Search results for: Edward Abraham

Authors: Mike T. Wei, Douglas N. Mintz, Lisa A. Mandl, Arielle W. Fein, Jayme C. Burket, Yuo-Yu Lee, Wei-Ti Huang, Vivian P. Bykerk, Mark P. Figgie, Edward F. Di Carlo, Bruce N. Cronstein, Susan M. Goodman

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Background/Purpose: Rheumatoid arthritis (RA) patients have excellent total hip arthroplasty (THA) survival, and methotrexate (MTX), an anti-inflammatory disease modifying drug which may affect bone reabsorption, may play a role. The purpose of this study is to determine the diagnosis leading to revision THA (rTHA) in RA patients and to assess the association of radiographic lucency with MTX use. Methods: All patients with validated diagnosis of RA in the institution’s THA registry undergoing rTHA from May 2007 - February 2011 were eligible. Diagnosis leading to rTHA and medication use was determined by chart review. Osteolysis was evaluated on available radiographs by measuring maximum lucency in each Gruen zone. Differences within RA patients with/without MTX in osteolysis, demographics, and medications were assessed with chi-squared, Fisher's exact tests or Mann-Whitney U tests as appropriate. The error rate for multiple comparisons of lucency in the different Gruen zones was corrected via false discovery rate methods. A secondary analysis was performed to determine differences in diagnoses leading to revision between RA and matched OA controls (2:1 match by sex age +/- 5 years). OA exclusion criteria included presence of rheumatic diseases, use of MTX, and lack of records. Results: 51 RA rTHA were identified and compared with 103 OA. Mean age for RA was 57.7 v 59.4 years for OA (p = 0.240). 82.4% RA were female v 83.5% OA (p = 0.859). RA had lower BMI than OA (25.5 v 28.2; p = 0.166). There was no difference in diagnosis leading to rTHA, including infection (RA 3.9 v OA 6.8%; p = 0.719) or dislocation (RA 23.5 v OA 23.3%; p = 0.975). There was no significant difference in the length of time the implant was in before revision: RA 11.0 v OA 8.8 years (p = 0.060). Among RA with/without MTX, there was no difference in use of biologics (30.0 v 43.3%, p = 0.283), steroids (47.6 v 50.0%, p = 0.867) or bisphosphonates (23.8 v 33.3%, p = 0.543). There was no difference in rTHA diagnosis with/without MTX, including loosening (52.4 v 56.7%, p = 0.762). There was no significant difference in lucencies with MTX use in any Gruen zone. Patients with MTX had femoral stem subsidence of 3.7mm v no subsidence without MTX (p = 0.006). Conclusion: There was no difference in the diagnosis leading to rTHR in RA and OA, although RA trended longer prior to rTHA. In this small retrospective study, there were no significant differences associated with MTX exposure or radiographic lucency among RA patients. The significance of subsidence is not clear. Further study of arthroplasty survival in RA patients is warranted.

Keywords: hip arthroplasty, methotrexate, revision arthroplasty, rheumatoid arthritis

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Authors: R. Edward Minchin Jr.

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The U.S. Federal Highway Administration (FHWA) Every Day Counts Program (EDC) has resulted in state DOTs putting evermore emphasis on speeding up the delivery of highway and bridge construction projects for use by the driving public. This has resulted in an increase in the use of alternative construction delivery systems such as design-build (D-B), construction manager at-risk (CMR) or construction manager/general contractor (CM/GC), and adding alternative technical concepts (ATCs) to traditional design-bid-build (DBB) contracts. ATCs have exhibited great potential for delivering substantial benefits like cost savings, increased constructability, and quicker project delivery. Previous research has found that knowledge of project constructability was lacking in state Department of Transportation (DOT) planning, programming, and environmental staffs. Many agencies have therefore relied on a set of ‘acceptable’ design solutions over the years of working with their local resource agencies. The result is that the permitting process for several government agencies has become increasingly restrictive with the result that the DOTs and their industry partners lose the ability to innovate after a permit is approved. The intent of this paper is to report on the research team’s progress in this ongoing effort furnish the United States government with a uniform set of guidelines for the application of constructability reviews during all phases of project development and delivery. The research uses surveys and interviews to determine which states have implemented formal programs to ensure that the constructor is furnished with a set of contract documents that affords said constructor with the best possible opportunity to successfully construct the project with the highest quality standards, within the contract duration and without exceeding the construction budget. Once these states are identified, workshops are held all over the nation, resulting in the team learning the best current practices and giving the team the ability to recommend new practices that will improve the process. The plan is for the FHWA to encourage or require state DOTs to use these practices on all federally funded highway and bridge construction projects. The project deliverable is a Guidebook for FHWA to use in disseminating the recommended practices to the states.

Keywords: alternative construction delivery, alternative technical concepts, constructability, construction design plans

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Authors: Valeria Abreu Minero, Edward Barker, Hannah Dickson, Francois Husson, Sandra Flynn, Jennifer Shaw

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Purpose – The purpose of this paper is to identify offender typologies based on aspects of the offenders’ psychopathology and their associations with crime scene behaviours using data derived from the National Confidential Enquiry into Suicide and Safety in Mental Health concerning homicides in England and Wales committed by offenders in contact with mental health services in the year preceding the offence (n=759). Design/methodology/approach – The authors used multiple correspondence analysis to investigate the interrelationships between the variables and hierarchical agglomerative clustering to identify offender typologies. Variables describing: the offender’s mental health history; the offenders’ mental state at the time of offence; characteristics useful for police investigations; and patterns of crime scene behaviours were included. Findings – Results showed differences in the offender’s histories in relation to their crime scene behaviours. Further, analyses revealed three homicide typologies: externalising, psychosis and depression. Analyses revealed three homicide typologies: externalising, psychotic and depressive. Practical implications – These typologies may assist the police during homicide investigations by: furthering their understanding of the crime or likely suspect; offering insights into crime patterns; provide advice as to what an offender’s offence behaviour might signify about his/her mental health background; findings suggest information concerning offender psychopathology may be useful for offender profiling purposes in cases of homicide offenders with schizophrenia, depression and comorbid diagnosis of personality disorder and alcohol/drug dependence. Originality/value – Empirical studies with an emphasis on offender profiling have almost exclusively focussed on the inference of offender demographic characteristics. This study provides a first step in the exploration of offender psychopathology and its integration to the multivariate analysis of offence information for the purposes of investigative profiling of homicide by identifying the dominant patterns of mental illness within homicidal behaviour.

Keywords: offender profiling, mental illness, psychopathology, multivariate analysis, homicide, crime scene analysis, crime scene behviours, investigative advice

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Authors: Chi-Feng Lai, Wen-Chun Liao Liao

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Many people are bothered by sleep difficulties in Taiwan’s society. However, majority of patients get medical treatments without a comprehensive sleep assessment. It is still a big challenge to formulate a comprehensive assessment of sleep difficulties in clinical settings, even though many assessment tools have existed in literature. This study tries to implement reliable and effective ‘comprehensive sleep assessment scales’ in a medical center and to explore differences in sleep-related factors between clinic clients with or without sleep difficulty complaints. The comprehensive sleep assessment (CSA) scales were composed of 5 dimensions: ‘personal factors’, ‘physiological factors’, ‘psychological factors’, ‘social factors’ and ‘environmental factors, and were first evaluated by expert validity and 20 participants with test-retest reliability. The Content Validity Index (CVI) of the CSA was 0.94 and the alpha of the consistency reliability ranged 0.996-1.000. Clients who visited sleep clinic due to sleep difficulties (n=32, 16 males and 16 females, ages 43.66 ±14.214) and gender-and age- matched healthy subjects without sleep difficulties (n=96, 47 males and 49 females, ages 41.99 ±13.69) were randomly recruited at a ratio of 1:3 (with sleep difficulties vs. without sleep difficulties) to compare their sleep and the CSA factors. Results show that all clinic clients with sleep difficulties did have poor sleep quality (PSQI>5) and mild to moderate daytime sleepiness (ESS >11). Personal factors of long working hours (χ2= 10.315, p=0.001), shift workers (χ2= 8.964, p=0.003), night shift (χ2=9.395, p=0.004) and perceived stress (χ2=9.503, p=0.002) were disruptors of sleep difficulties. Physiological factors from physical examination including breathing by mouth, low soft palate, high narrow palate, Edward Angle, tongue hypertrophy, and occlusion of the worn surface were observed in clinic clients. Psychological factors including higher perceived stress (χ2=32.542, p=0.000), anxiety and depression (χ2=32.868, p=0.000); social factors including lack of leisure activities (χ2=39.857, p=0.000), more drinking habits (χ2=1.798, p=0.018), irregular amount and frequency in meals (χ2=5.086, p=0.024), excessive dinner (χ2=21.511, p=0.000), being incapable of getting up on time due to previous poor night sleep (χ2=4.444, p=0.035); and environmental factors including lights (χ2=7.683, p=0.006), noise (χ2=5.086, p=0.024), low or high bedroom temperature (χ2=4.595, p=0.032) were existed in clients. In conclusion, the CSA scales can work as valid and reliable instruments for evaluating sleep-related factors. Findings of this study provide important reference for assessing clinic clients with sleep difficulties.

