Search results for: acute heart attacks

Authors: Marisa Catarina da Conceição Dinis

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The commercial companies’ management has suffered an important material and legal transformation in the last years, mainly related to the changes in the Portuguese legal framework and because of the fact they were recently object of great expansion. In fact, next to the smaller family businesses, whose management is regularly assumed by partners, companies with social investment highly scattered, whose owners are completely out from administration, are now arising. In those particular cases, the business transactions are much more complex and require from the companies’ managers a highly technical knowledge and some specific professionals’ skills and abilities. This kind of administration carries a high-level risk that can both result in great success or in great losses. Knowing that the administration performance can result in important losses to the companies, the Portuguese legislator has created a legal structure to impute them some responsibilities and sanctions. The main goal of this study is to analyze the Portuguese law and some jurisprudence about companies’ management rules and about the conflicts between the directors and the company. In order to achieve these purposes we have to consider, on the one hand, the legal duties directly connected to the directors’ functions and on the other hand the disrespect for those same rules. The Portuguese law in this matter, influenced by the common law, determines that the directors’ attitude should be guided by loyalty and honesty. Consequently, we must reflect in which cases the administrators should respond to losses that they might cause to companies as a result of their duties’ disrespect. In this way is necessary to study the business judgment rule wich is a rule that refers to a liability exclusion rule. We intend, in the same way, to evaluate if the civil liability that results from the directors’ duties disrespect can extend itself to those who have elected them ignoring or even knowing that they don´t have the necessary skills or appropriate knowledge to the position they hold. To charge directors’, without ruining entrepreneurship, charging, in the same way, those who select them reinforces the need for more responsible and cautious attitudes which will lead consequently to more confidence in the markets.

Keywords: Duty of loyalty, duty of care, business judgment rule, civil liability of directors.

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Authors: H. Alabed, K. Abuzayan, J. Waterhouse

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The Muslim faith requires individuals to fast between the hours of sunrise and sunset during the month of Ramadan. Our recent work has concentrated on some of the changes that take place during the daytime when fasting. A questionnaire was developed to assess subjective estimates of physical, mental and social activities, and fatigue. Four days were studied: in the weeks before and after Ramadan (control days) and during the first and last weeks of Ramadan (experimental days). On each of these four days, this questionnaire was given several times during the daytime and once after the fast had been broken and just before individuals retired at night. During Ramadan, daytime mental, physical and social activities all decreased below control values but then increased to abovecontrol values in the evening. The desires to perform physical and mental activities showed very similar patterns. That is, individuals tried to conserve energy during the daytime in preparation for the evenings when they ate and drank, often with friends. During Ramadan also, individuals were more fatigued in the daytime and napped more often than on control days. This extra fatigue probably reflected decreased sleep, individuals often having risen earlier (before sunrise, to prepare for fasting) and retired later (to enable recovery from the fast). Some physiological measures and objective measures of performance (including the response to a bout of exercise) have also been investigated. Urine osmolality fell during the daytime on control days as subjects drank, but rose in Ramadan to reach values at sunset indicative of dehydration. Exercise performance was also compromised, particularly late in the afternoon when the fast had lasted several hours. Self-chosen exercise work-rates fell and a set amount of exercise felt more arduous. There were also changes in heart rate and lactate accumulation in the blood, indicative of greater cardiovascular and metabolic stress caused by the exercise in subjects who had been fasting. Daytime fasting in Ramadan produces widespread effects which probably reflect combined effects of sleep loss and restrictions to intakes of water and food.

Keywords: Drinking, Eating, Mental Performance, Physical Performance, Social Activity, Sleepiness.

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Authors: Pawan Kumar, Pitamber Singh Negi

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Many of the regeneration failures in conifers are often being attributed to heavy insect attack and pathogens during the period of seed formation and under storage conditions. Conifer berries and seed insects occur throughout the known range of the hosts and also limit the production of seed for nursery stock. On occasion, even entire seed crops are lost due to insect attacks. The berry and seeds of both the species have been found to be infected with insects. Recently, heavy damage to the berry and seeds of Juniper and Chilgoza Pine was observed in the field as well as in stored conditions, leading to reduction in the viability of seeds to germinate. Both the species are under great threat and regeneration of the species is very low. Due to lack of adequate literature, the study on the damage potential of seed insects was urgently required to know the exact status of the insect-pests attacking seeds/berries of both the pine species so as to develop pest management practices against the insect pests attack. As both the species are also under threat and are fighting for survival, so the study is important to develop management practices for the insect-pests of seeds/berries of Juniper and Chilgoza pine so as to evaluate in the nursery, as these species form major vegetation of their distribution zones. A six-year study on the management of insect pests of seeds of Chilgoza revealed that seeds of this species are prone to insect pests mainly borers. During present investigations, it was recorded that cones of are heavily attacked only by Dioryctria abietella (Lepidoptera: Pyralidae) in natural conditions, but seeds which are economically important are heavily infected, (sometimes up to 100% damage was also recorded) by insect borer, Plodia interpunctella (Lepidoptera: Pyralidae) and is recorded for the first time ‘to author’s best knowledge’ infesting the stored Chilgoza seeds. Similarly, Juniper berries and seeds were heavily attacked only by a single borer, Homaloxestis cholopis (Lepidoptera: Lecithoceridae) recorded as a new report in natural habitat as well as in stored conditions. During the present investigation details of insect pest attack on Juniper and Chilgoza pine seeds and berries was observed and suitable management practices were also developed to contain the insect-pests attack.

Keywords: Borer, conifer, cones, chilgoza pine, lepidoptera, juniper, management, seed.

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Authors: Benjamin Osei-Tutu, Henrietta Awewole Kolson

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Background: Acute gastroenteritis is one of the frequently reported Out-Patient Department (OPD) cases. However, the causative pathogens of these cases are rarely identified at the OPD due to delay in laboratory results or failure to obtain specimens before antibiotics is administered. Method: A retrospective review of surveillance data from the Adentan Municipality, Accra, Ghana that were recorded in the National foodborne disease surveillance system of Ghana, was conducted with the main aim of describing the epidemiology and food practice of cases reported from the Adentan Municipality. The study involved a retrospective review of surveillance data kept on patients who visited health facilities that are involved in foodborne disease surveillance in Ghana, from January 2015 to December 2016. Results: A total of 375 cases were reviewed and these were classified as viral hepatitis (hepatitis A and E), cholera (Vibrio cholerae), dysentery (Shigella sp.), typhoid fever (Salmonella sp.) or gastroenteritis. Cases recorded were all suspected case and the average cases recorded per week was 3. Typhoid fever and dysentery were the two main clinically diagnosed foodborne illnesses. The highest number of cases were observed during the late dry season (Feb to April), which marks the end of the dry season and the beginning of the rainy season. Relatively high number of cases was also observed during the late wet seasons (Jul to Oct) when the rainfall is the heaviest. Home-made food and street vended food were the major sources of suspected etiological food, recording 49.01% and 34.87% of the cases respectively. Conclusion: Majority of cases recorded were classified as gastroenteritis due to the absence of laboratory confirmation. Few cases were classified as typhoid fever and dysentery based on clinical symptoms presented. Patients reporting with foodborne diseases were found to consume home meal and street vended foods as their predominant source of food.

