Search results for: follow up

Authors: Soheila Zhaeentan, Anders Von Heijne, Elisabet Hagert, André Stark, Björn Salomonsson

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Recommended treatment for traumatic rotator cuff tear (TRCT) is surgery within a few weeks after injury if the diagnosis is made early, especially if a functional impairment of the shoulder exists. This may lead to the assumption that a poor outcome then can be expected in delayed surgical treatment, when the patient is diagnosed at a later stage. The aim of this study was to investigate if a surgical repair later than three months after injury may result in successful outcomes and patient satisfaction. There is evidence in literature that good results of treatment can be expected up to three months after the injury, but little is known of later treatment with cuff repair. 73 patients (75 shoulders), 58 males/17 females, mean age 59 (range 34-­‐72), who had undergone surgical intervention for TRCT between January 1999 to December 2011 at our clinic, were included in this study. Patients were assessed by MRI investigation, clinical examination, Western Ontario Rotator Cuff index (WORC), Oxford Shoulder Score, Constant-­‐Murley Score, EQ-­‐5D and patient subjective satisfaction at follow-­‐up. The patients treated surgically within three months ( < 12 weeks) after injury (39 cases) were compared with patients treated more than three months ( ≥ 12 weeks) after injury (36 cases). WORC was used as the primary outcome measure and the other variables as secondary. A senior consultant radiologist, blinded to patient category and clinical outcome, evaluated all MRI-­‐images. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy was evaluated in all cases. The average follow-­‐up time was 56 months (range 14-­‐149) and the average time from injury to repair was 16 weeks (range 3-­‐104). No statistically significant differences were found for any of the assessed parameters or scores between the two groups. The mean WORC score was 77 (early group, range 25-­‐ 100 and late group, range 27-­‐100) for both groups (p= 0.86), Constant-­‐Murley Score (p= 0.91), Oxford Shoulder Score (p= 0.79), EQ-­‐5D index (p= 0.86). Re-­‐tear frequency was 24% for both groups, and the patients with re-­‐tear reported less satisfaction with outcome. Discussion and conclusion: This study shows that surgical repair of TRCT performed later than three months after injury may result in good functional outcomes and patient satisfaction. However, this does not motivate an intentional delay in surgery when there is an indication for surgical repair as that delay may adversely affect the possibility to perform a repair. Our results show that surgeons may safely consider surgical repair even if a delay in diagnosis has occurred. A retrospective cohort study on 75 shoulders shows good functional result after traumatic rotator cuff tear (TRCT) treated surgically up to one year after the injury.

Keywords: traumatic rotator cuff injury, time to surgery, surgical outcome, retrospective cohort study

Procedia PDF Downloads 198

Authors: Sara T. K. Li, Belinda H. J. Chung, Jeffery C. N. Yip, Janet H. Hsiao

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Music notation and text reading both involve statistical learning of music or linguistic structures. However, it remains unclear how music reading expertise influences text reading behavior. The present study examined this issue through an eye-tracking study. Chinese-English bilingual musicians and non-musicians read English sentences, Chinese sentences, musical phrases, and sentences in Tibetan, a language novel to the participants, with their eye movement recorded. Each set of stimuli consisted of two conditions in terms of structural regularity: syntactically correct and syntactically incorrect musical phrases/sentences. They then completed a sentence comprehension (for syntactically correct sentences) or a musical segment/word recognition task afterwards to test their comprehension/recognition abilities. The results showed that in reading musical phrases, as compared with non-musicians, musicians had a higher accuracy in the recognition task, and had shorter reading time, fewer fixations, and shorter fixation duration when reading syntactically correct (i.e., in diatonic key) than incorrect (i.e., in non-diatonic key/atonal) musical phrases. This result reflects their expertise in music reading. Interestingly, in reading Tibetan sentences, which was novel to both participant groups, while non-musicians did not show any behavior differences between reading syntactically correct or incorrect Tibetan sentences, musicians showed a shorter reading time and had marginally fewer fixations when reading syntactically correct sentences than syntactically incorrect ones. However, none of the musicians reported discovering any structural regularities in the Tibetan stimuli after the experiment when being asked explicitly, suggesting that they may have implicitly acquired the structural regularities in Tibetan sentences. This group difference was not observed when they read English or Chinese sentences. This result suggests that music reading expertise facilities reading texts in a novel language (i.e., Tibetan), but not in languages that the readers are already familiar with (i.e., English and Chinese). This phenomenon may be due to the similarities between reading music notations and reading texts in a novel language, as in both cases the stimuli follow particular statistical structures but do not involve semantic or lexical processing. Thus, musicians may transfer their statistical learning skills stemmed from music notation reading experience to implicitly discover structures of sentences in a novel language. This speculation is consistent with a recent finding showing that music reading expertise modulates the processing of English nonwords (i.e., words that do not follow morphological or orthographic rules) but not pseudo- or real words. These results suggest that the modulation of music reading expertise on language processing depends on the similarities in the cognitive processes involved. It also has important implications for the benefits of music education on language and cognitive development.

