Search results for: Calculation of risk factor

Authors: A. Taqaddas

Abstract:

Purpose: Planning and dosimetry of different VMAT algorithms (SmartArc, Ergo++, Autobeam) is compared with IMRT for Head and Neck Cancer patients. Modelling was performed to rule out the causes of discrepancies between planned and delivered dose. Methods: Five HNC patients previously treated with IMRT were re-planned with SmartArc (SA), Ergo++ and Autobeam. Plans were compared with each other and against IMRT and evaluated using DVHs for PTVs and OARs, delivery time, monitor units (MU) and dosimetric accuracy. Modelling of control point (CP) spacing, Leaf-end Separation and MLC/Aperture shape was performed to rule out causes of discrepancies between planned and delivered doses. Additionally estimated arc delivery times, overall plan generation times and effect of CP spacing and number of arcs on plan generation times were recorded. Results: Single arc SmartArc plans (SA4d) were generally better than IMRT and double arc plans (SA2Arcs) in terms of homogeneity and target coverage. Double arc plans seemed to have a positive role in achieving improved Conformity Index (CI) and better sparing of some Organs at Risk (OARs) compared to Step and Shoot IMRT (ss-IMRT) and SA4d. Overall Ergo++ plans achieved best CI for both PTVs. Dosimetric validation of all VMAT plans without modelling was found to be lower than ss-IMRT. Total MUs required for delivery were on average 19%, 30%, 10.6% and 6.5% lower than ss-IMRT for SA4d, SA2d (Single arc with 2⁰ Gantry Spacing), SA2Arcs and Autobeam plans respectively. Autobeam was most efficient in terms of actual treatment delivery times whereas Ergo++ plans took longest to deliver. Conclusion: Overall SA single arc plans on average achieved best target coverage and homogeneity for both PTVs. SA2Arc plans showed improved CI and some OARs sparing. Very good dosimetric results were achieved with modelling. Ergo++ plans achieved best CI. Autobeam resulted in fastest treatment delivery times.

Keywords: Dosimetry, Intensity Modulated Radiotherapy, Optimization Algorithms, Volumetric Modulated Arc Therapy.

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Authors: E. Dabbour, S. M. Easa

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Most of the collision warning systems currently available in the automotive market are mainly designed to warn against imminent rear-end and lane-changing collisions. No collision warning system is commercially available to warn against imminent turning collisions at intersections, especially for left-turn collisions when a driver attempts to make a left-turn at either a signalized or non-signalized intersection, conflicting with the path of other approaching vehicles traveling on the opposite-direction traffic stream. One of the major factors that lead to left-turn collisions is the human error and misjudgment of the driver of the turning vehicle when perceiving the speed and acceleration of other vehicles traveling on the opposite-direction traffic stream; therefore, using a properly-designed collision warning system will likely reduce, or even eliminate, this type of collisions by reducing human error. This paper introduces perceptual framework for a proposed collision warning system that can detect imminent left-turn collisions at intersections. The system utilizes a commercially-available detection sensor (either a radar sensor or a laser detector) to detect approaching vehicles traveling on the opposite-direction traffic stream and calculate their speeds and acceleration rates to estimate the time-tocollision and compare that time to the time required for the turning vehicle to clear the intersection. When calculating the time required for the turning vehicle to clear the intersection, consideration is given to the perception-reaction time of the driver of the turning vehicle, which is the time required by the driver to perceive the message given by the warning system and react to it by engaging the throttle. A regression model was developed to estimate perception-reaction time based on age and gender of the driver of the host vehicle. Desired acceleration rate selected by the driver of the turning vehicle, when making the left-turn movement, is another human factor that is considered by the system. Another regression model was developed to estimate the acceleration rate selected by the driver of the turning vehicle based on driver-s age and gender as well as on the location and speed of the nearest approaching vehicle along with the maximum acceleration rate provided by the mechanical characteristics of the turning vehicle. By comparing time-to-collision with the time required for the turning vehicle to clear the intersection, the system displays a message to the driver of the turning vehicle when departure is safe. An application example is provided to illustrate the logic algorithm of the proposed system.

Keywords: Collision warning systems, intelligent transportationsystems, vehicle safety.

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Authors: Josef Novák, Alena Kohoutková

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The performance of concrete structures in fire depends on several factors which include, among others, the change in material properties due to the fire. Today, fiber reinforced concrete (FRC) belongs to materials which have been widely used for various structures and elements. While the knowledge and experience with FRC behavior under ambient temperature is well-known, the effect of elevated temperature on its behavior has to be deeply investigated. This paper deals with an experimental investigation and stress‑strain relations for hybrid fiber reinforced concrete (HFRC) which contains siliceous aggregates, polypropylene and steel fibers. The main objective of the experimental investigation is to enhance a database of mechanical properties of concrete composites with addition of fibers subject to elevated temperature as well as to validate existing stress-strain relations for HFRC. Within the investigation, a unique heat transport test, compressive test and splitting tensile test were performed on 150 mm cubes heated up to 200, 400, and 600 °C with the aim to determine a time period for uniform heat distribution in test specimens and the mechanical properties of the investigated concrete composite, respectively. Both findings obtained from the presented experimental test as well as experimental data collected from scientific papers so far served for validating the computational accuracy of investigated stress-strain relations for HFRC which have been developed during last few years. Owing to the presence of steel and polypropylene fibers, HFRC becomes a unique material whose structural performance differs from conventional plain concrete when exposed to elevated temperature. Polypropylene fibers in HFRC lower the risk of concrete spalling as the fibers burn out shortly with increasing temperature due to low ignition point and as a consequence pore pressure decreases. On the contrary, the increase in the concrete porosity might affect the mechanical properties of the material. To validate this thought requires enhancing the existing result database which is very limited and does not contain enough data. As a result of the poor database, only few stress-strain relations have been developed so far to describe the structural performance of HFRC at elevated temperature. Moreover, many of them are inconsistent and need to be refined. Most of them also do not take into account the effect of both a fiber type and fiber content. Such approach might be vague especially when high amount of polypropylene fibers are used. Therefore, the existing relations should be validated in detail based on other experimental results.

Keywords: Elevated temperature, fiber reinforced concrete, mechanical properties, stress strain relation.

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Authors: Reinaldo Biscaro, Luciano R. Ferreira, Leonardo C. Biscaro, Raphael C. Biscaro, Isabela S. Vasconcelos, Laura C. R. Ferreira, Cristiano M. Galhardi, Erica P. Baciuk

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Introduction: The present study had the objective to present the profile of workers with shoulder disorders related to labor lawsuits in Brazil. The study analyzed the association between the worker’s health and the actions performed by the companies related to injured professional. The research method performed a retrospective, cross-sectional and quantitative database analysis. The documents of labor lawsuits with shoulder injury registered at the Regional Labor Court in the 15^th region (Campinas - São Paulo) were submitted to the medical examination and evaluated during the period from 2012 until 2015. The data collected were age, gender, onset of symptoms, length of service, current occupation, type of shoulder injury, referred complaints, type of acromion, associated or related diseases, company actions as CAT (workplace accident communication), compliance of NR7 by the organization (Environmental Risk Prevention Program - PPRA and Medical Coordination Program in Occupational Health - PCMSO). Results: From the 93 workers evaluated, there was a prevalence of men (58.1%), with a mean age of 42.6 y-o, and 54.8% were included in the age group 35-49 years. Regarding the length of work time in the company, 66.7% have worked for more than 5 years. There was an association between gender and current occupational status (p < 0.005), with predominance of women in household occupation (13 vs. 2) and predominance of unemployed men in job search situation (24 vs. 10) and reintegrated to work by judicial decision (8 vs. 2). There was also a correlation between pain and functional limitation (p < 0.01). There was a positive association of PPRA with the complaint of functional limitation and negative association with pain (p < 0.04). There was also a correlation between the sedentary lifestyle and the presence of PCMSO and PPRA (p < 0.04), and the absence of CAT in the companies (p < 0.001). It was concluded that the appearance or aggravation of osseous and articular shoulder pathologies in workers who have undertaken labor law suits seem to be associated with individual habits or inadequate labor practices. These data can help preventing the occurrence of these lesions by implementing local health promotion policies at work.

