Search results for: primary antioxidant
2051 The Counselling Practice of School Social Workers in Swedish Elementary Schools - A Focus Group Study
Authors: Kjellgren Maria, Lilliehorn Sara, Markström Urban
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This article describes the counselling practice of school social workers (SSWs) with individual children. SSWs work in the school system’s pupil health team, whose primary task is health promotion and prevention. The work of SSWs is about helping children and adolescents who, for various reasons, suffer from mental ill-health, school absenteeism, or stress that make them unable to achieve their intended goals. SSWs preferably meet these children in individual counselling sessions. The aim of this article is to describe and analyse SSWs’ experience of counselling with children and to examine the characteristics of counselling practice. The data collection was conducted through four semi-structured focus group interviews with a total of 22 SSWs in four different regions in Sweden. SSWs provide counselling to children in order to bring about improved feelings or behavioural changes. It can be noted that SSWs put emphasis on both the counselling process and the alliance with the child. The interviews showed a common practice among SSWs regarding the structure of the counselling sessions, with certain steps and approaches being employed. However, the specific interventions differed and were characterised by an eclectic standpoint in which SSWs utilise a broad repertoire of therapeutic schools and techniques. Furthermore, a relational perspective emerged as a most prominent focus for the SSWs by re-emerging throughout the material. We believe that SSWs could benefit from theoretical perspectives on ‘contextual model’ and ‘attachment theory’ as ‘models of the mind’. Being emotionally close to the child and being able to follow their development requires a lot from SSWs, as both professional caregivers and as “safe havens”.Keywords: school social conselling, school social workers, contextual model, attachment thory
Procedia PDF Downloads 1342050 A Sub-Conjunctiva Injection of Rosiglitazone for Anti-Fibrosis Treatment after Glaucoma Filtration Surgery
Authors: Yang Zhao, Feng Zhang, Xuanchu Duan
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Trans-differentiation of human Tenon fibroblasts (HTFs) to myo-fibroblasts and fibrosis of episcleral tissue are the most common reasons for the failure of glaucoma filtration surgery, with limited treatment options like antimetabolites which always have side-effects such as leakage of filter bulb, infection, hypotony, and endophthalmitis. Rosiglitazone, a specific thiazolidinedione is a synthetic high-affinity ligand for PPAR-r, which has been used in the treatment of type2 diabetes, and found to have pleiotropic functions against inflammatory response, cell proliferation and tissue fibrosis and to benefit to a variety of diseases in animal myocardium models, steatohepatitis models, etc. Here, in vitro we cultured primary HTFs and stimulated with TGF- β to induced myofibrogenic, then treated cells with Rosiglitazone to assess for fibrogenic response. In vivo, we used rabbit glaucoma model to establish the formation of post- trabeculectomy scarring. Then we administered subconjunctival injection with Rosiglitazone beside the filtering bleb, later protein, mRNA and immunofluorescence of fibrogenic markers are checked, and filtering bleb condition was measured. In vitro, we found Rosiglitazone could suppressed proliferation and migration of fibroblasts through macroautophagy via TGF- β /Smad signaling pathway. In vivo, on postoperative day 28, the mean number of fibroblasts in Rosiglitazone injection group was significantly the lowest and had the least collagen content and connective tissue growth factor. Rosiglitazone effectively controlled human and rabbit fibroblasts in vivo and in vitro. Its subconjunctiiva application may represent an effective, new avenue for the prevention of scarring after glaucoma surgery.Keywords: fibrosis, glaucoma, macroautophagy, rosiglitazone
Procedia PDF Downloads 2742049 Reducing Defects through Organizational Learning within a Housing Association Environment
Authors: T. Hopkin, S. Lu, P. Rogers, M. Sexton
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Housing Associations (HAs) contribute circa 20% of the UK’s housing supply. HAs are however under increasing pressure as a result of funding cuts and rent reductions. Due to the increased pressure, a number of processes are currently being reviewed by HAs, especially how they manage and learn from defects. Learning from defects is considered a useful approach to achieving defect reduction within the UK housebuilding industry. This paper contributes to our understanding of how HAs learn from defects by undertaking an initial round table discussion with key HA stakeholders as part of an ongoing collaborative research project with the National House Building Council (NHBC) to better understand how house builders and HAs learn from defects to reduce their prevalence. The initial discussion shows that defect information runs through a number of groups, both internal and external of a HA during both the defects management process and organizational learning (OL) process. Furthermore, HAs are reliant on capturing and recording defect data as the foundation for the OL process. During the OL process defect data analysis is the primary enabler to recognizing a need for a change to organizational routines. When a need for change has been recognized, new options are typically pursued to design out defects via updates to a HAs Employer’s Requirements. Proposed solutions are selected by a review board and committed to organizational routine. After implementing a change, both structured and unstructured feedback is sought to establish the change’s success. The findings from the HA discussion demonstrates that OL can achieve defect reduction within the house building sector in the UK. The paper concludes by outlining a potential ‘learning from defects model’ for the housebuilding industry as well as describing future work.Keywords: defects, new homes, housing association, organizational learning
Procedia PDF Downloads 3162048 Positive Energy Districts in the Swedish Energy System
Authors: Vartan Ahrens Kayayan, Mattias Gustafsson, Erik Dotzauer
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The European Union is introducing the positive energy district concept, which has the goal to reduce overall carbon dioxide emissions. Other studies have already mapped the make-up of such districts, and reviewed their definitions and where they are positioned. The Swedish energy system is unique compared to others in Europe, due to the implementation of low-carbon electricity and heat energy sources and high uptake of district heating. The goal for this paper is to start the discussion about how the concept of positive energy districts can best be applied to the Swedish context and meet their mitigation goals. To explore how these differences impact the formation of positive energy districts, two cases were analyzed for their methods and how these integrate into the Swedish energy system: a district in Uppsala with a focus on energy and another in Helsingborg with a focus on climate. The case in Uppsala uses primary energy calculations which can be critisied but take a virtual border that allows for its surrounding system to be considered. The district in Helsingborg has a complex methodology for considering the life cycle emissions of the neighborhood. It is successful in considering the energy balance on a monthly basis, but it can be problematized in terms of creating sub-optimized systems due to setting tight geographical constraints. The discussion of shaping the definitions and methodologies for positive energy districts is taking place in Europe and Sweden. We identify three pitfalls that must be avoided so that positive energy districts meet their mitigation goals in the Swedish context. The goal of pushing out fossil fuels is not relevant in the current energy system, the mismatch between summer electricity production and winter energy demands should be addressed, and further implementations should consider collaboration with the established district heating grid.Keywords: positive energy districts, energy system, renewable energy, European Union