Keywords: eye movement behavior, eye-tracking, music reading expertise, sentence reading, structural regularity, visual processing

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Authors: Gianluca Castelnuovo, Giada Pietrabissa, Gian Mauro Manzoni, Margherita Novelli, Emanuele Maria Giusti, Roberto Cattivelli, Enrico Molinari

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Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. Such conditions include not only type 2 diabetes, but also cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. The financial direct and indirect burden (considering also the clinical resources involved and the loss of productivity) is a real challenge in many Western health-care systems. Recently the Lancet journal defined diabetes as a 21st-century challenge. In order to promote patient compliance in diabesity treatment reducing costs, evidence-based interventions to improve weight-loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. Moreover, new technologies can provide useful solutions in this multidisciplinary approach, above all in maintaining long-term compliance and adherence in order to ensure clinical efficacy. Psychological therapies with diet and exercise plans could better help patients in achieving weight loss outcomes, both inside hospitals and clinical centers and during out-patient follow-up sessions. In the management of chronic diseases clinical psychology play a key role due to the need of working on psychological conditions of patients, their families and their caregivers. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of many chronic pathologies: one of the best up-to-date application is the management of obesity with type 2 diabetes, where mHealth solutions can provide remote opportunities for enhancing weight reduction and reducing complications from clinical, organizational and economic perspectives. A stepped care mHealth-based approach is an interesting perspective in chronic care management of obesity with type 2 diabetes. One promising future direction could be treating obesity, considered as a chronic multifactorial disease, using a stepped-care approach: -mhealth or traditional based lifestyle psychoeducational and nutritional approach. -health professionals-driven multidisciplinary protocols tailored for each patient. -inpatient approach with the inclusion of drug therapies and other multidisciplinary treatments. -bariatric surgery with psychological and medical follow-up In the chronic care management of globesity mhealth solutions cannot substitute traditional approaches, but they can supplement some steps in clinical psychology and medicine both for obesity prevention and for weight loss management.

Keywords: clinical health psychology, mhealth, obesity, type 2 diabetes, stepped care, chronic care management

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Authors: Moataz Elsawy, Hala F. Naguib, Hilda A. Aziz, Eid A. Ismail, Labiba I. Hussein, Maher Z. Elsabee

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Jojoba oil-wax is extracted from the seeds of the jojoba (Simmondsia chinensis Link Schneider), a perennial shrub that grows in semi-desert areas in Egypt and in some parts of the world. The main uses of jojoba oil wax are in the cosmetics and pharmaceutical industry, but new uses could arise related to the search of new energetic crops. This paper summarizes a process to convert the jojoba oil wax to biodiesel by transesterification with ethanol and a series of aliphatic alcohols using a more economic and energy saving method in a domestic microwave. The effect of time and power of the microwave on the extent of the transesterification using ethanol and other aliphatic alcohols has been studied. The separation of the alkyl esters from the fatty alcohols rich fraction has been done in a single crystallization step at low temperature (−18°C) from low boiling point petroleum ether. Gas chromatography has been used to follow up the transesterification process. All products have been characterized by spectral analysis.

Keywords: jojoba oil, transesterification, microwave, gas chromatography jojoba esters, jojoba alcohol

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Authors: Labiba Zerari Bourafa, Djebar Mohamed Reda, Berrebah Houria, Khadri Sihem, Chiheb Linda

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The study of the effect of metal dust (pollutants) was performed on higher plant white beans Phaseolus vulgaris; the experience took place in cellular toxicology laboratory (in vitro culture). The seeds of the bean Phaseolus vulgaris are cultured in a metal contaminated dust medium (a single treatment by different increasing doses), at a rate of 10 seeds per box, for 10 days. The measurement of morpho-metric parameters is performed during the first 96 hours that follow the germination; while the dosage of the proline, the protein content and histological sections are formed on the tenth day (240 h). All morpho-metric and biochemical parameters measured were highly disturbed by metal dust; histological sections confirm this disurbance.

Keywords: conductive fabrics, metal dust, osmoticums, roots, Phaseolus vulgaris

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Authors: Dammar Bahadur Adhikari

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Mathematics teaching begins with human civilization. The rular used to choose mathematician as prime adviser in many tribes and country. Mathematics was powerful tool for understanding economial situation and strength of rular. In ancient Nepal teaching of mathematics starts with informal education provided by religious leaders there after in modern education system seems to follow the world’s educational system. The aim of this paper is to present a brief historical background of the Nepalese mathematicians up to nineteenth century and highlight the transformation in mathematical science in the line with modern world. Secondary data and formal papers and informal publications were studied to explore the present situation of education. The study concluded that there is remarcable change in quality of education and there are sufficient human powers in the mathematical sciences in Nepal.

Keywords: human development, mathematics, Nepal, science, traditional

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Authors: Priyashri Kamlesh Sridhar, Suranga Nanayakkara

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Current frameworks in assessment follow lesson delivery and rely heavily on test performance or teacher’s observations. This, however, neglects the underlying cognitive load during the learning process. Identifying the pivotal points when the load occurs helps design effective pedagogies and tools that respond to learners’ cognitive state. There has been limited research on quantifying cognitive load in preschoolers, real-time. In this study, we recorded electrodermal activity and heart rate variability (HRV) from 10 kindergarteners performing executive function tasks and Johnson Woodcock test of cognitive abilities. Preliminary findings suggest that there are indeed sensitive task-dependent markers in skin conductance (number of SCRs and average amplitude of SCRs) and HRV (mean heart rate and low frequency component) captured during the learning process.