Keywords: comprehensive sleep assessment, sleep-related factors, sleep difficulties

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Authors: Yahoel Van Essen, Gordon Ho, Brett Russell, Hans-Georg Worms, Xiao Lin Long, Edward David Cooper, Avner Bachar

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Weeds reduce farm and forest productivity, invade crops, smother pastures and some can harm livestock. Farmers need to spend a significant amount of money to control weeds by means of biological, chemical, cultural, and physical methods. To solve the global agricultural labor shortage and remove poisonous chemicals, a fully autonomous, eco-friendly, and sustainable weeding technology is developed. This takes the form of a weeding robot, ‘Roboweeder’. Roboweeder includes a four-wheel-drive self-driving vehicle, a 4-DOF robotic arm which is mounted on top of the vehicle, an electromagnetic wave generator (magnetron) which is mounted on the “wrist” of the robotic arm, 48V battery packs, and a control/communication system. Cameras are mounted on the front and two sides of the vehicle. Using image processing and recognition, distinguish types of weeds are detected before being eliminated. The electromagnetic wave technology is applied to heat the individual weeds and clusters dielectrically causing them to wilt and die. The 4-DOF robotic arm was modeled mathematically based on its structure/mechanics, each joint’s load, brushless DC motor and worm gear’ characteristics, forward kinematics, and inverse kinematics. The Proportional-Integral-Differential control algorithm is used to control the robotic arm’s motion to ensure the waveguide aperture pointing to the detected weeds. GPS and machine vision are used to traverse the farm and avoid obstacles without the need of supervision. A Roboweeder prototype has been built. Multiple test trials show that Roboweeder is able to detect, point, and kill the pre-defined weeds successfully although further improvements are needed, such as reducing the “weeds killing” time and developing a new waveguide with a smaller waveguide aperture to avoid killing crops surrounded. This technology changes the tedious, time consuming and expensive weeding processes, and allows farmers to grow more, go organic, and eliminate operational headaches. A patent of this technology is pending.

Keywords: autonomous navigation, machine vision, precision heating, sustainable and eco-friendly

Procedia PDF Downloads 198

Authors: Joel F. Campbell, Bing Lin, Michael Obland, Susan Kooi, Tai-Fang Fan, Byron Meadows, Edward Browell, Wayne Erxleben, Doug McGregor, Jeremy Dobler, Sandip Pal, Christopher O'Dell, Ken Davis

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The Active Sensing of CO₂ Emissions over Nights, Days, and Seasons (ASCENDS) CarbonHawk Experiment Simulator (ACES) is a NASA Langley Research Center instrument funded by NASA’s Science Mission Directorate that seeks to advance technologies critical to measuring atmospheric column carbon dioxide (CO₂ ) mixing ratios in support of the NASA ASCENDS mission. The ACES instrument, an Intensity-Modulated Continuous-Wave (IM-CW) lidar, was designed for high-altitude aircraft operations and can be directly applied to space instrumentation to meet the ASCENDS mission requirements. The ACES design demonstrates advanced technologies critical for developing an airborne simulator and spaceborne instrument with lower platform consumption of size, mass, and power, and with improved performance. The Atmospheric Carbon and Transport – America (ACT-America) is an Earth Venture Suborbital -2 (EVS-2) mission sponsored by the Earth Science Division of NASA’s Science Mission Directorate. A major objective is to enhance knowledge of the sources/sinks and transport of atmospheric CO₂ through the application of remote and in situ airborne measurements of CO₂ and other atmospheric properties on spatial and temporal scales. ACT-America consists of five campaigns to measure regional carbon and evaluate transport under various meteorological conditions in three regional areas of the Continental United States. Regional CO₂ distributions of the lower atmosphere were observed from the C-130 aircraft by the Harris Corp. Multi-Frequency Fiber Laser Lidar (MFLL) and the ACES lidar. The airborne lidars provide unique data that complement the more traditional in situ sensors. This presentation shows the applications of CO₂ lidars in support of these science needs.

Keywords: CO₂ measurement, IMCW, CW lidar, laser spectroscopy

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Authors: Mike Yaw Osei-Atweneboana, John Asiedu Larbi, Edward Jenner Tettevi

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Background: The lymphatic filariasis (LF) control programme has been on-going in Ghana since 2000. This community-wide approach involves the use of ivermectin (IVM) and albendazole (ALB). Soil-transmitted helminth (STH) infections control is augmented within this programme; however, in areas where LF is not prevalent, albendazole alone is administered to school children. The purpose of this study was therefore, to determine the efficacy of albendazole against soils transmitted helminths and the impact of mass drug administration of albendazole and ivermectin on the health status of children of school going age and pregnant women. Material/Methods: This was a twelve months longitudinal study. A total of 412 subjects including school children (between the ages of 2-17 years) and pregnant women were randomly selected from four endemic communities in Kpandai district of the Northern region. Coprological assessment for parasites was based on the Kato–Katz technique in both dry and rainy seasons at baseline, 21 days and 3 months post-treatment. Single-dose albendazole treatment was administered to all patients at baseline. Preserved samples are currently under molecular studies to identify possible single nucleotide polymorphism (SNP) within the beta tubulin gene which is associated with benzimidazole resistance. Results: Of all the parasites found (hookworm, Trichuris trichiura, Hymenolepis nana, and Taenia sp.); hookworm was the most prevalent. In the dry season, the overall STHs prevalence at pre-treatment was 29%, while 9% and 13% prevalence was recorded at 21 days, and three months after treatment respectively. However, in the rainy season, the overall STHs prevalence was 8%, while 4% and 12% was recorded at 21 days and three months respectively after ALB treatment. In general, ALB treatment resulted in an overall hookworm egg count reduction rate of 89% in the dry season and 93% in the rainy season, while the T. trichiura egg count reduction rate was 100% in both seasons. Conclusions: STH infections still remains a significant public health burden in Ghana. Hookworm infection seems to respond poorly or sub-optimally to ALB, raising concerns of possible emergence of resistance which may lead to a major setback for the control and elimination of STH infections, especially hookworm infections.

Keywords: hookworm, sub-optimal response, albendazole, trichuriasis, soil-transmitted helminths

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Authors: Karima Chaabna, Sohaila Cheema, Amit Abraham, Hekmat Alrouh, Ravinder Mamtani, Javaid I. Sheikh

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We aimed to assess the production of systematic reviews (SRs) that synthesize observational studies discussing population health issues in the Middle East and North Africa (MENA). Two independent reviewers systematically searched MEDLINE through PubMed. Between 2008-2016, 5,747 articles (reviews, systematic reviews, and meta-analyses) were identified. Following a multi-stage screening process, 387 SRs (with or without meta-analysis) on population health issues in the MENA were included in our overview. Citation numbers for each SR were retrieved from Google Scholar. Impact factor of the journal during the publication year for the included SRs was retrieved from the Institute of Scientific Information’s Journal Citation Report. We conducted linear regression analysis to assess time trends of number of publications according to SRs’ characteristics. We characterized a linear statistically significant increase in the annual numbers of SRs that summarize observational studies on the MENA population health (p-value<0.0001, R2=0.95), from 15 in 2008 to 81 in 2016. Our analysis reveals also linear statistically significant increases in numbers of SRs published by authors affiliated to institutions located inside MENA and/or neighboring countries (N=113, p-value < 0.0001, R²=0.90), by authors located outside MENA (N=155, p-value=0.0007, R²=0.82), and by collaborating authors affiliated to institutions located outside MENA and inside the region and/or in MENA’s neighboring countries (total number of SRs (N)= 119, p-value=0.0004, R²=0.85). Furthermore, these SRs were published in journals with an IF ranging from 0 to 47.8 (median=2.1). Linear statistically significant increases in numbers of published SRs were demonstrated in journals’ impact factor (IF) categories (IF=[0-2[: R²=0.79, p-value=0.0012; IF=[2-4[:R²=0.86, p-value=0.0003; and IF=[4-6[:R²=0.53, p-value=0.026). Additionally, annual numbers of citations to the SRs varied between 0 and 471 (median=7). While each year, a couple of SRs were getting more than 50 annual citations, there were linear statistically significant increases in numbers of published SRs with an annual number of citations at [0-10[(R²=0.89, p-value=0.00014) and at [10-50[ (R²=0.76, p-value=0.0021). Between 2008-2016, increasingly SRs that summarize observational studies on population health issues in the MENA were published. Authors of these SRs were located inside and/or outside the MENA region and an increasing number of collaborations were seen. Increasing numbers of SRs were predominantly observed in journals with an IF between zero and six. Interestingly, SRs covering MENA region countries were being increasingly cited, indicating an escalation of interest in this region’s population health issues.

