Search results for: tertiary

Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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Authors: Anucha Taiwong, Nirobol Kanogsunthornrat

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This predictive research aimed to investigate the symptom clusters that influence the quality of life among patients with chronic kidney disease, as indicated in the Theory of Unpleasant Symptoms. The purposive sample consisted of 150 patients with stage 3-4 chronic kidney disease who received care at an outpatient chronic kidney disease clinic of a tertiary hospital in Roi-Et province. Data were collected from January to March 2016 by using a patient general information form, unpleasant symptom form, and quality of life (SF-36) and were analyzed by using descriptive statistics, factor analysis, and multiple regression analysis. Findings revealed six core symptom clusters including symptom cluster of the mental and emotional conditions, peripheral nerves abnormality, fatigue, gastro-intestinal tract, pain and, waste congestion. Significant predictors for quality of life were the two symptom clusters of pain (Beta = -.220; p < .05) and the mental and emotional conditions (Beta=-.204; p<.05) which had predictive value of 19.10% (R2=.191, p<.05). This study indicated that the symptom cluster of pain and the mental and emotional conditions would worsen the patients’ quality of life. Nurses should be attentive in managing the two symptom clusters to facilitate the quality of life among patients with chronic kidney disease.

Keywords: chronic kidney disease, symptom clusters, predictors of quality of life, pre-dialysis

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Authors: Abdulaziz Alkathiry

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Concussion is a common brain injury that affect physical and cognitive performance. While several studies indicated that adolescents are more likely to develop concussion, in the last decade concussion has been mainly explored in adults. Migraine has been identified as a common symptom reported after concussion and was tied with worse prognoses. Hence, we aimed to investigate the effect of migraine on functional performance and self-reported symptoms in children with concussion. This cross-sectional study involved 35 symptomatic children aged 9 – 17 years recruited within 1 year from their concussion injury at a tertiary balance center. Participants’ symptoms and functional performance were assessed using the post-concussion symptoms scale (PCSS) and the functional gait assessment (FGA) respectively. Concussed children with migraine showed significantly worse symptoms including fatigue, sleeping impairment, difficulty concentrating, and visual problems (P < 0.05). Functional performance didn’t show differences between concussed children with and without migraine. Although concussed children with and without migraine didn’t show any differences on functional performance, worse cognitive symptoms were found in concussed children with migraine. A customized treatment approach is indicated in the presence of migraine for the management of children with concussion. Keywords: Concussion; Migraine; Balance; Post-Concussion Symptoms Scale; Functional Gait Assessment

Keywords: concussion, migraine, post-concussion symptoms scale, functional gait assessment, balance

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Authors: Sherif Refaat, Hassan Aref

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Background: Although asthma is a well-identified presentation to the emergency department, little is known about the frequency and percentage of respiratory and non-respiratory symptoms in patients with acute asthma in the emergency department (ED). Objective: The aim of this study is to identify the relationship between acute asthma exacerbation and different respiratory and non-respiratory symptoms including chest pain encountered by patients visiting the emergency department. Subjects and methods: Prospective study included 169 (97 females and 72 males) asthmatic patients who were admitted to emergency department of two tertiary care facility hospitals for asthma exacerbation from the period of September 2010 to August 2013, an anonyms questionnaire was used to collect symptoms and analysis of symptoms. Results: Females were 97 (57%) of the patients, mean age was 35.6 years; dyspnea on exertion was the commonest symptom accounting for 161 (95.2%) of patients, followed by dyspnea at rest 155 (91.7%), wheezing in 152 (89.9%), chest pain was present in 82 patients (48.5%), the pain was burning in 36 (43.9%) of the total patients with chest pain. Non-respiratory symptoms were seen frequently in acute asthma in ED. Conclusions: Dyspnea was the commonest chest symptoms encountered in patients with acute asthma followed by wheezing. Chest pain in acute asthma is a common symptom and should be fully studied to exclude misdiagnosis as of cardiac origin; there is a need for a better dissemination of knowledge about this disease association with chest pain. It was also noted that other non-respiratory symptoms are frequently encountered with acute asthma in emergency department.

Keywords: asthma, emergency department, respiratory symptoms, non respiratory system

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Authors: Zainab Yahaya Suleiman

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Physical fitness, as one of the most important keys to a healthy wellbeing, is the basis of dynamic and creative intellectual activity. As a result, the fitness world is expanding every day. It is believed that a fitness centre is a place of healing and also the natural environment is vital to speedy recovery. The aim of this paper is to propose and designs a suitable location for a fitness centre in Batagarawa metropolis. Batagarawa city is enriched with four tertiary institutions with diverse commerce and culture but lacks the facility of a well-equipped fitness centre. The proposed fitness centre intends to be an organically sound centre that will make use of principles of organic architecture to create a new pleasant environment between man and his environments. Organic architecture is the science of designing a building within pleasant natural resources and features surrounding the environment. It is regarded as visual poetry and reinterpretation of nature’s principles; as well as embodies a settlement of person, place, and materials. Using organic architecture, the design was interlaced with the dynamic, organic and monumental features surrounding the environment. The city has inadequate/no facility that is considered organic where one can keep fit in a friendly, conducive and adequate location. Thus, the need for establishing a fitness centre to cater for this need cannot be over-emphasised. Conclusively, a fitness centre will be an added advantage to this fast growing centre of learning.