Keywords: early childhood, learning, methodologies, pedagogies

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Authors: Milena Trojanowska

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Disability is a phenomenon for which meanings and definitions have evolved over the decades. This became the trigger to start a project to answer the question of what disability constitutes in the course of an incurable chronic disease. The chosen research group are people living with multiple sclerosis.The contextual phase of the research was participant observation at the Polish Multiple Sclerosis Society, the largest NGO in Poland supporting people living with MS and their relatives. The research techniques used in the project are (in order of implementation): group interviews with people living with MS and their relatives, narrative interviews, asynchronous technique, participant observation during events organised for people living with MS and their relatives.The researcher is currently conducting follow-up interviews, as inaccuracies in the respondents' narratives were identified during the data analysis. Interviews and supplementary research techniques were used over the four years of the research, and the researcher also benefited from experience gained from 12 years of working with NGOs (diaries, notes). The research was carried out in Poland with the participation of people living in this country only.The research has been based on grounded theory methodology in a constructivist perspectivedeveloped by Kathy Charmaz. The goal was to follow the idea that research must be reliable, original, and useful. The aim was to construct an interpretive theory that assumes temporality and the processualityof social life. TheAtlas.ti software was used to collect research material and analyse it. It is a program from the CAQDAS(Computer-Assisted Qualitative Data Analysis Software) group.Several key factors influencing the construction of a disability identity by people living with multiple sclerosis was identified:-course of interaction with significant relatives,- the expectation of identification with disability (expressed by close relatives),- economic profitability (pension, allowances),- institutional advantages (e.g. parking card),- independence and autonomy (not equated with physical condition, but access to adapted infrastructure and resources to support daily functioning),- the way a person with MS construes the meaning of disability,- physical and mental state,- medical diagnosis of illness.In addition, it has been shown that making an assumption about the experience of disability in the course of MS is a form of cognitive reductionism leading to further phenomenon such as: the expectation of the person with MS to construct a social identity as a person with a disability (e.g. giving up work), the occurrence of institutional inequalities. It can also be a determinant of the choice of a life strategy that limits social and individual functioning, even if this necessity is not influenced by the person's physical or psychological condition.The results of the research are important for the development of knowledge about the phenomenon of disability. It indicates the contextuality and complexity of the disability phenomenon, which in the light of the research is a set of different phenomenon of heterogeneous nature and multifaceted causality. This knowledge can also be useful for institutions and organisations in the non-governmental sector supporting people with disabilities and people living with multiple sclerosis.

Keywords: disability, multiple sclerosis, grounded theory, poland

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Authors: Daniel Dahis, Haim Azhari

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Noninvasive image-guided intracranial treatments using high intensity focused ultrasound (HIFU) are on the course of translation into clinical applications. They include, among others, tumor ablation, hyperthermia, and blood-brain-barrier (BBB) penetration. Since many of these procedures are associated with local temperature elevation, thermal monitoring is essential. MRI constitutes an imaging method with high spatial resolution and thermal mapping capacity. It is the currently leading modality for temperature guidance, commonly under the name MRgHIFU (magnetic-resonance guided HIFU). Nevertheless, MRI is a very expensive non-portable modality which jeopardizes its accessibility. Ultrasonic thermal monitoring, on the other hand, could provide a modular, cost-effective alternative with higher temporal resolution and accessibility. In order to assess the feasibility of ultrasonic brain thermal monitoring, this study investigated the usage of brain tissue attenuation coefficient (AC) temporal changes as potential estimators of thermal changes. Newton's law of cooling describes a temporal exponential decay behavior for the temperature of a heated object immersed in a relatively cold surrounding. Similarly, in the case of cerebral HIFU treatments, the temperature in the region of interest, i.e., focal zone, is suggested to follow the same law. Thus, it was hypothesized that the AC of the irradiated tissue may follow a temporal exponential behavior during cool down regime. Three ex-vivo bovine brain tissue specimens were inserted into plastic containers along with four thermocouple probes in each sample. The containers were placed inside a specially built ultrasonic tomograph and scanned at room temperature. The corresponding pixel-averaged AC was acquired for each specimen and used as a reference. Subsequently, the containers were placed in a beaker containing hot water and gradually heated to about 45ᵒC. They were then repeatedly rescanned during cool down using ultrasonic through-transmission raster trajectory until reaching about 30ᵒC. From the obtained images, the normalized AC and its temporal derivative as a function of temperature and time were registered. The results have demonstrated high correlation (R² > 0.92) between both the brain AC and its temporal derivative to temperature. This indicates the validity of the hypothesis and the possibility of obtaining brain tissue temperature estimation from the temporal AC thermal changes. It is important to note that each brain yielded different AC values and slopes. This implies that a calibration step is required for each specimen. Thus, for a practical acoustic monitoring of the brain, two steps are suggested. The first step consists of simply measuring the AC at normal body temperature. The second step entails measuring the AC after small temperature elevation. In face of the urging need for a more accessible thermal monitoring technique for brain treatments, the proposed methodology enables a cost-effective high temporal resolution acoustical temperature estimation during HIFU treatments.

