Search results for: chronic back pain

Authors: Anna Slupik, Anna Mosiolek, Sebastian Wojtowicz, Dariusz Bialoszewski

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Introduction: Whole-body vibration (WBV) uses high frequency mechanical stimuli generated by a vibration plate and transmitted through bone, muscle and connective tissues to the whole body. Research has shown that long-term vibration-plate training improves neuromuscular facilitation, especially in afferent neural pathways, responsible for the conduction of vibration and proprioceptive stimuli, muscle function, balance and proprioception. Some researchers suggest that the vibration stimulus briefly inhibits the conduction of afferent signals from proprioceptors and can interfere with the maintenance of body balance. The aim of this study was to evaluate the influence of a single set of exercises associated with whole-body vibration on the joint position sense and body balance. Material and methods: The study enrolled 55 people aged 19-24 years. These individuals were randomly divided into a test group (30 persons) and a control group (25 persons). Both groups performed the same set of exercises on a vibration plate. The following vibration parameters: frequency of 20Hz and amplitude of 3mm, were used in the test group. The control group performed exercises on the vibration plate while it was off. All participants were instructed to perform six dynamic exercises lasting 30 seconds each with a 60-second period of rest between them. The exercises involved large muscle groups of the trunk, pelvis and lower limbs. Measurements were carried out before and immediately after exercise. Joint position sense (JPS) was measured in the knee joint for the starting position at 45° in an open kinematic chain. JPS error was measured using a digital inclinometer. Balance was assessed in a standing position with both feet on the ground with the eyes open and closed (each test lasting 30 sec). Balance was assessed using Matscan with FootMat 7.0 SAM software. The surface of the ellipse of confidence and front-back as well as right-left swing were measured to assess balance. Statistical analysis was performed using Statistica 10.0 PL software. Results: There were no significant differences between the groups, both before and after the exercise (p> 0.05). JPS did not change in both the test (10.7° vs. 8.4°) and control groups (9.0° vs. 8.4°). No significant differences were shown in any of the test parameters during balance tests with the eyes open or closed in both the test and control groups (p> 0.05). Conclusions. 1. Deterioration in proprioception or balance was not observed immediately after the vibration stimulus. This suggests that vibration-induced blockage of proprioceptive stimuli conduction can have only a short-lasting effect that occurs only as long as a vibration stimulus is present. 2. Short-term use of vibration in treatment does not impair proprioception and seems to be safe for patients with proprioceptive impairment. 3. These results need to be supplemented with an assessment of proprioception during the application of vibration stimuli. Additionally, the impact of vibration parameters used in the exercises should be evaluated.

Keywords: balance, joint position sense, proprioception, whole body vibration

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Authors: Tatsiana Ihnatovich, Darya Nizheharodava, Mikalai Halabarodzka, Tatsiana Savitskaya, Marina Zafranskaya

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Liver fibrosis is a complex of histological changes resulting from chronic liver disease accompanied by an excessive production and deposition of extracellular matrix components in the hepatic parenchyma. Liver fibrosis is a serious medical and social problem. Hepatic stellate cells (HSCs) make a significant contribution to the extracellular matrix deposition due to liver injury. Mesenchymal stem cells (MSCs) have a pronounced anti-inflammatory, regenerative and immunomodulatory effect; they are able to differentiate into hepatocytes and induce apoptosis of activated HSCs that opens the prospect of their use for preventing the excessive fibro-formation and the development of liver cirrhosis. The aim of the study is to evaluate the effect of MSCs therapy on the expression of fibrogenesis markers genes in liver tissue and HSCs cultures of rats with experimental liver cirrhosis (ELC). Materials and methods: ELC was induced by the common bile duct ligation (CBDL) in female Wistar rats (n = 19) with an average body weight of 250 (220 ÷ 270) g. Animals from the control group (n = 10) were sham-operated. On the 56th day after the CBDL, the rats of the experimental (n = 12) and the control (n = 5) groups received intraportal MSCs in concentration of 1×106 cells/animal (previously obtained from rat’s bone marrow) or saline, respectively. The animals were taken out of the experiment on the 21st day. HSCs were isolated by sequential liver perfusion in situ with following disaggregation, enzymatic treatment and centrifugation of cell suspension on a two-stage density gradient. The expression of collagen type I (Col1a1) and type III (Col3a1), matrix metalloproteinase type 2 (MMP2) and type 9 (MMP9), tissue inhibitor of matrix metalloproteinases type 1 (TIMP1), transforming growth factor β type 1 (TGFβ1) and type 3 (TGFβ3) was determined by real-time polymerase chain reaction. Statistical analysis was performed using Statistica 10.0. Results: In ELC rats compared to sham-operated animals, a significant increase of all studied markers expression was observed. The administration of MSCs led to a significant decrease of all detectable markers in the experimental group compared to rats without cell therapy. In ELC rats, an increased MMP9/TIMP1 ratio after cell therapy was also detected. The infusion of MSCs in the sham-operated animals did not lead to any changes. In the HSCs from ELC animals, the expression of Col1a1 and Col3a1 exceeded the similar parameters of the control group (p <0.05) and statistically decreased after the MSCs administration. The correlation between Col3a1 (Rs = 0.51, p <0.05), TGFβ1 (Rs = 0.6, p <0.01), and TGFβ3 (Rs = 0.75, p <0.001) expression in HSCs cultures and liver tissue has been found. Conclusion: Intraportal administration of MSCs to rats with ELC leads to a decreased Col1a1 and Col3a1, MMP2 and MMP9, TIMP1, TGFβ1 and TGFβ3 expression. The correlation between the expression of Col3a1, TGFβ1 and TGFβ3 in liver tissue and in HSCs cultures indicates the involvement of activated HSCs in the fibrogenesis that allows considering HSCs to be the main cell therapy target in ELC.

Keywords: cell therapy, experimental liver cirrhosis, hepatic stellate cells, mesenchymal stem cells

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Authors: Prajakta Patil, Yash Huzurbazar, Abhijeet Shinde

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Aim: To develop a treatment protocol for the management of tinnitus through multi-modality brain stimulation. Methodology: Present study included 33 adults with unilateral (31 subjects) and bilateral (2 subjects) chronic tinnitus with and/or without hearing loss independent of their etiology. The Treatment protocol included 5 consecutive sessions with follow-up of 6 months. Each session was divided into 3 parts: • Pre-treatment: a) Informed consent b) Pitch and loudness matching. • Treatment: Bimanual paper pen task with tinnitus masking for 30 minutes. • Post-treatment: a) Pitch and loudness matching b) Directive counseling and obtaining feedback. Paper-pen task is to be performed bimanually that included carrying out two different writing activities in different context. The level of difficulty of the activities was increased in successive sessions. Narrowband noise of a frequency same as that of tinnitus was presented at 10 dBSL of tinnitus for 30 minutes simultaneously in the ear with tinnitus. Result: The perception of tinnitus was no longer present in 4 subjects while in remaining subjects it reduced to an intensity that its perception no longer troubled them without causing residual facilitation. In all subjects, the intensity of tinnitus decreased by an extent of 45 dB at an average. However, in few subjects, the intensity of tinnitus also decreased by more than 45 dB. The approach resulted in statistically significant reductions in Tinnitus Functional Index and Tinnitus Handicap Inventory scores. The results correlate with pre and post treatment score of Tinnitus Handicap Inventory that dropped from 90% to 0%. Discussion: Brain mapping(qEEG) Studies report that there is multiple parallel overlapping of neural subnetworks in the non-auditory areas of the brain which exhibits abnormal, constant and spontaneous neural activity involved in the perception of tinnitus with each subnetwork and area reflecting a specific aspect of tinnitus percept. The paper pen task and directive counseling are designed and delivered respectively in a way that is assumed to induce normal, rhythmically constant and premeditated neural activity and mask the abnormal, constant and spontaneous neural activity in the above-mentioned subnetworks and the specific non-auditory area. Counseling was focused on breaking the vicious cycle causing and maintaining the presence of tinnitus. Diverting auditory attention alone is insufficient to reduce the perception of tinnitus. Conscious awareness of tinnitus can be suppressed when individuals engage in cognitively demanding tasks of non-auditory nature as the paper pen task used in the present study. To carry out this task selective, divided, sustained, simultaneous and split attention act cumulatively. Bimanual paper pen task represents a top-down activity which underlies brain’s ability to selectively attend to the bimanual written activity as a relevant stimulus and to ignore tinnitus that is the irrelevant stimuli in the present study. Conclusion: The study suggests that this novel treatment approach is cost effective, time saving and efficient to vanish the tinnitus or to reduce the intensity of tinnitus to a negligible level and thereby eliminating the negative reactions towards tinnitus.

