Search results for: level of sedation

Authors: Benjamin Ankomah-Asare, Richard Adade

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Sea level rise (SLR) poses a significant threat to coastal communities globally. Ghana has over the years implemented protective measures such as the construction of groynes and revetment to serve as barriers to sea waves in major cities and towns to prevent sea erosion and flooding. For vulnerable rural coastal communities, the planned retreat is often proposed; however, relocation costs are often underestimated as losses of future social and cultural value are not always adequately taken into account. Through a mixed-methods approach combining qualitative interviews, surveys, and spatial analysis, the study examined the experiences of coastal rural communities in Ghana and assess the effectiveness of relocation strategies in addressing the socio-economic and environmental challenges posed by sea level rise. The study revealed the devastating consequences of sea level rise on these communities, including increased flooding, erosion, and saltwater intrusion into freshwater sources. Moreover, it highlights the adaptive capacities within these communities and how factors such as infrastructure, economic activities, cultural heritage, and governance structures shape their resilience in the face of environmental change. While relocation can be an effective strategy in reducing the risks associated with sea level rise, the study recommends that proper implementation of this adaptation strategy can be achieved when coupled with community-led planning, participatory decision-making, and targeted support for vulnerable groups.

Keywords: sea level rise, relocation, socio-ecological impacts, rural communities

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Authors: Intan Maisarah Abd Rahim, Herlina Abdul Rahim, Rashidah Ghazali

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Diabetes is a medical condition that can lead to various diseases such as stroke, heart disease, blindness and obesity. In clinical practice, the concern of the diabetic patients towards the blood glucose examination is rather alarming as some of the individual describing it as something painful with pinprick and pinch. As for some patient with high level of glucose level, pricking the fingers multiple times a day with the conventional glucose meter for close monitoring can be tiresome, time consuming and painful. With these concerns, several non-invasive techniques were used by researchers in measuring the glucose level in blood, including ultrasonic sensor implementation, multisensory systems, absorbance of transmittance, bio-impedance, voltage intensity, and thermography. This paper is discussing the application of the near-infrared (NIR) spectroscopy as a non-invasive method in measuring the glucose level and the implementation of the linear system identification model in predicting the output data for the NIR measurement. In this study, the wavelengths considered are at the 1450 nm and 1950 nm. Both of these wavelengths showed the most reliable information on the glucose presence in blood. Then, the linear Autoregressive Moving Average Exogenous model (ARMAX) model with both un-regularized and regularized methods was implemented in predicting the output result for the NIR measurement in order to investigate the practicality of the linear system in this study. However, the result showed only 50.11% accuracy obtained from the system which is far from the satisfying results that should be obtained.

Keywords: diabetes, glucose level, linear, near-infrared, non-invasive, prediction system

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Authors: Taiyo Matsumura, Kuninori Takahashi, Takashi Ono

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The purpose of this research is to improve the convenience of waiting for trains at level crossings and stations and to prevent accidents resulting from forcible entry into level crossings, by providing level crossing users and passengers with information that tells them when the next train will pass through or arrive. For this paper, we proposed methods for estimating operation by means of an average value method, variable response smoothing method, and exponential smoothing method, on the basis of open data, which has low accuracy, but for which performance schedules are distributed in real time. We then examined the accuracy of the estimations. The results showed that the application of an exponential smoothing method is valid.

Keywords: exponential smoothing method, open data, operation estimation, train schedule

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Authors: Motalleb Byzedi, Seyedeh Chaman Naderi Korvandan

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Regarding annual statistics of groundwater level resources about current piezometers at Qorveh plains, both ARMA & PARMA modeling methods were applied in this study by the using of SAMS software. Upon performing required tests, a model was used with minimum amount of Akaike information criteria and suitable model was selected for piezometers. Then it was possible to make necessary estimations by using these models for future fluctuations in each piezometer. According to the results, ARMA model had more facilities for modeling of aquifer. Also it was cleared that eastern parts of aquifer had more failures than other parts. Therefore it is necessary to prohibit critical parts along with more supervision on taking rates of wells.

Keywords: qorveh plain, groundwater level, ARMA, PARMA

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Authors: Siri-Orn Champatong

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The objectives of this research were to study the attitude of service marketing mix that affected the decision making behavior to use fitness service in case of the fitness in Thailand. This study employed by survey research and questionnaire was used to collect the data from 400 of consumers who have used the service and interested in using the service in the future. The descriptive statistics and multiple regression analysis were used to analyze data. The results revealed that the attitude toward overall marketing mix was at moderate level. For particulars, attitude toward product and service aspects were at good level, however, attitude toward price, place, promotion, people, physical evidence and service quality aspects were at moderate level. The hypothesis testing results showed that attitude toward each aspect affected word of mouth, however, attitude toward product and service, place, promotion, people and physical evidence affected tendency to use fitness service at .05 statistically significant level.

