high safe margin when administered orally. Hence, the extract can be utilized for pharmaceutical formulations.

Keywords: acute oral toxicity, albino mice, Mystroxylon aethiopicum, safety

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Authors: Erwin Geroleo, Higinio Mappala

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Introduction Overt Hepatic Encephalopathy (OHE) is the most dreaded outcome of liver cirrhosis. Aside from the triggering factors which are already known to precipitate OHE, there is growing evidence that an altered gut microbiota profile (dysbiosis) can also trigger OHE. MHE is the mildest form of hepatic encephalopathy(HE), affecting about one-third of patients with cirrhosis, and close 80% of patients with cirrhosis and manifests as abnormalities in central nervous system function. Since these symptoms are subclinical most patients are not being treated to prevent OHE. The gut microbiota have been evaluated by several studies as a therapeutic option for MHE, especially in decreasing the levels of ammonia, thus preventing progression to OHE Objectives This study aims to evaluate the efficacy of probiotics in terms of reduction of ammonia levels in patient with minimal hepatic encephalopathies and to determine if Probiotics has role in the prevention of progression to overt hepatic encephalopathy in adult patients with minimal hepatic encephalopathy (MHE) Methods and Analysis The literature search strategy was restricted to human studies in adults subjects from 2004 to 2022. The Jadad Score Calculation was utilized in the assessment of the final studies included in this study. Eight (8) studies were included. Cochrane’s Revman Web, the Fixed Effects model and the Ztest were all used in the overall analysis of the outcomes. A p value of less than 0.0005 was statistically significant. Results. These results show that Probiotics significantly lowers the level of Ammonia in Cirrhotic patients with OHE. It also shows that the use of Probiotics significantly prevents the progression of MHE to OHE. The overall risk of bias graph indicates low risk of publication bias among the studies included in the meta-analysis. Main findings This research found that plasma ammonia concentration was lower among participants treated with probiotics (p<0.00001).) Ammonia level of the probiotics group is lower by 13.96 μmol/ on the average. Overall risk of developing overt hepatic encephalopathy in the probiotics group is shown to be decreased by 15% as compared to the placebo group Conclusion The analysis showed that compared with placebo, probiotics can decrease serum ammonia, may improve MHE and may prevent OHE.

Keywords: minimal hepatic encephalopathy, probiotics, liver cirrhosis, overt hepatic encephalopathy

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Authors: Laxuman Thakuri

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Community-based forest management is often glorified as one of the best forest management alternatives in the developing countries like Nepal. It is also believed that the transfer of forest management authorities to local communities is decisive to take efficient decisions, maximize the forest benefits and improve the people’s livelihood. The community forestry of Nepal also aims to maximize the forest benefits; share them among the user households and improve their livelihood. However, how the local communities fix the price of forest products and local pricing made by the forest user groups affects to equitable forest benefits-sharing among the user households and their livelihood improvement objectives, the answer is largely silent among the researchers and policy-makers alike. This study examines local pricing system of forest products in the lowland community forestry and its effects on equitable benefit-sharing and livelihood improvement objectives. The study discovered that forest user groups fixed the price of forest products based on three criteria: i) costs incur in harvesting, ii) office operation costs, and iii) livelihood improvement costs through community development and income generating activities. Since user households have heterogeneous socio-economic conditions, the forest user groups have been applied low pricing strategy even for high-value forest products that the access of socio-economically worse-off households can be increased. However, the results of forest products distribution showed that as a result of low pricing strategy the access of socio-economically better-off households has been increasing at higher rate than worse-off and an inequality situation has been created. Similarly, the low pricing strategy is also found defective to livelihood improvement objectives. The study suggests for revising the forest products pricing system in community forest management and reforming the community forestry policy as well.

Keywords: community forestry, forest products pricing, equitable benefit-sharing, livelihood improvement, Nepal

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Authors: Shreyas Gambhirrao, Aditya Vichare, Aniket Tembhurne, Shahuraj Bhosale

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In today's rapidly evolving environment, stress has emerged as a significant health concern across different age groups. Stress that isn't controlled, whether it comes from job responsibilities, health issues, or the never-ending news cycle, can have a negative effect on our well-being. The problem is further aggravated by the ongoing connection to technology. In this high-tech age, identifying and controlling stress is vital. In order to solve this health issue, the study focuses on three key metrics for stress detection: body temperature, heart rate, and galvanic skin response (GSR). These parameters along with the Support Vector Machine classifier assist the system to categorize stress into three groups: 1) Stressed, 2) Not stressed, and 3) Moderate stress. Proposed training model, a NodeMCU combined with particular sensors collects data in real-time and rapidly categorizes individuals based on their stress levels. Real-time stress detection is made possible by this creative combination of hardware and software.

Keywords: real time stress detection, NodeMCU, sensors, heart-rate, body temperature, galvanic skin response (GSR), support vector machine

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Authors: Jamila Mohammed Makarfi, Yontem Sonmez

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Developing countries like Nigeria have recently been affected by conflicts characterized by violence, high levels of risk and insecurity, resulting in loss of lives, livelihoods, displacement of communities, degradation of health, educational and social infrastructure as well as economic underdevelopment. The Nigerian government’s response to most of these conflicts has mainly been reactionary in the form of military deployments, as against precautionary to prevent or address the root causes of the conflicts. Several studies have shown that at various points of a conflict, conflict regions can benefit from the resources and expertise available outside the government, mainly from the private sector through mechanisms such as corporate social responsibility (CSR) by businesses. The main aim of this study is to examine the role of businesses in peacebuilding in Northern Nigeria through CSR in the last decade. The expected contributions from this will answer research questions, such as the key business motivations to engage in peacebuilding, as well as the degree of influence exerted from various stakeholder groups on the business decision to engage. The methodology of the study adopts a multiple case study of over 120 businesses of various sizes, ranging from small, medium and large-scale. A mixed method enabled the collection of quantitative and qualitative primary data to augment the secondary data. The results indicated that the most important business motivations to engage in peacebuilding were the negative effects of the conflict on economic stability, as well as stakeholder-driven motives. On the other hand, out of the 12 identified stakeholders, micro-, small- and medium-scale enterprises (MSMEs) considered the chief executive officer’s interest to be the most important factor, while large companies rated the government and community pressure as the highest. Overall, the foreign stakeholders scored low on the influence chart for all business types.