Keywords: multi-modality brain stimulation, neural subnetworks, non-auditory areas, paper-pen task, top-down activity

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Authors: Cheryl Forchuk, Sandra Fisman, Steve Cordes, Dan Catunto, Katherine Krakowski, Melissa Jeffrey, John D’Oria

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The discharge of youth aged 16-25 from hospital into homelessness is a prevalent issue despite research indicating social, safety, health and economic detriments on both the individual and community. Lack of stable housing for youth discharged into homelessness results in long-term consequences, including exacerbation of health problems and costly health care service use and hospital readmission. People experiencing homelessness are four times more likely to be readmitted within one month of discharge and hospitals must spend $2,559 more per client. Finding safe housing for these individuals is imperative to their recovery and transition back to the community. People discharged from hospital to homelessness experience challenges, including poor health outcomes and increased hospital readmissions. Youth are the fastest-growing subgroup of people experiencing homelessness in Canada. The needs of youth are unique and include supports related to education, employment opportunities, and age-related service barriers. This study aims to identify the needs of youth at risk of homelessness by evaluating the efficacy of the “Preventing Discharge to No Fixed Address – Youth” (NFA-Y) program, which aims to prevent youth from being discharged from hospital into homelessness. The program connects youth aged 16-25 who are inpatients at London Health Sciences Centre and St. Joseph’s Health Care London to housing and financial support. Supports are offered through collaboration with community partners: Youth Opportunities Unlimited, Canadian Mental Health Association Elgin Middlesex, City of London Coordinated Access, Ontario Works, and Salvation Army’s Housing Stability Bank. This study was reviewed and approved by Western University’s Research Ethics Board. A series of interviews are being conducted with approximately ninety-three youth participants at three time points: baseline (pre-discharge), six, and twelve months post-discharge. Focus groups with participants, health care providers, and community partners are being conducted at three-time points. In addition, administrative data from service providers will be collected and analyzed. Since homelessness has a detrimental effect on recovery, client and community safety, and healthcare expenditure, locating safe housing for psychiatric patients has had a positive impact on treatment, rehabilitation, and the system as a whole. If successful, the findings of this project will offer safe policy alternatives for the prevention of homelessness for at-risk youth, help set them up for success in their future years, and mitigate the rise of the homeless youth population in Canada.

Keywords: youth homelessness, no-fixed address, mental health, homelessness prevention, hospital discharge

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Authors: Tanima Bhattacharya, Joy Sen

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To transform a space into a better livable and sustainable zone, United Nations Summit in New York 2015, has decided upon 17 sustainable development goals (SDGs) that approach directly to achieve inclusive, people-centric, sustainable developments. Though sustainability has been majorly constructed by four pillars, namely, Ecological, Economic, Social and Cultural, but it is essentially reduced to economic and ecological consideration in the context of developing countries. Therefore, in most cases planning has reduced its ambit to concentrate around the tangible infrastructure, ignoring the fundamentals of socio-cultural heritage. With the accentuating hype of infrastructural augmentation, lack of emphasis of traditional concerns like ethnicity and social connection have further diluted the situation, disintegrating cultural continuity. As cultural continuity lacks its cohesion, it’s growing absence increasingly acts as a catalyst to degrade the heritage structures, spaces around and linking these structures, and the ability of stakeholders in identifying themselves rooted in that particular space. Hence, this paper will argue that sustainability depends on the people and their interaction with their surroundings, their culture and livelihood. The interaction between people and their surroundings strengthen community building and social interaction that abides by stakeholders reverting back to their roots. To assess the socio-cultural sustainability of the city of Kolkata, two study areas are selected, namely, an old settlement from the northern part of the city of Kolkata (KMA), imbued with social connection, age-old cultural and ethnic bonding and, another cluster of new high-rises coming up in the Newtown area having portions of planned city extension on the eastern side of the city itself. Whereas, Newtown prioritizes the surging post-industrial trends of economic aspiration and ecological aspects of urban sustainability; the former settlements of northern Kolkata still continue to represent the earliest community settlement of the British-colonial-cum native era and even the pre-colonial era, permeated with socio-cultural reciprocation. Thus, to compare and assess the inlayed organizational structure of both the spaces in the two cases, selected areas have been surveyed to portray their current imageability. The argument of this paper is structured in 5parts. First, an introduction of the idea has been forwarded, Secondly, a literature review has been conducted to ground the proposed ideas, Thirdly, methodology has been discussed and appropriate case study areas have been selected, Fourthly, surveys and analyses has been forwarded and lastly, the paper has arrived at a set of conclusions by suggesting a threefold development to create happy, healthy and sustainable community.

Keywords: art innovation, current scenario assessment, heritage, imageability, socio-cultural sustainability

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Authors: Bengan Simbarashe Manwere

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The entire African continent, comprising 55 countries, holds a 2% share of the global carbon market. The World Bank attributes the continent’s insignificant share and participation in the carbon market to the limited access to electricity. Approximately 800 million people spread across 47 African countries generate as much power as Spain, with a population of 45million. Only South Africa and North Africa have carbon-reduction investment opportunities on the continent and dominate the 2% market share of the global carbon market. On the back of the 2015 Paris Agreement, South Africa signed into law the Carbon Tax Act 15 of 2019 and the Customs and Excise Amendment Act 13 of 2019 (Gazette No. 4280) on 1 June 2019. By these laws, South Africa was ushered into the league of active global carbon market players. By increasing the cost of production by the rate of R120/tCO2e, the tax intentionally compels the internalization of pollution as a cost of production and, relatedly, stimulate investment in clean technologies. The first phase covered the 1 June 2019 – 31 December 2022 period during which the tax was meant to escalate at CPI + 2% for Scope 1 emitters. However, in the second phase, which stretches from 2023 to 2030, the tax will escalate at the inflation rate only as measured by the consumer price index (CPI). The Carbon Tax Act provides for carbon allowances as mitigation strategies to limit agents’ carbon tax liability by up to 95% for fugitive and process emissions. Although the June 2019 Carbon Tax Act explicitly makes provision for a carbon trading scheme (CTS), the carbon trading regulations thereof were only finalised in December 2020. This points to a delay in the establishment of a carbon trading scheme (CTS). Relatedly, emitters in South Africa are not able to benefit from the 95% reduction in effective carbon tax rate from R120/tCO2e to R6/tCO2e as the Johannesburg Stock Exchange (JSE) has not yet finalized the establishment of the market for trading carbon credits. Whereas most carbon trading schemes have been designed and constructed from the beginning as new tailor-made systems in countries the likes of France, Australia, Romania which treat carbon as a financial product, South Africa intends, on the contrary, to leverage existing trading infrastructure of the Johannesburg Stock Exchange (JSE) and the Clearing and Settlement platforms of Strate, among others, in the interest of the Paris Agreement timelines. Therefore the carbon trading scheme will not be constructed from scratch. At the same time, carbon will be treated as a commodity in order to align with the existing institutional and infrastructural capacity. This explains why the Carbon Tax Act is silent about the involvement of the Financial Sector Conduct Authority (FSCA).For South Africa, there is need to establish they equilibrium stability of the CTS. This is important as South Africa is an innovator in carbon trading and the successful trading of carbon credits on the JSE will lead to imitation by early adopters first, followed by the middle majority thereafter.

Keywords: carbon trading scheme (CTS), Johannesburg stock exchange (JSE), carbon tax act 15 of 2019, South Africa

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Authors: Durri Andriani, Irsan Tahar, Lilian Sarah Hiariey

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Every institution has to develop, implement, and control its policies to ensure the effectiveness of the institution. In doing so, all related stakeholders have to be involved to maximize the benefit of the policies and minimize the potential constraints and resistances. Open and distance education (ODE) institution is no different. As an education institution, ODE institution has to focus their attention to fulfilling academic needs of their students through open and distance measures. One of them is quality learning support system. Significant stakeholders in learning support system are tutors since they are the ones who directly communicate with students. Tutors are commonly seen as objects whose main responsibility is limited to implementing policies decided by management in ODE institutions. Nonetheless, tutors’ perceptions of tutorials are believed to influence tutors’ performances in facilitating learning support. It is therefore important to analyze tutors’ perception on various aspects of learning support. This paper presents analysis of tutors’ perceptions on policies of tutoriala in ODE institution using Policy Analysis Framework (PAF) modified by King, Nugent, Russell, and Lacy. Focus of this paper is on on-line tutors, those who provide tutorials via Internet. On-line tutors were chosen to stress the increasingly important used of Internet in ODE system. The research was conducted in Universitas Terbuka (UT), Indonesia. UT is purposely selected because of its large number (1,234) of courses offered and large area coverage (6000 inhabited islands). These posed UT in a unique position where learning support system has, to some extent, to be standardized while at the same time it has to be able to cater the needs of different courses in different places for students with different backgrounds. All 598 listed on-line tutors were sent the research questionnaires. Around 20% of the email addresses could not be reached. Tutors were asked to fill out open-ended questionnaires on their perceptions on definition of on-line tutorial, roles of tutors and students in on-line tutorials, requirement for on-line tutors, learning materials, and student evaluation in on-line tutorial. Data analyzed was gathered from 40 on-line tutors who sent back filled-out questionnaires. Data were analyzed qualitatively using content analysis from all 40 tutors. The results showed that using PAF as entry point in choosing learning support services as area of policy with delivery learning materials as the issue at UT has been able to provide new insights of aspects need to be consider in formulating policies in online tutorial and in learning support services. Involving tutors as source of information could be proven to be productive. In general, tutors had clear understanding about definition of online tutorial, roles of tutors and roles of students, and requirement of tutor. Tutors just need to be more involved in the policy formulation since they could provide data on students and problem faced in online tutorial. However, tutors need an adjustment in student evaluation which according tutors too focus on administrative aspects and subjective.

