Search results for: severe hyponatremia
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1875

Search results for: severe hyponatremia

1545 From Economic Crisis to Environmental Sustainability: The Case of Greece

Authors: Marula Tsagkari

Abstract:

Greece finds itself in challenging times, facing a severe economic slowdown since 2009. Despite the fact that Greece is in the epicenter of the global interest, to the best of our knowledge there is no extend research on how the crisis has affected the Greek environment (directly and indirectly), the past years. Thus, the present study aims to fill the aforementioned research gap by examining a number of environmental indicators related with air emissions, waste, water and energy. Our results indicate that the crisis affected the Greek environment in both positive and negative ways. For Greece, the main challenge is to recover from the present economic recession as soon as possible, but not at any cost to the environment. In this context, this research unfolds the interrelation between the economic and the environmental crisis and suggests a sustainable restructuring of the Greek economy.

Keywords: Greece, economic crisis, environmental policy, environmental indicators

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1544 Predictors of Glycaemic Variability and Its Association with Mortality in Critically Ill Patients with or without Diabetes

Authors: Haoming Ma, Guo Yu, Peiru Zhou

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Background: Previous studies show that dysglycemia, mostly hyperglycemia, hypoglycemia and glycemic variability(GV), are associated with excess mortality in critically ill patients, especially those without diabetes. Glycemic variability is an increasingly important measure of glucose control in the intensive care unit (ICU) due to this association. However, there is limited data pertaining to the relationship between different clinical factors and glycemic variability and clinical outcomes categorized by their DM status. This retrospective study of 958 intensive care unit(ICU) patients was conducted to investigate the relationship between GV and outcome in critically ill patients and further to determine the significant factors that contribute to the glycemic variability. Aim: We hypothesize that the factors contributing to mortality and the glycemic variability are different from critically ill patients with or without diabetes. And the primary aim of this study was to determine which dysglycemia (hyperglycemia\hypoglycemia\glycemic variability) is independently associated with an increase in mortality among critically ill patients in different groups (DM/Non-DM). Secondary objectives were to further investigate any factors affecting the glycemic variability in two groups. Method: A total of 958 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The glycemic variability was defined as the coefficient of variation (CV) of blood glucose. The main outcome was death during hospitalization. The secondary outcome was GV. The logistic regression model was used to identify factors associated with mortality. The relationships between GV and other variables were investigated using linear regression analysis. Results: Information on age, APACHE II score, GV, gender, in-ICU treatment and nutrition was available for 958 subjects. Predictors remaining in the final logistic regression model for mortality were significantly different in DM/Non-DM groups. Glycemic variability was associated with an increase in mortality in both DM(odds ratio 1.05; 95%CI:1.03-1.08,p<0.001) or Non-DM group(odds ratio 1.07; 95%CI:1.03-1.11,p=0.002). For critically ill patients without diabetes, factors associated with glycemic variability included APACHE II score(regression coefficient, 95%CI:0.29,0.22-0.36,p<0.001), Mean BG(0.73,0.46-1.01,p<0.001), total parenteral nutrition(2.87,1.57-4.17,p<0.001), serum albumin(-0.18,-0.271 to -0.082,p<0.001), insulin treatment(2.18,0.81-3.55,p=0.002) and duration of ventilation(0.006,0.002-1.010,p=0.003).However, for diabetes patients, APACHE II score(0.203,0.096-0.310,p<0.001), mean BG(0.503,0.138-0.869,p=0.007) and duration of diabetes(0.167,0.033-0.301,p=0.015) remained as independent risk factors of GV. Conclusion: We found that the relation between dysglycemia and mortality is different in the diabetes and non-diabetes groups. And we confirm that GV was associated with excess mortality in DM or Non-DM patients. Furthermore, APACHE II score, Mean BG, total parenteral nutrition, serum albumin, insulin treatment and duration of ventilation were significantly associated with an increase in GV in Non-DM patients. While APACHE II score, mean BG and duration of diabetes (years) remained as independent risk factors of increased GV in DM patients. These findings provide important context for further prospective trials investigating the effect of different clinical factors in critically ill patients with or without diabetes.

Keywords: diabetes, glycemic variability, predictors, severe disease

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1543 Detection of Intentional Attacks in Images Based on Watermarking

Authors: Hazem Munawer Al-Otum

Abstract:

In this work, an efficient watermarking technique is proposed and can be used for detecting intentional attacks in RGB color images. The proposed technique can be implemented for image authentication and exhibits high robustness against unintentional common image processing attacks. It deploys two measures to discern between intentional and unintentional attacks based on using a quantization-based technique in a modified 2D multi-pyramidal DWT transform. Simulations have shown high accuracy in detecting intentionally attacked regions while exhibiting high robustness under moderate to severe common image processing attacks.

Keywords: image authentication, copyright protection, semi-fragile watermarking, tamper detection

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1542 In the Face of Brokenness: Finding Meaning and Purpose in a Shattered World

Authors: Le Khanh Huyen

Abstract:

This dissertation focuses on the psychological study of children, particularly those who lack parental affection or face family pressures. It will analyze the severe consequences of insufficient parental love and familial pressure on children's psychology, including emotional and behavioral disorders, learning difficulties in academics and daily life, loss of faith, and low self-esteem. Additionally, this dissertation will propose solutions to support children in challenging circumstances, contributing to the protection of children's mental health.