Keywords: decision making behavior, fitness, marketing mix, marketing service

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Authors: Saeed Asiri

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The Novel Automated System (NAS) has the control system of the level of chlorine and acid (i.e. pH level) through a feedback in three forms of synchronous alerts. The feedback is in the form of an alert voice, a visible color, and a message on a digital screen. In addition, NAS contains a slide-in container in which chemicals are used to treat the problems of chlorine and acid levels independently. Moreover, NAS has a net in front of it to clean the pool on the surface of the water from leaves and wastes and so on which is controlled through a remote control. The material used is a lightweight aluminum with mechanical and electric parts integrated with each other. In fact, NAS is qualified to serve as an assistant security guard for swimming pools because it has the characteristics that make it unique and smart.

Keywords: novel automated system, pool safety, maintenance, pH level, digital screen

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Authors: Mohammed Mustapha Alhaji, Sadiku Salawu

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A clay soil which classified under A-7-6 soil according to AASHTO soil classification system and CH according to the unified soil classification system was stabilized using A-3 soil (AASHTO soil classification system). The clay soil was replaced with 0%, 10%, 20% to 100% A-3 soil, compacted at both the BSL and BSH compaction energy level and using unconfined compressive strength as evaluation criteria. The MDD of the compactions at both the BSL and BSH compaction energy levels showed increase in MDD from 0% A-3 soil replacement to 40% A-3 soil replacement after which the values reduced to 100% A-3 soil replacement. The trend of the OMC with varied A-3 soil replacement is similar to that of MDD but in a reversed order. The OMC reduced from 0% A-3 soil replacement to 40% A-3 soil replacement after which the values increased to 100% A-3 soil replacement. This trend was attributed to the observed reduction in the void ratio from 0% A-3 soil replacement to 40% A-3 soil replacement after which the void ratio increased to 100% A-3 soil replacement. The maximum UCS for clay at varied A-3 soil replacement increased from 272 and 770kN/m2 for BSL and BSH compaction energy level at 0% A-3 soil replacement to 295 and 795kN/m2 for BSL and BSH compaction energy level respectively at 10% A-3 soil replacement after which the values reduced to 22 and 60kN/m2 for BSL and BSH compaction energy level respectively at 70% A-3 soil replacement. Beyond 70% A-3 soil replacement, the mixture cannot be moulded for UCS test.

Keywords: A-3 soil, clay minerals, pozzolanic action, stabilization

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Authors: Majid Samavatian, Reza Gholamipour, Vahid Samavatian

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This study addresses the role of rejuvenation on the fluctuation of atomic-level stresses and nanoscale topological heterogeneity in ZrCuNiAl bulk metallic glass (BMG). Based on atomic force microscopy (AFM) results, the rejuvenation process leads to an increase in nanoscale spatial heterogeneity manifested by the intensification of the local viscoelastic response of the BMG nanostructure. It means that the rejuvenation process induces more loose-packing structures which behave towards an external load in a viscoelastic way. Hence, it is suggested that the alteration of such heterogeneity may be attributed to the variation of positional atomic rearrangement during the evolution of structural rejuvenation. On the other side, the synchrotron X-ray diffraction (XRD) results indicate that the rejuvenation intensifies the variation of internal stresses at the atomic level. This conclusion unfolds that the increase of atomic-level stresses during rejuvenation induces structural disordering and nanoscale heterogeneity in the amorphous material.

Keywords: bulk metallic glass, heterogeneity, rejuvenation, nanostructure

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Authors: X. Li, J. Sundquist, C. Sjöstedt, M. Winkleby, K. S. Kendler, K. Sundquist

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Aims: This study examines the association between the incidence of drug abuse (DA) and linking (communal) social capital, a theoretical concept describing the amount of trust between individuals and societal institutions. Methods: We present results from an 8-year population-based cohort study that followed all residents in Sweden, aged 15-44, from 2003 through 2010, for a total of 1,700,896 men and 1,642,798 women. Social capital was conceptualized as the proportion of people in a geographically defined neighborhood who voted in local government elections. Multilevel logistic regression was used to estimate odds ratios (ORs) and between-neighborhood variance. Results: We found robust associations between linking social capital (scored as a three level variable) and DA in men and women. For men, the OR for DA in the crude model was 2.11 [95% confidence interval (CI) 2.02-2.21] for those living in areas with the lowest vs. highest level of social capital. After accounting for neighborhood-level deprivation, the OR fell to 1.59 (1.51-1-68), indicating that neighborhood deprivation lies in the pathway between linking social capital and DA. The ORs remained significant after accounting for age, sex, family income, marital status, country of birth, education level, and region of residence, and after further accounting for comorbidities and family history of comorbidities and family history of DA. For women, the OR decreased from 2.15 (2.03-2.27) in the crude model to 1.31 (1.22-1.40) in the final model, adjusted for multiple neighborhood-level and individual-level variables. Conclusions: Our study suggests that low linking social capital may have important independent effects on DA.

