Search results for: chronic obstructive pulmonary disease (COPD)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4812

Search results for: chronic obstructive pulmonary disease (COPD)

1692 Metabolic Syndrome and Mental Health in Post Traumatic Stress Disorder Patient

Authors: Hassan Shahmiri Barzoki

Abstract:

Background: Posttraumatic stress disorder (PTSD) is an abnormal physiologic and psychological reaction in person with severe traumatic history. In recent studies, the relationship between PTSD and some other disease apparently unrelated to psychological situations, such as cardiovascular diseases, diabetes, and metabolic syndrome, has been revealed. Thus, the aim of this study was to survey the prevalence of metabolic syndrome and mental health in PTSD patients. Methods: The research design was retrospective cohort study. Subjects were consisted of 142 Iran-Iraq war veterans with PTSD (age: 40-60 years), and the control group was consisted of 153 veterans without PTSD. Data was collected using questionnaires, physical exams and laboratory tests. Results: Prevalence of metabolic syndrome was 45.1%in PTSD group and 17% in control group. In addition, blood pressure, triglyceride and fasting blood sugar in PTSD group were significantly higher than control group (p<0.05). Also, PTSD patients had significant high rates of psychiatric disorders. Conclusion: PTSD patients are more prone to metabolic syndrome and psychiatric disorders than control group.

Keywords: mental health, metabolic syndrome, post traumatic stress disorder, patient

Procedia PDF Downloads 94
1691 Components of Arterial Pressure and Its Association with Dietary Inflammatory Potential of Older Individuals: The Multinational Medis Study

Authors: Demosthenes Panagiotakos

Abstract:

The aim of the present work was to evaluate dietary habits’ inflammatory potential with various components of arterial blood pressure (hypertension, mean arterial pressure (MAP) and pulse pressure (PP)) in a sample of older Mediterranean people without known cardiovascular disease. During 2005-2011, 2,813 older (aged 65-100 years) individuals from 21 Mediterranean islands and the rural Mani region (Peloponnesus) were voluntarily enrolled. Standard procedures were used to determine arterial blood pressure, as well as PP and MAP, and for the evaluation of dietary habits, lifestyle, anthropometric and clinical characteristics of the participants. A dietary inflammatory index (DII) was assessed based on the participants specific dietary habits, and its calculation was based on a standard procedure. It was reported that the higher the DII level of a diet (adherence to a more pro-inflammatory diet) the greater was the likelihood of having an older adult hypertension [OR=3.82 (95% CI): 1.24 to 11.71]. Moreover, the higher the level of DII (more pro-inflammatory dietary habits) the greater were the levels of MAP [b-coefficient (95% CI): 7.23 (+1.86 to +12.59)] and PP, [b-coefficient (95% CI): 10.86 (+2.70 to +19.01)]. Diet’s inflammatory potential is related with various components of arterial pressure. Adherence to a more pro-inflammatory diet seems to be associated with increased arterial peripheral resistance and arterial stiffness.

Keywords: dietary inflammatory index, hypertension, mean arterial pressure, elderly

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1690 The Role of Flexible Cystoscopy in Managing Recurrent Urinary Tract Infections in Patients with Mesh Implants

Authors: George Shaker, Maike Eylert

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Recurrent urinary tract infections (UTIs) in patients with mesh implants, particularly following pelvic or abdominal surgeries, pose significant clinical challenges. This paper investigates whether flexible cystoscopy is an essential diagnostic and therapeutic tool in managing such patients. With the increasing prevalence of mesh-related complications, it is crucial to explore how diagnostic procedures like cystoscopy can aid in identifying mesh-associated issues that contribute to recurrent UTIs. While flexible cystoscopy is commonly used to evaluate lower urinary tract conditions, its necessity in cases involving patients with mesh implants remains under debate. This study aims to determine the value of flexible cystoscopy in identifying complications such as mesh erosion, fistula formation, and chronic inflammation, which may contribute to recurrent infections. The research compares patients who underwent flexible cystoscopy to those managed without this procedure, examining the diagnostic yield of cystoscopy in detecting mesh-related complications. Furthermore, the study investigates the relationship between recurrent UTIs and the mechanical effects of mesh on the urinary tract, as well as the potential for cystoscopy to guide treatment decisions, such as mesh removal or revision. The results indicate that while flexible cystoscopy can identify mesh-related complications in some cases, its routine use may not be necessary for all patients with recurrent UTIs and mesh. The study emphasizes the importance of patient selection, clinical history, and symptom severity in deciding whether to employ cystoscopy. In cases where there are clear signs of mesh erosion or unexplained recurrent infections despite standard treatments, cystoscopy proves valuable. However, the study also highlights potential risks and discomfort associated with the procedure, suggesting that cystoscopy should be reserved for select cases where non-invasive methods fail to provide clarity. The research concludes that while flexible cystoscopy remains a valuable tool in certain cases, its routine use for all patients with recurrent UTIs and mesh is not justified. The paper provides recommendations for clinical guidelines, emphasizing a more personalized approach to diagnostics that considers the patient’s overall condition, infection history, and mesh type.

Keywords: flexible cystoscopy, recurrent urinary tract infections, mesh implants, mesh erosion, diagnostic procedures, urology

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1689 Effect of Acute Ingestion of Ice Water on Blood Pressure in Relation to Body Mass Index

Authors: Savitri Siddanagoudra, Shantala Herlekar, Priya Arjunwadekar

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Background: The physiological response to water drinking in healthy subjects is an integrated response with an increase in sympathetic vasoconstrictor activity with induced bradycardia. Obesity is a modern pandemic, implicated in the pathogenesis of cardiovascular disease. In autonomic failure patients, water drinking has been shown the increased high blood pressure and bradycardia. Acute effects of ice water ingestion on blood pressure (BP) in relation to body mass index (BMI) is not addressed in literature. Objectives: Objective of this study is to evaluate BP before and after ingestion of cold water in all the three groups. Methods and Material: 60 healthy subjects between the age group of 18-24 yrs were selected and assigned into 3 groups based on BMI. BMI less than and equal to 25 kg/m2 is selected as Normal BMI group ,between 25- 29 kg/m2 as Overweight and BMI more than and equal to 30 kg/m2 as Obese. Procedure: Basal and after ingestion of 250 ml of cold water (7 0C ± 0.5 0C)BP was recorded in all the 3 groups. Results: Basal and after ice water ingestion BP increased statistically in all 3 groups. Conclusion: On acute ingestion of ice water overweight, obese may have more sympathoexcitaion compared to normal subjects.