Keywords: child psychology, lack of parental love, family pressure, emotional and behavioral disorders, learning difficulties, loss of faith, self-esteem, mental health

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1541 Management of Caverno-Venous Leakage: A Series of 133 Patients with Symptoms, Hemodynamic Workup, and Results of Surgery

Authors: Allaire Eric, Hauet Pascal, Floresco Jean, Beley Sebastien, Sussman Helene, Virag Ronald

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Background: Caverno-venous leakage (CVL) is devastating, although barely known disease, the first cause of major physical impairment in men under 25, and responsible for 50% of resistances to phosphodiesterase 5-inhibitors (PDE5-I), affecting 30 to 40% of users in this medication class. In this condition, too early blood drainage from corpora cavernosa prevents penile rigidity and penetration during sexual intercourse. The role of conservative surgery in this disease remains controversial. Aim: Assess complications and results of combined open surgery and embolization for CVL. Method: Between June 2016 and September 2021, 133 consecutive patients underwent surgery in our institution for CVL, causing severe erectile dysfunction (ED) resistance to oral medical treatment. Procedures combined vein embolization and ligation with microsurgical techniques. We performed a pre-and post-operative clinical (Erection Harness Scale: EHS) hemodynamic evaluation by duplex sonography in all patients. Before surgery, the CVL network was visualized by computed tomography cavernography. Penile EMG was performed in case of diabetes or suspected other neurological conditions. All patients were optimized for hormonal status—data we prospectively recorded. Results: Clinical signs suggesting CVL were ED since age lower than 25, loss of erection when changing position, penile rigidity varying according to the position. Main complications were minor pulmonary embolism in 2 patients, one after airline travel, one with Factor V Leiden heterozygote mutation, one infection and three hematomas requiring reoperation, one decreased gland sensitivity lasting for more than one year. Mean pre-operative pharmacologic EHS was 2.37+/-0.64, mean pharmacologic post-operative EHS was 3.21+/-0.60, p<0.0001 (paired t-test). The mean EHS variation was 0.87+/-0.74. After surgery, 81.5% of patients had a pharmacologic EHS equal to or over 3, allowing for intercourse with penetration. Three patients (2.2%) experienced lower post-operative EHS. The main cause of failure was leakage from the deep dorsal aspect of the corpus cavernosa. In a 14 months follow-up, 83.2% of patients had a clinical EHS equal to or over 3, allowing for sexual intercourse with penetration, one-third of them without any medication. 5 patients had a penile implant after unsuccessful conservative surgery. Conclusion: Open surgery combined with embolization for CVL is an efficient approach to CVL causing severe erectile dysfunction.

Keywords: erectile dysfunction, cavernovenous leakage, surgery, embolization, treatment, result, complications, penile duplex sonography

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1540 Fast Authentication Using User Path Prediction in Wireless Broadband Networks

Authors: Gunasekaran Raja, Rajakumar Arul, Kottilingam Kottursamy, Ramkumar Jayaraman, Sathya Pavithra, Swaminathan Venkatraman

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Wireless Interoperability for Microwave Access (WiMAX) utilizes the IEEE 802.1X mechanism for authentication. However, this mechanism incurs considerable delay during handoffs. This delay during handoffs results in service disruption which becomes a severe bottleneck. To overcome this delay, our article proposes a key caching mechanism based on user path prediction. If the user mobility follows that path, the user bypasses the normal IEEE 802.1X mechanism and establishes the necessary authentication keys directly. Through analytical and simulation modeling, we have proved that our mechanism effectively decreases the handoff delay thereby achieving fast authentication.

Keywords: authentication, authorization, and accounting (AAA), handoff, mobile, user path prediction (UPP) and user pattern

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1539 Reliability of Eyewitness Statements in Fire and Explosion Investigations

Authors: Jeff Colwell, Benjamin Knox

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While fire and explosion incidents are often observed by eyewitnesses, the weight that fire investigators should place on those observations in their investigations is a complex issue. There is no doubt that eyewitness statements can be an important component to an investigation, particularly when other evidence is sparse, as is often the case when damage to the scene is severe. However, it is well known that eyewitness statements can be incorrect for a variety of reasons, including deception. In this paper, we reviewed factors that can have an effect on the complex processes associated with the perception, retention, and retrieval of an event. We then review the accuracy of eyewitness statements from unique criminal and civil incidents, including fire and explosion incidents, in which the accuracy of the statements could be independently evaluated. Finally, the motives for deceptive eyewitness statements are described, along with techniques that fire and explosion investigators can employ, to increase the accuracy of the eyewitness statements that they solicit.

Keywords: fire, explosion, eyewitness, reliability

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1538 An Audit of the Process of Care in Surveillance Services for Children with Sickle Cell Disease in Wales

Authors: Charlie Jeffkins

Abstract:

Sickle cell disease is a serious life-limiting condition which can reduce the quality of life for many patients. Public Health England (PHE), in partnership with the Sickle Cell Society (SCS), has created guidelines to prevent severe complications from sickle cell disease. Data was collected from Children’s Hospital for Wales between 15/03/21-26/03/21. Methods: A manual search of patient records for children under the care of Rocket Ward and a key term search of online records was used. Results: Penicillin prophylaxis was given at 90 days for 89%, 77% of TCDs scans were done at 2-3 years, and 72% have had a scan in the last year. 53% of patients have had discussions about hydroxycarbamide, whilst 65% have started it. PPV vaccination was documented for 19%. Conclusion: Overall, none of the four standards were reached; however, TCD uptake has improved. There is a need for better documentation of treatment and annual re-audits.

Keywords: paediatric, haematology, sickle cell, audit

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1537 HRCT of the Chest and the Role of Artificial Intelligence in the Evaluation of Patients with COVID-19

Authors: Parisa Mansour

Abstract:

