Search results for: Background Extraction

Authors: Pranee Suecharoen, Jaturat Kanpittaya

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Background: The incidence of adverse reactions to iodinated contrast media has risen. The dearth of reports on reactions to the administration of iso- and low-osmolar contrast media should be addressed. We, therefore, studied the profile of adverse reactions to iodinated contrast media; viz., (a) the body systems affected (b) causality, (c) severity, and (d) preventability. Objective: To study adverse reactions (causes and severity) to iodinated contrast media at Srinagarind Hospital. Method: Between March and July, 2015, 1,101 patients from the Department of Radiology were observed and interviewed for the occurrence of adverse reactions. The patients were classified per Naranjo’s algorithm and through use of an adverse reactions questionnaire. Results: A total of 105 cases (9.5%) reported adverse reactions (57% male; 43% female); among whom 2% were iso-osmolar vs. 98% low-osmolar. Diagnoses included hepatoma and cholangiocarcinoma (24.8%), colorectal cancer (9.5%), breast cancer (5.7%), cervical cancer (3.8%), lung cancer (2.9%), bone cancer (1.9%), and others (51.5%). Underlying diseases included hypertension and diabetes mellitus type 2. Mild, moderate, and severe adverse reactions accounted for 92, 5 and 3%, respectively. The respective groups of escalating symptoms included (a) mild urticaria, itching, rash, nausea, vomiting, dizziness, and headache; (b) moderate hypertension, hypotension, dyspnea, tachycardia and bronchospasm; and (c) severe laryngeal edema, profound hypotension, and convulsions. All reactions could be anticipated per Naranjo’s algorithm. Conclusion: Mild to moderate adverse reactions to low-osmolar contrast media were most common and these occurred immediately after administration. For patient safety and better outcomes, improving the identification of patients likely to have an adverse reaction is essential.

Keywords: Adverse reactions, contrast media, computed tomography, iodinated contrast agents.

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Authors: Sadhana Ghnayem

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This article examines the relationship between several socio-economic and background variables of Arab-Israeli families and their effect on the conflict management style of forcing, where teenage children are expected to obey their parents without questioning. The article explores the inter-generational gap and the desire of Arab-Israeli parents to force their teenage children to obey without questioning. The independent variables include: the sex of the parent, religion (Christian or Muslim), income of the parent, years of education of the parent, and the sex of the teenage child. We use the dependent variable of “Obedience Without Questioning” that is reported twice: by each of the parents as well as by the children. We circulated a questionnaire and collected data from a sample of 180 parents and their adolescent child living in the Galilee area during 2018. In this questionnaire we asked each of the parent and his/her teenage child about whether the latter is expected to follow the instructions of the former without questioning. The outcome of this article indicates, first, that Christian-Arab families are less authoritarian than Muslims families in demanding sheer obedience from their children. Second, female parents indicate more than male parents that their teenage child indeed obeys without questioning. Third, there is a negative correlation between the variable “Income” and “Obedience without Questioning.” Yet, the regression coefficient of this variable is close zero. Fourth, there is a positive correlation between years of education and obedience reported by the children. In other words, more educated parents are more likely to demand obedience from their children.  Finally, after running the regression, the study also found that the impact of the variables of religion as well as the sex of the child on the dependent variable of obedience is also significant at above 95 and 90%, respectively.

Keywords: Arab-Israeli parents, Obedience, Forcing, Inter-generational gap.

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Authors: Azaz Zaman, Imtiaz Uddin Chowdhury, Mohammad Shariful Islam

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Corporate governance has become a crucial issue in both the business and academic world as a result of world-wide financial scandals and lack of trust in corporate practices. There is no doubt that in order to thrive and attain growth in the market, a company must earn the trust of its stakeholders by consistently delivering on its commitments. Directors of the companies thus comprehend the importance of upfront communication with relevant stakeholders to increase their confidence. The authors of this article argue that practicing good corporate governance is not enough in this highly competitive market place; corporate leaders need to market their good corporate governance practices in order to make the company more attractive to investors. This article also contends that the strength of corporate governance relies wholly upon the extent to which it is communicated simply, effectively and unceasingly to its stakeholders. The main objective of this study, therefore, is to explore the importance of branding good corporate governance in order to increase corporate brand equity, attract investors, and capture market share. A structured questionnaire comprising three sections and a total of 34 questions was prepared and surveyed by the authors among respondents residing in Bangladesh and who also have an academic and corporate background, to investigate the potential impact of branding good corporate governance in the market place. High mean values for individual questions and overall section depict that communicating and branding good corporate governance to the stakeholders will not only boost the investors’ confidence but also increase the corporate brand equity, yielding both profitable and sustainable business environment.

Keywords: Brand equity, investors’ preference, good corporate governance, sustainable business environment.

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Authors: Simran Ballani

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The purpose of this paper is to call education professionals to implement etiquette and public speaking skills for preschoolers, primary, middle and higher school students. In this paper the author aims to present importance of etiquette learning and public speaking curriculum for preschoolers, reflect on experiences from implementation of the curriculum and discuss the effect of the said implementation on higher education/global job market. Author’s aim to introduce this curriculum was to provide children with innovative learning and all around development. This training of soft skills at kindergarten level can have a long term effect on their social behaviors which in turn can contribute to professional success once they are ready for campus recruitment/global job markets. Additionally, if preschoolers learn polite, appropriate behavior at early age, it will enable them to become more socially attentive and display good manners as an adult. It is easier to nurture these skills in a child rather than changing bad manners at adulthood. Preschool/Kindergarten education can provide the platform for children to learn these crucial soft skills irrespective of the ethnicity, economic or social background they come from. These skills developed at such early years can go a long way to shape them into better and confident individuals. Unfortunately, accessibility of the etiquette learning and public speaking skill education is not standardized in pre-primary or primary level and most of the time embedding into the kindergarten curriculum is next to nil. All young children should be provided with equal opportunity to learn these soft skills which are essential for finding their place in job market.

