Search results for: late menopausal transition
Commenced in January 2007
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Edition: International
Paper Count: 2548

Search results for: late menopausal transition

2218 Opto-Electronic Properties and Structural Phase Transition of Filled-Tetrahedral NaZnAs

Authors: R. Khenata, T. Djied, R. Ahmed, H. Baltache, S. Bin-Omran, A. Bouhemadou

Abstract:

We predict structural, phase transition as well as opto-electronic properties of the filled-tetrahedral (Nowotny-Juza) NaZnAs compound in this study. Calculations are carried out by employing the full potential (FP) linearized augmented plane wave (LAPW) plus local orbitals (lo) scheme developed within the structure of density functional theory (DFT). Exchange-correlation energy/potential (EXC/VXC) functional is treated using Perdew-Burke and Ernzerhof (PBE) parameterization for generalized gradient approximation (GGA). In addition to Trans-Blaha (TB) modified Becke-Johnson (mBJ) potential is incorporated to get better precision for optoelectronic properties. Geometry optimization is carried out to obtain the reliable results of the total energy as well as other structural parameters for each phase of NaZnAs compound. Order of the structural transitions as a function of pressure is found as: Cu2Sb type → β → α phase in our study. Our calculated electronic energy band structures for all structural phases at the level of PBE-GGA as well as mBJ potential point out; NaZnAs compound is a direct (Γ–Γ) band gap semiconductor material. However, as compared to PBE-GGA, mBJ potential approximation reproduces higher values of fundamental band gap. Regarding the optical properties, calculations of real and imaginary parts of the dielectric function, refractive index, reflectivity coefficient, absorption coefficient and energy loss-function spectra are performed over a photon energy ranging from 0.0 to 30.0 eV by polarizing incident radiation in parallel to both [100] and [001] crystalline directions.

Keywords: NaZnAs, FP-LAPW+lo, structural properties, phase transition, electronic band-structure, optical properties

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2217 The Mediation Impact of Demographic and Clinical Characteristics on the Relationship between Trunk Control and Quality of Life among the Sub-Acute Stroke Population: A Cross-Sectional Study

Authors: Kumar Gular, Viswanathan S., Mastour Saeed Alshahrani, Ravi Shankar Reddy, Jaya Shanker Tedla, Snehil Dixit, Ajay Prasad Gautam, Venkata Nagaraj Kakaraparthi, Devika Rani Sangadala

Abstract:

Background: Despite trunk control’s significant contribution to improving various functional activity components, the independent effect of trunk performance on quality of life is yet to be estimated in stroke survivors. Ascertaining the correlation between trunk control and self-reported quality of life while evaluating the effect of demographic and clinical characteristics on their relationship will guide concerned healthcare professionals in designing ideal rehabilitation protocols during the late sub-acute stroke stage of recovery. The aims of the present research were to (1) investigate the associations of trunk performance with self-rated quality of life and (2) evaluate if age, body mass index (BMI), and clinical characteristics mediate the relationship between trunk motor performance and perceived quality of life in the sub-acute stroke population. Methods: Trunk motor functions and quality of life among the late sub-acute stroke population aged 57.53 ± 6.42 years were evaluated through the trunk Impairment Scale (TIS) and Stroke specific quality of life (SSQOL) questionnaire, respectively. Pearson correlation coefficients and mediation analysis were performed to elucidate the relationship of trunk motor function with quality of life and determine the mediation impact of demographic and clinical characteristics on their association, respectively. Results: The current study observed significant correlations between trunk motor functions (TIS) and quality of life (SSQOL) with r=0.68 (p<0.001). Age, BMI, and type of stroke were detected as potential mediating factors in the association between trunk performance and quality of life. Conclusion: Validated associations between trunk motor functions and perceived quality of life among the late sub-acute stroke population emphasize the importance of comprehensive evaluation of trunk control. Rehabilitation specialists should focus on appropriate strategies to enhance trunk performance anticipating the potential effects of age, BMI, and type of stroke to improve health-related quality of life in stroke survivors.

Keywords: sub-acute stroke, quality of life, functional independence, trunk control

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2216 The Effect of Geographical Differentials of Epidemiological Transition on Health-Seeking Behavior in India

Authors: Sumit Kumar Das, Laishram Ladusingh

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Aim: The aim of the study is to examine the differential of epidemiological transition across fifteen agro-climatic zones of India and its effect on health-seeking behavior. Data and Methods: Unit level data on consumption expenditure on health of India from three decadal rounds conducted by National Sample Survey Organization are used for the analysis. These three rounds are 52nd (1995-96), 60th (2004-05) and 71st (2014-15). The age-adjusted prevalence rate for communicable diseases and non-communicable diseases are estimated for fifteen agro-climatic zones of India for three time periods. Bivariate analysis is used to find out determinants of health-seeking behavior. Multilevel logistic regression is used to examine factors effecting on household health-seeking behavior. Result: The prevalence of communicable diseases is increasing in most of the zones of India. Every South Indian zones, Gujarat plains, and lower Gangetic plain are facing the severe attack of dual burden of diseases. Demand for medical advice has increased in southern zones, and east zones, reliance on private healthcare facilities are increasing in most of the zone. Demographic characteristics of the household head have a significant impact on health-seeking behavior. Conclusion: Proper program implementation is required considering the disease prevalence and differential in the pattern of health seeking behavior. Along with initiation and strengthening of programs for non-communicable, existing programs for communicable diseases need to monitor and supervised strictly.

Keywords: agro-climatic zone, epidemiological transition, health-seeking behavior, multilevel regression

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2215 The Synthesis, Structure and Catalytic Activity of Iron(II) Complex with New N2O2 Donor Schiff Base Ligand

Authors: Neslihan Beyazit, Sahin Bayraktar, Cahit Demetgul

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Transition metal ions have an important role in biochemistry and biomimetic systems and may provide the basis of models for active sites of biological targets. The presence of copper(II), iron(II) and zinc(II) is crucial in many biological processes. Tetradentate N2O2 donor Schiff base ligands are well known to form stable transition metal complexes and these complexes have also applications in clinical and analytical fields. In this study, we present salient structural features and the details of cathecholase activity of Fe(II) complex of a new Schiff Base ligand. A new asymmetrical N2O2 donor Schiff base ligand and its Fe(II) complex were synthesized by condensation of 4-nitro-1,2 phenylenediamine with 6-formyl-7-hydroxy-5-methoxy-2-methylbenzopyran-4-one and by using an appropriate Fe(II) salt, respectively. Schiff base ligand and its metal complex were characterized by using FT-IR, 1H NMR, 13C NMR, UV-Vis, elemental analysis and magnetic susceptibility. In order to determine the kinetics parameters of catechol oxidase-like activity of Schiff base Fe(II) complex, the oxidation of the 3,5-di-tert-butylcatechol (3,5-DTBC) was measured at 25°C by monitoring the increase of the absorption band at 390-400 nm of the product 3,5-di-tert-butylcatequinone (3,5-DTBQ). The compatibility of catalytic reaction with Michaelis-Menten kinetics also investigated by the method of initial rates by monitoring the growth of the 390–400 nm band of 3,5-DTBQ as a function of time. Kinetic studies showed that Fe(II) complex of the new N2O2 donor Schiff base ligand was capable of acting as a model compound for simulating the catecholase properties of type-3 copper proteins.