Introduction: Early diagnosis of coronavirus disease (COVID-19) is extremely important to isolate and treat patients in time, thus preventing the spread of the disease, improving prognosis and reducing mortality. High-resolution computed tomography (HRCT) chest imaging and artificial intelligence (AI)-based analysis of HRCT chest images can play a central role in the treatment of patients with COVID-19. Objective: To investigate different chest HRCT findings in different stages of COVID-19 pneumonia and to evaluate the potential role of artificial intelligence in the quantitative assessment of lung parenchymal involvement in COVID-19 pneumonia. Materials and Methods: This retrospective observational study was conducted between May 1, 2020 and August 13, 2020. The study included 2169 patients with COVID-19 who underwent chest HRCT. HRCT images showed the presence and distribution of lesions such as: ground glass opacity (GGO), compaction, and any special patterns such as septal thickening, inverted halo, mark, etc. HRCT findings of the breast at different stages of the disease (early: andlt) 5 days, intermediate: 6-10 days and late stage: >10 days). A CT severity score (CTSS) was calculated based on the extent of lung involvement on HRCT, which was then correlated with clinical disease severity. Use of artificial intelligence; Analysis of CT pneumonia and quot; An algorithm was used to quantify the extent of pulmonary involvement by calculating the percentage of pulmonary opacity (PO) and gross opacity (PHO). Depending on the type of variables, statistically significant tests such as chi-square, analysis of variance (ANOVA) and post hoc tests were applied when appropriate. Results: Radiological findings were observed in HRCT chest in 1438 patients. A typical pattern of COVID-19 pneumonia, i.e., bilateral peripheral GGO with or without consolidation, was observed in 846 patients. About 294 asymptomatic patients were radiologically positive. Chest HRCT in the early stages of the disease mostly showed GGO. The late stage was indicated by such features as retinal enlargement, thickening and the presence of fibrous bands. Approximately 91.3% of cases with a CTSS = 7 were asymptomatic or clinically mild, while 81.2% of cases with a score = 15 were clinically severe. Mean PO and PHO (30.1 ± 28.0 and 8.4 ± 10.4, respectively) were significantly higher in the clinically severe categories. Conclusion: Because COVID-19 pneumonia progresses rapidly, radiologists and physicians should become familiar with typical TC chest findings to treat patients early, ultimately improving prognosis and reducing mortality. Artificial intelligence can be a valuable tool in treating patients with COVID-19.

Keywords: chest, HRCT, covid-19, artificial intelligence, chest HRCT

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1536 Household Perspectives and Resistance to Preventive Relocation in Flood Prone Areas: A Case Study in the Polwatta River Basin, Southern Sri Lanka

Authors: Ishara Madusanka, So Morikawa

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Natural disasters, particularly floods, pose severe challenges globally, affecting both developed and developing countries. In many regions, especially Asia, riverine floods are prevalent and devastating. Integrated flood management incorporates structural and non-structural measures, with preventive relocation emerging as a cost-effective and proactive strategy for areas repeatedly impacted by severe flooding. However, preventive relocation is often hindered by economic, psychological, social, and institutional barriers. This study investigates the factors influencing resistance to preventive relocation and evaluates the role of flood risk information in shaping relocation decisions through risk perception. A conceptual model was developed, incorporating variables such as Flood Risk Information (FRI), Place Attachment (PA), Good Living Conditions (GLC), and Adaptation to Flooding (ATF), with Flood Risk Perception (FRP) serving as a mediating variable. The research was conducted in Welipitiya in the Polwatta river basin, Matara district, Sri Lanka, a region experiencing recurrent flood damage. For this study, an experimental design involving a structured questionnaire survey was utilized, with 185 households participating. The treatment group received flood risk information, including flood risk maps and historical data, while the control group did not. Data were collected in 2023 and analyzed using independent sample t-tests and Partial Least Squares Structural Equation Modeling (PLS-SEM). PLS-SEM was chosen for its ability to model latent variables, handle complex relationships, and suitability for exploratory research. Multi-group Analysis (MGA) assessed variations across different flood risk areas. Findings indicate that flood risk information had a limited impact on flood risk perception and relocation decisions, though its effect was significant in specific high-risk areas. Place attachment was a significant factor influencing relocation decisions across the sample. One potential reason for the limited impact of flood risk information on relocation decisions could be the lack of specificity in the information provided. The results suggest that while flood risk information alone may not significantly influence relocation decisions, it is crucial in specific contexts. Future studies and practitioners should focus on providing more detailed risk information and addressing psychological factors like place attachments to enhance preventive relocation efforts.

Keywords: flood risk communication, flood risk perception, place attachment, preventive relocation, structural equation modeling

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1535 Rehabilitation Team after Brain Damages as Complex System Integrating Consciousness

Authors: Olga Maksakova

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A work with unconscious patients after acute brain damages besides special knowledge and practical skills of all the participants requires a very specific organization. A lot of said about team approach in neurorehabilitation, usually as for outpatient mode. Rehabilitologists deal with fixed patient problems or deficits (motion, speech, cognitive or emotional disorder). Team-building means superficial paradigm of management psychology. Linear mode of teamwork fits casual relationships there. Cases with deep altered states of consciousness (vegetative states, coma, and confusion) require non-linear mode of teamwork: recovery of consciousness might not be the goal due to phenomenon uncertainty. Rehabilitation team as Semi-open Complex System includes the patient as a part. Patient's response pattern becomes formed not only with brain deficits but questions-stimuli, context, and inquiring person. Teamwork is sourcing of phenomenology knowledge of patient's processes as Third-person approach is replaced with Second- and after First-person approaches. Here is a chance for real-time change. Patient’s contacts with his own body and outward things create a basement for restoration of consciousness. The most important condition is systematic feedbacks to any minimal movement or vegetative signal of the patient. Up to now, recovery work with the most severe contingent is carried out in the mode of passive physical interventions, while an effective rehabilitation team should include specially trained psychologists and psychotherapists. It is they who are able to create a network of feedbacks with the patient and inter-professional ones building up the team. Characteristics of ‘Team-Patient’ system (TPS) are energy, entropy, and complexity. Impairment of consciousness as the absence of linear contact appears together with a loss of essential functions (low energy), vegetative-visceral fits (excessive energy and low order), motor agitation (excessive energy and excessive order), etc. Techniques of teamwork are different in these cases for resulting optimization of the system condition. Directed regulation of the system complexity is one of the recovery tools. Different signs of awareness appear as a result of system self-organization. Joint meetings are an important part of teamwork. Regular or event-related discussions form the language of inter-professional communication, as well as the patient's shared mental model. Analysis of complex communication process in TPS may be useful for creation of the general theory of consciousness.