Keywords: bibliometric, citation, impact factor, Middle East and North Africa, population health, systematic review

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Authors: Andrew Wee

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As a result of the Italian Independence Wars starting in 1848, Italy began to change through unification. People gradually moved away from some of their traditional practices and values, such as the long-held belief that women were inferior to men, as part of the Risorgimento. Italians began to take interest in opera as a form of emotional release. As opera became more popular and prominent in their culture, it aided in the dissemination of ideas, especially stimulating the spread of imperialism, in the late 19th century, as Italy began extending its presence to other countries. In order to collect the information needed to analyze Italy’s foreign presence, it was necessary to consult texts concerning the culture of the Risorgimento. These texts included primary sources from operatic composers and contemporary recorded accounts. Letters from Giuseppe Verdi, a leader in opera during the Risorgimento, have been scrutinized for indications of popular attitudes of the time. The cultural context of the Risorgimento is essential to understanding the Italian motives and attitudes towards the outside world. On the more political side, research has also entailed the study of historical data of general laws, policies, and their purposes concerning geopolitical boundaries and foreign affairs, such as Edward Said’s thesis on Orientalism. By establishing these two characteristics of Italy, the paper will thoroughly illustrate Italy’s presence in foreign affairs. Texts have been searched with the intent of using information that reveals Italian attitudes toward exotic countries to determine whether their demeanor was positive or condescending. Motives behind sources have been interpreted in context in order to form a complete picture of the Italian sentiment towards foreigners. Additionally, research pertaining to Italian nationalism and imperialism such as song and literature has been used. The primary form of research has been the division of sources that are culturally based and those that are political in nature. Opera had always been developing since its creation in the 17th century, and in the 19th century, the bel canto movement revolutionized opera and its role in Italian society. This paper uses evidence that popular sentiment was influenced by opera to support the belief that the evolution of opera was as a result of the nationalist sentiment, and in turn fueled the cultural movement known as the Risorgimento. In this way, opera proceeded to affect Italian culture by spreading the idea of imperialism.

Keywords: opera, Italian unification, music history, imperialism

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Authors: Calvin Ralph, Edward Archer, Alistair McIlhagger

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3D woven textile composites continue to emerge as an advanced material for structural applications and composite manufacture due to their bespoke nature, through thickness reinforcement and near net shape capabilities. When 3D woven preforms are produced, they are in their optimal physical state. As 3D weaving is a dry preforming technology it relies on compression of the preform to achieve the desired composite thickness, fibre volume fraction (Vf) and consolidation. This compression of the preform during manufacture results in changes to its thickness and architecture which can often lead to under-performance or changes of the 3D woven composite. Unlike traditional 2D fabrics, the bespoke nature and variability of 3D woven architectures makes it difficult to know exactly how each 3D preform will behave during processing. Therefore, the focus of this study is to investigate the effect of compression on differing 3D woven architectures in terms of structure, crimp or fibre waviness and thickness as well as analysing the accuracy of available software to predict how 3D woven preforms behave under compression. To achieve this, 3D preforms are modelled and compression simulated in Wisetex with varying architectures of binder style, pick density, thickness and tow size. These architectures have then been woven with samples dry compression tested to determine the compressibility of the preforms under various pressures. Additional preform samples were manufactured using Resin Transfer Moulding (RTM) with varying compressive force. Composite samples were cross sectioned, polished and analysed using microscopy to investigate changes in architecture and crimp. Data from dry fabric compression and composite samples were then compared alongside the Wisetex models to determine accuracy of the prediction and identify architecture parameters that can affect the preform compressibility and stability. Results indicate that binder style/pick density, tow size and thickness have a significant effect on compressibility of 3D woven preforms with lower pick density allowing for greater compression and distortion of the architecture. It was further highlighted that binder style combined with pressure had a significant effect on changes to preform architecture where orthogonal binders experienced highest level of deformation, but highest overall stability, with compression while layer to layer indicated a reduction in fibre crimp of the binder. In general, simulations showed a relative comparison to experimental results; however, deviation is evident due to assumptions present within the modelled results.

Keywords: 3D woven composites, compression, preforms, textile composites

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Authors: Abraham Ampong

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BACKGROUND AND SIGNIFICANCE OF THE STUDY: The development of information technology and its influence today is inevitable in the world of education. The development of information technology and communication (ICT) has an impact on the use of teaching aids such as computers and the Internet, for example, E-learning. E-learning is a learning process attained through electronic means. But learning is not merely technology because learning is essentially more about the process of interaction between teacher, student, and source study. The main purpose of the study is to investigate learners’ online learning experiences in a blended learning approach, evaluate how learners’ experience of an online learning environment affects the blended learning approach and examine the future of online learning in a blended learning environment. Blended learning pedagogies have been recognized as a path to improve teacher’s instructional strategies for teaching using technology. Blended learning is perceived to have many advantages for teachers and students, including any-time learning, anywhere access, self-paced learning, inquiry-led learning and collaborative learning; this helps institutions to create desired instructional skills such as critical thinking in the process of learning. Blended learning as an approach to learning has gained momentum because of its widespread integration into educational organizations. METHODOLOGY: Based on the research objectives and questions of the study, the study will make use of the qualitative research approach. The rationale behind the selection of this research approach is that participants are able to make sense of their situations and appreciate their construction of knowledge and understanding because the methods focus on how people understand and interpret their experiences. A case study research design is adopted to explore the situation under investigation. The target population for the study will consist of selected students from selected universities. A simple random sampling technique will be used to select the targeted population. The data collection instrument that will be adopted for this study will be questions that will serve as an interview guide. An interview guide is a set of questions that an interviewer asks when interviewing respondents. Responses from the in-depth interview will be transcribed into word and analyzed under themes. Ethical issues to be catered for in this study include the right to privacy, voluntary participation, and no harm to participants, and confidentiality. INDICATORS OF THE MAJOR FINDINGS: It is suitable for the study to find out that online learning encourages timely feedback from teachers or that online learning tools are okay to use without issues. Most of the communication with the teacher can be done through emails and text messages. It is again suitable for sampled respondents to prefer online learning because there are few or no distractions. Learners can have access to technology to do other activities to support their learning”. There are, again, enough and enhanced learning materials available online. CONCLUSION: Unlike the previous research works focusing on the strengths and weaknesses of blended learning, the present study aims at the respective roles of its two modalities, as well as their interdependencies.

Keywords: online learning, blended learning, technologies, teaching methods

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Authors: Iliyasu Musa Omoyine, Musa Sunday Abraham, Oladele Sunday Blessing, Iliya Ibrahim Abdullahi, Ibegbu Augustine Oseloka, Nuhu Nana-Hawau, Animoku Abdulrazaq Amoto, Yusuf Abdullateef Onoruoiza, Sambo Sohnap James, Akpulu Steven Peter, Ajayi Abayomi

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The neuroprotective role of inflammation from detrimental intrinsic and extrinsic factors has been reported. However, the overactivation of astrocytes and microglia due to lead toxicity produce excessive pro-inflammatory cytokines, mediating neurodegenerative diseases. The present study investigated the mitigatory effects of quercetin on neuroinflammation, correlating with memory function in lead-exposed rats. In this study, Wistar rats were administered orally with Quercetin (Q: 60 mg/kg) and Succimer as a standard drug (S: 10 mg/kg) for 21 days after lead exposure (Pb: 125 mg/kg) of 21 days or in combination with Pb, once daily for 42 days. Working and reference memory was assessed using an Eight-arm radial water maze (8-ARWM). The changes in brain lead level, the neuronal nitric oxide synthase (nNOS) activity, and the level of neuroinflammatory markers such as tumour necrosis factor-alpha (TNF-α) and Interleukin 1 Beta (IL-1β) were determined. Immunohistochemically, astrocyte expression was evaluated. The results showed that the brain level of lead was increased significantly in lead-exposed rats. The expression of astrocytes increased in the CA3 and CA1 regions of the hippocampus, and the levels of brain TNF-α and IL-1β increased in lead-exposed rats. Lead impaired reference and working memory by increasing reference memory errors and working memory incorrect errors in lead-exposed rats. However, quercetin treatment effectively improved memory and inhibited neuroinflammation by reducing astrocytes’ expression and the levels of TNF-α and IL-1β. The expression of astrocytes and the levels of TNF-α and IL-1β correlated with memory function. The possible explanation for quercetin’s anti-neuroinflammatory effect is that it modulates the activity of cellular proteins involved in the inflammatory response; inhibits the transcription factor of nuclear factor-kappa B (NF-κB), which regulates the expression of proinflammatory molecules; inhibits kinases required for the synthesis of Glial fibrillary acidic protein (GFAP) and modifies the phosphorylation of some proteins, which affect the structure and function of intermediate filament proteins; and, lastly, induces Cyclic-AMP Response Element Binding (CREB) activation and neurogenesis as a compensatory mechanism for memory deficits and neuronal cell death. In conclusion, the levels of neuroinflammatory markers negatively correlated with memory function. Thus, quercetin may be a promising therapy in neuroinflammation and memory dysfunction in populations prone to lead exposure.

