Search results for: heart failure reversal therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5163

Search results for: heart failure reversal therapy

1323 Fatigue Life Prediction under Variable Loading Based a Non-Linear Energy Model

Authors: Aid Abdelkrim

Abstract:

A method of fatigue damage accumulation based upon application of energy parameters of the fatigue process is proposed in the paper. Using this model is simple, it has no parameter to be determined, it requires only the knowledge of the curve W–N (W: strain energy density N: number of cycles at failure) determined from the experimental Wöhler curve. To examine the performance of nonlinear models proposed in the estimation of fatigue damage and fatigue life of components under random loading, a batch of specimens made of 6082 T 6 aluminium alloy has been studied and some of the results are reported in the present paper. The paper describes an algorithm and suggests a fatigue cumulative damage model, especially when random loading is considered. This work contains the results of uni-axial random load fatigue tests with different mean and amplitude values performed on 6082T6 aluminium alloy specimens. The proposed model has been formulated to take into account the damage evolution at different load levels and it allows the effect of the loading sequence to be included by means of a recurrence formula derived for multilevel loading, considering complex load sequences. It is concluded that a ‘damaged stress interaction damage rule’ proposed here allows a better fatigue damage prediction than the widely used Palmgren–Miner rule, and a formula derived in random fatigue could be used to predict the fatigue damage and fatigue lifetime very easily. The results obtained by the model are compared with the experimental results and those calculated by the most fatigue damage model used in fatigue (Miner’s model). The comparison shows that the proposed model, presents a good estimation of the experimental results. Moreover, the error is minimized in comparison to the Miner’s model.

Keywords: damage accumulation, energy model, damage indicator, variable loading, random loading

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1322 Late Presentation of Pseudophakic Macula Edema from Oral Kinase Inhibitors: A Case and Literature Review

Authors: Christolyn Raj, Lewis Levitz

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Introduction: Two cases of late presentation ( > five years ) of bilateral pseudophakic macula edema related to oral tyrosine kinase inhibitors are described. These cases are the first of their type in the published literature. A review of ocular inflammatory complications of tyrosine kinase inhibitors in the current literature is explored. Case Presentations(s): Case 1 is an 83-year-old female who has been stable on Ibrutinib (Imbruvica ®) for chronic lymphocytic leukemia (CLL). She presented with bilateral blurred vision from severe cystoid macula edema seven years following routine cataract surgery. She was treated with intravitreal steroids with complete resolution without relapse. Case 2 is a 76-year-old female who was on therapy for polycythemia vera with Ruxolitinib (Jakafi®). She presented with bilateral blurred vision from mild cystoid macula edema six years following routine cataract surgery. She responded well to topical steroids without relapse. In both cases, oral tyrosine kinase inhibitor agents were presumed to be the underlying cause and were ceased. Over the last five years, there have been increasing reports in the literature of the inflammatory effects of tyrosine kinase inhibitors on the retina, uvea and optic nerve. Conclusion: Late presentation of pseudophakic macula edema following routine cataract surgery is rare. Such presentations should prompt investigation of the chronic use of systemic medications, especially oral kinase inhibitors. Patients who must remain on these agents require ongoing ophthalmologic assessment in view of their long-term inflammatory side effects.

Keywords: macula edema, oral kinase inhibitors, retinal toxicity, pseudo-phakia

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1321 The Effect of Bisphenol A and Its Selected Analogues on Antioxidant Enzymes Activity in Human Erythrocytes

Authors: Aneta Maćczak, Bożena Bukowska, Jaromir Michałowicz

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Bisphenols are one of the most widely used chemical compounds worldwide. They are used in the manufacturing of polycarbonates, epoxy resins and thermal paper which are applied in plastic containers, bottles, cans, newspapers, receipt and other products. Among these compounds, bisphenol A (BPA) is produced in the highest amounts. There are concerns about endocrine impact of BPA and its other toxic effects including hepatotoxicity, neurotoxicity and carcinogenicity on human organism. Moreover, BPA is supposed to increase the incidence the obesity, diabetes and heart disease. For this reason the use of BPA in the production of plastic infant feeding bottles and some other consumers products has been restricted in the European Union and the United States. Nowadays, BPA analogues like bisphenol F (BPF) and bisphenol S (BPS) have been developed as alternative compounds. The replacement of BPA with other bisphenols contributed to the increase of the exposure of human population to these substances. Toxicological studies have mainly focused on BPA. In opposite, a small number of studies concerning toxic effects of BPA analogues have been realized, which makes impossible to state whether those substituents are safe for human health. Up to now, the mechanism of bisphenols action on the erythrocytes has not been elucidated. That is why, the aim of this study was to assess the effect of BPA and its selected analogues such as BPF and BPS on the activity of antioxidant enzymes, i.e. catalase (EC 1.11.1.6.), glutathione peroxidase (E.C.1.11.1.9) and superoxide dismutase (EC.1.15.1.1) in human erythrocytes. Red blood cells in respect to their function (transport of oxygen) and very well developed enzymatic and non-enzymatic antioxidative system, are useful cellular model to assess changes in redox balance. Erythrocytes were incubated with BPA, BPF and BPS in the concentration ranging from 0.5 to 100 µg/ml for 24 h. The activity of catalase was determined by the method of Aebi (1984). The activity of glutathione peroxidase was measured according to the method described by Rice-Evans et al. (1991), while the activity of superoxide dismutase (EC.1.15.1.1) was determined by the method of Misra and Fridovich (1972). The results showed that BPA and BPF caused changes in the antioxidative enzymes activities. BPA decreased the activity of examined enzymes in the concentration of 100 µg/ml. We also noted that BPF decreased the activity of catalase (5-100 µg/ml), glutathione peroxidase (50-100 µg/ml) and superoxide dismutase (25-100 µg/ml), while BPS did not cause statistically significant changes in investigated parameters. The obtained results suggest that BPA and BPF disrupt redox balance in human erythrocytes but the observed changes may occur in human organism only during occupational or subacute exposure to these substances.