Keywords: Work-related accidents, cross-sectional study, shoulder lesions, labor lawsuits.

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Authors: Nikou Javadi, Uğur Dağlı

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The importance of culture and tourism in the attractiveness and competitiveness of the countries is central, and many regions are evidencing their cultural assets, tangible and intangible, as a means to create comparative advantages in tourism and produce a distinctive place in response to the pressures of globalization. Culture and tourism are interlinked because of their obvious combination and growth potential. Cultural tourism is a crucial global tourism market with fast growing. Regions can develop significant relations between culture and tourism to increase their attractiveness as places to visit, live and invest, increasing their competitiveness. Accordingly, having new and creative approach to historical areas as cultural value-based destinations can improve their conditions to promote tourism. Furthermore, in 21st century, media become the most important factor affecting the development of urban cities, including public places. As a result of the digital revolution, re-imaging and re-linkage public places by media are essential to create more interactions between public spaces and users, interaction media display, and urban screens, one of the most important defined media. This interaction can transform the urban space from being neglected to be more interactive space with users, especially the pedestrians. The paper focuses on The Walled City of Famagusta. As many other historic quarters elsewhere in the world, is in a process, of decay and deterioration, and its functionally distinctive areas are severely threatened by physical, functional, locational, and image obsolescence at varying degrees. So the focus on the future development of this area through tourism promotion can be an appropriate decision for the monument enhancement of the spatial quality in Walled City of Famagusta. In this paper, it is aimed to identify the effects of these new digital factors to transform public spaces especially in historic urban areas to promote creative tourism. Accordingly, two different analysis methods are used as well as a theoretical review. The first is case study on site and the second is Close ended questionnaire, test many concepts raised in this paper. The physical analysis on site carried out in order to evaluate the walled city restoration for touristic purpose. Besides, theoretical review is done in order to provide background to the subject and cleared Factors to attract tourists.

Keywords: Historical areas, Media Facade, Sustainable tourism, Walled city of Famagusta.

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Authors: Alexander Buhr, Klaus Ehrenfried

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Trackside induced airflow velocities, also known as slipstream velocities, are an important criterion for the design of high-speed trains. The maximum permitted values are given by the Technical Specifications for Interoperability (TSI) and have to be checked in the approval process. For train manufactures it is of great interest to know in advance, how new train geometries would perform in TSI tests. The Reynolds number in moving model experiments is lower compared to full-scale. Especially the limited model length leads to a thinner boundary layer at the rear end. The hypothesis is that the boundary layer rolls up to characteristic flow structures in the train wake, in which the maximum flow velocities can be observed. The idea is to enlarge the boundary layer using roughness elements at the train model head so that the ratio between the boundary layer thickness and the car width at the rear end is comparable to a full-scale train. This may lead to similar flow structures in the wake and better prediction accuracy for TSI tests. In this case, the design of the roughness elements is limited by the moving model rig. Small rectangular roughness shapes are used to get a sufficient effect on the boundary layer, while the elements are robust enough to withstand the high accelerating and decelerating forces during the test runs. For this investigation, High-Speed Particle Image Velocimetry (HS-PIV) measurements on an ICE3 train model have been realized in the moving model rig of the DLR in Göttingen, the so called tunnel simulation facility Göttingen (TSG). The flow velocities within the boundary layer are analysed in a plain parallel to the ground. The height of the plane corresponds to a test position in the EN standard (TSI). Three different shapes of roughness elements are tested. The boundary layer thickness and displacement thickness as well as the momentum thickness and the form factor are calculated along the train model. Conditional sampling is used to analyse the size and dynamics of the flow structures at the time of maximum velocity in the train wake behind the train. As expected, larger roughness elements increase the boundary layer thickness and lead to larger flow velocities in the boundary layer and in the wake flow structures. The boundary layer thickness, displacement thickness and momentum thickness are increased by using larger roughness especially when applied in the height close to the measuring plane. The roughness elements also cause high fluctuations in the form factors of the boundary layer. Behind the roughness elements, the form factors rapidly are approaching toward constant values. This indicates that the boundary layer, while growing slowly along the second half of the train model, has reached a state of equilibrium.

Keywords: Boundary layer, high-speed PIV, ICE3, moving train model, roughness elements.

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Authors: Vanda Lucia Zammuner

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Subjective loneliness describes people who feel a disagreeable or unacceptable lack of meaningful social relationships, both at the quantitative and qualitative level. The studies to be presented tested an Italian 18-items self-report loneliness measure, that included items adapted from scales previously developed, namely a short version of the UCLA (Russell, Peplau and Cutrona, 1980), and the 11-items Loneliness scale by De Jong-Gierveld & Kamphuis (JGLS; 1985). The studies aimed at testing the developed scale and at verifying whether loneliness is better conceptualized as a unidimensional (so-called 'general loneliness') or a bidimensional construct, namely comprising the distinct facets of social and emotional loneliness. The loneliness questionnaire included 2 singleitem criterion measures of sad mood, and social contact, and asked participants to supply information on a number of socio-demographic variables. Factorial analyses of responses obtained in two preliminary studies, with 59 and 143 Italian participants respectively, showed good factor loadings and subscale reliability and confirmed that perceived loneliness has clearly two components, a social and an emotional one, the latter measured by two subscales, a 7-item 'general' loneliness subscale derived from UCLA, and a 6–item 'emotional' scale included in the JGLS. Results further showed that type and amount of loneliness are related, negatively, to frequency of social contacts, and, positively, to sad mood. In a third study data were obtained from a nation-wide sample of 9.097 Italian subjects, 12 to about 70 year-olds, who filled the test on-line, on the Italian web site of a large-audience magazine, Focus. The results again confirmed the reliability of the component subscales, namely social, emotional, and 'general' loneliness, and showed that they were highly correlated with each other, especially the latter two. Loneliness scores were significantly predicted by sex, age, education level, sad mood and social contact, and, less so, by other variables – e.g., geographical area and profession. The scale validity was confirmed by the results of a fourth study, with elderly men and women (N 105) living at home or in residential care units. The three subscales were significantly related, among others, to depression, and to various measures of the extension of, and satisfaction with, social contacts with relatives and friends. Finally, a fifth study with 315 career-starters showed that social and emotional loneliness correlate with life satisfaction, and with measures of emotional intelligence. Altogether the results showed a good validity and reliability in the tested samples of the entire scale, and of its components.

Keywords: Emotional loneliness, social loneliness, scale development and testing, life span and cultural differences.