Keywords: organic architecture, fitness center, environment, natural resources, natural features, building design

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Authors: Arturo Maldonado

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In the iron ore mining industry, the intact strength of rock units is defined using the uniaxial compressive strength (UCS). This parameter is very important for the classification of shale materials, allowing the split between rock and cohesive soils based on the magnitude of UCS. For this research, it is assumed that UCS less than or equal to 1 MPa is representative of soils. Several researchers have anticipated that the magnitude of UCS reduces with weathering progression, also since UCS is a directional property, its magnitude depends upon the rock fabric orientation. Thus, the paper presents how the UCS of shales is affected by both weathering grade and bedding orientation. The mineralogy of shales has been defined using Hyper-spectral and chemical assays to define the mineral constituents of shale and other non-shale materials. Geological classification tools have been used to define distinct lithological types, and in this manner, the author uses mineralogical datasets to recognize and isolate shales from other rock types and develop tertiary plots for fresh and weathered shales. The mineralogical classification of shales has reduced the contamination of lithology types and facilitated the study of the physical factors affecting the intact strength of shales, like anisotropic strength due to bedding orientation. The analysis of mineralogical characteristics of shales is perhaps the most important contribution of this paper to other researchers who may wish to explore similar methods.

Keywords: rock mechanics, mineralogy, shales, weathering, anisotropy

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Authors: O. Starineca

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Some organizations as employers have difficulties to attract job seekers and retain their employees. Strategic planning of Human Resources (HR) presumes broad analysis of perspectives including analysis of potential job seekers in the field. Human Resources Recruitment (HRR) influences employer brand of an organization and peculiarities of both external organizational factors and stakeholders. Defining peculiarities of the future job seekers, who could potentially become the employees of the organization, could help to adjust HRR tools and methods adapt to the youngest generation employees’ preferences and be more successful in selecting the best candidates, who are likely to be loyal to the employer. The aim of the empirical study is definition of some students’ as job seekers peculiarities and their requirements to their potential employer. The survey in Latvia, Lithuania and Spain. Respondents were students from these countries’ tertiary education institutions Public Administration (PA) or relevant study programs. All three countries students’ peculiarities have just a slight difference. Overall, they all wish to work for a socially responsible employer that is able to provide positive working environment and possibilities for professional development and learning. However, respondents from each country have own peculiarities. The study might have a practical application. PA of the examined countries might use the results developing employer brand and creating job advertisements focusing on recent graduates’ recruitment.

Keywords: generation Y, human resources recruitment, job seekers, public administration

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Authors: Denise Allison D. Garcia, Camille C. Garcia, Keanu Raphael Garrido, Crestita B. Tan

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Introduction: Anxiety is a common problem among pre-operative patients. Several methods or interventions are being applied in order to relieve anxiety. Laughter yoga, however, is a method that has been used to relieve anxiety but has not yet been tested to pre-operative patients. Therefore, this study determined the effectiveness of laughter yoga in reducing anxiety among pre-operative middle-aged patients scheduled for major surgery. Methods: After Ethics Review Board approval, a quasi-experimental study was conducted among 40 purposely-selected pre-operative patients in two tertiary hospitals. Anxiety level was measured prior to administration of laughter yoga using the State-Trait Anxiety Inventory with a Cronbach alpha of 0.83. After Laughter yoga, anxiety level was then measured again. Gathered data were analyzed in SPSS version 20 using paired and independent t-test and ANCOVA. Results: After analysis of the data gathered, the results showed that there was a significant decrease in the anxiety level of patients in the experimental group. From an anxiety level of 44.00, the rating went down to 36.85. Meanwhile in the control group, the anxiety level at the pretest at 41.25 went up to 42.50. Laughter yoga was an effective non-pharmacologic intervention for reducing anxiety of pre-operative patients. Conclusion: It is therefore concluded that laughter yoga causes a significant decrease in the anxiety level of patients.