Procedia PDF Downloads 782047 A Three-Dimensional Investigation of Stabilized Turbulent Diffusion Flames Using Different Type of Fuel
Authors: Moataz Medhat, Essam E. Khalil, Hatem Haridy
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In the present study, a numerical simulation study is used to 3-D model the steady-state combustion of a staged natural gas flame in a 300 kW swirl-stabilized burner, using ANSYS solver to find the highest combustion efficiency by changing the inlet air swirl number and burner quarl angle in a furnace and showing the effect of flue gas recirculation, type of fuel and staging. The combustion chamber of the gas turbine is a cylinder of diameter 1006.8 mm, and a height of 1651mm ending with a hood until the exhaust cylinder has been reached, where the exit of combustion products which have a diameter of 300 mm, with a height of 751mm. The model was studied by 15 degree of the circumference due to axisymmetric of the geometry and divided into a mesh of about 1.1 million cells. The numerical simulations were performed by solving the governing equations in a three-dimensional model using realizable K-epsilon equations to express the turbulence and non-premixed flamelet combustion model taking into consideration radiation effect. The validation of the results was done by comparing it with other experimental data to ensure the agreement of the results. The study showed two zones of recirculation. The primary one is at the center of the furnace, and the location of the secondary one varies by changing the quarl angle of the burner. It is found that the increase in temperature in the external recirculation zone is a result of increasing the swirl number of the inlet air stream. Also it was found that recirculating part of the combustion products back to the combustion zone decreases pollutants formation especially nitrogen monoxide.Keywords: burner selection, natural gas, analysis, recirculation
Procedia PDF Downloads 1612046 Microgravity, Hydrological and Metrological Monitoring of Shallow Ground Water Aquifer in Al-Ain, UAE
Authors: Serin Darwish, Hakim Saibi, Amir Gabr
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The United Arab Emirates (UAE) is situated within an arid zone where the climate is arid and the recharge of the groundwater is very low. Groundwater is the primary source of water in the United Arab Emirates. However, rapid expansion, population growth, agriculture, and industrial activities have negatively affected these limited water resources. The shortage of water resources has become a serious concern due to the over-pumping of groundwater to meet demand. In addition to the deficit of groundwater, the UAE has one of the highest per capita water consumption rates in the world. In this study, a combination of time-lapse measurements of microgravity and depth to groundwater level in selected wells in Al Ain city was used to estimate the variations in groundwater storage. Al-Ain is the second largest city in Abu Dhabi Emirates and the third largest city in the UAE. The groundwater in this region has been overexploited. Relative gravity measurements were acquired using the Scintrex CG-6 Autograv. This latest generation gravimeter from Scintrex Ltd provides fast, precise gravity measurements and automated corrections for temperature, tide, instrument tilt and rejection of data noise. The CG-6 gravimeter has a resolution of 0.1μGal. The purpose of this study is to measure the groundwater storage changes in the shallow aquifers based on the application of microgravity method. The gravity method is a nondestructive technique that allows collection of data at almost any location over the aquifer. Preliminary results indicate a possible relationship between microgravity and water levels, but more work needs to be done to confirm this. The results will help to develop the relationship between monthly microgravity changes with hydrological and hydrogeological changes of shallow phreatic. The study will be useful in water management considerations and additional future investigations.Keywords: Al-Ain, arid region, groundwater, microgravity
Procedia PDF Downloads 1532045 Mapping of Geological Structures Using Aerial Photography
Authors: Ankit Sharma, Mudit Sachan, Anurag Prakash
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Rapid growth in data acquisition technologies through drones, have led to advances and interests in collecting high-resolution images of geological fields. Being advantageous in capturing high volume of data in short flights, a number of challenges have to overcome for efficient analysis of this data, especially while data acquisition, image interpretation and processing. We introduce a method that allows effective mapping of geological fields using photogrammetric data of surfaces, drainage area, water bodies etc, which will be captured by airborne vehicles like UAVs, we are not taking satellite images because of problems in adequate resolution, time when it is captured may be 1 yr back, availability problem, difficult to capture exact image, then night vision etc. This method includes advanced automated image interpretation technology and human data interaction to model structures and. First Geological structures will be detected from the primary photographic dataset and the equivalent three dimensional structures would then be identified by digital elevation model. We can calculate dip and its direction by using the above information. The structural map will be generated by adopting a specified methodology starting from choosing the appropriate camera, camera’s mounting system, UAVs design ( based on the area and application), Challenge in air borne systems like Errors in image orientation, payload problem, mosaicing and geo referencing and registering of different images to applying DEM. The paper shows the potential of using our method for accurate and efficient modeling of geological structures, capture particularly from remote, of inaccessible and hazardous sites.Keywords: digital elevation model, mapping, photogrammetric data analysis, geological structures
Procedia PDF Downloads 6862044 A Multiple Case Study of How Bilingual-Bicultural Teachers' Language Shame and Loss Affects Teaching English Language Learners
Authors: Lisa Winstead, Penny Congcong Wang
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This two-year multiple case study of eight Spanish-English speaking teachers explores bilingual-bicultural Latino teachers’ lived experiences as English Language Learners and, more recently, as adult teachers who work with English Language Learners in mainstream schools. Research questions explored include: How do bilingual-bicultural teachers perceive their native language use and sense of self within society from childhood to adulthood? Correspondingly, what are bilingual teachers’ perceptions of how their own language learning experience might affect teaching students of similar linguistic and cultural backgrounds? This study took place in an urban area in the Pacific Southwest of the United States. Participants were K-8 teachers and enrolled in a Spanish-English bilingual authorization program. Data were collected from journals, focus group interviews, field notes, and class artifacts. Within case and cross-case analysis revealed that the participants were shamed about their language use as children which contributed to their primary language loss. They similarly reported how experiences of mainstream educator and administrator language shaming invalidated their ability to provide support for Latino heritage ELLs, despite their bilingual-bicultural expertise. However, participants reported that counter-narratives from the bilingual authorization program, parents, community and church organizations, and cultural responsive teachers were effective in promoting their language retention, pride, and feelings of well-being.Keywords: teacher education, bilingual education, English language learners, emergent bilinguals, social justice, language shame, language loss, translanguaging