Keywords: attenuation coefficient, brain, HIFU, image-guidance, temperature

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Authors: Talib M. Albayati, Omar S. Mahdy, Ghanim M. Alwan

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This work is aimed to prepare magnetic nanoporous material Fe/MCM-41 and study its Physical characterization in order to enhance the magnetic properties for study the operating conditions on separation efficiency of methyl orange (MO) from wastewater by adsorption process. The experimental results are analysed to select the best operating conditions for different studied parameters which were obtained for both adsorbents mesoporous material samples MCM-41 and magnetic Fe/MCM-41 as follow: constant temperature (20 ºC), pH: (2) adsorbent dosage (0.03 gm), contact time (10 minute) and concentrations (30 mg/L). The results are demonstrated that the adsorption processes can be well fitted by the Langmuir isotherm model for pure MCM-41 with a higher correlation coefficient (0.999) and fitted by the freundlich isotherm model for magnetic Fe/MCM-41 with a higher correlation coefficient of (0.994).

Keywords: adsorption, nanoporous materials, mcm-41, magnetic material, wastewater, orange, wastewater

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Authors: El H. Bouziani, H. A. Reguieg Yssaad

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The phytotoxicity of heavy metals can be expressed on roots and visible part of plants and is characterized by molecular and metabolic answers at various levels of organization of the whole plant. The present study was undertaken on two varieties of broad bean Vicia faba (Sidi Aïch and Super Aguadulce). The device was mounted on a substrate prepared by mixing sand, soil and compost, the substrate was artificially contaminated with three doses of lead nitrate [Pb(NO3)2] 0, 500 and 1000 ppm. Our objective is to follow the behavior of plant opposite the stress by evaluating the physiological parameters. The results reveal a reduction in the parameters of the productivity (chlorophyll and proteins production) with an increase in the osmoregulators (soluble sugars and proline).These results show that the production of broad bean is strongly modified by the disturbance of its internal physiology under lead exposure.

Keywords: broad bean, lead, stress, physiological parameters, phytotoxicity

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Authors: Anthony Barker, Roland Jiang

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Dupuytren’s contractures are a debilitating condition affecting the palmar fascia of the hand reducing its function. This case series looks at the minimally-invasive technique of Xiaflex injections and the outcome in a public health setting. 15 patients undertook collagenase injection (Xiaflex, C. histolyticum) injection over the period from September 2015 to May 2017 at Fairfield Hospital, NSW. Their reported outcome post injection and in follow-up was recorded as well as their satisfaction and likelihood to request the procedure in the future. Other treatment modalities include percutaneous needle aponeurotomy, limited palmar fasciotomy, and palmar fasciectomy. A literature review of cost-effectiveness was performed to compare Xiaflex suitability for waitlist reduction in a public setting given average waiting times in the public setting extend past 365 days.

Keywords: Dupuytrens Disease, xiaflex, collagenase, plastic surgery

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Authors: Michael Kvopka, Ezekiel Kingston

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A 61-year-old man with no significant past medical history presented to a quaternary ophthalmic referral center with acute right-sided medial canthal pain, periorbital edema, and erythema despite oral antibiotic therapy. CT imaging confirmed the presence of right preseptal cellulitis and lacrimal sac aspiration identified multi-resistant Enterobacter cloacae. A diagnosis of acute right-sided dacryocystitis with preseptal cellulitis was made. He was successfully treated with broadening of antibiotic therapy to intravenous meropenem. The symptomatic resolution was noted on follow-up without evidence of disease recurrence. To the Authors’ best knowledge, this is the first reported case of multi-resistant E. cloacae dacryocystitis and preseptal cellulitis. The management of this patient required a multi-disciplinary approach, so the Authors believe this report is relevant to general ophthalmologists and oculoplastic sub-specialists.

Keywords: enterobacter, dacryocystitis, preseptal cellulitis, antibiotic resistance

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Authors: Ron Bishop, Jim Mitchell, Talitha Best

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The increase in air travel worldwide has resulted in a pilot shortage. To increase student pilot capacity and lower costs, flight schools have increased the use of recreational aircraft (RA) with technological advanced cockpits in flight schools. The impact of RA based training compared to general aviation (GA) aircraft training on student mental workload is not well understood. This research investigated student pilot (N = 17) awareness of mental workload between technologically advanced cockpit equipped RA training with analogue gauge equipped GA training. The results showed a significantly higher rating of mental workload across subscales of mental and physical demand on the NASA-TLX in recreational aviation aircraft training compared to GA aircraft. Similarly, thematic content analysis of follow-up questions identified that mental workload of the student pilots flying the RA was perceived to be more than the GA aircraft.