Keywords: Accra, etiologic food, food poisoning, gastroenteritis, illness, surveillance.

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Authors: A. F. Agboola, B. R. O. Omidiwura, A. Oyeyemi, E. A. Iyayi, A. S. Adelani

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Dietary cholesterol has elicited the most public interest as it relates with coronary heart disease. Thus, humans have been paying more attention to health, thereby reducing consumption of cholesterol enriched food. Egg is considered as one of the major sources of human dietary cholesterol. However, an alternative way to reduce the potential cholesterolemic effect of eggs is to modify the fatty acid composition of the yolk. The effect of palm oil (PO), soybean oil (SO), sesame seed oil (SSO) and fish oil (FO) supplementation in the diets of layers on egg yolk fatty acid, cholesterol, egg production and egg quality parameters were evaluated in a 42-day feeding trial. One hundred and five Isa Brown laying hens of 34 weeks of age were randomly distributed into seven groups of five replicates and three birds per replicate in a completely randomized design. Seven corn-soybean basal diets (BD) were formulated: BD+No oil (T1), BD+1.5% PO (T2), BD+1.5% SO (T3), BD+1.5% SSO (T4), BD+1.5% FO (T5), BD+0.75% SO+0.75% FO (T6) and BD+0.75% SSO+0.75% FO (T7). Five eggs were randomly sampled at day 42 from each replicate to assay for the cholesterol, fatty acid profile of egg yolk and egg quality assessment. Results showed that there were no significant (P>0.05) differences observed in production performance, egg cholesterol and egg quality parameters except for yolk height, albumen height, yolk index, egg shape index, haugh unit, and yolk colour. There were no significant differences (P>0.05) observed in total cholesterol, high density lipoprotein and low density lipoprotein levels of egg yolk across the treatments. However, diets had effect (P<0.05) on TAG (triacylglycerol) and VLDL (very low density lipoprotein) of the egg yolk. The highest TAG (603.78 mg/dl) and VLDL values (120.76 mg/dl) were recorded in eggs of hens on T4 (1.5% sesame seed oil) and was similar to those on T3 (1.5% soybean oil), T5 (1.5% fish oil) and T6 (0.75% soybean oil + 0.75% fish oil). However, results revealed a significant (P<0.05) variations on eggs’ summation of polyunsaturated fatty acid (PUFA). In conclusion, it is suggested that dietary oils could be included in layers’ diets to produce designer eggs low in cholesterol and high in PUFA especially omega-3 fatty acids.

Keywords: Dietary oils, Egg cholesterol, Egg fatty acid profile, Egg quality parameters.

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Authors: Samuel P. Prahlow, Anthony Sciuva, Katherine Bombly, Emily Wilson, Shiv Dhiman, Savita Arya

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A prevalence cohort study of atherosclerotic lesions within cadavers was performed to better understand and characterize the prevalence of atherosclerosis among Georgia residents within body donors in the Philadelphia College of Osteopathic Medicine (PCOM) - Georgia body donor program. We procured specimens from cadavers used for medical student, physical therapy student, and biomedical science student cadaveric anatomical dissection at PCOM - South Georgia and PCOM - Georgia. Tissues were prepared using hematoxylin and eosin (H&E) stain as histological slides by Colquitt Regional Medical Center Laboratory Services. One section from each of the following arteries was taken after cadaveric dissection at the site of most calcification palpated grossly (if present): left anterior descending coronary artery, left internal carotid artery, abdominal aorta, splenic artery, and hepatic artery. All specimens were graded and categorized according to the American Heart Association’s Modified and Conventional Standards for Atherosclerotic Lesions using x4, x10, x40 microscopic magnification. Our study cohort included 22 cadavers, with 16 females and 6 males. The average age was 72.54 and median age was 72, with a range of 52 to 90 years old. The cause of death determination listing vascular and/or cardiovascular causes were present on 6 of the 22 death certificates. 19 of 22 (86%) cadavers had at least a single artery grading > 5. Of the cadavers with at least a single artery graded at greater than 5, only 5 of 19 (26%) cadavers had a vascular or cardiovascular cause of death reported. Malignancy was listed as a cause of death on 7 (32%) of death certificates. The average atherosclerosis grading of the common hepatic, splenic and left internal carotid arteries (2.15, 3.05, and 3.36 respectively) were lower than the left anterior descending artery and the abdominal aorta (5.16 and 5.86 respectively). This prevalence study characterizes atherosclerosis found in five medium and large systemic arteries within cadavers from the state of Georgia.

Keywords: Atherosclerosis, cardiovascular, histology, pathology.

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Authors: Maryam Memarian, Mahmood Naghizadeh

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Deconstruction is an approach that is entirely incompatible with the traditional prevalent architecture. Considering the fact that this approach attempts to put architecture in sharp contrast with its opposite events and transpires with attending to the neglected and missing aspects of architecture and deconstructing its stable structures. It also recklessly proceeds beyond the existing frameworks and intends to create a different and more efficient prospect for space. The aim of deconstruction architecture is to satisfy both the prospective and retrospective visions as well as takes into account all tastes of the present in order to transcend time. Likewise, it ventures to fragment the facts and symbols of the past and extract new concepts from within their heart, which coincide with today’s circumstances. Since this approach is an attempt to surpass the limits of the prevalent architecture, it can be employed to design places in which creative events occur and imagination and ambition flourish. Thought-provoking artistic events can grow and mature in such places and be represented in the best way possible to all people. The concept of event proposed in the plan grows out of the interaction between space and creation. In addition to triggering surprise and high impressions, it is also considered as a bold journey into the suspended realms of the traditional conflicts in architecture such as architecture-landscape, interior-exterior, center-margin, product-process, and stability-instability. In this project, at first, through interpretive-historical research method and examining the inputs and data collection, recognition and organizing takes place. After evaluating the obtained data using deductive reasoning, the data is eventually interpreted. Given the fact that the research topic is in its infancy and there is not a similar case in Iran with limited number of corresponding instances across the world, the selected topic helps to shed lights on the unrevealed and neglected parts in architecture. Similarly, criticizing, investigating and comparing specific and highly prized cases in other countries with the project under study can serve as an introduction into this architecture style.

Keywords: Creativity, deconstruction, event.