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Authors: Orkide Donma, Mustafa M. Donma

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Obesity may lead to growing serious health problems throughout the world. Vitamin D appears to play a role in cardiovascular and metabolic health. Vitamin D deficiency may add to derangements in human metabolic systems, particularly those of children. Childhood obesity is associated with an increased risk of chronic and sophisticated diseases. The aim of this study is to investigate associations as well as possible differences related to parameters affected by obesity and their relations with vitamin D status in obese (OB) and morbid obese (MO) children. This study included a total of 78 children. Of them, 41 and 37 were OB and MO, respectively. WHO BMI-for age percentiles were used for the classification of obesity. The values above 99 percentile were defined as MO. Those between 95 and 99 percentiles were included into OB group. Anthropometric measurements were recorded. Basal metabolic rates (BMRs) were measured. Vitamin D status is determined by the measurement of 25-hydroxy cholecalciferol [25- hydroxyvitamin D3, 25(OH)D] using high-performance liquid chromatography. Vitamin D status was evaluated as deficient, insufficient and sufficient. Values < 20.0 ng/ml, values between 20-30 ng/ml and values > 30.0 ng/ml were defined as vitamin D deficient, insufficient and sufficient, respectively. Optimal 25(OH)D level was defined as ≥ 30 ng/ml. SPSSx statistical package program was used for the evaluation of the data. The statistical significance degree was accepted as p < 0.05. Mean ages did not differ between the groups. Significantly increased body mass index (BMI), waist circumference (C) and neck C as well as significantly decreased fasting blood glucose (FBG) and vitamin D values were observed in MO group (p < 0.05). In OB group, 37.5% of the children were vitamin D deficient, and in MO group the corresponding value was 53.6%. No difference between the groups in terms of lipid profile, systolic blood pressure (SBP), diastolic blood pressure (DBP) and insulin values was noted. There was a severe statistical significance between FBG values of the groups (p < 0.001). Important correlations between BMI, waist C, hip C, neck C and both SBP as well as DBP were found in OB group. In MO group, correlations only with SBP were obtained. In a similar manner, in OB group, correlations were detected between SBP-BMR and DBP-BMR. However, in MO children, BMR correlated only with SBP. The associations of vitamin D with anthropometric indices as well as some lipid parameters were defined. In OB group BMI, waist C, hip C and triglycerides (TRG) were negatively correlated with vitamin D concentrations whereas none of them were detected in MO group. Vitamin D deficiency may contribute to the complications associated with childhood obesity. Loss of correlations between obesity indices-DBP, vitamin D-TRG, as well as relatively lower FBG values, observed in MO group point out that the emergence of MetS components starts during obesity state just before the transition to morbid obesity. Aside from its deficiency state, associations of vitamin D with anthropometric measurements, blood pressures and TRG should also be evaluated before the development of morbid obesity.

Keywords: Children, morbid obesity, obesity, vitamin D.

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Authors: Ali K. M. Al-Nasrawi, Uday A. Al-Hamdany, Sarah M. Hamylton, Brian G. Jones, Yasir M. Alyazichi

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Surface elevation dynamics have always responded to disturbance regimes. Creating Digital Elevation Models (DEMs) to detect surface dynamics has led to the development of several methods, devices and data clouds. DEMs can provide accurate and quick results with cost efficiency, in comparison to the inherited geomatics survey techniques. Nowadays, remote sensing datasets have become a primary source to create DEMs, including LiDAR point clouds with GIS analytic tools. However, these data need to be tested for error detection and correction. This paper evaluates various DEMs from different data sources over time for Apple Orchard Island, a coastal site in southeastern Australia, in order to detect surface dynamics. Subsequently, 30 chosen locations were examined in the field to test the error of the DEMs surface detection using high resolution global positioning systems (GPSs). Results show significant surface elevation changes on Apple Orchard Island. Accretion occurred on most of the island while surface elevation loss due to erosion is limited to the northern and southern parts. Concurrently, the projected differential correction and validation method aimed to identify errors in the dataset. The resultant DEMs demonstrated a small error ratio (≤ 3%) from the gathered datasets when compared with the fieldwork survey using RTK-GPS. As modern modelling approaches need to become more effective and accurate, applying several tools to create different DEMs on a multi-temporal scale would allow easy predictions in time-cost-frames with more comprehensive coverage and greater accuracy. With a DEM technique for the eco-geomorphic context, such insights about the ecosystem dynamic detection, at such a coastal intertidal system, would be valuable to assess the accuracy of the predicted eco-geomorphic risk for the conservation management sustainability. Demonstrating this framework to evaluate the historical and current anthropogenic and environmental stressors on coastal surface elevation dynamism could be profitably applied worldwide.

Keywords: DEMs, eco-geomorphic-dynamic processes, geospatial information science. Remote sensing, surface elevation changes.

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Authors: Samar Saadeldin Abdelmotalab Omer, Ikram Mohamed Eltayeb Elsiddig, Amna Beshir Medani Ahmed, Saad Mohamed Hussein Ayoub

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Many herbal medicinal products are considered potential anti-hypercholesterolemic agents with encouraging safety profiles, however only a limited amount of clinical research exists to support their efficacy. The present study was designed to compare the antihypercholesterolemic and antioxidant activities of the crude ethanolic extracts of Citrus reticulata fruit peel, Zingiber officinale rhizome and Sesamum indicum seeds. Forty-five rats were used throughout the experiment which are extended for four weeks. These were divided into nine groups, five rats per each group as follows; group 1 was the normal control group (rats only fed standard normal rat diet), group 2 was the hypercholesterolemic control group (rats fed only hypercholesterolemic diet which contained 1% cholesterol plus 10% saturated animal fat added to the normal rat diet), groups 3 and 4 were fed hypercholesterolemic diet in addition to Citrus reticulata ethanolic extract at doses of (250mg/kg (group 3) and 500mg/kg (group 4)) administered daily via oral route, groups 5 and 6 were given hypercholesterolemic diet in addition to Zingiber officinale ethanolic extract at doses of (250mg/kg (group 5) and 500mg/kg (group 6)) daily through oral route, groups 7 and 8 fed on hypercholesterolemic diet in addition to Sesamum indicum ethanolic extract at doses of (250mg/kg (group 7) and 500mg/kg (group 8)) daily orally; and group 9 rats were given hypercholesterolemic diet in addition to atorvastatin (0.18mg/kg) daily via oral route as a standard reference antihypercholesterolemic drug. Blood samples from all groups were drawn from the retro-orbital venous plexus four weeks following treatment after overnight fasting and the lipid profile (total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) and triglyceride levels) were measured and the risk ratio (TC/HDL-C) was assessed. The antioxidant activity of the three plants extracts was determined using DPPH free-radical antioxidant assay. Results of in vivo and in vitro antihypercholesterolemic and antioxidant assay respectively, revealed that the three extracts possess comparable antioxidant and antihypercholesterolemic activities.

Keywords: Antihypercholesterolemic effects, Antioxidant activity, HDL, LDL, TC, TGs, Citrus reticulata, Sesamum indicum, Zingiber officinale.

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Authors: R. Abdulrahman, A. Eardley, A. Soliman

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The proliferation in the development of mobile learning (m-learning) has played a vital role in the rapidly growing electronic learning market. This relatively new technology can help to encourage the development of in learning and to aid knowledge transfer a number of areas, by familiarizing students with innovative information and communications technologies (ICT). M-learning plays a substantial role in the deployment of learning methods for nursing students by using the Internet and portable devices to access learning resources ‘anytime and anywhere’. However, acceptance of m-learning by students is critical to the successful use of m-learning systems. Thus, there is a need to study the factors that influence student’s intention to use m-learning. This paper addresses this issue. It outlines the outcomes of a study that evaluates the unified theory of acceptance and use of technology (UTAUT) model as applied to the subject of user acceptance in relation to m-learning activity in nurse education. The model integrates the significant components across eight prominent user acceptance models. Therefore, a standard measure is introduced with core determinants of user behavioural intention. The research model extends the UTAUT in the context of m-learning acceptance by modifying and adding individual innovativeness (II) and quality of service (QoS) to the original structure of UTAUT. The paper goes on to add the factors of previous experience (of using mobile devices in similar applications) and the nursing students’ readiness (to use the technology) to influence their behavioural intentions to use m-learning. This study uses a technique called ‘convenience sampling’ which involves student volunteers as participants in order to collect numerical data. A quantitative method of data collection was selected and involves an online survey using a questionnaire form. This form contains 33 questions to measure the six constructs, using a 5-point Likert scale. A total of 42 respondents participated, all from the Nursing Institute at the Armed Forces Hospital in Saudi Arabia. The gathered data were then tested using a research model that employs the structural equation modelling (SEM), including confirmatory factor analysis (CFA). The results of the CFA show that the UTAUT model has the ability to predict student behavioural intention and to adapt m-learning activity to the specific learning activities. It also demonstrates satisfactory, dependable and valid scales of the model constructs. This suggests further analysis to confirm the model as a valuable instrument in order to evaluate the user acceptance of m-learning activity.