Keywords: drug abuse, social linking capital, environment, family

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Authors: K. Piórkowska

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The overarching aim of the paper is to incorporate the micro-foundations perspective in strategic management and offering possibilities to bridge the macro–micro divide, to review the concept of habits, as well as to propose research findings and directions in terms of further exploring the habit construct and its impact on higher epistemological level phenomena (for instance organizational routines, which is a domain inherently multilevel in nature). To realize this aim, the following sections have been developed: (1) habits’ origins, (2) habits – cognitive constellations, (3) interrelationships between habits and mental representations, intentions, (4) habits and organizational routines, and (5) habits and routines linkages with adaptation. The conclusions that have been made support recent and current studies linking the level of individual heterogeneous agents with the level of macro (organizational) outcomes.

Keywords: behaviorism, habits, micro-foundations, routines

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Authors: Khiara Claudine C. Carbonel, Patricia Joy A. Canapi, Tracy Gabriella M. Canlas, Teresa Zaine C. Canseco, Reena Marie A. Capistrano, Vernon A. Carandang, Carlo G. Ranoco

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Research problem: The main problem of the study was to determine the effect of Projecting the Reflection of the Individual’s Self-esteem (PRIDE) therapy on the level of self-esteem of physically challenged adolescents. Objectives of the Study: The study determined the effect of PRIDE (Projecting the Reflection of the Individuals Self-esteem) therapy on the level of self-esteem among physically challenged adolescents. Methodology: A quasi-experimental study was used which involved 30 randomly-assigned subjects, 15 in the experimental group and 15 in the control group. The Projecting the reflection of the Individuals’ Self-Esteem (PRDIE) therapy was administered to the experimental group. The researchers utilized the Sorensen Self-Esteem test tool as a pretest and posttest questionnaire and yielded a Cronbach’s alpha of .912. Paired T-test was used to analyze the gathered data. Results: The results showed that after the administration of PRIDE therapy, there was an increase on the level of self-esteem. The experimental group had a value of 3.590, which was significant and meant that the level of self-esteem is significantly increased. On the other hand, the control group, had a value of -2.207 which was also significant, therefore, the level of self esteem significantly decreased. Conclusion: the PRIDE Therapy is effective in increasing the level of self-esteem among physically challenged adolescent. Recommendations: The researchers recommend the use of PRIDE Therapy as an intervention in handling physically challenged patients, especially adolescents, in order to enhance their self-esteem. Also, the researchers recommend that nursing students be informed on the efficacy of PRIDE Therapy in enhancing the self-esteem of physically challenged patients. Furthermore, the inclusion of a psychologist during the implementation of PRIDE Therapy, specifically art therapy, to be able to have a more focused interpretation of the drawings and really be able to see the projection of their self-esteem is also recommended.

Keywords: PRIDE therapy, physically challenged adolescents, self-esteem, art therapy

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Authors: Kahil Amar, Meziani Faroudja, Khelil Nacim

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The principal objective of this study is the evaluation of the seismic performance of reinforced concrete frame structures, taking into account of the behavior laws, reflecting the real behavior of materials, using CASTEM2000 software. A finite element model used is based in modified Takeda model with Timoshenko elements for columns and beams. This model is validated on a Vecchio experimental reinforced concrete (RC) frame model. Then, a study focused on the behavior of a RC frame with three-level and three-story in order to visualize the positioning the plastic hinge (plastic rotation), determined from the curvature distribution along the elements. The results obtained show that the beams of the 1^st and 2^nd level developed a very large plastic rotations, or these rotations exceed the values corresponding to CP (Collapse prevention with cp q_CP = 0.02 rad), against those developed at the 3^rd level, are between IO and LS (Immediate occupancy and life Safety with q_IO = 0.005 rad and rad q_LS = 0.01 respectively), so the beams of first and second levels submit a very significant damage.

Keywords: seismic performance, performance level, pushover analysis, plastic rotation, plastic hinge

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Authors: Timothy A. Oloyede

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The study assessed the influence of playing field, climatic conditions, rate of exposure to matches, skill level and competition level on the occurrence and severity of football injuries. The prospective outline of the study was as follows: after a baseline examination and measurements were performed ascertaining possible predictors of injury, all players were followed up weekly for one year to register subsequent injuries and complaints. Four hundred and thirty-five out of 455 subjects completed the weekly follow-ups over one year. Multiple regression analysis was employed to analyse the data collected. Results showed that playing field, climatic conditions, rate of exposure to matches skill level and competition level were predictors of injuries among the professional footballer. Playing on natural grass, acclimatization, reduction of physical overload, among others, were strategies postulated for preventing injuries.