Keywords: antioxidant enzymes, bisphenol A, bisphenol a analogues, human erythrocytes

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1320 The Fracture Resistance of Zirconia Based Dental Crowns from Cyclic Loading: A Function of Relative Wear Depth

Authors: T. Qasim, B. El Masoud, D. Ailabouni

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This in vitro study focused on investigating the fatigue resistance of veneered zirconia molar crowns with different veneering ceramic thicknesses, simulating the relative wear depths under simulated cyclic loading. A mandibular first molar was prepared and then scanned using computer-aided design/computer-aided manufacturing (CAD/CAM) technology to fabricate 32 zirconia copings of uniform 0.5 mm thickness. The manufactured copings then veneered with 1.5 mm, 1.0 mm, 0.5 mm, and 0.0 mm representing 0%, 33%, 66%, and 100% relative wear of a normal ceramic thickness of 1.5 mm. All samples were thermally aged to 6000 thermo-cycles for 2 minutes with distilled water between 5 ˚C and 55 ˚C. The samples subjected to cyclic fatigue and fracture testing using SD Mechatronik chewing simulator. These samples are loaded up to 1.25x10⁶ cycles or until they fail. During fatigue, testing, extensive cracks were observed in samples with 0.5 mm veneering layer thickness. Veneering layer thickness 1.5-mm group and 1.0-mm group were not different in terms of resisting loads necessary to cause an initial crack or final failure. All ceramic zirconia-based crown restorations with varying occlusal veneering layer thicknesses appeared to be fatigue resistant. Fracture load measurement for all tested groups before and after fatigue loading exceeded the clinical chewing forces in the posterior region. In general, the fracture loads increased after fatigue loading and with the increase in the thickness of the occlusal layering ceramic.

Keywords: all ceramic, cyclic loading, chewing simulator, dental crowns, relative wear, thermally ageing

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1319 STAT6 Mediates Local and Systemic Fibrosis and Type Ii Immune Response via Macrophage Polarization during Acute and Chronic Pancreatitis in Murine Model

Authors: Hager Elsheikh, Matthias Sendler, Juliana Glaubnitz

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In pancreatitis, an inflammatory reaction occurs in the pancreatic secretory cells due to premature activation of proteases, leading to pancreatic self-digestion and necrotic cell death of acinar cells. Acute pancreatitis in patients is characterized by a severe immune reaction that could lead to serious complications, such as organ failure or septic shock, if left untreated. Chronic pancreatitis is a recurrence of episodes of acute pancreatitis resulting in a fibro-inflammatory immune response, in which the type 2 immune response is primarily driven by AAMs in the pancreas. One of the most important signaling pathways for M2 macrophage activation is the IL-4/STAT6 pathway. Pancreatic fibrosis is induced by the hyperactivation of pancreatic stellate cells by dysregulation in the inflammatory response, leading to further damage, autodigestion and possibly necrosis of pancreatic acinar cells. The aim of this research is to investigate the effect of STAT6 knockout in disease severity and development of fibrosis wound healing in the presence of different macrophage populations, regulated by the type 2 immune response, after inducing chronic and/or acute pancreatitis in mice models via cerulean injection. We further investigate the influence of the JAK/STAT6 signaling pathway on the balance of fibrosis and regeneration in STAT6 deficient and wild-type mice. The characterization of resident and recruited macrophages will provide insight into the influence of the JAK/STAT6 signaling pathway on infiltrating cells and, ultimately, tissue fibrosis and disease severity.

Keywords: acute and chronic pancreatitis, tissue regeneration, macrophage polarization, Gastroenterology

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1318 Next Generation UK Storm Surge Model for the Insurance Market: The London Case

Authors: Iacopo Carnacina, Mohammad Keshtpoor, Richard Yablonsky

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Non-structural protection measures against flooding are becoming increasingly popular flood risk mitigation strategies. In particular, coastal flood insurance impacts not only private citizens but also insurance and reinsurance companies, who may require it to retain solvency and better understand the risks they face from a catastrophic coastal flood event. In this context, a framework is presented here to assess the risk for coastal flooding across the UK. The area has a long history of catastrophic flood events, including the Great Flood of 1953 and the 2013 Cyclone Xaver storm, both of which led to significant loss of life and property. The current framework will leverage a technology based on a hydrodynamic model (Delft3D Flexible Mesh). This flexible mesh technology, coupled with a calibration technique, allows for better utilisation of computational resources, leading to higher resolution and more detailed results. The generation of a stochastic set of extra tropical cyclone (ETC) events supports the evaluation of the financial losses for the whole area, also accounting for correlations between different locations in different scenarios. Finally, the solution shows a detailed analysis for the Thames River, leveraging the information available on flood barriers and levees. Two realistic disaster scenarios for the Greater London area are simulated: In the first scenario, the storm surge intensity is not high enough to fail London’s flood defences, but in the second scenario, London’s flood defences fail, highlighting the potential losses from a catastrophic coastal flood event.

Keywords: storm surge, stochastic model, levee failure, Thames River

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1317 Design of 3D Bioprinted Scaffolds for Cartilage Regeneration

Authors: Gloria Pinilla, Jose Manuel Baena, Patricia Gálvez-Martín, Juan Antonio Marchad

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Cartilage is a dense connective tissue with limited self-repair properties. Currently, the therapeutic use of autologous or allogenic chondrocytes makes up an alternative therapy to the pharmacological treatment. The design of a bioprinted 3D cartilage with chondrocytes and biodegradable biomaterials offers a new therapeutic alternative able of bridging the limitations of current therapies in the field. We have developed an enhanced printing processes-Injection Volume Filling (IVF) to increase the viability and survival of the cells when working with high-temperature thermoplastics without the limitation of the scaffold geometry in contact with cells. We have demonstrated the viability of the printing process using chondrocytes for cartilage regeneration. This development will accelerate the clinical uptake of the technology and overcomes the current limitation when using thermoplastics as scaffolds. An alginate-based hydrogel combined with human chondrocytes (isolated from osteoarthritis patients) was formulated as bioink-A and the polylactic acid as bioink-B. The bioprinting process was carried out with the REGEMAT V1 bioprinter (Regemat 3D, Granada-Spain) through a IVF. The printing capacity of the bioprinting plus the viability and cell proliferation of bioprinted chondrociytes was evaluated after five weeks by confocal microscopy and Alamar Blue Assay (Biorad). Results showed that the IVF process does not decrease the cell viability of the chondrocytes during the printing process as the cells do not have contact with the thermoplastic at elevated temperatures. The viability and cellular proliferation of the bioprinted artificial 3D cartilage increased after 5 weeks. In conclusion, this study demonstrates the potential use of Regemat V1 for 3D bioprinting of cartilage and the viability of bioprinted chondrocytes in the scaffolds for application in regenerative medicine.