Keywords: Etiquette learning, public speaking, preschoolers, overall child development, early childhood interventions, soft skills.

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Authors: D. Ščeulovs, E. Gaile-Sarkane

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Latvia is the fourth in the world by means of broadband internet speed. The total number of internet users in Latvia exceeds 70% of its population. The number of active mailboxes of the local internet e-mail service Inbox.lv accounts for 68% of the population and 97.6% of the total number of internet users. The Latvian portal Draugiem.lv is a phenomenon of social media, because 58.4 % of the population and 83.5% of internet users use it. A majority of Latvian company profiles are available on social networks, the most popular being Twitter.com. These and other parameters prove the fact consumers and companies are actively using the Internet. 

However, after the authors in a number of studies analyzed how enterprises are employing the e-environment, namely, e-environment tools, they arrived to the conclusions that are not as flattering as the aforementioned statistics. There is an obvious contradiction between the statistical data and the actual studies. As a result, the authors have posed a question: Why are entrepreneurs resistant to e-tools? In order to answer this question, the authors have addressed the Technology Acceptance Model (TAM). The authors analyzed each phase and determined several factors affecting the use of e-environment, reaching the main conclusion that entrepreneurs do not have a sufficient level of e-literacy (digital literacy). 

The authors employ well-established quantitative and qualitative methods of research: grouping, analysis, statistic method, factor analysis in SPSS 20  environment etc. 

The theoretical and methodological background of the research is formed by, scientific researches and publications, that from the mass media and professional literature, statistical information from legal institutions as well as information collected by the author during the survey.

Keywords: E-environment, e-environment tools, technology acceptance model, factors.

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Authors: K. Afsahi, M. Soheilifar, S. H. Hosseini, O. S. Esmaeili, R. Kezemi, N. Mehrbod, N. Vahed, T. Hajiahmad, N. N. Ansari

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Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of virtual reality (VR) beside conventional rehabilitation versus conventional rehabilitation alone on the spasticity and motor function in stroke patients. Materials and methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were Modified Ashworth scale, Recovery Stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in combination group (P = 0.003). Only wrist extension was varied between groups and was better in combination group. The variables generally had statistically significant difference (P < 0.05). Conclusion: VR plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: Stroke, virtual therapy, efficacy, rehabilitation.

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Authors: Obaidul Fattah Tanvir, Zinat Ara Afroze

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Community living adjacent to forests and Protected Areas, especially in South Asian countries, have a common practice in extracting resources for their living and livelihoods. This extraction of resources, because the way it is done, destroys the biophysical features of the area. Deforestation, wildlife poaching, illegal logging, unauthorized hill cutting etc. are some of the serious issues of concern for the sustainability of the natural resources that has a direct impact on environment and climate as a whole. To ensure community involvement in conservation initiatives of the state, community based forest management, commonly known as Comanagement, has been in practice in 6 South Asian countries. These are -India, Nepal, Sri Lanka, Pakistan, Bhutan and Bangladesh. Involving community in forestry management was initiated first in Bangladesh in 1979 and reached as an effective co-management approach through a several paradigm shifts. This idea of Comanagement has been institutionalized through a Government Order (GO) by the Ministry of Environment and Forests, Government of Bangladesh on November 23, 2009. This GO clearly defines the structure and functions of Co-management and its different bodies. Bangladesh Forest Department has been working in association with community to conserve and manage the Forests and Protected areas of Bangladesh following this legal document. Demographically young people constitute the largest segment of population in Bangladesh. This group, if properly sensitized, can produce valuable impacts on the conservation initiatives, both by community and government. This study traced the major factors that motivate community youths to work effectively with different tiers of comanagement organizations in conservation of forests and Protected Areas of Bangladesh. For the purpose of this study, 3 FGDs were conducted with 30 youths from the community living around the Protected Areas of Cox’s bazar, South East corner of Bangladesh, who are actively involved in Co-management organizations. KII were conducted with 5 key officials of Forest Department stationed at Cox’s Bazar. 2 FGDs were conducted with the representatives of 7 Co-management organizations working in Cox’s Bazar region and approaches of different community outreach activities conducted for forest conservation by 3 private organizations and Projects have been reviewed. Also secondary literatures were reviewed for the history and evolution of Co-management in Bangladesh and six South Asian countries. This study found that innovative community outreach activities that are financed by public and private sectors involving youths and community as a whole have played a pivotal role in conservation of forests and Protected Areas of the region. This approach can be replicated in other regions of Bangladesh as well as other countries of South Asia where Co-Management exists in practice.

Keywords: Community, co-management, conservation, forests, protected areas, youth.