Keywords: conflict, corporate social responsibility, peacebuilding, stakeholder

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Authors: Munqeth Othman Agha

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The historical formation of urban centres in the eastern Arab world was shaped by rapid urbanization and sudden transformation from the age of the pre-industrial to a post-industrial economy, coupled with uneven development, informal urban expansion, and constant surges in unemployment and poverty rates. The city was stratified accordingly as overlapping layers of division and inequality that have been built on top of each other, creating complex horizontal and vertical divisions based on economic, social, political, and ethno-sectarian basis. This has been further exacerbated during the neoliberal era, which transferred the city into a sort of dual city that is inhabited by heterogeneous and often antagonistic social groups. Economic deprivation combined with a growing sense of marginalization and inequality across the city planted the seeds of political instability, outbreaking in 2011. Unlike other popular uprisings that occupy central squares, as in Egypt and Tunisia, the Syrian uprising in 2011 took place mainly within inner streets and neighborhood squares, mobilizing primarily on more or less upon the lines of stratification. This has emphasized the role of micro-urban and social settings in shaping mobilization and resistance tactics, which necessitates us to understand the way the city was stratified and place it at the center of the city-conflict nexus analysis. This research aims to understand to what extent pre-conflict urban stratification lines played a role in determining the different trajectories of three cities’ neighborhoods (Homs, Dara’a and Deir-ez-Zor). The main argument of the paper is that the way the Syrian city has been stratified creates various social groups within the city who have enjoyed different levels of accessibility to life chances, material resources and social statuses. This determines their relationship with other social groups in the city and, more importantly, their relationship with the state. The advent of a political opportunity will be depicted differently across the city’s different social groups according to their perceived interests and threats, which consequently leads to either political mobilization or demobilization. Several factors, including the type of social structures, built environment, and state response, determine the ability of social actors to transfer the repertoire of contention to collective action or transfer from social actors to political actors. The research uses urban stratification lines as the basis for understanding the different patterns of political upheavals in urban areas while explaining why neighborhoods with different social and urban environment settings had different abilities and capacities to mobilize, resist state repression and then descend into a military conflict. It particularly traces the transformation from social groups to social actors and political actors by applying the Explaining-outcome Process-Tracing method to depict the causal mechanisms that led to including or excluding different neighborhoods from each stage of the uprising, namely mobilization (M1), response (M2), and control (M3).

Keywords: urban stratification, syrian conflict, social movement, process tracing, divided city

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Authors: Mohannad N. H. Al-Malichi

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Because of its exceptional properties, graphene has become the most promising nanomaterial for the development of a new generation of advanced materials from battery electrodes to structural composites. However, current methods to meet requirements for the mass production of high-quality graphene are limited by harsh oxidation, high temperatures, and tedious processing steps. To extend the scope of the bulk production of graphene, herein, a facile, reproducible and cost-effective approach has been developed. This involved heating a specific mixture of chemical materials at an extremely low temperature (70 C) for a short period (7 minutes) to exfoliate functionalized graphene platelets with high structural integrity. The obtained graphene platelets have an average thickness of 3.86±0.71 nm and a lateral size less than ~2 µm with a low defect intensity ID/IG ~0.06. The thin film (~2 µm thick) exhibited a low surface resistance of ~0.63 Ω/sq⁻¹, confirming its high electrical conductivity. Additionally, these nanoplatelets were decorated with polar functional groups (epoxy and carboxyl groups), thus have the potential to toughen and provide multifunctional polymer nanocomposites. Moreover, such a simple method can be further exploited for the novel exfoliation of other layered two-dimensional materials such as MXenes.

Keywords: functionalized graphene nanoplatelets, high structural integrity graphene, low temperature exfoliation of graphene, functional graphene platelets

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Authors: Saroj Kumar Rath

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India's Muslims represent 15 percent of the nation's population, the world's third largest group in any nation after Indonesia and Pakistan. Extremist groups like the Islamic State, Al Qaeda, the Taliban and the Haqqani network increasingly view India as a target. Several trends explain the rise: Terrorism threats in South Asia are linked and mobile - if one source is batted down, jihadists relocate to find another Islamic cause. As NATO withdraws from Afghanistan, some jihadists will eye India. Pakistan regards India as a top enemy and some officials even encourage terrorists to target areas like Kashmir or Mumbai. Meanwhile, a stream of Wahhabi preachers have visited India, offering hard-line messages; extremist groups like Al Qaeda and the Islamic State compete for influence, and militants even pay jihadists. Muslims as a minority population in India could offer fertile ground for the extremist recruiters. This paper argues that there is an urgent need for the Indian government to profile militants and examine social media sites to attack Wahhabi indoctrination while supporting education and entrepreneurship for all of India's citizens.

Keywords: Al Qaeda, terrorism, Islamic state, India, haqqani network, Pakistan, Taliban

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