Keywords: anxiety, laughter yoga, non-pharmacologic, pre-operative

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Authors: Jyoti Agrawal

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Introduction: Renal diseases in children and young adult can be difficult to diagnose early as it may present only with few symptoms, tends to have different course than adult and respond variously to different treatment. The pattern of renal disease in children is different from developing countries as compared to developed countries. Methods: This study was a hospital based prospective observational study carried from March, 2014 to February 2015 at BP Koirala institute of health sciences. Patients with renal disease, both inpatient and outpatient from birth to 14 years of age were enrolled in the study. The diagnosis of renal disease was be made on clinical and laboratory criteria. Results: Total of 120 patients were enrolled in our study which contributed to 3.74% % of total admission. The commonest feature of presentation was edema (75%), followed by fever (65%), hypertension (60%), decreased urine output (45%) and hematuria (25%). Most common diagnosis was acute glomerulonephritis (40%) followed by Nephrotic syndrome (25%) and urinary tract infection (25%). Renal biopsy was done for 10% of cases and most of them were steroid dependent nephrotic syndrome. 5% of our cases expired because of multiorgan dysfunction syndrome, sepsis and acute kidney injury. Conclusion: Renal disease contributes to a large part of hospital pediatric admission as well as mortality and morbidity to the children.

Keywords: glomerulonephritis, nephrotic syndrome, renal disease, urinary tract infection

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Authors: Ana-Marija Stjepić, Luka Sušac, Dalia Suša Vugec

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In the last few years, examples from scientific literature and business practices show that the adoption of technological innovations increases enterprises' performance. Recently, when it comes to the field of information technology innovation, business intelligence systems (BISs) have drawn a significant amount of attention of the scientific circles. BISs can be understood as a form of technological innovation which can bring certain benefits to the organizations that are adopting it. Therefore, the aim of this paper is twofold: (1) to define determinants of successful BISs adoption in small and medium enterprises and thus contribute to this neglected research area and (2) to present the current state of BISs adoption in small and medium-sized companies. In order to do so, determinants are defined and classified into three dimensions, according to the Technology – Organization – Environment (TOE) theoretical framework that describes the impact of each dimension on technological innovations adoption. Moreover, paper brings a case study presenting the adoption of BISs in practice within an organization from tertiary (service) industry sector. Based on the results of the study, guidelines for more efficient, faster and easier BISs adoption are presented.

Keywords: adoption, business intelligence, business intelligence systems, case study, TOE framework

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Authors: Natasha Goh, Sebastian Brown

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Purpose: This case report describes an unusual presentation of uveal melanoma. Method: Case notes, imaging, and histopathological specimen were reviewed for this case report. Result: The patient is a 62-year-old lady of Chinese heritage who had been receiving follow-up at the eye clinic of a tertiary hospital. She had a longstanding history of poor vision in her right eye after sustaining trauma to the eye at age 3. She was found to have a carotid-cavernous sinus fistula in the right eye in 2009 and underwent stenting in China. Unfortunately, this was unsuccessful and resulted in a painful blind eye. She had represented with headaches, worsening eye pain, and ptosis in Sydney in 2016. Her CT angiogram showed a calcified vascular structure in the orbit and globe, and she was offered a digital subtraction angiography by the neurosurgical team, which she ultimately declined. She had since been followed up at the eye clinic for the pthisical eye. Due to chronic ocular pain and recurrent conjunctivitis, the decision was made for an evisceration in 2021. The specimen was sent for routine histopathological examination and returned positive for uveal melanoma. The patient was subsequently referred to a melanoma center for further follow-up, which comprised serial imaging and radiotherapy treatment. Conclusion: Clinicians should bear in mind that uveal melanomas may present in a longstanding phthisical eye and in patients with no or little apparent risk factors.

Keywords: uveal melanoma, pthisical eye, carotid cavernous fistula, uveal melanoma risk factors

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Authors: A. Pokharel, A. Farooque, B. Acharya

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Pyrolysis can be used for energy production from waste biomass of agriculture and forestry. Biochar is the solid byproduct of pyrolysis and its cascading use can offset the cost of the process. A wide variety of research on biochar has highlighted its ability to absorb nutrients, metal and complex compounds; filter suspended solids; enhance microorganisms’ growth; retain water and nutrients as well as to increase carbon content of soil. In addition, sustainable biochar systems are an attractive approach for carbon sequestration and total waste management cycle. Commercially available biochar from Sigma Aldrich was studied for adsorption of nitrogen from effluent of municipal wastewater treatment plant. Adsorption isotherm and breakthrough curve were determined for the biochar. Similarly, biochar’s effects in aerobic as well as anaerobic bioreactors were also studied. In both cases, the biomass was increased in presence of biochar. The amount of gas produced for anaerobic digestion of fruit mix (apple and banana) was similar but the rate of production was significantly faster in biochar fed reactors. The cumulative goal of the study is to use biochar in various wastewater treatment units like aeration tank, secondary clarifier and tertiary nutrient recovery system as well as in anaerobic digestion of the sludge to optimize utilization and add value before being used as a soil amendment.