Keywords: mental workload, recreational aircraft, student pilot, training

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Authors: Tatsanawalai Utarasakul, Ch. Hirannukhrao

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The purpose of this research was to investigate the appropriate guidelines for promoting manuscript publication of the academic staff in Faculty of Science and Technology, Suan Sunandha Rajabhat University (SciSSRU). Data were collected from 88 academic staff of SciSSRU. The qualitative approach and knowledge management were used to determine the guidelines for promoting manuscript publication. In addition, TUNA Model was applied in order to follow the process of knowledge management. Simplified techniques were presented and shared with academic staff in the Knowledge Management exhibition, brochure, and websites. The result of this study revealed that, the comparison of number of manuscript publication of academic staff between academic year 2012 and 2013 is rapidly increasing for 60 percentages.

Keywords: knowledge management, articles, publication, academic staff

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Authors: Abdulwhab Alotaibi, Abdullah Alzahrani, Ziyad Bokhari, Abdulelah Alghamdi

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First described in 1975 by Dr. Miller, Medical dressings are uncommon but possible cause of hand digital ischemia due the tourniquet-like effect. The incident of this complication has been reported across wide range of age-groups, yet it seems like that the pediatric population are specifically vulnerable. Multiple dressing types were reported to have caused ischemic injury, such as elastic wrap, tubular gauze, and self-adherent dressings. We present a case of medical dressing induced digital ischemia in patient with Congenital insensitivity to pain and anhidrosis (CIPA), which further challenge the discovery of the condition. An 8-year-old girl known case of CIPA. Brought by her mother to the ER after nail bed injury, which she managed by application of elastic wrap that was left for 24 hours. When the mother found out she immediately removed the elastic band, and noticed the fingertip was black and cold with tense bullae. The color then changed later when she arrived to the ER to dark purple with bluish discoloration on the tip. On examination there was well demarcated tense bullae on the distal right fifth finger. Neurovascular intact, pulse oximetry on distal digit 100%, capillary refill time was delayed. She was seen under Plastic surgery and conservative management recommended, and patient was discharged with safety netting. Two days later the patient came as follow-up visit at which her condition demonstrated significant improvement, the bullae has since ruptured leaving behind sloughed skin, capillary refill and pulse oximetry were both within normal limits, sensory function couldn’t be assessed but her motor function and ROM were normal, topical bacitracin and bandage dressings were applied for the eroded skin. Patient was scheduled for a follow-up in 2 weeks. Preventatively it’s advisable to avoid the commonly implicated dressings such as elastic, tubular gauze or self-adherent wraps in hand or digital injuries when possible, but in cases where the use of these dressings is of necessity the appropriate precautions must be taken, Dr. Makarewich proposed the following 5 measures to help minimize the incidence of the injury: 1-Unwrapping 12 inches of the dressing before rolling the injured finger. 2-Wrapping from distal to proximal with minimal tension to avoid vascular embarrassment. 3-The use of 5-25 inch to overlap the entire wrap. 4-Maintaining light pressure over the wrap to allow adherence of the dressing. 5-Minimization of the number of layers used to wrap the affected digit. Also assessing the capillary refill after the application can help in determining the patency of the supplying blood vessels. It’s also important to selectively determine if the patient is a candidate for conservative management, as tailored approach can help in maximizing the positive outcomes for our patients.

Keywords: congenital insensitivity to pain, digital ischemia, medical dressing, conservative management

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Authors: Felipe H. Sanders, Bryan A. Edwards, Matthew Fusco, Rod J. Oskouian, R. Shane Tubbs

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Introduction: Sinus pericranii is a rare vascular malformation that connects the intracranial dural sinuses to the extracranial venous drainage system and is caused by either trauma or congenital defects. Although the majority of these vascular structures are due to trauma, some are congenital. Case report: Herein, we report a 5-month-old patient with a very large and fluctuating subcutaneous mass over the occiput and the diagnosis of Crouzon’s syndrome. The child presented with a large midline mass that on imaging, connected to the underlying torcular and was diagnosed as a sinus pericranii. At long-term follow up and without operative intervention, the sinus pericranii resolved. This uncommon relationship is reviewed. Conclusion: Premature closure of posterior fossa sutures as part of Crouzon syndrome can present with large sinus pericranii. Such subcutaneous swellings might resolve spontaneously.

Keywords: congenital, craniosynostosis, pediatric, vascular malformation

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Authors: Priyanka Manghani, Manthan Patel, Rahul Peddawad