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Authors: Mohammed Agbali, Claudia Trillo, Yusuf Arayici, Terrence Fernando

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The wide-spread adoption of the Smart City concept has introduced a new era of computing paradigm with opportunities for city administrators and stakeholders in various sectors to re-think the concept of urbanization and development of healthy cities. With the world population rapidly becoming urban-centric especially amongst the emerging economies, social innovation will assist greatly in deploying emerging technologies to address the development challenges in core sectors of the future cities. In this context, sustainable health-care delivery and improved quality of life of the people is considered at the heart of the healthy city agenda. This paper examines the Boston innovation landscape from the perspective of smart services and innovation ecosystem for sustainable development, especially in transportation and healthcare. It investigates the policy implementation process of the Healthy City agenda and eHealth economy innovation based on the experience of Massachusetts’s City of Boston initiatives. For this purpose, three emerging areas are emphasized, namely the eHealth concept, the innovation hubs, and the emerging technologies that drive innovation. This was carried out through empirical analysis on results of public sector and industry-wide interviews/survey about Boston’s current initiatives and the enabling environment. The paper highlights few potential research directions for service integration and social innovation for deploying emerging technologies in the healthy city agenda. The study therefore suggests the need to prioritize social innovation as an overarching strategy to build sustainable Smart Cities in order to avoid technology lock-in. Finally, it concludes that the Boston example of innovation economy is unique in view of the existing platforms for innovation and proper understanding of its dynamics, which is imperative in building smart and healthy cities where quality of life of the citizenry can be improved.

Keywords: Smart city, social innovation, eHealth, innovation hubs, emerging technologies, equitable healthcare, healthy cities.

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Authors: Mpho A. Mbeo, Patient Rambe

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The 13th year of the Central University of Technology, Free State’s (CUT) transition from a vocational and professional training orientation institution (i.e. a technikon) into a university with a strong research focus has neither been a smooth nor an easy one. At the heart of this transition was the need to transform the psychological faculties of academic and research staffs compliment who were accustomed to training graduates for industrial placement. The lack of a research culture that fully embraces the strong solid ethos of conducting cutting-edge research needs to be addressed. The induction and socialisation of academic staff into the development and execution of cutting-edge research also required the provision of research support and the creation of a conducive academic environment for research, both for emerging and non-research active academics. Drawing on ten cases, consisting of four heads of departments, three seasoned researchers, and three novice researchers, this study explores the challenges faced in establishing a strong research culture at the university. Furthermore, it gives an account of the extent to which the current research interventions have addressed the perceivably “missing research culture”, and the implications of these interventions for knowledge management. Evidence suggests that the capability of an ideal institutional research environment, consisting of mentorship of novice researchers by seasoned researchers, balanced effort into teaching and research responsibilities, should be supported by strong research-oriented leadership. Furthermore, recruitment of research passionate staff, adoption of a salary structure that encourages the retention of excellent scholars should be matched by a coherent research incentive culture to growth research publication outputs. This is critical for building new knowledge and entrenching knowledge management founded on communities of practice and scholarly networking through the documentation and communication of research findings. The study concludes that the multiple policy documents set for the different domains of research may be creating pressure on researchers to engage research activities and increase output at the expense of research quality.

Keywords: Central University of Technology, performance, publication, research culture, university.

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Authors: Simon B. N. Thompson

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Cortisol is essential to the regulation of the immune system and pathological yawning is a symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved – extended or flexed; and yawning has been shown to be highly correlated with cortisol levels in healthy people as shown in the Thompson Cortisol Hypothesis. It is likely that these elevated cortisol levels are also seen in people with MS. The possible link between EMG in the jaw muscles and rises in saliva cortisol levels during yawning were investigated in a randomized controlled trial of 60 volunteers aged 18-69 years who were exposed to conditions that were designed to elicit the yawning response. Saliva samples were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, and EMG data was additionally collected during rest and yawning phases. Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, and health details were collected and the following exclusion criteria were adopted: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and poststimuli, which was non-significant. There were also significant differences between yawners and non-yawners for the EMG potentials with the yawners having higher rest and post-yawning potentials. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with the yawning response. Further research is underway to explore the use of cortisol as a potential diagnostic tool as an assist to the early diagnosis of symptoms related to neurological disorders. Bournemouth University Research & Ethics approval granted: JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality, and safety issues have been addressed and approved in the Ethics submission. Trials identification number: ISRCTN61942768. http://www.controlled-trials.com/isrctn/

Keywords: Cortisol, Electromyography, Neurology, Yawning.

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Authors: Barot Jagruti

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The textile industry plays a major role in the economy of India and on the other side of the coin it is the major source for water pollution. As azo dyes is the largest dye class they are extensively used in many fields such as textile industry, leather tanning industry, paper production, food, color photography, pharmaceuticals and medicine, cosmetic, hair colorings, wood staining, agricultural, biological and chemical research etc. In addition to these, they can have acute and/or chronic effects on organisms depending on their concentration and length of exposure when they discharged as effluent in the environment. The aim of this study was to assess the genotoxic and histotoxic potentials of environmentally relevant concentrations of C. I. Reactive Red 120 (RR 120) on Catla catla, important edible freshwater fingerlings. For this, healthy Catla catla fingerlings were procured from the Government Fish Farm and acclimatized in 100 L capacity and continuously aerated glass aquarium in laboratory for 15 days. According to APHA some physic-chemical parameters were measured and maintained such as temperature, pH, dissolve oxygen, alkalinity, total hardness. Water along with excreta had been changed every 24 hrs. All fingerlings were fed artificial food palates once a day @ body weight. After 15 days fingerlings were grouped in 5 (10 in each) and exposed to various concentrations of RR 120 (Control, 10, 20, 30 and 40 mg.l-1) and samples (peripheral blood and gills, kidney) were collected and analyzed at 96 hrs. All results were compared with the control. Micronuclei (MN), nuclear buds (NB), fragmented-apoptotic (FA) and bi-nucleated (BN) cells in blood smears and in tissues (gills and kidney cells) were observed. Prominent histopathological alterations were noticed in gills such as aneurism, hyperplasia, degenerated central axis, lifting of gill epithelium, curved secondary gill lamellae etc. Similarly kidney showed some detrimental changes like shrunken glomeruli with increased periglomerular space, degenerated renal tubules etc. Both haematological and histopathological changes clearly reveal the toxic potential of RR 120. This work concludes that water pollution assessment can be done by these two biomarkers which provide baseline to the further chromosomal or molecular work.

Keywords: Catla catla, genotoxicity, histopathlogicalchanges, RR 120azo dye.

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Authors: Lara Dutil-Fafard, Caroline Rhéaume, Patrick Archambault, Daniel Lafond, Neal W. Pollock

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Improving resources for medical autonomy of astronauts in prolonged space missions, such as a Mars mission, requires not only technology development, but also decision-making support systems. The Advanced Crew Medical System - Medical Condition Requirements study, funded by the Canadian Space Agency, aimed to create knowledge content and a scenario-based query capability to support medical autonomy of astronauts. The key objective of this study was to create a prototype tool for identifying medical infrastructure requirements in terms of medical knowledge, skills and materials. A multicriteria decision-making method was used to prioritize the highest risk medical events anticipated in a long-term space mission. Starting with those medical conditions, event sequence diagrams (ESDs) were created in the form of decision trees where the entry point is the diagnosis and the end points are the predicted outcomes (full recovery, partial recovery, or death/severe incapacitation). The ESD formalism was adapted to characterize and compare possible outcomes of medical conditions as a function of available medical knowledge, skills, and supplies in a given mission scenario. An extensive literature review was performed and summarized in a medical condition database. A PostgreSQL relational database was created to allow query-based evaluation of health outcome metrics with different medical infrastructure scenarios. Critical decision points, skill and medical supply requirements, and probable health outcomes were compared across chosen scenarios. The three medical conditions with the highest risk rank were acute coronary syndrome, sepsis, and stroke. Our efforts demonstrate the utility of this approach and provide insight into the effort required to develop appropriate content for the range of medical conditions that may arise.

