Search results for: Qajar period
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5662

Search results for: Qajar period

1522 Cost-Effectiveness Analysis of the Use of COBLATION™ Knee Chondroplasty versus Mechanical Debridement in German Patients

Authors: Ayoade Adeyemi, Leo Nherera, Paul Trueman, Antje Emmermann

Abstract:

Background and objectives: Radiofrequency (RF) generated plasma chondroplasty is considered a promising treatment alternative to mechanical debridement (MD) with a shaver. The aim of the study was to perform a cost-effectiveness analysis comparing costs and outcomes following COBLATION chondroplasty versus mechanical debridement in patients with knee pain associated with a medial meniscus tear and idiopathic ICRS grade III focal lesion of the medial femoral condyle from a payer perspective. Methods: A decision-analytic model was developed comparing economic and clinical outcomes between the two treatment options in German patients following knee chondroplasty. Revision rates based on the frequency of repeat arthroscopy, osteotomy and conversion to total knee replacement, reimbursement costs and outcomes data over a 4-year time horizon were extracted from published literature. One-way sensitivity analyses were conducted to assess uncertainties around model parameters. Threshold analysis determined the revision rate at which model results change. All costs were reported in 2016 euros, future costs were discounted at a 3% annual rate. Results: Over a 4 year period, COBLATION chondroplasty resulted in an overall net saving cost of €461 due to a lower revision rate of 14% compared to 48% with MD. Threshold analysis showed that both options were associated with comparable costs if COBLATION revision rate was assumed to increase up to 23%. The initial procedure costs for COBLATION were higher compared to MD and outcome scores were significantly improved at 1 and 4 years post-operation versus MD. Conclusion: The analysis shows that COBLATION chondroplasty is a cost-effective option compared to mechanical debridement in the treatment of patients with a medial meniscus tear and idiopathic ICRS grade III defect of the medial femoral condyle.

Keywords: COBLATION, cost-effectiveness, knee chondroplasty, mechanical debridement

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1521 Identification and Antibiotic Resistance Rates of Proteus Mirabilis Strains from Various Clinical Specimens in a University Hospital, 2013-2015

Authors: Recep Keşli, Gülşah Aşık, Cengiz Demir, Onur Türkyılmaz

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Objective: Proteus mirabilis (P. mirabilis) is one of Gram-negative pathogens in human and it causes urinary tract and nosocomial infections. P. mirabilis is susceptible to β-lactams, aminoglycosides, fluoroquinolones, and trimethoprim/sulfamethoxazole. It was aimed to investigate the resistance status to antimicrobial agents of Proteus mirabilis strains produced from samples sent to Afyon Kocatepe University, ANS Research and Practice Hospital, Microbiology Laboratory from different clinics and polyclinics during the period of 24 months. Methods: Between October 2013 and September 2015, a total of 30 Proteus were isolated from clinical samples of patients were hospitalized in intensive care units and in various departments of Afyon Kocatepe University, ANS Research and Practice Hospital. Identification of the bacteria was determined by conventional methods and VITEK 2 system (bioMérieux, France) was used additionally. Antibacterial susceptibility tests were performed by Kirby Bauer disc (Oxoid, Hempshire, England) diffusion method following the recommendations of CLSI. Results: Of the total 30 Proteus strains isolated from clinical samples, 19 from urine, 7 from wound, 4 from tracheal aspiration materials were isolated. Antimicrobial resistant for these strains were determined to 24,3% for meropenem, 26.2% for imipenem, 20.2% for amikacin 10.5% for cefepim, 33.3% for ciprofloxacin and levofloxacine, 31.6% for ceftazidime, 20% for ceftriaxone, 15.2% for gentamicin and 26.6% for amoxicillin-clavulanate, 26.2% trimethoprim-sulfamethoxale. Conclusion: In the present study, the highest number of clinical isolates of P. mirabilis were isolated from urine (63,3%), followed by the others (36,6%). The distribution of samples P. mirabilis strains to the clinics were as fallows; 16,8% intensive care unit (ICU), 29,9% polyclinics, 53,3% hospital service units The most effective antibiotic on the total of strains were found to be cefepim, the least effective antibiotics on the total of strains were found to be trimethoprim-sulfamethoxale.

Keywords: proteus mirabilis, antibiotic resistance, intensive care unit, Proteus spp.