Keywords: lead, quercetin, neuroinflammation, memory

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Authors: Petr Daniel Edward Kovarik, Malcolm Jackson, Charles Kelly, Rahul Patil, Shahid Iqbal

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Introduction: Recognition of the presence of extra capsular spread (ECS) has been a major change in the TNM 8th edition published by the American Joint Committee on Cancer in 2018. Irrespective of the size or number of lymph nodes, the presence of ECS makes N3b disease a stage IV disease. The objective of this retrospective observational study was to conduct a comparative analysis of survival outcomes in patients with lymph node-positive cutaneous head and neck squamous cell carcinoma (CHNSCC) based on their TNM 7th and TNM 8th editions classification. Materials and Methods: From January 2010 to December 2020, 71 patients with CHNSCC were identified from our centre’s database who were treated with radical surgery and adjuvant radiotherapy. All histopathological reports were reviewed, and comprehensive nodal mapping was performed. The data were collected retrospectively and survival outcomes were compared using TNM 7th and 8th editions. Results: The median age of the whole group of 71 patients was 78 years, range 54 – 94 years, 63 were male and 8 female. In total, 2246 lymph nodes were analysed; 195 were positive for cancer. ECS was present in 130 lymph nodes, which led to a change in TNM staging. The details on N-stage as per TNM 7th edition was as follows; pN1 = 23, pN2a = 14, pN2b = 32, pN2c = 0, pN3 = 2. After incorporating the TNM 8th edition criterion (presence of ECS), the details on N-stage were as follows; pN1 = 6, pN2a = 5, pN2b = 3, pN2c = 0, pN3a = 0, pN3b = 57. This showed an increase in overall stage. According to TNM 7th edition, there were 23 patients were with stage III and remaining 48 patients, stage IV. As per TNM 8th edition, there were only 6 patients with stage III as compared to 65 patients with stage IV. For all patients, 2-year disease specific survival (DSS) and overall survival (OS) were 70% and 46%. 5-year DSS and OS rates were 66% and 20% respectively. Comparing the survival between stage III and stage IV of the two cohorts using both TNM 7th and 8th editions, there is an obvious greater survival difference between the stages if TNM 8th staging is used. However, meaningful statistics were not possible as the majority of patients (n = 65) were with stage IV and only 6 patients were stage III in the TNM 8th cohort. Conclusion: Our study provides a comprehensive analysis on lymph node data mapping in this specific patient population. It shows a better differentiation between stage III and stage IV in the TNM 8th edition as compared to TNM 7th however meaningful statistics were not possible due to the imbalance of patients in the sub-cohorts of the groups.

Keywords: cutaneous head and neck squamous cell carcinoma, extra capsular spread, neck lymphadenopathy, TNM 7th and 8th editions

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Authors: Precious Barnes, Abraham Mensah, Leonard Derkyi-Kwarteng, Benjamin Amoani, George Adjei, Ernest Adankwah, Faustina Pappoe, Kwabena Dankwah, Daniel Amoako-Sakyi, Samuel Victor Nuvor, Dorcas Obiri-Yeboah, Ewura Seidu Yahaya, Patrick Kafui Akakpo, Roland Osei Saahene

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Context: Breast cancer is a prevalent and aggressive type of cancer among African women, with high mortality rates in Ghana. Nuclear factor kappa B (NF-kB) is a transcription factor that has been associated with tumor progression in breast cancer. However, there is a lack of published data on NF-kB in breast cancer patients in Ghana or other African countries. Research Aim: The aim of this study was to assess the prognostic significance of NF-kB (p65) expression and its association with various clinicopathological features in breast cancer patients at the Cape Coast Teaching Hospital in Ghana. Methodology: A total of 90 formalin-fixed breast cancer tissues and 15 normal breast tissues were used in this study. The expression level of NF-kB (p65) was examined using immunohistochemical techniques. Correlation analysis between NF-kB (p65) expression and clinicopathological features was performed using SPSS version 25. Findings: The study found that NF-kB (p65) was expressed in 86.7% of breast cancer tissues. There was a significant relationship between NF-kB (p65) expression and tumor grade, proliferation index (Ki67), and molecular subtype. High-level expression of NF-kB (p65) was more common in tumor grade 3 compared to grade 1, and Ki67 > 20 had higher expression of NF-kB (p65) compared to Ki67 ≤ 20. Triple-negative breast cancer patients had the highest overexpression of NF-kB (p65) compared to other molecular subtypes. There was no significant association between NF-kB (p65) expression and other clinicopathological parameters. Theoretical Importance: This study provides important insights into the expression of NF-kB (p65) in breast cancer patients in Ghana, particularly in relation to tumor grade and proliferation index. The findings suggest that NF-kB (p65) could serve as a potential biological marker for cancer stage, progression, prognosis and as a therapeutic target. Data Collection and Analysis Procedures: Formalin-fixed breast cancer tissues and normal breast tissues were collected and analyzed using immunohistochemical techniques. Correlation analysis between NF-kB (p65) expression and clinicopathological features was performed using SPSS version 25. Question Addressed: This study addressed the question of the prognostic significance of NF-kB (p65) expression and its association with clinicopathological features in breast cancer patients in Ghana. Conclusion: This study, the first of its kind in Ghana, demonstrates that NF-kB (p65) is highly expressed among breast cancer patients at the Cape Coast Teaching Hospital, especially in triple-negative breast cancer patients. The expression of NF-kB (p65) is associated with tumor grade and proliferation index. NF-kB (p65) could potentially serve as a biological marker for cancer stage, progression, prognosis, and as a therapeutic target.

Keywords: breast cancer, Ki67, NF-kB (p65), tumor grade

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Authors: Vijaya Kumar, Vidayasagar Pagilla, Abraham Joshua, Rakshith Kedambadi, Prasanna Mithra

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Background: Post stroke rehabilitation are aimed to accelerate for optimal sensorimotor recovery, functional gain and to reduce long-term dependency. Intensive physical therapy interventions can enhance this recovery as experience-dependent neural plastic changes either directly act at cortical neural networks or at distal peripheral level (muscular components). Neuromuscular Electrical Stimulation (NMES), a traditional bottom-up approach, mirror therapy (MT), a relatively new top down approach have found to be an effective adjuvant treatment methods for lower extremity motor and functional recovery in stroke rehabilitation. However there is a scarcity of evidence to compare their therapeutic gain in stroke recovery.Aim: To compare the efficacy of neuromuscular electrical stimulation (NMES) and mirror therapy (MT) in very early phase of post stroke rehabilitation addressed to lower extremity motor recovery and balance. Design: observer blinded Randomized Clinical Trial. Setting: Neurorehabilitation Unit, Department of Physical Therapy, Tertiary Care Hospitals. Subjects: 32 acute stroke subjects with first episode of unilateral stroke with hemiparesis, referred for rehabilitation (onset < 3 weeks), Brunnstorm lower extremity recovery stages ≥3 and MMSE score more than 24 were randomized into two group [Group A-NMES and Group B-MT]. Interventions: Both the groups received eclectic approach to remediate lower extremity recovery which includes treatment components of Roods, Bobath and Motor learning approaches for 30 minutes a day for 6 days. Following which Group A (N=16) received 30 minutes of surface NMES training for six major paretic muscle groups (gluteus maximus and medius,quadriceps, hamstrings, tibialis anterior and gastrocnemius). Group B (N=16) was administered with 30 minutes of mirror therapy sessions to facilitate lower extremity motor recovery. Outcome measures: Lower extremity motor recovery, balance and activities of daily life (ADLs) were measured by Fugyl Meyer Assessment (FMA-LE), Berg Balance Scale (BBS), Barthel Index (BI) before and after intervention. Results: Pre Post analysis of either group across the time revealed statistically significant improvement (p < 0.001) for all the outcome variables for the either group. All parameters of NMES had greater change scores compared to MT group as follows: FMA-LE (25.12±3.01 vs. 23.31±2.38), BBS (35.12±4.61 vs. 34.68±5.42) and BI (40.00±10.32 vs. 37.18±7.73). Between the groups comparison of pre post values showed no significance with FMA-LE (p=0.09), BBS (p=0.80) and BI (p=0.39) respectively. Conclusion: Though either groups had significant improvement (pre to post intervention), none of them were superior to other in lower extremity motor recovery and balance among acute stroke subjects. We conclude that eclectic approach is an effective treatment irrespective of NMES or MT as an adjunct.

Keywords: balance, motor recovery, mirror therapy, neuromuscular electrical stimulation, stroke

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Authors: Edward Shizha

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Citizenship is not only political, but it is also a socio-cultural expectation that naturalized immigrants desire for. However, the outcomes of citizenship desirability are determined by forces outside the individual’s control based on legislation and laws that are designed at the macro and exosystemic levels by politicians and policy makers. These laws are then applied to determine the status (permanency or temporariness) of citizenship for immigrants and refugees, but the same laws do not apply to non-immigrant citizens who attain it by birth. While theoretically, citizenship has generally been considered an irrevocable legal status and the highest and most secure legal status one can hold in a state, it is not inviolate for immigrants. While Article 8 of the United Nations Convention on the Reduction of Statelessness provides grounds for revocation of citizenship obtained by immigrants and refugees in host countries, nation-states have their own laws tied to the convention that provide grounds for revocation. Ever since the 9/11 attacks in the USA, there has been a rise in conditional citizenship and the state’s withdrawal of citizenship through revocation laws that denaturalize citizens who end up not merely losing their citizenship but also the right to reside in the country of immigration. Because immigrants can be perceived as a security threat, the securitization of citizenship and the legislative changes have been adopted to specifically allow greater discretionary power in stripping people of their citizenship.The paper ‘Do We Really Belong Here?’ Transnationalism and the Temporality of Naturalized Citizenship examines literature on the temporality of naturalized citizenship and questions whether citizenship, for newcomers (immigrants and refugees), is a protected human right or a privilege. The paper argues that citizenship in a host country is a well sought-after status by newcomers. The question is whether their citizenship, if granted, has a permanent or temporary status and whether it is treated in the same way as that of non-immigrant citizens. The paper further argues that, despite citizenship having generally been considered an irrevocable status in most Western countries, in practice, if not in law, for immigrants and refugees, citizenship comes with strings attached because of policies and laws that control naturalized citizenship. These laws can be used to denationalize naturalized citizens through revocations for those stigmatized as ‘undesirables’ who are threatened with deportation. Whereas non-immigrant citizens (those who attain it by birth) have absolute right to their citizenship, this is seldom the case for immigrants.This paper takes a multidisciplinary approach using Urie Bronfenbrenner’s ecological systems theory, the macrosystem and exo-system, to examine and review literature on the temporality of naturalized citizenship and questions whether citizenship is a protected right or a privilege for immigrants. The paper challenges the human rights violation of citizenship revocation and argues for equality of treatment for all citizens despite how they acquired their citizenship. The fragility of naturalized citizenship undermines the basic rights and securities that citizenship status can provide to the person as an inclusive practice in a diverse society.