Keywords: Decision support system, event sequence diagram, exploration mission, medical autonomy, scenario-based queries, space medicine.

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Authors: Denise Levy, Anna Lucia C. H. Villavicencio

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Food irradiation is a processing and preservation technique to eliminate insects and parasites and reduce disease-causing microorganisms. Moreover, the process helps to inhibit sprouting and delay ripening, extending fresh fruits and vegetables shelf-life. Nevertheless, most Brazilian consumers seem to misunderstand the difference between irradiated food and radioactive food and the general public has major concerns about the negative health effects and environmental contamination. Society´s judgment and decision making are directly linked to perceived benefits and risks. The web-based project entitled ‘Scientific information about food irradiation: Internet as a tool to approach science and society’ was created by the Nuclear and Energetic Research Institute (IPEN), in order to offer an interdisciplinary approach to science education, integrating economic, ethical, social and political aspects of food irradiation. This project takes into account that, misinformation and unfounded preconceived ideas impact heavily on the acceptance of irradiated food and purchase intention by the Brazilian consumer. Taking advantage of the potential value of the Internet to enhance communication and education among general public, a research study was carried out regarding the possibilities and trends of Information and Communication Technologies among the Brazilian population. The content includes concepts, definitions and Frequently Asked Questions (FAQ) about processes, safety, advantages, limitations and the possibilities of food irradiation, including health issues, as well as its impacts on the environment. The project counts on eight self-instructional interactive web courses, situating scientific content in relevant social contexts in order to encourage self-learning and further reflections. Communication is a must to improve public understanding of science. The use of information technology for quality scientific divulgation shall contribute greatly to provide information throughout the country, spreading information to as many people as possible, minimizing geographic distances and stimulating communication and development.

Keywords: Food irradiation, multimedia learning tools, nuclear science, society and education.

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Authors: Syed Dawood Md. Taimur, Saidur Rahman Khan, Farzana Islam

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To evaluate the factors which predetermine the coronary artery disease in patients having positive Exercise Tolerance Test (ETT) that is treadmill results and coronary artery findings. This descriptive study was conducted at Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from 1st January, 2014 to 31st August, 2014. All patients who had done ETT (treadmill) for chest pain diagnosis were studied. One hundred and four patients underwent coronary angiogram after positive treadmill result. Patients were divided into two groups depending upon the angiographic findings, i.e. true positive and false positive. Positive treadmill test patients who have coronary artery involvement these are called true positive and who have no involvement they are called false positive group. Both groups were compared with each other. Out of 104 patients, 81 (77.9%) patients had true positive ETT and 23 (22.1%) patients had false positive ETT. The mean age of patients in positive ETT was 53.46± 8.06 years and male mean age was 53.63±8.36 years and female was 52.87±7.0 years. Sixty nine (85.19%) male patients and twelve (14.81%) female patients had true positive ETT, whereas 15 (65.21%) males and 8 (34.79%) females had false positive ETT, this was statistically significant (p<0.032) in the two groups (sex) in comparison of true and false positive ETT. The risk factors of these patients like diabetes mellitus, hypertension, dyslipidemia, family history and smoking were seen among these patients. Hypertensive patients having true positive which were statistically significant (p<0.004) and diabetic, dyslipidemic patients having true positive which were statistically significant (p<0.032 & 0.030).True positive patients had family history were 68(83.95%) and smoking were 52 (64.20%), where family history patients had statistically significant (p<0.017) between two groups of patients and smokers were significant (p<0.012). 46 true positive patients achieved THR which was not statistically significant (P<0.138) and 79 true patients had abnormal resting ECG whether it was significant (p<0.036). Amongst the vessels involvement the most common was LAD 55 (67.90 %) followed by LCX 42 (51.85%), RCA 36 (44.44%), and the LMCA was 9 (11.11%). 40 patients (49.38%) had SVD, 26 (30.10%) had DVD, 15(18.52%) had TVD and 23 had normal coronary arteries. It can be concluded that among the female patients who have positive ETT with normal resting ECG, who had achieved target heart rate are likely to have a false positive test result. Conversely male patients, resting abnormal ECG who had not achieved THR, symptom limited ETT, have a hypertension, diabetes, dyslipidemia, family history and smoking are likely to have a true positive treadmill test result.

Keywords: Exercise tolerance test, Coronary artery disease, Coronary angiography, True positive, False positive.

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Authors: El-Sayed, Mona, Y., U. E. Mahrous

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A total of 60 male mule ducks and 60 male Muscovy ducks were allotted into three groups (n = 20) to estimate the effects of overfeeding (two and four meals) versus ad libitum feeding on productive performance traits, foie gras production, internal organs, and blood parameters.

The results show that force-feeding four meals significantly increased (P < 0.01) body weight, weight gain, and gain percentage compared to force-feeding two meals. Both force-feeding regimes (two or four meals) induced significantly higher body weight, weight gain, gain percentage, and absolute carcass weight than ad libitum feeding; however, carcass percentage was significantly higher in ad libitum feeding. Mule ducks had significantly higher weight gain and weight gain percentages than Muscovy ducks.

Feed consumption per kilogram of foie gras and per kilogram weight gain was lower for the four-meal than for the two-meal forced feeding regime. Force-feeding four meals induced significantly higher liver weight and percentage (488.96 ± 25.78g, 7.82 ± 0.40%) than force-feeding two meals (381.98 ± 13.60g, 6.42 ± 0.21%). Moreover, feed conversion was significantly higher under forced feeding than under ad libitum feeding (77.65 ± 3.41g, 1.72 ± 0.05%; P < 0.01).

Forced feeding (two or four meals) increased all organ weights (intestine, proventriculus, heart, spleen, and pancreas) over ad libitum feeding weights, except for the gizzard; however intestinal and abdominal fat values were higher for four-meal forced feeding than for two-meal forced feeding.

Overfeeding did not change blood parameters significantly compared to ad libitum feeding; however, four-meal forced feeding improved the quality of foie gras since it significantly increased the percentage of grade A foie gras (62.5%) at the expense of grades B (33.33%) and C (4.17%) compared with the two-meal forced feeding.

The mortality percentage among Muscovy ducks during the forced feeding period was 22.5%, compared to 0% in mule ducks. Liver weight was highly significantly correlated with life weight after overfeeding and certain blood plasma traits.

Keywords: Foie gras, overfeeding, ducks, productive performance.

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Authors: Noda L. M., Salvador I. C, C. M. L. G. Parada, Fonseca C. R. B.