Keywords: sports’ injuries, predictors of sports’ injuries, intrinsic risk factors, extrinsic risk factors, injury mechanism, professional footballer

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Authors: Abhinay Puvvala, Veerendra Kumar Rai

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A bottleneck situation arises when the outflow is lesser than the inflow in a pipe-like setup. A more practical interpretation of bottlenecks emphasizes on the realization of Service Level Objectives (SLOs) at given workloads. Our approach detects two key aspects of bottlenecks – when and where. To identify ‘when’ we continuously poll on certain key metrics such as resource utilization, processing time, request backlog and throughput at a system level. Further, when the slope of the expected sojourn time at a workload is greater than ‘K’ times the slope of expected sojourn time at the previous step of the workload while the workload is being gradually increased in discrete steps, a bottleneck situation arises. ‘K’ defines the threshold condition and is computed based on the system’s service level objectives. The second aspect of our approach is to identify the location of the bottleneck. In multi-tier systems with a complex network of layers, it is a challenging problem to locate bottleneck that affects the overall system performance. We stage the system by varying workload incrementally to draw a correlation between load increase and system performance to the point where Service Level Objectives are violated. During the staging process, multiple metrics are monitored at hardware and application levels. The correlations are drawn between metrics and the overall system performance. These correlations along with the Service Level Objectives are used to arrive at the threshold conditions for each of these metrics. Subsequently, the same method used to identify when a bottleneck occurs is used on metrics data with threshold conditions to locate bottlenecks.

Keywords: bottleneck, workload, service level objectives (SLOs), throughput, system performance

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Authors: Amro Issam Hamed Attia Ramadan, Marco Zappatore, Pasquale Balena, Antonella Longo

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Considering the energetic crisis that is hitting Europe, it becomes more and more necessary to change the energy policies to depend less on fossil fuels and replace them with energy from renewable sources. This has triggered the urge to use clean energy not only to satisfy energy needs and fulfill the required consumption but also to decrease the danger of climatic changes due to harmful emissions. Many countries have already started creating energetic communities based on renewable energy sources. The first step to understanding energy needs in any place is to perfectly know the consumption. In this work, we aim to estimate electricity consumption for a municipality that makes up part of a rural area located in southern Italy using forecast models that allow for the estimation of electricity consumption for the next ten years, and we then apply the same model to the province where the municipality is located and estimate the future consumption for the same period to examine whether it is possible to start from the municipality level to reach the province level when creating energy communities.

Keywords: ARIMA, electricity consumption, forecasting models, time series

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Authors: Saeed Zeinali, Nasser Talebbeydokhti, Mehdi Saeidian, Shahrad Vosough

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In this article, bathymetry changes have been studied as a case study for Larak Island, located in The South of Iran. The advanced 2D model of Mike21 has been used for this purpose. A simple procedure has been utilized in this model. First, the hydrodynamic (HD) module of Mike21 has been used to obtain the required output for sediment transport model (ST module). The ST module modeled the area for tidal currents only. Bed level changes are resulted by series of modeling for both HD and ST module in 3 months time step. The final bathymetry in each time step is used as the primary bathymetry for next time step. This consecutive procedure been continued until bathymetry for the year 2020 is obtained.

Keywords: bed level changes, Larak Island, hydrodynamic, sediment transport

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Authors: Aryana Collins Jackson, Elisabetta Bevacqua, Pierre De Loor, Ronan Querrec

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This paper presents a taxonomy of non-technical skills, communicative intentions, and behavior for an individual acting as a medical coordinator. In medical emergency situations, a leader among the group is imperative to both patient health and team emotional and mental health. Situational Leadership is used to make clear and easy-to-follow guidelines for behavior depending on circumstantial factors. Low-level leadership behaviors belonging to two different styles, directive and supporting, are identified from literature and are included in the proposed taxonomy. The high-level information in the taxonomy consists of the necessary non-technical skills belonging to a medical coordinator: situation awareness, decision making, task management, and teamwork. Finally, communicative intentions, dimensions, and functions are included. Thus this work brings high-level and low-level information - medical non-technical skills, communication capabilities, and leadership behavior - into a single versatile taxonomy of behavior.

Keywords: human behavior, leadership styles, medical, taxonomy

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Authors: Jin Koo

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During the coronavirus pandemic, there has been a further increasing demand for computer-based tests (CBT), and now it has become an important test mode. The main purpose of this study is to investigate the comparability of student scores obtained from computerized-based formats of a standardized test in the two subject areas of reading and mathematics. Also, this study investigates whether there is an interaction effect between test modes of CBT and paper-based tests (PBT) and gender/ability level in each subject area. The test used in this study is a multiple-choice standardized test for students in grades 8-11. For this study, data were collected during four test administrations: 2015-16, 2017-18, and 2020-21. This research used a one-factor between-subjects ANOVA to compute the PBT and CBT groups’ test means for each subject area (reading and mathematics). Also, 2-factor between-subjects ANOVAs were conducted to investigate examinee characteristics: gender (male and female), ethnicity (African-American, Asian, Hispanic, multi-racial, and White), and ability level (low, average, and high-ability groups). The author found that students’ test scores in the two subject areas varied across CBT and PBT by gender and ability level, meaning that gender, ethnicity, and ability level were related to the score difference. These results will be discussed according to the current testing systems. In addition, this study’s results will open up to school teachers and test developers the possible influence that gender, ethnicity, and ability level have on a student’s score based on whether they take the CBT or PBT.