Keywords: citizenship, citizenship revocation, dual citizenship, human rights, naturalization, naturalized citizenship

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Authors: Christian Ihwiwhu, Nnamdi Obioha, Udeme John, Edward Bobade, Oghenerunor Bekibele, Adedeji Awujoola, Ibi-Ada Itotoi

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Understanding the complexity in the distribution of hydrocarbon in a simple structure with flow baffles and connectivity issues is critical in targeting and developing the remaining pay in a mature asset. Subtle facies changes (heterogeneity) can have a drastic impact on reservoir fluids movement, and this can be crucial to identifying sweet spots in mature fields. This study aims to evaluate selected reservoirs in Ovhor Field, Niger Delta, Nigeria, with the objective of optimising production from the field by targeting undeveloped oil reserves, bypassed pay, and gaining an improved understanding of the selected reservoirs to increase the company’s reservoir limits. The task at the Ovhor field is complicated by poor stratigraphic seismic resolution over the field. 3-D geological (sedimentology and stratigraphy) interpretation, use of results from quantitative interpretation, and proper understanding of production data have been used in recognizing flow baffles and undeveloped compartments in the field. The full field 3-D model has been constructed in such a way as to capture heterogeneities and the various compartments in the field to aid the proper simulation of fluid flow in the field for future production prediction, proper history matching and design of good trajectories to adequately target undeveloped oil in the field. Reservoir property models (porosity, permeability, and net-to-gross) have been constructed by biasing log interpreted properties to a defined environment of deposition model whose interpretation captures the heterogeneities expected in the studied reservoirs. At least, two scenarios have been modelled for most of the studied reservoirs to capture the range of uncertainties we are dealing with. The total original oil in-place volume for the four reservoirs studied is 157 MMstb. The cumulative oil and gas production from the selected reservoirs are 67.64 MMstb and 9.76 Bscf respectively, with current production rate of about 7035 bopd and 4.38 MMscf/d (as at 31/08/2019). Dynamic simulation and production forecast on the 4 reservoirs gave an undeveloped reserve of about 3.82 MMstb from two (2) identified oil restoration activities. These activities include side-tracking and re-perforation of existing wells. This integrated approach led to the identification of bypassed oil in some areas of the selected reservoirs and an improved understanding of the studied reservoirs. New wells have/are being drilled now to test the results of our studies, and the results are very confirmatory and satisfying.

Keywords: facies, flow baffle, bypassed pay, heterogeneities, history matching, reservoir limit

Procedia PDF Downloads 102

Authors: Radwa Saad

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The Sahara is normatively treated as a barrier separating “two Africas"; one to the North with closer affinity to the Arab world, and one to the South that encompasses a diverse range of racial, ethnic and religious groups, commonly referred to as "Sub-Saharan Africa". This dichotomy however was challenged by many anticolonial leaders and intellectuals seeking to advance counter-hegemonic narratives that treat the Sahara as a bridge facilitating a long history of exchange, collaboration, and fusion between different civilizations on the continent. This paper reexamines the discourses governing the geographic distinction between North Africa and Sub-Saharan Africa. It argues that demarcating the African continent along the lines of the Sahara is part-and-parcel of a Euro-centric spatial imaginary that has served to enshrine a racialized global hierarchy of power. By drawing on Edward Said’s concept of ‘imagined geography’ and Charles Mill’s notion of “the racial contract”, it demonstrates how spatial boundaries often coincide with racial epistemologies to reinforce certain geopolitical imaginaries, whilst silencing others. It further draws on the works of two notable post-colonial figures - Gamal Abdel Nasser and Leopold Senghor - to explore alternative spatial imaginaries while highlighting some of the tensions embedded in advancing a trans-Saharan political project. Firstly, it deconstructs some of the normative claims used to justify the distinction between North and “sub-Saharan” Africa across political, literary and disciplinary boundaries. Secondly, it draws parallels between Said’s and Mills’ work to demonstrate how geographical boundaries and demarcations have been constructed to create racialized subjects and reinforce a hierarchy of color that favors European standpoints and epistemologies. Third, it draw on Leopard Senghor’s The Foundations of Africanité and Gamal Abdel Nasser’s The Philosophy of the Egyptian Revolution to examine some of the competing strands of unity that emerged out of the Saharan discourse. In these texts, one can identify a number of convergences and divergences in how post-colonial African elites attempts to reclaim and rearticulate the function of the Sahara along different epistemic, political and cultural premises. It concludes with reflections on some of the policy challenges that emerge from reinforcing the Saharan divide, particularly in the realm of peace and security.

Keywords: regional integration, politics of knowledge production, arab-african relations, african solutions to african problems

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Authors: Liya Abraham

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Eritrea is located along the Red Sea, north of the Horn of Africa, between Djibouti and Sudan and has a population of about 3.2 million as of 2010. It has six administrative regions; Anseba, Debub, Debubawi K’eyih Bahri, Gash-Barka, Ma'akel, and Semenawi K’eyih Bahri. Eritrea has got its independence in 1991 after 30 years war of liberation. The country is blessed with various medicinal flora and fauna, and marine and terrestrial biodiversity. Traditional Medicine (TM) has been an integral part of the Eritrean culture for centuries. So far, more than 19 TM modalities have been recognized, and are broadly categorized as; herbal, procedure-based and spiritual. Despite the availability of modern medicine to the majority of the population, TM is still widely practiced. The rationale behind widespread use is accessibility, affordability and cultural acceptability. Hence, TM is of great contribution to the Eritrean health care system. As a matter of fact, harnessing the potential contribution of effective and safe TM in order to attain Universal Health Coverage (UHC) has been emphasized in the WHO TM strategy 2014-2023. The Eritrean TM, however, was operating without regulation and reliable scientific justification behind its safety and efficacy. Thus, the Ministry of Health (MoH), in recognition of the role of TM in primary healthcare and safeguard public health, established a regulatory body for TM so-called as Traditional Medicine Unit (TMU) in 2012. The mission of the unit is to ensure rational TM use through an integrated health service delivery system and contribute to the country’s economic and social development. The unit has established its national TM policy in 2017. The activities of the unit are guided by the National TM Advisory Committee (TMAC), responsible for the provision of technical assistance and advisory role. Moreover, the Legal Framework and Code of Ethics and Practice which provide a legal basis for the regulation of TM have also been drafted. In recognition of the importance of TM research and development, the unit launched a nationwide TM survey in 2017 and had surveyed two zones (Gash-Barka and Debub). The findings of the survey were subjected to a research dissemination workshop and publication in international journals. Furthermore, TM-related adverse events reporting tool (Green Form) aiming to guide regulatory interventions and researches have been established by the unit, and ever since reports are flowing. The unit has also been offering training to THPs, pharmacy students and health care professionals regarding TM and its regulatory activities. In addition, as part of the establishment of the national medicinal plants' database and herbal monograph, more than 329 and 30 medicinal plants, have been compiled respectively. In conclusion, TM is still widely accepted and practiced in Eritrea. The TMU ever since its establishment is endeavoring to ensure the safety and efficacy of the TM, and its integration in the mainstream health service delivery system.

Keywords: efficacy, regulation, safety, traditional medicine, traditional medicine unit, universal health coverage

Procedia PDF Downloads 149

Authors: Edward R. Moad

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Al-Ghazali’s Tahāfat al Falāsifa is widely construed as an attack on philosophy in favor of theological fideism. Consequently, he has been blamed for ‘death of philosophy’ in the Muslim world. ‘Falsifa’ however is not philosophy itself, but rather a range of philosophical doctrines mainly influenced by or inherited form Greek thought. In these terms, this work represents a defense of philosophy against what we could call ‘falsifical’ fideism. In the introduction, Ghazali describes his target audience as, not the falasifa, but a group of pretenders engaged in taqlid to a misconceived understanding of falasifa, including the belief that they were capable of demonstrative certainty in the field of metaphysics. He promises to use falsifa standards of logic (with which he independently agrees), to show that that the falasifa failed to demonstratively prove many of their positions. Whether or not he succeeds in that, the exercise of subjecting alleged proofs to critical scrutiny is quintessentially philosophical, while uncritical adherence to a doctrine, in the name of its being ‘philosophical’, is decidedly unphilosophical. If we are to blame the intellectual decline of the Muslim world on someone’s ‘bad’ way of thinking, rather than more material historical circumstances (which is already a mistake), then blame more appropriately rests with modernist Muslim thinkers who, under the influence of orientalism (and like Ghazali’s philosophical pretenders) mistook taqlid to the falasifa as philosophy itself. The discussion of the Tahāfut takes place in the context of an epistemic (and related social) hierarchy envisioned by the falasifa, corresponding to the faculties of the sense, the ‘estimative imagination’ (wahm), and the pure intellect, along with the respective forms of discourse – rhetoric, dialectic, and demonstration – appropriate to each category of that order. Al-Farabi in his Book of Letters describes a relation between dialectic and demonstration on the one hand, and theology and philosophy on the other. The latter two are distinguished by method rather than subject matter. Theology is that which proceeds dialectically, while philosophy is (or aims to be?) demonstrative. Yet, Al-Farabi tells us, dialectic precedes philosophy like ‘nourishment for the tree precedes its fruit.’ That is, dialectic is part of the process, by which we interrogate common and imaginative notions in the pursuit of clearly understood first principles that we can then deploy in the demonstrative argument. Philosophy is, therefore, something we aspire to through, and from a discursive condition of, dialectic. This stands in apparent contrast to the understanding of Ibn Sina, for whom one arrives at the knowledge of first principles through contact with the Active Intellect. It also stands in contrast to that of Ibn Rushd, who seems to think our knowledge of first principles can only come through reading Aristotle. In conclusion, based on Al-Farabi’s framework, Ghazali’s Tahafut is a truly an exercise in philosophy, and an effort to keep the door open for true philosophy in the Muslim mind, against the threat of a kind of developing theology going by the name of falsifa.