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In Brazil, neonatal mortality rate is considered incompatible with the country development conditions, and has been a Public Health concern. Reduction in infant mortality rates has also been part of the Millennium Development Goals, a commitment made by countries, members of the Organization of United Nations (OUN), including Brazil. Fetal mortality rate is considered a highly sensitive indicator of health care quality. Suitable actions, such as good quality and access to health services may contribute positively towards reduction in these fetal and neonatal rates. With appropriate antenatal follow-up and health care during gestation and delivery, some death causes could be reduced or even prevented by means of early diagnosis and intervention, as well as changes in risk factors and interventions. Objectives: To study the quality of maternal and infant health care based on fetal and neonatal mortality, as well as the possible actions to prevent those deaths in Botucatu (Brazil). Methods: Classification of prevention according to the International Classification of Diseases and the modified Wigglesworth´s classification. In order to evaluate adequacy, indicators of quality of antenatal and delivery care were established by the authors. Results: Considering fetal deaths, 56.7% of them occurred before delivery, which reveals possible shortcomings in antenatal care, and 38.2% of them were a result of intra- labor changes, which could be prevented or reduced by adequate obstetric management. These findings were different from those in the group of early neonatal deaths which were also studied. Adequacy of health services showed that antenatal and childbirth care was appropriate for 24% and 33.3% of pregnant women, respectively, which corroborates the results of prevention. These results revealed that shortcomings in obstetric and antenatal care could be the causes of deaths in the study. Early and late neonatal deaths have similar characteristics: 76% could be prevented or reduced mainly by adequate newborn care (52.9%) and adequate health care for gestational women (11.7%). When adequacy of care was evaluated, childbirth and newborn care was adequate in 25.8% and antenatal care was adequate in 16.1%. In conclusion, direct relationship was found between adequacy and quality of care rendered to pregnant women and newborns, and fetal and infant mortality. Moreover, our findings highlight that deaths could be prevented by an adequate obstetric and neonatal management.

Keywords: Fetal Mortality, Infant Mortality, Maternal-Child Health Services, Program Evaluation.

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Authors: Tamara Kelly

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The past decade has witnessed a good opportunities for city development schemes in UK. The government encouraged restoration of city centers to comprise mixed use developments with high density residential apartments. Investments in regeneration areas were doing well according to the analyses of Property Databank (IPD). However, more recent analysis by IPD has shown that since 2007, property in regeneration areas has been more vulnerable to the market downturn than other types of investment property. The early stages of a property market downturn may be felt most in regeneration where funding, investor confidence and occupier demand would dissipate because the sector was considered more marginal or risky when development costs rise. Moreover, the Bank of England survey shows that lenders have sequentially tightened the availability of credit for commercial real estate since mid-2007. A sharp reduction in the willingness of banks to lend on commercial property was recorded. The credit crunch has already affected commercial property but its impact has been particularly severe in certain kinds of properties where residential developments are extremely difficult, in particular city centre apartments and buy-to-let markets. Commercial property – retail, industrial leisure and mixed use were also pressed, in Birmingham; tens of mixed use plots were built to replace old factories in the heart of the city. The purpose of these developments was to enable young professionals to work and live in same place. Thousands of people lost their jobs during the recession, moreover lending was more difficult and the future of many developments is unknown. The recession casts its shadow upon the society due to cuts in public spending by government, Inflation, rising tuition fees and high rise in unemployment generated anger and hatred was spreading among youth causing vandalism and riots in many cities. Recent riots targeted many mixed used development in the UK where banks, shops, restaurants and big stores were robbed and set into fire leaving residents with horror and shock. This paper examines the impact of the recession and riots on mixed use development in UK.

Keywords: Diversity, mixed use development, outdoor comfort, public realm, safe places, safety by design.

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Authors: Ghaffari, H., Changi Ashtiani, A., Younessi, A.

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There are three distinct stages in the evolution of economic thought, namely: 1. in the first stage, the major concern was to accelerate economic growth with increased availability of material goods, especially in developing economies with very low living standards, because poverty eradication meant faster economic growth. 2. in the second stage, economists made distinction between growth and development. Development was seen as going beyond economic growth, and bringing certain changes in the structure of the economy with more equitable distribution of the benefits of growth, with the growth coming automatic and sustained. 3. the third stage is now reached. Our concern is now with “sustainable development", that is, development not only for the present but also of the future. Thus the focus changed from “sustained growth" to “sustained development". Sustained development brings to the fore the long term relationship between the ecology and economic development. Since the creation of UNEP in 1972 it has worked for development without destruction for environmentally sound and sustained development. It was realised that the environment cannot be viewed in a vaccum, it is not separate from development, nor is it competing. It suggested for the integration of the environment with development whereby ecological factors enter development planning, socio-economic policies, cost-benefit analysis, trade, technology transfer, waste management, educational and other specific areas. Industrialisation has contributed to the growth of economy of several countries. It has improved the standards of living of its people and provided benefits to the society. It has also created in the process great environmental problems like climate change, forest destruction and denudation, soil erosion and desertification etc. On the other hand, industry has provided jobs and improved the prospects of wealth for the industrialists. The working class communities had to simply put up with the high levels of pollution in order to keep up their jobs and also to save their income. There are many roots of the environmental problem. They may be political, economic, cultural and technological conditions of the modern society. The experts concede that industrial growth lies somewhere close to the heart of the matter. Therefore, the objective of this paper is not to document all roots of an environmental crisis but rather to discuss the effects of industrial growth and development. We have come to the conclusion that although public intervention is often unnecessary to ensure that perfectly competitive markets will function in society-s best interests, such intervention is necessary when firms or consumers pollute.

Keywords: Development, Environment, Industrial Development, Iran, Occupational problems, Pollution.

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Authors: Maciej Zasuwa, Grzegorz Ptasinski, Antoni Kopyt

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Nowadays flight simulators offer tremendous possibilities for safe and cost-effective pilot training, by utilization of powerful, computational tools. Due to technology outpacing methodology, vast majority of training related work is done by human instructors. It makes assessment not efficient, and vulnerable to instructors’ subjectivity. The research presents an Objective Assessment Tool (gOAT) developed at the Warsaw University of Technology, and tested on SW-4 helicopter flight simulator. The tool uses database of the predefined manoeuvres, defined and integrated to the virtual environment. These were implemented, basing on Aeronautical Design Standard Performance Specification Handling Qualities Requirements for Military Rotorcraft (ADS-33), with predefined Mission-Task-Elements (MTEs). The core element of the gOAT enhanced algorithm that provides instructor a new set of information. In details, a set of objective flight parameters fused with report about psychophysical state of the pilot. While the pilot performs the task, the gOAT system automatically calculates performance using the embedded algorithms, data registered by the simulator software (position, orientation, velocity, etc.), as well as measurements of physiological changes of pilot’s psychophysiological state (temperature, sweating, heart rate). Complete set of measurements is presented on-line to instructor’s station and shown in dedicated graphical interface. The presented tool is based on open source solutions, and flexible for editing. Additional manoeuvres can be easily added using guide developed by authors, and MTEs can be changed by instructor even during an exercise. Algorithm and measurements used allow not only to implement basic stress level measurements, but also to reduce instructor’s workload significantly. Tool developed can be used for training purpose, as well as periodical checks of the aircrew. Flexibility and ease of modifications allow the further development to be wide ranged, and the tool to be customized. Depending on simulation purpose, gOAT can be adjusted to support simulator of aircraft, helicopter, or unmanned aerial vehicle (UAV).