Keywords: Mobile learning, nursing institute, unified theory of acceptance and use of technology model.

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Authors: Nilima D. Gajbhiye

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Sodium nitrate has been used industrially in a number of work fields ranging from agriculture to food industry. Sodium nitrate and nitrite are associated with a higher risk of cancer in human beings. In present study, the effect of sodium nitrate on germinating seeds was studied. Two different sets of ungerminated Vigna radiata seeds were taken. In one set Vigna radiata seeds were soaked in distilled water for 4 hours and they were allowed to germinate in distilled water (Control) and 0.1 to 1% and 10% concentrations of sodium nitrate (NaNo₃). In soaked seed set, on 2^nd day radical developed in control and 0.1 to 1% concentrations of sodium nitrate. Seeds size was enlarged in 1% and 10% concentrations of sodium nitrate. On 3^rd day in 0.1% sodium nitrate length of the radicle was 7.5cm with one leaf let and control sample showed 9cm with one leaflet. On 5^th day in 0.1% sodium nitrate length of the radicle was 10 cm with one leaf let and control sample showed 11.5cm with one leaflet. No radicle developed in 1 and 10% NaNo₃ concentrations. On 10^th day all plants including control were dead. More number of mitotic cells was observed in apical root meristems of control germinating seeds and less mitotic cells were observed in 0.1% NaNo₃ germinating seeds. But cells were elongated in 0.9%NaNo₃ concentration and particles are deposited in the cells and no mitotic cells were observed. In other sets, dry seeds were allowed to germinate in Distilled water (control) and in 0.1 to 1% and 10% concentrations of sodium nitrate. In dry seed set, on 2^nd day radicle developed from control set. In 0.1 to 1% concentrations of sodium nitration seed enlarged in size but but not allowed germination. But in 10% NaNo₃ seeds coat colour was changed from dark green to brown. On 3^rd day the radicle was developed in 0.1% concentration of NaNo₃. No growth of radicle was observed in 0.3 to 10% concentrations of NaNo₃ but plumule was observed in control plant. Seed coat color was changed from dark green to brown in color in 1% and 10% NaNo₃. On 5^th day in control seeds the radicle growth was 11cm and 0.1% NaNo₃ concentration was 1.3 cm. On 10^th day all plants including control were dead. More number of mitotic cells was observed in apical root meristems of control germinating seeds and less mitotic cells were observed in 0.1% NaNo3 germinating seeds. At higher concentrations of NaNo₃ allowed seed germination in soaked seeds but produced radicle decay. In comparison to it, in dry seed set, germination of seeds observed only in 0.1% NaNo₃ concentration. The inhibitory effect of NaNo₃ on seed germination is due to reduction of water imbibition and mitotic activity.

Keywords: Germinating seeds, NaNo3, Vigna radiate, mitotic activity.

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Authors: Anuruddha Jayasuriya, Thanakorn Pheeraphan

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In this paper, a review of different mathematical models which can be used as prediction tools to assess the time to crack reinforced concrete (RC) due to corrosion is investigated. This investigation leads to an experimental study to validate a selected prediction model. Most of these mathematical models depend upon the mechanical behaviors, chemical behaviors, electrochemical behaviors or geometric aspects of the RC members during a corrosion process. The experimental program is designed to verify the accuracy of a well-selected mathematical model from a rigorous literature study. Fundamentally, the experimental program exemplifies both one-dimensional chloride diffusion using RC squared slab elements of 500 mm by 500 mm and two-dimensional chloride diffusion using RC squared column elements of 225 mm by 225 mm by 500 mm. Each set consists of three water-to-cement ratios (w/c); 0.4, 0.5, 0.6 and two cover depths; 25 mm and 50 mm. 12 mm bars are used for column elements and 16 mm bars are used for slab elements. All the samples are subjected to accelerated chloride corrosion in a chloride bath of 5% (w/w) sodium chloride (NaCl) solution. Based on a pre-screening of different models, it is clear that the well-selected mathematical model had included mechanical properties, chemical and electrochemical properties, nature of corrosion whether it is accelerated or natural, and the amount of porous area that rust products can accommodate before exerting expansive pressure on the surrounding concrete. The experimental results have shown that the selected model for both one-dimensional and two-dimensional chloride diffusion had ±20% and ±10% respective accuracies compared to the experimental output. The half-cell potential readings are also used to see the corrosion probability, and experimental results have shown that the mass loss is proportional to the negative half-cell potential readings that are obtained. Additionally, a statistical analysis is carried out in order to determine the most influential factor that affects the time to corrode the reinforcement in the concrete due to chloride diffusion. The factors considered for this analysis are w/c, bar diameter, and cover depth. The analysis is accomplished by using Minitab statistical software, and it showed that cover depth is the significant effect on the time to crack the concrete from chloride induced corrosion than other factors considered. Thus, the time predictions can be illustrated through the selected mathematical model as it covers a wide range of factors affecting the corrosion process, and it can be used to predetermine the durability concern of RC structures that are vulnerable to chloride exposure. And eventually, it is further concluded that cover thickness plays a vital role in durability in terms of chloride diffusion.

Keywords: Accelerated corrosion, chloride diffusion, corrosion cracks, passivation layer, reinforcement corrosion.

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Authors: Jill Stephenson, Marie Vaganay, Robert Cameron, Caoimhe McGurk, Neil Hewitt

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Purpose: The key aim of the research was to identify the secondary stressors experienced by businesses affected by single or repeated flooding and to determine to what extent businesses were affected by these stressors, along with any resulting impact on health. Additionally the research aimed to establish the likelihood of businesses being re-exposed to the secondary stressors through assessing awareness of flood risk, implementation of property protection measures and level of community resilience. Design/methodology/approach: The chosen research method involved the distribution of a questionnaire survey to businesses affected by either single or repeated flood events. The questionnaire included the Impact of Event Scale (a 15-item self-report measure which assesses subjective distress caused by traumatic events). Findings: 55 completed questionnaires were returned by flood impacted businesses. 89% of the businesses had sustained internal flooding, while 11% had experienced external flooding. The results established that the key secondary stressors experienced by businesses, in order of priority, were: flood damage, fear of reoccurring flooding, prevention of access to the premise/closure, loss of income, repair works, length of closure and insurance issues. There was a lack of preparedness for potential future floods and consequent vulnerability to the emergence of secondary stressors among flood affected businesses, as flood resistance or flood resilience measures had only been implemented by 11% and 13% respectively. In relation to the psychological repercussions, the Impact of Event scores suggested that potential prevalence of posttraumatic stress disorder (PTSD) was noted among 8 out of 55 respondents (l5%). Originality/value: The results improve understanding of the enduring repercussions of flood events on businesses, indicating that not only residents may be susceptible to the detrimental health impacts of flood events and single flood events may be just as likely as reoccurring flooding to contribute to ongoing stress. Lack of financial resources is a possible explanation for the lack of implementation of property protection measures among businesses, despite 49% experiencing flooding on multiple occasions. Therefore it is recommended that policymakers should consider potential sources of financial support or grants towards flood defences for flood impacted businesses. Any form of assistance should be made available to businesses at the earliest opportunity as there was no significant association between the time of the last flood event and the likelihood of experiencing PTSD symptoms.