Keywords: rehabilitation team, urgent rehabilitation, severe brain damage, consciousness disorders, complex system theory

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1534 The Impact of the Great Irish Famine on Irish Mass Migration to the United States at the Turn of the Twentieth Century

Authors: Gayane Vardanyan, Gaia Narciso, Battista Severgnini

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This paper investigates the long-run impact of the Great Irish Famine on emigration from Ireland at the turn of the twentieth century. To do it we combine the 1901 and the 1911 Irish Census data sets with the Ellis Island Administrative Records on Irish migrants to the United States. We find that the migrants were more likely to be Catholic, literate, unmarried, young and Gaelic speaking compared to the ones that stay. Running individual level specifications, our preliminary findings suggest that being born in a place where the Famine was more severe increases the probability of becoming a migrant in the long-run. We also intend to explore the mechanisms through which this impact occurs.

Keywords: Great Famine, mass migration, long-run impact, mechanisms

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1533 How Acupuncture Improve Migraine: A Literature Review

Authors: Hsiang-Chun Lai, Hsien-Yin Liao, Yi-Wen Lin

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Migraine is a primary headache disorder which presented as recurrent and moderate to severe headaches and affects nearly fifteen percent of people’s daily life. In East Asia, acupuncture is a common treatment for migraine prevention. Acupuncture can modulate migraine through both peripheral and central mechanism and decrease the allodynia process. Molecular pathway suggests that acupuncture relief migraine by regulating neurotransmitters/neuromodulators. This process was also proven by neural imaging. Acupuncture decrease the headache frequency and intensity compared to routine care. We also review the most common chosen acupoints to treat migraine and its treatment protocol. As a result, we suggested that acupuncture can serve as an option to migraine treatment and prevention. However, more studies are needed to establish the mechanism and therapeutic roles of acupuncture in treating migraine.

Keywords: acupuncture, allodynia, headache, migraine

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1532 Reduction in Hospital Acquire Infections after Intervention of Hand Hygiene and Personal Protective Equipment at COVID Unit Indus Hospital Karachi

Authors: Aisha Maroof

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Introduction: Coronavirus Disease 2019 (COVID-19) is spreading rapidly around the world with devastating consequences on patients, health care workers and health systems. Severe 2019 novel coronavirus infectious disease (COVID-19) with pneumonia is associated with high rates of admission to the intensive care unit (ICU) and they are at high risk to obtain the hospital acquire bloodstream infection (HAIs) such as central line associated bloodstream infection (CLABSI), catheter associated urinary tract infections (CAUTI) and laboratory confirm bloodstream infection (LCBSI). The chances of infection transmission increase when healthcare worker’s (HCWs) practice is inappropriate. Risk related to hand hygiene (HH) and personal protective equipment (PPE) as regards multidrug-resistant organism transmission: use of multiple gloving instead of HH and incorrect use of PPE can lead to a significant increase of device-related infections. As it reaches low- and middle-income countries, its effects could be even more, because it will be difficult for them to react aggressively to the pandemic. HAIs are one of the biggest medical concerns, resulting in increased mortality rates. Objective: To assess the effect of intervention on compliance of hand hygiene and PPE among HCWs reduce the rate of HAI in COVID-19 patients. Method: An interventional study was done between July to December, 2020. CLABSI, CAUTI and LCBSI data were collected from the medical record and direct observation. There were total of 50 Nurses, 18 doctors and all patients with laboratory-confirmed severe COVID-19 admitted to the hospital were included in this research study. Respiratory tract specimens were obtained after the first 48 h of ICU admission. Practices were observed after and before intervention. Education was provided based on WHO guidelines. Results: During the six months of study July to December, the rate of CLABSI, CAUTI and LCBSI pre and post intervention was reported. CLABSI rate decreasedd from 22.7 to 0, CAUTI rate was decreased from 1.6 to 0, LCBSI declined from 3.3 to 0 after implementation of intervention. Conclusion: HAIs are an important cause of morbidity and mortality. Most of the device related infections occurs due to lack of correct use of PPE and hand hygiene compliance. Hand hygiene and PPE is the most important measure to protect patients, through education it can be improved the correct use of PPE and hand hygiene compliance and can reduce the bacterial infection in COVID-19 patients.

Keywords: hospital acquire infection, healthcare workers, hand hygiene, personal protective equipment

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1531 Metachromatic Leukodystrophy: A Case Report

Authors: Mary Rose Eunice S. Gundayao, Manolo M. Fernandez

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Metachromatic leukodystrophy (MLD) is a rare lysosomal storage disorder with an autosomal recessive inheritance pattern. Lysosomal storage disorders are often severe, follow a progressively neurodegenerative path, and may result in multi-organ failure, potentially leading to death within 5 to 6 years in cases of early-onset forms. There are limited data regarding cases of MLD in Filipino children. This is the case of a 2-year-old Filipino girl who presented with progressive neurological deterioration and was diagnosed with metachromatic leukodystrophy by molecular genetic testing. This case report aims to present this patient’s clinical history, neurological findings, diagnosis and novel genetic mutations causing MLD. A concise review of updated literature on MLD will be discussed.