Keywords: ability level, computer-based, gender, paper-based, test

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Authors: Kristiana Haryanti, Theresia Dwi Hastuti, Agustine Eva Maria Soekesi

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Entrepreneurship is an important topic today that is widely discussed in the business world. The COVID-19 pandemic has devastated all businesses in the world, especially businesses at the micro-level. This study tries to prove the relationship between job satisfaction of micro-level business owners and family social support for their resilience. The respondents of this study amounted to 58 entrepreneurs. The results of this study indicate that there is a relationship between job satisfaction and social support with entrepreneurial resilience in continuing the family business.

Keywords: family business, family social support, job satisfaction, resilience

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Authors: Martin Popescu D. Dana Maria

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The aims of this research are to broaden the study on the relationship between emotional intelligence and counterproductive work behavior (CWB). The study sample consisted in 441 Romanian employees from companies all over the country. Data has been collected through web surveys and processed with SPSS. The results indicated an average correlation between the two constructs and their sub variables, employees with a high level of emotional intelligence tend to be less aggressive. In addition, labeling was considered an individual difference which has the power to influence the level of employee aggression. A regression model was used to underline the importance of emotional intelligence together with labeling as predictors of CWB. Results have shown that this regression model enforces the assumption that labeling and emotional intelligence, taken together, predict CWB. Employees, who label themselves as victims and have a low degree of emotional intelligence, have a higher level of CWB.

Keywords: aggression, CWB, emotional intelligence, labeling

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Authors: Vladyslav Povoroznyuk, Galina Dubetska, Roksolana Povoroznyuk

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In recent years, the problem of hyperuricemia is getting a particular importance due to its increased incidence in the world population. The aim of this study was to determine uriс acid level in blood serum, incidence of hyperuricemia among women in postmenopausal period and their association with body mass index and some components of metabolic syndrome (triglyceride, cholesterol, systolic and diastolic pressure). We examined 412 women in postmenopausal period. They were divided in to the following groups: I group (BMI = 18,5-24,9), II group (BMI = 25,0-29,9), III group (BMI = 30,0-34,9), IV group (BMI > 35). We determined uric acid level among women during postmenopausal period depending on their body mass index. The higher level of uric acid was found in patients with the maximal body mass index (BMI > 35). In the I group it was 277,52 ± 8,40; in the II group – 286,81 ± 7,79; in the III group – 291,81 ± 7,56; in the IV group – 327,17 ± 12,17. Incidence of hyperuricemia among women in the I group was 10,2%, in the II group – 15,9%; in the III group – 21,2%, in the IV group – 34,2%. We found an interdependence between an uric acid level and BMI in the examined women (r = 0,21, p < 0,05). We determined that the highest level of triglyceride (F = 18,62, p < 0,05), cholesterol (F = 3,64, p < 0,05), atherogenic coefficient (F = 22,64, p < 0,05), systolic (F = 10,5, p < 0,05) and diastolic pressure (F = 4,30, p < 0,05) was among women with hyperuricemia. It was an interdependence between an uric acid level and triglyceride (r = 0,26, p < 0,05), atherogenic coefficient (r = 0,24, p < 0,05) among women in postmenopausal period.

Keywords: hyperuricemia, uric acid, body mass index, women

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Authors: Ali Bakari Mohammed

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Transitioning is a continuous process of radical change in a society which involves co-evolution of institutional, technological, socio-cultural, and ecological developments at different scales and levels. Transition management model is a methodology that influences structural change of complex systems over a period (0-30 years) by experimenting and implementing new techniques. A transition management in the context of groundwater is a radical change from the current operate and control system to a next generation integrated and sustainable system that takes into account quality protection and sustained supply into the future. This study evaluates the transition management model in adopting it as a viable tool for the attainment of sustainable groundwater management. The outcome of the evaluation shows that there are three levels (strategic, tactical and operational) of operating the transition management model. At the strategic level, long-term goals for sustainable groundwater management are formulated, at the tactical level activities such as inter institutional networking, negotiation, planning and financing are carried out, and at the operational level, transition experiments and strategic niche management are carried out at the societal level. Overall, different actors and set of activities are required to partake at each management level. The outcome of this paper will provide basis for the implementation of the Sustainable Development Goal (SDG) 6 in Nigeria.