Keywords: Flood event, flood resilience, flood resistance, PTSD, secondary stressors.

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Authors: B. Lefranc, C. Aufauvre-Poupon, C. Martin-Krumm, M. Trousselard

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Isolated and confined environments (ICE) present several challenges which may adversely affect human’s psychology and physiology. Submariners in Sub-Surface Ballistic Nuclear (SSBN) mission exposed to these environmental constraints must be able to perform complex tasks as part of their normal duties, as well as during crisis periods when emergency actions are required or imminent. The operational and environmental constraints they face contribute to challenge human adaptability. The impact of such a constrained environment has yet to be explored. Establishing a knowledge framework is a determining factor, particularly in view of the next long space travels. Ensuring that the crews are maintained in optimal operational conditions is a real challenge because the success of the mission depends on them. This study focused on the evaluation of the impact of stress on mental health and sensory degradation of submariners during a mission on SSBN using cardiac biosignal (heart rate variability, HRV) clustering. This is a pragmatic exploratory study of a prospective cohort included 19 submariner volunteers. HRV was recorded at baseline to classify by clustering the submariners according to their stress level based on parasympathetic (Pa) activity. Impacts of high Pa (HPa) versus low Pa (LPa) level at baseline were assessed on emotional state and sensory perception (interoception and exteroception) as a cardiac biosignal during the patrol and at a recovery time one month after. Whatever the time, no significant difference was found in mental health between groups. There are significant differences in the interoceptive, exteroceptive and physiological functioning during the patrol and at recovery time. To sum up, compared to the LPa group, the HPa maintains a higher level in psychosensory functioning during the patrol and at recovery but exhibits a decrease in Pa level. The HPa group has less adaptable HRV characteristics, less unpredictability and flexibility of cardiac biosignals while the LPa group increases them during the patrol and at recovery time. This dissociation between psychosensory and physiological adaptation suggests two treatment modalities for ICE environments. To our best knowledge, our results are the first to highlight the impact of physiological differences in the HRV profile on the adaptability of submariners. Further studies are needed to evaluate the negative emotional and cognitive effects of ICEs based on the cardiac profile. Artificial intelligence offers a promising future for maintaining high level of operational conditions. These future perspectives will not only allow submariners to be better prepared, but also to design feasible countermeasures that will help support analog environments that bring us closer to a trip to Mars.

Keywords: Adaptation, exteroception, HRV, ICE, interoception, SSBN.

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Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

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Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires were returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age ranges from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge; however, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non- significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: Gene Profiling, Knowledge, Malaysia, Physician.

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Authors: Ju-Chun Chien

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Rapid aging and depopulation could lead to serious problems, including workforce shortages and health expenditure costs. The current and predicted future LTC workforce shortages could be a real threat to Taiwan’s society. By means of comparison of data from 144 nursing aide trainees and 727 general public, the main purpose of the present study was to determine whether there were any notable differences between the two groups toward engaging in LTC services. Moreover, this study focused on recognizing the attributes of the general public who had the willingness to take LTC jobs but continue to ride the fence. A self-developed questionnaire was designed based on Ajzen’s Theory of Planned Behavior model. After conducting exploratory factor analysis (EFA) and reliability analysis, the questionnaire was a reliable and valid instrument for both nursing aide trainees and the general public. The main results were as follows: Firstly, nearly 70% of nursing aide trainees showed interest in LTC jobs. Most of them were middle-aged female (M = 46.85, SD = 9.31), had a high school diploma or lower, had unrelated work experience in healthcare, and were mostly unemployed. The most common reason for attending the LTC training program was to gain skills in a particular field. The second most common reason was to obtain the license. The third and fourth reasons were to be interested in caring for people and to increase income. The three major reasons that might push them to leave LTC jobs were physical exhaustion, payment is bad, and being looked down on. Secondly, the variables that best-predicted nursing aide trainees’ intention to engage in LTC services were having personal willingness, perceived behavior control, with high school diploma or lower, and supported from family and friends. Finally, only 11.80% of the general public reported having interest in LTC jobs (the disapproval rating was 50% for the general public). In comparison to nursing aide trainees who showed interest in LTC settings, 64.8% of the new workforce for LTC among the general public was male and had an associate degree, 54.8% had relevant healthcare experience, 67.1% was currently employed, and they were younger (M = 32.19, SD = 13.19) and unmarried (66.3%). Furthermore, the most commonly reason for the new workforce to engage in LTC jobs were to gain skills in a particular field. The second priority was to be interested in caring for people. The third and fourth most reasons were to give back to society and to increase income, respectively. The top five most commonly reasons for the new workforce to quitting LTC jobs were listed as follows: physical exhaustion, being looked down on, excessive working hours, payment is bad, and excessive job stress.

Keywords: Long-term care services, nursing aide trainees, Taiwanese people, theory of planned behavior.

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Authors: A. Kourou, S. Kyriakopoulos, N. Anyfanti

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A lot of children under the age of five spend their daytime hours away from their home, in a kindergarten. Caring for children is a serious subject, and their safety in case of earthquake is the first priority. Being aware of earthquakes helps to prioritize the needs and take the appropriate actions to limit the effects. Earthquakes occurring anywhere at any time require emergency planning. Earthquake planning is a cooperative effort and childcare providers have unique roles and responsibilities. Greece has high seismicity and Ionian Islands Region has the highest seismic activity of the country. Earthquake Planning and Protection Organization (EPPO) is a national organization in Greece. The mission of EPPO is the seismic risk reduction by designing an earthquake management program of mitigation and preparedness. Among other actions EPPO has analyzed the needs and requirements of kindergartens on earthquake protection issues and has designed specific activities to familiarize the day care centers staff being prepared for earthquakes.  This research presents the results of a survey that detects the level of earthquake preparedness of kindergartens in all over the country and Ionian Islands too. A closed-form questionnaire of 20 main questions was developed for the survey in order to detect the aspects of participants concerning the earthquake preparedness actions at individual, family and day care environment level. 2668 questionnaires were gathered from March 2014 to May 2019, and analyzed by EPPO’s Department of Education. Moreover, this paper presents the EPPO’s educational activities targeted to the Ionian Islands Region that implemented in the framework of “Telemachus” Project. To provide safe environment for children to learn, and staff to work is the foremost goal of any State, community and kindergarten. This project is funded under the Priority Axis “Environmental Protection and Sustainable Development” of Operational Plan “Ionian Islands 2014-2020”. It is increasingly accepted that emergency preparedness should be thought of as an ongoing process rather than a one-time activity. Creating an earthquake safe daycare environment that facilitates learning is a challenging task. Training, drills, and update of emergency plan should take place throughout the year at kindergartens to identify any gaps and to ensure the emergency procedures. EPPO will continue to work closely with regional and local authorities to actively address the needs of children and kindergartens before, during and after earthquakes.

Keywords: Child care centers, education on earthquake issues, emergency planning, Ionian Islands Region of Greece, kindergartens, preparedness.

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: Home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis.