Keywords: cartilage regeneration, bioprinting, bioink, scaffold, chondrocyte

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1316 Ending Communal Conflicts in Africa: The Relevance of Traditional Approaches to Conflict Resolution

Authors: Kindeye Fenta Mekonnen, Alagaw Ababu Kifle

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The failure of international responses to armed conflict to address local preconditions for national stability has recently attracted what has been called the ‘local turn’ in peace building. This ‘local turn’ in peace building amplified a renewed interest in traditional/indigenous methods of conflict resolution, a field that has been hitherto dominated by anthropologists with their focus on the procedures and rituals of such approaches. This notwithstanding, there is still limited empirical work on the relevance of traditional methods of conflict resolution to end localized conflicts vis-à-vis hybrid and modern approaches. The few exceptions to this generally draw their conclusion from very few (almost all successful) cases that make it difficult to judge the validity and cross-case application of their results. This paper seeks to fill these gaps by undertaking a quantitative analysis of the trend and applications of different communal conflict resolution initiatives, their potential to usher in long-term peace, and the extent to which their outcomes are influenced by the intensity and scope of a conflict. The paper makes the following three tentative conclusions. First, traditional mechanisms and traditional actors still dominate the communal conflict resolution landscape, either individually or in combination with other methods. Second, traditional mechanisms of conflict resolution tend to be more successful in ending a conflict and preventing its re-occurrence compared to hybrid and modern arrangements. This notwithstanding and probably due to the scholarly call for local turn in peace building, contemporary communal conflict resolution approaches are becoming less and less reliant on traditional mechanisms alone and (therefore) less effective. Third, there is yet inconclusive evidence on whether hybridization is an asset or a liability in the resolution of communal conflicts and the extent to which this might be mediated by the intensity of a conflict.

Keywords: traditional conflict resolution, hybrid conflict resolution, communal conflict, relevance, conflict intensity

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1315 Diabetes Mellitus and Blood Glucose Variability Increases the 30-day Readmission Rate after Kidney Transplantation

Authors: Harini Chakkera

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Background: Inpatient hyperglycemia is an established independent risk factor among several patient cohorts with hospital readmission. This has not been studied after kidney transplantation. Nearly one-third of patients who have undergone a kidney transplant reportedly experience 30-day readmission. Methods: Data on first-time solitary kidney transplantations were retrieved between September 2015 to December 2018. Information was linked to the electronic health record to determine a diagnosis of diabetes mellitus and extract glucometeric and insulin therapy data. Univariate logistic regression analysis and the XGBoost algorithm were used to predict 30-day readmission. We report the average performance of the models on the testing set on five bootstrapped partitions of the data to ensure statistical significance. Results: The cohort included 1036 patients who received kidney transplantation, and 224 (22%) experienced 30-day readmission. The machine learning algorithm was able to predict 30-day readmission with an average AUC of 77.3% (95% CI 75.30-79.3%). We observed statistically significant differences in the presence of pretransplant diabetes, inpatient-hyperglycemia, inpatient-hypoglycemia, and minimum and maximum glucose values among those with higher 30-day readmission rates. The XGBoost model identified the index admission length of stay, presence of hyper- and hypoglycemia and recipient and donor BMI values as the most predictive risk factors of 30-day readmission. Additionally, significant variations in the therapeutic management of blood glucose by providers were observed. Conclusions: Suboptimal glucose metrics during hospitalization after kidney transplantation is associated with an increased risk for 30-day hospital readmission. Optimizing the hospital blood glucose management, a modifiable factor, after kidney transplantation may reduce the risk of 30-day readmission.

Keywords: kidney, transplant, diabetes, insulin

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1314 Innovative Food Production and Food Consumption Entrepreneurship: a Recipe for Delivering Global Sustainable Goals in South Africa

Authors: Faith Samkange, Juliet Chipumuro, Henry Wanyama

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Business development and entrepreneurship constitute a major part of economic and human development for many countries within the Southern Africa Development Communities (SADC). While a marked increase in entrepreneurship activity has been registered, more than 70% of these business enterprises are still failing particularly in their conceptual years. One of the major reasons for this failure is that project process trends have tended to be fragmented and linear in approach while focusing primarily on isolated articulation of development aspects such as marketing, operations, accounting and human resources management with limited integration. Given the complexity of environmental, economic and human development issues in the SADC region, a multi-disciplinary, transformative, systematic and coordinated approach towards entrepreneurship development may be a more useful approach. This paper develops a proposed conceptual framework for an innovative and sustainable food production and food consumption Agritech entrepreneurship project in the Eastern Cape Province of South Africa based on a systematic review of existing literature. A thematic analysis of the literature reviewed is applied to develop this theoretical contribution to knowledge. The conceptual framework will be tested in a research driven intervention project designed to improve the quality of life for marginalized indigenous African communities by addressing poverty alleviation, unemployment and gender inequality as stipulated in the global sustainable development goals by the United Nations in 2018.

Keywords: innovative entrepreneurship, sustainability, food production and consumption, marginalised communities, poverty alleviation

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1313 A Study on the Microbilogical Profile and Antibiotic Sensitivity Pattern of Bacterial Isolates Causing Urinary Tract Infection in Intensive Care Unit Patients in a Tertiary Care Hospital in Eastern India

Authors: Pampita Chakraborty, Sukumar Mukherjee

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The study was done to determine the microbiological profile and changing pattern of the pathogens causing UTI in the ICU patients. All the patients admitted to the ICU with urinary catheter insertion for more than 48hours were included in the study. Urine samples were collected in a sterile container with aseptic precaution using disposable syringe and was processed as per standards. Antimicrobial susceptibility test was done by Disc Diffusion method as per CLSI guidelines. A total of 100 urine samples were collected from ICU patients, out of which 30% showed significant bacterial growth and 7% showed growth of candida spp. Prevalence of UTI was more in female (73%) than male (27.%). Gram-negative bacilli 26(86.67%) were more common in our study followed by gram-positive cocci 4(13.33%). The most common uropathogens isolated were Escherichia coli 14 (46.67%), followed by Klebsiella spp 7(23.33%), Staphylococcus aureus 4(13.33%), Acinetobacter spp 3(10%), Enterococcus faecalis 1(3.33%) and Pseudomonas aeruginosa 1(3.33%). Most of the Gram-negative bacilli were sensitive to amikacin (80%) and nitrofurantoin (80%), where as all gram-positive organisms were sensitive to Vancomycin. A large number ESBL producers were also observed in this study. The study finding showed that E.coli is the predominant pathogen and has increasing resistance pattern to the commonly used antibiotics. The study proposes that the adherence to antibiotic policy is the key ingredients for successful outcome in ICU patients and also emphasizes that repeated evaluation of microbial characteristics and continuous surveillance of resistant bacteria is required for selection of appropriate antibiotic therapy.