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1520 Impact of Dietary Rumen Protected Choline on Transition Dairy Cows’ Productive Performance

Authors: Mohamed Ahmed Tony, Fayez Abaza

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The effects of a dietary supplement of rumen-protected choline on feed intake, milk yield, milk composition and some blood metabolites were evaluated in transition dairy cows. Forty multiparous cows were blocked into 20 pairs and then randomly allocated to either one of 2 treatments. The treatments were supplementation either with or without (control) rumen-protected choline. Treatments were applied from 2 weeks before and until 8 weeks after calving. Both groups received the same basal diet as total mixed ration. Additionally, 50 g of a rumen-protected choline supplement (25% rumen protected choline chloride) was added individually in the feed. Individual feed intake, milk yield, and body weight were recorded daily. Milk samples were analyzed weekly for fat, protein, and lactose content. Blood was sampled at week 2 before calving, d 1, d 4, d 7, d 10, week 2, week 3, and week 8 after calving. Glucose, triglycerids, nonesterified fatty acids, and β-hydroxybutyric acid in blood were analysed. The results revealed that choline supplementation increased DM intake from 16.5 to 18.0 kg/d and, hence, net energy intake from 99.2 to 120.5 MJ/d at the intercept of the lactation curve at 1 day in milk. Choline supplementation had no effect on milk yield, milk fat yield, or lactose yield. Milk protein yield was increased from 1.11 to 1.22 kg/d at the intercept of the lactation curve. Choline supplementation was associated with decreased milk fat concentration at the intercept of the lactation curve at 1 day in milking, but the effect of choline on milk fat concentration gradually decreased as lactation progressed. Choline supplementation decreased the concentration of blood triglycerids during the first 4 wk after parturition. Choline supplementation had no effect on energy-corrected milk yield, energy balance, body weight and body condition score. Results from this study suggest that fat metabolism in periparturient dairy cows is improved by choline supplementation during the transition period and this may potentially decrease the risk for metabolic disorders in the periparturient dairy cow.

Keywords: choline, dairy cattle, transition cow, triglycerids

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1519 A Quasi-Experimental Study of the Impact of 5Es Instructional Model on Students' Mathematics Achievement in Northern Province, Rwanda

Authors: Emmanuel Iyamuremye, Jean François Maniriho, Irenee Ndayambaje

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Mathematics is the foundational enabling discipline that underpins science, technology, and engineering disciplines. Science, technology, engineering, and mathematics (STEM) subjects are foreseen as the engine for socio-economic transformation. Rwanda has done reforms in education aiming at empowering and preparing students for the real world job by providing career pathways in science, technology, engineering, and mathematics related fields. While that considered so, the performance in mathematics has remained deplorable in both formative and national examinations. Therefore, this paper aims at exploring the extent to which the engage, explore, explain, elaborate and evaluate (5Es) instructional model contributing towards students’ achievement in mathematics. The present study adopted the pre-test, post-test non-equivalent control group quasi-experimental design. The 5Es instructional model was applied to the experimental group while the control group received instruction with the conventional teaching method for eight weeks. One research-made instrument, mathematics achievement test (MAT), was used for data collection. A pre-test was given to students before the intervention to make sure that both groups have equivalent characteristics. At the end of the experimental period, the two groups have undergone a post-test to ascertain the contribution of the 5Es instructional model. Descriptive statistics and analysis of covariance (ANCOVA) were used for the analysis of the study. For determining the improvement in mathematics, Hakes methods of calculating gain were used to analyze the pre-test and post-test scores. Results showed that students exposed to 5Es instructional model achieved significantly better performance in mathematics than students instructed using the conventional teaching method. It was also found that 5Es instructional model made lessons more interesting, easy and created friendship among students. Thus, 5Es instructional model was recommended to be adopted as a close substitute to the conventional teaching method in teaching mathematics in lower secondary schools in Rwanda.

Keywords: 5Es instructional model, achievement, conventional teaching method, mathematics

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1518 The Optimal Order Policy for the Newsvendor Model under Worker Learning

Authors: Sunantha Teyarachakul

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We consider the worker-learning Newsvendor Model, under the case of lost-sales for unmet demand, with the research objective of proposing the cost-minimization order policy and lot size, scheduled to arrive at the beginning of the selling-period. In general, the New Vendor Model is used to find the optimal order quantity for the perishable items such as fashionable products or those with seasonal demand or short-life cycles. Technically, it is used when the product demand is stochastic and available for the single selling-season, and when there is only a one time opportunity for the vendor to purchase, with possibly of long ordering lead-times. Our work differs from the classical Newsvendor Model in that we incorporate the human factor (specifically worker learning) and its influence over the costs of processing units into the model. We describe this by using the well-known Wright’s Learning Curve. Most of the assumptions of the classical New Vendor Model are still maintained in our work, such as the constant per-unit cost of leftover and shortage, the zero initial inventory, as well as the continuous time. Our problem is challenging in the way that the best order quantity in the classical model, which is balancing the over-stocking and under-stocking costs, is no longer optimal. Specifically, when adding the cost-saving from worker learning to such expected total cost, the convexity of the cost function will likely not be maintained. This has called for a new way in determining the optimal order policy. In response to such challenges, we found a number of characteristics related to the expected cost function and its derivatives, which we then used in formulating the optimal ordering policy. Examples of such characteristics are; the optimal order quantity exists and is unique if the demand follows a Uniform Distribution; if the demand follows the Beta Distribution with some specific properties of its parameters, the second derivative of the expected cost function has at most two roots; and there exists the specific level of lot size that satisfies the first order condition. Our research results could be helpful for analysis of supply chain coordination and of the periodic review system for similar problems.