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Authors: Ana Cristina García-Luna Romero

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This document seeks to reflect on the urban project from its conceptual identity root. In the first instance, a proposal is made on how the city project is sustained from the conceptual root, from the logos: it opens a way to assimilate the imagination; what we imagine becomes a reality. In this way, firstly, the need to use language as a vehicle for transmitting the stories that sustain us as humanity can be deemed as an important social factor that enables us to social behavior. Secondly, the need to attend to the written language as a mechanism of power, as a means to consolidate a dominant ideology or a political position, is raised; as it served to carry out the modernization project, it is therefore addressed differences between the real and the literate city. Thus, the consolidated urban-architectural project is based on logos, the project, and planning. Considering the importance of materiality and its relation to subjective well-being contextualized from a socio-urban approach, we question ourselves into how we can look at something that is doubtful. From a philosophy perspective, the truth is considered to be nothing more than a matter of correspondence between the observer and the observed. To understand beyond the relative of the gaze, it is necessary to expose different perspectives since it depends on the understanding of what is observed and how it is critically analyzed. Therefore, the analysis of materiality, as a political field, takes a proposal based on this research in the principles in transgenesis: principle of communication, representativeness, security, health, malleability, availability of potentiality or development, conservation, sustainability, economy, harmony, stability, accessibility, justice, legibility, significance, consistency, joint responsibility, connectivity, beauty, among others. The (urban) human being acts because he wants to live in a certain way: in a community, in a fair way, with opportunity for development, with the possibility of managing the environment according to their needs, etc. In order to comply with this principle, it is necessary to design strategies from the principles in transgenesis, which must be named, defined, understood, and socialized by the urban being, the companies, and from themselves. In this way, the technical status of the city in the neoliberal present determines extraordinary conditions for reflecting on an almost emergency scenario created by the impact of cities that, far from being limited to resilient proposals, must aim at the reflection of the urban process that the present social model has generated. Therefore, can we rethink the paradigm of the perception of life quality in the current neoliberal model in the production of the character of public space related to the practices of being urban. What we are trying to do within this document is to build a framework to study under what logic the practices of the social system that make sense of the public space are developed, what the implications of the phenomena of the inscription of action and materialization (and its results over political action between the social and the technical system) are and finally, how we can improve the quality of life of individuals from the urban space.

Keywords: Cities, nature, society, urban quality of life.

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Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

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This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: Antinuclear antibody, Subclinical hypothyroidism, Thyroxin, TPO antibody.

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Authors: Agâh Tuğrul Korucu, Ismail Fatih Yavuzaslan, Lale Toraman

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Nowadays, thanks to development of technology, integration of technology into teaching and learning activities is spreading. Increasing technological literacy which is one of the expected competencies for individuals of 21st century is associated with the effective use of technology in education. The most important factor in effective use of technology in education institutions is ICT teachers. The concept of computer assisted instruction (CAI) refers to the utilization of information and communication technology as a tool aided teachers in order to make education more efficient and improve its quality in the process of educational. Teachers can use computers in different places and times according to owned hardware and software facilities and characteristics of the subject and student in CAI. Analyzing teachers’ use of computers in education is significant because teachers are the ones who manage the course and they are the most important element in comprehending the topic by students. To accomplish computer-assisted instruction efficiently is possible through having positive attitude of teachers. Determination the level of knowledge, attitude and behavior of teachers who get the professional knowledge from educational faculties and elimination of deficiencies if any are crucial when teachers are at the faculty. Therefore, the aim of this paper is to identify ICT teachers' attitudes toward computer-assisted instruction in terms of different variables. Research group consists of 200 prospective ICT teachers studying at Necmettin Erbakan University Ahmet Keleşoğlu Faculty of Education CEIT department. As data collection tool of the study; “personal information form” developed by the researchers and used to collect demographic data and "the attitude scale related to computer-assisted instruction" are used. The scale consists of 20 items. 10 of these items show positive feature, while 10 of them show negative feature. The Kaiser-Meyer-Olkin (KMO) coefficient of the scale is found 0.88 and Barlett test significance value is found 0.000. The Cronbach’s alpha reliability coefficient of the scale is found 0.93. In order to analyze the data collected by data collection tools computer-based statistical software package used; statistical techniques such as descriptive statistics, t-test, and analysis of variance are utilized. It is determined that the attitudes of prospective instructors towards computers do not differ according to their educational branches. On the other hand, the attitudes of prospective instructors who own computers towards computer-supported education are determined higher than those of the prospective instructors who do not own computers. It is established that the departments of students who previously received computer lessons do not affect this situation so much. The result is that; the computer experience affects the attitude point regarding the computer-supported education positively.

Keywords: Attitude, computer based instruction, information and communication technologies, technology based instruction, teacher candidate.

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Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, Burns, FLAMES, scoring systems, outcome.

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Authors: Jacqueline P. Davies

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Introduction: Student nurses must develop skills in observation, communication and reflection as well as public health knowledge from their first year of training. This paper will explain a method developed for students to collect their own findings about public health in urban areas. These areas are both rich in the history of old public health that informs the content of many traditional public health walks, but are also locations where new public health concerns about chronic disease are concentrated. The learning method explained in this paper enables students to collect their own data and write original work as first year students. Examples of their findings will be given. Methodology: In small groups, health care students are instructed to walk in neighbourhoods near to the hospitals they will soon attend as apprentice nurses. On their walks, they wander slowly, engage in conversations, and enter places open to the public. As they drift, they observe with all five senses in the real three dimensional world to collect data for their reflective accounts of old and new public health. They are encouraged to stop for refreshments and taste, as well as look, hear, smell, and touch while on their walk. They reflect as a group and later develop an individual reflective account in which they write up their deep reflections about what they observed on their walk. In preparation for their walk, they are encouraged to look at studies of quality of Life and other neighbourhood statistics as well as undertaking a risk assessment for their walk. Findings: Reflecting on their walks, students apply theoretical concepts around social determinants of health and health inequalities to develop their understanding of communities in the neighbourhoods visited. They write about the treasured historical architecture made of stone, bronze and marble which have outlived those who built them; but also how the streets are used now. The students develop their observations into thematic analyses such as: what we drink as illustrated by the empty coke can tossed into a now disused drinking fountain; the shift in home-life balance illustrated by streets where families once lived over the shop which are now walked by commuters weaving around each other as they talk on their mobile phones; and security on the street, with CCTV cameras placed at regular intervals, signs warning trespasses and barbed wire; but little evidence of local people watching the street. Conclusion: In evaluations of their first year, students have reported the health walk as one of their best experiences. The innovative approach was commended by the UK governing body of nurse education and it received a quality award from the nurse education funding body. This approach to education allows students to develop skills in the real world and write original work.

Keywords: Education, innovation. nursing, urban.