Keywords: catecholase activity, Michaelis-Menten kinetics, Schiff base, transition metals

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2214 The On-Board Critical Message Transmission Design for Navigation Satellite Delay/Disruption Tolerant Network

Authors: Ji-yang Yu, Dan Huang, Guo-ping Feng, Xin Li, Lu-yuan Wang

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The navigation satellite network, especially the Beidou MEO Constellation, can relay data effectively with wide coverage and is applied in navigation, detection, and position widely. But the constellation has not been completed, and the amount of satellites on-board is not enough to cover the earth, which makes the data-relay disrupted or delayed in the transition process. The data-relay function needs to tolerant the delay or disruption in some extension, which make the Beidou MEO Constellation a delay/disruption-tolerant network (DTN). The traditional DTN designs mainly employ the relay table as the basic of data path schedule computing. But in practical application, especially in critical condition, such as the war-time or the infliction heavy losses on the constellation, parts of the nodes may become invalid, then the traditional DTN design could be useless. Furthermore, when transmitting the critical message in the navigation system, the maximum priority strategy is used, but the nodes still inquiry the relay table to design the path, which makes the delay more than minutes. Under this circumstances, it needs a function which could compute the optimum data path on-board in real-time according to the constellation states. The on-board critical message transmission design for navigation satellite delay/disruption-tolerant network (DTN) is proposed, according to the characteristics of navigation satellite network. With the real-time computation of parameters in the network link, the least-delay transition path is deduced to retransmit the critical message in urgent conditions. First, the DTN model for constellation is established based on the time-varying matrix (TVM) instead of the time-varying graph (TVG); then, the least transition delay data path is deduced with the parameters of the current node; at last, the critical message transits to the next best node. For the on-board real-time computing, the time delay and misjudges of constellation states in ground stations are eliminated, and the residual information channel for each node can be used flexibly. Compare with the minute’s delay of traditional DTN; the proposed transmits the critical message in seconds, which improves the re-transition efficiency. The hardware is implemented in FPGA based on the proposed model, and the tests prove the validity.

Keywords: critical message, DTN, navigation satellite, on-board, real-time

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2213 Polygenetic Iron Mineralization in the Baba-Ali and Galali Deposits, Further Evidences from Stable (S, O, H) Isotope Data, NW Hamedan, Iran

Authors: Ghodratollah Rostami Paydar

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The Baba-Ali and Galali iron deposits are located in northwest Hamedan and the Iranian Sanandaj-Sirjan geological structural zone. The host rocks of these deposits are metavolcanosedimentary successions of Songhor stratigraphic series with permo-trriassic age. Field investigation, ore geometry, textures and structures and paragenetic sequence of minerals, all indicate that the ore minerals are crystallized in four stages: primary volcanosedimentary stage, secondary regional metamorphism with formation of ductile shear zones, contact metamorphism and metasomatism stage and the finally late hydrothermal mineralization within uplift and exposure. Totally 29 samples of sulfide, oxide-silicate and carbonate minerals of iron orees and gangue has been purified for stable isotope analysis. The isotope ratio data assure that occurrence of dynamothermal metamorphism in these areas typically involves a lengthy period of time, which results in a tendency toward isotopic homogenization specifically in O and H stable isotopes and showing the role of metamorphic waters in mineralization process. Measurement of δ34S (CDT) in first generation of pyrite is higher than another ones, so it confirms the volcanogenic origin of primary iron mineralization. δ13C data measurements in Galali carbonate country rocks show a marine origin. δ18O in magnetite and skarn forming silicates, δ18O and δ13C in limestone and skarn calcite and δ34S in sulphides are all consistent with the interaction of a magmatic-equilibrated fluid with Galali limestone, and a dominantly magmatic source for S. All these data imply skarn formation and mineralisation in a magmatic-hydrothermal system that maintained high salinity to relatively late stages resulting in the formation of the regional Na metasomatic alteration halo. Late stage hydrothermal quartz-calcite veinlets are important for gold mineralization, but the economic evaluation is required to detailed geochemical studies.

Keywords: iron, polygenetic, stable isotope, BabaAli, Galali

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2212 Prenatal Can Reduce the Burden of Preterm Birth and Low Birthweight from Maternal Sexually Transmitted Infections: US National Data

Authors: Anthony J. Kondracki, Bonzo I. Reddick, Jennifer L. Barkin

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We sought to examine the association of maternal Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and treponema pallidum (TP) (syphilis) infections with preterm birth (PTB) (<37 weeks gestation), low birth weight (LBW) (<2500 grams) and prenatal care (PNC) attendance. This cross-sectional study was based on data drawn from the 2020 United States National Center for Health Statistics (NCHS) Natality File. We estimated the prevalence of all births, early/late PTBs, moderately/very LBW, and the distribution of sexually transmitted infections (STIs) according to maternal characteristics in the sample. In multivariable logistic regression models, we examined adjusted odds ratios (aORs) and their corresponding 95% confidence intervals (CIs) of PTB and LBW subcategories in the association with maternal/infant characteristics, PNC status, and maternal CT, NG, and TP infections. In separate logistic regression models, we assessed the risk of these newborn outcomes stratified by PNC status. Adjustments were made for race/ethnicity, age, education, marital status, health insurance, liveborn parity, previous preterm birth, gestational hypertension, gestational diabetes, PNC status, smoking, and infant sex. Additionally, in a sensitivity analysis, we assessed the association with early, full, and late term births and the potential impact of unmeasured confounding using the E-value. CT (1.8%) was most prevalent STI in pregnancy, followed by NG (0.3%), and TP (0.1%). Non-Hispanic Black women, 20-24 years old, with a high school education, and on Medicaid had the highest rate of STIs. Around 96.6% of women reported receiving PNC and about 60.0% initiated PNC early in pregnancy. PTB and LBW were strongly associated with NG infection (12.2% and 12.1%, respectively) and late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits received (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-foldhigher for each STI among women who received ≤10 prenatal visits than >10 visits. Adequate prenatal care utilization and timely screening and treatment of maternal STIs can substantially reduce the burden of adverse newborn outcomes.