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Cervical Cancer is a major public health hurdle in the area of women’s health. The most common cause of Cervical Cancer is the Human Papilloma Virus (HPV). Human papilloma virus has various genotypes, with HPV 16 and HPV 18 being the major etiological factor causing carcinoma of the Cervix. Early screening and detection by Papanicolaou Smears (PAP) is an effective method for identifying premalignant and malignant lesions. In case of existing pre- malignant lesions /cervical dysplasia’s found with HPV 16 or 18, appropriate follow up can be done to prevent it from developing into a neoplasm. Aims and Objectives: Primary Aim; To study various abnormal cervical cytology reports as detected by Pap Smear Tests, using the Bethesda System in women at a Tertiary Care Hospital. Secondary Aim; To discuss the importance of Pap smear in Cervical Cancer Screening Program. Materials and Methods: Our study is a prospective study, based on 101 women who attended the Out-patient department of Obstetrics and Gynecology at a tertiary care hospital in age group 20-40 years with chief complaints of white/foul vaginal discharge, post-coital Bleeding, low back pain, irregular menstruation, etc. 60 women, who were tested, of the total no of women, were commercial sex workers, thus being a high-risk group for HPV infection. All women underwent conventional cytology. For all the abnormal smears, further cervical biopsies were done, and the final diagnosis was done on the basis of histopathology (gold standard). Results: In all these patients, 16 patients presented with normal smears out of which 2 belonged to the category of commercial sex workers (3.33%) and 14 being from the normal/control group (34.15%). 44 women presented with inflammatory smears out of which 30 were commercial sex workers (50%) and 14 from the control Group (34.15%). A total of 11 women presented with infectious etiology with 6 being commercial sex workers (10%) and 5 (12.2%) being in the control group. A total of 8 patients presented with low-grade squamous intra epithelial lesion (LSIL) with 7 (11.7%) being commercial sex workers and 1(2.44%) patient belonging to the control group. A Total of 7 patients presented with high-grade squamous intraepithelial lesion (HSIL) with 6 (10%) being commercial sex workers and 1 (2.44%) belonging to the control group. 9 patients in total presented with atypical squamous cells of undetermined significance (ASCUS) with 6(10%) being commercial sex workers and 3 (7.32%) belonging to the control group. Squamous cell carcinoma(SCC) presence was found only in 1(1.7%) commercial sex worker. Conclusion – We conclude that HSIL, LSIL, SCC and sexually related infections are comparatively more common in vulnerable groups such as sex workers due to a variety of factors such as multiple sexual partners and poor genital hygiene. Early screening and follow up interventions are highly needed for them along with Health education for risk factors and to emphasize on the importance of Pap smear screening.

Keywords: cervical cancer, papanicolaou (pap) smear, bethesda system, neoplasm

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Authors: Fahad Ahmed Qureshi

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Is it essential for a Muslim businessperson and employees of Islamic financial institutions not only in Islamic Banks to perform his/her actions ethically in a universally, competing habitat? The answer is an emphatic NO! in Islam, ethics conduct all departments of life. The orders for eternal success or falah in Islam are the same for all Muslims–whether in managing their business activities or in carrying out their routine affairs. Without designating any circumstantial ambience, Allah specify people who achieve success as those who are “inviting to all that is good (Khayr), enjoining what is right (Ma'ruf) and forbidding what is wrong (Munkar).” Within a business context, however, what sole axioms of regimen should a company follow? What is a Muslim businessperson’s encumbrance to internal and external stakeholders? Although an organization’s top executives may display sterling ethical behavior, how can middle- and lower-level managers be enthusiastic to perform in a correspondingly ethical manner? What are some protocols that would clinch persistent ethical behavior in a Muslim business?

Keywords: business, ethics, finance, Islam

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Authors: D. Muley, H. S. Al-Mandhari

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This paper evaluates the performance of a multi-lane four-legged modern roundabout operating in Muscat using SIDRA model. The performance measures include Degree of Saturation (DOS), average delay, and queue lengths. The geometric and traffic data were used for model preparation. Gap acceptance parameters, critical gap, and follow-up headway were used for calibration of SIDRA model. The results from the analysis showed that currently the roundabout is experiencing delays up to 610 seconds with DOS 1.67 during peak hour. Further, sensitivity analysis for general and roundabout parameters was performed, amongst lane width, cruise speed, inscribed diameter, entry radius, and entry angle showed that inscribed diameter is the most crucial factor affecting delay and DOS. Upgradation of the roundabout to the fully signalized junction was found as the suitable solution which will serve for future years with LOS C for design year having DOS of 0.9 with average control delay of 51.9 seconds per vehicle.

Keywords: performance analysis, roundabout, sensitivity analysis, SIDRA

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Authors: A. W. Zularisam, Lakhveer Singh, Mimi Sakinah Abdul Munaim

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In this study, the optimization of hydrogen production using polyethylene glycol (PEG) immobilized sludge was investigated in batch tests. Palm oil mill effluent (POME) is used as a substrate that can act as a carbon source. Experiment focus on the effect of some important affecting factors on fermentative hydrogen production. Results showed that immobilized sludge demonstrated the maximum hydrogen production rate of 340 mL/L-POME/h under follow optimal condition: amount of biomass 10 mg VSS/ g bead, PEG concentration 10%, and cell age 24 h or 40 h. More importantly, immobilized sludge not only enhanced hydrogen production but can also tolerate the harsh environment and produce hydrogen at the wide ranges of pH. The present results indicate the potential of PEG-immobilized sludge for large-scale operations as well; these factors play an important role in stable and continuous hydrogen production.