Keywords: antimicrobial sensitivity, intensive care unit, nosocomial infection, urinary tract infection

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1312 Green Synthesis and Characterisation of Gold Nanoparticles from the Stem Bark and Leaves of Khaya Senegalensis and Its Cytotoxicity on MCF7 Cell Lines

Authors: Stephen Daniel Iduh, Evans Chidi Egwin, Oluwatosin Kudirat Shittu

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The process for the development of reliable and eco-friendly metallic Nanoparticles is an important step in the field of Nanotechnology for biomedical application. To achieve this, use of natural sources like biological systems becomes essential. In the present work, extracellular biosynthesis of gold Nanoparticles using aqueous leave and stembark extracts of K. senegalensis has been attempted. The gold Nanoparticles produced were characterized using High Resolution scanning electron microscopy, Ultra Violet–Visible spectroscopy, zeta-sizer Nano, Energy-Dispersive X-ray (EDAX) Spectroscopy and Fourier Transmission Infrared (FTIR) Spectroscopy. The cytotoxicity of the synthesized gold nanoparticles on MCF-7 cell line was evaluated using MTT assay. The result showed a rapid development of Nano size and shaped particles within 5 minutes of reaction with Surface Plasmon Resonance at 520 and 525nm respectively. An average particle size of 20-90nm was confirmed. The amount of the extracts determines the core size of the AuNPs. The core size of the AuNPs decreases as the amount of extract increases and it causes the shift of Surface Plasmon Resonance band. The FTIR confirms the presence of biomolecules serving as reducing and capping agents on the synthesised gold nanoparticles. The MTT assay shows a significant effect of gold nanoparticles which is concentration dependent. This environment-friendly method of biological gold Nanoparticle synthesis has the potential and can be directly applied in cancer therapy.

Keywords: biosynthesis, gold nanoparticles, characterization, calotropis procera, cytotoxicity

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1311 Educational Policies Vis-à-Vis Implementation and Challenges in the Case of Physically Disabled Children in Balochistan, Pakistan

Authors: Mumtaz Ali Baloch

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This article aims at to review the policies and gaps including the socioeconomic and institutional factors that affected the enrollment of disabled children and caused drop-outs. It provides insights to scrutinize the gaps in policies, socioeconomic, and institutional factors with the specific concern in enrollment and drop out of disabled children in Pakistan, and Balochistan in particular. The findings of this study revealed that the old-age centralized policies and a number of socio-economic and institutional factors seemed to have significantly affected the enrollment and quality education in the case of physically disabled children. There were only a few schools functional in entire Balochistan. For example, an entire province (Balochistan) there are only two schools for disabled children, established in Quetta city. In the other 31 districts, an estimated population of 300,000 people of each district there were no schools for the disabled children. The findings of this study revealed that there is a great distinction between the policy and practice in the case of physically disabled children in Quetta, Balochistan. Consequently, such children seemed to have been out of schools. Dropout after the class eighth grade is almost 100%, as there are no high schools available for physically/disabled children, in Balochistan. The concerned organizations and authorities need to develop and ratify specific policies, provide required) facilities to the schools including sufficient budget, streamline the academic planning, and an effective monitoring and evaluation system. Only awareness and motivation could not help in improving the enrollment rate and decreasing the dropout in the case of physically disabled children. There is an urgent need to provide the required facilities to the schools. Almost all students needed assistive equipment, effective physical therapy as well as regular medical facilities. Such measures can improve the enrolment and rehabilitation of children.

Keywords: education policy, practices, physically disabled children, challenges, Balochistan, Pakistan

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1310 Integrating Multi-Sectoral Approaches to Address Gender-Based Violence in Lagos State: Prevalence, Perceptions, and Policy Recommendations

Authors: Lola Vivour-Adeniyi, Oluwatoyosi Abikoye

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Gender-based violence (GBV) is a pervasive issue that demands a nuanced understanding to foster effective solutions. This study, conducted by the Lagos State Domestic and Sexual Violence Agency (DSVA), delves into the heart of Lagos State to uncover the realities of GBV, from the perceptions of its residents to the efficacy of support systems in place. Covering ten local government areas (LGAs) and drawing from a diverse range of demographics—gender, age, marital status, literacy levels, religion, and ethnicity—this research paints a comprehensive picture of GBV's impact. The narrative begins with the voices of the community, revealing a widespread awareness of GBV's multifaceted nature—physical, emotional, psychological, and structural. Through their stories, key drivers such as poverty, low education levels, and substance abuse emerge, illustrating the interconnected factors that sustain GBV. Despite a high level of awareness, there is a significant gap in knowledge about reporting mechanisms, highlighting an urgent need for improved accessibility and information dissemination on support services. Notably, inter-agency collaboration and public awareness campaigns play crucial roles in the community's fight against GBV. This study evaluates these efforts by the Lagos State Government, shedding light on successful educational interventions that have transformed community attitudes. Case studies of these initiatives provide examples of success, demonstrating the power of coordinated action and informed advocacy. In conclusion, the study calls for a robust, multi-sectoral approach—engaging government agencies, civil society organizations, and community stakeholders—to address GBV comprehensively. Recommendations include scaling successful models to other urban centers, enhancing reporting mechanisms for greater accessibility and confidentiality, and investing in ongoing research to refine our understanding of GBV's dynamics with the aim to foster a safer and more inclusive society, tackling the root causes of GBV and improving support for survivors.

Keywords: gender based violence, policy recommendations, public awareness, Iinter agency collaboration

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1309 Psychoanalytic Understanding of the Autistic Self

Authors: Aastha Chaudhry

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This continuous structuring of the ego through the developmental ages, starting with the body, has been understood through various perspectives from the object-relations world. Klein, Ogden, Winnicott to name a few, have been masters at helping mark a trajectory for the self to come to fruition. However, what constitutes those states, those relational structures, the dynamics of transference and the concept of inner objects has been more or less left unexplored in the psychoanalytic developmental theory. In this paper, through the help of a case study, Ogden’s ideas of an autistic contagious position and Kleinian theory of object relations is proposed to visualize a lens that helps to understand the relationship of the autistic self and body and allows us to take a look at object relations through countertransference. With the help of case vignettes, an understanding of experience is seen as dominated in the autistic contagious position with the help of defensive structuring that is not only self-fulfilling and sensorial oriented, but is also a pre symbolic mode of relating to the other. The aim of this clinical, experiential study is to better understand the self-body and the self-other relationships, or the absence thereof, in the autistic world and states. The goal of the study was to find such a relationship between play, body, structuring of experience and an autistic self in these individuals through that. Aim being that psychotherapy is brought to fore in the world of autism. The method was case study with one on one intervention, that was psychodynamically informed and play therapy based. Some of the findings after a year of work with these individuals were that: in the absence of a shared vocabulary, communication in two contrasting individuals happens primarily through the assistance of the body. Somatic countertransference, for instance, is how one can be with someone in a therapeutic relationship – and with autistic adolescents it is a further complicated relationship. With a mind somewhere in infanthood, and body experiencing adulthood, it becomes a challenge for the therapist to meet the client where they are. With pre-verbal states, play becomes such a potential space where two individuals could meet – a safe ground for forces to be contained. Play, then, becomes a mode of communication with such a population.