Keywords: distance education, on-line tutorial, tutorial policy, tutors’ perspectives

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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

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Authors: Bharti Garg, Ashleigh Cousins, Pauline Pearson, Vincent Verheyen, Paul Feron

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The presence of SO₂ in power plant flue gases makes flue gas desulfurization (FGD) an essential requirement prior to post combustion CO₂ (PCC) removal facilities. Although most of the power plants worldwide deploy FGD in order to comply with environmental regulations, generally the achieved SO₂ levels are not sufficiently low for the flue gases to enter the PCC unit. The SO₂ level in the flue gases needs to be less than 10 ppm to effectively operate the PCC installation. The existing FGD units alone cannot bring down the SO₂ levels to or below 10 ppm as required for CO₂ capture. It might require an additional scrubber along with the existing FGD unit to bring the SO₂ to the desired levels. The absence of FGD units in Australian power plants brings an additional challenge. SO₂ concentrations in Australian power station flue gas emissions are in the range of 100-600 ppm. This imposes a serious barrier on the implementation of standard PCC technologies in Australia. CSIRO’s developed CS-Cap process is a unique solution to capture SO₂ and CO₂ in a single column with single absorbent which can potentially bring cost-effectiveness to the commercial deployment of carbon capture in Australia, by removing the need for FGD. Estimated savings of removing SO₂ through a similar process as CS-Cap is around 200 MMUSD for a 500 MW Australian power plant. Pilot plant trials conducted to generate the proof of concept resulted in 100% removal of SO₂ from flue gas without utilising standard limestone-based FGD. In this work, removal of absorbed sulfur from aqueous amine absorbents generated in the pilot plant trials has been investigated by reactive crystallisation and thermal reclamation. More than 95% of the aqueous amines can be reclaimed back from the sulfur loaded absorbent via reactive crystallisation. However, the recovery of amines through thermal reclamation is limited and depends on the sulfur loading on the spent absorbent. The initial experimental work revealed that reactive crystallisation is a better fit for CS-Cap’s sulfur-rich absorbent especially when it is also capable of generating K₂SO₄ crystals of highly saleable quality ~ 99%. Initial cost estimation carried on both the technologies resulted in almost similar capital expenditure; however, the operating cost is considerably higher in thermal reclaimer than that in crystalliser. The experimental data generated in the laboratory from both the regeneration techniques have been used to generate the simulation model in Aspen Plus. The simulation model illustrates the economic benefits which could be gained by removing flue gas desulfurization prior to standard PCC unit and replacing it with a CS-Cap absorber column co-capturing CO₂ and SO₂, and it's absorbent regeneration system which would be either reactive crystallisation or thermal reclamation.

Keywords: combined capture, cost analysis, crystallisation, CS-Cap, flue gas desulfurisation, regeneration, sulfur, thermal reclamation

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Authors: R. Christopher, C. Brandt, N. Damons

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Background: The sequence of prevention model states that by constant assessment of injury, injury mechanisms and risk factors are identified, highlighting that collecting and recording of data is a core approach for preventing injuries. Several screening tools are available for use in the clinical setting. These screening techniques only recently received research attention, hence there is a dearth of inconsistent and controversial data regarding their applicability, validity, and reliability. Several systematic reviews related to common soccer injuries have been conducted; however, none of them addressed the screening tools for common soccer injuries. Objectives: The purpose of this study was to conduct a review of screening tools and their accuracy for common injuries in soccer. Methods: A systematic scoping review was performed based on the Joanna Briggs Institute procedure for conducting systematic reviews. Databases such as SPORT Discus, Cinahl, Medline, Science Direct, PubMed, and grey literature were used to access suitable studies. Some of the key search terms included: injury screening, screening, screening tool accuracy, injury prevalence, injury prediction, accuracy, validity, specificity, reliability, sensitivity. All types of English studies dating back to the year 2000 were included. Two blind independent reviewers selected and appraised articles on a 9-point scale for inclusion as well as for the risk of bias with the ACROBAT-NRSI tool. Data were extracted and summarized in tables. Plot data analysis was done, and sensitivity and specificity were analyzed with their respective 95% confidence intervals. I² statistic was used to determine the proportion of variation across studies. Results: The initial search yielded 95 studies, of which 21 were duplicates, and 54 excluded. A total of 10 observational studies were included for the analysis: 3 studies were analysed quantitatively while the remaining 7 were analysed qualitatively. Seven studies were graded low and three studies high risk of bias. Only high methodological studies (score > 9) were included for analysis. The pooled studies investigated tools such as the Functional Movement Screening (FMS™), the Landing Error Scoring System (LESS), the Tuck Jump Assessment, the Soccer Injury Movement Screening (SIMS), and the conventional hamstrings to quadriceps ratio. The accuracy of screening tools was of high reliability, sensitivity and specificity (calculated as ICC 0.68, 95% CI: 52-0.84; and 0.64, 95% CI: 0.61-0.66 respectively; I² = 13.2%, P=0.316). Conclusion: Based on the pooled results from the included studies, the FMS™ has a good inter-rater and intra-rater reliability. FMS™ is a screening tool capable of screening for common soccer injuries, and individual FMS™ scores are a better determinant of performance in comparison with the overall FMS™ score. Although meta-analysis could not be done for all the included screening tools, qualitative analysis also indicated good sensitivity and specificity of the individual tools. Higher levels of evidence are, however, needed for implication in evidence-based practice.

Keywords: accuracy, screening tools, sensitivity, soccer injuries, specificity

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Authors: O. O. Sufyani, M. E. Oraiby, S. A. Qumaiy, A. I. Alaamri, Z. M. Eisa, A. M. Hakami, M. A. Attafi, O. M. Alhassan, W. M. Elsideeg, E. M. Noureldin, Y. A. Hobani, Y. Q. Majrabi, I. A. Khardali, A. B. Maashi, A. A. Al Mane, A. H. Hakami, I. M. Alkhyat, A. A. Sahly, I. M. Attafi

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According to the Food and Agriculture Organization (FAO) Pesticides Use Database, pesticide use in agriculture in Saudi Arabia has more than doubled from 4539 tons in 2009 to 10496 tons in 2019. Among pesticides, pyrethroids is commonly used in Saudi Arabia. Pesticides may increase susceptibility to a variety of diseases, particularly among pesticide workers, due to their extensive use, indiscriminate use, and long-term exposure. Therefore, analyzing blood chemo-profiles and evaluating the detected substances as biomarkers for pyrethroid pesticide exposure may assist to identify and predicting adverse effects of exposure, which may be used for both preventative and risk assessment purposes. The purpose of this study was to (a) analyze chemo-profiling by Gas Chromatography-Mass Spectrometry (GC-MS) analysis, (b) identify the most commonly detected chemicals in a time-exposure-dependent manner using a Venn diagram, and (c) identify their associated disease among pesticide workers using analyzer tools on the Comparative Toxicogenomics Database (CTD) website, (250 healthy male volunteers (20-60 years old) who deal with pesticides in the Jazan region of Saudi Arabia (exposure intervals: 1-2, 4-6, 6-8, more than 8 years) were included in the study. A questionnaire was used to collect demographic information, the duration of pesticide exposure, and the existence of chronic conditions. Blood samples were collected for biochemistry analysis and extracted by solid-phase extraction for gas chromatography-mass spectrometry (GC-MS) analysis. Biochemistry analysis reveals no significant changes in response to the exposure period; however, an inverse association between the albumin level and the exposure interval was observed. The blood chemo-profiling was differentially expressed in an exposure time-dependent manner. This analysis identified the common chemical set associated with each group and their associated significant occupational diseases. While some of these chemicals are associated with a variety of diseases, the distinguishing feature of these chemically associated disorders is their applicability for prevention measures. The most interesting finding was the identification of several chemicals; erucic acid, pelargonic acid, alpha-linolenic acid, dibutyl phthalate, diisobutyl phthalate, dodecanol, myristic Acid, pyrene, and 8,11,14-eicosatrienoic acid, associated with pneumoconiosis, asbestosis, asthma, silicosis and berylliosis. Chemical-disease association study also found that cancer, digestive system disease, nervous system disease, and metabolic disease were the most often recognized disease categories in the common chemical set. The hierarchical clustering approach was used to compare the expression patterns and exposure intervals of the chemicals found commonly. More study is needed to validate these chemicals as early markers of pyrethroid insecticide-related occupational disease, which might assist evaluate and reducing risk. The current study contributes valuable data and recommendations to public health.

Keywords: occupational, toxicology, chemo-profiling, pesticide, pyrethroid, GC-MS

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Authors: Catherine Sunter, Marius Nygaard, Lars Hamran, Børre Skodvin, Ute Groba

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Globally, the construction and operation of buildings contribute up to 30% of annual green house gas emissions. In addition, the building sector is responsible for approximately a third of global waste. In this context, the utilization of renewable resources in buildings, especially materials that store carbon, will play a significant role in the growing city. These are two reasons for introducing wood as a building material with a growing relevance. A third is the potential economic value in countries with a forest industry that is not currently used to capacity. In 2013, a four-year interdisciplinary research project titled “Wood Be Better” was created, with the principle goal to produce and publicise knowledge that would facilitate increased use of wood in buildings in urban areas. The research team consisted of architects, engineers, wood technologists and mycologists, both from research institutions and industrial organisations. Five structured work packages were included in the initial research proposal. Work package 2 was titled “Design-based research” and proposed using architecture master courses as laboratories for systematic architectural exploration. The aim was twofold: to provide students with an interdisciplinary team of experts from consultancies and producers, as well as teachers and researchers, that could offer the latest information on wood technologies; whilst at the same time having the studio course test the effects of the use of wood on the functional, technical and tectonic quality within different architectural projects on an urban scale, providing results that could be fed back into the research material. The aim of this article is to examine the successes and failures of this pedagogical approach in an architecture school, as well as the opportunities for greater integration between academic research projects, industry experts and studio courses in the future. This will be done through a set of qualitative interviews with researchers, teaching staff and students of the studio courses held each semester since spring 2013. These will investigate the value of the various experts of the course; the different themes of each course; the response to the urban scale, architectural form and construction detail; the effect of working with the goals of a research project; and the value of the studio projects to the research. In addition, six sample projects will be presented as case studies. These will show how the projects related to the research and could be collected and further analysed, innovative solutions that were developed during the course, different architectural expressions that were enabled by timber, and how projects were used as an interdisciplinary testing ground for integrated architectural and engineering solutions between the participating institutions. The conclusion will reflect on the original intentions of the studio courses, the opportunities and challenges faced by students, researchers and teachers, the educational implications, and on the transparent and inclusive discourse between the architectural researcher, the architecture student and the interdisciplinary experts.