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Authors: Abeer A. Abdelhamed

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Background: Diabetic sensorimotor polyneuropathy (DSP) is one of the most common microvascular complications of type 2 diabetes. Loss of sensation is thought to contribute to a lack of static and dynamic stability and increased risk of falling. Purpose: The purpose of this study was to compare the effects of low-level laser (LLL) and monochromatic near-infrared photo energy (MIRE) on pain, cutaneous sensation, static stability, and index of lower limb blood flow in diabetic patients with peripheral neuropathy. Methods: Forty diabetic patients with peripheral neuropathy were recruited for participation in this study. They were divided into two groups: The MIRE group, which contained 20 patients, and the LLL group, which contained 20 patients. All patients who participated in the study had been subjected to various physical assessment procedures, including pain, cutaneous sensation, Doppler flow meter, and static stability assessments. The baseline measurements were followed by treatment sessions that were conducted twice a week for six successive weeks. Results: The statistical analysis of the data revealed significant improvement of pain in both groups, with significant improvement in cutaneous sensation and static balance in the MIRE group compared to the LLL group; on the other hand, the results showed no significant differences in lower limb blood flow between the groups. Conclusion: LLL and MIRE can improve painful symptoms in patients with diabetic neuropathy. On the other hand, MIRE is also useful in improving cutaneous sensation and static stability in patients with diabetic neuropathy.

Keywords: Diabetic neuropathy, Doppler flow meter, –Lowlevel laser, Monochromatic near-infrared photo energy.

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Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: Virological non-suppression, HIV-positive, ART, Woliso Town, Ethiopia.

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Authors: D. Farsi, Gh. Dokhtvasi, S. Abbasi, S. Shafiee Ardestani, E. Payani

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Background and aim: It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FT versus fentanyl-midazolam (FM) in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods: In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccessful rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P<0.001). The occurrence of adverse effects was low in both groups (p=0.31). Conclusion: PSA using FT is effective and appears to be safe for orthopedic procedures in the ED. Therefore, regarding the prompt onset of action, short recovery period of thiopental, it seems that this combination can be considered more for performing PSA in orthopedic procedures in ED.

Keywords: Procedural Sedation and Analgesia, Thiopental, Fentanyl, Midazolam, Orthopedic Procedure, Emergency Department, Pain.

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Authors: Anthropometric, Physical Fitness Ability Profile of Elite, Non-Elite Boxers of Manipur

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Background: Boxing is one of the oldest combat sports where different anthropological and fitness ability parameters determine performance. It is characterized by short duration, high intensity bursts of activity. The purpose of this research was to determine anthropometric and physical fitness profile of male elite and non-elite boxers of Manipur and to compare the two groups. Materials and Methods: Nineteen subjects were selected as elite boxers and twenty-four were non-elite boxers of Manipur. A cross-sectional study was conducted on anthropometric measurements and physical fitness ability tests on 33 subjects (elite and non-elite boxers). Statistical analysis was done using descriptive statistics, t-test and logistic regression with the help of SPSS version 15 software. Results: Results showed elite boxers have significantly reduced neck girth and calf girth as compare to non-elite boxers. Elite boxers have significantly lower sub scapular skin fold (SSF) and supra iliac skin fold (SISF) than their counterparts. Higher stature, larger BTB and lower percent fat are associated with higher performance in boxing. Sit ups (SU), standing Broad Jump (SBJ), Plat taping (PT), Sit and reach (SAR) and Harvard Step Test (HST) are predicted as most contributing factors enhancing performance level among the physical fitness components. Elite boxers are found to have more functional strength (sit ups), higher explosive strength (SBJ), more agility (PT), cardio-vascular endurance and flexibility (SAR) than non-elite boxers. Conclusion: In conclusion, lower fat, higher lean body mass, larger bi-trochantric breadth, high explosive strength, agility and flexibility are significantly associated with higher performance and chance of becoming elite boxers.

Keywords: Anthropometry, elite and non-elite boxers, Manipur, physical fitness.

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Authors: Eglė Bilevičiūtė, Vidmantas Egidijus Kurapka, Snieguolė Matulienė, Sigutė Stankevičiūtė

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The Council of European Union (EU Council) has stressed on several occasions the need for a concerted, comprehensive and effective solution to delinquency problems in EU communities. In the context of establishing a European Forensic Science Area and the development of forensic science infrastructure in Europe, EU Council believes that forensic science can significantly contribute to the efficiency of law enforcement, crime prevention and combating crimes. Lithuanian scientists have consolidated to implement a project named “Conception of the vision for European Forensic Science 2020 implementation in Lithuania” (the project is funded for the period of 1 March 2014 - 31 December 2016) with the objective to create a conception of implementation of the vision for European Forensic Science 2020 in Lithuania by 1) evaluating the current status of Lithuania’s forensic system and opportunities for its improvement; 2) analysing achievements and knowledge in investigation of crimes listed in conclusions of EU Council on the vision for European Forensic Science 2020 including creation of a European Forensic Science Area and the development of forensic science infrastructure in Europe: trafficking in human beings, organised crime and terrorism; 3) analysing conceptions of criminalistics, which differ in different EU member states due to the variety of forensic schools, and finding means for their harmonization. Apart from the conception of implementation of the vision for European Forensic Science 2020 in Lithuania, the Project is expected to suggest provisions that will be relevant to other EU countries as well. Consequently, the presented conception of implementation of vision for European Forensic Science 2020 in Lithuania could initiate a project for a common vision of European Forensic Science and contribute to the development of the EU as an area of freedom, security and justice. The article presents main ideas of the project of the conception of the vision for European Forensic Science 2020 of EU Council and analyses its legal background, as well as prospects of and challenges for its implementation in Lithuania and the EU.

Keywords: EUROVIFOR, standardization, Vision for European Forensic Science 2020.