Procedia PDF Downloads 1892043 Needs for Primary Prevention in Families with Mentally Ill Parents
Authors: Patricia Wahl, Dirk Bruland, Albert Lenz
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Children of mentally ill parents are a large high risk group for mental disorders which is hardly reached by preventive programs. The children inherit a heightened risk to develop a mental disorder themselves during their lifetime, but they and their parents are often rejecting to seek help. To elicit the factors determining this prevention dilemma, an explorative qualitative interview study is conducted in 25 families with mentally ill parents and yet unaffected children. Inclusion criteria are the children’s age (7 to 14 years old) and that these children live together with the affected parent. With regard to the concept of Mental Health Literacy the following research questions are leading the Qualitative Content Analysis: What are the needs of families with mentally ill parents? How can their help-seeking behaviour be described? What are their subjective illness theories? And which influences do gender, ethnicity and socio-economic status have on needs, help-seeking and illness theories? Mental Health Literacy relates to the knowledge and attitudes towards mental disorders influencing the recognition, management or prevention of these disorders. The concept seems to be an interesting starting point for our analysis with the aim to understand antecedences and processes in the families more deeply. Results of an extensive literature review serve as deductive framework for our analysis, first findings from the interviews will be available up to the time of the conference and can be presented. They hopefully will give inside in the families’ living environment and help to adapt/develop interventions and in the long term reduce health inequalities. The project at hand is part of the Health Literacy in Childhood and Adolescence (HLCA) Research Consortium financed by the German Federal Ministry of Education and Research (BMBF).Keywords: children of mentally ill parents, help-seeking behaviour, mental health literacy, prevention dilemma
Procedia PDF Downloads 4062042 Challenging Heteronormativity and Mononormativity in Academia: Incorporating Consensual Non-Monogamy into Psychological Romantic Relationship Research
Authors: Jessica Wood, Serge Desmarais
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There has been recent resurgence in the popular and academic interest of consensual non-monogamous (CNM) relationships- an umbrella term that defines relationships in which each partner has openly agreed to engage in additional romantic and/or sexual relationships outside of their primary partnership. Despite an increase in the academic study of CNM, little psychological attention has been paid to the study of CNM, with the consideration of these relationships commonly occurring within related social science disciplines such as sociology or anthropology. As a discipline, psychology has a history of conducting research in the area of intimate relationships, and psychologists have amassed a wealth of theoretical knowledge in this field. However, historically individuals who engage in "alternative" sexual and romantic behaviours, such as non-heterosexual sex or sex with multiple partners have been pathologized within psychological research. Individuals in CNM relationships or individuals identifying as lesbian, gay, bisexual, trans or queer have often been excluded from research or “othered” in psychological interpretations of what healthy relationships entail. Thus, our current theoretical understandings of romantic relationships are limited to heterosexual, monogamous relationships. The goal of this presentation is to examine commonly cited components of relationship satisfaction (e.g., commitment, communication) and to critically assess how CNM experiences are presented in, or missing from, the psychological literature on romantic relationships. Additionally, the presentation will also consider how CNM relationships may add to our understanding or enhancement of traditional psychological theories and address issues related to heteronormativity and mononormativity within the discipline. Finally, we will close with a consideration of additional theoretical perspectives that may aid in our understanding of CNM relationships and suggest directions for future research.Keywords: heteronormativity, mononormativity, psychological research, diverse relationships, gender, sexuality, feminism, queer theory
Procedia PDF Downloads 3822041 Removal of Lead Ions from Aqueous Medium Using Devised Column Filters Packed with Chitosan from Trash Crab Shells: A Characterization Study
Authors: Charles Klein O. Gorit, Mark Tristan J. Quimque Jr., M. Cecilia V. Almeda, Concepcion M. Salvana
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Chitosan is a promising biopolymer commonly found in crustacean shells that has plausible effects in water purification and wastewater treatment. It is a primary derivative of chitin and considered second of the most abundant biopolymer prior to cellulose. Morphological analysis had been done using Scanning Electron Microscopy with Energy Dispersive Microscopy (SEM/EDS), and due to its porous nature, it showcases a certain degree of porosity, hence, larger adsorption site of heavy metal. The Energy Dispersive Spectroscopy of the chitosan and ‘lead-bound’ chitosan, shows a relative increase of percent abundance of lead cation from 1.44% to 2.08% hence, adsorption occurs. Chitosan, as a nitrogenous polysaccharide, subjected to Fourier transform infrared spectroscopy (FTIR) analysis shows amide bands ranging from 1635.36 cm⁻¹ for amide 1 band and 1558.40 cm-1 for amide 2 band with NH stretching. For ‘lead-bound’ chitosan, the FT-IR analysis shows a change in peaks upon adsorption of Pb(II) cation. The spectrum shows broadening of OH and NH stretching band. Such observation can be attributed to the probability that the attachment of Pb(II) ions is in these functional groups. A column filter was devised with lead-bound chitosan to determine the zero point charge (pHzpc) of the biopolymer. The results show that at pH 8.34, below than the zpc level of literatures cited for lead which ranges from pH 4 to 7, favors the adsorption site of chitosan and its capability to adsorb traces amount of aqueous lead.Keywords: chitosan, biopolymer, FT-IR, SEM, zero-point charge, heavy metal, lead ions
Procedia PDF Downloads 1512040 Association between Severe Acidemia before Endotracheal Intubation and the Lower First Attempt Intubation Success Rate
Authors: Keiko Naito, Y. Nakashima, S. Yamauchi, Y. Kunitani, Y. Ishigami, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi
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Background: A presence of severe acidemia, defined as pH < 7.2, is common during endotracheal intubation for critically ill patients in the emergency department (ED). Severe acidemia is widely recognized as a predisposing factor for intubation failure. However, it is unclear that acidemic condition itself actually makes endotracheal intubation more difficult. We aimed to evaluate if a presence of severe acidemia before intubation is associated with the lower first attempt intubation success rate in the ED. Methods: This is a retrospective observational cohort study in the ED of an urban hospital in Japan. The collected data included patient demographics, such as age, sex, and body mass index, presence of one or more factors of modified LEMON criteria for predicting difficult intubation, reasons for intubation, blood gas levels, airway equipment, intubation by emergency physician or not, and the use of the rapid sequence intubation technique. Those with any of the following were excluded from the analysis: (1) no blood gas drawn before intubation, (2) cardiopulmonary arrest, and (3) under 18 years of age. The primary outcome was the first attempt intubation success rates between a severe acidemic patients (SA) group and a non-severe acidemic patients (NA) group. Logistic regression analysis was used to test the first attempt success rates for intubations between those two groups. Results: Over 5 years, a total of 486 intubations were performed; 105 in the SA group and 381 in the NA group. The univariate analysis showed that the first attempt intubation success rate was lower in the SA group than in the NA group (71.4% vs 83.5%, p < 0.01). The multivariate logistic regression analysis identified that severe acidemia was significantly associated with the first attempt intubation failure (OR 1.9, 95% CI 1.03-3.68, p = 0.04). Conclusions: A presence of severe acidemia before endotracheal intubation lowers the first attempt intubation success rate in the ED.Keywords: acidemia, airway management, endotracheal intubation, first-attempt intubation success rate
Procedia PDF Downloads 2482039 Isolation and Elimination of Latent and Productive Herpes Simplex Virus from the Sacral and Trigeminal Ganglions
Authors: Bernard L. Middleton, Susan P. Cosgrove
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There is an immediate need for alternative anti-herpetic treatment options effective for both primary infections and reoccurring reactivations of herpes simplex virus types 1 (HSV-1) and 2 (HSV-2). Alternatives currently approved for the purposes of clinical administration includes antivirals and a reduced set of nucleoside analogues. The present article tests a treatment based on a systemic understanding of how the herpes virus affects cell inhibition and breakdown and targets different phases of the viral cycle, including the entry stage, reproductive cross mutation, and cell-to-cell infection. The treatment consisted of five immunotherapeutic core compounds (5CC), which were hypothesized to be capable of neutralizing human monoclonal antibodies. The tested 5CC were noted as being functional in the application of eliminating the DNA synthesis of herpes viral interferon (IFN) - induced cellular antiviral response. They were here found to neutralize antiviral reproduction by blocking cell-to-cell infection. The activity of the 5CC was tested on RC-37 in vitro using an assay plaque reduction and in vivo against HSV-1 and HSV-2. The 50% inhibitory concentration (IC50) of 5CC was 0.0009% for HSV-1 plaque formation and 0.0008% for HSV-2 plaque formation. Further tests were performed to evaluate the susceptibility of HSV-1 and HSV-2 to anti-herpetic drugs in Vero cells after virus entry. There were high-level markers of the 5CC virucidal activity in the viral suspension of HSV-1 and HSV-2. These concentrations of the 5CC are nontoxic and reduced plaque formation by 98.2% for HSV-1 and 93.0% for HSV-2. Virus HSV-1 and HSV-2 titers were reduced significantly by 5CC to the point of being negative, ranging 0.01–0.09 in 72%. The results concluded the 5CC as being an effective treatment option for the herpes simplex virus.Keywords: synergy pharmaceuticals, herpes treatment, herpes cure, synergy pharmaceuticals treatment
Procedia PDF Downloads 2412038 The Effect of an Infill on the Bearing Capacity and Stiffness of Infilled Frames
Authors: Goran Baloevic, Jure Radnic, Nikola Grgic
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The application of frames with masonry or panel infill is common in the engineering practice. In these cases, a frame is often considered to be a primary structure, while an infill is considered to be a secondary structure. In past calculations, the infill was rarely included in the design of frame structures in terms of their bearing capacity and safety. Recent calculations of such structures necessarily include the effect of infill since it contributes to stiffness and bearing capacity of overall system, especially under horizontal loads. In certain cases, if the infill is not included in the seismic design of frame structures, the result can be lower design safety. However, since the different configuration of the infill through the building’s height can be made, it is possible that contribution of such infill to the overall bearing capacity can be lower and seismic forces on the building can be increased due to greater stiffness of the structure. So far, many experimental and numerical researches on the behavior of infilled frames under horizontal static forces and earthquake have been performed. In this paper, several masonry-infilled concrete and steel frames under horizontal static forces and earthquake are analysed. The experimental results by shake-table and numerical results are compared in terms of the bearing capacity of bare and infilled frames. Herein, the stiffness of frames and infill were varied, with different position of the infill and different types of openings. Cases with positive and negative effects of the infill to the bearing capacity of the frames were considered. Finally, main conclusions and recommendations for practical application and design of masonry-infilled concrete and steel frames are given.Keywords: bearing capacity, infilled frame, numerical model, shake table
Procedia PDF Downloads 4642037 Foreign Football League and Its Socio-Economic Implications in Nigeria
Authors: Usman Dutse, Eldah Ephraim Buba, Dalhatu Sa’idu
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The popularity of foreign football leagues are getting a soaring in Africa. Nigerian youths are following these leagues with high sense of dedication and devotion. The paper examines the factors behind the growing popularity of foreign football league in Nigeria and its socio economic implications on the country. Primary data were largely used for the study and collected through the use of questionnaire and interview. The data collected were analysed with the use of descriptive and qualitative methods of analysis. The findings made from the analysis indicates that the reasons why foreign league is popular in Nigeria is because the quality of national league in Nigeria is poor, the matches are not mostly televised, corruption/match fixing is common; for the above mentioned reasons national football league become uninteresting compared to foreign leagues. It was also confirmed that the overwhelming popularity of foreign league has the following social effects: friendship and acquaintance are created between supporters of the same club via social media and viewing centres, it has increased the knowledge and awareness of youth about the economics and politics of international sports. However, it has also brewed rivalry between supporters of clubs, drugs are sold in viewing centres and it sometimes serves as a meeting point for miscreants and criminals. Some of the economic effects were also identified as follows: small entrepreneurs establish commercial viewing centres and they employ other supporting staff to operate. On the strength of the above findings, the following were recommended: There is the urgent need to reform our national league to an acceptable standard; improve the quality of the team, the facilities and media coverage of the matches. This might make Nigerians to channel some of the love for foreign leagues to the local leagues.Keywords: foreign, league, socioeconomic, implications