Keywords: autism, psychoanalytic, play, self

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1308 A Literature Review on the Effect of Financial Knowledge toward Corporate Growth: The Important Role of Financial Risk Attitude

Authors: Risna Wijayanti, Sumiati, Hanif Iswari

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This study aims to analyze the role of financial risk attitude as a mediation between financial knowledge and business growth. The ability of human resources in managing capital (financial literacy) can be a major milestone for a company's business to grow and build its competitive advantage. This study analyzed the important role of financial risk attitude in bringing about financial knowledge on corporate growth. There have been many discussions arguing that financial knowledge is one of the main abilities of corporate managers in determining the success of managing a company. However, a contrary argument of other scholars also enlightened that financial knowledge did not have a significant influence on corporate growth. This study used literatures' review to analyze whether there is another variable that can mediate the effect of financial knowledge toward corporate growth. Research mapping was conducted to analyze the concept of risk tolerance. This concept was related to people's risk aversion effects when making a decision under risk and the role of financial knowledge on changes in financial income. Understanding and managing risks and investments are complicated, in particular for corporate managers, who are always demanded to maintain their corporate growth. Substantial financial knowledge is extremely needed to identify and take accurate information for corporate financial decision-making. By reviewing several literature, this study hypothesized that financial knowledge of corporate managers would be meaningless without manager's courage to bear risks for taking favorable business opportunities. Therefore, the level of risk aversion from corporate managers will determine corporate action, which is a reflection of corporate-level investment behavior leading to attain corporate success or failure for achieving the company's expected growth rate.

Keywords: financial knowledge, financial risk attitude, corporate growth, risk tolerance

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1307 Long-Term Cohort of Patients with Beta Thalassemia; Prevailing Role of Serum Ferritin Levels in Hypocalcemia and Growth Retardation

Authors: Shervin Rashidinia, Sara Shahmoradi, Seyyed Shahin Eftekhari, Mohsen Talebizadeh, Mohammad Saleh Sadeghi

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Background: Beta-thalassemia Major (BTM) is a kind of hereditary hemolytic anemia which depended on regular monthly blood transfusion. However, iron deposition into the organs leads to multi-organ damage. The present study is the first study which aimed to evaluate the average of five-years serum ferritin level and compared by the prevalence of short stature and hypocalcemia. Materials/Methods: A cross-sectional retrospective study which a total of 140 patients with beta-thalassemia who were referred to Qom Thalassemia Clinic between February 2011 and July 2016 were enrolled to be reviewed. The exclusion criteria were consisting of incomplete medical records, diagnosis less than 2-years-ago and the blood transfusion less than every 4 weeks. The data including age, gender, weight, height, age of initial blood transfusion, age of initial chelation therapy, ferritin, and calcium were collected and analysis by SPSS version 24. Results: A total of 140 patients were enrolled. Of them, 75 (53.4%) were female. The mean age of the patients was 13.4±4.6 years.The mean age of initial diagnosis was 20.2±7.4 months. Hypocalcemia and short stature were occurred in 41 (29.3%) and 37 (26.4%) patients, respectively. The mean five-years serum ferritin level was significantly higher in the patients with short stature and hypocalcemia (P<0.0001). However, rise in serum ferritin level significantly increases the risk of short-stature and hypocalcemia (1.0004- and 1.0029 fold, respectively). Conclusion: We demonstrated that prevalence of short stature and hypocalcemia were significantly higher in the BTM.However, ferritin significantly increases the risk of short stature and hypocalcemia.

Keywords: beta-thalassemia, ferritin, growth retardation, hypocalcemia

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1306 MOVIDA.polis: Physical Activity mHealth Based Platform

Authors: Rui Fonseca-Pinto, Emanuel Silva, Rui Rijo, Ricardo Martinho, Bruno Carreira

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The sedentary lifestyle is associated to the development of chronic noncommunicable diseases (obesity, hypertension, Diabetes Mellitus Type 2) and the World Health Organization, given the evidence that physical activity is determinant for individual and collective health, defined the Physical Activity Level (PAL) as a vital signal. Strategies for increasing the practice of physical activity in all age groups have emerged from the various social organizations (municipalities, universities, health organizations, companies, social groups) by increasingly developing innovative strategies to promote motivation strategies and conditions to the practice of physical activity. The adaptation of cities to the new paradigms of sustainable mobility has provided the adaptation of urban training circles and mobilized citizens to combat sedentarism. This adaptation has accompanied the technological evolution and makes possible the use of mobile technology to monitor outdoor training programs and also, through the network connection (IoT), use the training data to make personalized recommendations. This work presents a physical activity counseling platform to be used in the physical maintenance circuits of urban centers, the MOVIDA.polis. The platform consists of a back office for the management of circuits and training stations, and for a mobile application for monitoring the user performance during workouts. Using a QRcode, each training station is recognized by the App and based on the individual performance records (effort perception, heart rate variation) artificial intelligence algorithms are used to make a new personalized recommendation. The results presented in this work were obtained during the proof of concept phase, which was carried out in the PolisLeiria training circuit in the city of Leiria (Portugal). It was possible to verify the increase in adherence to the practice of physical activity, as well as to decrease the interval between training days. Moreover, the AI-based recommendation acts as a partner in the training and an additional challenging factor. The platform is ready to be used by other municipalities in order to reduce the levels of sedentarism and approach the weekly goal of 150 minutes of moderate physical activity. Acknowledgments: This work was supported by Fundação para a Ciência e Tecnologia FCT- Portugal and CENTRO2020 under the scope of MOVIDA project: 02/SAICT/2016 – 23878.

Keywords: physical activity, mHealth, urban training circuits, health promotion

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1305 Expanding the Therapeutic Utility of Curcumin

Authors: Azza H. El-Medany, Hanan H. Hagar, Omnia A. Nayel, Jamila H. El-Medany

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In search for drugs that can target cancer cell micro-environment in as much as being able to halt malignant cellular transformation, the natural dietary phytochemical curcumin was currently assessed in DMH-induced colorectal cancer rat model. The study enrolled 50 animals divided into a control group (n=10) and DMH-induced colorectal cancer control group (n=20) (20mg/kg-body weight for 28 weeks) versus curcumin-treated group (n=20) (160 mg/kg suspension daily oral for further 8 weeks). Treatment by curcumin succeeded to significantly decrease the percent of ACF and tended to normalize back the histological changes retrieved in adenomatous and stromal cells induced by DMH. The drug also significantly elevated GSH and significantly reduced most of the accompanying biochemical elevations (namely MDA, TNF-α, TGF-β and COX2) observed in colonic carcinomatous tissue, induced by DMH, thus succeeding to revert that of MDA, COX2 and TGF-β back to near normal as justified by being non-significantly altered as compared to normal controls. The only exception was PAF that was insignificantly altered by the drug. When taken together, it could be concluded that curcumin possess the potentiality to halt some of the orchestrated cross-talk between cancerous transformation and its micro-environmental niche that contributes to cancer initiation, progression and metastasis in this experimental cancer colon model. Envisioning these merits to a drug with already known safety preferentiality, awaits final results of current ongoing clinical trials, before curcumin can be added to the new therapeutic armamentarium of anticancer therapy.