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Authors: Javed Y. Uppal

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The background of this study is the great degree of stress that the world is experiencing today, internationally among the countries, within a community among people, and even individually within one’s own self. The significance of the study is the attempt to find a solution of this stress in the philosophy of the olden times of Jalaluddin Rumi and comparatively recently of that of Allama Iqbal. The methodology adopted in this paper is firstly exploration of the perspectives of these philosophers that are being consolidated by a number of psychic and spiritual experts of today, who are being widely read but less followed. This paper further goes on presenting brief life sketches of Rumi and Iqbal. It expounds the key concepts proposed by them and the social change that was resulted in the times of the two above mentioned metaphysical philosophers. It is further amplified that with the recent advancements, in both metaphysics and the physical sciences, the gap between the two is closing down. Both Rumi and Iqbal emphasized their common essence. The old time's concepts, postulates, and philosophies are hence once again becoming valid. The findings of this paper are that the existence of human empathy, affection and mutual social attraction among humans is still valid. The positive inner belief system that dictates our thoughts and actions is vital. As a conclusion, empathy should enable us solving our problems collectively. We need to strengthen our inner communication system, to listen to the messages that come to our inner-selves. We need to get guidance and strength from them. We need to value common needs and purposes collectively to achieve results. Spiritual energy among us is to be harnessed and utilized. Connectivity is to be recognized to unify and strengthen ties among people. Mutual bonding at small and large group levels is to be employed for the survival of the disadvantaged, and sustainability of the empowering trends. With the above guidelines, hopefully, we can define a framework towards a brave and happy new humane world.

Keywords: Belief system, connectivity, human empathy, inner-self, mutual bonding, spiritual energy.

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Authors: S. Zeynep Siretioglu Girgin, Gizem Turna Cebeci

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Turkey’s immigration policy is a controversial issue considering its legal, economic, social, and political and human rights dimensions. Formulation of an immigration policy goes hand in hand with political processes, where natives’ attitudes play a significant role. On the other hand, as was the case in Turkey, radical changes made in immigration policy or policies lacking transparency may cause severe reactions by the host society. The underlying discussion paper aims to analyze quantitatively the effects of the existing ‘open door’ immigration policy on the economic integration of Syrian refugees in Turkey, and on the perception of the native population of refugees. For the analysis, semi-structured in-depth interviews and focus group interviews have been conducted. After the introduction, a literature review is provided, followed by theoretical background on the explanation of natives’ attitudes towards immigrants. In the next section, a qualitative analysis of natives’ attitudes towards Syrian refugees is presented with the subtopics of (i) awareness, general opinions and expectations, (ii) open-door policy and management of the migration process, (iii) perception of positive and negative impacts of immigration, (iv) economic integration, and (v) cultural similarity. Results indicate that, natives concurrently have social, economic and security concerns regarding refugees, while difficulties regarding security and economic integration of refugees stand out. Socio-economic characteristics of the respondents, such as the educational level and employment status, are not sufficient to explain the overall attitudes towards refugees, while they can be used to explain the awareness of the respondents and the priority of the concerns felt.

Keywords: Economic integration, immigration policy, integration policies, migrants, natives’ attitudes, perception, Syrian refugees, Turkey.

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Authors: Yasser R. Tawfic, Mohamed A. Eid

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Foundation differential settlement and supported structure tilting are an occasionally occurred engineering problem. This may be caused by overloading, changes in ground soil properties or unsupported nearby excavations. Engineering thinking points directly toward the logic solution for such problem by uplifting the settled side. This can be achieved with deep foundation elements such as micro-piles and macro-piles™, jacked piers, and helical piers, jet grouted mortar columns, compaction grout columns, cement grouting or with chemical grouting, or traditional pit underpinning with concrete and mortar. Although, some of these techniques offer economic, fast and low noise solutions, many of them are quite the contrary. For tilted structures, with the limited inclination, it may be much easier to cause a balancing settlement on the less-settlement side which shall be done carefully in a proper rate. This principal has been applied in Leaning Tower of Pisa stabilization with soil extraction from the ground surface. In this research, the authors attempt to introduce a new solution with a different point of view. So, the micro-tunneling technique is presented in here as an intended ground deformation cause. In general, micro-tunneling is expected to induce limited ground deformations. Thus, the researchers propose to apply the technique to form small size ground unsupported holes to produce the target deformations. This shall be done in four phases: 1. Application of one or more micro-tunnels, regarding the existing differential settlement value, under the raised side of the tilted structure. 2. For each individual tunnel, the lining shall be pulled out from both sides (from jacking and receiving shafts) in the slow rate. 3. If required, according to calculations and site records, an additional surface load can be applied on the raised foundation side. 4. Finally, a strengthening soil grouting shall be applied for stabilization after adjustment. A finite element based numerical model is presented to simulate the proposed construction phases for different tunneling positions and tunnels group. For each case, the surface settlements are calculated and induced plasticity points are checked. These results show the impact of the suggested procedure on the tilted structure and its feasibility. Comparing results also show the importance of the position selection and tunnels group gradual effect. Thus, a new engineering solution is presented to one of the structural and geotechnical engineering challenges.

Keywords: Differential settlement, micro-tunnel, soil-structure interaction, tilted structures.