Keywords: metachromatic leukodystrophy, ARSA gene, peripheral neuropathy, case report, demyelinating disease

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1530 First-Trimester Screening of Preeclampsia in a Routine Care

Authors: Tamar Grdzelishvili, Zaza Sinauridze

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Introduction: Preeclampsia is a complication of the second trimester of pregnancy, which is characterized by high morbidity and multiorgan damage. Many complex pathogenic mechanisms are now implicated to be responsible for this disease (1). Preeclampsia is one of the leading causes of maternal mortality worldwide. Statistics are enough to convince you of the seriousness of this pathology: about 100,000 women die of preeclampsia every year. It occurs in 3-14% (varies significantly depending on racial origin or ethnicity and geographical region) of pregnant women, in 75% of cases - in a mild form, and in 25% - in a severe form. During severe pre-eclampsia-eclampsia, perinatal mortality increases by 5 times and stillbirth by 9.6 times. Considering that the only way to treat the disease is to end the pregnancy, the main thing is timely diagnosis and prevention of the disease. Identification of high-risk pregnant women for PE and giving prophylaxis would reduce the incidence of preterm PE. First-trimester screening model developed by the Fetal Medicine Foundation (FMF), which uses the Bayes-theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, has been proven to be effective and have superior screening performance to that of traditional risk factor-based approach for the prediction of PE (2) Methods: Retrospective single center screening study. The study population consisted of women from the Tbilisi maternity hospital “Pineo medical ecosystem” who met the following criteria: they spoke Georgian, English, or Russian and agreed to participate in the study after discussing informed consent and answering questions. Prior to the study, the informed consent forms approved by the Institutional Review Board were obtained from the study subjects. Early assessment of preeclampsia was performed between 11-13 weeks of pregnancy. The following were evaluated: anamnesis, dopplerography of the uterine artery, mean arterial blood pressure, and biochemical parameter: Pregnancy-associated plasma protein A (PAPP-A). Individual risk assessment was performed with performed by Fast Screen 3.0 software ThermoFisher scientific. Results: A total of 513 women were recruited and through the study, 51 women were diagnosed with preeclampsia (34.5% in the pregnant women with high risk, 6.5% in the pregnant women with low risk; P<0.000 1). Conclusions: First-trimester screening combining maternal factors with uterine artery Doppler, blood pressure, and pregnancy-associated plasma protein-A is useful to predict PE in a routine care setting. More patient studies are needed for final conclusions. The research is still ongoing.

Keywords: first-trimester, preeclampsia, screening, pregnancy-associated plasma protein

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1529 Strategic Interventions to Combat Socio-economic Impacts of Drought in Thar - A Case Study of Nagarparkar

Authors: Anila Hayat

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Pakistan is one of those developing countries that are least involved in emissions but has the most vulnerable environmental conditions. Pakistan is ranked 8th in most affected countries by climate change on the climate risk index 1992-2011. Pakistan is facing severe water shortages and flooding as a result of changes in rainfall patterns, specifically in the least developed areas such as Tharparkar. Nagarparkar, once an attractive tourist spot located in Tharparkar because of its tropical desert climate, is now facing severe drought conditions for the last few decades. This study investigates the present socio-economic situation of local communities, major impacts of droughts and their underlying causes and current mitigation strategies adopted by local communities. The study uses both secondary (quantitative in nature) and primary (qualitative in nature) methods to understand the impacts and explore causes on the socio-economic life of local communities of the study area. The relevant data has been collected through household surveys using structured questionnaires, focus groups and in-depth interviews of key personnel from local and international NGOs to explore the sensitivity of impacts and adaptation to droughts in the study area. This investigation is limited to four rural communities of union council Pilu of Nagarparkar district, including Bheel, BhojaBhoon, Mohd Rahan Ji Dhani and Yaqub Ji Dhani villages. The results indicate that drought has caused significant economic and social hardships for the local communities as more than 60% of the overall population is dependent on rainfall which has been disturbed by irregular rainfall patterns. The decline in Crop yields has forced the local community to migrate to nearby areas in search of livelihood opportunities. Communities have not undertaken any appropriate adaptive actions to counteract the adverse effect of drought; they are completely dependent on support from the government and external aid for survival. Respondents also reported that poverty is a major cause of their vulnerability to drought. An increase in population, limited livelihood opportunities, caste system, lack of interest from the government sector, unawareness shaped their vulnerability to drought and other social issues. Based on the findings of this study, it is recommended that the local authorities shall create awareness about drought hazards and improve the resilience of communities against drought. It is further suggested to develop, introduce and implement water harvesting practices at the community level to promote drought-resistant crops.

Keywords: migration, vulnerability, awareness, Drought

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1528 Correlation between Sleeping Disturbance and Academic Achievement in University Female Students

Authors: Amel Fayed, Shaden AlSubaih, Nouf Al-Qahtani, Asmaa Gosty, Asma Aljuhaimi

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Introduction: Sleep difficulties are vastly predominant among adults and affect different aspects of their life. Many literatures found out that females are more liable to suffer from sleeping problems. College students are typical example of people dealing with daily pressure and stress to fulfill the daily tasks and responsibilities. In addition to their ultimate goal of achieving excellent academic records which require their full concentration and effort. Consequently, many of them start complaining of sleep deprivations which can undesirably affect their academic achievements. This study was aiming to investigate how prevalent is sleeping disorders among different colleges in the university and its relation their academic achievements. Methods: A cross-sectional study of female university students at Princess Norah Bint Abdulrahman University using self-administered questionnaire was conducted. Insomnia Severity Index (ISI) was used to assess different grades of insomnia. Students were requested to answer the questions evaluating their sleeping habits over the last two weeks. Participants reported their latest Grade Point Average (GPA). According to ISI, insomnia severity is reported as ‘No clinically significant’, ‘Subthreshold ‘,’ Clinical moderate insomnia’ and ‘Clinical severe’. Results: In the current study, 228 students participated; 172(75.4%) from medical colleges and 56 (24.6%) from non-medical colleges. About 80% of them claimed to have never taken any medications to help them sleep while only three students confirmed their regular use of sleep-inducing medications. About 16% of the students drink milk or other hot drinks to help them fall asleep. None of the students was suspected of having obstructive sleep apnea or apparent psychiatric disorder. According to ISI, 182 (79.8%) students suffered from subthreshold insomnia, 37 (16.2%) had clinical insomnia (moderate severity) and 9 (3.9%) of students had sleeping problems of non-clinically significance level. However, none of students was found to have severe clinical insomnia. Clinical moderate insomnia was reported in 15.1% of medical students and 19.6% of non-medical students. Moreover, about 82% of medical students suffered from subthreshold insomnia compared to 73.2% of non-medical students. This difference was not statistically significant (P=0.24). About 63% of medical students and 48% of non-medical students believed that high percentage of their colleagues are suffering from insomnias (p-value 0.08) The association between GPA and insomnia revealed that; 19.5% of low GPA group compared to 9.3% of high GPA group had clinical moderate insomnia. This association was not statistically significant (p=0.15). The correlation between the GPA and the ISI score was negative but not conclusive (r=-0.08, p-value = 0.29). More than 92% of all students agreed that sleeping problems affect their academic achievement to varying degrees. Conclusion: our results suggest that insomnia is commonly prevalent among female university students and might affect the students’ achievement. This study provides preliminary data about the quality of sleep among medical and non-medical university students which may be used to promote the healthy sleeping habits among female students.