Keywords: low birthweight, prenatal care, preterm birth, sexually transmitted infections

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2211 Developing Drought and Heat Stress Tolerant Chickpea Genotypes

Authors: Derya Yucel, Nigar Angın, Dürdane Mart, Meltem Turkeri, Volkan Catalkaya, Celal Yucel

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Chickpea (Cicer arietinum L.) with high protein content is a vital food, especially in under-developed and developing countries for the people who do not consume enough meat due to low-income level. The objective of the proposed study is to evaluate growing, yield and yield components of chickpea genotypes under Mediterranean condition so determine tolerance of chickpea genotypes against drought and heat stress. For this purpose, a total of 34 chickpea genotypes were used as material. The experiment was conducted according to factorial randomized complete block design with 3 reps at the Eastern Mediterranean Research Institute, Adana, TURKEY for 2014-15 growing season under three different growing conditions (Winter sowing, irrigated-late sowing and non-irrigated- late sowing). According to results of this experiment, vegetative period, flowering time, poding time, maturity time, plant height, height of first pod, seed yield and 100 seed weight were ranged between 68.33 to 78.77 days, 94.22 to 85.00 days, 94.11 to 106.44 days, 198.56 to 214.44 days, 37.18 to 64.89 cm, 18.33 to 34.83 cm, 417.1 to 1746.4 kg/ha and 14.02 to 45.02 g, respectively. Among the chickpea genotypes, the Aksu, Arda, Çakır, F4 09 (X 05 TH 21-16189), FLIP 03-108 were least affected by drought and heat stress. Therefore, these genotypes can be used as sources of drought and heat tolerance in further breeding programme for evolving the drought and heat tolerant genotypes in chickpea.

Keywords: chickpea, drought stress, heat stress, yield

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2210 Frequency Control of Self-Excited Induction Generator Based Microgrid during Transition from Grid Connected to Island Mode

Authors: Azhar Ulhaq, Zubair Yameen, Almas Anjum

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Frequency behaviour of self-excited induction generator (SEIG) wind turbines during control mode transition from grid connected to islanded mode is studied in detail. A robust control scheme for frequency regulation based on combined action of STATCOM, energy storage system (ESS) and pitch angle control for wind powered microgrid (MG) is proposed. Suggested STATCOM controller comprises a 3-phase voltage source converter (VSC) that contains insulated gate bipolar transistors (IGBTs) based pulse width modulation (PWM) inverters along with a capacitor bank. Energy storage system control consists of current controlled voltage source converter and battery bank. Both of them acting simultaneously after detection of island compensates for reactive and active power demands, thus regulating frequency at point of common coupling (PCC) and also improves load stability. STATCOM integrates at point of common coupling and ESS is connected to microgrids main bus. Results reveal that proposed control not only stabilizes frequency during transition duration but also minimizes sudden frequency imbalance caused by load variation or wind intermittencies in islanded operation. System is investigated with and without suggested control scheme. The efficacy of proposed strategy has been verified by simulation in MATLAB/Simulink.

Keywords: energy storage system, island, wind, STATCOM, self-excited induction generator, SEIG, transient

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2209 Anticancer Effects of MicroRNA-1275 in Human Nasopharyngeal Carcinoma by Targeting HOXB5

Authors: Cheng-Cao Sun, Shu-Jun Li, De-Jia Li

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Through analysis of a published micro-array-based high-throughput assessment, we discovered that miR-1275 was markedly down-regulated in nasopharyngeal carcinoma (NPC) tissues. However, little is known about its effect and mechanism involved in NPC development and progression. In this study, we investigated the role of miR-1275 on the development of NPC. The results indicated that miR-1275 was significantly down-regulated in primary NPC tissues, and very low levels were found in NPC cell lines. Ectopic expression of miR-1275 in NPC cell lines significantly suppressed cell growth as evidenced by cell viability assay and colony formation assay, through inhibition of HOXB5. In addition, miR-1275 suppresses G1/S transition through inhibition of HOXB5. Further, oncogene HOXB5 was revealed to be a putative target of miR-1275, which was inversely correlated with miR-1275 expression in NPC. Collectively, our study demonstrates that as a tumor suppressor, miR-1275 played a pivotal role on NPC through inhibiting cell proliferation, and suppressing G1/S transition by targeting oncogenic HOXB5.

Keywords: microRNA-1275 (miR-1275), HOXB5, nasopharyngeal carcinoma, proliferation

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2208 The Effect of Annual Weather and Sowing Date on Different Genotype of Maize (Zea mays L.) in Germination and Yield

Authors: Ákos Tótin

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In crop production the most modern hybrids are available for us, therefore the yield and yield stability is determined by the agro-technology. The purpose of the experiment is to adapt the modern agrotechnology to the new type of hybrids. The long-term experiment was set up in 2015-2016 on chernozem soil in the Hajdúság (eastern Hungary). The plots were set up in 75 thousand ha-1 plant density. We examined some mainly use hybrids of Hungary. The conducted studies are: germination dynamic, growing dynamic and the effect of annual weather for the yield. We use three different sowing date as early, average and late, and measure how many plant germinated during the germination process. In the experiment, we observed the germination dynamics in 6 hybrid in 4 replication. In each replication, we counted the germinated plants in 2m long 2 row wide area. Data will be shown in the average of the 6 hybrid and 4 replication. Growing dynamics were measured from the 10cm (4-6 leaf) plant highness. We measured 10 plants’ height in two weeks replication. The yield was measured buy a special plot harvester - the Sampo Rosenlew 2010 – what measured the weight of the harvested plot and also took a sample from it. We determined the water content of the samples for the water release dynamics. After it, we calculated the yield (t/ha) of each plot at 14% of moisture content to compare them. We evaluated the data using Microsoft Excel 2015. The annual weather in each crop year define the maize germination dynamics because the amount of heat is determinative for the plants. In cooler crop year the weather is prolonged the germination. At the 2015 crop year the weather was cold in the beginning what prolonged the first sowing germination. But the second and third sowing germinated faster. In the 2016 crop year the weather was much favorable for plants so the first sowing germinated faster than in the previous year. After it the weather cooled down, therefore the second and third sowing germinated slower than the last year. The statistical data analysis program determined that there is a significant difference between the early and late sowing date growing dynamics. In 2015 the first sowing date had the highest amount of yield. The second biggest yield was in the average sowing time. The late sowing date has lowest amount of yield.