Keywords: architecture, interdisciplinary, research, studio, students, wood

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Authors: Dagmara A. Niedziela, Mark P. Murphy, Orla M. Keane, Finola C. Leonard

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Staphylococcus aureus is the most frequent cause of clinical and subclinical bovine mastitis in Ireland. Mastitis caused by S. aureus is often chronic and tends to recur after antibiotic treatment. This may be due to several virulence factors, including attributes that enable the bacterium to internalize into bovine mammary epithelial cells, where it may evade antibiotic treatment, or evade the host immune response. Four bovine-adapted lineages (CC71, CC97, CC151 and ST136) were identified among a collection of Irish S. aureus mastitis isolates. Genotypic variation of mastitis-causing strains may contribute to different presentations of the disease, including differences in milk somatic cell count (SCC), the main method of mastitis detection. The objective of this study was to investigate the influence of bacterial strain and lineage on host immune response, by employing cell culture methods in vitro as well as an in vivo infection model. Twelve bovine adapted S. aureus strains were examined for internalization into bovine mammary epithelial cells (bMEC) and their ability to induce an immune response from bMEC (using qPCR and ELISA). In vitro studies found differences in a variety of virulence traits between the lineages. Strains from lineages CC97 and CC71 internalized more efficiently into bovine mammary epithelial cells (bMEC) than CC151 and ST136. CC97 strains also induced immune genes in bMEC more strongly than strains from the other 3 lineages. One strain each of CC151 and CC97 that differed in their ability to cause an immune response in bMEC were selected on the basis of the above in vitro experiments. Fourteen first-lactation Holstein-Friesian cows were purchased from 2 farms on the basis of low SCC (less than 50 000 cells/ml) and infection free status. Seven cows were infected with 1.73 x 102 c.f.u. of the CC97 strain (Group 1) and another seven with 5.83 x 102 c.f.u. of the CC151 strain (Group 2). The contralateral quarter of each cow was inoculated with PBS (vehicle). Clinical signs of infection (temperature, milk and udder appearance, milk yield) were monitored for 30 days. Blood and milk samples were taken to determine bacterial counts in milk, SCC, white blood cell populations and cytokines. Differences in disease presentation in vivo between groups were observed, with two animals from Group 2 developing clinical mastitis and requiring antibiotic treatment, while one animal from Group 1 did not develop an infection for the duration of the study. Fever (temperature > 39.5⁰C) was observed in 3 animals from Group 2 and in none from Group 1. Significant differences in SCC and bacterial load between groups were observed in the initial stages of infection (week 1). Data is also being collected on cytokines and chemokines secreted during the course of infection. The results of this study suggest that a strain from lineage CC151 may cause more severe clinical mastitis, while a strain from lineage CC97 may cause mild, subclinical mastitis. Diversity between strains of S. aureus may therefore influence the clinical presentation of mastitis, which in turn may influence disease detection and treatment needs.

Keywords: Bovine mastitis, host immune response, host-pathogen interactions, Staphylococcus aureus

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Authors: Hilal T. Sasmazel, Seda Surucu

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Skin tissue engineering is a promising field for the treatment of skin defects using scaffolds. This approach involves the use of living cells and biomaterials to restore, maintain, or regenerate tissues and organs in the body by providing; (i) larger surface area for cell attachment, (ii) proper porosity for cell colonization and cell to cell interaction, and (iii) 3-dimensionality at macroscopic scale. Recent studies on this area mainly focus on fabrication of scaffolds that can closely mimic the natural extracellular matrix (ECM) for creation of tissue specific niche-like environment at the subcellular scale. Scaffolds designed as ECM-like architectures incorporating into the host with minimal scarring/pain and facilitate angiogenesis. This study is related to combining of synthetic PCL and natural chitosan polymers to form 3D PCL/Chitosan core-shell structures for skin tissue engineering applications. Amongst the polymers used in tissue engineering, natural polymer chitosan and synthetic polymer poly(ε-caprolactone) (PCL) are widely preferred in the literature. Chitosan has been among researchers for a very long time because of its superior biocompatibility and structural resemblance to the glycosaminoglycan of bone tissue. However, the low mechanical flexibility and limited biodegradability properties reveals the necessity of using this polymer in a composite structure. On the other hand, PCL is a versatile polymer due to its low melting point (60°C), ease of processability, degradability with non-enzymatic processes (hydrolysis) and good mechanical properties. Nevertheless, there are also several disadvantages of PCL such as its hydrophobic structure, limited bio-interaction and susceptibility to bacterial biodegradation. Therefore, it became crucial to use both of these polymers together as a hybrid material in order to overcome the disadvantages of both polymers and combine advantages of those. The scaffolds here were fabricated by using electrospinning technique and the characterizations of the samples were done by contact angle (CA) measurements, scanning electron microscopy (SEM), transmission electron microscopy (TEM) and X-Ray Photoelectron spectroscopy (XPS). Additionally, gas permeability test, mechanical test, thickness measurement and PBS absorption and shrinkage tests were performed for all type of scaffolds (PCL, chitosan and PCL/chitosan core-shell). By using ImageJ launcher software program (USA) from SEM photographs the average inter-fiber diameter values were calculated as 0.717±0.198 µm for PCL, 0.660±0.070 µm for chitosan and 0.412±0.339 µm for PCL/chitosan core-shell structures. Additionally, the average inter-fiber pore size values exhibited decrease of 66.91% and 61.90% for the PCL and chitosan structures respectively, compare to PCL/chitosan core-shell structures. TEM images proved that homogenous and continuous bead free core-shell fibers were obtained. XPS analysis of the PCL/chitosan core-shell structures exhibited the characteristic peaks of PCL and chitosan polymers. Measured average gas permeability value of produced PCL/chitosan core-shell structure was determined 2315±3.4 g.m-2.day-1. In the future, cell-material interactions of those developed PCL/chitosan core-shell structures will be carried out with L929 ATCC CCL-1 mouse fibroblast cell line. Standard MTT assay and microscopic imaging methods will be used for the investigation of the cell attachment, proliferation and growth capacities of the developed materials.

Keywords: chitosan, coaxial electrospinning, core-shell, PCL, tissue scaffold

Procedia PDF Downloads 459

Authors: Chirag Raval, Jimmy Toussaint, Tieuvi Nguyen, Hadi Fadaifard, George Wolberg, Steven Quarfordt, Kung-ming Jan, David S. Rumschitzki

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Numerous studies examine aquaporins’ role in osmotic water transport in various systems but virtually none focus on aquaporins’ role in hydrostatically-driven water transport involving mammalian cells save for our laboratory’s recent study of aortic endothelial cells. Here we investigate aquaporin-1 expression and function in the aortic endothelium in two high-renin rat models of hypertension, the spontaneously hypertensive genomically altered Wystar-Kyoto rat variant and Sprague-Dawley rats made hypertensive by two kidney, one clip Goldblatt surgery. We measured aquaporin-1 expression in aortic endothelial cells from whole rat aortas by quantitative immunohistochemistry, and function by measuring the pressure driven hydraulic conductivities of excised rat aortas with both intact and denuded endothelia on the same vessel. We use them to calculate the effective intimal hydraulic conductivity, which is a combination of endothelial and subendothelial components. We observed well-correlated enhancements in aquaporin-1 expression and function in both hypertensive rat models as well as in aortas from normotensive rats whose expression was upregulated by 2h forskolin treatment. Upregulated aquaporin-1 expression and function may be a response to hypertension that critically determines conduit artery vessel wall viability and long-term susceptibility to atherosclerosis. Numerous studies examine aquaporins’ role in osmotic water transport in various systems but virtually none focus on aquaporins’ role in hydrostatically-driven water transport involving mammalian cells save for our laboratory’s recent study of aortic endothelial cells. Here we investigate aquaporin-1 expression and function in the aortic endothelium in two high-renin rat models of hypertension, the spontaneously hypertensive genomically altered Wystar-Kyoto rat variant and Sprague-Dawley rats made hypertensive by two kidney, one clip Goldblatt surgery. We measured aquaporin-1 expression in aortic endothelial cells from whole rat aortas by quantitative immunohistochemistry, and function by measuring the pressure driven hydraulic conductivities of excised rat aortas with both intact and denuded endothelia on the same vessel. We use them to calculate the effective intimal hydraulic conductivity, which is a combination of endothelial and subendothelial components. We observed well-correlated enhancements in aquaporin-1 expression and function in both hypertensive rat models as well as in aortas from normotensive rats whose expression was upregulated by 2h forskolin treatment. Upregulated aquaporin-1 expression and function may be a response to hypertension that critically determines conduit artery vessel wall viability and long-term susceptibility to atherosclerosis.