Keywords: biochar, nutrient recyling, wastewater treatment, soil amendment

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Authors: Barzin Rajabloo, Martin Desilets

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First, an electrochemical model for the reduction of CO₂ into CH₃OH is developed in which mass and charge transfer, reactions at the surface of the electrodes and fluid flow of the electrolyte are considered. This mathematical model is developed in COMSOL Multiphysics® where both secondary and tertiary current distribution interfaces are coupled to consider concentrations and potentials inside different parts of the cell. Constant reaction rates are assumed as the fitted parameters to minimize the error between experimental data and modeling results. The model is validated through a comparison with experimental data in terms of faradaic efficiency for production of CH₃OH, the current density in different applied cathode potentials as well as current density in different electrolyte flow rates. The comparison between model outputs and experimental measurements shows a good agreement. The model indicates the higher hydrogen evolution in comparison with CH₃OH production as well as mass transfer limitation caused by CO₂ concentration, which are consistent with findings in the literature. After validating the model, in the second part of the study, some design parameters of the cell, such as cathode geometry and catholyte/anolyte channel widths, are modified to reach better performance and higher faradaic efficiency of methanol production.

Keywords: carbon dioxide, electrochemical reduction, methanol, modeling

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Authors: Bello Ali

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The use of Information and Communication Technology (ICT) in tertiary institutions by lecturers and students has become a necessity for the enhancement of quality teaching and learning. This study examined availability, accessibility and utilization of ICT in Teaching-Learning Islamic Studies in Colleges of Education, North-East, Nigeria. The study adopted multi-stage sampling technique, in which, five out of the eleven Colleges of Education (both Federal and State owned) were purposively selected for the study. Primary data was drawn from the respondents by the use of questionnaire, interviews and observations. The results of the study, generally, indicate that the availability and accessibility to ICT facilities in Colleges of Education in North-East, Nigeria, especially in teaching/learning delivery of Islamic studies were relatively inadequate and rare to lecturers and students. The study further reveals that the respondents’ level of utilization of ICT is low and only few computer packages and internet services were involved in the ICT utilization, which is yet to reach the real expected situation of the globalization and advancement in the application of ICT if compared to other parts of the world, as far as the teaching and learning of Islamic studies is concerned. Observations and conclusion were drawn from the findings and finally, recommendations on how to improve on ICT availability, accessibility and utilization in teaching/ learning were suggested.

Keywords: accessibility, availability, college of education, ICT, Islamic studies, learning, North-East, teaching, utilization

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Authors: Yaser Meeralam, Walaa Alharthi, Hadeel Ashi, Alaa Bakhsh, Kholood Aljabri, Ebtihal Bin Salim

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Background:Basidiobolusranrum causes one of the rare fungal diseases that infects mainly immunocompetent individuals. Gastrointestinal Basidiobolomycosis (GIB) is a rare and uncommon form of this fungal infection. It’s still ambiguous how this fungus is reaching the gastrointestinal tract leading to Gastrointestinal Basidiobolomycosis. Objective: To summarize the clinical features, imaging, and histopathological of patients diagnosed with GIB in our institution. Patients and methods: A series of five cases of patients who diagnosed by basidiobolomycosis in King Abdullah Medical City, Makkah, Saudi Arabia, which reviewed by latest literature related to diagnosis and treatment. Results: Most of the patients were externally evaluated and were initially misdiagnosed. Some of them were suspected of colonic malignancy, other presumed to have hepatic hemangioma and fistulizing crohn’s disease. The definitive diagnosis is often based on histopathological examination and fungal culture of the surgically resected mass. An optimum standardized treatment of basidiobolomycosis has not yet been established. Conclusion: Deeper knowledge of clinical characteristics, diagnosis, and treatment of basidiobolomycosis will allow early initiating of treatment with a subsequent positive impact on the patients’ outcome. More studies are needed to establish a definite treatment.

Keywords: gastrointestinal infection, crohn's mimics, malignancy mimics, fungal infection

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Authors: Fahd Hamad Alqasham

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This longitudinal study investigates Saudi students’ use trajectory and experiences of Twitter as an innovative tool for in-class learning of the English language in a Saudi tertiary English as a foreign language (EFL) context for a 12-week semester. The study adopted van Lier’s agency theory (2008, 2010) as the analytical framework to obtain an in-depth analysis of how the learners’ could utilize Twitter to create innovative ways for them to engage in English learning inside the language classroom. The study implemented a mixed methods approach, including six data collection instruments consisting of a research log, observations, focus group participation, initial and post-project interviews, and a post-project questionnaire. The study was conducted at Qassim University, specifically at Preparatory Year Program (PYP) on the main campus. The sample included 25 male students studying in the first level of PYP. The findings results revealed that although Twitter’s affordances initially paled a crucial role in motivating the learners to initiate their agency inside the classroom to learn English, the contextual constraints, mainly anxiety, the university infrastructure, and the teacher’s role negatively influenced the sustainability of Twitter’s use past week nine of its implementation.