Keywords: blood pressure, body mass index, ice water, symathoexcitation

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1688 Assessing Immunization across Life Stages of the Cuban Treefrog (Osteopilus septentrionalis) to the Pathogenic Chytrid Fungus (Batrachochytrium dendrobatidis)

Authors: Kerri L. Surbaugh, Lakmini Y. Mallikarachchi, Jason R. Rohr

Abstract:

Emerging diseases are key factors in the disconcerting rate of contemporary amphibian declines. The chytrid fungus, Batrachochytrium dendrobatidis (Bd), ranks among the chief pathogenic challenges to vulnerable amphibian populations. Although live Bd can immunosuppress amphibian hosts, amphibian exposure to dead Bd can induce an adaptive immune response, leading to acquired resistance to the pathogen. In this experiment, dose and duration of flash-frozen Bd were manipulated over a variety of life-stages of the Cuban treefrog (Osteopilus septentrionalis) and the magnitude of acquired resistance to the pathogen was quantified via qPCR analyses of spore abundance post subsequent live Bd challenges. It was found that Cuban treefrogs can develop resistance to Bd and that life stage, dose and duration thresholds exist for acquired resistance. This experiment will aid in facilitating the development of a vaccine against Bd which could be used on location and could help curb worldwide amphibian declines associated with this pathogen.

Keywords: acquired resistance, ecoimmunology, emerging infectious disease, fungal host response, fungal pathogen, immunization

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1687 A Qualitative Examination of the Impact of COVID-19 on the Wellbeing of Undergraduate Students in Ontario

Authors: Soumya Mishra, Elena Neiterman

Abstract:

Aligned with the growing interest in the impact of the pandemic on academic experiences of university students, this study aimed to examine the challenges Canadian undergraduate students experienced during the university closures due to COVID-19. Using qualitative methodological approach, the study utilized semi-structured interviews conducted with 20 undergraduate students enrolled in an Ontario university to explore their thoughts and experience regarding online learning during the peak of the COVID-19 pandemic, from January 2021 to March 2021. The interviews yielded four major themes with the following associated subthemes: Personal Challenges Associated with Adapting to the Pandemic (Change in the Type of Stress Experienced, Unique Impact on Certain Groups of Students, Decreased Motivation, Crucial Role of Resilience), Social Challenges Associated with Adapting to the Pandemic (Increased Loneliness, Challenges Faced while Communicating, Perception of Group work, Role of Living Conditions), Challenges associated with Accessing University Resources (Crucial Role of Professors, Perception of Virtual Events, Importance of Physical Spaces). Overall, the analysis showed that the COVID-19 pandemic fostered resilience and psychological flexibility amongst all students. However, the mental health and social wellbeing of students deteriorated during the COVID-19 pandemic and they reported experiencing chronic stress, anxiety and loneliness. International students, first year and final year students experienced a unique set of challenges. It was hard for participants in our study to make strong new connections with their classmates and maintain existing friendships with their peers. The importance of professors in facilitating learning was amplified in the online environment due to the lack of in-person interaction with other students. Despite these challenges, most participants reported that they received high grades during online learning. The findings from this study could be helpful for organizations and individuals working towards fostering the wellbeing of undergraduate students. They can also help in making post-secondary institutions more resilient to future emergencies by creating contingency plans regarding online instructions and risk management techniques.

Keywords: Canadian, COVID-19, university students, wellbeing

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1686 Intelligent Technology for Real-Time Monitor and Data Analysis of the Aquaculture Toxic Water Concentration

Authors: Chin-Yuan Hsieh, Wei-Chun Lu, Yu-Hong Zeng

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The situation of a group of fish die is frequently found due to the fish disease caused by the deterioration of aquaculture water quality. The toxic ammonia is produced by animals as a byproduct of protein. The system is designed by the smart sensor technology and developed by the mathematical model to monitor the water parameters 24 hours a day and predict the relationship among twelve water quality parameters for monitoring the water quality in aquaculture. All data measured are stored in cloud server. In productive ponds, the daytime pH may be high enough to be lethal to the fish. The sudden change of the aquaculture conditions often results in the increase of PH value of water, lack of oxygen dissolving content, water quality deterioration and yield reduction. From the real measurement, the system can send the message to user’s smartphone successfully on the bad conditions of water quality. From the data comparisons between measurement and model simulation in fish aquaculture site, the difference of parameters is less than 2% and the correlation coefficient is at least 98.34%. The solubility rate of oxygen decreases exponentially with the elevation of water temperature. The correlation coefficient is 98.98%.

Keywords: aquaculture, sensor, ammonia, dissolved oxygen

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1685 Evaluation of the Synergistic Inhibition of Enterovirus 71 Infection by Interferon-α Coupled with Pleconaril in RD Cells

Authors: Wen-Yu Lin, Yi-Ching Chung, Tzyy-Rong Jinn

Abstract:

It is well known that enterovirus 71 (EV71) causes recurring outbreaks of hand, foot and mouth disease (HFMD) and encephalitis leading to complications or death in young children. And, several HFMD of EV71 with high mortalities occurred in Asia countries, such as Malaysia (1997), Taiwan (1998) and China (2008). Thus, more effective antiviral drugs are needed to prevent or reduce EV71-related complications. As reported, interferon-α protects mice from lethal EV71 challenge by the modulation of innate immunity and then degrade enterovirus protease 3Cᵖʳᵒ. On the other side, pleconaril by targeting enterovirus VP1 protein and then block virus entry and attachment. Thus, the aim of this study was to evaluate the synergistic antiviral activity of interferon-α and pleconaril against enterovirus 71 infection. In a preliminary study showed that pleconaril at concentrations of 50, 100 and 300 µg/mL reduced EV71-induced CPE to 52.0 ± 2.5%, 40.2 ± 3.5% and 26.5 ± 1.5%, respectively, of that of the EV71-infected RD control cells (taken as 100%). Notably, 1000 IU/mL of interferon-α in combination with pleconaril at concentrations of 50, 100 and 300µg/mL suppressed EV71-induced CPE by 30.2 ± 3.8%, 16.5 ± 1.3% and 2.8 ± 2.0%, respectively, of that of the pleconaril alone treated with the infected RD cells. These results indicated that interferon-α 1000 IU/mL combination with pleconaril (50, 100 and 300µg/mL) inhibited EV71-induced CPE more effectively than treated with pleconaril alone in the infected RD cells.