Keywords: bioydrogen, immobilization, polyethylene glycol, palm oil mill effluent, dark fermentation

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Authors: Ritesh Verma, Manisha Rathi, Chand Singh Dhull, Sumit Sachdeva, Jitender Phogat

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Temporal trabeculectomy with the Ologen implant was done in a 66-year-old lady with uveitic glaucoma. Serial IOP measurement was done to assess the efficacy of ologen implant in uveitic glaucoma. The patient had an IOP of 4mmhg day 1 postoperatively and Ologen implant was in place with a well-formed bleb. On follow up patient had an IOP of 14mmhg and unaided visual acuity of 6/12 on day 10 postoperatively. After 12 weeks of Trabeculectomy with Ologen implant, the IOP of the patient was 14 mmHg, the vision was 6/6 with -1.25 DS and -1.25 DC at 90 degrees. Trabeculectomy performed in patients with uveitic glaucoma has a higher chance of failure due to increased inflammation and fibrosis. Trabeculectomy with ologen implant done in a patient of uveitic glaucoma provides excellent postoperative results and the patient has a well-controlled IOP even after 56 weeks of surgery and a best corrected visual acuity of 6/6. Trabeculectomy with the ologen implant is superior to other surgeries in cases of secondary glaucoma with increased inflammation.

Keywords: glaucoma surgery, ologen implant, temporal trabeculectomy, uveitic glaucoma

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Authors: Fazeera Ujin, Kamran Shavarebi Ali, Zarina Yasmin Hanur Harith

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This research paper reports on the feasibility and viability of eggshells ash and its effects on the water content and setting time of cement. An experiment was carried out to determine the quantity of water required in order to follow standard cement paste of normal consistency in accordance with MS EN 196-3:2007. The eggshells ash passing the 90µm sieve was used in the investigation. Eggshells ash with percentage of 0%, 0.1%, 0.5%, 1.0%, 1.5% and 2.0% were constituted to replace the cement. Chemical properties of both eggshells ash and cement are compared. From the results obtained, both eggshells ash and cement have the same chemical composition and primary composition which is the calcium compounds. Results from the setting time show that by adding the eggshells ash to the cement, the setting time of the cement decreases. In short, the higher amount of eggshells ash, the faster the rate of setting and apply to all percentage of eggshells ash that were used in this investigation. Both initial and final setting times fulfill the setting time requirements by Malaysian Standard. Hence, it is suggested that eggshells ash can be used as an admixture in concrete mix.

Keywords: construction materials, eggshells ash, solid waste, setting time

Procedia PDF Downloads 366

Authors: Mohammad Ashraf

Abstract:

This research links the use of Building Information Modeling technology in constructions and infrastructure projects, starting from the moment when considering the establishment of a project to demolishing or renovating it, going through the design work, planning, procurement and implementation. BIM Software's which used are Revit, Navisworks and Asta Project in the case study for the Atletico Madrid Stadium project (Wanda Stadium). Also, the project improves through various phases of construction (planning - implementation - management). Besides, the level of the details managed within this project advances gradually. In addition, the construction process problems become about 30 % less than before, resulting from high coordination between designing, implementation and follow through that is done by the project management office (PMO). The current disposition in the industry is to tightly manage the detail contained within the planning and coordination phases of construction, but we miss the opportunity to manage that data as it matures and grows into the execution and commissioning phases.

Keywords: construction management, BIM technology, planning, design, procurements, critical path method

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Authors: Essam Abdelhamid Hegazy

Abstract:

This paper aims to read Margaret Atwood's The Penelopiad (2005) via a revisionist and deconstructive approach. This novel is a postmodernist exploration of the grand-narrative myth The Odyssey (800 BC) by Homer, who portrayed the heroic warrior and the faithful wife as the epitome of perfect male and female models _examples whom all must follow and mimic. In Atwood's narrative, the same two hero models are the two great tricksters who are willing to perform any sort of obnoxious act for achieving their goals. This research tries to examine how Atwood tried to synthesize the change in character’s narratives leading to the humanization of the perfect hero and the ideal wife. The researcher has used a multidisciplinary approach where the feminist, revisionist and deconstructive theories were implemented to identify and find out the new interpretations of the myths that center the experiences and perspectives of women. Research findings are that revisionist approach was applied through giving an opportunity to the victimized and the voiceless to speak out and retaliate against their prosecutions.

Keywords: margret atwood, patriarchal, penelopiad, revisionism

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Authors: Lisa Listiana

Abstract:

ASEAN leader agreed to accelerate ASEAN Economic Community (AEC) implementation by 2015. The AEC Blueprint has set up obligations for its members to follow which include the establishment of (a) free trade in goods, according to ASEAN Free Trade Area: AFTA, (b) free trade in services, according to ASEAN Framework Agreement on Services: AFAS, (c) free trade in investment, according to ASEAN Comprehensive Investment Agreement: ACIA, (d) free capital flow, and (e) free flow of skilled labors. Consequently, these obligations bring both challenges and opportunities for its members. As accountant is included in the coverage of 8 skilled labors, the readiness of accounting profession to embrace AEC 2015 is pivotal. If Indonesian accountants do not accelerate their learning effort, the knowledge gap between Indonesian accountants and their international colleagues will only be worsened. This paper aims to analyze the current progress of AEC preparation and its challenges and opportunities for Indonesian accountants, and also to propose recommendation as necessary.