Keywords: transition management, groundwater, sustainable management, tool, Nigeria

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Authors: Nazif Fuat Turkmen

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Domestic violence is the most common form of violence that risks the health and psychological well-being of victims and its witnesses. Psychology as a scientific field has made contributions in research, exploration, assessment, intervention, and prevention of domestic violence. The present study will be exploring the level of recognition of Turkish Cypriots on domestic violence and their understanding about it in general terms. While discussing the level of awareness of Turkish Cypriots on domestic violence and the effects of this level of awareness on the general well-being of the members of the society, the most common types of domestic violence as well as how Turkish Cypriots recognize and interpret these different types will be explored. The participants consisted of 224 Turkish Cypriots; 48.4% (n= 109) were female, 51.1% (n=115) were male. For the purpose of the study, a 28-item questionnaire was prepared and used for data collection. According to the results, there is a strong relationship between the education level of the respondents and their awareness on domestic violence. The study shows that cultural approaches on child rearing effect people’s recognition of violence in general and awareness on domestic violence in particular.

Keywords: culture, domestic violence, health psychology, public health, Turkish Cypriots, violence

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Authors: Luciano Tarantino

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Gas gangrene is a rare, severe infection with a very high mortality rate caused by Clostridium species. The infection causes a non-suppurative localized producing gas lesion from which harmful toxins that impair the inflammatory response cause vessel damage and multiple organ failure. Gas gangrene of the liver is very rare and develops suddenly, often as a complication of abdominal surgery and liver transplantation. The present paper deals with a case of gas gangrene of the liver that occurred after percutaneous MW ablation of hepatocellular carcinoma, resulting in progressive liver necrosis and multi-organ failure in spite of specific antibiotics administration. The patient was successfully treated with percutaneous Radiofrequency ablation. Case report: Female, 76 years old, Child A class cirrhosis, treated with synchronous insertion of 3 MW antennae for large HCC (5.5 cm) in the VIII segment. 24 hours after treatment, the patient was asymptomatic and left the hospital . 2 days later, she complained of fever, weakness, abdominal swelling, and pain. Abdominal US detected a 2.3 cm in size gas-containing area, eccentric within the large (7 cm) ablated area. The patient was promptly hospitalized with the diagnosis of anaerobic liver abscess and started antibiotic therapy with Imipenem/cilastatine+metronidazole+teicoplanine. On the fourth day, the patient was moved to the ICU because of dyspnea, congestive heart failure, atrial fibrillation, right pleural effusion, ascites, and renal failure. Blood tests demonstrated severe leukopenia and neutropenia, anemia, increased creatinine and blood nitrogen, high-level FDP, and high INR. Blood cultures were negative. At US, unenhanced CT, and CEUS, a progressive enlargement of the infected liver lesion was observed. Percutaneous drainage was attempted, but only drops of non-suppurative brownish material could be obtained. Pleural and peritoneal drainages gave serosanguineous muddy fluid. The Surgeon and the Anesthesiologist excluded any indication of surgical resection because of the high perioperative mortality risk. Therefore, we asked for the informed consent of the patient and her relatives to treat the gangrenous liver lesion by percutaneous Ablation. Under conscious sedation, percutaneous RFA of GG was performed by double insertion of 3 cool-tip needles (Covidien LDT, USA ) into the infected area. The procedure was well tolerated by the patient. A dramatic improvement in the patient's condition was observed in the subsequent 24 hours and thereafter. Fever and dyspnea disappeared. Normalization of blood tests, including creatinine, was observed within 4 days. Heart performance improved, 10 days after the RFA the patient left the hospital and was followed-up with weekly as an outpatient for 2 months and every two months thereafter. At 18 months follow-up, the patient is well compensated (Child-Pugh class B7), without any peritoneal or pleural effusion and without any HCC recurrence at imaging (US every 3 months, CT every 6 months). Percutaneous RFA could be a valuable therapy of focal GG of the liver in patients non-responder to antibiotics and when surgery and liver transplantation are not feasible. A fast and early indication is needed in case of rapid worsening of patient's conditions.

Keywords: liver tumor ablation, interventional ultrasound, liver infection, gas gangrene, radiofrequency ablation

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Authors: Ekaterina Sánchez Romero, Emily Gabriela Aguirre Herrera, Sandra Luz Espinoza Esquerra, Jorge García Campos