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Authors: Yao Jie, Yeo Khoon Seng

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In recent decades, flapping wing aerodynamics has attracted great interest. Understanding the physics of biological flyers such as birds and insects can help improve the performance of micro air vehicles. The present research focuses on the aerodynamics of insect-like flapping wing flight with the approach of numerical computation. Insect model of hawkmoth is adopted in the numerical study with rigid wing assumption currently. The numerical model integrates the computational fluid dynamics of the flow and active control of wing kinematics to achieve stable flight. The computation grid is a hybrid consisting of background Cartesian nodes and clouds of mesh-free grids around immersed boundaries. The generalized finite difference method is used in conjunction with single value decomposition (SVD-GFD) in computational fluid dynamics solver to study the dynamics of a free hovering hummingbird hawkmoth. The longitudinal dynamics of the hovering flight is governed by three control parameters, i.e., wing plane angle, mean positional angle and wing beating frequency. In present work, a PID controller works out the appropriate control parameters with the insect motion as input. The controller is adjusted to acquire desired maneuvering of the insect flight. The numerical scheme in present study is proven to be accurate and stable to simulate the flight of the hummingbird hawkmoth, which has relatively high Reynolds number. The PID controller is responsive to provide feedback to the wing kinematics during the hovering flight. The simulated hovering flight agrees well with the real insect flight. The present numerical study offers a promising route to investigate the free flight aerodynamics of insects, which could overcome some of the limitations of experiments.

Keywords: Aerodynamics, flight control, computational fluid dynamics, flapping-wing flight.

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

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Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: Cancer, complementary and alternative medicine, ozone therapy, palliative care, PEMF Therapy.

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Authors: S. Shakibaei, P. Alpkokin

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The railway network is one of the major components of a transportation system in a country which may be an indicator of the country’s level of economic improvement. Since 2000s on, revival of national railways and development of High Speed Rail (HSR) lines are one of the most remarkable policies of Turkish government in railway sector. Within this trend, the railway age is to be revived and coming decades will be a golden opportunity. Indubitably, major infrastructures such as road and railway networks require sizeable investment capital, precise maintenance and reparation. Traditionally, governments are held responsible for funding, operating and maintaining these infrastructures. However, lack or shortage of financial resources, risk responsibilities (particularly cost and time overrun), and in some cases inefficacy in constructional, operational and management phases persuade governments to find alternative options. Financial power, efficient experiences and background of private sector are the factors convincing the governments to make a collaboration with private parties to develop infrastructures. Public-Private Partnerships (PPP or 3P or P3) and related regulatory issues are born considering these collaborations. In Turkey, PPP approaches have attracted attention particularly during last decade and these types of investments have been accelerated by government to overcome budget limitations and cope with inefficacy of public sector in improving transportation network and its operation. This study mainly tends to present a comprehensive overview of PPP concept, evaluate the regulatory procedure in Europe and propose a general framework for Turkish State Railways (TCDD) as an outlook on privatization, liberalization and deregulation of railway network.

Keywords: Deregulation, high-speed rail, liberalization, privatization, public-private partnership.

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Authors: Pei-Ti Hsu, I-Ju Chen, Jeu-Jung Chen, Cheng-Fen Chang, Shiu-Yan Yang

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Background: Taiwan now is an aging society. Research on the elderly should not be confined to caring for seniors, but should also be focused on ways to improve health and the quality of life. Senior citizens who participate in volunteer services could become less lonely, have new growth opportunities, and regain a sense of accomplishment. Thus, the question of how to get the elderly to participate in volunteer service is worth exploring. Objective: Apply the Transtheoretical Model to understand stages of change in regular volunteer service and voluntary service behaviour among the seniors. Methods: 1525 adults over the age of 65 from the Renai district of Keelung City were interviewed. The research tool was a self-constructed questionnaire, and individual interviews were conducted to collect data. Then the data was processed and analyzed using the IBM SPSS Statistics 20 (Windows version) statistical software program. Results: In the past six months, research subjects averaged 9.92 days of volunteer services. A majority of these elderly individuals had no intention to change their regular volunteer services. We discovered that during the maintenance stage, the self-efficacy for volunteer services was higher than during all other stages, but self-perceived barriers were less during the preparation stage and action stage. Self-perceived benefits were found to have an important predictive power for those with regular volunteer service behaviors in the previous stage, and self-efficacy was found to have an important predictive power for those with regular volunteer service behaviors in later stages. Conclusions/Implications for Practice: The research results support the conclusion that community nursing staff should group elders based on their regular volunteer services change stages and design appropriate behavioral change strategies.

Keywords: Seniors, stages of change in regular volunteer services, volunteer service behavior, self-efficacy, self-perceived benefits.

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Authors: R. S. Giraddi, C. M. Poleshi

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Organic cultivation of crops is gaining importance consumer awareness towards pesticide residue free foodstuffs is increasing globally. This is also because of high costs of synthetic fertilizers and pesticides, making the conventional farming non-remunerative. In India, organic manures (such as vermicompost) are an important input in organic agriculture.  Though vermicompost obtained through earthworm and microbe-mediated processes is known to comprise most of the crop nutrients, but they are in small amounts thus necessitating enrichment of nutrients so that crop nourishment is complete. Another characteristic of organic manures is that the pest infestations are kept under check due to induced resistance put up by the crop plants. In the present investigation, deoiled neem cake containing azadirachtin, copper ore tailings (COT), a source of micro-nutrients and microbial consortia were added for enrichment of vermicompost. Neem cake is a by-product obtained during the process of oil extraction from neem plant seeds. Three enriched vermicompost blends were prepared using vermicompost (at 70, 65 and 60%), deoiled neem cake (25, 30 and 35%), microbial consortia and COTwastes (5%). Enriched vermicompost was thoroughly mixed, moistened (25+5%), packed and incubated for 15 days at room temperature. In the crop response studies, the field trials on chili (Capsicum annum var. longum) and soybean, (Glycine max cv JS 335) were conducted during Kharif 2015 at the Main Agricultural Research Station, UAS, Dharwad-Karnataka, India. The vermicompost blend enriched with neem cake (known to possess higher amounts of nutrients) and vermicompost were applied to the crops and at two dosages and at two intervals of crop cycle (at sowing and 30 days after sowing) as per the treatment plan along with 50% recommended dose of fertilizer (RDF). 10 plants selected randomly in each plot were studied for pest density and plant damage. At maturity, crops were harvested, and the yields were recorded as per the treatments, and the data were analyzed using appropriate statistical tools and procedures. In the crops, chili and soybean, crop nourishment with neem enriched vermicompost reduced insect density and plant damage significantly compared to other treatments. These treatments registered as much yield (16.7 to 19.9 q/ha) as that realized in conventional chemical control (18.2 q/ha) in soybean, while 72 to 77 q/ha of green chili was harvested in the same treatments, being comparable to the chemical control (74 q/ha). The yield superiority of the treatments was of the order neem enriched vermicompost>conventional chemical control>neem cake>vermicompost>untreated control.  The significant features of the result are that it reduces use of inorganic manures by 50% and synthetic chemical insecticides by 100%.