Keywords: enterovirus 71, interferon-α, pleconaril, RD cells

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1684 Radix Saposhnikoviae Suppresses Allergic Contact Dermatitis in Mice by Regulating DCs Activated Th1-Type Cells

Authors: Hailiang Liu, Yan Ni, Jie Zheng, Xiaoyan Jiang, Min Hong

Abstract:

Allergic contact dermatitis (ACD) is a commonly clinical type IV allergic skin disease, with the pathological features of infiltration by mononuclear cells and tissue necrosis. Traditional Chinese medicine Radix Saposhnikoviae (RS) is traditionally employed to treat exogenous evils, rubella, itching, rheumatism and tetanus. Meanwhile, it is an important component of the commonly used anti-allergy compound. It’s now widely used as an immuno-modulating agent in mixed herbal decoctions to treat inflammation. However, its mechanism of anti-allergy remains unknown. RS was found to reduce ear thickness, as well as the infiltration of eosinophils. The proliferation of T lymphocytes was inhibited significantly by RS, markedly decreased IFN-γ levels in the supernatant of cells cultured and serum were detected with the treatment of RS. RS significantly decreased the amount of DCs in the mouse lymph nodes, and inhibited the expression of CD4 0 and CD86. Meanwhile, T-bet mRNA expression was down remarkably regulated by RS. These results indicate that RS cures Th1-induced allergic skin inflammation by regulating Th1/Th2 balance with decreasing Th1 differentiation, which might be associated with DCs.

Keywords: allergic contact dermatitis, Radix saposhnikoviae, dendritic cells, T-bet, GATA-3, CD4+ CD25+ Foxp3+ treg cells

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1683 Diabetes Diagnosis Model Using Rough Set and K- Nearest Neighbor Classifier

Authors: Usiobaifo Agharese Rosemary, Osaseri Roseline Oghogho

Abstract:

Diabetes is a complex group of disease with a variety of causes; it is a disorder of the body metabolism in the digestion of carbohydrates food. The application of machine learning in the field of medical diagnosis has been the focus of many researchers and the use of recognition and classification model as a decision support tools has help the medical expert in diagnosis of diseases. Considering the large volume of medical data which require special techniques, experience, and high diagnostic skill in the diagnosis of diseases, the application of an artificial intelligent system to assist medical personnel in order to enhance their efficiency and accuracy in diagnosis will be an invaluable tool. In this study will propose a diabetes diagnosis model using rough set and K-nearest Neighbor classifier algorithm. The system consists of two modules: the feature extraction module and predictor module, rough data set is used to preprocess the attributes while K-nearest neighbor classifier is used to classify the given data. The dataset used for this model was taken for University of Benin Teaching Hospital (UBTH) database. Half of the data was used in the training while the other half was used in testing the system. The proposed model was able to achieve over 80% accuracy.

Keywords: classifier algorithm, diabetes, diagnostic model, machine learning

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1682 Coping Heat Stress By Crushed Fennel (Foeniculum Vulgare) Seeds in Broilers: Growth, Redox Balance, and Humoral Immune Response

Authors: Adia Fatima, Naila Chand, Rifat Ullah Khan

Abstract:

The goal of this study was to determine how fennel seed supplementation affected broiler growth, carcass quality, antioxidant status, and antibody titer in heat-stressed broilers. A total of 720 one-day-old broiler chickens were weighed and assigned to 28-floor pens (25 broiler chickens per pen). The broiler chickens were housed in a thermoneutral (TN) environment and were exposed to heat stress (HS). For 23 hours, the broiler chickens were kept under fluorescent lighting. For 35d, HS broiler chickens were fed a control diet and three levels of fennel seeds powder at rates of 15g/kg (Fen-15), 20 g/kg (Fen-20), and 25 g/kg (Fen-25). Overall feed intake, weight gain, and dressing % were considerably greater (P < 0.05) in Fen-25 and TN, but FCR was significantly reduced (P<0.01) in the same groups. When TN, Fen-20, and Fen-25 were compared to the control, malondialdehyde (MDA), paraoxonase (PON1), and antibody titer against New Castle disease (ND) were considerably (P < 0.05) greater. Further, the linear and quadratic response was for feed intake, weight gain, FCR, MDA, PON1, and ND titer. It was concluded that Fen-20 and Fen-25 increased broiler growth, carcass quality, antioxidant status, and immunological response under HS conditions.

Keywords: heat stress, growth, antioxidant, immunity

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1681 Correlation between Diabetic Cataract, HBA1C and Gurakhu, a Clinical Study in Chhattisgarh State

Authors: A. Bhattacharya, Sanjay Gupta, S. H. Bodakhe

Abstract:

HbA1c is form of the haemoglobin that is used to measure the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose. In diabetes mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease, nephropathy, and retinopathy. Guraku’s basic components are nicotine and jaggery, jaggery is made up of sugarcane so can have a diabetogenic potential which is exacerbated in presence of nicotine. This work had done with the aim to find correlation between Diabetic cataract, HbA1c and Guraku. Subjects were enrolled according to the inclusion and exclusion criteria. In this study total 75 subjects were included. In the study it was found that people consuming Guraku had a high level of HbA1c thus are more prone to the development of diabetic cataract. Male subjects are the more than female subjects. Most of the subjects belong to the lower socioeconomical class and not very educated. It could be concluded that this type of study could be useful in indentifying number of subjects suffering from diabetic cataract whose condition get worse by use of nicotine product like Guraku and preventive measure to be taken in prevention of this type of diabetic complication.

Keywords: diabetic cataract, HbA1c, Guraku, diabetogenic potential

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1680 Consumers’ Perceptions of Non-Communicable Diseases and Perceived Product Value Impacts on Healthy Food Purchasing Decisions

Authors: Khatesiree Sripoothon, Usanee Sengpanich, Rattana Sittioum

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The objective of this study is to examine the factors influencing consumer purchasing decisions about healthy food. This model consists of two latent variables: Consumer Perception relating to NCDs and Consumer Perceived Product Value. The study was conducted in the northern provinces of Thailand, which are popular with tourists and have received support from the government for health tourism. A survey was used as the data collection method, and the questionnaire was applied to 385 tourists. An accidental sampling method was used to identify the sample. The statistics of frequency, percentage, mean, and structural equation model were used to analyze the data obtained. Additionally, all factors had a significant positive influence on healthy food purchasing decisions (p<0.01) and were predictive of healthy food purchasing decisions at 46.20 (R2=0.462). Also, these findings seem to underline a supposition that consumer perceptions of NCDs and perceived product value are key variables that strengthens the competitive effects of a healthy-friendly business entrepreneur. Moreover, reduce the country's public health costs for treating patients with the disease of NCDs in Thailand.