Keywords: CALL, agency, innovation, EFL, language learning

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Authors: F. A. Ogundolie, F. Okogue, D. V. Adegunloye

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Greywater samples were obtained from three restaurants in the Federal University of Technology; Akure coded SSR, MGR and GGR. Fungi isolates obtained include Rhizopus stolonifer, Aspergillus niger, Mucor mucedo, Aspergillus flavus, Saccharomyces cerevisiae. Of these fungi isolates obtained, R. stolonifer, A. niger and A. flavus showed significant degradation ability on grey water and was used for this research. A simple bioreactor was constructed using biodegradation process in purification of waste water samples. Waste water undergoes primary treatment; secondary treatment involves the introduction of the isolated organisms into the waste water sample and the tertiary treatment which involved the use of filter candle and the sand bed filtration process to achieve the end product without the use of chemicals. A. niger brought about significant reduction in both the bacterial load and the fungi load of the greywater samples of the three respective restaurants with a reduction of (1.29 × 108 to 1.57 × 102 cfu/ml; 1.04 × 108 to 1.12 × 102 cfu/ml and 1.72 × 108 to 1.60 × 102 cfu/ml) for bacterial load in SSR, MGR and GGR respectively. Reduction of 2.01 × 104 to 1.2 × 101; 1.72 × 104 to 1.1 × 101, and 2.50 × 104 to 1.5 × 101 in fungi load from SSR, MGR and GGR respectively. Result of degradation of these selected waste water by the fungi showed that A. niger was probably more potent in the degradation of organic matter and hence, A. niger could be used in the treatment of wastewater.

Keywords: Aspergillus niger, greywater, bacterial, fungi, microbial load, bioreactor, biodegradation, purification, organic matter and filtration

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Authors: Sawan Kumar Jangid

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The paper attempts to study various facets of urbanization and regional planning in the framework of the present conditions and future needs. Urbanization is a dynamic system in which development and changes are prominent features; which implies population growth and changes in the primary, secondary and tertiary sector in the economy. Urban population is increasing day by day due to a natural increase in population and migration from rural areas, and the impact is bound to have in urban areas in terms of infrastructure, environment, water supply and other vital resources. For the organized way of planning and monitoring the implementation of Physical urban and regional plans high-resolution satellite imagery is the potential solution. Now the Remote Sensing data is widely used in urban as well as regional planning, infrastructure planning mainly telecommunication and transport network planning, highway development, accessibility to market area development in terms of catchment and population built-up area density. With Remote Sensing it is possible to identify urban growth, which falls outside the formal planning control. Remote Sensing and GIS technique combined together facilitate the planners, in making a decision, for general public and investors to have relevant data for their use in minimum time. This paper sketches out the Urbanization modal for the future development of Urban and Regional Planning. The paper suggests, a dynamic approach towards regional development strategy.

Keywords: development, dynamic, migration, resolution

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Authors: Sanaa Mekdad, Leenah Alsayed

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Pharmacists play an important role in the CDTM in the care of patients with heart failure (HF). CDTM allows specialized, dedicated clinical pharmacists in a formal agreement in collaborative practice with physicians. Thus, the aim of this study is to investigate the role of cardiology clinical pharmacists in CDTM in decreasing hospitalization and cost. We studied patients with left ventricular systolic dysfunction in a cluster-randomized selection in a tertiary care center. We allocated 296 patients to pharmacist intervention from 1480 patients. Results: With an acceptance rate of 86%, we documented 696 interventions carried out by clinical pharmacists in cardiology. The average intervention was 2.4 patients, and the admission after interventions decreased from 0.79 to. 0.24 (p value = 0.001). Conclusions: In HF CDTM, clinical pharmacists play a crucial role in enhancing medication management, patient education, and lifestyle modification of patients with chronic heart failure. These efforts improve patients' outcomes and lower costs by reducing hospitalization and other associated expenses.

Keywords: cardiology, medication management, heart failure, outpatient therapy, pharmacist-based services, chronic heart failure, heart failure recommendations, CDTM, Middle East, pharmacist-based services, quality of life, pharmacist

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Authors: Imeobong Joseph Inyang, Aniekan-Augusta Okon Eyo, Abel William Essien

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Hepatitis B virus (HBV) is one of the known human carcinogens. The presence of HBsAg in liver tissues indicates active viral replication. More than 85% of Hepatocellular Carcinoma (HCC) cases occur in countries with increased rates of chronic HBV infection. An evaluation study to determine the relationship between positivity for HBsAg and development of HCC and its distribution between age and gender of subjects was done. Shikata Orcein and Haematoxylin and Eosin (H&E) staining techniques were performed on liver sections. A total of 50 liver tissue specimens comprising 38 biopsy and 12 post-mortem specimens were processed. Thirty-five of the 50 specimens were positive for HBsAg with Orcein stain whereas only 16 were positive with H&E stain, and these were also positive with Orcein stain, giving an HBsAg prevalence of 70.0% (35/50). The prevalence of HCC in the study was 56.0% (28/50), of which 21 (75.0%) cases were positive for HBsAg, 18 (64.3%) were males while 10 (35.7%) were females distributed within the age range of 20-70 years. The highest number of HBsAg positive HCC cases, 7/21 (33.3%) occurred in the age group 40-49 years. There was no relationship in the pattern of distribution of HCC between age and gender using the Pearson correlation coefficient (r = 0.0474; P < 0.05). HBV infection predisposed to HCC. Orcein technique was more specific and is therefore recommended for screening of liver tissues where facilities for immunohistochemistry are inaccessible.