Keywords: acute hypertension, aquaporin-1, hydraulic conductivity, hydrostatic pressure, aortic endothelial cells, transcellular flow

Procedia PDF Downloads 205

Authors: Kristina Colovic, Mari Janikian, Nikolaos Takis, Fotini-Sonia Apergi

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A considerable number of Afghan asylum seekers in Greece are still waiting for answers about their future and status for personal, social and societal advancement. Most have been trapped in a stalemate of continuously postponed or temporarily progressed levels of integration into the EU/Greek process of asylum. Limited quantitative research exists investigating the psychological effects of long-term displacement among Afghans refugees in Greece. The purpose of this study is to investigate factors that are associated with and predict psychological distress symptoms among this population. Data from a sample of native Afghan nationals (N > 70) living in Greece for approximately the last ten years will be collected from May to July 2016. Criteria for participation include the following: being 18 years of age or older, and emigration from Afghanistan to Greece from 2003 onwards (i.e., long-term refugees or part of the 'old system of asylum'). Snowball sampling will be used to recruit participants, as this is considered the most effective option when attempting to study refugee populations. Participants will complete self-report questionnaires, consisting of the Afghan Symptom Checklist (ASCL), a culturally validated measure of psychological distress, the World Health Organization Quality of Life scale (WHOQOL-BREF), an adapted version of the Comprehensive Trauma Inventory-104 (CTI-104), and a modified Psychological Acculturation Scale. All instruments will be translated in Greek, through the use of forward- and back-translations by bilingual speakers of English and Greek, following WHO guidelines. A pilot study with 5 Afghan participants will take place to check for discrepancies in understanding and for further adapting the instruments as needed. Demographic data, including age, gender, year of arrival to Greece and current asylum status will be explored. Three different types of analyses (descriptive statistics, bivariate correlations, and multivariate linear regression) will be used in this study. Descriptive findings for respondent demographics, psychological distress symptoms, traumatic life events and quality of life will be reported. Zero-order correlations will assess the interrelationships among demographic, traumatic life events, psychological distress, and quality of life variables. Lastly, a multivariate linear regression model will be estimated. The findings from the study will contribute to understanding the determinants of acculturation, distress and trauma on daily functioning for Afghans in Greece. The main implications of the current study will be to advocate for capacity building and empower communities through effective program evaluation and design for mental health services for all refugee populations in Greece.

Keywords: Afghan refugees, evaluation, Greece, mental health, quality of life

Procedia PDF Downloads 264

Authors: Jayden R. Hunter, Alexander J. MacQuarrie, Samantha C. Sheridan, Richard High, Carolyn Waite

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Workplace exercise programs have been recommended to improve the musculoskeletal fitness of paramedics with the aim of reducing injury rates, and while they have shown efficacy in other occupations, they have not been delivered and evaluated in Australian paramedics to our best knowledge. This study investigated the effectiveness of a 6-month workplace exercise program (MedicFit; MF) to improve paramedic fitness with or without health coach (HC) support. A group of regional Australian paramedics (n=76; 43 male; mean ± SD 36.5 ± 9.1 years; BMI 28.0 ± 5.4 kg/m²) were randomised at the station level to either exercise with remote health coach support (MFHC; n=30), exercise without health coach support (MF; n=23), or no-exercise control (CON; n=23) groups. MFHC and MF participants received a 6-month, low-moderate intensity resistance and flexibility exercise program to be performed ƒ on station without direct supervision. Available exercise equipment included dumbbells, resistance bands, Swiss balls, medicine balls, kettlebells, BOSU balls, yoga mats, and foam rollers. MFHC and MF participants were also provided with a comprehensive exercise manual including sample exercise sessions aimed at improving musculoskeletal strength and flexibility which included exercise prescription (i.e. sets, reps, duration, load). Changes to upper-body (push-ups), lower-body (wall squat) and core (plank hold) strength and flexibility (back scratch and sit-reach tests) after the 6-month intervention were analysed using repeated measures ANOVA to compare changes between groups and over time. Upper-body (+20.6%; p < 0.01; partial eta squared = 0.34 [large effect]) and lower-body (+40.8%; p < 0.05; partial eta squared = 0.08 (moderate effect)) strength increased significantly with no interaction or group effects. Changes to core strength (+1.4%; p=0.17) and both upper-body (+19.5%; p=0.56) and lower-body (+3.3%; p=0.15) flexibility were non-significant with no interaction or group effects observed. While upper- and lower-body strength improved over the course of the intervention, providing a 6-month workplace exercise program with or without health coach support did not confer any greater strength or flexibility benefits than exercise testing alone (CON). Although exercise adherence was not measured, it is possible that participants require additional methods of support such as face-to-face exercise instruction and guidance and individually-tailored exercise programs to achieve adequate participation and improvements in musculoskeletal fitness. This presents challenges for more remote paramedic stations without regular face-to-face access to suitably qualified exercise professionals, and future research should investigate the effectiveness of other forms of exercise delivery and guidance for these paramedic officers such as remotely-facilitated digital exercise prescription and monitoring.

Keywords: workplace exercise, paramedic health, strength training, flexibility training

Procedia PDF Downloads 114

Authors: Hilal Turkoglu Sasmazel, Ozan Ozkan, Seda Surucu

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Tissue engineering is the field of treating defects caused by injuries, trauma or acute/chronic diseases by using artificial scaffolds that mimic the extracellular matrix (ECM), the natural biological support for the tissues and cells within the body. The main aspects of a successful artificial scaffold are (i) large surface area in order to provide multiple anchorage points for cells to attach, (ii) suitable porosity in order to achieve 3 dimensional growth of the cells within the scaffold as well as proper transport of nutrition, biosignals and waste and (iii) physical, chemical and biological compatibility of the material in order to obtain viability throughout the healing process. By hybrid scaffolds where two or more different materials were combined with advanced fabrication techniques into complex structures, it is possible to combine the advantages of individual materials into one single structure while eliminating the disadvantages of each. Adding this to the complex structure provided by advanced fabrication techniques enables obtaining the desired aspects of a successful artificial tissue scaffold. In this study, fibroblast compatibility of poly(ε-caprolactone) (PCL)/chitosan core-shell electrospun hybrid scaffolds with proper mechanical, chemical and physical properties successfully developed in our previous study was investigated. Standard 7-day cell culture was carried out with L929 fibroblast cell line. The viability of the cells cultured with the scaffolds was monitored with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) viability assay for every 48 h starting with 24 h after the initial seeding. In this assay, blank commercial tissue culture polystyrene (TCPS) Petri dishes, single electrospun PCL and single electrospun chitosan mats were used as control in order to compare and contrast the performance of the hybrid scaffolds. The adhesion, proliferation, spread and growth of the cells on/within the scaffolds were observed visually on the 3rd and the 7th days of the culture period with confocal laser scanning microscopy (CSLM) and scanning electron microscopy (SEM). The viability assay showed that the hybrid scaffolds caused no toxicity for fibroblast cells and provided a steady increase in cell viability, effectively doubling the cell density for every 48 h for the course of 7 days, as compared to TCPS, single electrospun PCL or chitosan mats. The cell viability on the hybrid scaffold was ~2 fold better compared to TCPS because of its 3D ECM-like structure compared to 2D flat surface of commercially cell compatible TCPS, and the performance was ~2 fold and ~10 fold better compared to single PCL and single chitosan mats, respectively, even though both fabricated similarly with electrospinning as non-woven fibrous structures, because single PCL and chitosan mats were either too hydrophobic or too hydrophilic to maintain cell attachment points. The viability results were verified with visual images obtained with CSLM and SEM, in which cells found to achieve characteristic spindle-like fibroblast shape and spread on the surface as well within the pores successfully at high densities.

Keywords: chitosan, core-shell, fibroblast, electrospinning, PCL

Procedia PDF Downloads 142

Authors: Aparna Saha, Tuhin Ahmed

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West Bengal has a number of important rivers, each with its distinctive character and a story. Traditionally, cities have ‘divulged’ to rivers at the river edges and rivers have been an inseparable part of the urban experience. Considering the research aspect, the area is taken in Barrackpore, a small but important outgrowth of Kolkata Municipal Association, West Bengal. Barrackpore, at present, has ample inadequate public open spaces at the neighborhood level where people of different socio-cultural, economic, and religious backgrounds can come together and engage in various leisure activities, but there is no opportunity either, where people can learn about and explore the rich history of the settlement. Pertaining to these issues forms the backdrop of this research paper which has been conceptualized as a place from space that will bring people back to the river and increase community interactions and will also celebrate and commemorate towards the historical importance of the river and its edges. The entire precinct bordering the river represents the transition from pre-independence (Raj era) to Sepoy phase (Swaraj era), finally culminating into the Gandhian philosophy which is being projected into the already existing Gandhi Ghat. The ultimate aim of the paper entitled ‘Utsadhara- Rejuvenating the dead river edge into an urban activity space along the banks of river Hooghly’ is to create a socio-cultural space keeping the heritage identity intact through judicious use of the water body. Also, a balance is kept between the natural ecosystem and the cosmetic development of the surrounding open spaces. It can be duly achieved by the aforementioned methodology provided in the document, but mainly it would focus into preserving the historic ethnicity of the place by holding its character through various facts and figures as well as features. Most importantly the natural topography of the place is left intact. The second priority is given in terms of hierarchy of well connected public plazas, podiums where people from different socio-economic backgrounds irrespective of age and sex could socialize and reach towards venturing into a cordial relationship with one another. The third priority is to provide a platform for the common mass for showcasing their skills and talent through different art and craft forms which in turn would enhance their individual self and also the community as a whole through economic rise. Apart from this here some spaces are created in accordance to different age groups or class of people. The paper intends to see the river as a major multifunctional public space to attract people for different activities and re-establish the relationship of the river with the settlement. Hence, it is apprehended that the paper is not only intended to a simple riverfront conservation project but unlike others it is a place which is created for the people, by the people and of the people towards a holistic community development through a sustainable approach.