Procedia PDF Downloads 2542036 Effect of Built in Polarization on Thermal Properties of InGaN/GaN Heterostructures
Authors: Bijay Kumar Sahoo
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An important feature of InₓGa₁-ₓN/GaN heterostructures is strong built-in polarization (BIP) electric field at the hetero-interface due to spontaneous (sp) and piezoelectric (pz) polarizations. The intensity of this electric field reaches several MV/cm. This field has profound impact on optical, electrical and thermal properties. In this work, the effect of BIP field on thermal conductivity of InₓGa₁-ₓN/GaN heterostructure has been investigated theoretically. The interaction between the elastic strain and built in electric field induces additional electric polarization. This additional polarization contributes to the elastic constant of InₓGa₁-ₓN alloy. This in turn modifies material parameters of InₓGa₁-ₓN. The BIP mechanism enhances elastic constant, phonon velocity and Debye temperature and their bowing constants in InₓGa₁-ₓN alloy. These enhanced thermal parameters increase phonon mean free path which boost thermal conduction process. The thermal conductivity (k) of InxGa1-xN alloy has been estimated for x=0, 0.1, 0.3 and 0.9. Computation finds that irrespective of In content, the room temperature k of InₓGa₁-ₓN/GaN heterostructure is enhanced by BIP mechanism. Our analysis shows that at a certain temperature both k with and without BIP show crossover. Below this temperature k with BIP field is lower than k without BIP; however, above this temperature k with BIP field is significantly contributed by BIP mechanism leading to k with BIP field become higher than k without BIP field. The crossover temperature is primary pyroelectric transition temperature. The pyroelectric transition temperature of InₓGa₁-ₓN alloy has been predicted for different x. This signature of pyroelectric nature suggests that thermal conductivity can reveal pyroelectricity in InₓGa₁-ₓN alloy. The composition dependent room temperature k for x=0.1 and 0.3 are in line with prior experimental studies. The result can be used to minimize the self-heating effect in InₓGa₁-ₓN/GaN heterostructures.Keywords: built-in polarization, phonon relaxation time, thermal properties of InₓGa₁-ₓN /GaN heterostructure, self-heating
Procedia PDF Downloads 4112035 Delicate Balance between Cardiac Stress and Protection: Role of Mitochondrial Proteins
Authors: Zuzana Tatarkova, Ivana Pilchova, Michal Cibulka, Martin Kolisek, Peter Racay, Peter Kaplan
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Introduction: Normal functioning of mitochondria is crucial for cardiac performance. Mitochondria undergo mitophagy and biogenesis, and mitochondrial proteins are subject to extensive post-translational modifications. The state of mitochondrial homeostasis reflects overall cellular fitness and longevity. Perturbed mitochondria produce less ATP, release greater amounts of reactive molecules, and are more prone to apoptosis. Therefore mitochondrial turnover is an integral aspect of quality control in which dysfunctional mitochondria are selectively eliminated through mitophagy. Currently, the progressive deterioration of physiological functions is seen as accumulation of modified/damaged proteins with limiting regenerative ability and disturbance of such affected protein-protein communication throughout aging in myocardial cells. Methodologies: For our study was used immunohistochemistry, biochemical methods: spectrophotometry, western blotting, immunodetection as well as more sophisticated 2D electrophoresis and mass spectrometry for evaluation protein-protein interactions and specific post-translational modification. Results and Discussion: Mitochondrial stress response to reactive species was evaluated as electron transport chain (ETC) complexes, redox-active molecules, and their possible communication. Protein-protein interactions revealed a strong linkage between age and ETC protein subunits. Redox state was strongly affected in senescent mitochondria with shift in favor of more pro-oxidizing condition within cardiomyocytes. Acute myocardial ischemia and ischemia-reperfusion (IR) injury affected ETC complexes I, II and IV with no change in complex III. Ischemia induced decrease in total antioxidant capacity, MnSOD, GSH and catalase activity with recovery in some extent during reperfusion. While MnSOD protein content was higher in IR group, activity returned to 95% of control. Nitric oxide is one of the biological molecules that can out compete MnSOD for superoxide and produce peroxynitrite. This process is faster than dismutation and led to the 10-fold higher production of nitrotyrosine after IR injury in adult with higher protection in senescent ones. 2D protein profiling revealed 140 mitochondrial proteins, 12 of them with significant changes after IR injury and 36 individual nitrotyrosine-modified proteins further identified by mass spectrometry. Linking these two groups, 5 proteins were altered after IR as well as nitrated, but only one showed massive nitration per lowering content of protein after IR injury in adult. Conclusions: Senescent cells have greater proportion of protein content, which might be modulated by several post-translational modifications. If these protein modifications are connected to functional consequences and protein-protein interactions are revealed, link may lead to the solution. Assume all together, dysfunctional proteostasis can play a causative role and restoration of protein homeostasis machinery is protective against aging and possibly age-related disorders. This work was supported by the project VEGA 1/0018/18 and by project 'Competence Center for Research and Development in the field of Diagnostics and Therapy of Oncological diseases', ITMS: 26220220153, co-financed from EU sources.Keywords: aging heart, mitochondria, proteomics, redox state
Procedia PDF Downloads 1682034 Development of Energy Benchmarks Using Mandatory Energy and Emissions Reporting Data: Ontario Post-Secondary Residences
Authors: C. Xavier Mendieta, J. J McArthur
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Governments are playing an increasingly active role in reducing carbon emissions, and a key strategy has been the introduction of mandatory energy disclosure policies. These policies have resulted in a significant amount of publicly available data, providing researchers with a unique opportunity to develop location-specific energy and carbon emission benchmarks from this data set, which can then be used to develop building archetypes and used to inform urban energy models. This study presents the development of such a benchmark using the public reporting data. The data from Ontario’s Ministry of Energy for Post-Secondary Educational Institutions are being used to develop a series of building archetype dynamic building loads and energy benchmarks to fill a gap in the currently available building database. This paper presents the development of a benchmark for college and university residences within ASHRAE climate zone 6 areas in Ontario using the mandatory disclosure energy and greenhouse gas emissions data. The methodology presented includes data cleaning, statistical analysis, and benchmark development, and lessons learned from this investigation are presented and discussed to inform the development of future energy benchmarks from this larger data set. The key findings from this initial benchmarking study are: (1) the importance of careful data screening and outlier identification to develop a valid dataset; (2) the key features used to develop a model of the data are building age, size, and occupancy schedules and these can be used to estimate energy consumption; and (3) policy changes affecting the primary energy generation significantly affected greenhouse gas emissions, and consideration of these factors was critical to evaluate the validity of the reported data.Keywords: building archetypes, data analysis, energy benchmarks, GHG emissions