Keywords: Hepatitis B. surface antigen, hepatocellular carcinoma, orcein, pathology

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Authors: Abdullah I. Alkraiji, Thomas W. Jackson, Ian Murray

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The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.

Keywords: interoperabilty, medical data exchange, health data standards, case study, Saudi Arabia

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Authors: Hamid Mustafa, Adeela Ajmal, Kim EuiSoo, Noor-ul-Ain

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World wild, buffalo production is considered as most important component of food industry. Efficient buffalo production is related with reproductive performance of this species. Lack of knowledge of reproductive efficiency and its related genes in buffalo species is a major constraint for sustainable buffalo production. In this study, we performed some bioinformatics analysis on Follicle Stimulating Hormone Receptor (FSHR) gene and explored the possible relationship of this gene among different buffalo breeds and with other farm animals. We also found the evolution pattern for this gene among these species. We investigate CDS lengths, Stop codon variation, homology search, signal peptide, isoelectic point, tertiary structure, motifs and phylogenetic tree. The results of this study indicate 4 different motif in this gene, which are Activin-recp, GS motif, STYKc Protein kinase and transmembrane. The results also indicate that this gene has very close relationship with cattle, bison, sheep and goat. Multiple alignment (MA) showed high conservation of motif which indicates constancy of this gene during evolution. The results of this study can be used and applied for better understanding of this gene for better characterization of Follicle Stimulating Hormone Receptor (FSHR) gene structure in different farm animals, which would be helpful for efficient breeding plans for animal’s production.

Keywords: buffalo, FSHR gene, bioinformatics, production

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Authors: Marie Alaghband, Niloofar Yousefi, Ivan Garibay

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Facial expressions are important parts of both gesture and sign language recognition systems. Despite the recent advances in both fields, annotated facial expression datasets in the context of sign language are still scarce resources. In this manuscript, we introduce an annotated sequenced facial expression dataset in the context of sign language, comprising over 3000 facial images extracted from the daily news and weather forecast of the public tv-station PHOENIX. Unlike the majority of currently existing facial expression datasets, FePh provides sequenced semi-blurry facial images with different head poses, orientations, and movements. In addition, in the majority of images, identities are mouthing the words, which makes the data more challenging. To annotate this dataset we consider primary, secondary, and tertiary dyads of seven basic emotions of "sad", "surprise", "fear", "angry", "neutral", "disgust", and "happy". We also considered the "None" class if the image’s facial expression could not be described by any of the aforementioned emotions. Although we provide FePh as a facial expression dataset of signers in sign language, it has a wider application in gesture recognition and Human Computer Interaction (HCI) systems.

Keywords: annotated facial expression dataset, gesture recognition, sequenced facial expression dataset, sign language recognition

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Authors: Huma Naqeeb

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Epidemiological studies have shown the robust link between breast cancer and dietary pattern. There has been no previous study conducted in Pakistan, which specifically focuses on dietary patterns among breast cancer women. This study aims to examine the association of breast cancer with dietary patterns among Pakistani women. This case-control research was carried in multiple tertiary care facilities. Newly diagnosed primary breast cancer patients were recruited as cases (n = 408); age matched controls (n = 408) were randomly selected from the general population. Data on required parameters were systematically collected using subjective and objective tools. Factor and Principal Component Analysis (PCA) techniques were used to extract women’s dietary patterns. Four dietary patterns were identified based on eigenvalue >1; (i) veg-ovo-fish, (ii) meat-fat-sweet, (iii) mix (milk and its products, and gourds vegetables) and (iv) lentils - spices. Results of the multiple regressions were displayed as adjusted odds ratio (Adj. OR) and their respective confidence intervals (95% CI). After adjusted for potential confounders, veg-ovo-fish dietary pattern was found to be robustly associated with a lower risk of breast cancer among women (Adj. OR: 0.68, 95%CI: (0.46-0.99, p<0.01). The study findings concluded that attachment to the diets majorly composed of fresh vegetables, and high quality protein sources may contribute in lowering the risk of breast cancer among women.