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Authors: Ponshano Kaselekela, Simooya O. Oscar, Lunshano Boyd

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The Copperbelt University Health Services (CBUHS) was designated by the Zambia Medicines Regulatory Authority (ZAMRA), formally the Pharmaceutical Regulatory Authority (PRA) as a regional pharmacovigilance centre to carryout activities of drug safety monitoring in four provinces in Zambia. CBUHS’s mandate included stimulating the reporting of adverse drug reactions (ADRs), as well as collecting and collating ADR reports from health institutions in the four provinces. This report covers the researchers’ experiences from May 2008 to September, 2016. The main objectives are 1) to monitor ADRs in the Zambian population, 2) to disseminate information to all health professionals in the region advising that the CBU health was a centre for reporting ADRs in the region, 3) to monitor polypharmacy as well as the benefit-risk profile of medicines, 4) to generate independent, evidence based recommendations on the safety of medicines, 5) to support ZAMRA in formulating safety related regulatory decisions for medicines, and 6) to communicate findings with all key stakeholders. The methodology involved monthly visits, beginning in early May 2008 to September, 2016, by the CBUHS to health institutions in the programme areas. Activities included holding discussions with health workers, distribution of ADR forms and collection of ADRs reports. These reports, once collected, were documented and assessed at the CBUHS. A report was then prepared for ZAMRA on quarterly basis. At ZAMRA, serious ADRs were noted and recommendations made to the Ministry of Health of the Republic of Zambia. The results show that 2,600 ADRs reports were received at the pharmacovigilance regional centre. Most of the ADRs reports that received were due to antiretroviral drugs, as well as a few from anti-malarial drugs like Artemether/Lumefantrine – Coartem®. Three hundred and twelve ADRs were entered in the Uppsala Monitoring Centre WHO Vigiflow for further analysis. It was concluded that in general, 2008-16 were exciting years for the pharmacovigilance group at CBUHS. From a very tentative beginning, a lot of strides were made and contacts established with healthcare facilities in the region. The researchers were encouraged by the support received from the Copperbelt University management, the motivation provided by ZAMRA and most importantly the enthusiasm of health workers in all the health care facilities visited. As a centre for drug safety in Zambia, the results show it achieves its objectives for monitoring ADRs, Pharmacovigilance (drug safety monitoring), and activities of monitoring ADRs as well as preventing them. However, the centre faces critical challenges caused by erratic funding that prevents the smooth running of the programme.

Keywords: Assessments, evaluation, monitoring, pharmacovigilance.

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Authors: László L. Lippai

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In addition to the fact that mental health bears great significance to a particular individual, it can also be regarded as an organizational, community and societal resource. Within the Szeged Health Promotion Research Group, we conducted mental health surveys on two levels: The inhabitants of a medium-sized Hungarian town and students of a Hungarian university with a relatively big headcount were requested to participate in surveys whose goals were to define local government priorities and organization-level health promotion programmes, respectively. To facilitate professional decision-making, we defined three, pragmatically relevant, groups of the target population: the mentally healthy, the vulnerable and the endangered. In order to determine which group a person actually belongs to, we designed a simple and quick measurement tool, which could even be utilised as a smoothing method, the Mental State Questionnaire validity of the above three categories was verified by analysis of variance against psychological quality of life variables. We demonstrate the pragmatic significance of our method via the analyses of the scores of our two mental health surveys. On town level, during our representative survey in Hódmezővásárhely (N=1839), we found that 38.7% of the participants was mentally healthy, 35.3% was vulnerable, while 16.3% was considered as endangered. We were able to identify groups that were in a dramatic state in terms of mental health. For example, such a group consisted of men aged 45 to 64 with only primary education qualification and the ratios of the mentally healthy, vulnerable and endangered were 4.5, 45.5 and 50%, respectively. It was also astonishing to see to what a little extent qualification prevailed as a protective factor in the case of women. Based on our data, the female group aged 18 to 44 with primary education—of whom 20.3% was mentally healthy, 42.4% vulnerable and 37.3% was endangered—as well as the female group aged 45 to 64 with university or college degree—of whom 25% was mentally healthy, 51.3 vulnerable and 23.8% endangered—are to be handled as priority intervention target groups in a similarly difficult position. On organizational level, our survey involving the students of the University of Szeged, N=1565, provided data to prepare a strategy of mental health promotion for a university with a headcount exceeding 20,000. When developing an organizational strategy, it was important to gather information to estimate the proportions of target groups in which mental health promotion methods; for example, life management skills development, detection, psychological consultancy, psychotherapy, would be applied. Our scores show that 46.8% of the student participants were mentally healthy, 42.1% were vulnerable and 11.1% were endangered. These data convey relevant information as to the allocation of organizational resources within a university with a considerable headcount. In conclusion, The Mental State Questionnaire, as a valid smoothing method, is adequate to describe a community in a plain and informative way in the terms of mental health. The application of the method can promote the preparation, design and implementation of mental health promotion interventions. 

Keywords: Health promotion, mental health promotion, mental state questionnaire, psychological well-being.

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is associated with cardiovascular disease risk factors and metabolic syndrome (MetS). In this study, associations between adipokines and adipokine as well as obesity indices were evaluated. Plasma adipokine levels may exhibit variations according to body adipose tissue mass. Besides, upon consideration of obesity as an inflammatory disease, adipokines may play some roles in this process. The ratios of proinflammatory adipokines to adiponectin may act as highly sensitive indicators of body adipokine status. The aim of the study is to present some adipokine indices, which are thought to be helpful for the evaluation of childhood obesity and also to determine the best discriminators in the diagnosis of MetS. 80 prepubertal children (aged between 6-9.5 years) included in the study were divided into three groups; 30 children with normal weight (NW), 25 morbid obese (MO) children and 25 MO children with MetS. Physical examinations were performed. Written informed consent forms were obtained from the parents. The study protocol was approved by Ethics Committee of Namik Kemal University Medical Faculty. Anthropometric measurements, such as weight, height, waist circumference (C), hip C, head C, neck C were recorded. Values for body mass index (BMI), diagnostic obesity notation model assessment Index-II (D2 index) as well as waist-to-hip, head-to-neck ratios were calculated. Adiponectin, resistin, leptin, chemerin, vaspin, progranulin assays were performed by ELISA. Adipokine-to-adiponectin ratios were obtained. SPSS Version 20 was used for the evaluation of data. p values ≤ 0.05 were accepted as statistically significant. Values of BMI and D2 index, waist-to-hip, head-to-neck ratios did not differ between MO and MetS groups (p ≥ 0.05). Except progranulin (p ≤ 0.01), similar patterns were observed for plasma levels of each adipokine. There was not any difference in vaspin as well as resistin levels between NW and MO groups. Significantly increased leptin-to-adiponectin, chemerin-to-adiponectin and vaspin-to-adiponectin values were noted in MO in comparison with those of NW. The most valuable adipokine index was progranulin-to-adiponectin (p ≤ 0.01). This index was strongly correlated with vaspin-to-adiponectin ratio in all groups (p ≤ 0.05). There was no correlation between vaspin-to-adiponectin and chemerin-to--adiponectin in NW group. However, a correlation existed in MO group (r = 0.486; p ≤ 0.05). Much stronger correlation (r = 0.609; p ≤ 0.01) was observed in MetS group between these two adipokine indices. No correlations were detected between vaspin and progranulin as well as vaspin and chemerin levels. Correlation analyses showed a unique profile confined to MetS children. Adiponectin was found to be correlated with waist-to-hip (r = -0.435; p ≤ 0.05) as well as head-to-neck (r = 0.541; p ≤ 0.05) ratios only in MetS children. In this study, it has been investigated if adipokine indices have priority over adipokine levels. In conclusion, vaspin-to-adiponectin, progranulin-to-adiponectin, chemerin-to-adiponectin along with waist-to-hip and head-to-neck ratios were the optimal combinations. Adiponectin, waist-to-hip, head-to-neck, vaspin-to-adiponectin, chemerin-to-adiponectin ratios had appropriate discriminatory capability for MetS children.

Keywords: Adipokine indices, metabolic syndrome, obesity indices, pediatric obesity.