Keywords: academic achievement, females, insomnia, university student

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1527 Effects of Visual Agnosia in Children’s Linguistic Abilities: Psychoneurolinguistic Approach

Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

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Objective: The aim of the study is to examine the relationship between visual agnosia and learning delay in Yemeni children. Method: A total of 80 subjects (experimental group= 60, 30 males and 30 females and control group= 20, 10 males and 10 females) in two institutions (old and new). The age of all subjects at hand ranges between 6- and 12 years old. Pre and post-tests were administered. Results: Outline results show severe effects on the performance of the children due to visual agnosia this effect was benign in the group that received the treatment, and this can be clearly seen in their results in the post-test compared to the other group that did not receive the treatment and outcomes in general can be better understood in light of the control group.

Keywords: visual, agnosia, linguistics, abilities, effects, psychoneurolinguistics

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1526 Empirical Acceleration Functions and Fuzzy Information

Authors: Muhammad Shafiq

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In accelerated life testing approaches life time data is obtained under various conditions which are considered more severe than usual condition. Classical techniques are based on obtained precise measurements, and used to model variation among the observations. In fact, there are two types of uncertainty in data: variation among the observations and the fuzziness. Analysis techniques, which do not consider fuzziness and are only based on precise life time observations, lead to pseudo results. This study was aimed to examine the behavior of empirical acceleration functions using fuzzy lifetimes data. The results showed an increased fuzziness in the transformed life times as compare to the input data.

Keywords: acceleration function, accelerated life testing, fuzzy number, non-precise data

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1525 Analyzing Spatio-Structural Impediments in the Urban Trafficscape of Kolkata, India

Authors: Teesta Dey

Abstract:

Integrated Transport development with proper traffic management leads to sustainable growth of any urban sphere. Appropriate mass transport planning is essential for the populous cities in third world countries like India. The exponential growth of motor vehicles with unplanned road network is now the common feature of major urban centres in India. Kolkata, the third largest mega city in India, is not an exception of it. The imbalance between demand and supply of unplanned transport services in this city is manifested in the high economic and environmental costs borne by the associated society. With the passage of time, the growth and extent of passenger demand for rapid urban transport has outstripped proper infrastructural planning and causes severe transport problems in the overall urban realm. Hence Kolkata stands out in the world as one of the most crisis-ridden metropolises. The urban transport crisis of this city involves severe traffic congestion, the disparity in mass transport services on changing peripheral land uses, route overlapping, lowering of travel speed and faulty implementation of governmental plans as mostly induced by rapid growth of private vehicles on limited road space with huge carbon footprint. Therefore the paper will critically analyze the extant road network pattern for improving regional connectivity and accessibility, assess the degree of congestion, identify the deviation from demand and supply balance and finally evaluate the emerging alternate transport options as promoted by the government. For this purpose, linear, nodal and spatial transport network have been assessed based on certain selected indices viz. Road Degree, Traffic Volume, Shimbel Index, Direct Bus Connectivity, Average Travel and Waiting Tine Indices, Route Variety, Service Frequency, Bus Intensity, Concentration Analysis, Delay Rate, Quality of Traffic Transmission, Lane Length Duration Index and Modal Mix. Total 20 Traffic Intersection Points (TIPs) have been selected for the measurement of nodal accessibility. Critical Congestion Zones (CCZs) are delineated based on one km buffer zones of each TIP for congestion pattern analysis. A total of 480 bus routes are assessed for identifying the deficiency in network planning. Apart from bus services, the combined effects of other mass and para transit modes, containing metro rail, auto, cab and ferry services, are also analyzed. Based on systematic random sampling method, a total of 1500 daily urban passengers’ perceptions were studied for checking the ground realities. The outcome of this research identifies the spatial disparity among the 15 boroughs of the city with severe route overlapping and congestion problem. North and Central Kolkata-based mass transport services exceed the transport strength of south and peripheral Kolkata. Faulty infrastructural condition, service inadequacy, economic loss and workers’ inefficiency are the most dominant reasons behind the defective mass transport network plan. Hence there is an urgent need to revive the extant road based mass transport system of this city by implementing a holistic management approach by upgrading traffic infrastructure, designing new roads, better cooperation among different mass transport agencies, better coordination of transport and changing land use policies, large increase in funding and finally general passengers’ awareness.

Keywords: carbon footprint, critical congestion zones, direct bus connectivity, integrated transport development

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1524 Adsorption of Thionine Dye from its Aqueous Solution over Peanut Hull as a Low Cost Biosorbent

Authors: Alpana Saini, Sanghamitra Barman

Abstract:

Investigations were carried out to determine whether low cost peanut hull as adsorbent hold promise in removal of thionine dyes in the biomedical industries. Pollution of water due to presence of colorants is a severe socio-environmental problem caused by the discharge of industrial wastewater. In view of their toxicity, non-biodegradability and persistent nature, their removal becomes an absolute necessity. For the removal of Thionine Dye using Peanut Hull, the 10mg/L concentration of dyes, 0.5g/l of adsorbent and 200 rpm agitation speed are found to be optimum for the adsorption studies. The Spectrophotometric technique was adopted for the measurement of concentration of dyes before and after adsorption at ʎmax 598nm. The adsorption data has been fitted well to Langmuir isotherm than to Freundlich adsorption isotherm. The adsorbent was characterized by Scanning Electron Microscopy (SEM).