Keywords: germination, maize, sowing date, yield

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2207 Epidemiology of Primary Bronchopulmonary Cancer in Tunisia

Authors: Melliti Rihab, Zaeid Sonia, Khechine Wiem, Daldoul Amira

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Introduction: Lung cancer is the leading cause of cancer death. Its incidence is increasing, and its prognosis remains pejorative. We present the clinical, pathological, and therapeutic characteristics of bronchopulmonary cancer (BPC) in Tunisia. Methods: Retrospective study including patients followed in the oncology department of the University Hospital of Monastir between April 2014 and December 2021 suffering from lung cancer. Results: These are 117 patients, including 86.3% men and 13.7% women (sex ratio 6.3). The average age was 64 years ± 9 (37-83), with 95.7% being over 50 years old. Patients were smokers in 82% of cases. The clinical signs were dominated by chest pain (27.5%) and dyspnea in 21.1% of cases. In 6 patients, an episode of COVID-19 infection revealed the diagnosis. Half of the patients had a PS between 0 and 1. Small cell lung cancer was present in 18 patients (15.4%). The majority of non small cell lung cancer was of the adenocarcinoma type (68.7%). The diagnosis was late (stage IV) in 62.4% of cases. BPC was metastatic to bone (52%), contralateral lung (25.9%), and brain (27.3%). Patients were oligometastatic in 26% of cases. Surgery and radiotherapy were performed respectively in 14.5% and 23.1% of cases. Three-quarters of the patients had had nutrition (75.2%). The ROS1 mutation was present in 1 patient. PDL-1 expression was >40% in 2 patients. Survival was mean eight months ± 7.4. Conclusion: Lung cancer is diagnosed at a late stage in Tunisia. The lack of molecular study for non-small cell PBC and the lack of marketing authorization for tyrosine kinase inhibitors in Tunisia make the management incomplete.

Keywords: SCLC, NCSLC, ROS1, PDL1

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2206 Transformation of Antitrust Policy against Collusion in Russia and Transition Economies

Authors: Andrey Makarov

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This article will focus on the development of antitrust policy in transition economies in the context of preventing explicit and tacit collusion. Experience of BRICS, CIS (Ukraine, Kazakhstan) and CEE countries (Bulgaria, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, Slovenia, Czech Republic, Estonia) in the creation of antitrust institutions was analyzed, including both legislation and enforcement practice. Most of these countries in the early 90th were forced to develop completely new legislation in the field of protection of competition and it is important to compare different ways of building antitrust institutions and policy results. The article proposes a special approach to evaluation of preventing collusion mechanisms. This approach takes into account such enforcement problems as: classification problems (tacit vs explicit collusion, vertical vs horizontal agreements), flexibility of prohibitions (the balance between “per se” vs “rule of reason” approaches de jure and in practice), design of sanctions, private enforcement challenge, leniency program mechanisms, the role of antitrust authorities etc. The analysis is conducted using both official data, published by competition authorities, and expert assessments. The paper will show how the integration process within the EU predetermined some aspects of the development of antitrust policy in CEE countries, including the trend of the use of "rule of reason" approach. Simultaneously was analyzed the experience of CEE countries in special mechanisms of government intervention. CIS countries in the development of antitrust policy followed more or less original ways, without such a great impact from the European Union, more attention will be given to Russian experience in this field, including the analysis of judicial decisions in antitrust cases. Main problems and challenges for transition economies in this field will be shown, including: Legal uncertainty problem; Problem of rigidity of prohibitions; Enforcement priorities of the regulator; Interaction of administrative and criminal law, limited effectiveness of criminal sanctions in the antitrust field; The effectiveness of leniency program design; Private enforcement challenge.

Keywords: collusion, antitrust policy, leniency program, transition economies, Russia, CEE

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2205 Political Transition in Nepal: Challenges and Limitations to Post-Conflict Peace-Building

Authors: Sourina Bej

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Since the process of decolonization in 1940, several countries in South Asia have witnessed intra-state conflicts owing to ineffective political governance. The conflicts have remained protracted as the countries have failed to make a holistic transition to a democratic state. Nepal is one such South Asian country facing a turmultous journey from monarchy to republicanism. The paper aims to focus on the democratic transition in the context of Nepal’s political, legal and economic institutions. The presence of autocratic feudalistic and centralised state structure with entrenched socio-economic inequalities has resulted in mass uprising only to see the country slip back to the old order. Even a violent civil war led by the Maoists could not overhaul the political relations or stabilize the democratic space. The paper aims to analyse the multiple political, institutional and operational challenges in the implementation of the peace agreement with the Maoist. Looking at the historical background, the paper will examine the problematic nation-building that lies at the heart of fragile peace process in Nepal. Regional dynamics have played a big role in convoluting the peace-building. The new constitution aimed at conflict resolution brought to the open, deep seated hatred among different ethnic groups in Nepal. Apart from studying the challenges to the peace process and the role of external players like India and China in the political reconstruction, the paper will debate on a viable federal solution to the ethnic conflict in Nepal. If the current government fails to pass a constitution accepted by most ethnic groups, Nepal will remain on the brink of new conflict outbreaks.

Keywords: democratisation, ethnic conflict, Nepal, peace process

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2204 Feasibility Studies in Public Construction Projects in South Africa: Barriers and Implications

Authors: Kenneth O. Otasowie, Matthew Ikuabe, Clinton Aigbavboa, Ayodeji Oke

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The practice of feasibility studies plays a huge role in the success of construction projects. Feasibility studies according to several research should be the reason for embarking on any project. However, it has been discovered that in South Africa (SA), feasibility studies are mainly done in the private sector construction but skipped in the construction of most public projects. Hence, this study aims to evaluate the barriers to feasibility studies practice in public projects and the implications. A survey design was adopted. A total number of One hundred and fifty (150) questionnaires were administered to Quantity Surveyors, Construction managers, Construction project managers, Project managers, Architects and Civil and Structural engineers in Guateng Province, SA and ninety (90) were returned and found suitable for analysis. Collected data was analysed using percentage, mean item score, standard deviation, one-sample t-test. The findings show that political interference and corruption are the most significant barriers to feasibility studies practice in the public construction projects in SA, while late project completion, poor quality infrastructure are among the implication of not conducting feasibility studies in SA public projects. Therefore, the study recommends the development of a framework for public projects execution that will reduce the interference of the political class in the country, that way the risk of late project completion and poor quality infrastructure will be mitigated.

Keywords: arriers, feasibility studies, public construction, South Africa.