Keywords: curcumin, dimethyl hydralazine, aberrant crypt foci, malondialdehyde, reduced glutathione, cyclooxygenase-2, tumour necrosis factor-alpha, transforming growth factor-beta, platelet activating factor

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1304 Prevalence and Pattern of Abnormalities Pap Smear Examination in Women Attending Fertility Clinic in Uniosun Teaching Hospitals, Osun State, Nigeria

Authors: Ayodeji Blessing Ajileye

Abstract:

Introduction: Infertility is described as failure to conceive after one year of unprotected sexual intercourse. One of the causes of female infertility is caused by cervical abnormalities which may be due to bacterial and parasitological infections, hormonal imbalances of Lentinizing hormone, follicular stimulating hormone, oestrogen hormone and progesterone hormone. Aim of the Study: This study aimed to determine the prevalence and pattern of abnormal cervical Pap smear in women with infertility attending fertility clinics at Uniosun Teaching Hospitals Osogbo, Osun State. Methods: This study was conducted at the fertility clinic of University of Osun Teaching Hospital, Osogbo, Osun State. The study population comprised of 50 infertile women and 50 fertile women who are attending the gynecology clinic of University of Osun Teaching Hospital, Osogbo, Osun State. Questionnaire was used to obtain relevant data. Cervical sample was collected using Ayre’s spatula, two smears were prepared and stained with Papanicolaous and H&E staining techniques. Results were analyzed using frequency table. Results: This study observed the prevalence of abnormal cervical smear among infertility women to be 16(30%), while only 03(6%) were observed among the control group (fertile women). Atypical squamous cells of undetermined significance have the highest abnormalities observed in this study with 30%, about 28% of the Pap smear results were negative for inflammation, while total inflammation observed was 72% among the infertility women. Conclusion: This study concluded that abnormal pap smears in this study is significantly more often in women with infertility as compared with fertile women.

Keywords: infertility, oestrogen hormone, pap smears, progesterone hormone

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1303 Improving Efficiency and Effectiveness of FMEA Studies

Authors: Joshua Loiselle

Abstract:

This paper discusses the challenges engineering teams face in conducting Failure Modes and Effects Analysis (FMEA) studies. This paper focuses on the specific topic of improving the efficiency and effectiveness of FMEA studies. Modern economic needs and increased business competition require engineers to constantly develop newer and better solutions within shorter timeframes and tighter margins. In addition, documentation requirements for meeting standards/regulatory compliance and customer needs are becoming increasingly complex and verbose. Managing open actions and continuous improvement activities across all projects, product variations, and processes in addition to daily engineering tasks is cumbersome, time consuming, and is susceptible to errors, omissions, and non-conformances. FMEA studies are proven methods for improving products and processes while subsequently reducing engineering workload and improving machine and resource availability through a pre-emptive, systematic approach of identifying, analyzing, and improving high-risk components. If implemented correctly, FMEA studies significantly reduce costs and improve productivity. However, the value of an effective FMEA is often shrouded by a lack of clarity and structure, misconceptions, and previous experiences and, as such, FMEA studies are frequently grouped with the other required information and documented retrospectively in preparation of customer requirements or audits. Performing studies in this way only adds cost to a project and perpetuates the misnomer that FMEA studies are not value-added activities. This paper discusses the benefits of effective FMEA studies, the challenges related to conducting FMEA studies, best practices for efficiently overcoming challenges via structure and automation, and the benefits of implementing those practices.

Keywords: FMEA, quality, APQP, PPAP

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1302 Evaluation of Current Methods in Modelling and Analysis of Track with Jointed Rails

Authors: Hossein Askarinejad, Manicka Dhanasekar

Abstract:

In railway tracks, two adjacent rails are either welded or connected using bolted jointbars. In recent years the number of bolted rail joints is reduced by introduction of longer rail sections and by welding the rails at location of some joints. However, significant number of bolted rail joints remains in railways around the world as they are required to allow for rail thermal expansion or to provide electrical insulation in some sections of track. Regardless of the quality and integrity of the jointbar and bolt connections, the bending stiffness of jointbars is much lower than the rail generating large deflections under the train wheels. In addition, the gap or surface discontinuity on the rail running surface leads to generation of high wheel-rail impact force at the joint gap. These fundamental weaknesses have caused high rate of failure in track components at location of rail joints resulting in significant economic and safety issues in railways. The mechanical behavior of railway track at location of joints has not been fully understood due to various structural and material complexities. Although there have been some improvements in the methods for analysis of track at jointed rails in recent years, there are still uncertainties concerning the accuracy and reliability of the current methods. In this paper the current methods in analysis of track with a rail joint are critically evaluated and the new advances and recent research outcomes in this area are discussed. This research is part of a large granted project on rail joints which was defined by Cooperative Research Centre (CRC) for Rail Innovation with supports from Australian Rail Track Corporation (ARTC) and Queensland Rail (QR).

Keywords: jointed rails, railway mechanics, track dynamics, wheel-rail interaction

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1301 Mutation Analysis of the ATP7B Gene in 43 Vietnamese Wilson’s Disease Patients

Authors: Huong M. T. Nguyen, Hoa A. P. Nguyen, Mai P. T. Nguyen, Ngoc D. Ngo, Van T. Ta, Hai T. Le, Chi V. Phan

Abstract:

Wilson’s disease (WD) is an autosomal recessive disorder of the copper metabolism, which is caused by a mutation in the copper-transporting P-type ATPase (ATP7B). The mechanism of this disease is the failure of hepatic excretion of copper to bile, and leads to copper deposits in the liver and other organs. The ATP7B gene is located on the long arm of chromosome 13 (13q14.3). This study aimed to investigate the gene mutation in the Vietnamese patients with WD, and make a presymptomatic diagnosis for their familial members. Forty-three WD patients and their 65 siblings were identified as having ATP7B gene mutations. Genomic DNA was extracted from peripheral blood samples; 21 exons and exon-intron boundaries of the ATP7B gene were analyzed by direct sequencing. We recognized four mutations ([R723=; H724Tfs*34], V1042Cfs*79, D1027H, and IVS6+3A>G) in the sum of 20 detectable mutations, accounting for 87.2% of the total. Mutation S105* was determined to have a high rate (32.6%) in this study. The hotspot regions of ATP7B were found at exons 2, 16, and 8, and intron 14, in 39.6 %, 11.6 %, 9.3%, and 7 % of patients, respectively. Among nine homozygote/compound heterozygote siblings of the patients with WD, three individuals were determined as asymptomatic by screening mutations of the probands. They would begin treatment after diagnosis. In conclusion, 20 different mutations were detected in 43 WD patients. Of this number, four novel mutations were explored, including [R723=; H724Tfs*34], V1042Cfs*79, D1027H, and IVS6+3A>G. The mutation S105* is the most prevalent and has been considered as a biomarker that can be used in a rapid detection assay for diagnosis of WD patients. Exons 2, 8, and 16, and intron 14 should be screened initially for WD patients in Vietnam. Based on risk profile for WD, genetic testing for presymptomatic patients is also useful in diagnosis and treatment.