Keywords: philosophy, incoherence, theology, Tahafut

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Authors: Jeremy Jenrette, Z. Y. C. Liu, Pranav Chimote, Edward Fox, Trevor Hastie, Francesco Ferretti

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Suitable shark conservation depends on well-informed population assessments. Direct methods such as scientific surveys and fisheries monitoring are adequate for defining population statuses, but species-specific indices of abundance and distribution coming from these sources are rare for most shark species. We can rapidly fill these information gaps by boosting media-based remote monitoring efforts with machine learning and automation. We created a database of shark images by sourcing 24,546 images covering 219 species of sharks from the web application spark pulse and the social network Instagram. We used object detection to extract shark features and inflate this database to 53,345 images. We packaged object-detection and image classification models into a Shark Detector bundle. We developed the Shark Detector to recognize and classify sharks from videos and images using transfer learning and convolutional neural networks (CNNs). We applied these models to common data-generation approaches of sharks: boosting training datasets, processing baited remote camera footage and online videos, and data-mining Instagram. We examined the accuracy of each model and tested genus and species prediction correctness as a result of training data quantity. The Shark Detector located sharks in baited remote footage and YouTube videos with an average accuracy of 89\%, and classified located subjects to the species level with 69\% accuracy (n =\ eight species). The Shark Detector sorted heterogeneous datasets of images sourced from Instagram with 91\% accuracy and classified species with 70\% accuracy (n =\ 17 species). Data-mining Instagram can inflate training datasets and increase the Shark Detector’s accuracy as well as facilitate archiving of historical and novel shark observations. Base accuracy of genus prediction was 68\% across 25 genera. The average base accuracy of species prediction within each genus class was 85\%. The Shark Detector can classify 45 species. All data-generation methods were processed without manual interaction. As media-based remote monitoring strives to dominate methods for observing sharks in nature, we developed an open-source Shark Detector to facilitate common identification applications. Prediction accuracy of the software pipeline increases as more images are added to the training dataset. We provide public access to the software on our GitHub page.

Keywords: classification, data mining, Instagram, remote monitoring, sharks

Procedia PDF Downloads 89

Authors: Ebenezer Kwesi Armah-Ansah, Kenneth Fosu Oteng, Esther Selasi Avinu, Eugene Budu, Edward Kwabena Ameyaw

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Background: Maternal mortality, particularly in Benin, is a major public health concern in Sub-Saharan Africa. To provide a positive pregnancy experience and reduce maternal morbidities, all pregnant women must get appropriate and timely prenatal support. However, many pregnant women in developing countries, including Benin, begin antenatal care late. There is a paucity of empirical literature on the prevalence and predictors of early antenatal care visits in Benin. As a result, the purpose of this study is to investigate the prevalence and predictors of early antenatal care visits among women of productive age in Benin. Methods: This is a secondary analysis of the 2017/2018 Benin Demographic and Health Survey (BDHS) data. The study involved 6,919 eligible women. Data analysis was conducted using Stata version 14.2 for Mac OS. We adopted a multilevel logistic regression to examine the predictors of early ANC visits in Benin. The results were presented as odds ratios (ORs) associated with 95% confidence intervals (CIs) and p-value <0.05 to determine the significant associations. Results: The prevalence of early ANC visits among pregnant women in Benin was 57.03% [95% CI: 55.41-58.64]. In the final multilevel logistic regression, early ANC visit was higher among women aged 30-34 [aOR=1.60, 95% CI=1.17-2.18] compared to those aged 15-19, women with primary education [aOR=1.22, 95% CI=1.06-142] compared to the non-educated women, women who were covered by health insurance [aOR=3.03, 95% CI=1.35-6.76], women without a big problem in getting the money needed for treatment [aOR=1.31, 95% CI=1.16-1.49], distance to the health facility, not a big problem [aOR=1.23, 95% CI=1.08-1.41], and women whose partners had secondary/higher education [aOR=1.35, 95% CI=1.15-1.57] compared with those who were not covered by health insurance, had big problem in getting money needed for treatment, distance to health facility is a big problem and whose partners had no education respectively. However, women who had four or more births [aOR=0.60, 95% CI=0.48-0.74] and those in Atacora Region [aOR=0.50, 95% CI=0.37-0.68] had lower odds of early ANC visit. Conclusion: This study revealed a relatively high prevalence of early ANC visits among women of reproductive age in Benin. Women's age, educational status of women and their partners, parity, health insurance coverage, distance to health facilities, and region were all associated with early ANC visits among women of reproductive in Benin. These factors ought to be taken into account when developing ANC policies and strategies in order to boost early ANC visits among women in Benin. This will significantly reduce maternal and newborn mortality and help achieve the World Health Organization’s recommendation that all pregnant women should initiate early ANC visits within the first three months of pregnancy.

Keywords: antenatal care, Benin, maternal health, pregnancy, DHS, public health

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Authors: Lamiek Abraham, Xinli Du, Yohan Noh, Polin Hsu, Tingting Wu, Tom Logan, Ifan Yen

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In the field of minimally invasive, smart medical instruments such as catheters and guidewires are typically used at a remote distance to gain access to the diseased artery, often negotiating tortuous, complex, and diseased vessels in the process. Three optical fiber sensors with a diameter of 1.5mm each that are 120° apart from each other is proposed to be mounted into a catheter-based pump device with a diameter of 10mm. These sensors are configured to solve the challenges surgeons face during insertion through curvy major vessels such as the aortic arch. Moreover, these sensors deal with providing information on rubbing the walls and shape sensing. This study presents an experimental and mathematical models of the optical fiber sensors with 2 degrees of freedom. There are two eight gear-shaped tubes made up of 3D printed thermoplastic Polyurethane (TPU) material that are connected. The optical fiber sensors are mounted inside the first tube for protection from external light and used TPU material as a prototype for a catheter. The second tube is used as a flat reflection for the light intensity modulation-based optical fiber sensors. The first tube is attached to the linear guide for insertion and withdrawal purposes and can manually turn it 45° by manipulating the tube gear. A 3D hard material phantom was developed that mimics the aortic arch anatomy structure in which the test was carried out. During the insertion of the sensors into the 3D phantom, datasets are obtained in terms of voltage, distance, and position of the sensors. These datasets reflect the characteristics of light intensity modulation of the optical fiber sensors with a plane project of the aortic arch structure shape. Mathematical modeling of the light intensity was carried out based on the projection plane and experiment set-up. The performance of the system was evaluated in terms of its accuracy in navigating through the curvature and information on the position of the sensors by investigating 40 single insertions of the sensors into the 3D phantom. The experiment demonstrated that the sensors were effectively steered through the 3D phantom curvature and to desired target references in all 2 degrees of freedom. The performance of the sensors echoes the reflectance of light theory, where the smaller the radius of curvature, the more of the shining LED lights are reflected and received by the photodiode. A mathematical model results are in good agreement with the experiment result and the operation principle of the light intensity modulation of the optical fiber sensors. A prototype of a catheter using TPU material with three optical fiber sensors mounted inside has been developed that is capable of navigating through the different radius of curvature with 2 degrees of freedom. The proposed system supports operators with pre-scan data to make maneuverability and bendability through curvy major vessels easier, accurate, and safe. The mathematical modelling accurately fits the experiment result.

Keywords: Intensity modulated optical fiber sensor, mathematical model, plane projection, shape sensing.