Keywords: holistic community development, public activity space, river-urban precinct, urban dead space

Procedia PDF Downloads 110

Authors: Chun-Yu Chen, Kua-Rong Wu, Yu-Cheng Chen, Perng-Jy Tsai

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Cooking fumes are known containing polycyclic aromatic hydrocarbons (PAHs) and aldehydes, and some of them have been proven carcinogenic or possibly carcinogenic to humans. Considering their chronic health effects, long-term exposure data is required for assessing cooking workers’ lifetime health risks. Previous exposure assessment studies, due to both time and cost constraints, mostly were based on the cross-sectional data. Therefore, establishing a long-term exposure data has become an important issue for conducting health risk assessment for cooking workers. An approach was proposed in this study. Here, the generation rates of both PAHs and aldehydes from a cooking process were determined by placing a sampling train exactly under the under the exhaust fan under the both the total enclosure condition and normal operating condition, respectively. Subtracting the concentration collected by the former (representing the total emitted concentration) from that of the latter (representing the hood collected concentration), the fugitive emitted concentration was determined. The above data was further converted to determine the generation rates based on the flow rates specified for the exhaust fan. The determinations of the above generation rates were conducted in a testing chamber with a selected cooking process (deep-frying chicken nuggets under 3 L peanut oil at 200°C). The sampling train installed under the exhaust fan consisted respectively an IOM inhalable sampler with a glass fiber filter for collecting particle-phase PAHs, followed by a XAD-2 tube for gas-phase PAHs. The above was also used to sample aldehydes, however, installed with a filter pre-coated with DNPH, and followed by a 2,4-DNPH-cartridge for collecting particle-phase and gas-phase aldehydes, respectively. PAHs and aldehydes samples were analyzed by GC/MS-MS (Agilent 7890B), and HPLC-UV (HITACHI L-7100), respectively. The obtained generation rates of both PAHs and aldehydes were applied to the near-field/ far-field exposure model to estimate the exposures of cooks (the estimated near-field concentration), and helpers (the estimated far-field concentration). For validating purposes, both PAHs and aldehydes samplings were conducted simultaneously using the same sampling train at both near-field and far-field sites of the testing chamber. The sampling results, together with the use of the mixed-effect model, were used to calibrate the estimated near-field/ far-field exposures. In the present study, the obtained emission rates were further converted to emission factor of both PAHs and aldehydes according to the amount of food oil consumed. Applying the long-term food oil consumption records, the emission rates for both PAHs and aldehydes were determined, and the long-term exposure databanks for cooks (the estimated near-field concentration), and helpers (the estimated far-field concentration) were then determined. Results show that the proposed approach was adequate to determine the generation rates of both PAHs and aldehydes under various fan exhaust flow rate conditions. The estimated near-field/ far-field exposures, though were significantly different from that obtained from the field, can be calibrated using the mixed effect model. Finally, the established long-term data bank could provide a useful basis for conducting long-term exposure assessments for cooking workers exposed to PAHs and aldehydes.

Keywords: aldehydes, cooking oil fumes, long-term exposure assessment, modeling, polycyclic aromatic hydrocarbons (PAHs)

Procedia PDF Downloads 115

Authors: Robert Caulk

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A generalized framework for adaptive machine learning deployments in algorithmic trading is introduced, tested, and released as open-source code. The presented software aims to test the hypothesis that recent data contains enough information to form a probabilistically favorable short-term price prediction. Further, the framework contains various adaptive machine learning techniques that are geared toward generating profit during strong trends and minimizing losses during trend changes. Results demonstrate that this adaptive machine learning approach is capable of capturing trends and generating profit. The presentation also discusses the importance of defining the parameter space associated with the dynamic training data-set and using the parameter space to identify and remove outliers from prediction data points. Meanwhile, the generalized architecture enables common users to exploit the powerful machinery while focusing on high-level feature engineering and model testing. The presentation also highlights common strengths and weaknesses associated with the presented technique and presents a broad range of well-tested starting points for feature set construction, target setting, and statistical methods for enforcing risk management and maintaining probabilistically favorable entry and exit points. The presentation also describes the end-to-end data processing tools associated with FreqAI, including automatic data fetching, data aggregation, feature engineering, safe and robust data pre-processing, outlier detection, custom machine learning and statistical tools, data post-processing, and adaptive training backtest emulation, and deployment of adaptive training in live environments. Finally, the generalized user interface is also discussed in the presentation. Feature engineering is simplified so that users can seed their feature sets with common indicator libraries (e.g. TA-lib, pandas-ta). The user also feeds data expansion parameters to fill out a large feature set for the model, which can contain as many as 10,000+ features. The presentation describes the various object-oriented programming techniques employed to make FreqAI agnostic to third-party libraries and external data sources. In other words, the back-end is constructed in such a way that users can leverage a broad range of common regression libraries (Catboost, LightGBM, Sklearn, etc) as well as common Neural Network libraries (TensorFlow, PyTorch) without worrying about the logistical complexities associated with data handling and API interactions. The presentation finishes by drawing conclusions about the most important parameters associated with a live deployment of the adaptive learning framework and provides the road map for future development in FreqAI.

Keywords: machine learning, market trend detection, open-source, adaptive learning, parameter space exploration

Procedia PDF Downloads 63

Authors: Mohamed Elmeshad

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During the mid-1990's Egypt had become obliged to implement the Economic Reform and Structural Adjustment Program that included broad economic liberalization, expansion of the private sector and a contraction the size of government spending. This coincided as well with attempts to appear more democratic and open to liberalizing public space and discourse. At the same time, economic pressures and the proliferation of social media access and activism had led to increased pressure to open a mediascape and remove it from the clutches of the government, which had monopolized print and broadcast mass media for over 4 decades by that point. However, the mechanisms that governed the privatization of mass media allowed for sustained government control, even through the prism of ostensibly privately owned newspapers and television stations. These mechanisms involve barriers to entry from a financial and security perspective, as well as operational capacities of distribution and access to means of production. The power dynamics between mass media establishments and the state were moulded during this period in a novel way. Power dynamics within media establishments had also formed under such circumstances. The changes in the country's political economy itself somehow mirrored these developments. This paper will examine these dynamics and shed light on the political economy of Egypt's newly privatized mass media in the early 2000's especially. Methodology: This study will rely on semi-structured interviews from individuals involved with these changes from the perspective of the media organizations. It also will map out the process of media privatization by looking at the administrative, operative and legislative institutions and contexts in order to attempt to draw conclusions on methods of control and the role of the state during the process of privatization. Finally, a brief discourse analysis will be necessary in order to aptly convey how these factors ultimately reflected on media output. Findings and conclusion: The development of Egyptian private, “independent” mirrored the trajectory of transitions in the country’s political economy. Liberalization of the economy meant that a growing class of business owners would explore opportunities that such new markets would offer. However the regime’s attempts to control access to certain forms of capital, especially in sectors such as the media affected the structure of print and broadcast media, as well as the institutions that would govern them. Like the process of liberalisation, much of the regime’s manoeuvring with regards to privatization of media had been haphazardly used to indirectly expand the regime and its ruling party’s ability to retain influence, while creating a believable façade of openness. In this paper, we will attempt to uncover these mechanisms and analyse our findings in ways that explain how the manifestations prevalent in the context of a privatizing media space in a transitional Egypt provide evidence of both the intentions of this transition, and the ways in which it was being held back.

Keywords: business, mass media, political economy, power, privatisation

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Authors: Vinodhini Elangovan, Jen Heng Pek

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Background: An ectopic pregnancy is defined as any pregnancy implanted outside of the endometrial cavity. Cornual pregnancy, a rare variety of ectopic pregnancies, is seen in about 2-4% of ectopic pregnancies. It develops in the interstitial portion of the fallopian tube and invades through the uterine wall. This case describes a third-trimester cornual pregnancy that resulted in a uterine rupture. Case: A 38-year old Chinese lady was brought to the Emergency Department (ED) as a standby case for hypotension. She was 30+6 weeks pregnant (Gravida 3, Parous 1). Her past obstetric history included a live birth delivered via lower segment Caesarean section due to non-reassuring fetal status in 2002 and a miscarriage in 2012. She developed generalized abdominal pain. There was no per vaginal bleeding or leaking liquor. There was also no fever, nausea, vomiting, constipation, diarrhea, or urinary symptoms. On arrival in the ED, she was pale, diaphoretic, and lethargic. She had generalized tenderness with guarding and rebound over her abdomen. Point of care ultrasound was performed and showed a large amount of intra-abdominal free fluid, and the fetal heart rate was 170 beats per minute. The point of care hemoglobin was 7.1 g/dL, and lactate was 6.8 mmol/L. The patient’s blood pressure dropped precipitously to 50/36 mmHg, and her heart rate went up to 141 beats per minute. The clinical impression was profound shock secondary to uterine rupture. Intra-operatively, there was extensive haemoperitoneum, and the fetus was seen in the abdominal cavity. The fetus was delivered immediately and handed to the neonatal team. On exploration of the uterus, the point of rupture was at the left cornual region where the placenta was attached to. Discussion: Cornual pregnancies are difficult to diagnose pre-operatively with low ultrasonographic sensitivity and hence are commonly confused with normal intrauterine pregnancies. They pose a higher risk of rupture and hemorrhage compared to other types of ectopic pregnancies. In very rare circumstances, interstitial pregnancies can result in a viable fetus. Uterine rupture resulting in hemorrhagic shock is a true obstetric emergency that can result in significant morbidity and mortality for the patient and the fetus, and early diagnosis in the emergency department is crucial. The patient in this case presented with known risk factors of multiparity, advanced maternal age, and previous lower segment cesarean section, which increased the suspicion of uterine rupture. Ultrasound assessment may be beneficial to any patient who presents with symptoms and a history of uterine surgery to assess the possibility of uterine dehiscence or rupture. Management of a patient suspected of uterine rupture should be systematic in the emergency department and follow an ABC approach. Conclusion: This case demonstrates the importance for an emergency physician to maintain the suspicion for ectopic pregnancy even at advanced gestational ages. It also highlights how even though all emergency physicians may not be qualified to do a detailed pelvic ultrasound, it is essential for them to be competent with a point of care ultrasound to make a prompt diagnosis of conditions such as uterine rupture.