Keywords: breast cancer, dietary pattern, women, principal component analysis

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Authors: G. Disciglio, G. Gatta, A. Libutti, A. Tarantino, L. Frabboni, E. Tarantino

Abstract:

Results of a field study carried out at Trinitapoli (Puglia region, southern Italy) on the irrigation of an artichoke crop with three types of water (secondary-treated wastewater, SW; tertiary-treated wastewater, TW; and freshwater, FW) are reported. Physical, chemical and microbiological analyses were performed on the irrigation water, and on soil and yield samples. The levels of most of the chemical parameters, such as electrical conductivity, total suspended solids, Na+, Ca2+, Mg+2, K+, sodium adsorption ratio, chemical oxygen demand, biological oxygen demand over 5 days, NO3 –N, total N, CO32, HCO3, phenols and chlorides of the applied irrigation water were significantly higher in SW compared to GW and TW. No differences were found for Mg2+, PO4-P, K+ only between SW and TW. Although the chemical parameters of the three irrigation water sources were different, few effects on the soil were observed. Even though monitoring of Escherichia coli showed high SW levels, which were above the limits allowed under Italian law (DM 152/2006), contamination of the soil and the marketable yield were never observed. Moreover, no Salmonella spp. were detected in these irrigation waters; consequently, they were absent in the plants. Finally, the data on the quantitative-qualitative parameters of the artichoke yield with the various treatments show no significant differences between the three irrigation water sources. Therefore, if adequately treated, municipal wastewater can be used for irrigation and represents a sound alternative to conventional water resources.

Keywords: artichoke, soil chemical characteristics, fecal indicators, treated municipal wastewater, water recycling

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Authors: S. Fadda, M. Fiori, C. Matzuzzi

Abstract:

Mineralized formations in the bottom sediments of a Miocene transgression have been discovered in Sardinia. The mineral assemblage consists of copper sulphides and oxidates suggesting fluctuations of redox conditions in neutral to high-pH restricted shallow-water coastal basins. Azurite/malachite has been observed as authigenic and occurs as loose spheroidal crystalline particles associated with the transitional-littoral horizon forming the bottom of the marine transgression. Many field observations are consistent with a supergenic circulation of metals involving terrestrial groundwater-seawater mixing. Both clastic materials and metals come from Tertiary volcanic edifices while the main precipitating anions, carbonates, and sulphides species are of both continental and marine origin. Formation of Cu carbonates as a supergene secondary 'oxide' assemblage, does not agree with field evidences, petrographic observations along with textural evidences in the host-rock types. Samples were collected along the sedimentary sequence for different analyses: the majority of elements were determined by X-ray fluorescence and plasma-atomic emission spectroscopy. Mineral identification was obtained by X-ray diffractometry and scanning electron microprobe. Thin sections of the samples were examined in microscopy while porosity measurements were made using a mercury intrusion porosimeter. Cu-carbonates deposited at a temperature below 100 C° which is consistent with the clay minerals in the matrix of the host rock dominated by illite and montmorillonite. Azurite nodules grew during the early diagenetic stage through reaction of cupriferous solutions with CO₂ imported from the overlying groundwater and circulating through the sandstones during shallow burial. Decomposition of organic matter in the bottom anoxic waters released additional carbon dioxide to pore fluids for azurite stability. In this manner localized reducing environments were also generated in which Cu was fixed as Cu-sulphide and sulphosalts. Microscopic examinations of textural features of azurite nodules give evidence of primary malachite/azurite deposition rather than supergene oxidation in place of primary sulfides. Photomicrographs show nuclei of azurite and malachite surrounded by newly formed microcrystalline carbonates which constitute the matrix. The typical pleochroism of crystals can be observed also when this mineral fills microscopic fissures or cracks. Sedimentological evidence of transgression and regression indicates that the pore water would have been a variable mixture of marine water and groundwaters with a possible meteoric component in an alternatively exposed and subaqueous environment owing to water-level fluctuation. Salinity data of the pore fluids, assessed at random intervals along the mineralised strata confirmed the values between about 7000 and 30,000 ppm measured in coeval sediments at the base of Miocene falling in the range of a more or less diluted sea water. This suggests a variation in mean pore-fluids pH between 5.5 and 8.5, compatible with the oxidized and reduced mineral paragenesis described in this work. The results of stable isotopes studies reflect the marine transgressive-regressive cyclicity of events and are compatibile with carbon derivation from sea water. During the last oxidative stage of diagenesis, under surface conditions of higher activity of H₂O and O₂, CO₂ partial pressure decreased, and malachite becomes the stable Cu mineral. The potential for these small but high grade deposits does exist.

Keywords: sedimentary, Cu-carbonates, authigenic, tertiary, Sardinia

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Authors: Chowdhury Md. Navim Kabir

Abstract:

Renal impairment is one of the most severe non-communicable diseases around the world. Especially patients with diagnosed/newly diagnosed renal impairment who need surgery are more focused on preoperative and postoperative preparation. Serum creatinine is the prime biochemical marker for assessing renal function, and the level of impairment is widely measured by this marker as well as Glomerular Filtration Rate (GFR). Objective: Factors responsible for fluctuating serum creatinine during preoperative and postoperative periods and minimizing the process of serum creatinine is the ultimate goal of this study. Method: 37 patients participated in this cross-sectional study who were previously diagnosed/newly diagnosed. They were admitted to different tertiary-level hospitals for emergency or elective surgery. Fifteen patients were admitted in the renal function impairment stage and 22 were admitted as normal patients’. Values of creatinine at the pre-admission stage and 2nd/3rd post-admission follow-up were compared. Results: 0.41 was the average of 22 patients' creatinine between pre-admission and 2nd/3rd follow-up. The responsible factor like prolonged staying, immobilization, co-morbidities, different preoperative antibiotics and Non-Steroidal Anti Inflammatory Drugs (NSAIDs) were also inducers for creatinine elevation. After postoperative hemodialysis rapid decrease of creatinine is seen in normal patients, but this decrease is very much minor in Chronic Kidney Disease (CKD) diagnosed patients.