Procedia PDF Downloads 3062033 Suicide Prevention among Young People: Findings from the Evaluation of Youth Aware of Mental Health in Australian Secondary Schools
Authors: Lauren McGillivray, Michelle Torok, Alison Calear
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Suicide is the leading cause of death for Australians aged 15-24 years, with rates increasing over the past decade. As young people can be particularly vulnerable to mental health problems and suicidal behavior, they are an essential and obvious target for suicide prevention efforts. This study investigates the effectiveness of the universal mental health promotion and suicide prevention program, Youth Aware of Mental Health (YAM), to reduce suicidal ideation and attempts and increase help-seeking in young people. This trial took place in Australian schools across four regions in New South Wales that form part of LifeSpan, a larger multilevel suicide prevention research trial. The YAM program was delivered to Year 9 students in up to 78 schools over two years (from January 2017 to December 2019). All schools were invited to participate in YAM's evaluation, which included completing a student questionnaire at three time-points: baseline, 3-month post-intervention, and 6-month follow-up. The primary outcome is suicidal ideation severity. Secondary outcomes are new reports of suicide attempts, stigma towards suicide, knowledge about suicide, help-seeking intentions and behaviors, and depressive symptoms. Results from pre-post and follow-up data will be presented. These research findings are promising and will contribute to the evidence-based for YAM and suicide prevention programs in Australian schools. These findings are also expected to promote YAM's value and sustainability to be more widely delivered in Australian secondary schools.Keywords: adolescent mental health, suicidal ideation, suicide prevention, universal program
Procedia PDF Downloads 1322032 The Use of the Mediated Learning Experience in Response of Special Needs Education
Authors: Maria Luisa Boninelli
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This study wants to explore the effects of a mediated intervention program in a primary school. The participants where 120 students aged 8-9, half of them Italian and half immigrants of first or second generation. The activities consisted on the cognitive enhancement of the participants through Feuerstein’s Instrumental Enrichment, (IE) and on an activity centred on body awareness and mediated learning experience. Given that there are limited studied on learners in remedial schools, the current study intented to hypothesized that participants exposed to mediation would yiel a significant improvement in cognitive functioning. Hypothesis One proposed that, following the intervention, improved Q1vata scores of the participants would occur in each of the groups. Hypothesis two postulated that participants within the Mediated Learning Experience would perform significantly better than those group of control. For the intervention a group of 60 participants constituted a group of Mediation sample and were exposed to Mediated Learning Experience through Enrichment Programm. Similiary the other 60 were control group. Both the groups have students with special needs and were exposed to the same learning goals. A pre-experimental research design, in particular a one-group pretest-posttest approach was adopted. All the participants in this study underwent pretest and post test phases whereby they completed measures according to the standard instructions. During the pretest phase, all the participants were simultaneously exposed to Q1vata test for logical and linguistic evaluation skill. During the mediation intervention, significant improvement was demonstrated with the group of mediation. This supports Feuerstein's Theory that initial poor performance was a result of a lack of mediated learning experience rather than inherent difference or deficiencies. Furthermore the use of an appropriate mediated learning enabled the participants to function adequately.Keywords: cognitive structural modifiability, learning to learn, mediated learning experience, Reuven Feuerstein, special needs
Procedia PDF Downloads 3782031 L-Carnitine vs Extracorporeal Elimination for Acute Valproic Acid Intoxication: A Systemic Review
Authors: Byung Keun Yang, Jae Eun Ku, Young Seon Joo, Je Sung You, Sung Phil Chung, Hahn Shick Lee
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The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication. PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs. 11 days) in case of delayed extracorporeal therapy. Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.Keywords: carnitine, overdose, poisoning, renal dialysis, valproic acid
Procedia PDF Downloads 3682030 Efficacy and Safety of Probiotic Treatment in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis
Authors: Samir Malhotra, Rajan K. Khandotra, Rakesh K. Dhiman, Neelam Chadha
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There is paucity of data about safety and efficacy of probiotic treatment on patient outcomes in cirrhosis. Specifically, it is important to know whether probiotics can improve mortality, hepatic encephalopathy (HE), number of hospitalizations, ammonia levels, quality of life, and adverse events. Probiotics may improve outcomes in patients with acute or chronic HE. However, it is also important to know whether probiotics can prevent development of HE, even in situations where patients do not have acute HE at the time of administration. It is also important to know if probiotics are useful as primary prophylaxis of HE. We aimed to conduct an updated systematic review and meta-analysis to evaluate the safety and efficacy of probiotics in patients with cirrhosis. We searched PubMed, Cochrane library, Embase, Scopus, SCI, Google Scholar, conference proceedings, and references of included studies till June 2017 to identify randomised clinical trials comparing probiotics with other treatments in cirrhotics. Data was analyzed using MedCalc. Probiotics had no effect on mortality but significantly reduced HE (14 trials, 1073 patients, OR 0.371; 95% CI 0.282 to 0.489). There was not enough data to conduct a meta-analysis on outcomes like hospitalizations and quality of life. The effect on plasma ammonia levels was not significant (SMD -0.429; 95%CI -1.034 – 0.177). There was no difference in adverse events. To conclude, although the included studies had a high risk of bias, the available evidence does suggest a beneficial effect on HE. Larger studies with longer periods of follow-up are needed to determine if probiotics can reduce all-cause mortality.Keywords: cirrhosis, hepatic encephalopathy, meta-analysis, probiotic
Procedia PDF Downloads 2012029 Antepartum and Postpartum Pulmonary Cryptococcosis: A Case Report and Systematic Review
Authors: Ghadeer M Alkusayer, Adelicia Yu, Pamela Orr