Keywords: ATP7B gene, mutation detection, presymptomatic diagnosis, Vietnamese Wilson’s disease

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1300 The Impact of Child Maltreatment on School Performance in Saudi Arabia

Authors: Al Muneef Maha, Al Tamimi Dana

Abstract:

Introduction: Child maltreatment was proven to negatively impact children’s and adolescent’s academic performances; showing less academic achievements, problems completing homework assignments, and was marginally associated with being frequently absent from school (1). Objectives: To identify the impact of child maltreatment on school performance among adolescents in National Guard Schools. Materials and Methods: The study was conducted at National Guard schools in Riyadh. Students aged 12-19 years were invited to participate. Participants (N=674) completed the survey instrument which included demographics, exposure to different types of abuse, and overall level of academic performance. Results: Participants’ mean age was 15.6±1.6 years and males (53%). Ninety-five percent lived with both parents, 2% with single parent, and 3% with step parents. Four percent lived with alcoholic parents or guardians, and 7% have lived with a family member who has been arrested or imprisoned. Poor performance (failure in exam) were more likely among the students who lived with alcoholics vs. non-alcoholics (33% vs. 11%, p<0.01), imprisoned family member vs. non-imprisoned (26% vs. 11%, p<0.01), psychologically abused vs. not abused (21% vs. 10%, p<0.01), physically abused vs. not abused (19% vs. 9%, p<0.01). Predisposing factors to poor performance in school included living with alcoholic parents or guardians (OR=2.8, CI=1.1-6.7), psychologically abused (OR=1.7, CI=1.0-3.0), and physically abused (OR=1.7, CI=1.0-2.8). Conclusions: The results suggest that child maltreatment may adversely impact school performance. These findings highlight the importance of increasing the awareness about the impact of child maltreatment on school performance among families, schools, and the community. Recommend to the Ministry of Education to consider counseling of students with poor performance due to adverse child experiences or maltreatment.

Keywords: child abuse, child maltreatment, school performance, Saudi Arabia

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1299 Effect of Various Durations of Type 2 Diabetes on Muscle Performance

Authors: Santosh Kumar Yadav, Shobha Keswani, Nishat Quddus, Sohrab Ahmad Khan, Zuheb Ahmad Shiddiqui, Varsha Chorsiya

Abstract:

Introduction: Early onset diabetes is more aggressive than the late onset diabetes. Diabetic individual has a greater spectrum of life period to suffer from its damage, complications, and long-term disability. This study aimed at assessing knee joint muscle performance under various durations of diabetes. Method and Materials: A total of 30 diabetic subjects (18 male and 12 females) without diabetic neuropathy were included for the study. They were divided into three groups with 5 years, 10 years and 15 years of duration of disease each. Muscle performance was evaluated through strength and flexibility. Peak torque for quadriceps muscle was measured using isokinetic dynamometer. Flexibility for quadriceps and hamstring muscles were measured through Ducan’s Elys test and 90/90 test. Results: The result showed significant difference in muscle strength (p<0.05), flexibility (p≤0.05) between groups. Discussion: Optimal muscle strength and flexibility are vital for musculoskeletal health and functional independence. Conclusion: The reduced muscle performance and functional impairment in nonneuropathic diabetic patients suggest that other mechanism besides neuropathy that contribute to altered biomechanics. These findings of this study project early management of these altered parameters through disease-specific physical therapy and assessment-based intervention. Clinical Relevance: Managing disability is more costly than managing disease. Prompt and timely identification and management strategy can dramatically reduce the cost of care for diabetic patients.

Keywords: muscle flexibility, muscle performance, muscle torque, type 2 diabetes

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1298 A Service-Learning Experience in the Subject of Adult Nursing

Authors: Eva de Mingo-Fernández, Lourdes Rubio Rico, Carmen Ortega-Segura, Montserrat Querol-García, Raúl González-Jauregui

Abstract:

Today, one of the great challenges that the university faces is to get closer to society and transfer knowledge. The competency-based training approach favours a continuous interaction between practice and theory, which is why it is essential to establish real experiences with reflection and debate and to contrast them with personal and professional knowledge. Service-learning (SL) consists of an integration of academic learning with service in the community, which enables teachers to transfer knowledge with social value and students to be trained on the basis of experience of real needs and problems with the aim of solving them. SLE combines research, teaching, and social value knowledge transfer with the real social needs and problems of a community. Goal: The objective of this study was to design, implement, and evaluate a service-learning program in the subject of adult nursing for second-year nursing students. Methodology: After establishing collaboration with eight associations of people with different pathologies, the students were divided into eight groups, and each group was assigned an association. The groups were made up of 10-12 students. The associations willing to participate were for the following conditions: diabetes, multiple sclerosis, cancer, inflammatory bowel disease, fibromyalgia, heart, lung, and kidney diseases. The methodological design consisting of 5 activities was then applied. Three activities address personal and individual reflections, where the student initially describes what they think it is like to live with a certain disease. They then express their reflections resulting from an interview conducted by peers, in person or online, with a person living with this particular condition, and after sharing the results of their reflections with the rest of the group, they make an oral presentation in which they present their findings to the other students. This is followed by a service task in which the students collaborate in different activities of the association, and finally, a third individual reflection is carried out in which the students express their experience of collaboration. The evaluation of this activity is carried out by means of a rubric for both the reflections and the presentation. It should be noted that the oral presentation is evaluated both by the rest of the classmates and by the teachers. Results: The evaluation of the activity, given by the students, is 7.80/10, commenting that the experience is positive and brings them closer to the reality of the people and the area.