Keywords: healthy food, perceived product value, perception of non-communicable diseases, purchasing decisions

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1679 Point-of-Decision Design (PODD) to Support Healthy Behaviors in the College Campuses

Authors: Michelle Eichinger, Upali Nanda

Abstract:

Behavior choices during college years can establish the pattern of lifelong healthy living. Nearly 1/3rd of American college students are either overweight (25 < BMI < 30) or obese (BMI > 30). In addition, overweight/obesity contributes to depression, which is a rising epidemic among college students, affecting academic performance and college drop-out rates. Overweight and obesity result in an imbalance of energy consumption (diet) and energy expenditure (physical activity). Overweight/obesity is a significant contributor to heart disease, diabetes, stroke, physical disabilities and some cancers, which are the leading causes of death and disease in the US. There has been a significant increase in obesity and obesity-related disorders such as type 2 diabetes, hypertension, and dyslipidemia among people in their teens and 20s. Historically, the evidence-based interventions for obesity prevention focused on changing the health behavior at the individual level and aimed at increasing awareness and educating people about nutrition and physical activity. However, it became evident that the environmental context of where people live, work and learn was interdependent to healthy behavior change. As a result, a comprehensive approach was required to include altering the social and built environment to support healthy living. College campus provides opportunities to support lifestyle behavior and form a health-promoting culture based on some key point of decisions such as stairs/ elevator, walk/ bike/ car, high-caloric and fast foods/balanced and nutrient-rich foods etc. At each point of decision, design, can help/hinder the healthier choice. For example, stair well design and motivational signage support physical activity; grocery store/market proximity influence healthy eating etc. There is a need to collate the vast information that is in planning and public health domains on a range of successful point of decision prompts, and translate it into architectural guidelines that help define the edge condition for critical point of decision prompts. This research study aims to address healthy behaviors through the built environment with the questions, how can we make the healthy choice an easy choice through the design of critical point of decision prompts? Our hypothesis is that well-designed point of decision prompts in the built environment of college campuses can promote healthier choices by students, which can directly impact mental and physical health related to obesity. This presentation will introduce a combined health and architectural framework aimed to influence healthy behaviors through design applied for college campuses. The premise behind developing our concept, point-of-decision design (PODD), is healthy decision-making can be built into, or afforded by our physical environments. Using effective design intervention strategies at these 'points-of-decision' on college campuses to make the healthy decision the default decision can be instrumental in positively impacting health at the population level. With our model, we aim to advance health research by utilizing point-of-decision design to impact student health via core sectors of influences within college settings, such as campus facilities and transportation. We will demonstrate how these domains influence patterns/trends in healthy eating and active living behaviors among students. how these domains influence patterns/trends in healthy eating and active living behaviors among students.

Keywords: architecture and health promotion, college campus, design strategies, health in built environment

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1678 Preliminary Results on a Study of Antimicrobial Susceptibility Testing of Bacillus anthracis Strains Isolated during Anthrax Outbreaks in Italy from 2001 to 2017

Authors: Viviana Manzulli, Luigina Serrecchia, Adelia Donatiello, Valeria Rondinone, Sabine Zange, Alina Tscherne, Antonio Parisi, Antonio Fasanella

Abstract:

Anthrax is a zoonotic disease that affects a wide range of animal species (primarily ruminant herbivores), and can be transmitted to humans through consumption or handling of contaminated animal products. The etiological agent B.anthracis is able to survive in unfavorable environmental conditions by forming endospore which remain viable in the soil for many decades. Furthermore, B.anthracis is considered as one of the most feared agents to be potentially misused as a biological weapon and the importance of the disease and its treatment in humans has been underscored before the bioterrorism events in the United States in 2001. Due to the often fatal outcome of human cases, antimicrobial susceptibility testing plays especially in the management of anthrax infections an important role. In Italy, animal anthrax is endemic (predominantly found in the southern regions and on islands) and is characterized by sporadic outbreaks occurring mainly during summer. Between 2012 and 2017 single human cases of cutaneous anthrax occurred. In this study, 90 diverse strains of B.anthracis, isolated in Italy from 2001 to 2017, were screened to their susceptibility to sixteen clinically relevant antimicrobial agents by using the broth microdilution method. B.anthracis strains selected for this study belong to the strain collection stored at the Anthrax Reference Institute of Italy located inside the Istituto Zooprofilattico Sperimentale of Puglia and Basilicata. The strains were isolated at different time points and places from various matrices (human, animal and environmental). All strains are a representative of over fifty distinct MLVA 31 genotypes. The following antibiotics were used for testing: gentamicin, ceftriaxone, streptomycin, penicillin G, clindamycin, chloramphenicol, vancomycin, linezolid, cefotaxime, tetracycline, erythromycin, rifampin, amoxicillin, ciprofloxacin, doxycycline and trimethoprim. A standard concentration of each antibiotic was prepared in a specific diluent, which were then twofold serial diluted. Therefore, each wells contained: bacterial suspension of 1–5x104 CFU/mL in Mueller-Hinton Broth (MHB), the antibiotic to be tested at known concentration and resazurin, an indicator of cell growth. After incubation overnight at 37°C, the wells were screened for color changes caused by the resazurin: a change from purple to pink/colorless indicated cell growth. The lowest concentration of antibiotic that prevented growth represented the minimal inhibitory concentration (MIC). This study suggests that B.anthracis remains susceptible in vitro to many antibiotics, in addition to doxycycline (MICs ≤ 0,03 µg/ml), ciprofloxacin (MICs ≤ 0,03 µg/ml) and penicillin G (MICs ≤ 0,06 µg/ml), recommend by CDC for the treatment of human cases and for prophylactic use after exposure to the spores. In fact, the good activity of gentamicin (MICs ≤ 0,25 µg/ml), streptomycin (MICs ≤ 1 µg/ml), clindamycin (MICs ≤ 0,125 µg/ml), chloramphenicol(MICs ≤ 4 µg/ml), vancomycin (MICs ≤ 2 µg/ml), linezolid (MICs ≤ 2 µg/ml), tetracycline (MICs ≤ 0,125 µg/ml), erythromycin (MICs ≤ 0,25 µg/ml), rifampin (MICs ≤ 0,25 µg/ml), amoxicillin (MICs ≤ 0,06 µg/ml), towards all tested B.anthracis strains demonstrates an appropriate alternative choice for prophylaxis and/or treatment. All tested B.anthracis strains showed intermediate susceptibility to the cephalosporins (MICs ≥ 16 µg/ml) and resistance to trimethoprim (MICs ≥ 128 µg/ml).

Keywords: Bacillus anthracis, antibiotic susceptibility, treatment, minimum inhibitory concentration

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1677 Anemia and Nutritional Status as Dominant Factor of the Event Low Birth Weight in Indonesia: A Systematic Review

Authors: Lisnawati Hutagalung

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Background: Low birth weight (LBW) is one cause of newborn death. Babies with low birth weight tend to have slower cognitive development, growth retardation, more at risk of infectious disease event at risk of death. Objective: Identifying risk factors and dominant factors that influence the incidence of LBW in Indonesia. Method: This research used some database of public health such as Google Scholar, UGM journals, UI journals and UNAND journals in 2012-2015. Data were filtered using keywords ‘Risk Factors’ AND ‘Cause LBW’ with amounts 2757 study. The filtrate obtained 5 public health research that meets the criteria. Results: Risk factors associated with LBW, among other environment factors (exposure to cigarette smoke and residence), social demographics (age and socio-economic) and maternal factors (anemia, placental abnormal, nutritional status of mothers, examinations antenatal, preeclampsia, parity, and complications in pregnancy). Anemia and nutritional status become the dominant factor affecting LBW. Conclusions: The risk factors that affect LBW, most commonly found in the maternal factors. The dominant factors are a big effect on LBW is anemia and nutritional status of the mother during pregnancy.