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Authors: Soyon Kim, Edward Kim

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In order to retrieve information from the massive stream of songs in the music industry, music search by title, lyrics, artist, mood, and genre has become more important. Despite the subjectivity and controversy over the definition of music genres across different nations and cultures, automatic genre classification systems that facilitate the process of music categorization have been developed. Manual genre selection by music producers is being provided as statistical data for designing automatic genre classification systems. In this paper, an automatic music genre classification system utilizing non-negative matrix factorization (NMF) is proposed. Short-term characteristics of the music signal can be captured based on the timbre features such as mel-frequency cepstral coefficient (MFCC), decorrelated filter bank (DFB), octave-based spectral contrast (OSC), and octave band sum (OBS). Long-term time-varying characteristics of the music signal can be summarized with (1) the statistical features such as mean, variance, minimum, and maximum of the timbre features and (2) the modulation spectrum features such as spectral flatness measure, spectral crest measure, spectral peak, spectral valley, and spectral contrast of the timbre features. Not only these conventional basic long-term feature vectors, but also NMF based feature vectors are proposed to be used together for genre classification. In the training stage, NMF basis vectors were extracted for each genre class. The NMF features were calculated in the log spectral magnitude domain (NMF-LSM) as well as in the basic feature vector domain (NMF-BFV). For NMF-LSM, an entire full band spectrum was used. However, for NMF-BFV, only low band spectrum was used since high frequency modulation spectrum of the basic feature vectors did not contain important information for genre classification. In the test stage, using the set of pre-trained NMF basis vectors, the genre classification system extracted the NMF weighting values of each genre as the NMF feature vectors. A support vector machine (SVM) was used as a classifier. The GTZAN multi-genre music database was used for training and testing. It is composed of 10 genres and 100 songs for each genre. To increase the reliability of the experiments, 10-fold cross validation was used. For a given input song, an extracted NMF-LSM feature vector was composed of 10 weighting values that corresponded to the classification probabilities for 10 genres. An NMF-BFV feature vector also had a dimensionality of 10. Combined with the basic long-term features such as statistical features and modulation spectrum features, the NMF features provided the increased accuracy with a slight increase in feature dimensionality. The conventional basic features by themselves yielded 84.0% accuracy, but the basic features with NMF-LSM and NMF-BFV provided 85.1% and 84.2% accuracy, respectively. The basic features required dimensionality of 460, but NMF-LSM and NMF-BFV required dimensionalities of 10 and 10, respectively. Combining the basic features, NMF-LSM and NMF-BFV together with the SVM with a radial basis function (RBF) kernel produced the significantly higher classification accuracy of 88.3% with a feature dimensionality of 480.

Keywords: mel-frequency cepstral coefficient (MFCC), music genre classification, non-negative matrix factorization (NMF), support vector machine (SVM)

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Authors: Vinod Balakrishnan, Chrisalice Ela Joseph

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The Burmese Exodus of 1942, which left more than 4 lakh as refugees and thousands dead, is one of the worst forced migrations in recorded history. Adding to the woes of the refugees is the lack of credible documentation of their lived experiences, trauma, and stories and their erasure from recorded history. Media reports, national records, and mainstream narratives that have registered the exodus provide sanitized versions which have reduced the refugees to a nameless, faceless mass of travelers and obliterated their lived experiences, trauma, and sufferings. This attitudinal problem compels the need to stem the insensitivity that accompanies institutional memory by making a case for a more humanistically evolved policy that puts in place protocols for the way the humanities would voice the concern for the refugee. A definite step in this direction and a far more relevant project in our times is the need to build a comprehensive refugee archive that can be a repository of the refugee experiences and perspectives. The paper draws on Hannah Arendt’s position on the Jewish refugee crisis, Agamben’s work on statelessness and citizenship, Foucault’s notion of governmentality and biopolitics, Edward Said’s concepts on Exile, Fanon’s work on the dispossessed, Derrida’s work on ‘the foreigner and hospitality’ in order to conceptualize the refugee condition which will form the theoretical framework for the paper. It also refers to the existing scholarship in the field of refugee studies such as Roger Zetter’s work on the ‘refugee label’, Philip Marfleet’s work on ‘refugees and history’, Lisa Malkki’s research on the anthropological discourse of the refugee and refugee studies. The paper is also informed by the work that has been done by the international organizations to address the refugee crisis. The emphasis is on building a strong argument for the establishment of the refugee archive that finds but a passing and a none too convincing reference in refugee studies in order to enable a multi-dimensional understanding of the refugee crisis. Some of the old questions cannot be dismissed as outdated as the continuing travails of the refugees in different parts of the world only remind us that they are still, largely, unanswered. The questions are -What is the nature of a Refugee Archive? How is it different from the existing historical and political archives? What are the implications of the refugee archive? What is its contribution to refugee studies? The paper draws on Diana Taylor’s concept of the archive and the repertoire to theorize the refugee archive as a repository that has the documentary function of the ‘archive’ and the ‘agency’ function of the repertoire. It then reads Ayya’s Accounts- a memoir by Anand Pandian -in the light of Hannah Arendt’s concepts of the ‘refugee as vanguard’ and ‘story telling as political action’- to illustrate how the memoir contributes to the refugee archive that provides the refugee a place and agency in history. The paper argues for a refugee archive that has implications for the formulation of inclusive refugee policies.

Keywords: Ayya’s Accounts, Burmese Exodus, policy protocol, refugee archive

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Authors: Shivakumar M, Leslie Edward S Lewis, Shashikala Devadiga, Sonia Khurana

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Introduction: Methylxanthines are used for the treatment of AOP, to facilitate extubation and as a prophylactic agent to prevent apnea. Though the popularity of Caffeine has risen, it is expensive in a resource constrained developing countries like India. Objective: To evaluate the cost-effectiveness of Caffeine compared with Aminophylline treatment for AOP with respect to additional ventilatory resource utilized in different birth weight categorization. Design, Settings and Participants – Single centered, retrospective economic evaluation was done. Participants included preterm newborns with < 34 completed weeks of gestation age that were recruited under an Indian Council of Medical Research funded randomized clinical trial. Per protocol data was included from Neonatal Intensive Care Unit, Kasturba Hospital, Manipal, India between April 2012 and December 2014. Exposure: Preterm neonates were randomly allocated to either Caffeine or Aminophylline as per the trial protocol. Outcomes and Measures – We assessed surfactant requirement, duration of Invasive and Non-Invasive Ventilation, Total Methylxanthine cost and additional cost for respiratory support bared by the payers per day during hospital stay. For the purpose of this study Newborns were stratified as Category A – < 1000g, Category B – 1001 to 1500g and Category C – 1501 to 2500g. Results: Total 146 (Caffeine -72 and Aminophylline – 74) babies with Mean ± SD gestation age of 29.63 ± 1.89 weeks were assessed. 32.19% constitute of Category A, 55.48% were B and 12.33% were C. The difference in median duration of additional NIV and IMV support was statistically insignificant. However 60% of neonates who received Caffeine required additional surfactant therapy (p=0.02). The total median (IQR) cost of Caffeine was significantly high with Rs.10535 (Q3-6317.50, Q1-15992.50) where against Aminophylline cost was Rs.352 (Q3-236, Q1-709) (p < 0.001). The additional costs spent on respiratory support per day in neonates on either Methylxanthines were found to be statistically insignificant in the entire weight based category of our study. Whereas in Category B, the median O2 charges per day were found to have more in Caffeine treated newborns (p=0.05) with border line significance. In category A, providing one day NIV or IMV support significantly increases the unit log cost of Caffeine by 13.6% (CI – 95% ranging from 4 to 24; p=0.005) over log cost of Aminophylline. Conclusion: Cost of Caffeine is expensive than Aminophylline. It was found to be equally efficacious in reducing the number duration of NIV or IMV support. However adjusted with the NIV and IMV days of support, neonates fall in category A and category B who were on Caffeine pays excess amount of respiratory charges per day over aminophylline. In perspective of resource poor settings Aminophylline is cost saving and economically approachable.

Keywords: methylxanthines include caffeine and aminophylline, AOP (apnea of prematurity), IMV (invasive mechanical ventilation), NIV (non invasive ventilation), category a – <1000g, category b – 1001 to 1500g and category c – 1501 to 2500g

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Authors: Joanne DiFrancisco-Donoghue, Seth E. Jenny, Peter C. Douris, Sophia Ahmad, Kyle Yuen, Hillary Gan, Kenney Abraham, Amber Sousa

Abstract:

Background: Guidelines for the maintenance of health of esports players and the cognitive changes that accompany competitive gaming are understudied. Executive functioning is an important cognitive skill for an esports player. The relationship between executive functions and physical exercise has been well established. However, the effects of prolonged sitting regardless of physical activity level have not been established. Prolonged uninterrupted sitting reduces cerebral blood flow. Reduced cerebral blood flow is associated with lower cognitive function and fatigue. This decrease in cerebral blood flow has been shown to be offset by frequent and short walking breaks. These short breaks can be as little as 2 minutes at the 30-minute mark and 6 minutes following 60 minutes of prolonged sitting. The rationale is the increase in blood flow and the positive effects this has on metabolic responses. The primary purpose of this study was to evaluate executive function changes following 6-minute bouts of walking and complete rest mid-session, compared to no break, during prolonged gameplay in competitive first-person shooter (FPS) esports players. Methods: This study was conducted virtually due to the Covid-19 pandemic and was approved by the New York Institute of Technology IRB. Twelve competitive FPS participants signed written consent to participate in this randomized pilot study. All participants held a gold ranking or higher. Participants were asked to play for 2 hours on three separate days. Outcome measures to test executive function included the Color Stroop and the Tower of London tests which were administered online each day prior to gaming and at the completion of gaming. All participants completed the tests prior to testing for familiarization. One day of testing consisted of a 6-minute walk break after 60-75 minutes of play. The Rate of Perceived Exertion (RPE) was recorded. The participant continued to play for another 60-75 minutes and completed the tests again. Another day the participants repeated the same methods replacing the 6-minute walk with lying down and resting for 6 minutes. On the last day, the participant played continuously with no break for 2 hours and repeated the outcome tests pre and post-play. A Latin square was used to randomize the treatment order. Results: Using descriptive statistics, the largest change in mean reaction time incorrect congruent pre to post play was seen following the 6-minute walk (662.0 (609.6) ms pre to 602.8 (539.2) ms post), followed by the 6-minute rest group (681.7(618.1) ms pre to 666.3 (607.9) ms post), and with minimal change in the continuous group (594.0(534.1) ms pre to 589.6(552.9) ms post). The mean solution time was fastest in the resting condition (7774.6(6302.8)ms), followed by the walk condition (7929.4 (5992.8)ms), with the continuous condition being slowest (9337.3(7228.7)ms). the continuous group 9337.3(7228.7) ms; 7929.4 (5992.8 ) ms 774.6(6302.8) ms. Conclusion: Short walking breaks improve blood flow and reduce the risk of venous thromboembolism during prolonged sitting. This pilot study demonstrated that a low intensity 6 -minute walk break, following 60 minutes of play, may also improve executive function in FPS gamers.