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2203 Interactions of Socioeconomic Status, Age at Menarche, Body Composition and Bone Mineral Density in Healthy Turkish Female University Students

Authors: Betül Ersoy, Deniz Özalp Kizilay, Gül Gümüşer, Fatma Taneli

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Introduction: Peak bone mass is reached in late adolescence in females. Age at menarche influences estrogen exposure, which plays a vital role in bone metabolism. The relationship between age at menarche and bone mineral density (BMD) is still controversial. In this study, we investigated the relationship between age at menarche, BMD, socioeconomic status (SES) and body composition in female university student. Participant and methods: A total of 138 healthy girls at late adolescence period (mean age 20.13±0.93 years, range 18-22) were included in this university school-based cross-sectional study in the urban area western region of Turkey. Participants have been randomly selected to reflect the university students studying in all faculties. We asked relevant questions about socioeconomic status and age at menarche to female university students. Students were grouped into three SES as lower, middle and higher according to the educational and occupational levels of their parents using Hollingshead index. Height and weight were measured. Body Mass Index (BMI) (kg/m2 ) was calculated. Dual energy X-ray absorptiometry (DXA) was performed using the Lunar DPX series, and BMD and body composition were evaluated. Results: The mean age of menarche of female university student included in the study was 13.09.±1.3 years. There was no significant difference between the three socioeconomic groups in terms of height, body weight, age at menarche, BMD [BMD (gr/cm2 ) (L2-L4) and BMD (gr/cm2 ) (total body)], and body composition (lean tissue, fat tissue, total fat, and body fat) (p>0.05). While no correlation was found between the age at menarche and any parameter (p>0.05), a positive significant correlation was found between lean tissue and BMD L2-L4 (r=0.286, p=0.01). When the relationships were evaluated separately according to socioeconomic status, there was a significant correlation between BMDL2-L4 (r: 0.431, p=0.005) and lean tissue in females with low SES, while this relationship disappeared in females with middle and high SES. Conclusion: Age at menarche did not change according to socioeconomic status, nor did BMD and body composition in female at late adolescents. No relationship was found between age at menarche and BMD and body composition determined by DEXA in female university student who were close to reaching peak bone mass. The results suggested that especially BMDL2-L4 might increase as lean tissue increases.

Keywords: bone, osteoposis, menarche, dexa

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2202 Live and Learn in Ireland: Supporting International Students

Authors: Tom Farrelly, Yvoonne Kavanagh, Tony Murphy

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In the last 20 years, Ireland has enjoyed an upsurge in the number of international students coming to avail of its well-regarded Higher Education system. While welcome, the influx of international students has posed a number of cultural, social and academic challenges for the Irish HE sector, both at institutional and individual lecturer level. Notwithstanding the challenge to the Irish HE sector, the difficulties that incoming students face needs to be acknowledged and addressed. For students who have never left their home country before the transition can be daunting even if they have not learned the customs and ways of the new country. In 2013, Ireland’s National Forum for the Advancement of Teaching and Learning in Higher Education invited submissions from interested parties to design and implement digital supports aimed at assisting students transitioning into or exiting higher education. Five colleges—the Institute of Technology, Tralee; University College Cork, Institute of Technology, Carlow; Cork Institute of Technology and Waterford Institute of Technology—collectively known as the Southern Cluster, were granted funding to research and develop digital objects to support international students' transition into the Irish higher education system. One of the key fundamentals of this project was its strong commitment to incorporating the student voice to help inform the design of the digital objects. The primary research method used to ascertain student views was the circulation of an online questionnaire using SurveyMonkey to existing international students in each of the five participant colleges. The questionnaire sought to examine the experiences and opinions of the students in relation to three main aspects of their living and studying in Ireland (hence the name of the project LiveAndLearnInIreland) (1) the academic environment (2) the social aspects of living in Ireland and (3) the practical aspects of living in Ireland. The response to the survey (n=573), revealed a number of sometimes surprising issues and themes for the digital objects to address. The research, therefore, offers insight into the types of concerns that any college, whether in Ireland or further afield, needs to take into consideration, if it is to genuinely assist what can be a difficult transition for the international student. That said, while there are a number of themes that emerged that have international implications there are other themes that have a particular resonance for the Irish HE sector.

Keywords: international, transition, support, inclusion

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2201 Investigating the Post-Liver Transplant Complications and Their Management in Children Referred to the Children’s Medical Center

Authors: Hosein Alimadadi, Fatemeh Farahmand, Ali Jafarian, Nasir Fakhar, Mohammad Hassan Sohouli, Neda Raeesi

Abstract:

Backgroundsː Regarding the important role of liver transplantation as the only treatment in many cases of end-stage liver disease in children, the aim of this study is to investigate the complications of liver transplantation and their management in children referred to the Children's Medical Center. Methods: This study is a cross-sectional study on pediatric patients who have undergone liver transplants in the years 2016 to 2021. The indication for liver transplantation in this population was confirmed by a pediatric gastroenterologist, and a liver transplant was performed by a transplant surgeon. Finally, information about the patient before and after the transplantation was collected and recorded. Results: A total of 53 patients participated in this study, including 25 (47.2%) boys and 28 (52.8%) girls. The most common causes of liver transplantation were cholestatic and metabolic diseases. The most common early complication of liver transplantation in children was acute cellular rejection (ACR) and anastomotic biliary stricture. The most common late complication in these patients was an infection which was observed in 56.6% of patients. Among the drug side effects, neurotoxicity (convulsions) was seen more in patients, and 15.1% of the transplanted patients died. Conclusion: In this study, the most common early complication of liver transplantation in children was ACR and biliary stricture, and the most common late complication was infection. Neurotoxicity (convulsions) was the most common side effect of drugs.

Keywords: liver transplantation, complication, infection, survival rate

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2200 Investigation of the Grain-Boundary Segregation Transition in the Binary Fe-C Alloy

Authors: Végh Ádám, Mekler Csaba, Dezső András, Szabó Dávid, Stomp Dávid, Kaptay György

Abstract:

Grain boundary segregation transition (GBST) has been calculated by a thermodynamic model in binary alloys. The method is used on cementite (Fe3C) segregation in base-centered cubic (ferrite) iron (Fe) in the Fe-C binary system. The GBST line is shown in the Fe3C lacking part of the phase diagram with high solvent (Fe) concentration. At a lower solute content (C) or at higher temperature the grain boundary is composed mostly of the solvent atoms (Fe). On higher concentration compared to the GBST line or at lower temperature a phase transformation occurs at the grain boundary, the latter mostly composed of the associates (Fe3C). These low-segregation and high-segregation states are first order interfacial phase transitions of the grain boundary and can be transformed into each other reversibly. These occur when the GBST line is crossed by changing the bulk composition or temperature.