Keywords: low birth weight, anemia, nutritional status, the dominant factor

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1676 Effects of Physical Activity on the Association of CETP Gene with HDL Cholesterol Levels in Korean Population

Authors: Jae Woong Sull, Sun Ha Jee

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High-density lipoprotein (HDL) cholesterol levels are associated with decreased risk of coronary artery disease. Several genome-wide association studies (GWAS) for HDL cholesterol levels have implicated cholesterol ester transfer protein (CETP) as possibly causal. We tested for the association between single nucleotide polymorphisms (SNPs) in CETP gene and HDL cholesterol levels in Korean population. Subjects were selected from the Korean Metabolic Syndrome Research Initiative study in the Bundang-Gu area. A total of 2,304 individuals from Bundang-Gu were recruited in 2008. Other subjects were selected from the Severance Hospital (N=4,294). SNP rs6499861 in the CETP gene was associated with mean HDL cholesterol levels (effect per allele -2.044 mg/dL, p=7.23×10-7). Subjects with the CG/GG genotype had a 1.46 -fold (range 1.24–1.72-fold) higher risk of having abnormal HDL cholesterol levels (<40 mg/dL) than subjects with the CC genotype. When analyzed by gender, the association of CETP was stronger in women than in men. When analyzed by physical activity behavior, the association with CETP was much stronger in male subjects with low physical activity (OR=1.54, 95% CI: 1.23-1.92, P=0.0001) than in male subjects with high physical activity. This study clearly demonstrates that genetic variants in CETP influence HDL cholesterol levels in Korean adults.

Keywords: CETP, HDL cholesterol, physical activity, polymorphisms

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1675 Is Sodium Channel Nav1.7 an Ideal Therapeutically Analgesic Target? A Systematic Review

Authors: Yutong Wan, John N. Wood

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Introduction: SCN9A encoded Nav1.7 is an ideal therapeutic target with minimal side effects for the pharmaceutical industry because SCN9A variants can cause both human gains of function pain-related mutations and loss of function pain-free mutations. This study reviews the clinical effectiveness of existing Nav1.7 inhibitors, which theoretically should be powerful analgesics. Methods: A systematic review is conducted on the effectiveness of current Nav1.7 blockers undergoing clinical trials. Studies were mainly extracted from PubMed, U.S. National Library of Medicine Clinical Trials, World Health Organization International Clinical Trials Registry, ISRCTN registry platform, and Integrated Research Approval System by NHS. Only studies with full text available and those conducted using double-blinded, placebo controlled, and randomised designs and reporting at least one analgesic measurement were included. Results: Overall, 61 trials were screened, and eight studies covering PF 05089771 (Pfizer), TV 45070 (Teva & Xenon), and BIIB074 (Biogen) met the inclusion criteria. Most studies were excluded because results were not published. All three compounds demonstrated insignificant analgesic effects, and the comparison between PF 05089771 and pregabalin/ibuprofen showed that PF 05089771 was a much weaker analgesic. All three drug candidates only have mild side effects, indicating the potentials for further investigation of Nav1.7 antagonists. Discussion: The failure of current Nav1.7 small molecule inhibitors might attribute to ignorance of the key role of endogenous systems in Nav1.7 null mutants, the lack of selectivity and blocking potency, and central impermeability. The synergistic combination of analgesic drugs, a recent UCL patent, combining a small dose of Nav1.7 blockers and opioids or enkephalinase inhibitors dramatically enhanced the analgesic effects. Conclusion: The current clinical testing Nav1.7 blockers are generally disappointing. However, the newer generation of Nav1.7 targeting analgesics has overcome the major constraints of its predecessors.

Keywords: chronic pain, Nav1.7 blockers, SCN9A, systematic review

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1674 Do Women with Endometriosis Have Higher Perceived Stress Levels than Healthy Women?

Authors: Jodie Hughes

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Endometriosis affects 1 in 10 individuals that were born female globally. Endometriosis incidence rates peak between 30-40 year of age, in young women and adolescents it is a rarely suspected and often ill-diagnosed. The average cost of endometriosis is €9,579 per woman. More than 75% of women have reported being absent from work due to endometriosis, with 40% of women becoming unemployed due to the disease. 46% of patients with endometriosis need to have appointments with upward of five doctors to gain a correct diagnosis. Quantitative data were collected by way of an online PSS-10 survey that included demographic questions from two sample groups of females, group 1 was females with endometriosis, group 2 were healthy women. The data were scored using Cohens scoring system, overall scores were input to SPSS. A non-parametric Mann-Whitney U test and ANOVA was used to ascertain any differences between the PSS-10 scores of the two groups. A significance level of P<0.05 was adopted. Four women were invited to take part in a semi structured interview that was recorded, transcribed and coded using interpretive phenomenological analysis (IPA) using NVivo 12. Results showed that the PSS-10 scores were significantly higher in women with endometriosis compared to healthy women with a p=<0.005. Endometriosis affects all aspects of a patient’s life, to adequately diagnose and treat the condition and improve HRQoL there needs to be better understanding of the clinical symptoms and how they impact the lives of patients.

Keywords: endometriosis, HRQoL, perceived stress, women

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1673 Evaluation of Orthodontic Patients’ Dental Visits and Problems During Covid-19 Pandemic in Sari Dental School in 2021

Authors: Mobina Bagherianlemraski, Parastoo Namdar

Abstract:

Background: The ongoing coronavirus disease has affected most countries. This virus has high transmission power. Due to the closure of most dental clinics, millions of orthodontic patients missed their appointments during the COVID-19 pandemic. Methods: A questionnaire was developed and sent to patients receiving orthodontic treatment at a public or private clinic. Results: A total of 200 responses were analyzed: These included 153 women (76.5%) and 47 men (23.5%). The mean and standard deviation of their age was 18.92±7.23 years, with an age range of 8 to 40 years. One hundred eighty-nine patients (94.5%) had fixed appliances, and 11 patients (5.5%) had removable appliances. Of all participants, 35% (70) missed their appointments. The highest and lowest reasons for stopping appointments were concerned about the spread of COVID-19 with 28 cases (40%) and the closure of the clinic with 15 cases (21.4%). Of the 53 patients who contacted their orthodontists, 86.8 % (46) communicated via office phone and 5.7% (3) through social media. Conclusion: This study determined that the coronavirus pandemic and quarantine have had an important impact on orthodontic treatments. The greatest concern of orthodontic patients was increasing in treatment duration. Patients who used fixed appliances reported missing dental appointments more than others. Therefore, during COVID 19 Pandemic, orthodontists should prepare patients to solve their problems linked to orthodontic appliances when possible.