Keywords: cornual ectopic , ectopic pregnancy, emergency medicine, obstetric emergencies

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Authors: Fabienne Fel, Eric Griette

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Reshoring, whether concerning back-reshoring or near-reshoring, is a quite recent phenomenon. Despite the economic and political interest of this topic, academic research questioning determinants of reshoring remains rare. Our paper aims at contributing to fill this gap. In order to better understand the reasons for reshoring, we conducted a study among 280 French firms during spring 2016, three-quarters of which sourced, or source, in China. 105 firms in the sample have reshored all or part of their Chinese production or supply in recent years, and we aimed to establish a typology of the motives that drove them to this decision. We asked our respondents about the history of their Chinese supplies, their current reshoring strategies, and their motivations. Statistical analysis was performed with SPSS 22 and SPAD 8. Our results show that change in commercial and financial terms with China is the first motive explaining the current reshoring movement from this country (it applies to 54% of our respondents). A change in corporate strategy is the second motive (30% of our respondents); the reshoring decision follows a change in companies’ strategies (upgrading, implementation of a CSR policy, or a 'lean management' strategy). The third motive (14% of our sample) is a mere correction of the initial offshoring decision, considered as a mistake (under-estimation of hidden costs, non-quality and non-responsiveness problems). Some authors emphasize that developing a short supply chain, involving geographic proximity between design and production, gives a competitive advantage to companies wishing to offer innovative products. Admittedly 40% of our respondents indicate that this motive could have played a part in their decision to reshore, but this reason was not enough for any of them and is not an intrinsic motive leading to leaving Chinese suppliers. Having questioned our respondents about the importance given to various problems leading them to reshore, we then performed a Principal Components Analysis (PCA), associated with an Ascending Hierarchical Classification (AHC), based on Ward criterion, so as to point out more specific motivations. Three main classes of companies should be distinguished: -The 'Cost Killers' (23% of the sample), which reshore their supplies from China only because of higher procurement costs and so as to find lower costs elsewhere. -The 'Realists' (50% of the sample), giving equal weight or importance to increasing procurement costs in China and to the quality of their supplies (to a large extend). Companies being part of this class tend to take advantage of this changing environment to change their procurement strategy, seeking suppliers offering better quality and responsiveness. - The 'Voluntarists' (26% of the sample), which choose to reshore their Chinese supplies regardless of higher Chinese costs, to obtain better quality and greater responsiveness. We emphasize that if the main driver for reshoring from China is indeed higher local costs, it is should not be regarded as an exclusive motivation; 77% of the companies in the sample, are also seeking, sometimes exclusively, more reactive suppliers, liable to quality, respect for the environment and intellectual property.

Keywords: China, procurement, reshoring, strategy, supplies

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Authors: Mariam Khaled, Noha Farag, Ghada Mohamed Abdel Salam, Khaled Abu-Aisha, Mohamed El-Azizi

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Gastric and colorectal cancers are among the most frequent causes of cancer-associated mortalities in Africa. They have been considered as a global public health concern, as nearly one million new cases are reported per year. IL-1β is a pro-inflammatory cytokine-produced by activated macrophages and monocytes- and a member of the IL-1 family. The inactive IL-1β precursor is cleaved and activated by caspase-1 enzyme, which itself is activated by the assembly of intracellular structures defined as NLRP3 (Nod Like receptor P3) inflammasomes. Activated IL-1β stimulates the Interleukin-1 receptor type-1 (IL-1R1), which is responsible for the initiation of a signal transduction pathway leading to cell proliferation. It has been proven that the IL-1β gene is a highly polymorphic gene in which single nucleotide polymorphisms (SNPs) may affect its expression. It has been previously reported that SNPs including base transitions between C and T at positions, -511 (C-T; dbSNP: rs16944) and -31 (C-T; dbSNP: rs1143627), from the transcriptional start site, contribute to the pathogenesis of gastric and colorectal cancers by affecting IL-1β levels. Altered production of IL-1β due to such polymorphisms is suspected to stimulate an amplified inflammatory response and promote Epithelial Mesenchymal Transition leading to malignancy. Allele frequency distribution of the IL-1β-31 and -511 SNPs, in different populations, and their correlation to the incidence of gastric and colorectal cancers, has been intriguing to researchers worldwide. The current study aims to investigate allele distributions of the IL-1β SNPs among gastric and colorectal cancers Egyptian patients. In order to achieve to that, 89 Biopsy and surgical specimens from the antrum and corpus mucosa of chronic gastritis subjects and gastric and colorectal carcinoma patients was collected for DNA extraction followed by restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR). The amplified PCR products of IL-1β-31C > T and IL-1β-511T > C were digested by incubation with the restriction endonuclease enzymes ALu1 and Ava1. Statistical analysis was carried out to determine the allele frequency distribution in the three studied groups. Also, the effect of the IL-1β -31 and -511 SNPs on nuclear factor binding was analyzed using Fluorescence Electrophoretic Mobility Shift Assay (EMSA), preceded by nuclear factor extraction from gastric and colorectal tissue samples and LPS stimulated monocytes. The results of this study showed that a significantly higher percentage of Egyptian gastric cancer patients have a homozygous CC genotype at the IL-1β-31 position and a heterozygous TC genotype at the IL-1β-511 position. Moreover, a significantly higher percentage of the colorectal cancer patients have a homozygous CC genotype at the IL-1β-31 and -511 positions as compared to the control group. In addition, the EMSA results showed that IL-1β-31C/T and IL-1β-511T/C SNPs do not affect nuclear factor binding. Results of this study suggest that the IL-1β-31 C/T and IL-1β-511 T/C may be correlated to the incidence of gastric cancer in Egyptian patients; however, similar findings couldn’t be proven in the colorectal cancer patients group for the IL-1β-511 T/C SNP. This is the first study to investigate IL-1β -31 and -511 SNPs in the Egyptian population.

Keywords: colorectal cancer, Egyptian patients, gastric cancer, interleukin-1β, single nucleotide polymorphisms

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Authors: Emily Moore, Andrew Gaukroger, Matthew Solan, Lucy Bailey, Alexandra Boxall, Andrew Carne, Chintu Gadamsetty, Charlotte Morley, Katy Western, Iwona Kolodziejczyk

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Introduction: Rupture of the Achilles tendon is common and has a long recovery period. Most cases are managed non-operatively. Foot and Ankle Surgeons advise an ultrasound scan to check the gap between the torn ends. A large gap (with the ankle in equinus) is a relative indication for surgery. The definitive decision regarding surgical versus non-operative management can only be made once an ultrasound scan is undertaken and the patient is subsequently reviewed by a Foot and Ankle surgeon. To get to this point, the patient journey involves several hospital departments. In nearby trusts, patients reattend for a scan and go to the plaster room both before and after the ultrasound for removal and re-application of the cast. At a third visit to the hospital, the surgeon and patient discuss options for definitive treatment. It may take 2-3 weeks from the initial Emergency Department visit before the final treatment decision is made. This “wasted time” is ultimately added to the recovery period for the patient. In this hospital, Achilles rupture patients are seen in a weekly multidisciplinary OneStop Heel Pain clinic. This pathway was already efficient but subject to occasional frustrating delays if a key staff member was absent. A new pathway was introduced with the goal to reduce delays to a definitive treatment plan. Method: A retrospective series of Achilles tendon ruptures managed according to the 2019 protocol was identified. Time taken from the Emergency Department to have both an ultrasound scan and specialist Foot and Ankle surgical review were calculated. 30 consecutive patients were treated with our new pathway and prospectively followed. The time taken for a scan and for specialist review were compared to the 30 consecutive cases from the 2019 (pre-COVID) cohort. The new pathway includes 1. A new contoured splint applied to the front of the injured limb held with a bandage. This can be removed and replaced (unlike a plaster cast) in the ultrasound department, removing the need for plaster room visits. 2. Urgent triage to a Foot and Ankle specialist. 3. Ultrasound scan for assessment of rupture gap and deep vein thrombosis check. 4. Early decision regarding surgery. Transfer to weight bearing in a prosthetic boot in equinuswithout waiting for the once-a-week clinic. 5. Extended oral VTE prophylaxis. Results: The time taken for a patient to have both an ultrasound scan and specialist review fell > 50%. All patients in the new pathway reached a definitive treatment decision within one week. There were no significant differences in patient demographics or rates of surgical vs non-operative treatment. The mean time from Emergency Department visit to specialist review and ultrasound scan fell from 8.7 days (old protocol) to 2.9 days (new pathway). The maximum time for this fell from 23 days (old protocol) to 6 days (new pathway). Conclusion: Teamwork and innovation have improved the experience for patients with an Achilles tendon rupture. The new pathway brings many advantages - reduced time in the Emergency Department, fewer hospital visits, less time using crutches and reduced overall recovery time.