Keywords: executive function, FPS, physical activity, prolonged sitting

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Authors: Yifan Lu, Ying Cui, Ying Zhu, Edward S. Lu, Rebecca Zeng, Rohan Bajaj, Raviv Katz, Rongrong Le, Jay C. Wang, John B. Miller

Abstract:

Purpose: Retinal artery occlusion (RAO) is an ophthalmic emergency that can lead to poor visual outcome and is associated with an increased risk of cerebral stroke and cardiovascular events. Fluorescein angiography (FA) is the traditional diagnostic tool for RAO; however, wide-field swept-source optical coherence tomography angiography (WF SS-OCTA), as a nascent imaging technology, is able to provide quick and non-invasive angiographic information with a wide field of view. In this study, we looked for associations between OCT-A vascular metrics and visual acuity in patients with prior diagnosis of RAO. Methods: Patients with diagnoses of central retinal artery occlusion (CRAO) or branched retinal artery occlusion (BRAO) were included. A 6mm x 6mm Angio and a 15mm x 15mm AngioPlex Montage OCT-A image were obtained for both eyes in each patient using the Zeiss Plex Elite 9000 WF SS-OCTA device. Each 6mm x 6mm image was divided into nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. The average measurement of the central foveal subfield, inner ring, and outer ring was calculated for each parameter. Non-perfusion area (NPA) was manually measured using 15mm x 15mm Montage images. A linear regression model was utilized to identify a correlation between the imaging metrics and visual acuity. A P-value less than 0.05 was considered to be statistically significant. Results: Twenty-five subjects were included in the study. For RAO eyes, there was a statistically significant negative correlation between vision and retinal thickness as well as superficial capillary plexus vessel density (SCP VD). A negative correlation was found between vision and deep capillary plexus vessel density (DCP VD) without statistical significance. There was a positive correlation between vision and choroidal thickness as well as choroidal volume without statistical significance. No statistically significant correlation was found between vision and the above metrics in contralateral eyes. For NPA measurements, no significant correlation was found between vision and NPA. Conclusions: This is the first study to our best knowledge to investigate the utility of WF SS-OCTA in RAO and to demonstrate correlations between various retinal vascular imaging metrics and visual outcomes. Further investigations should explore the associations between these imaging findings and cardiovascular risk as RAO patients are at elevated risk for symptomatic stroke. The results of this study provide a basis to understand the structural changes involved in visual outcomes in RAO. Furthermore, they may help guide management of RAO and prevention of cerebral stroke and cardiovascular accidents in patients with RAO.

Keywords: OCTA, swept-source OCT, retinal artery occlusion, Zeiss Plex Elite

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Authors: Nourhan Hussein Fanaki, Hoda Mohamed Gamal El-Din Omar, Nihal Kadry Moussa, Eva Adel Edward Farid

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The resistance of staphylococci to various antibiotics has become a major concern for health care professionals. The efficacy of the combinations of selected glycopeptides (vancomycin and teicoplanin) with gentamicin or rifampicin, as well as that of gentamicin/rifampicin combination, was studied against selected pathogenic staphylococcus isolated from Egypt. The molecular distribution of genes conferring resistance to these four antibiotics was detected among tested clinical isolates. Antibiotic combinations were studied using the checkerboard technique and the time-kill assay (in both the stationary and log phases). Induction of resistance to glycopeptides in staphylococci was tried in the absence and presence of diclofenac sodium as inducer. Transmission electron microscopy was used to study the effect of glycopeptides on the ultrastructure of the cell wall of staphylococci. Attempts were made to cure gentamicin resistance plasmids and to study the transfer of these plasmids by conjugation. Trials for the transformation of the successfully isolated gentamicin resistance plasmid to competent cells were carried out. The detection of genes conferring resistance to the tested antibiotics was performed using the polymerase chain reaction. The studied antibiotic combinations proved their efficacy, especially when tested during the log phase. Induction of resistance to glycopeptides in staphylococci was more promising in presence of diclofenac sodium, compared to its absence. Transmission electron microscopy revealed the thickening of bacterial cell wall in staphylococcus clinical isolates due to the presence of tested glycopeptides. Curing of gentamicin resistance plasmids was only successful in 2 out of 9 tested isolates, with a curing rate of 1 percent for each. Both isolates, when used as donors in conjugation experiments, yielded promising conjugation frequencies ranging between 5.4 X 10-2 and 7.48 X 10-2 colony forming unit/donor cells. Plasmid isolation was only successful in one out of the two tested isolates. However, low transformation efficiency (59.7 transformants/microgram plasmid DNA) of such plasmids was obtained. Negative regulators of autolysis, such as arlR, lytR and lrgB, as well as cell-wall associated genes, such as pbp4 and/or pbp2, were detected in staphylococcus isolates with reduced susceptibility to the tested glycopeptides. Concerning rifampicin resistance genes, rpoBstaph was detected in 75 percent of the tested staphylococcus isolates. It could be concluded that in vitro studies emphasized the usefulness of the combination of vancomycin or teicoplanin with gentamicin or rifampicin, as well as that of gentamicin with rifampicin, against staphylococci showing varying resistance patterns. However, further in vivo studies are required to ensure the safety and efficacy of such combinations. Diclofenac sodium can act as an inducer of resistance to glycopeptides in staphylococci. Cell-wall thickness is a major contributor to such resistance among them. Gentamicin resistance in these strains could be chromosomally or plasmid mediated. Multiple mutations in the rpoB gene could mediate staphylococcus resistance to rifampicin.

Keywords: glycopeptides, combinations, induction, diclofenac, transmission electron microscopy, polymerase chain reaction

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Authors: Boris G. German, Edward Jiménez, Sebastián Espinoza, Andrés G. Chico, Ricardo A. Narváez

Abstract:

The unique flora and fauna of The Galapagos Islands has leveraged a tourism-driven growth in the islands. Nonetheless, such development is energy-intensive and requires thousands of gallons of diesel each year for thermoelectric electricity generation. The needed transport of fossil fuels from the continent has generated oil spillages and affectations to the fragile ecosystem of the islands. The Zero Fossil Fuels initiative for The Galapagos proposed by the Ecuadorian government as an alternative to reduce the use of fossil fuels in the islands, considers the replacement of diesel in thermoelectric generators, by Jatropha curcas vegetable oil. However, the Jatropha oil supply cannot entirely cover yet the demand for electricity generation in Galapagos. Within this context, the present work aims to provide an optimization model that can be used as a selection criterion for approving new Jatropha Curcas collection points in rural areas of Manabi-Ecuador. For this purpose, existing Jatropha collection points in Manabi were grouped under three regions: north (7 collection points), center (4 collection points) and south (9 collection points). Field work was carried out in every region in order to characterize the collection points, to establish local Jatropha supply and to determine transportation costs. Data collection was complemented using GIS software and an objective function was defined in order to determine the profit associated to Jatropha oil production. The market price of both Jatropha oil and residual cake, were considered for the total revenue; whereas Jatropha price, transportation and oil extraction costs were considered for the total cost. The tonnes of Jatropha fruit and seed, transported from collection points to the extraction plant, were considered as variables. The maximum and minimum amount of the collected Jatropha from each region constrained the optimization problem. The supply chain was optimized using linear programming in order to maximize the profits. Finally, a sensitivity analysis was performed in order to find a profit-based criterion for the acceptance of future collection points in Manabi. The maximum profit reached a value of $ 4,616.93 per year, which represented a total Jatropha collection of 62.3 tonnes Jatropha per year. The northern region of Manabi had the biggest collection share (69%), followed by the southern region (17%). The criteria for accepting new Jatropha collection points in the rural areas of Manabi can be defined by the current maximum profit of the zone and by the variation in the profit when collection points are removed one at a time. The definition of new feasible collection points plays a key role in the supply chain associated to Jatropha oil production. Therefore, a mathematical model that assists decision makers in establishing new collection points while assuring profitability, contributes to guarantee a continued Jatropha oil supply for Galapagos and a sustained economic growth in the rural areas of Ecuador.

Keywords: collection points, Jatropha curcas, linear programming, supply chain

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