Keywords: CKD, Meropenam, NSAID, comorbidities, immobilized

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Authors: Ali Ait Boughrous, Said Benyoussef, Hossain El Ouarghi, Moulay Abdelazize Aboulhassan, Samah Aitbnichou, Said Benguamra

Abstract:

The Rhiss-Nekor aquifer represents a primary water source for the central Rif region. Many operating structures were built for irrigation and drinking water supply. Because of the vulnerability of this aquifer, a thorough knowledge of the environment is needed to evaluate and protect resources. This work aims at the quality assessment of the water table of the plain Ghiss-Nekor and determination of pollution sources in order to establish a map of the web. The plain-Rhiss Nekor, with an area of 100 km2, is located on the Mediterranean coast of Morocco. It has a particular geological structure resulting from the opening of a graben at the end of the Tertiary, which is filled by the accumulation of hundreds of meters of sediment, generating considerable heterogeneity in deposits. This heterogeneity gives various hydrodynamic properties within the aquifer of the plain. The analysis of the water quality of twenty water points, well distributed over the plain, showed high natural salinity linked to the geological nature of the area. This salinity increases in the littoral area by the seawater intrusion phenomenon. This is accentuated by overexploitation of the ground water due to the growing demand. Some wells, located inland, are characterized by organic pollution caused by wastewater seepage from septic tanks and lost wells widespread in the region.

Keywords: anthropogenic factors, groundwater quality, marine intrusion, Rhiss-Nekor aquifer

Procedia PDF Downloads 111

Authors: Bernett Nkwayi Mulungo

Abstract:

There are vast community music projects in South African townships, and their courses range from music theory aural practical individual and ensemble lessons on orchestral instruments and recorders – these instruments being primarily “Western”. Despite this relative success – indeed one of the few in the realm of arts in post-apartheid South Africa – what remains troubling is the dominance of western thought (as music theory) and modes of teaching music that maintain the idea of music study as alien in black communities. This identified problem speaks to a significant theme, namely: Arts education for community development, which is my area of interest. Primarily for, it is a timely platform to firmly entrench appreciation, understanding, and, most undoubtedly, the value(s) of the arts to the youth. Drawing on one’s experience as a lecturer in (and graduate from) a South African tertiary institution and as a teacher in a community project, this research will interrogate the content of some of the program(s): from the theoretical material taught in music theory classes to the practical repertoire taught and/or performed. The focal point of this research is on how this content informs or speaks to its intended “beneficiaries” – the African youth. Through these and other considerations, the paper aims to sketch the potentially radical consequences that transformed music education at community and earlier levels will have for higher education music studies in South Africa.

Keywords: decolonization, Africanization, indigenous knowledge, community engagement

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Authors: Muhammad Munir, Riffat Mehboob, Samina Naeem, Muhammad Salman, Shehryar Ahmed, Irshad Hussain Qureshi, Tahira Murtaza Cheema, Ashraf Sultan, Akmal Laeeq, Nakhshab Choudhry, Asad Aslam Khan, Fridoon Jawad Ahmad

Abstract:

A dengue outbreak in Lahore, Pakistan during 2011 was unprecedented in terms of severity and magnitude. This research aims to determine the serotype distribution of dengue virus during this outbreak and classify the patients demographically. 5ml of venous blood was drawn aseptically from 166 patients with dengue-like signs to test for the virus between the months of August to November 2011. The samples were sent to the CDC, Atlanta, Georgia for the purpose of molecular assays to determine their serotype. RT-PCR protocol was performed targeting at the 4 dengue serotypes. Out of 166 cases, dengue infection was detected with RT-PCR in 95 cases, all infected with same serotype DEN-2. 75% of positive cases were males while 25% were females. Most positive patients were in the age range of 16-30 years. 33% positive cases had accompanying bleeding. This is first study during the 2011 dengue epidemic in Lahore that reports DEN-2 as the only prevalent serotype. It also indicates that more infected patients were males, adults, within age range of 16-30 years, peaked in the month of November, Dengue hemorrhagic fever (DHF) is manifested more in females, Ravi town was heavily hit by dengue virus infection.

Keywords: dengue, serotypes, Pakistan, DEN 2, Lahore, demography, serotype distrbution, 2011 epidemic

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