Keywords: GBST, cementite, segregation, Fe-C alloy

Procedia PDF Downloads 567
2199 Analysis of Career Support Programs for Olympic Athletes in Japan with Fifteen Conceptual Categories

Authors: Miyako Oulevey, Kaori Tsutsui, David Lavallee, Naohiko Kohtake

Abstract:

The Japan Sports Agency has made efforts to unify several career support programs for Olympic athletes prior to the 2020 Tokyo Olympics. One of the programs, the Japan Olympic Committee Career Academy (JCA) was established in 2008 for Olympic athletes at their retirement. Research focusing on the service content of sport career support programs can help athletes experience a more positive transition. This study was designed to investigate the service content of the JCA program in relation to athletes’ career transition needs, including any differences of the reasons for retirement between Summer/Winter and Male/Female Olympic athletes, and to suggest the directions of how to unify the career support programs in Japan after hosting the Olympic Games using sport career transition models. Semi-structured interviews were conducted and analyzed the JCA director who started and managed the program since its inception, and a total of 15 conceptual categories were generated by the analysis. Four conceptual categories were in the result of “JCA situation”, 4 conceptual categories were in the result of “Athletes using JCA”, and 7 conceptual categories were in the result of “JCA current difficulties”. Through the analysis it was revealed that: the JCA had occupational supports for both current and retired Olympic athletes; other supports such as psychological support were unclear due to the lack of psychological professionals in JCA and the difficulties collaborating with other sports organizations; and there are differences in tendencies of visiting JCA, financial situations, and career choices depending on Summer/Winter and Male/Female athletes.

Keywords: career support programs, causes of career termination, Olympic athlete, Olympic committee

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2198 Agroecology Approaches Towards Sustainable Agriculture and Food System: Reviewing and Exploring Selected Policies and Strategic Documents through an Agroecological Lens

Authors: Dereje Regasa

Abstract:

The global food system is at a crossroads, which requires prompt action to minimize the effects of the crises. Agroecology is gaining prominence due to its contributions to sustainable food systems. To support efforts in mitigating the crises, the Food and Agriculture Organization (FAO) established alternative approaches for sustainable agri-food systems. Agroecological elements and principles were developed to guide and support measures that countries need to achieve the Sustainable Development Goals (SDGs). The SDGs require the systemic integration of practices for a smart intensification or adaptation of traditional or industrial agriculture. As one of the countries working towards SDGs, the agricultural practices in Ethiopia need to be guided by these agroecological elements and principles. Aiming at the identification of challenging aspects of a sustainable agri-food system and the characterization of an enabling environment for agroecology, as well as exploring to what extent the existing policies and strategies support the agroecological transition process, five policy and strategy documents were reviewed. These documents are the Rural Development Policy and Strategy, the Environment Policy, the Biodiversity Policy, and the Soil Strategy of the Ministry of Agriculture (MoA). Using the Agroecology Criteria Tool (ACT), the contents were reviewed, focusing on agroecological requirements and the inclusion of sustainable practices. ACT is designed to support a self-assessment of elements supporting agroecology. For each element, binary values were assigned based on the inclusion of the minimum requirements index and then validated through discussion with the document owners. The results showed that the documents were well below the requirements for an agroecological transition of the agri-food system. The Rural Development Policy and Strategy only suffice to 83% in Human and Social Value. It does not support the transition concerning the other elements. The Biodiversity Policy and Soil Strategy suffice regarding the inclusion of Co-creation and Sharing of knowledge (100%), while the remaining elements were not considered sufficiently. In contrast, the Environment Policy supports the transition with three elements accounting for 100%. These are Resilience, Recycling, and Human and Social Care. However, when the four documents were combined, elements such as Synergies, Diversity, Efficiency, Human and Social value, Responsible governance, and Co-creation and Sharing of knowledge were identified as fully supportive (100%). This showed that the policies and strategies complemented one another to a certain extent. However, the evaluation results call for improvements concerning elements like Culture and food traditions, Circular and solidarity economy, Resilience, Recycling, and Regulation and balance since the majority of the elements were not sufficiently observed. Consequently, guidance for the smart intensification of local practices is needed, as well as traditional knowledge enriched with advanced technologies. Ethiopian agricultural and environmental policies and strategies should provide sufficient support and guidance for the intensification of sustainable practices and should provide a framework for an agroecological transition towards a sustainable agri-food system.

Keywords: agroecology, diversity, recycling, sustainable food system, transition

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2197 Modeling, Topology Optimization and Experimental Validation of Glass-Transition-Based 4D-Printed Polymeric Structures

Authors: Sara A. Pakvis, Giulia Scalet, Stefania Marconi, Ferdinando Auricchio, Matthijs Langelaar

Abstract:

In recent developments in the field of multi-material additive manufacturing, differences in material properties are exploited to create printed shape-memory structures, which are referred to as 4D-printed structures. New printing techniques allow for the deliberate introduction of prestresses in the specimen during manufacturing, and, in combination with the right design, this enables new functionalities. This research focuses on bi-polymer 4D-printed structures, where the transformation process is based on a heat-induced glass transition in one material lowering its Young’s modulus, combined with an initial prestress in the other material. Upon the decrease in stiffness, the prestress is released, which results in the realization of an essentially pre-programmed deformation. As the design of such functional multi-material structures is crucial but far from trivial, a systematic methodology to find the design of 4D-printed structures is developed, where a finite element model is combined with a density-based topology optimization method to describe the material layout. This modeling approach is verified by a convergence analysis and validated by comparing its numerical results to analytical and published data. Specific aspects that are addressed include the interplay between the definition of the prestress and the material interpolation function used in the density-based topology description, the inclusion of a temperature-dependent stiffness relationship to simulate the glass transition effect, and the importance of the consideration of geometric nonlinearity in the finite element modeling. The efficacy of topology optimization to design 4D-printed structures is explored by applying the methodology to a variety of design problems, both in 2D and 3D settings. Bi-layer designs composed of thermoplastic polymers are printed by means of the fused deposition modeling (FDM) technology. Acrylonitrile butadiene styrene (ABS) polymer undergoes the glass transition transformation, while polyurethane (TPU) polymer is prestressed by means of the 3D-printing process itself. Tests inducing shape transformation in the printed samples through heating are performed to calibrate the prestress and validate the modeling approach by comparing the numerical results to the experimental findings. Using the experimentally obtained prestress values, more complex designs have been generated through topology optimization, and samples have been printed and tested to evaluate their performance. This study demonstrates that by combining topology optimization and 4D-printing concepts, stimuli-responsive structures with specific properties can be designed and realized.