Keywords: AEC, ASEAN, readiness, Indonesian accountants

Procedia PDF Downloads 416

Authors: Tiron-Tudor Adriana, Farcas Teodora Viorica, Ciolomic Ioana Andreea

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The issue of human capital mobility inside Europe is still an open one. Even though there were created some tools in order to better move from one country to another to work and study the number of the people doing this is very low because of various factors presented in this paper. The "rethinking educational" agenda of the European Commission has open the floor for new projects which can create steps towards a European language for skills and competences, qualifications. One of these projects is the Partnership for Exchange of experience in Student on-the-job Training. As part of this project, we are interested to see the situation of the human capital inside EU and the elements that were created until now to support this mobility. Also, the main objective of the project is to make a comparison between the four countries involved in PEST project (Romania, Hungary, Finland, and Estonia), at the education and internship level. The results are helpful for the follow of the project, for identifying where changes can be done and need to be done.

Keywords: ECVET, human capital mobility, partnership exchange, students on the job mobility, vocational education and training

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Authors: John Knight, Fuchun Li, Yan Xu

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Based on a new method of the nonparametric estimator of the drift function, we propose a consistent test for the parametric specification of the drift function in the short rate diffusion process using observations from a panel of yields. The test statistic is shown to follow an asymptotic normal distribution under the null hypothesis that the parametric drift function is correctly specified, and converges to infinity under the alternative. Taking the daily 7-day European rates as a proxy of the short rate, we use our test to examine whether the drift of the short rate diffusion process is linear or nonlinear, which is an unresolved important issue in the short rate modeling literature. The testing results indicate that none of the drift functions in this literature adequately captures the dynamics of the drift, but nonlinear specification performs better than the linear specification.

Keywords: diffusion process, nonparametric estimation, derivative security price, drift function and volatility function

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Authors: Charlotte Dreger, Erik Bollaert

Abstract:

This paper presents two environmentally-friendly coastal structures realized on the Lake of Neuchâtel. Both structures reflect current environmental issues of concern on the lake and have been strongly affected by extreme meteorological conditions between their period of design and their actual operational period. The Lake of Neuchatel is one of the biggest Swiss lakes and measures around 38 km in length and 8.2 km in width, for a maximum water depth of 152 m. Its particular topographical alignment, situated in between the Swiss Plateau and the Jura mountains, combines strong winds and large fetch values, resulting in significant wave heights during storm events at both north-east and south-west lake extremities. In addition, due to flooding concerns, historically, lake levels have been lowered by several meters during the Jura correction works in the 19th and 20th century. Hence, during storm events, continuous erosion of the vulnerable molasse shorelines and sand banks generate frequent and abundant littoral transport from the center of the lake to its extremities. This phenomenon does not only cause disturbances of the ecosystem, but also generates numerous problems at natural or man-made infrastructures located along the shorelines, such as reed plants, harbor entrances, canals, etc. A first example is provided at the southwestern extremity, near the city of Yverdon, where an ensemble of 11 small islands, the Iles des Vernes, have been artificially created in view of enhancing biological conditions and food availability for bird species during their migration process, replacing at the same time two larger islands that were affected by lack of morphodynamics and general vegetalization of their surfaces. The article will present the concept and dimensioning of these islands based on 2D numerical modelling, as well as the realization and follow-up campaigns. In particular, the influence of several major storm events that occurred immediately after the works will be pointed out. Second, a sediment retention dike is discussed at the northeastern extremity, at the entrance of the Canal de la Broye into the lake. This canal is heavily used for navigation and suffers from frequent and significant sedimentation at its outlet. The new coastal structure has been designed to minimize sediment deposits around the exutory of the canal into the lake, by retaining the littoral transport during storm events. The article will describe the basic assumptions used to design the dike, as well as the construction works and follow-up campaigns. Especially the huge influence of changing meteorological conditions on the littoral transport of the Lake of Neuchatel since project design ten years ago will be pointed out. Not only the intensity and frequency of storm events are increasing, but also the main wind directions alter, affecting in this way the efficiency of the coastal structure in retaining the sediments.

Keywords: meteorological evolution, sediment transport, lake of Neuchatel, numerical modelling, environmental measures

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Authors: Sudhina H. K, Ravi M. Yadahalli, N. M. Shetti

Abstract:

Reconfigurable antennas represent a recent innovation in antenna design that changes from classical fixed-form, Fixed function antennas to modifiable structures that can be adapted to fit the requirements of a time varying system. The ability to control the operating band of an antenna system can have many useful applications. Systems that operate in an acquire-and-track configuration would see a benefit from active bandwidth control. In such systems a wide band search mode is first employed to find a desired signal, Then a narrow band track mode is used to follow only that signal. Utilizing active antenna bandwidth control, A single antenna would function for both the wide band and narrow band configurations providing the rejection of unwanted signals with the antenna hardware. This ability to move a portion of the RF filtering out of the receiver and onto the antenna itself will also aid in reducing the complexity of the often expensive RF processing subsystems.

Keywords: designing methods, mems, stack, reconfigurable elements

Procedia PDF Downloads 248