Keywords: Automated assessment, flight simulator, human factors, pilot training.

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Authors: Mustafa M. Donma, Orkide Donma

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Spexin, expressed in the central nervous system, has attracted much interest in feeding behavior, obesity, diabetes, energy metabolism and cardiovascular functions. Fetuin A is known as the negative acute phase reactant synthesized in the liver. Eosinophils are early indicators of cardiometabolic complications. Patients with elevated platelet count, associated with hypercoagulable state in the body, are also more liable to cardiovascular diseases (CVDs). In this study, the aim is to examine the profiles of spexin and fetuin A concomitant with the course of variations detected in eosinophil as well as platelet counts in morbid obese children. 34 children with normal-body mass index (N-BMI) and 51 morbid obese (MO) children participated in the study. Written-informed consent forms were obtained prior to the study. Institutional ethics committee approved the study protocol. Age- and sex-adjusted BMI percentile tables prepared by World Health Organization were used to classify healthy and obese children. Mean age ± SEM of the children were 9.3 ± 0.6 years and 10.7 ± 0.5 years in N-BMI and MO groups, respectively. Anthropometric measurements of the children were taken. BMI values were calculated from weight and height values. Blood samples were obtained after an overnight fasting. Routine hematologic and biochemical tests were performed. Within this context, fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein-cholesterol (HDL-C) concentrations were measured. Homeostatic model assessment for insulin resistance (HOMA-IR) values were calculated. Spexin and fetuin A levels were determined by enzyme-linked immunosorbent assay. Data were evaluated from the statistical point of view. Statistically significant differences were found between groups in terms of BMI, fat mass index, INS, HOMA-IR and HDL-C. In MO group, all parameters increased as HDL-C decreased. Elevated concentrations in MO group were detected in eosinophils (p < 0.05) and platelets (p > 0.05). Fetuin A levels decreased in MO group (p > 0.05). However, decrease was statistically significant in spexin levels for this group (p < 0.05). In conclusion, these results have suggested that increases in eosinophils and platelets exhibit behavior as cardiovascular risk factors. Decreased fetuin A behaved as a risk factor suitable to increased risk for cardiovascular problems associated with the severity of obesity. Along with increased eosinophils, increased platelets and decreased fetuin A, decreased spexin was the parameter, which reflects best its possible participation in the early development of CVD risk in MO children.

Keywords: Cardiovascular diseases, eosinophils, fetuin A, pediatric morbid obesity, platelets, spexin.

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Authors: Justyna Humięcka-Jakubowska

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Background in music analysis: Traditionally, when we think about a composer’s sketches, the chances are that we are thinking in terms of the working out of detail, rather than the evolution of an overall concept. Since music is a “time art,” it follows that questions of a form cannot be entirely detached from considerations of time. One could say that composers tend to regard time either as a place gradually and partially intuitively filled, or they can look for a specific strategy to occupy it. It seems that the one thing that sheds light on Stockhausen’s compositional thinking is his frequent use of “form schemas,” that is often a single-page representation of the entire structure of a piece. Background in music technology: Sonic Visualiser is a program used to study a musical recording. It is an open source application for viewing, analyzing, and annotating music audio files. It contains a number of visualisation tools, which are designed with useful default parameters for musical analysis. Additionally, the Vamp plugin format of SV supports to provide analysis such as for example structural segmentation. Aims: The aim of paper is to show how SV may be used to obtain a better understanding of the specific musical work, and how the compositional strategy does impact on musical structures and musical surfaces. It is known that “traditional” music analytic methods don’t allow indicating interrelationships between musical surface (which is perceived) and underlying musical/acoustical structure. Main Contribution: Stockhausen had dealt with the most diverse musical problems by the most varied methods. A characteristic which he had never ceased to be placed at the center of his thought and works, it was the quest for a new balance founded upon an acute connection between speculation and intuition. In the case with Mikrophonie I (1964) for tam-tam and 6 players Stockhausen makes a distinction between the “connection scheme,” which indicates the ground rules underlying all versions, and the form scheme, which is associated with a particular version. The preface to the published score includes both the connection scheme, and a single instance of a “form scheme,” which is what one can hear on the CD recording. In the current study, the insight into the compositional strategy chosen by Stockhausen was been compared with auditory image, that is, with the perceived musical surface. Stockhausen’s musical work is analyzed both in terms of melodic/voice and timbre evolution. Implications: The current study shows how musical structures have determined of musical surface. The general assumption is this, that while listening to music we can extract basic kinds of musical information from musical surfaces. It is shown that interactive strategies of musical structure analysis can offer a very fruitful way of looking directly into certain structural features of music.

Keywords: Automated analysis, composer's strategy, Mikrophonie I, musical surface, Stockhausen.

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Authors: Maha Jameal Balgoon, Gehan A. Raouf, Safaa Y. Qusti, Soad Shaker Ali

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The main cause of Alzheimer disease (AD) was believed to be mainly due to the accumulation of free radicals owing to oxidative stress (OS) in brain tissue. The mechanism of the neurotoxicity of Aluminum chloride (AlCl3) induced AD in hippocampus Albino wister rat brain tissue, the curative & the protective effects of Lipidium sativum group (LS) water extract were assessed after 8 weeks by attenuated total reflection spectroscopy ATR-IR and histologically by light microscope. ATR-IR results revealed that the membrane phospholipid undergo free radical attacks, mediated by AlCl3, primary affects the polyunsaturated fatty acids indicated by the increased of the olefinic -C=CH sub-band area around 3012 cm-1 from the curve fitting analysis. The narrowing in the half band width (HBW) of the sνCH2 sub-band around 2852 cm-1 due to Al intoxication indicates the presence of trans form fatty acids rather than gauch rotomer. The degradation of hydrocarbon chain to shorter chain length, increasing in membrane fluidity, disorder, and decreasing in lipid polarity in AlCl3 group indicated by the detected changes in certain calculated area ratios compared to the control. Administration of LS was greatly improved these parameters compared to the AlCl3 group. Al influences the Aβ aggregation and plaque formation, which in turn interferes to and disrupts the membrane structure. The results also showed a marked increase in the β-parallel and antiparallel structure, that characterize the Aβ formation in Al-induced AD hippocampal brain tissue, indicated by the detected increase in both amide I sub-bands around 1674, 1692 cm-1. This drastic increase in Aβ formation was greatly reduced in the curative and protective groups compared to the AlCl3 group and approached nearly the control values. These results supported too by the light microscope. AlCl3 group showed significant marked degenerative changes in hippocampal neurons. Most cells appeared small, shrieked and deformed. Interestingly, the administration of LS in curative and protective groups markedly decreases the amount of degenerated cells compared to the non-treated group. In addition, the intensity of congo red stained cells was decreased. Hippocampal neurons looked more/or less similar to those of control. This study showed a promising therapeutic effect of Lipidium sativum group (LS) on AD rat model that seriously overcome the signs of oxidative stress on membrane lipid and restore the protein misfolding.