Keywords: academic learning integration, knowledge transfer, service-learning, teaching methodology

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1297 Seepage Analysis through Earth Dam Embankment: Case Study of Batu Dam

Authors: Larifah Mohd Sidik, Anuar Kasa

Abstract:

In recent years, the demands for raw water are increasing along with the growth of the economy and population. Hence, the need for the construction and operation of dams is one of the solutions for the management of water resources problems. The stability of the embankment should be taken into consideration to evaluate the safety of retaining water. The safety of the dam is mostly based on numerous measurable components, for instance, seepage flowrate, pore water pressure and deformation of the embankment. Seepage and slope stability is the primary and most important reason to ascertain the overall safety behavior of the dams. This research study was conducted to evaluate static condition seepage and slope stability performances of Batu dam which is located in Kuala Lumpur capital city. The numerical solution Geostudio-2012 software was employed to analyse the seepage using finite element method, SEEP/W and slope stability using limit equilibrium method, SLOPE/W for three different cases of reservoir level operations; normal and flooded condition. Results of seepage analysis using SEEP/W were utilized as parental input for the analysis of SLOPE/W. Sensitivity analysis on hydraulic conductivity of material was done and calibrated to minimize the relative error of simulation SEEP/W, where the comparison observed field data and predicted value were also carried out. In seepage analysis, such as leakage flow rate, pore water distribution and location of a phreatic line are determined using the SEEP/W. The result of seepage analysis shows the clay core effectively lowered the phreatic surface and no piping failure is shown in the result. Hence, the total seepage flux was acceptable and within the permissible limit.

Keywords: earth dam, dam safety, seepage, slope stability, pore water pressure

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1296 Gas Monitoring and Soil Control at the Natural Gas Storage Site (Minerbio, Italy)

Authors: Ana Maria Carmen Ilie, Carmela Vaccaro

Abstract:

Gas migration through wellbore failure, in particular from abandoned wells, is repeatedly identified as the highest risk mechanism. The vadose zone was subject to monitoring system close to the wellbore in Minerbio, methane storage site. The new technology has been well-developed and used with the purpose to provide reliable estimates of leakage parameters. Of these techniques, soil flux sampling at the soil surface, via the accumulation chamber method and soil flux sampling at the depths of 100cm below the ground surface, have been an important technique for characterizing the gas concentrations at the gas storage site. We present results of soil Radon Bq/m3, CO2%, CH4% and O2% concentration gases. Measurements have been taken for radon concentrations with an Durridge RAD7 Company, Inc., USA, instrument. We used for air and soil quality an Biogas ETG instrument monitoring system, with NDIR CO2, CH4 gas sensor and electrochemical O2 gas sensor. The measurements started in September-October 2015, where no outliers have been identified. The measurements have continued in March-April-July-August-September 2016, almost at the same time in the same place around the gas storage site, values measured 15 minutes for each sampling, to determine their concentration, their distribution and to understand the relationship among gases and atmospheric conditions. At a depth of 100 cm, the maximum soil radon gas concentrations were found to be 1770 ±±582 Bq/m3, the soil consists of 64.31% sand, 20.75% silt and 14.94% clay, and with 0.526 ppm of Uranium. The maximum concentration (September 2016), in soil at 100cm below the ground surface, with 83% sand, 8.96% silt and 7.89% clay, was about 0.06% CH4, and in atmosphere 0.06% CH4 at 40°C (T). In the other months the values have been on the range of 0.01% to 0.03% CH4. Since we did not have outliers in the gas storage site, soil-gas samples for isotopic analysis have not been done.

Keywords: leakage gas monitoring, lithology, soil gas, methane

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1295 Directly Observed Treatment Short-Course (DOTS) for TB Control Program: A Ten Years Experience

Authors: Solomon Sisay, Belete Mengistu, Woldargay Erku, Desalegne Woldeyohannes

Abstract:

Background: Tuberculosis is still the leading cause of illness in the world which accounted for 2.5% of the global burden of disease, and 25% of all avoidable deaths in developing countries. Objectives: The aim of study was to assess impact of DOTS strategy on tuberculosis case finding and treatment outcome in Gambella Regional State, Ethiopia from 2003 up to 2012 and from 2002 up to 2011, respectively. Methods: Health facility-based retrospective study was conducted. Data were collected and reported in quarterly basis using WHO reporting format for TB case finding and treatment outcome from all DOTS implementing health facilities in all zones of the region to Federal Ministry of Health. Results: A total of 10024 all form of TB cases had been registered between the periods from 2003 up to 2012. Of them, 4100 (40.9%) were smear-positive pulmonary TB, 3164 (31.6%) were smear-negative pulmonary TB and 2760 (27.5%) had extra-pulmonary TB. Case detection rate of smear-positive pulmonary TB had increased from 31.7% to 46.5% from the total TB cases and treatment success rate increased from 13% to 92% with average mean value of being 40.9% (SD= 0.1) and 55.7% (SD=0.28), respectively for the specified year periods. Moreover, the average values of treatment defaulter and treatment failure rates were 4.2% and 0.3%, respectively. Conclusion: It is possible to achieve the recommended WHO target which is 70% of CDR for smear-positive pulmonary TB, and 85% of TSR as it was already been fulfilled the targets for treatments more than 85% from 2009 up to 2011 in the region. However, it requires strong efforts to enhance case detection rate of 40.9% for smear-positive pulmonary TB through implementing alternative case finding strategies.

Keywords: Gambella Region, case detection rate, directly observed treatment short-course, treatment success rate, tuberculosis

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1294 Design and Creation of a BCI Videogame for Training and Measure of Sustained Attention in Children with ADHD

Authors: John E. Muñoz, Jose F. Lopez, David S. Lopez

Abstract:

Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that affects 1 out of 5 Colombian children, converting into a real public health problem in the country. Conventional treatments such as medication and neuropsychological therapy have been proved to be insufficient in order to decrease high incidence levels of ADHD in the principal Colombian cities. This work demonstrates a design and development of a videogame that uses a brain computer interface not only to serve as an input device but also as a tool to monitor neurophysiologic signal. The video game named “The Harvest Challenge” puts a cultural scene of a Colombian coffee grower in its context, where a player can use his/her avatar in three mini games created in order to reinforce four fundamental aspects: i) waiting ability, ii) planning ability, iii) ability to follow instructions and iv) ability to achieve objectives. The details of this collaborative designing process of the multimedia tool according to the exact clinic necessities and the description of interaction proposals are presented through the mental stages of attention and relaxation. The final videogame is presented as a tool for sustained attention training in children with ADHD using as an action mechanism the neuromodulation of Beta and Theta waves through an electrode located in the central part of the front lobe of the brain. The processing of an electroencephalographic signal is produced automatically inside the videogame allowing to generate a report of the theta/beta ratio evolution - a biological marker, which has been demonstrated to be a sufficient measure to discriminate of children with deficit and without.

Keywords: BCI, neuromodulation, ADHD, videogame, neurofeedback, theta/beta ratio

Procedia PDF Downloads 355