Keywords: orthodontic patients, coronavirus pandemic, appointments, COVID-19

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1672 Analysis of the Impacts and Challenges of Conventional Solid Waste Management in Urban Centers of Developing Countries

Authors: Haruna Abdu Usman, J. Mohammed Umar, U. M. Bashir

Abstract:

Solid waste management continued to be the biggest threat to the sustainability of urban centers of developing countries. Most streets corners of these urban centers are characterized by heaps of uncollected wastes at drains, public spaces and road sides destroying the aesthetic qualities and environmental ecosystems of these cities. Also, harboring disease vectors and rodents putting the health of the populace at risk, thus posing a serious challenge to the municipalities who are in most cases responsible for the solid waste management in these cities. The typical or commonest method adapted by these agencies in dealing with the solid waste management is the conventional approach; focusing mainly on waste collection ,treatment(composting and incineration)and disposal giving little consideration to the 3RS, of waste reduce, re-used and recycled. The resultant consequence being huge budget spending in solid waste management as high as 80% but little collection rate as low as 50%. This paper attempt to analyze the impacts and effects of the conventional solid waste management practices on the stakeholders in solid waste management; the municipal authorities, the communities, formal and informal waste managers, the NGOs and CBOs and suggests appropriate measures that would lessen the effects.

Keywords: conventional waste management, solid waste, waste stakeholders, developing countries

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1671 Improving Depression, Anxiety and Distress Symptoms in Type 2 Diabetes Patients

Authors: Seyed Reza Alvani, Norzarina Mohd Zaharim

Abstract:

Diabetes mellitus is one of the chronic, progressive illnesses that has reached a widespread level all over the world and considered an extreme life-threatening condition in South East Asian countries region include Malaysia. Co-morbid psychological factors like diabetes-related distress and low level of psychological well-being are related to high levels of blood sugar and hypo/hyperglycemia complications. As a result, the implementation of any effective psychological interventions among diabetes patients is necessary. One such intervention is cognitive behavioural therapy (CBT) that is approved and suggested by many professionals as an empirically-supported technique of treatment for people how are suffering from diabetes around the world where there is no clear evidence of using this technique in Malaysia. The target of this study was to see whether or not participation in group CBT would end in an improvement of psychological well-being (by decreasing the levels of depression and anxiety) and diabetes-related distress followed by lower level of blood sugar level. The sample of the present study was 60 type 2 diabetes adults (ages 20-65) with HbA1c ≥ 7 from Universiti Sains Malaysia (USM) clinic. All participants were selected by the convenience sampling technique. Participants completed Well-Being Questionaire (W-BQ) and Distress Scale (DDS-17) after signing written consent form. Those participants who were interested to join CBT groups were placed to the experimental groups, and people who were not interested were assigned to the control group. The experimental groups (n = 30) received group CBT, whereas participants in the control group (n = 30) did not receive any kind of psychological intervention. For testing the effect of intervention, mixed between-within ANOVA used. The entire intervention program took three months, and a significant improvement in the level of psychological well-being and decline in the level of diabetes distress observed among participants from experimental group, but not for those in the control group. Additionally, the result of the study suggested that group CBT could help participants in experimental group achieve more acceptable HbA1c levels in comparison with those in the control group. Malaysian Ministry of Health, researcher and governors should give due interest and commitment to psychological care as a pathway to diabetes mitigation among Malaysian adults.

Keywords: cognitive behavioral therapy, diabetes related distress, diabetes type 2, Malaysia, well-being

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1670 Dietetics Practice in the Scope of Disease Prevention in Community Settings: A School-Based Obesity Prevention Program

Authors: Elham Abbas Aljaaly, Nahlaa Abdulwahab Khalifa

Abstract:

The active method of disease prevention is seen as the most affordable and sustainable action to deal with risks of non-communicable diseases such as obesity. This eight-week project aimed to pilot the feasibility and acceptability of a school-based programme, which is proposed to prevent and modify overweight status and possible related risk factors among student girls 'at the intermediate level' in Jeddah city. The programme was conducted through comprehensible approach targeting physical environment and school policies (nutritional/exercise/behavioural approach). The programme was designed to cultivate the personal and environmental awareness in schools for girls. This was applied by promoting healthy eating and physical activity through policies, physical education, healthier options for school canteens, and the creation of school health teams. The prevention programme was applied on 68 students (who agreed to participate) from grades 7th, 8th and 9th. A pre and post assessment questionnaire was employed on 66 students. The questionnaires were designed to obtain information on students' knowledge about health, nutrition and physical activity. Survey questions included information about nutrients, food consumption patterns, food intake and lifestyle. Physical education included training sessions for new opportunities for physical activities to be performed during school or after school hours. A running competition 'to enhance students’ performance for physical activities' was also conducted during the school visit. A visit to the school canteen was conducted to check, observe, record and assess all available food/beverage items and meals. The assessment method was a subjective method for the type of food/beverages if high in saturated fat, salt and sugar (HFSS) or non-HFSS. The school canteen administrators were encouraged to provide healthy food/beverage items and a sample healthy canteen was provided for implementation. Two healthy options were introduced to the school canteen. A follow up for students’ preferences for the introduced options and the purchasing power were assessed. Thirty-eight percent of young girls (n=26) were not participating in any form of physical activities inside or outside school. Skipping breakfast was stated by 42% (n=28) of students with no daily consumption (19%, n=13) for fruit/vegetables. Significant changes were noticed in students’ (n=66) overall responses to the pre and post questions (P value=.001). All students had participated in the conducted running competition sessions and reported satisfaction and enjoyment about the sessions. No absence was reported by the research team for attending physical education and activity sessions throughout the delivered programme. The purchasing power of the introduced healthy options of 'Salad and oatmeal' was increased to 18% in 8 weeks at the school canteen, and slightly affected the purchase for other less healthy options. The piloted programme indorsed better health and nutrition knowledge, healthy eating and lifestyle attitude, which could help young girls to obtain sustainable changes. It is expected that the outcomes of the programme will be a cornerstone for the futuristic national study that will assist policy makers and participants to build a knowledgeable health promotion scenario and make sure that school students have access to healthy foods, physical exercise and healthy lifestyle.