Keywords: orthopaedics, achilles rupture, ultrasound, innovation

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Authors: Simona Dostalova, Pavel Kopel, Marketa Vaculovicova, Vojtech Adam, Rene Kizek

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Protein apoferritin seems to be a very promising structure for use as a nanocarrier. It is prepared from intracellular ferritin protein naturally found in most organisms. The role of ferritin proteins is to store and transport ferrous ions. Apoferritin is a hollow protein cage without ferrous ions that can be prepared from ferritin by reduction with thioglycolic acid or dithionite. The structure of apoferritin is composed of 24 protein subunits, creating a sphere with 12 nm in diameter. The inner cavity has a diameter of 8 nm. The drug encapsulation process is based on the response of apoferritin structure to the pH changes of surrounding solution. In low pH, apoferritin is disassembled into individual subunits and its structure is “opened”. It can then be mixed with any desired cytotoxic drug and after adjustment of pH back to neutral the subunits are reconnected again and the drug is encapsulated within the apoferritin particles. Excess drug molecules can be removed by dialysis. The receptors for apoferritin, SCARA5 and TfR1 can be found in the membrane of both healthy and cancer cells. To enhance the specific targeting of apoferritin nanocarrier, it is possible to modify its surface with targeting moieties, such as antibodies. To ensure sterically correct complex, we used a a peptide linker based on a protein G with N-terminus affinity towards Fc region of antibodies. To connect the peptide to the surface of apoferritin, the C-terminus of peptide was made of cysteine with affinity to gold. The surface of apoferritin with encapsulated doxorubicin (ApoDox) was coated either with gold nanoparticles (ApoDox-Nano) or gold (III) chloride hydrate reduced with sodium borohydride (ApoDox-HAu). The applied amount of gold in form of gold (III) chloride hydrate was 10 times higher than in the case of gold nanoparticles. However, after removal of the excess unbound ions by electrophoretic separation, the concentration of gold on the surface of apoferritin was only 6 times higher for ApoDox-HAu in comparison with ApoDox-Nano. Moreover, the reduction with sodium borohydride caused a loss of doxorubicin fluorescent properties (excitation maximum at 480 nm with emission maximum at 600 nm) and thus its biological activity. Fluorescent properties of ApoDox-Nano were similar to the unmodified ApoDox, therefore it was more suited for the intended use. To evaluate the specificity of apoferritin modified with antibodies, we used ELISA-like method with the surface of microtitration plate wells coated by the antigen (goat anti-human IgG antibodies). To these wells, we applied ApoDox without targeting antibodies and ApoDox-Nano modified with targeting antibodies (human IgG antibodies). The amount of unmodified ApoDox on antigen after incubation and subsequent rinsing with water was 5 times lower than in the case of ApoDox-Nano modified with targeting antibodies. The modification of non-gold ApoDox with antibodies caused no change in its targeting properties. It can therefore be concluded that the demonstrated procedure allows us to create nanocarrier with enhanced targeting properties, suitable for nanomedicine.

Keywords: apoferritin, doxorubicin, nanocarrier, targeting antibodies

Procedia PDF Downloads 362

Authors: Irina Deputat, Anatoly Gribanov, Yuliya Dzhos, Alexandra Nekhoroshkova, Tatyana Yemelianova, Irina Bolshevidtseva, Irina Deryabina, Yana Kereush, Larisa Startseva, Tatyana Bagretsova, Irina Ikonnikova

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In the modern world the number of elderly people increases. Preservation of functionality of an organism in the elderly becomes very important now. During aging the higher cortical functions such as feelings, perception, attention, memory, and ideation are gradual decrease. It is expressed in the rate of information processing reduction, volume of random access memory loss, ability to training and storing of new information decrease. Perspective directions in studying of aging neurophysiological parameters are brain imaging: computer electroencephalography, neuroenergy mapping of a brain, and also methods of studying of a neurodynamic brain processes. Research aim – to study features of a brain aging in elderly people by electroencephalogram (EEG) and the DC-potential level. We examined 130 people aged 55 - 74 years that did not have psychiatric disorders and chronic states in a decompensation stage. EEG was recorded with a 128-channel GES-300 system (USA). EEG recordings are collected while the participant sits at rest with their eyes closed for 3 minutes. For a quantitative assessment of EEG we used the spectral analysis. The range was analyzed on delta (0,5–3,5 Hz), a theta - (3,5–7,0 Hz), an alpha 1-(7,0–11,0 Hz) an alpha 2-(11–13,0 Hz), beta1-(13–16,5 Hz) and beta2-(16,5–20 Hz) ranges. In each frequency range spectral power was estimated. The 12-channel hardware-software diagnostic ‘Neuroenergometr-KM’ complex was applied for registration, processing and the analysis of a brain constant potentials level. The DC-potential level registered in monopolar leads. It is revealed that the EEG of elderly people differ in higher rates of spectral power in the range delta (р < 0,01) and a theta - (р < 0,05) rhythms, especially in frontal areas in aging. By results of the comparative analysis it is noted that elderly people 60-64 aged differ in higher values of spectral power alfa-2 range in the left frontal and central areas (р < 0,05) and also higher values beta-1 range in frontal and parieto-occipital areas (р < 0,05). Study of a brain constant potential level distribution revealed increase of total energy consumption on the main areas of a brain. In frontal leads we registered the lowest values of constant potential level. Perhaps it indicates decrease in an energy metabolism in this area and difficulties of executive functions. The comparative analysis of a potential difference on the main assignments testifies to unevenness of a lateralization of a brain functions at elderly people. The results of a potential difference between right and left hemispheres testify to prevalence of the left hemisphere activity. Thus, higher rates of functional activity of a cerebral cortex are peculiar to people of early advanced age (60-64 years) that points to higher reserve opportunities of central nervous system. By 70 years there are age changes of a cerebral power exchange and level of electrogenesis of a brain which reflect deterioration of a condition of homeostatic mechanisms of self-control and the program of processing of the perceptual data current flow.

Keywords: brain, DC-potential level, EEG, elderly people

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Authors: Aurora Sheehy, Caitlin Prince

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Within current orthodox medical protocols, trauma and mental health issues are deemed to reside within the realm of cognitive or psychological therapists and are marginalised in these areas, in part due to limited drugs option available, mostly manipulating neurotransmitters or sedating patients to reduce symptoms. By contrast, this research presents examples from the clinical practice of how trauma can be assessed and treated physiologically. Adverse Childhood Experiences (ACEs) are a tally of different types of abuse and neglect. It has been used as a measurable and reliable predictor of the likelihood of the development of autoimmune disease. It is a direct way to demonstrate reliably the health impact of traumatic life experiences. A second assessment tool is Allostatic Load, which refers to the cumulative effects that chronic stress has on mental and physical health. It records the decline of an individual’s physiological capacity to cope with their experience. It uses a specific grouping of serum testing and physical measures. It includes an assessment of neuroendocrine, cardiovascular, immune and metabolic systems. Allostatic load demonstrates the health impact that trauma has throughout the body. It forms part of an initial intake assessment in clinical practice and could also be used in research to evaluate treatment. Examining medicinal plants for their physiological, neurological and somatic effects through the lens of Polyvagal theory offers new opportunities for trauma treatments. In situations where Polyvagal theory recommends activities and exercises to enable parasympathetic activation, many herbs that affect Effector Memory T (TEM) cells also enact these responses. Traditional or Indigenous European herbs show the potential to support the polyvagal tone, through multiple mechanisms. As the ventral vagal nerve reaches almost every major organ, plants that have actions on these tissues can be understood via their polyvagal actions, such as monoterpenes as agents to improve respiratory vagal tone, cyanogenic glycosides to reset polyvagal tone, volatile oils rich in phenyl methyl esters improve both sympathetic and parasympathetic tone, bitters activate gut function and can strongly promote parasympathetic regulation. Auricular Acupuncture uses a system of somatotopic mapping of the auricular surface overlaid with an image of an inverted foetus with each body organ and system featured. Given that the concha of the auricle is the only place on the body where the Vagus Nerve neurons reach the surface of the skin, several investigators have evaluated non-invasive, transcutaneous electrical nerve stimulation (TENS) at auricular points. Drawn from an interdisciplinary evidence base and developed through clinical practice, these assessment and treatment tools are examples of practitioners in the field innovating out of necessity for the best outcomes for patients. This paper draws on case studies to direct future research.

Keywords: polyvagal, auricular acupuncture, trauma, herbs

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Authors: Ujene Ikem Godspower

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Acts of terror perpetrated either by state or non-state actors are considered a social ill and impugn on the collective well-being of the society. As such, there is the need for social reparations, which is meant to ensure the healing of the social wounds resulting from the atrocities committed by errant individuals under different guises. In order to ensure social closure and effectively repair the damages done by anomic behaviors, society must ensure that justice is served and those whose rights and privileges have been denied and battered are given the necessary succour they deserve. With regards to the ongoing terrorism in the Northeast, the moves to rehabilitate and reintegrate Boko Haram members have commenced with the establishment of Operation Safe Corridor,1 and a proposed bill for the establishment of “National Agency for the Education, Rehabilitation, De-radicalisation and Integration of Repentant Insurgents in Nigeria”2. All of which Nigerians have expressed mixed feelings about. Some argue that the endeavor is lacking in ethical decency and justice and totally insults human reasoning. Terrorism and counterterrorism in Nigeria have been enmeshed in gross human rights violations both by the military and the terrorists, and this raises the concern of Nigeria’s ability to fairly and justiciably implement the deradicalization and reintegration efforts. On the other hand, there is the challenge of the community dwellers that are victims of terrorism and counterterrorism and their ability to forgive and welcome back their immediate-past tormentors even with the slightest sense of injustice in the process of terrorists reintegration and rehabilitation. With such efforts implemented in other climes, the Nigeria’s case poses a unique challenge and commands keen interests by stakeholders and the international community due to the aforementioned reasons. It is therefore pertinent to assess the communities’ level of involvement in the cycle of reintegration- hence, the objective of this paper. Methodologically as a part of my larger PhD thesis, this study intends to explore the three different local governments (Michika in Adamawa, Chibok in Borno, and Yunusari in Yobe), all based on the intensity of terrorists attacks. Twenty five in-depth interview will be conducted in the study locations above featuring religious leaders, Community (traditional) leaders, Internally displaced persons, CSOs management officials, and ex-Boko Haram insurgents who have been reintegrated. The data that will be generated from field work will be analyzed using the Nvivo-12 software package, which will help to code and create themes based on the study objectives. Furthermore, the data will be content-analyzed, employing verbatim quotations where necessary. Ethically, the study will take into consideration the basic ethical principles for research of this nature. It will strictly adhere to the principle of voluntary participation, anonymity, and confidentiality.

Keywords: boko haram, reintegration, rehabilitation, terrorism, victimology

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