Keywords: Aluminum chloride, Alzheimer’s disease, ATR-IR, Lipidium sativum.

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Authors: Igor Pejic

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The main focus of this research will be on analyzing correlative links between terrorism as an asymmetrical threat and the consequences it leaves on conventional security forces. The methodology behind the research will include qualitative research methods focusing on comparative analysis of books, scientific papers, documents and other sources, in order to deduce, explore and formulate the results of the research. With the coming of the 21^st century and the rising multi-polar, new world threats quickly emerged. The realistic approach in international relations deems that relations among nations are in a constant state of anarchy since there are no definitive rules and the distribution of power varies widely. International relations are further characterized by egoistic and self-orientated human nature, anarchy or absence of a higher government, security and lack of morality. The asymmetry of power is also reflected on countries' security capabilities and its abilities to project power. With the coming of the new millennia and the rising multi-polar world order, the asymmetry of power can be also added as an important trait of the global society which consequently brought new threats. Among various others, terrorism is probably the most well-known, well-based and well-spread asymmetric threat. In today's global political arena, terrorism is used by state and non-state actors to fulfill their political agendas. Terrorism is used as an all-inclusive tool for regime change, subversion or a revolution. Although the nature of terrorist groups is somewhat inconsistent, terrorism as a security and social phenomenon has a one constant which is reflected in its political dimension. The state's security apparatus, which was embodied in the form of conventional armed forces, is now becoming fragile, unable to tackle new threats and to a certain extent outdated. Conventional security forces were designed to defend or engage an exterior threat which is more or less symmetric and visible. On the other hand, terrorism as an asymmetrical threat is a part of hybrid, special or asymmetric warfare in which specialized units, institutions or facilities represent the primary pillars of security. In today's global society, terrorism is probably the most acute problem which can paralyze entire countries and their political systems. This problem, however, cannot be engaged on an open field of battle, but rather it requires a different approach in which conventional armed forces cannot be used traditionally and their role must be adjusted. The research will try to shed light on the phenomena of modern day terrorism and to prove its correlation with the state conventional armed forces. States are obliged to adjust their security apparatus to the new realism of global society and terrorism as an asymmetrical threat which is a side-product of the unbalanced world.

Keywords: Asymmetrical warfare, conventional forces, security, terrorism.

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Authors: Carmiña L. Vargas-Zapata, María A. Conde-Sarmiento, Maria Consuelo Maestre-Vargas

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Calcium is an essential element for good growth and development of the organism, and its requirement is increased at school age. Low socio-economic populations of developing countries such as Colombia may have food deficiency of this mineral in schoolchildren that could be reflected in calcium biochemical indicators, bone alterations and anthropometric indicators. The objective of this investigation was to evaluate some calcium biochemical indicators in a group of schoolchildren of low socioeconomic level from Barranquilla city and to correlate with body mass index. 60 schoolchildren aged 7 to 15 years were selected from Jesus’s Heart Educational Institution in Barranquilla-Atlántico, apparently healthy, without suffering from infectious or gastrointestinal diseases, without habits of drinking alcohol or smoking another hallucinogenic substance and without taking supplementation with calcium in the last six months or another substance that compromises bone metabolism. The research was approved by the ethics committee at Universidad del Atlántico. The selected children were invited to donate a blood and urine sample in a fasting time of 12 hours, the serum was separated by centrifugation and frozen at ˗20 ℃ until analyzed and the same was done with the urine sample. On the day of the biological collections, the weight and height of the students were measured to determine the nutritional status by BMI using the WHO tables. Calcium concentrations in serum and urine (SCa, UCa), alkaline phosphatase activity total and of bone origin (SAPT, SBAP) and urinary creatinine (UCr) were determined by spectrophotometric methods using commercial kits. Osteocalcin and Cross-linked N-telopeptides of type I collagen (NTx-1) in serum were measured with an enzyme-linked inmunosorbent assay. For statistical analysis the Statgraphics software Centurium XVII was used. 63% (n = 38) and 37% (n = 22) of the participants were male and female, respectively. 78% (n = 47), 5% (n = 3) and 17% (n = 10) had a normal, malnutrition and high nutritional status, respectively. The averages of evaluated indicators levels were (mean ± SD): 9.50 ± 1.06 mg/dL for SCa; 181.3 ± 64.3 U/L for SAPT, 143.8 ± 73.9 U/L for SBAP; 9.0 ± 3.48 ng/mL for osteocalcin and 101.3 ± 12.8 ng/mL for NTx-1. UCa level was 12.8 ± 7.7 mg/dL that adjusted with creatinine ranged from 0.005 to 0.395 mg/mg. Considering serum calcium values, approximately 7% of school children were hypocalcemic, 16% hypercalcemic and 77% normocalcemic. The indicators evaluated did not correlate with the BMI. Low values ​​were observed in calcium urinary excretion and high in NTx-1, suggesting that mechanisms such as increase in renal retention of calcium and in bone remodeling may be contributing to calcium homeostasis.

Keywords: Calcium, calcium biochemical, indicators, school children, low socioeconomic status.

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Authors: Esraa A. Khalil, Mohamed N. AbouZeid

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Building materials selection is critical for the sustainability of any project. The choice of building materials has a huge impact on the built environment and cost of projects. Building materials emit huge amount of carbon dioxide (CO₂) due to the use of cement as a basic component in the manufacturing process and as a binder, which harms our environment. Energy consumption from buildings has increased in the last few years; a huge amount of energy is being wasted from using unsustainable building and finishing materials, as well as from the process of heating and cooling of buildings. In addition, the construction sector in Egypt is taking a good portion of the economy; however, there is a lack of awareness of buildings environmental impacts on the built environment. Using advanced building materials and different wall systems can help in reducing heat consumption, the project’s initial and long-term costs, and minimizing the environmental impacts. Red Bricks is one of the materials that are being used widely in Egypt. There are many other types of bricks such as Autoclaved Aerated Concrete (AAC); however, the use of Red Bricks is dominating the construction industry due to its affordability and availability. This research focuses on the New Egyptian Administrative Capital as a case study to investigate the potential of the influence of using different wall systems such as AAC on the project’s cost and the environment. The aim of this research is to conduct a comparative analysis between the traditional and most commonly used bricks in Egypt, which is Red Bricks, and AAC wall systems. Through an economic and environmental study, the difference between the two wall systems will be justified to encourage the utilization of uncommon techniques in the construction industry to build more affordable, energy efficient and sustainable buildings. The significance of this research is to show the potential of using AAC in the construction industry and its positive influences. The study analyzes the factors associated with choosing suitable building materials for different projects according to the need and criteria of each project and its nature without harming the environment and wasting materials that could be saved or recycled. The New Egyptian Administrative Capital is considered as the country’s new heart, where ideas regarding energy savings and environmental benefits are taken into consideration. Meaning that, Egypt is taking good steps to move towards more sustainable construction. According to the analysis and site visits, there is a potential in reducing the initial costs of buildings by 12.1% and saving energy by using different techniques up to 25%. Interviews with the mega structures project engineers and managers reveal that they are more open to introducing sustainable building materials that will help in saving the environment and moving towards green construction as well as to studying more effective techniques for energy conservation.