Keywords: 4D-printing, glass transition, shape memory polymer, topology optimization

Procedia PDF Downloads 179
2196 A Literature Review on Virtual Interventions for Midlife Women

Authors: Daniel D'Souza, Ping Zou

Abstract:

The period before, during, and after menopause is a sensitive time for women as they experience intense physical and psychological health changes and symptoms. These changes accompany the hormonal changes that mark the end of a woman’s reproductive age. To help mitigate and cope with these changes, prompt and correct treatment is needed. eHealth has emerged as a branch of telemedicine in the past few decades as an alternate avenue for patients to receive care quickly and conveniently, as it relies on the Internet and computers. Within the past few years, eHealth has also given rise to mHealth, which is the use of personal mobile devices to receive treatment and care. However, there is a lack of study on their use for menopause. This review aimed to review and summarize the literature for eHealth or mHealth and menopause. Several databases related to women’s health and digital health were searched for original studies about eHealth or mHealth and menopause. The search yielded 25 results. The results were generally positive, with these interventions being feasible and having positive effects on physical and psychosocial outcomes. However, several issues were raised regarding their design process that may inadvertently prevent these interventions from addressing the needs of all potential users. Therefore, while eHealth and mHealth certainly represent a future model of healthcare delivery for menopausal women, further research and design modifications are needed before this can happen.

Keywords: eHealth, menopause, mHealth, midlife women

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2195 Analysis of Electric Mobility in the European Union: Forecasting 2035

Authors: Domenico Carmelo Mongelli

Abstract:

The context is that of great uncertainty in the 27 countries belonging to the European Union which has adopted an epochal measure: the elimination of internal combustion engines for the traction of road vehicles starting from 2035 with complete replacement with electric vehicles. If on the one hand there is great concern at various levels for the unpreparedness for this change, on the other the Scientific Community is not preparing accurate studies on the problem, as the scientific literature deals with single aspects of the issue, moreover addressing the issue at the level of individual countries, losing sight of the global implications of the issue for the entire EU. The aim of the research is to fill these gaps: the technological, plant engineering, environmental, economic and employment aspects of the energy transition in question are addressed and connected to each other, comparing the current situation with the different scenarios that could exist in 2035 and in the following years until total disposal of the internal combustion engine vehicle fleet for the entire EU. The methodologies adopted by the research consist in the analysis of the entire life cycle of electric vehicles and batteries, through the use of specific databases, and in the dynamic simulation, using specific calculation codes, of the application of the results of this analysis to the entire EU electric vehicle fleet from 2035 onwards. Energy balance sheets will be drawn up (to evaluate the net energy saved), plant balance sheets (to determine the surplus demand for power and electrical energy required and the sizing of new plants from renewable sources to cover electricity needs), economic balance sheets (to determine the investment costs for this transition, the savings during the operation phase and the payback times of the initial investments), the environmental balances (with the different energy mix scenarios in anticipation of 2035, the reductions in CO2eq and the environmental effects are determined resulting from the increase in the production of lithium for batteries), the employment balances (it is estimated how many jobs will be lost and recovered in the reconversion of the automotive industry, related industries and in the refining, distribution and sale of petroleum products and how many will be products for technological innovation, the increase in demand for electricity, the construction and management of street electric columns). New algorithms for forecast optimization are developed, tested and validated. Compared to other published material, the research adds an overall picture of the energy transition, capturing the advantages and disadvantages of the different aspects, evaluating the entities and improvement solutions in an organic overall picture of the topic. The results achieved allow us to identify the strengths and weaknesses of the energy transition, to determine the possible solutions to mitigate these weaknesses and to simulate and then evaluate their effects, establishing the most suitable solutions to make this transition feasible.

Keywords: engines, Europe, mobility, transition

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2194 Thyroid Hormones and Thyrotropin Status in Nepalese Postmenopausal Women

Authors: S. A. Khan, B. Mishra, O. Sherchan

Abstract:

Background and Aims: Thyroid disorder is the most common endocrine disorder after diabetes mellitus. Females are more vulnerable to this disease, and old age is an important risk factor. This study was undertaken to investigate the burden of thyroid disorder in Nepalese postmenopausal women. Methods: In the present cross-sectional study, we included 271 post-menopausal women. Three ml of blood was collected following standard protocol after taking the written consent. Serum was separated and analyzed for free T3, free T4, and Thyroid Stimulating Hormone (TSH) by Chemiluminescence Immunoassay (CLIA) method in Snibe Maglumi 1000 analyzer. Data obtained was analyzed in SPSS Version 21. P < 0.05 was set for statistical significant at 95% Confidence Interval (CI). Results: Majority of the participants belong to Janjati (46.5%) ethnicity, followed by Brahmin/Chhetri (41.7%), residing either in urban or suburban locality. Most of them were non-vegetarian, non-smoker, and non-alcoholic. Subjects were divided into hyperthyroid (TSH < 0.3 uIU/ml), hypothyroid (TSH > 4.5 uIU/ml), and euthyroid (TSH=0.3-4.5 uIU/ml) based on TSH value. We reported 10.3% hyperthyroid and 29.2% hypothyroid cases. TSH was significantly correlated with T3 (r=-0.244; p < 0.001) T4 (r=-0.398; p < 0.001); age (r=-0.138; p=0.023) and BMI (r=0.123; p=0.043). Multiple linear regression model for TSH reveals only T3 and T4 were significantly associated with TSH (p < 0.001; p=0.001). Conclusion: To conclude, nearly 39.5% of the postmenopausal women had thyroid disorder. Postmenopausal women are vulnerable to thyroid disorder; therefore, requires regular thyroid monitoring.

Keywords: thyroid stimulating hormone, TSH, T3, T4, thyroid disorder

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2193 Risk Assessment of Flood Defences by Utilising Condition Grade Based Probabilistic Approach

Authors: M. Bahari Mehrabani, Hua-Peng Chen

Abstract:

Management and maintenance of coastal defence structures during the expected life cycle have become a real challenge for decision makers and engineers. Accurate evaluation of the current condition and future performance of flood defence structures is essential for effective practical maintenance strategies on the basis of available field inspection data. Moreover, as coastal defence structures age, it becomes more challenging to implement maintenance and management plans to avoid structural failure. Therefore, condition inspection data are essential for assessing damage and forecasting deterioration of ageing flood defence structures in order to keep the structures in an acceptable condition. The inspection data for flood defence structures are often collected using discrete visual condition rating schemes. In order to evaluate future condition of the structure, a probabilistic deterioration model needs to be utilised. However, existing deterioration models may not provide a reliable prediction of performance deterioration for a long period due to uncertainties. To tackle the limitation, a time-dependent condition-based model associated with a transition probability needs to be developed on the basis of condition grade scheme for flood defences. This paper presents a probabilistic method for predicting future performance deterioration of coastal flood defence structures based on condition grading inspection data and deterioration curves estimated by expert judgement. In condition-based deterioration modelling, the main task is to estimate transition probability matrices. The deterioration process of the structure related to the transition states is modelled according to Markov chain process, and a reliability-based approach is used to estimate the probability of structural failure. Visual inspection data according to the United Kingdom Condition Assessment Manual are used to obtain the initial condition grade curve of the coastal flood defences. The initial curves then modified in order to develop transition probabilities through non-linear regression based optimisation algorithms. The Monte Carlo simulations are then used to evaluate the future performance of the structure on the basis of the estimated transition probabilities. Finally, a case study is given to demonstrate the applicability of the proposed method under no-maintenance and medium-maintenance scenarios. Results show that the proposed method can provide an effective predictive model for various situations in terms of available condition grading data. The proposed model also provides useful information on time-dependent probability of failure in coastal flood defences.