Keywords: adsorption, langmuir isotherm, peanut hull, thionine

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1523 Correction of Skeletal Deformity by Surgical Approach – A Case Report

Authors: Davender Kumar, Virender Singh, Rekha Sharma

Abstract:

Correction of skeletal deformities in adult patients with orthodontics is limited. In adult severe cases, the combined approach, orthodontic and orthognathic surgery, is always the treatment of choice, and the results obtained usually ensure a better esthetic, functional, and stable results Orthognathic surgery is the best option for cases when camouflage treatment is questionable and growth modulation is not possible. This case report illustrates the benefit of the team approach in correcting mandible retrusion along with class II skeletal deformity with 100% deep bite. Correction was achieved by anterior repositioning of mandible osteotomy along with orthodontic treatment. The patient's facial appearance was markedly improved along with functional and stable occlusion.

Keywords: camouflage, skeletal, orthognathic, dental

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1522 Effect of Copper Addition at a Rate of 4% Weight on the Microstructure, Mechanical Characteristics, and Surface Roughness on the Hot Extrusion of Aluminum

Authors: S. M. A. Al Qawabah, A. I. O. Zaid

Abstract:

Al-4%Cu alloys are now widely used in many engineering applications especially in robotic, aerospace and vibration control area. The main problem arises from the weakness of their mechanical characteristics. Therefore, this study is directed towards enhancing the mechanical properties through severe plastic deformation. In this work, the hot direct extrusion process was chosen to provide the required hot work for this purpose. A direct extrusion die was designed and manufactured to be used in this investigation. The general microstructure, microhardness, surface roughness, and compression tests were performed on specimens from the produced Al-4%Cu alloy both in the as cast and after extrusion conditions. It was found that a pronounced enhancement in the mechanical characteristics of the produced Al-4%Cu after extrusion was achieved. The microhardness increased by 89.3%, the flow stress was decreased by 10% at 0.2 strain and finally the surface roughness was reduced by 81.6%.

Keywords: aluminum, copper, surface roughness, hot extrusion

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1521 Impact of Helicobacter pylori Infection on Colorectal Adenoma-Colorectal Carcinoma Sequence

Authors: Jannis Kountouras, Nikolaos Kapetanakis, Stergios A. Polyzos, Apostolis Papaeftymiou, Panagiotis Katsinelos, Ioannis Venizelos, Christina Nikolaidou, Christos Zavos, Iordanis Romiopoulos, Elena Tsiaousi, Evangelos Kazakos, Michael Doulberis

Abstract:

Background & Aims: Helicobacter pylori infection (Hp-I) has been recognized as a substantial risk agent involved in gastrointestinal (GI) tract oncogenesis by stimulating cancer stem cells (CSCs), oncogenes, immune surveillance processes, and triggering GI microbiota dysbiosis. We aimed to investigate the possible involvement of active Hp-I in the sequence: chronic inflammation–adenoma–colorectal cancer (CRC) development. Methods: Four pillars were investigated: (i) endoscopic and conventional histological examinations of patients with CRC, colorectal adenomas (CRA) versus controls to detect the presence of active Hp-I; (ii) immunohistochemical determination of the presence of Hp; expression of CD44, an indicator of CSCs and/or bone marrow-derived stem cells (BMDSCs); expressions of oncogene Ki67 and anti-apoptotic Bcl-2 protein; (iii) expression of CD45, indicator of immune surveillance locally (assessing mainly T and B lymphocytes locally); and (iv) correlation of the studied parameters with the presence or absence of Hp-I. Results: Among 50 patients with CRC, 25 with CRA, and 10 controls, a significantly higher presence of Hp-I in the CRA (68%) and CRC group (84%) were found compared with controls (30%). The presence of Hp-I with accompanying immunohistochemical expression of CD44 in biopsy specimens was revealed in a high proportion of patients with CRA associated with moderate/severe dysplasia (88%) and CRC patients with moderate/severe degree of malignancy (91%). Comparable results were also obtained for Ki67, Bcl-2, and CD45 immunohistochemical expressions. Concluding Remarks: Hp-I seems to be involved in the sequence: CRA – dysplasia – CRC, similarly to the upper GI tract oncogenesis, by several pathways such as the following: Beyond Hp-I associated insulin resistance, the major underlying mechanism responsible for the metabolic syndrome (MetS) that increase the risk of colorectal neoplasms, as implied by other Hp-I related MetS pathologies, such as non-alcoholic fatty liver disease and upper GI cancer, the disturbance of the normal GI microbiota (i.e., dysbiosis) and the formation of an irritative biofilm could contribute to a perpetual inflammatory upper GIT and colon mucosal damage, stimulating CSCs or recruiting BMDSCs and affecting oncogenes and immune surveillance processes. Further large-scale relative studies with a pathophysiological perspective are necessary to demonstrate in-depth this relationship.