Keywords: Humic acid, azadirachtin, vermicompost, insect-pest.

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Authors: Roberto Sabatini, Celia Bartel, Anish Kaharkar, Tesheen Shaid, Subramanian Ramasamy

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Two multisensor system architectures for navigation and guidance of small Unmanned Aircraft (UA) are presented and compared. The main objective of our research is to design a compact, light and relatively inexpensive system capable of providing the required navigation performance in all phases of flight of small UA, with a special focus on precision approach and landing, where Vision Based Navigation (VBN) techniques can be fully exploited in a multisensor integrated architecture. Various existing techniques for VBN are compared and the Appearance-Based Navigation (ABN) approach is selected for implementation. Feature extraction and optical flow techniques are employed to estimate flight parameters such as roll angle, pitch angle, deviation from the runway centreline and body rates. Additionally, we address the possible synergies of VBN, Global Navigation Satellite System (GNSS) and MEMS-IMU (Micro-Electromechanical System Inertial Measurement Unit) sensors, and the use of Aircraft Dynamics Model (ADM) to provide additional information suitable to compensate for the shortcomings of VBN and MEMS-IMU sensors in high-dynamics attitude determination tasks. An Extended Kalman Filter (EKF) is developed to fuse the information provided by the different sensors and to provide estimates of position, velocity and attitude of the UA platform in real-time. The key mathematical models describing the two architectures i.e., VBN-IMU-GNSS (VIG) system and VIGADM (VIGA) system are introduced. The first architecture uses VBN and GNSS to augment the MEMS-IMU. The second mode also includes the ADM to provide augmentation of the attitude channel. Simulation of these two modes is carried out and the performances of the two schemes are compared in a small UA integration scheme (i.e., AEROSONDE UA platform) exploring a representative cross-section of this UA operational flight envelope, including high dynamics manoeuvres and CAT-I to CAT-III precision approach tasks. Simulation of the first system architecture (i.e., VIG system) shows that the integrated system can reach position, velocity and attitude accuracies compatible with the Required Navigation Performance (RNP) requirements. Simulation of the VIGA system also shows promising results since the achieved attitude accuracy is higher using the VBN-IMU-ADM than using VBN-IMU only. A comparison of VIG and VIGA system is also performed and it shows that the position and attitude accuracy of the proposed VIG and VIGA systems are both compatible with the RNP specified in the various UA flight phases, including precision approach down to CAT-II.

Keywords: Global Navigation Satellite System (GNSS), Lowcost Navigation Sensors, MEMS Inertial Measurement Unit (IMU), Unmanned Aerial Vehicle, Vision Based Navigation.

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Authors: H. M. N. L. Handagiripathira

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The distributions of naturally occurring and anthropogenic radioactive materials were determined in surface sediments taken at 27 different locations along the bank of Negombo Lagoon in Sri Lanka. Hydrographic parameters of lagoon water and the grain size analyses of the sediment samples were also carried out for this study. The conductivity of the adjacent water was varied from 13.6 mS/cm to 55.4 mS/cm near to the southern end and the northern end of the lagoon, respectively, and equally salinity levels varied from 7.2 psu to 32.1 psu. The average pH in the water was 7.6 and average water temperature was 28.7 °C. The grain size analysis emphasized the mass fractions of the samples as sand (60.9%), fine sand (30.6%) and fine silt+clay (1.3%) in the sampling locations. The surface sediment samples of wet weight, 1 kg each from upper 5-10 cm layer, were oven dried at 105 °C for 24 hours to get a constant weight, homogenized and sieved through a 2 mm sieve (IAEA technical series no. 295). The radioactivity concentrations were determined using gamma spectrometry technique. Ultra Low Background Broad Energy High Purity Ge Detector, BEGe (Model BE5030, Canberra) was used for radioactivity measurement with Canberra Industries' Laboratory Source-less Calibration Software (LabSOCS) mathematical efficiency calibration approach and Geometry composer software. The mean activity concentration was found to be 24 ± 4, 67 ± 9, 181 ± 10, 59 ± 8, 3.5 ± 0.4 and 0.47 ± 0.08 Bq/kg for 238U, 232Th, 40K, 210Pb, 235U and 137Cs respectively. The mean absorbed dose rate in air, radium equivalent activity, external hazard index, annual gonadal dose equivalent and annual effective dose equivalent were 60.8 nGy/h, 137.3 Bq/kg, 0.4, 425.3 mSv/year and 74.6 mSv/year, respectively. The results of this study will provide baseline information on the natural and artificial radioactive isotopes and environmental pollution associated with information on radiological risk.

Keywords: Gamma spectrometry, lagoon, radioactivity, sediments.