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Female, 7 months old, daughter of a mother with anemia during pregnancy, with no history of atopy in the family, since birth she presents with recurrent dermatological and gastrointestinal infections, chronically treated for recurrent diaper dermatitis. At 6 months of age, she begins with generalized pallor, hyperpigmentation in hands and feet, smooth tongue, psychomotor retardation with lack of head support, sedation, and hypoactivity. She was referred to our hospital for a fever of 38°C, severe diaper rash, and pancytopenia with HB 9.3, platelets 38000, neutrophils 0.39 MCV: 86.80 high for her age. The approach was initiated to rule out myeloproliferative syndrome, with negative immunohistochemical results of bone marrow aspirate; during her stay, she presented neurological regression, lack of sucking, and focal seizures. CT scan showed cortical atrophy. The patient was diagnosed with primary immunodeficiency due to history; gamma globulin was administered without improvement with normal results of immunoglobulins and metabolic screening. When dermatological and neurological diagnoses were ruled out as the primary cause, a nutritional factor was evaluated, and a therapeutic trial was started with the administration of vitamin B12 and zinc, presenting clinical neurological improvement and resolution of pancytopenia in 2 months. It was decided to continue outpatient management. Discussion: We present a patient with neurological, dermatological involvement, and pancytopenia, so the most common differential diagnoses in this population were ruled out. Vitamin B12 deficiency is an uncommon entity. Due to maternal and clinical history, a therapeutic trial was started resulting in an improvement. Conclusion: VitaminB12 deficiency should be considered one of the differential diagnoses in the approach to pancytopenia with megaloblastic anemia associated with dermatologic and neurologic manifestations. Early treatment can reduce irreversible damage in these patients.

Keywords: vitamin B12 deficiency, pediatrics, pancytopenia, diaper dermatitis

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Authors: D. Supaporn, B. Julaluk

Abstract:

The purposes of this study were to study symptom cluster, functional status and quality of life of patients with chronic obstructive pulmonary disease (COPD), and to examine factors related to and predicting symptom cluster, functional status and quality of life of COPD patients. The sample was 180 COPD patients multi-stage random sampling from 4 hospitals in the eastern region, Thailand. The research instruments were 8 questionnaires and recorded forms measuring personal and illness data, co-morbidity, physical and psychological symptom, health status perception, social support, and regimen adherence, functional status and quality of life. Spearman rank and Pearson correlation coefficient, exploratory factors analysis and standard multiple regression were used to analyzed data. The findings revealed that two symptom clusters were generated: physical symptom cluster including dyspnea, fatigue and insomnia; and, psychological symptom cluster including anxiety and depression. Scores of physical symptom cluster was at moderate level while that of psychological symptom cluster was at low level. Scores on functional status, social support and overall regimen adherence were at good level whereas scores on quality of life and health status perception were at moderate level. Disease severity was positively related to physical symptom cluster, psychological symptom cluster and quality of life, and was negatively related to functional status at a moderate level (rs = .512, .509, .588 and -.611, respectively). Co-morbidity was positively related to physical symptom cluster and psychological symptom cluster at a low level (r = .179 and .176, respectively). Regimen adherence was negatively related to quality of life and psychological symptom cluster at a low level (r=-.277 and -.309, respectively), and was positively related to functional status at a moderate level (r=.331). Health status perception was negatively related to physical symptom cluster, psychological symptom cluster and quality of life at a moderate to high level (r = -.567, -.640 and -.721, respectively) and was positively related to functional status at a high level (r = .732). Social support was positively related to functional status (r=.235) and was negatively related to quality of life at a low level (r=-.178). Physical symptom cluster was negatively related to functional status (r= -.490) and was positively related to quality of life at a moderate level (r=.566). Psychological symptom cluster was negatively related to functional status and was positively related to quality of life at a moderate level (r= -.566 and .559, respectively). Disease severity, co-morbidity and health status perception could predict 40.2% of the variance of physical symptom cluster. Disease severity, co-morbidity, regimen adherence and health status perception could predict 49.8% of the variance of psychological symptom cluster. Co-morbidity, regimen adherence and health status perception could predict 65.0% of the variance of functional status. Disease severity, health status perception and physical symptom cluster could predict 60.0% of the variance of quality of life in COPD patients. The results of this study can be used for enhancing quality of life of COPD patients.

Keywords: chronic obstructive pulmonary disease, functional status, quality of life, symptom cluster

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Authors: Charawee Butbumrung

Abstract:

The purpose of this research were to study the factors influencing savings of people between 30-40 years old in Dusit District, Bangkok Metropolis. The statistic used in data analysis were frequency, mean and standard deviation, t-test, one-way ANOVA and Pearson’s correlation coefficient based on social science statistic program. Result of hypothesis testing showed that married people earning different monthly salary generally saved by depositing into the bank at different level. People of different occupation saved in form of life insurance at different level at statistical significance 0.05. Result of influence testing between saving motivation was found that people saved for use upon sickness or getting older, saved for the children. Worthiness and certainty influenced saving in the same direction at high level while saving motivation in public relation, annual tax reduction, inducement by the others, bonus gift influenced saving in the same direction at moderate level at statistical significance 0.05.