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Study objective: To report a case of postpartum pulmonary cryptococcal infection (CCI) in an otherwise healthy 35-year-old woman. Additionally, the cases of pulmonary cryptococcal infections either in the antepartum or the postpartum period with pregnancy outcomes, were systematically reviwed. Methods: A systematic search of Cochrane Library, MEDLINE, and EMBASE was conducted for peer-reviewed studies without date restrictions, published in English and relating to CCI during pregnancy or postpartum period. Conference press, editorials, opinion pieces and letters were excluded. Two authors independently screened citations and full-text articles, extracted data and assessed study quality. Given the heterogeneity of study designs, a narrative synthesis was conducted. Results: The search identified 128 references, of which 22 case reports and series met the inclusion criteria. This is a total of 29 women (including the current case) . The mean age of the women was 28.3 ± 12.3 years. Nine (31.03%) presented and were diagnosed in the postpartum period. Two (6.90%) of the patients were reported as immunocompromised with HIV. Four maternal deaths (13.79%) were found in this case series with one (4.3%) patient with severe neurological deficits. Four (17.4%) infant deaths were reported. Women primary presentation varied with chest pain 13 (44.82%), headache 10 (35.70%), dyspnea 19 (65.51%), or fever 12 (41.38%). Three studies reported placental pathology positive for C. neoformans. Conclusion: This case of pulmonary cryptococcal infection in the postpartum period is an important addition to the literature of this rare infection in pregnancy. The patient is not immunocompromised. The patient was successfully treated with 4 months of Fluconazole 400 mg and continued to breastfeed the healthy baby.Keywords: pulmonary cryptococcus, pregnancy, cryptococci , postpartum
Procedia PDF Downloads 1412028 Experimental Monitoring of the Parameters of the Ionosphere in the Local Area Using the Results of Multifrequency GNSS-Measurements
Authors: Andrey Kupriyanov
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In recent years, much attention has been paid to the problems of ionospheric disturbances and their influence on the signals of global navigation satellite systems (GNSS) around the world. This is due to the increase in solar activity, the expansion of the scope of GNSS, the emergence of new satellite systems, the introduction of new frequencies and many others. The influence of the Earth's ionosphere on the propagation of radio signals is an important factor in many applied fields of science and technology. The paper considers the application of the method of transionospheric sounding using measurements from signals from Global Navigation Satellite Systems to determine the TEC distribution and scintillations of the ionospheric layers. To calculate these parameters, the International Reference Ionosphere (IRI) model of the ionosphere, refined in the local area, is used. The organization of operational monitoring of ionospheric parameters is analyzed using several NovAtel GPStation6 base stations. It allows performing primary processing of GNSS measurement data, calculating TEC and fixing scintillation moments, modeling the ionosphere using the obtained data, storing data and performing ionospheric correction in measurements. As a result of the study, it was proved that the use of the transionospheric sounding method for reconstructing the altitude distribution of electron concentration in different altitude range and would provide operational information about the ionosphere, which is necessary for solving a number of practical problems in the field of many applications. Also, the use of multi-frequency multisystem GNSS equipment and special software will allow achieving the specified accuracy and volume of measurements.Keywords: global navigation satellite systems (GNSS), GPstation6, international reference ionosphere (IRI), ionosphere, scintillations, total electron content (TEC)
Procedia PDF Downloads 1812027 More Precise: Patient-Reported Outcomes after Stroke
Authors: Amber Elyse Corrigan, Alexander Smith, Anna Pennington, Ben Carter, Jonathan Hewitt
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Background and Purpose: Morbidity secondary to stroke is highly heterogeneous, but it is important to both patients and clinicians in post-stroke management and adjustment to life after stroke. The consideration of post-stroke morbidity clinically and from the patient perspective has been poorly measured. The patient-reported outcome measures (PROs) in morbidity assessment help improve this knowledge gap. The primary aim of this study was to consider the association between PRO outcomes and stroke predictors. Methods: A multicenter prospective cohort study assessed 549 stroke patients at 19 hospital sites across England and Wales during 2019. Following a stroke event, demographic, clinical, and PRO measures were collected. Prevalence of morbidity within PRO measures was calculated with associated 95% confidence intervals. Predictors of domain outcome were calculated using a multilevel generalized linear model. Associated P -values and 95% confidence intervals are reported. Results: Data were collected from 549 participants, 317 men (57.7%) and 232 women (42.3%) with ages ranging from 25 to 97 (mean 72.7). PRO morbidity was high post-stroke; 93.2% of the cohort report post-stroke PRO morbidity. Previous stroke, diabetes, and gender are associated with worse patient-reported outcomes across both the physical and cognitive domains. Conclusions: This large-scale multicenter cohort study illustrates the high proportion of morbidity in PRO measures. Further, we demonstrate key predictors of adverse outcomes (Diabetes, previous stroke, and gender) congruence with clinical predictors. The PRO has been demonstrated to be an informative and useful stroke when considering patient-reported outcomes and has wider implications for considerations of PROs in clinical management. Future longitudinal follow-up with PROs is needed to consider association of long-term morbidity.Keywords: morbidity, patient-reported outcome, PRO, stroke
Procedia PDF Downloads 1312026 3D-printing for Ablation Planning in Patients Undergoing Atrial Fibrillation Ablation: 3D-GALA Trial
Authors: Terentes Printzios Dimitrios, Loanna Gourgouli, Vlachopoulos Charalambos
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Aims: Atrial fibrillation (AF) remains one of the major causes of stroke, heart failure, sudden death and cardiovascular morbidity. Ablation techniques are becoming more appealing after the latest results of randomized trials showing the overall clinical benefit. On the other hand, imaging techniques and the frontier application of 3D printing are emerging as a valuable ally for cardiac procedures. However, no randomized trial has directly assessed the impact of preprocedural imaging and especially 3D printing guidance for AF ablation. The present study is designed to investigate for the first time the effect of 3D printing of the heart on the safety and effectiveness of the ablation procedure. Methods and design: The 3D-GALA trial is a randomized, open-label, controlled, multicentre clinical trial of 2 parallel groups designed to enroll a total of 100 patients undergoing ablation using cryo-balloon for paroxysmal and persistent AF. Patients will be randomized with a patient allocation ratio of 1: 1 to preprocedural MRI scan of the heart and 3D printing of left atrium and pulmonary veins and cryoablation versus standard cryoablation without imaging. Patients will be followed up to 6 months after the index procedure. The primary outcome measure is the reduction of radiation dose and contrast amount during pulmonary veins isolation. Secondary endpoints will include the percentage of atrial fibrillation relapse at 24h-Holter electrocardiogram monitoring at 6 months after initial treatment. Discussion: To our knowledge, the 3D-GALA trial will be the first study to provide evidence about the clinical impact of preprocedural imaging and 3D printing before cryoablation.Keywords: atrial fibrillation, cardiac MRI, cryoablation, 3-d printing
Procedia PDF Downloads 1782025 Grapevine Farmers’ Adaptation to Climate Change and its Implication to Human Health: A Case of Dodoma, Tanzania
Authors: Felix Y. Mahenge, Abiud L. Kaswamila, Davis G. Mwamfupe