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Authors: Kulaya Wimolwat, Panlop Chakravitthamrong, Neti Waranuch

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Background: Seborrheic dermatitis is a common chronic skin condition affecting the face, scalp, chest, and trunk. The cause of seborrheic dermatitis is still unknown. Sebum production, lipid composition, hormone levels, and Malassezia species have been suggested as important factors in the development of seborrheic dermatitis. Curcuma aeruginosa Roxb. extract-containing cream with anti-inflammatory and anti-androgenic properties may be beneficial for treating mild to moderate facial seborrheic dermatitis. Objectives: We evaluated the efficacy and safety of 2% C. aeruginosa Roxb. extract-containing cream in the treatment of mild to moderate seborrheic dermatitis. Methods: This was a prospective, open-label, and non-comparative study. Ten adult patients clinically diagnosed with mild to moderate seborrheic dermatitis were enrolled in a four-week study. The 2% C. aeruginosa Roxb. cream was applied twice daily to a lesional area on the face for four weeks. The Scoring Index (SI) ranking system on days 14 and 28 was compared with that at baseline to determine the efficacy of treatment. The adverse events (burning sensation and erythema) were evaluated on days 14 and 28 to determine the safety of the treatment. Results: Significant improvement was observed in the reduction of the mean SI at day 14 (2.9) and 28 (1.4) compared to that at baseline (4.9). An adverse reaction was observed on day 14 (mild erythema 20% and mild burning sensation 10%) and was resolved by the end of the study. Conclusion: This open-label pilot study has shown that there was a significant improvement in the severity in these seborrheic patients and most reported they were satisfied with it. Reported adverse events were all mild.

Keywords: Anti-androgenic, antifungals, anti-inflammatory, Curcuma aeruginosa, seborrheic dermatitis, efficacy, safety.

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Authors: Sophia Ming Lee Wen, Chao-Ching Kuo, Yu-Line Hu, Yu-Lung Ho, Chih-Cheng Huang, Yi-Hwa Lee

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Teaching and learning should involve social issues by which effectiveness and humanity is due consideration as a guideline for sharing and co-creating knowledge. A qualitative method was used after a pioneer study to confirm pre-service teachers’ awareness of open knowledge. There are 17 in-service teacher candidates sampling from 181 schools in Taiwan. Two questions are to resolve: a) How did teachers change their educational ideas, in particular, their attitudes to meet the needs of knowledge sharing and co-creativity; and b) How did they acknowledge the necessity of working out an appropriate way between the educational efficiency and the nature of education for high performance management. This interview investigated teachers’ attitude of sharing and co-creating knowledge. The results show two facts in Taiwan: A) Individuals who must be able to express themselves will be capable of taking part in an open learning environment; and B) Teachers must lead the direction to inspire high performance and improve students’ capacity via knowledge sharing and co-creating knowledge, according to the student-centered philosophy. Collected data from interviewing showed that the teachers were well aware of changing their teaching methods and make some improvements to balance the educational efficiency and the nature of education. Almost all teachers acknowledge that ICT is helpful to motivate learning enthusiasm. Further, teaching integrated with ICT saves teachers’ time and energy on teaching preparation and promoting effectiveness. Teachers are willing to co-create knowledge with students, though using information is not easy due to the lack of operating skills of the website and ICT. Some teachers are against to co-create knowledge in the informational background since they hold that is not feasible for there being a knowledge gap between teachers and students. Technology would easily mislead teachers and students to the goal of instrumental rationality, which makes pedagogy dysfunctional and inhumane; however, any high quality of teaching should take a dialectical balance between effectiveness and humanity.

Keywords: Open knowledge, dialect between effectiveness and humanity, pedagogy, critical thinking.

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Authors: Pradeep Kulshrestha, Maulana Ayoub Ali

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The concept of financial inclusion has been tabled in the whole world where practitioners, academicians, policy makers and economists are working hard to look for the best possible opportunities in order to enable the whole society to be in the banking cycle. The Islamic banking system is considered to be one of the said opportunities. Countries like the United Kingdom, United States of America, Malaysia, Saudi Arabia, the whole of the United Arab Emirates and many African countries have accommodated the aspect of Islamic banking in the conventional banking system as one of the financial inclusion strategies. This paper tries to analyse the current state of affairs of the Islamic Banking system in Tanzania in order to understand the improvement of the provision of Islamic banking products and services in the said country. The paper discusses the historical background of the banking system in Tanzania, the level of penetration of banking products and services and the coming of the Islamic banking system in the country. Furthermore, the paper discusses banking regulatory bodies, legal instruments governing banking operations as well as number of legal challenges facing Islamic banking operations in the country. Following a critical literature review, the paper discovered that there is no legal instrument which talks about the introduction and provision of Islamic banking system in Tanzania. Furthermore, the Islamic banking system was considered as a banking product which is absolutely incorrect because Islamic banking is considered to be as a banking system of its own. In addition to that, it has been discovered that lack of a proper regulatory system and legal instruments to harmonize the conventional and Islamic banking systems has resulted in the closure of one Islamic window in the country, which in the end affects the credibility of the newly introduced banking system. In its conclusive remarks, the paper suggests that Tanzania should work on all legal challenges affecting the smooth operations of the Islamic banking system. This can be in a way of adopting various Islamic banking legal models which are used in countries like Malaysia and others, or a borrowing legal harmonization process which has been adopted by the UK, Uganda, Nigeria and Kenya.

Keywords: Islamic banking, Islamic Windows, regulations, banks.