Keywords: Dusit District, factors, saving, Bangkok Metropolis

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Authors: Somaiya Mateen, Shagufta Moin, Mohammad Owais, Abdul Khan, Atif Zafar

Abstract:

In rheumatoid arthritis (RA), impaired oxidative metabolism and imbalance between pro-and anti-inflammatory cytokines are responsible for causing inflammation and the degradation of cartilage and bone. The present study was done to evaluate the level and hence the role of reactive oxygen species (ROS) and inflammatory cytokines in the pathogenesis of RA. The present study was performed in the blood of 80 RA patients and 55 age and sex-matched healthy controls. The level of ROS (in 5% hematocrit) and the plasma level of pro-inflammatory cytokines [TNF-α, interleukin-6 (IL-6), IL-22] and anti-inflammatory cytokines (IL-4 and IL-5) were monitored in healthy subjects and RA patients. For evaluating the role of rheumatoid factor (RF) in the pathogenesis of RA, patients were sub-divided on the basis of presence or absence of RF. Reactive species and inflammatory cytokines were correlated with disease activity measure-Disease Activity Score for 28 joints (DAS28). The level of ROS, TNF-α, IL-6 and IL-22 were found to be significantly higher in RA patients as compared to the healthy controls, with the increase being more significant in patients positive for rheumatoid factor and those having high disease severity. On the other hand, a significant decrease in the level of IL-4 and IL-10 were observed in RA patients compared with healthy controls, with the decrease being more prominent in severe cases of RA. Higher ROS (indicative of impaired anti-oxidant defence system) and pro-inflammatory cytokines level in RA patients may lead to the damage of biomolecules which in turn contributes to tissue damage and hence to the development of more severe RA. The imbalance between pro-and anti-inflammatory cytokines may lead to the development of multi-system immune complications. ROS and inflammatory cytokines may also serve as a potential biomarker for assessing the disease severity.

Keywords: rheumatoid arthritis, reactive oxygen species, pro-inflammatory cytokines, anti-inflammatory cytokines

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Authors: Jaypee Limueco

Abstract:

This research focused on the impact of Peer Instruction and PhET Simulations on the level of motivation and Physics anxiety of Grade 9 students. Two groups of students were used in the study. The experimental group involved 65 registered students while the control group has 64 registered students. To determine the level of motivation of students in learning physics, the Physics Motivation Questionnaire was administered. On the other hand, to determine the level of Physics anxiety of the students in each group, Physics Anxiety Rating Scale was used. Peer Instruction supplemented with PhET simulations was implemented in the experimental group while the traditional lecture method was used in the control group. Both instruments were again administered after the implementation of the two different teaching approaches. “Wilcoxon Signed Rank test” was used to test the significant difference between pretest and posttest of each group. “Mann Whitney U” was used to test if significant differences exist between each group before and after instruction. Results showed that there is no significant difference between the level of motivation and anxiety of the experimental and control group before the implementation at p<0.05 significance level. It implies that the students have the same level of motivation and physics anxiety before instruction. However, the results of both tests have significant differences between the groups after instruction. It is also found that there is a significant positive change in the responses of the students in the experimental group while no change was evident on the control. The result of the analysis of the Mann Whitney U shows that the change in the attributes of the students is caused by the treatment. Therefore, it is concluded that Peer Instruction and PhET simulation helped in alleviating motivation of students and minimizing their anxiety towards Physics.

Keywords: anxiety, motivation, peer instruction, PhET simulations

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Authors: Mohd A. Azizan, Mohd Z. Zali

Abstract:

It is well established that exposure to vibration has an adverse effect on human health, comfort, and performance. However, there is little quantitative knowledge on performance combined with drowsiness level during vibration exposure. This paper reports a study investigating the influence of vibration amplitude on seated occupant reaction time and drowsiness level. Eighteen male volunteers were recruited for this experiment. Before commencing the experiment, total transmitted acceleration measured at interfaces between the seat pan and seatback to human body was adjusted to become 0.2 ms-2 r.m.s and 0.4 ms-2 r.m.s for each volunteer. Seated volunteers were exposed to Gaussian random vibration with frequency band 1-15 Hz at two level of amplitude (low vibration amplitude and medium vibration amplitude) for 20-minutes in separate days. For the purpose of drowsiness measurement, volunteers were asked to complete 10-minutes PVT test before and after vibration exposure and rate their subjective drowsiness by giving score using Karolinska Sleepiness Scale (KSS) before vibration, every 5-minutes interval and following 20-minutes of vibration exposure. Strong evidence of drowsiness was found as there was a significant increase in reaction time and number of lapse following exposure to vibration in both conditions. However, the effect is more apparent in medium vibration amplitude. A steady increase of drowsiness level can also be observed in KSS in all volunteers. However, no significant differences were found in KSS between low vibration amplitude and medium vibration amplitude. It is concluded that exposure to vibration has an adverse effect on human alertness level and more pronounced at higher vibration amplitude. Taken together, these findings suggest a role of vibration in promoting drowsiness, especially at higher vibration amplitude.

Keywords: drowsiness, human vibration, karolinska sleepiness scale, psychomotor vigilance test

Procedia PDF Downloads 254