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Grapevine is a drought resistant crop, although in recent years it has been observed to be affect by climate change. This compelled investigation of grapevine farmers’ adaptation strategies to climate change in Dodoma, Tanzania. A mixed research approach was adopted. Likewise, purposive and random sampling techniques were used to select individuals for the study. About 248 grapevine farmers and 64 key informants and members of focus group discussions were involved. Primary data were collected through surveys, discussions, interviews, and observations, while secondary data were collected through documentary reviews. Quantitative data were analysed through descriptive statistics by means of IBM (SPSS) software while the qualitative data were analysed through content analysis. The findings indicate that climate change has adversely affected grapevine production leading to the occurrence of grapevine pests and diseases, drought which increases costs for irrigation and uncertainties which affect grapevine markets. For the purpose of lessening grapevine production constraints due to climate change, farmers have been using several adaptation strategies. Some of the strategies include application of pesticides, use of scarers to threaten birds, irrigation, timed pruning, manure fertilisers and diversification to other farm or non-farm activities. The use of pesticides and industrial fertilizers were regarded as increasing human health risks in the study area. The researchers recommend that the Tanzania government should strengthen the agricultural extension services in the study area so that the farmers undertake adaptation strategies with the consideration of human health safety.Keywords: grapevine farmers, adaptation, climate change, human health
Procedia PDF Downloads 912024 Accounting for Rice Productivity Heterogeneity in Ghana: The Two-Step Stochastic Metafrontier Approach
Authors: Franklin Nantui Mabe, Samuel A. Donkoh, Seidu Al-Hassan
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Rice yields among agro-ecological zones are heterogeneous. Farmers, researchers and policy makers are making frantic efforts to bridge rice yield gaps between agro-ecological zones through the promotion of improved agricultural technologies (IATs). Farmers are also modifying these IATs and blending them with indigenous farming practices (IFPs) to form farmer innovation systems (FISs). Also, different metafrontier models have been used in estimating productivity performances and their drivers. This study used the two-step stochastic metafrontier model to estimate the productivity performances of rice farmers and their determining factors in GSZ, FSTZ and CSZ. The study used both primary and secondary data. Farmers in CSZ are the most technically efficient. Technical inefficiencies of farmers are negatively influenced by age, sex, household size, education years, extension visits, contract farming, access to improved seeds, access to irrigation, high rainfall amount, less lodging of rice, and well-coordinated and synergized adoption of technologies. Albeit farmers in CSZ are doing well in terms of rice yield, they still have the highest potential of increasing rice yield since they had the lowest TGR. It is recommended that government through the ministry of food and agriculture, development partners and individual private companies promote the adoption of IATs as well as educate farmers on how to coordinate and synergize the adoption of the whole package. Contract farming concept and agricultural extension intensification should be vigorously pursued to the latter.Keywords: efficiency, farmer innovation systems, improved agricultural technologies, two-step stochastic metafrontier approach
Procedia PDF Downloads 2682023 Adobe Attenuation Coefficient Determination and Its Comparison with Other Shielding Materials for Energies Found in Common X-Rays Procedures
Authors: Camarena Rodriguez C. S., Portocarrero Bonifaz A., Palma Esparza R., Romero Carlos N. A.
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Adobe is a construction material that fulfills the same function as a conventional brick. Widely used since ancient times, it is present in an appreciable percentage of buildings in Latin America. Adobe is a mixture of clay and sand. The interest in the study of the properties of this material arises due to its presence in the infrastructure of hospital´s radiological services, located in places with low economic resources, for the attenuation of radiation. Some materials such as lead and concrete are the most used for shielding and are widely studied in the literature. The present study will determine the mass attenuation coefficient of Adobe. The minimum required thicknesses for the primary and secondary barriers will be estimated for the shielding of radiological facilities where conventional and dental X-rays are performed. For the experimental procedure, an X-ray source emitted direct radiation towards different thicknesses of an Adobe barrier, and a detector was placed on the other side. For this purpose, an UNFORS Xi solid state detector was used, which collected information on the difference of radiation intensity. The initial parameters of the exposure started at 45 kV; and then the tube tension was varied in increments of 5 kV, reaching a maximum of 125 kV. The X-Ray tube was positioned at a distance of 0.5 m from the surface of the Adobe bricks, and the collimation of the radiation beam was set for an area of 0.15 m x 0.15 m. Finally, mathematical methods were applied to determine the mass attenuation coefficient for different energy ranges. In conclusion, the mass attenuation coefficient for Adobe was determined and the approximate thicknesses of the most common Adobe barriers in the hospital buildings were calculated for their later application in the radiological protection.Keywords: Adobe, attenuation coefficient, radiological protection, shielding, x-rays
Procedia PDF Downloads 1572022 Simultaneous Bilateral Patella Tendon Rupture: A Systematic Review
Authors: André Rui Coelho Fernandes, Mariana Rufino, Divakar Hamal, Amr Sousa, Emma Fossett, Kamalpreet Cheema
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Aim: A single patella tendon rupture is relatively uncommon, but a simultaneous bilateral event is a rare occurrence and has been scarcely reviewed in the literature. This review was carried out to analyse the existing literature on this event, with the aim of proposing a standardised approach to the diagnosis and management of this injury. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent reviewers conducted searches in PubMed, OvidSP for Medline and Embase, as well as Cochrane Library using the same search strategy. From a total of 183 studies, 45 were included, i.e. 90 patellas. Results: 46 patellas had a Type 1 Rupture equating to 51%, with Type 3 being the least common, with only 7 patellas sustaining this injury. The mean Insall-Salvio ratio for each knee was 1.62 (R) and 1.60 (L) Direct Primary Repair was the most common surgical technique compared to Tendon Reconstruction, with End to End and Transosseous techniques split almost equally. Brace immobilisation was preferred over cast, with a mean start to weight-bearing of 3.23 weeks post-op. Conclusions: Bilateral patellar tendon rupture is a rare injury that should be considered in patients with knee extensor mechanism disruption. The key limitation of this study was the low number of patients encompassed by the eligible literature. There is space for a higher level of evidence study, specifically regarding surgical treatment choice and methods, as well as post-operative management, which could potentially improve the outcomes in the management of this injury.Keywords: trauma and orthopaedic surgery, bilateral patella, tendon rupture, trauma
Procedia PDF Downloads 136