Keywords: Helicobacter pylori, colorectal cancer, colorectal adenomas, gastrointestinal oncogenesis

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1520 The Effects of Planting Date on the Yield and Yield Components of Corn (Zea mays L.) Cultivar, Single Cross 704

Authors: Mehranoosh Gholipoor

Abstract:

The effects of planting date on performance and yield components of maize single cross 704 was carried out in 2003.this experiment was designed in randomized complete block pattern with 3 replications in the field of College campus of Agricultural Sciences and Natural Resources in Gorgan. Treatments consisted of four planting dates (May5, May19, June4 and June19) respectively. The results showed that the planting on June4 were the best time for planting date in the field of seed performance and many other measurement qualities while planting date on June19 had the lowest seed performance in corn, due to a severe reduction in seed numbers had the highest In 1000 seed weight. Between the planting date on May 5 and May19 were observed no significant differences

Keywords: corn, planting date, performance and yield components

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1519 Behavior of Polymeric Mortars: An Analysis from the Point of View of Application in Severe Conditions

Authors: J. P. Gorninski, J. M. L. Reis

Abstract:

This present work was aimed to develop polymeric mortars having as binder two polyester resins namely isophtalic and orthophtalic polyester. The inorganic phase was composed by medium-size river sand and fly ash fíller, a by-product of the burning of coal in power plants. The compositions in this study are high performance mortars and were assessed by mechanical properties, through compressive strength and flexural strength, by durability strength when exposed to the cyclical variation of temperature from -400C to +300C and by the chemical aggression test. The composites displayed good performance when exposed to cyclical temperature variations and chemical solutions. The mechanical strength values reached the 100 MPa, the flexural strength yielded values of about twenty percent of mechanical strength.

Keywords: polymer mortar, mechanical strength, cyclical temperatures, chemical strength, sustainability

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1518 Effect of Internet Addiction on Dietary Behavior and Lifestyle Characteristics among University Students

Authors: Hafsa Kamran, Asma Afreen, Zaheer Ahmed

Abstract:

Internet addiction, an emerging mental health disorder from last two decades, is manifested by the inability in the controlled use of internet leading to academics, social, physiological and/or psychological difficulties. The present study aimed to assess the levels of internet addiction among university students in Lahore and to explore the effects of internet addiction on their dietary behavior and lifestyle. It was an analytical cross-sectional study. Data was collected from October to December 2016 from students of four universities selected through two-stage sampling method. The numbers of participants were 500 and 13 questionnaires were rejected due to incomplete information. Levels of Internet Addiction (IA) were calculated using Young Internet Addiction Test (YIAT). Data was also collected on students’ demographics, lifestyle factors and dietary behavior using self-reported questionnaire. Data was analyzed using SPSS (version 21). Chi-square test was applied to evaluate the relationship between variables. Results of the study revealed that 10% of the population had severe internet addiction while moderate Internet Addiction was present in 42%. High prevalence was found among males (11% vs. 8%), private sector university students (p = 0.008) and engineering students (p = 0.000). The lifestyle habits of internet addicts were significantly of poorer quality than normal users (p = 0.05). Internet addiction was found associated with lesser physically activity (p = 0.025), had shorter duration of physical activity (p = 0.016), had more disorganized sleep pattern (p = 0.023), had less duration of sleep (p = 0.019), reported being more tired and sleepy in class (p = 0.033) and spending more time on internet as compared to normal users. Severe and moderate internet addicts also found to be more overweight and obese than normal users (p = 0.000). The dietary behavior of internet addicts was significantly poorer than normal users. Internet addicts were found to skip breakfast more than a normal user (p = 0.039). Common reasons for meal skipping were lack of time and snacking between meals (p = 0.000). They also had increased meal size (p = 0.05) and habit of snacking while using the internet (p = 0.027). Fast food (p = 0.016) and fried items (p = 0.05) were most consumed snacks, while carbonated beverages (p = 0.019) were most consumed beverages among internet addicts. Internet Addicts were found to consume less than recommended daily servings of dairy (p = 0.008) and fruits (p = 0.000) and more servings of meat group (p = 0.025) than their no internet addict counterparts. In conclusion, in this study, it was demonstrated that internet addicts have unhealthy dietary behavior and inappropriate lifestyle habits. University students should be educated regarding the importance of balanced diet and healthy lifestyle, which are critical for effectual primary prevention of numerous chronic degenerative diseases. Furthermore, it is necessary to raise awareness concerning adverse effects of internet addiction among youth and their parents.

Keywords: dietary behavior, internet addiction, lifestyle, university students

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1517 Criminal Liability for Criminal Tax

Authors: Theresia Simatupang dan Rahmayanti

Abstract:

Tax Law is a legal product and therefore should be subject to the legal norms, both about this actions, implementation, and about the material. Law has always aimed at providing justice, and besides that the law as a tool used to organize the order or rule of law. tax classification of a crime in this is very necessary, because the crime of taxation is very detrimental to the country and is still very high in society and socialization associated with punishment in sentencing that would have to provide a deterrent for the perpetrators, so refer to the this, these criminal offenses can endanger the stability of the nation's economy and the country that require special snacks. The application of legal sanctions against the perpetrators of the crime of taxation already has a strong legal basis, namely UU KUP. UU KUP have loaded threat (sanctions) severe punishment for tax payers who commit offenses and crimes in the field of taxation, which is contained in Article 38, and Article 39, Article 41, Article 41 A, and 41 B as well as Article 43 of Law and Law No. 12 KUP about 1985 Land Tax and Building. Criminal sanctions against violators of the tax provision are important because tax payers sanctions for violating tax laws.

Keywords: accountability, tax crime, criminal liability, taxation

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1516 Interface Analysis of Annealed Al/Cu Cladded Sheet

Authors: Joon Ho Kim, Tae Kwon Ha

Abstract:

Effect of aging treatment on microstructural aspects of interfacial layers of the Cu/Al clad sheet produced by Differential Speed Rolling (DSR) process were studied by Electron Back Scattered Diffraction (EBSD). Clad sheet of Al/Cu has been fabricated by using DSR, which caused severe shear deformation between Al and Cu plate to easily bond to each other. Rolling was carried out at 100°C with speed ratio of 2, in which the total thickness reduction was 45%. Interface layers of clad sheet were analyzed by EBSD after subsequent annealing at 400°C for 30 to 120 min. With increasing annealing time, thickness of interface layer and fraction of high angle grain boundary were increased and average grain size was decreased.

Keywords: aluminium/copper clad sheet, differential speed rolling, interface layer, microstructure, annealing, electron back scattered diffraction

Procedia PDF Downloads 366