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Authors: L. Chiriatti, H. Hafid, H. R. Mercado-Mendoza, K. L. Apedo, C. Fond, F. Feugeas

Abstract:

Substituting natural aggregate with recycled aggregate coming from concrete demolition represents a promising alternative to face the issues of both the depletion of natural resources and the congestion of waste storage facilities. However, the crushing process of concrete demolition waste, currently in use to produce recycled concrete aggregate, does not allow the complete separation of natural aggregate from a variable amount of adhered mortar. Given the physicochemical characteristics of the latter, the introduction of recycled concrete aggregate into a concrete mix modifies, to a certain extent, both fresh and hardened concrete properties. As a consequence, the behavior of recycled reinforced concrete members could likely be influenced by the specificities of recycled concrete aggregates. Beyond the mechanical properties of concrete, and as a result of the composite character of reinforced concrete, the bond characteristics at the rebar/concrete interface have to be taken into account in an attempt to describe accurately the mechanical response of recycled reinforced concrete members. Hence, a comparative experimental campaign, including 16 pull-out tests, was carried out. Four concrete mixes with different recycled concrete aggregate content were tested. The main mechanical properties (compressive strength, tensile strength, Young’s modulus) of each concrete mix were measured through standard procedures. A single 14-mm-diameter ribbed rebar, representative of the diameters commonly used in the domain of civil engineering, was embedded into a 200-mm-side concrete cube. The resulting concrete cover is intended to ensure a pull-out type failure (i.e. exceedance of the rebar/concrete interface shear strength). A pull-out test carried out on the 100% recycled concrete specimen was enriched with exploratory acoustic emission measurements. Acoustic event location was performed by means of eight piezoelectric transducers distributed over the whole surface of the specimen. The resulting map was compared to existing data related to natural aggregate concrete. Damage distribution around the reinforcement and main features of the characteristic bond stress/free-end slip curve appeared to be similar to previous results obtained through comparable studies carried out on natural aggregate concrete. This seems to show that the usual bond mechanism sequence (‘chemical adhesion’, mechanical interlocking and friction) remains unchanged despite the addition of recycled concrete aggregate. However, the results also suggest that bond efficiency seems somewhat improved through the use of recycled concrete aggregate. This observation appears to be counter-intuitive with regard to the diminution of the main concrete mechanical properties with the recycled concrete aggregate content. As a consequence, the impact of recycled concrete aggregate content on bond characteristics seemingly represents an important factor which should be taken into account and likely to be further explored in order to determine flexural parameters such as deflection or crack distribution.

Keywords: Acoustic emission monitoring, high-bond steel rebar, pull-out test, recycled aggregate concrete.

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Authors: Nadezhda M. Usmanova, Nikolai V. Tomilin

Abstract:

Mammalian genomes contain large number of retroelements (SINEs, LINEs and LTRs) which could affect expression of protein coding genes through associated transcription factor binding sites (TFBS). Activity of the retroelement-associated TFBS in many genes is confirmed experimentally but their global functional impact remains unclear. Human SINEs (Alu repeats) and mouse SINEs (B1 and B2 repeats) are known to be clustered in GCrich gene rich genome segments consistent with the view that they can contribute to regulation of gene expression. We have shown earlier that Alu are involved in formation of cis-regulatory modules (clusters of TFBS) in human promoters, and other authors reported that Alu located near promoter CpG islands have an increased frequency of CpG dinucleotides suggesting that these Alu are undermethylated. Human Alu and mouse B1/B2 elements have an internal bipartite promoter for RNA polymerase III containing conserved sequence motif called B-box which can bind basal transcription complex TFIIIC. It has been recently shown that TFIIIC binding to B-box leads to formation of a boundary which limits spread of repressive chromatin modifications in S. pombe. SINEassociated B-boxes may have similar function but conservation of TFIIIC binding sites in SINEs located near mammalian promoters has not been studied earlier. Here we analysed abundance and distribution of retroelements (SINEs, LINEs and LTRs) in annotated sequences of the Database of mammalian transcription start sites (DBTSS). Fractions of SINEs in human and mouse promoters are slightly lower than in all genome but >40% of human and mouse promoters contain Alu or B1/B2 elements within -1000 to +200 bp interval relative to transcription start site (TSS). Most of these SINEs is associated with distal segments of promoters (-1000 to -200 bp relative to TSS) indicating that their insertion at distances >200 bp upstream of TSS is tolerated during evolution. Distribution of SINEs in promoters correlates negatively with the distribution of CpG sequences. Using analysis of abundance of 12-mer motifs from the B1 and Alu consensus sequences in genome and DBTSS it has been confirmed that some subsegments of Alu and B1 elements are poorly conserved which depends in part on the presence of CpG dinucleotides. One of these CpG-containing subsegments in B1 elements overlaps with SINE-associated B-box and it shows better conservation in DBTSS compared to genomic sequences. It has been also studied conservation in DBTSS and genome of the B-box containing segments of old (AluJ, AluS) and young (AluY) Alu repeats and found that CpG sequence of the B-box of old Alu is better conserved in DBTSS than in genome. This indicates that Bbox- associated CpGs in promoters are better protected from methylation and mutation than B-box-associated CpGs in genomic SINEs. These results are consistent with the view that potential TFIIIC binding motifs in SINEs associated with human and mouse promoters may be functionally important. These motifs may protect promoters from repressive histone modifications which spread from adjacent sequences. This can potentially explain well known clustering of SINEs in GC-rich gene rich genome compartments and existence of unmethylated CpG islands.

Keywords: Retroelement, promoter, CpG island, DNAmethylation.

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Authors: Ali Reza Vaezi, Fereshteh Haghshenas

Abstract:

Land use has generally been considered a local environmental issue, but it is becoming a force of global importance. Extensive changes to forests and pastures are being driven by the need to provide food, fiber, and shelter for people in recent decades. Land use is an important factor affecting soil organic carbon accumulation and storage in soils which influence directly on other physicochemical soil properties, soil productivity and soil’s susceptibility to water erosion. The change of pastures to the agricultural lands has been increasing rapidly in most semi-arid regions in Iran. Information on the effect of the land use change in these areas on the deterioration of soil physicochemical properties is limited. Therefore, this study was conducted to investigate the physical deterioration of soil as affected by land use change in semi-arid pastures in north west of Iran. Toward this, seven areas covering both pasture and rainfed lands with different soil textures (clay loam, silty clay loam, sandy clay loam, silt loam, loam, sandy loam and sandy loam) were selected in a semi-arid region in Zanjan, NW Iran. Pasture in the area is covered with poor vegetation and mostly grazed in wet seasons (end of winter and early spring and autumn). Rainfed lands resulting land use change are mostly planted for winter wheat production. In each area, soil samples (0-30 cm depth) were collected from the two land uses (pasture and rainfed land) at three replications. A total of 42 soil samples were taken from the study area. Various soil physical properties consisting of bulk density, total porosity, coarse pores volume, aggregate size, aggregate stability, water-holding capacity and saturated hydraulic conductivity were determined in the soil samples using the laboratory conventional methods. The results showed that the change of pastures to rainfeds is severely deteriorated soil physical properties. However, the variation rate of the physical soil properties is different. The loss of soil physical properties as a result of the land use change was in the following order: 61% water-stable aggregates, 60% aggregate size > 41% macroporosity > 28% bulk density > 22% total porosity > 11% water holding capacity > 5% saturated point. This result reveals that the structural characteristics of soils in this area are the most important soil physical characteristics that are affected by land use change. The deterioration of these soil properties influences negatively the pore size distribution and volume percentage of macroporosity. Effects of land use change on deterioration of soil physical properties were different in various soil textures. The highest mean loss of soil physical properties was found in loam (42%), whereas the lowest value was in silty clay loam (23%). As a consequence, loam is the most vulnerable soil to physical degradation caused by land use change in the pastures. This physical loss of soil is associated with its higher percentage of larger aggregates as well as water-stable aggregates.

Keywords: Pasture, soil physical properties, soil structural characteristics, soil texture.

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