Keywords: AAC blocks, building material, environmental impact, modern construction, New Egyptian Administrative Capital.

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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: Wenhsuan Lee, Yachi Chang, Yingyih Shih

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In clinical practices, it is common that while facing the unknown progress of their disease, palliative care patients may easily feel anxious and depressed. These types of reactions are a cause of psychosomatic diseases and may also influence treatment results. However, the purpose of palliative care is to provide relief from all kinds of pains. Therefore, how to make patients more comfortable is an issue worth studying. This study adopted the “bio-psycho-social model” proposed by Engel and applied spontaneous breathing training, in the hope of seeing patients’ psychological state changes caused by their physiological state changes, improvements in their anxious conditions, corresponding adjustments of their cognitive functions, and further enhancement of their social functions and the social support system. This study will be a one-year study. Palliative care outpatients will be recruited and assigned to the experimental group or the control group for six outpatient visits (once a month), with 80 patients in each group. The patients of both groups agreed that this study can collect their physiological quantitative data using an HRV device before the first outpatient visit. They also agreed to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” before the first outpatient visit, to fill a self-report questionnaire after each outpatient visit, and to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” after the last outpatient visit. The patients of the experimental group agreed to receive the breathing training under HRV monitoring during the first outpatient visit of this study. Before each of the following three outpatient visits, they were required to fill a self-report questionnaire regarding their breathing practices after going home. After the outpatient visits, they were taught how to practice breathing through an HRV device and asked to practice it after going home. Later, based on the results from the HRV data analyses and the pre-tests and post-tests of the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire”, the influence of the breathing training in the bio, psycho, and social aspects were evaluated. The data collected through the self-report questionnaires of the patients of both groups were used to explore the possible interfering factors among the bio, psycho, and social changes. It is expected that this study will support the “bio-psycho-social model” proposed by Engel, meaning that bio, psycho, and social supports are closely related, and that breathing training helps to transform palliative care patients’ psychological feelings of anxiety and depression, to facilitate their positive interactions with others, and to improve the quality medical care for them.

Keywords: Palliative care, breathing training, bio-psycho-social Model, heart rate variability.

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Authors: Michael A. Unbehauen, Gregory D. Sloan, Alberto J. Squatrito

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Missile proliferation and global stability are intrinsically linked. Missile threats continually appear at the forefront of global security issues. North Korea’s recently demonstrated nuclear and intercontinental ballistic missile (ICBM) capabilities, for the first time since the Cold War, renewed public interest in strategic missile defense capabilities. To protect from limited ICBM attacks from so-called rogue actors, the United States developed the Ground-based Midcourse Defense (GMD) system. This study examines if the GMD missile defense shield has contributed to a safer world or triggered a new arms race. Based upon increased missile-related developments and the lack of adherence to international missile treaties, it is generally perceived that the GMD system is a destabilizing factor for global security. By examining the current state of arms control treaties as well as existing missile arsenals and ongoing efforts in technologies to overcome U.S. missile defenses, this study seeks to analyze the contribution of GMD to global stability. A thorough investigation cannot ignore that, through the establishment of this limited capability, the U.S. violated longstanding, successful weapons treaties and caused concern among states that possess ICBMs. GMD capability contributes to the perception that ICBM arsenals could become ineffective, creating an imbalance in favor of the United States, leading to increased global instability and tension. While blame for the deterioration of global stability and non-adherence to arms control treaties is often placed on U.S. missile defense, the facts do not necessarily support this view. The notion of a renewed arms race due to GMD is supported neither by current missile arsenals nor by the inevitable development of new and enhanced missile technology, to include multiple independently targeted reentry vehicles (MIRVs), maneuverable reentry vehicles (MaRVs), and hypersonic glide vehicles (HGVs). The methodology in this study encapsulates a period of time, pre- and post-GMD introduction, while analyzing international treaty adherence, missile counts and types, and research in new missile technologies. The decline in international treaty adherence, coupled with a measurable increase in the number and types of missiles or research in new missile technologies during the period after the introduction of GMD, could be perceived as a clear indicator of GMD contributing to global instability. However, research into improved technology (MIRV, MaRV and HGV) prior to GMD, as well as a decline of various global missile inventories and testing of systems during this same period, would seem to invalidate this theory. U.S. adversaries have exploited the perception of the U.S. missile defense shield as a destabilizing factor as a pretext to strengthen and modernize their militaries and justify their policies. As a result, it can be concluded that global stability has not significantly decreased due to GMD; but rather, the natural progression of technological and missile development would inherently include innovative and dynamic approaches to target engagement, deterrence, and national defense.

Keywords: Arms control, arms race, global security, GMD, ICBM, missile defense, proliferation.

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Authors: Moustafa Osman Mohammed

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This paper introduces Luhmann’s autopoietic social systems starting with the original concept of autopoiesis by biologists and scientists, including the modification of general systems based on socialized medicine. A specific type of autopoietic system is explained in the three existing groups of the ecological phenomena: interaction, social and medical sciences. This hypothesis model, nevertheless, has a nonlinear interaction with its natural environment ‘interactional cycle’ for the exchange of photon energy with molecular without any changes in topology. The external forces in the systems environment might be concomitant with the natural fluctuations’ influence (e.g. radioactive radiation, electromagnetic waves). The cantilever sensor deploys insights to the future chip processor for prevention of social metabolic systems. Thus, the circuits with resonant electric and optical properties are prototyped on board as an intra–chip inter–chip transmission for producing electromagnetic energy approximately ranges from 1.7 mA at 3.3 V to service the detection in locomotion with the least significant power losses. Nowadays, therapeutic systems are assimilated materials from embryonic stem cells to aggregate multiple functions of the vessels nature de-cellular structure for replenishment. While, the interior actuators deploy base-pair complementarity of nucleotides for the symmetric arrangement in particular bacterial nanonetworks of the sequence cycle creating double-stranded DNA strings. The DNA strands must be sequenced, assembled, and decoded in order to reconstruct the original source reliably. The design of exterior actuators have the ability in sensing different variations in the corresponding patterns regarding beat-to-beat heart rate variability (HRV) for spatial autocorrelation of molecular communication, which consists of human electromagnetic, piezoelectric, electrostatic and electrothermal energy to monitor and transfer the dynamic changes of all the cantilevers simultaneously in real-time workspace with high precision. A prototype-enabled dynamic energy sensor has been investigated in the laboratory for inclusion of nanoscale devices in the architecture with a fuzzy logic control for detection of thermal and electrostatic changes with optoelectronic devices to interpret uncertainty associated with signal interference. Ultimately, the controversial aspect of molecular frictional properties is adjusted to each other and forms its unique spatial structure modules for providing the environment mutual contribution in the investigation of mass temperature changes due to pathogenic archival architecture of clusters.

Keywords: Autopoiesis, quantum photonics, portable energy, photonic structure, photodynamic therapeutic system.

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

Abstract:

The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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