Keywords: adolescents, diet, exercise, behaviours, overweight/obesity, prevention-intervention programme, Saudi Arabia, schoolgirls

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1669 Development and Evaluation of Novel Diagnostic Methods for Infectious Rhinotracheitis of Cattle

Authors: Wenxiao Liu, Kun Zhang, Yongqing Li

Abstract:

Bovine herpesvirus 1, a member of the genus Variellovirus of the subfamily Alphaherpesvirinae, has caused severe economic cost to the bovine industry. In this study, BoHV-1 glycerol protein gD was expressed in insect cells, and the purified gD was immunized in the Balb/C mice to generate monoclonal antibodies. Based on hybridoma cell fusion techniques, 20 monoclonal antibodies against Bovine herpesvirus 1 have been obtained. Further, mAb 3F8 with neutralizing activity and gD were applied to develop a blocking enzyme-linked immunosorbent assay (Elisa) for detecting neutralizing antibodies against BoHV-1, which shows a significant correlation between the blocking Elisa and VNT. The sensitivity and specificity of the test were estimated to be 94.59% and 93.42%, respectively. Furthermore, antibody pairing tests revealed that mAb 1B6 conjugated to fluorescence microspheres was used as the capture antibody, and mAb 3F9 was used as the detectable antibody to establish the immunochromatographic assay (ICS). The ICS was conducted to detect BoHV-1 in bovine samples with high sensitivity, specificity, and good stability. Clinical sample testing revealed that the results of ICS and real-time PCR have a coincidence rate of 95.42%. Our research confirmed that the ICS is a rapid and reliable method for the diagnosis of BoHV-1. In conclusion, our results lay a solid foundation for the prevention and control of BoHV-1 infection.

Keywords: bovine disease, BoHV-1, ELISA, ICS assay

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1668 Prevalence of Metabolic Syndrome According to Different Criteria in Population over 20 Years Old in Ahvaz

Authors: Armaghan Moravej Aleali, Hajieh Shahbazian, Seyed Mahmoud Latifi, Leila Yazdanpanah

Abstract:

Objective: Metabolic syndrome or insulin resistance syndrome or syndrome X is a collection of abdominal obesity, hypertension, glucose intolerance and lipid abnormalities (elevated triglycerides, elevated LDL, and decrease the amount of HDL). That increases the incidence of diabetes and risk of cardiovascular disease. The aim of this study is to investigate the prevalence of metabolic syndrome in people over 20 years of Ahvaz according to IDF, ATPIII, Harmonized I and Harmonized II. Material & Methods: A cross-sectional study with a random cluster sampling in six health centers in Ahvaz was done. After obtaining informed consent, questionnaire for each person filled up including demographic data and examinations, including blood pressure in sitting position, weight, height, waist circumference, and waist circumference measurement. Results: From all participating 912 people, (434 (2/47%) male and 478 (2/52%) female) were evaluated. Mean age was 42/27± 14years (44/2±14/26 for male and 40/5±13/5 for female). Prevalence of metabolic syndrome was 22/8%, 28/4%, 30/9% and 16/9% according to ATPIII, IDF, Harmonized I and Harmonized II criteria respectively and increased with age in both sexes. IDF and Harmonized I had most kappa coordination (0/94). Conclusion: The results show a high prevalence of metabolic syndrome in Ahvaz. So, identification of the risk factors should be attempted to prevent metabolic syndrome.

Keywords: metabolic syndrome, IDF, ATP III, prevalence

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1667 Relevance of Dosing Time for Everolimus Toxicity on Thyroid Gland and Hormones in Mice

Authors: Dilek Ozturk, Narin Ozturk, Zeliha Pala Kara, Engin Kaptan, Serap Sancar Bas, Nurten Ozsoy, Alper Okyar

Abstract:

Most physiological processes oscillate in a rhythmic manner in mammals including metabolism and energy homeostasis, locomotor activity, hormone secretion, immune and endocrine system functions. Endocrine body rhythms are tightly regulated by the circadian timing system. The hypothalamic-pituitary-thyroid (HPT) axis is under circadian control at multiple levels from hypothalamus to thyroid gland. Since circadian timing system controls a variety of biological functions in mammals, circadian rhythms of biological functions may modify the drug tolerability/toxicity depending on the dosing time. Selective mTOR (mammalian target of rapamycin) inhibitor everolimus is an immunosuppressant and anticancer agent that is active against many cancers. It was also found to be active in medullary thyroid cancer. The aim of this study was to investigate the dosing time-dependent toxicity of everolimus on the thyroid gland and hormones in mice. Healthy C57BL/6J mice were synchronized with 12h:12h Light-Dark cycle (LD12:12, with Zeitgeber Time 0 – ZT0 – corresponding to Light onset). Everolimus was administered to male (5 mg/kg/day) and female mice (15 mg/kg/day) orally at ZT1-rest period- and ZT13-activity period- for 4 weeks; body weight loss, clinical signs and possible changes in serum thyroid hormone levels (TSH and free T4) were examined. Histological alterations in the thyroid gland were evaluated according to the following criteria: follicular size, colloid density and viscidity, height of the follicular epithelium and the presence of necrotic cells. The statistical significance between differences was analyzed with ANOVA. Study findings included everolimus-related diarrhea, decreased activity, decreased body weight gains, alterations in serum TSH levels, and histopathological changes in thyroid gland. Decreases in mean body weight gains were more evident in mice treated at ZT1 as compared to ZT13 (p < 0.001, for both sexes). Control tissue sections of thyroid glands exhibited well-organized histoarchitecture when compared to everolimus-treated groups. Everolimus caused histopathological alterations in thyroid glands in male (5 mg/kg, slightly) and female mice (15 mg/kg; p < 0.01 for both ZT as compared to their controls) irrespective of dosing-time. TSH levels were slightly decreased upon everolimus treatment at ZT13 in both males and females. Conversely, increases in TSH levels were observed when everolimus treated at ZT1 in both males (5 mg/kg; p < 0.05) and females (15 mg/kg; slightly). No statistically significant alterations in serum free T4 levels were observed. TSH and free T4 is clinically important thyroid hormones since a number of disease states have been linked to alterations in these hormones. Serum free T4 levels within the normal ranges in the presence of abnormal serum TSH levels in everolimus treated mice may suggest subclinical thyroid disease which may have repercussions on the cardiovascular system, as well as on other organs and systems. Our study has revealed the histological damage on thyroid gland induced by subacute everolimus administration, this effect was irrespective of dosing time. However, based on the body weight changes and clinical signs upon everolimus treatment, tolerability for the drug was best following dosing at ZT13 in both male and females. Yet, effects of everolimus on thyroid functions may deserve further studies regarding their clinical importance and chronotoxicity.

Keywords: circadian rhythm, chronotoxicity, everolimus, thyroid gland, thyroid hormones

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1666 Nonlinear Analysis of Postural Sway in Multiple Sclerosis

Authors: Hua Cao, Laurent Peyrodie, Olivier Agnani, Cecile Donze

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Multiple sclerosis (MS) is a disease, which affects the central nervous system, and causes balance problem. In clinical, this disorder is usually evaluated using static posturography. Some linear or nonlinear measures, extracted from the posturographic data (i.e. center of pressure, COP) recorded during a balance test, has been used to analyze postural control of MS patients. In this study, the trend (TREND) and the sample entropy (SampEn), two nonlinear parameters were chosen to investigate their relationships with the expanded disability status scale (EDSS) score. Forty volunteers with different EDSS scores participated in our experiments with eyes open (EO) and closed (EC). TREND and two types of SampEn (SampEn1 and SampEn2) were calculated for each combined COP’s position signal. The results have shown that TREND had a weak negative correlation to EDSS while SampEn2 had a strong positive correlation to EDSS. Compared to TREND and SampEn1, SampEn2 showed a better significant correlation to EDSS and an ability to discriminate the MS patients in the EC case. In addition, the outcome of the study suggests that the multi-dimensional nonlinear analysis could provide some information about the impact of disability progression in MS on dynamics of the COP data.