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Authors: Laila Salah Seada, Ashraf Ibrahim, Fawaz Al Rashid, Ihab Abdo, Hassan Kasim, Waleed Al Mansi, Saud Al Shabli

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Background and Objectives: Colorectal carcinoma is increasing among both men and women worldwide. It has a multifactorial etiology including genetic factors, environmental factors and inflammatory conditions of the digestive tract. A clinicopathologic assessment of colorectal carcinoma in Hail region is done, considering any changing patterns in two 5-year periods from 2005-2009 (A) and from 2012 to 2017 (B). All data had been retrieved from histopathology files of King Khalid Hospital, Hail. Results: During period (A), 75 cases were diagnosed as colorectal carcinoma. Male patients comprised 56/75 (74.7%) of the study, with a mean age of 58.4 (36-97), while females were 19/75 (25.3%) with a mean age of 50.3(30-85) and the difference was significant (p = 0.05). M:F ratio was 2.9:1. Most common histological type was adenocarcioma in 68/75 (90.7%) patients mostly well differentiated in 44/68 (64.7%). Mucinous neoplasms comprised only 7/75 (9.3%) of cases and tended to have a higher stage (p = 0.04). During period (B), 115 cases were diagnosed with an increase of 53.3% in number of cases than period (A). Male to female ratio also decreased to 1.35:1, females being 44.83% more affected. Adenocarcinoma remained the prevalent type (93.9%), while mucinous type was still rare (5.2%). No distal metastases found at time of presentation. Localization of tumors was rectosigmoid in group (A) in 41.4%, which increased to 56.6% in group (B), with an increase of 15.2%. Iliocecal location also decreased from 8% to 3.5%, being 56.25% less. Other proximal areas of the colon were decreased by 25.75%, from 53.9% in group (A) to 40% in group (B). Conclusion: Colorectal carcinoma in Hail region has increased by 53.3% in the past 5 years, with more females being diagnosed. Localization has also shifted distally by 15.2%. These findings are different from Western world patterns which experienced a decrease in incidence and proximal shift of the colon cancer localization. This might be due to better diagnostic tools, population awareness of the disease, as well as changing of life style and/or food habits in the region.

Keywords: Colorectal cancer, Hail Region, changing pattern, distal shift.

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Authors: Magda M. Mohsen, Manal E. Fareed

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Background: Widespread use of chemotherapeutic drugs in the treatment of cancer has lead to higher health hazards among employee who handle and administer such drugs, so nurses should know how to protect themselves, their patients and their work environment against toxic effects of chemotherapy. Aim of this study was carried out to examine the effect of chemotherapy safety protocol for oncology nurses on their protective measure practices. Design: A quasi experimental research design was utilized. Setting: The study was carried out in oncology department of Menoufia university hospital and Tanta oncology treatment center. Sample: A convenience sample of forty five nurses in Tanta oncology treatment center and eighteen nurses in Menoufiya oncology department. Tools: 1. an interviewing questionnaire that covering sociodemographic data, assessment of unit and nurses' knowledge about chemotherapy. II: Obeservational check list to assess nurses' actual practices of handling and adminestration of chemotherapy. A base line data were assessed before implementing Chemotherapy Safety protocol, then Chemotherapy Safety protocol was implemented, and after 2 monthes they were assessed again. Results: reveled that 88.9% of study group I and 55.6% of study group II improved to good total knowledge scores after educating on the safety protocol, also 95.6% of study group I and 88.9% of study group II had good total practice score after educating on the safety protocol. Moreover less than half of group I (44.4%) reported that heavy workload is the most barriers for them, while the majority of group II (94.4%) had many barriers for adhering to the safety protocol such as they didn’t know the protocol, the heavy work load and inadequate equipment. Conclusions: Safety protocol for Oncology Nurses seemed to have positive effect on improving nurses' knowledge and practice. Recommendation: chemotherapy safety protocol should be instituted for all oncology nurses who are working in any oncology unit and/ or center to enhance compliance, and this protocol should be done at frequent intervals.

Keywords: Chemotherapy Safety protocol, Effect, protective measure practice.

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Authors: Ahmed R. Z. Baghdadi, Amira A. A. Abdallah

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Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel un-satisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much.

Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA) and uni-compartmental knee arthroplasty (UKA) on dynamic balance, pain and functional performance following rehabilitation.

Methods: Fifteen patients with CRTKA (group I), fifteen with PSTKA (group II), fifteen with UKA (group III) and fifteen indicated for arthroplasty but weren’t operated on yet (group IV) participated in the study. The mean age was 54.53±3.44, 55.13±3.48, 52.8±1.93 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99, 35.6±1.88 and 35.73±1.03 kg/m² for group I, II, III and IV respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four and eight weeks pre- and post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1^st week), home-based (2^nd-4^th weeks), and outpatient clinic (5^th-8^th weeks) programs.

Results: The Mixed design MANOVA revealed that group III had significantly higher BBS scores, and lower pain scores and TUG and SC time than groups I and II four and eight weeks post-operatively. In addition, group I had significantly lower pain scores and SC time compared with group II eight weeks post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly eight weeks post-operatively compared with the three other assessments in group I, II and III with the opposite being true four weeks post-operatively.

Interpretation/Conclusion: CRTKA is preferable to PSTKA with UKA being generally superior to TKA, possibly due to the preserved human proprioceptors in the un-excised compartmental articular surface.

Keywords: Dynamic Balance, Functional Performance, Knee Arthroplasty, Pain.

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Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

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Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.

Keywords: Health care provider, hospital, weight management, weight control.

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Authors: Ticijana Prijon, Branko Ermenc

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Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall. An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: Aorta, blunt trauma, car accidents, morphology, risk factors.

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