Keywords: condition grading, flood defense, performance assessment, stochastic deterioration modelling

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2192 Effect of Polyethylene Glycol on Physiochemical Properties of Spherical Agglomerates of Pioglitazone Hydrochloride

Authors: S. V. Patil , S. K. Sahoo, K. Y. Chougule, S. S. Patil

Abstract:

Spherically agglomerated crystals of Pioglitazone hydrochloride (PGH) with improved flowability and compactibility were successfully prepared by emulsion solvent diffusion method. Plane agglomerates and agglomerates with additives: polyethylene glycol 6000 (PEG), polyvinyl pyrrolidone (PVP) and β cyclodextrin (β-CD) were prepared using methanol, chloroform and water as good solvent, bridging liquid and poor solvent respectively. Particle size, flowability, compactibility and packability of plane, PEG and β-CD agglomerates were preferably improved for direct tableting compared with raw crystals and PVP agglomerates of PGH. These improved properties of spherically agglomerated crystals were due to their large and spherical shape and enhanced fragmentation during compaction which was well supported by increased tensile strength and less elastic recovery of its compact. X-ray powder diffraction and differential scanning calorimetry study were indicated polymorphic transition of PGH from form II to I during recrystallization but not associated with chemical transition indicated by fourier transforms infrared spectra.

Keywords: spherical crystallization, pioglitazone hydrochloride, compactibility, packability

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2191 Preparation and Study of Pluronic F127 Monolayers at Air-Water Interface

Authors: Neha Kanodia, M. Kamil

Abstract:

Properties of mono layers of Pluronic F127 at air/water interface have been investigated by using Langmuir trough method. Pluronic F127 is a triblock copolymer of poly (ethyleneoxide) (PEO groups)– poly (propylene oxide) (PO groups)–poly(ethylene oxide) (PEO groups). Surface pressure versus mean molecular area isotherms is studied. The isotherm of the mono layer showed the characteristics of a pancake-to-brush transition upon compression of the mono layer. The effect of adding surfactant (SDS) to polymer and the effect of increasing loading on polymer was also studied. The effect of repeated compression and expansion cycle (or hysteresis curve) is investigated to know about stability of the film formed. Static elasticity of mono layer gives information about molecular arrangement, phase structure and phase transition.

Keywords: surface-pressure, mean molecular area isotherms, hysteresis, static elasticity

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2190 Does Clinical Guidelines Affect Healthcare Quality and Populational Health: Quebec Colorectal Cancer Screening Program

Authors: Nizar Ghali, Bernard Fortin, Guy Lacroix

Abstract:

In Quebec, colonoscopies volumes have continued to rise in recent years in the absence of effective monitoring mechanism for the appropriateness and the quality of these exams. In 2010, November, Quebec Government introduced the colorectal cancer-screening program in the objective to control for volume and cost imperfection. This program is based on clinical standards and was initiated for first group of institutions. One year later, Government adds financial incentives for participants institutions. In this analysis, we want to assess for the causal effect of the two components of this program: clinical pathways and financial incentives. Especially we assess for the reform effect on healthcare quality and population health in the context that medical remuneration is not directly dependent on this additional funding offered by the program. We have data on admissions episodes and deaths for 8 years. We use multistate model analog to difference in difference approach to estimate reform effect on the transition probability between different states for each patient. Our results show that the reform reduced length of stay without deterioration in hospital mortality or readmission rate. In the other hand, the program contributed to decrease the hospitalization rate and a less invasive treatment approach for colorectal surgeries. This is a sign of healthcare quality and population health improvement. We demonstrate in this analysis that physicians’ behavior can be affected by both clinical standards and financial incentives even if offered to facilities.

Keywords: multi-state and multi-episode transition model, healthcare quality, length of stay, transition probability, difference in difference

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2189 The Influence of Neural Synchrony on Auditory Middle Latency and Late Latency Responses and Its Correlation with Audiological Profile in Individuals with Auditory Neuropathy

Authors: P. Renjitha, P. Hari Prakash

Abstract:

Auditory neuropathy spectrum disorder (ANSD) is an auditory disorder with normal cochlear outer hair cell function and disrupted auditory nerve function. It results in unique clinical characteristic with absent auditory brainstem response (ABR), absent acoustic reflex and the presence of otoacoustic emissions (OAE) and cochlear microphonics. The lesion site could be at cochlear inner hair cells, the synapse between the inner hair cells and type I auditory nerve fibers, and/or the auditory nerve itself. But the literatures on synchrony at higher auditory system are sporadic and are less understood. It might be interesting to see if there is a recovery of neural synchrony at higher auditory centers. Also, does the level at which the auditory system recovers with adequate synchrony to the extent of observable evoke response potentials (ERPs) can predict speech perception? In the current study, eight ANSD participants and healthy controls underwent detailed audiological assessment including ABR, auditory middle latency response (AMLR), and auditory late latency response (ALLR). AMLR was recorded for clicks and ALLR was evoked using 500Hz and 2 kHz tone bursts. Analysis revealed that the participant could be categorized into three groups. Group I (2/8) where ALLR was present only for 2kHz tone burst. Group II (4/8), where AMLR was absent and ALLR was seen for both the stimuli. Group III (2/8) consisted individuals with identifiable AMLR and ALLR for all the stimuli. The highest speech identification sore observed in ANSD group was 30% and hence considered having poor speech perception. Overall test result indicates that the site of neural synchrony recovery could be varying across individuals with ANSD. Some individuals show recovery of neural synchrony at the thalamocortical level while others show the same only at the cortical level. Within ALLR itself there could be variation across stimuli again could be related to neural synchrony. Nevertheless, none of these patterns could possible explain the speech perception ability of the individuals. Hence, it could be concluded that neural synchrony as measured by evoked potentials could not be a good clinical predictor speech perception.

Keywords: auditory late latency response, auditory middle latency response, auditory neuropathy spectrum disorder, correlation with speech identification score

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