Keywords: balance, multiple sclerosis, nonlinear analysis, postural sway

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1665 The Role of Leisure in Older Adults Transitioning to New Homes

Authors: Kristin Prentice, Carri Hand

Abstract:

As the Canadian population ages and chronic health conditions continue to escalate, older adults will require various types of housing, such as long term care or retirement homes. Moving to a new home may require a change in leisure activities and social networks, which could be challenging to maintain identity and create a sense of home. Leisure has been known to help older adults maintain or increase their quality of life and life satisfaction and may help older adults in moving to new homes. Sense of home and identity within older adults' transitions to new homes are concepts that may also relate to leisure engagement. Literature is scant regarding the role of leisure in older adults moving to new homes and how the sense of home and identity inter-relate. This study aims to explore how leisure may play a role in older adults' transitioning to new homes, including how sense of home and identity inter-relate. An ethnographic approach will be used to understand the culture of older adults transitioning to new homes. This study will involve older adults who have recently relocated to a mid-sized city in Ontario, Canada. The study will focus on the older adult’s interactions with and connections to their home environment through leisure. Data collection will take place via video-conferencing and will include a narrative interview and two other interviews to discuss an activity diary of leisure engagement pre and post move and mental maps to capture spaces where participants engaged in leisure. Participants will be encouraged to share photographs of leisure engagement taken inside and outside their home to help understand the social spaces the participants refer to in their activity diaries and mental maps. Older adults attempt to adjust to their new homes by maintaining their identity, developing a sense of home through creating attachment to place, and maintaining social networks, all of which have been linked to engaging in leisure. This research will provide insight into the role of leisure in this transition process and the extent that the home and community can contribute to aiding their transition to the new home. This research will contribute to existing literature on the inter-relationships of leisure, sense of home, and identity and how they relate to older adults moving to new homes. This research also has potential for influencing policy and practice for meeting the housing needs of older adults.

Keywords: leisure, older adults, transition, identity

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1664 Decrease of Aerobic Capacity in Twenty Years in Lithuanian 11–18 Years-Old Youth

Authors: Arunas Emeljanovas, Brigita Mieziene, Tomas Venckunas

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Background statement: Level of aerobic capacity in school age children provides important information about the current and future cardiovascular, skeletal and mental health. It is widely recognised that risk factors for modern chronic diseases of the adults have their origins in childhood and adolescence. The aim of the study was to analyse the trends of aerobic capacity across decades within groups of gender and age. Methods. The research included data of participants from the three nationally representative cohort studies performed in Lithuania in the years 1992, 2002 and 2012 among 11 to 18-years-old school children. Total of 18,294 school children were recruited for testing. Only those who had their body weight and height measured and completed 20 m shuttle endurance test were included in the analysis. The total number of students included in the analyses was 15,213 (7608 boys and 7605 girls). The permission to conduct the study was obtained from the Lithuanian Bioethics Committee (permission number BE-2-45). Major findings: Results are performed across gender and age groups. The comparison of shuttle endurance test, controlling for body mass index, indicated that in general there is a constant decrease of aerobic capacity across decades in both genders and age groups. The deterioration in aerobic capacity in boys accounted for 17 to 43 percent across age groups within decades. The biggest decrease was in 14 years-old boys. The deterioration in girls accounted for 19 to 37 percent across age groups with the highest decrease in 11 years-old girls. Though, girls had lower levels of aerobic capacity through all age groups and across three decades. Body mass index, as a covariate, accounted for up to six percent in deterioration of aerobic capacity. Final statement: The detected relationships may reflect the level and pattern of engagement in physical activity and sports where increased activity associates with superior performance in the tests because of the upregulated physiological function and instigated competitive/motivational level. The significance of the decade indirectly supports the importance of the recently changed activity among schoolchildren for this relationship.

Keywords: aerobic capacity, cardiovascular health, endurance, school age children

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1663 Assessing the Prevalence of Accidental Iatrogenic Paracetamol Overdose in Adult Hospital Patients Weighing <50kg: A Quality Improvement Project

Authors: Elisavet Arsenaki

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Paracetamol overdose is associated with significant and possibly permanent consequences including hepatotoxicity, acute and chronic liver failure, and death. This quality improvement project explores the prevalence of accidental iatrogenic paracetamol overdose in hospital patients with a low body weight, defined as <50kg and assesses the impact of educational posters in trying to reduce it. The study included all adult inpatients on the admissions ward, a short stay ward for patients requiring 12-72 hour treatment, and consisted of three cycles. Each cycle consisted of 3 days of data collection in a given month (data collection for cycle 1 occurred in January 2022, February 2022 for cycle 2 and March 2022 for cycle 3). All patients given paracetamol had their prescribed dose checked against their charted weight to identify the percentage of adult inpatients <50kg who were prescribed 1g of paracetamol instead of 500mg. In the first cycle of the audit, data were collected from 83 patients who were prescribed paracetamol on the admissions ward. Subsequently, four A4 educational posters were displayed across the ward, on two separate occasions and with a one-month interval in between each poster display. The aim of this was to remind prescribing doctors of their responsibility to check patient body weight prior to prescribing paracetamol. Data were collected again one week after each round of poster display, from 72 and 70 patients respectively. Over the 3 cycles with a cumulative 225 patients, 15 weighed <50kg (6.67%) and of those, 5 were incorrectly prescribed 1g of paracetamol, yielding a 33.3% prevalence of accidental iatrogenic paracetamol overdose in adult inpatients. In cycle 1 of the project, 3 out of 6 adult patients weighing <50kg were overdosed on paracetamol, meaning that 50% of low weight patients were prescribed the wrong dose of paracetamol for their weight. In the second data collection cycle, 1 out of 5 <50kg patients were overdosed (20%) and in the third cycle, 1 out of 4 (25%). The use of educational posters resulted in a lower prevalence of accidental iatrogenic paracetamol overdose in low body weight adult inpatients. However, the differences observed were statistically insignificant (p value 0.993 and 0.995 respectively). Educational posters did not induce a significant decrease in the prevalence of accidental iatrogenic paracetamol overdose. More robust strategies need to be employed to further decrease paracetamol overdose in patients weighing <50kg.

Keywords: iatrogenic, overdose, paracetamol, patient, safety

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