Keywords: inventory management, Newsvendor model, order policy, worker learning

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1517 Model Based Design and Development of Horticultural Produce Crate from Bamboo

Authors: Sisay Wondmagegn Molla, Mulugeta Admasu Delele, Tadelle Nigusu Mekonen

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It is common to observe quality deterioration and mechanical injury of horticulture products as a result of suboptimal design and handling of the packaging systems. Society uses the old and primitive way of handling horticulture products, which is produced through trial and error This method is known to have many limitations on quality, environmental pollution, labor and cost. Ethiopia stands first in bamboo resources in Africa, which is 67 % of the African and 7 % of the world's bamboo resources. The purpose of this project was to design and develop bamboo-based ventilated horticultural produce crates using validated computational fluid dynamics (CFD). The model was used to predict the airflow and temperature distribution inside the loaded crate. The study included: sizing, collection of the thermo-physical properties, and designing and developing a CFD model of the bamboo-based ventilated horticultural crate. The designed crate (40×30×25cm) had a capacity of about 18 kg, and cold air temperature (130C) was used for cooling the fruit. Airflow in the loaded crate is far from uniform. There is a relatively high-velocity flow at the top, near inlet and near outlet sections, and a relatively low airflow near the center of the loaded crate. The predicted velocity variation within the bulk of the produce was relatively large, it was in the range of 0.04-7m/s. The vented produce package contributed the highest cooling airflow resistance. Similar to the airflow, the cooling characteristics of the product were not uniform. There was a difference in the cooling rate of the produce in the airflow direction and from the top to the bottom section of the loaded crate. The products that were located near the inlet side and top of the bulk showed a faster cooling rate than the rest of the bulk. The result showed that the produced volume average temperature was 17.9°C after a cooling period of 3 hr. It was reduced by 12.05°C. The result showed the potential of the CFD modeling approach in developing the bamboo-based design of horticultural produce crates in terms of airflow and heat transfer characteristics.

Keywords: bamboo, modeling, cooling, horticultural, packaging

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1516 Seasonal Variability of the Price and Quality of Fresh Red Porgy Fish Sold in the Local Market of Igoumenitsa, NW Greece

Authors: C. Nathanailides, P. Logothetis, G. Kanlis S. Anastasiou, L. Kokokiris, P. Mpeza

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Farmed Red porgy (Pagrus pagrus) is one of the “new candidate fish species” for the diversification of Mediterranean aquaculture which is predomintly based on the cultivation of the European sea bass, (Dicenfrarchus labrax), and the gilthead sea bream, (Sparus aurata). The quality of farmed red porgy (Pagrus pagrus) was investigated with samples obtained from the local fish market in the region of Igoumenitsa, NW Greece. Sample of the fish (ungutted and with scales) were purchased from three local fish mongers and transported to the laboratory within few minutes in foamed polystyrene boxes in ice. The average weight of whole fish ranged between 271-289g. A sample of the fish flesh taken from the upper epaxial region was transferred aseptically to a stomacher bag containing sterile Buffered Peptone Water solution (0.1%) and homogenized. After serial dilutions in 0.1% peptone water, the homogenates were spread on the surface of agar plates. Total viable counts (TVC) were determined using plate count agar after incubation at 30 oC for 3 days. The quality attributes monitored during the present work included bacterial load (total mesophilic) and the pH of the flesh. There was a marginal increase in the price of fresh red porgy sold during the summer time, with prices ranging, over a period of four seasons, from 5.85 to 7.5 per kilo. The results of the microbiological analysis indicate that with the exception of summer samples (which exhibited 5.23 (±0.13) log cfu/g), the bacterial load remained well below the legal limits and was around 3.1 log cfu/g. The pH values varied between 6.54 and 6.69. The results indicate a possible influence of season on the bacterial load of fish sold in the market. Nevertheless, the parameters investigated in the present work indicate that the bacteria load was well below the legal limit and that fish were sold within few days after harvesting. The peak of bacterial load in the summer samples may be a result of a post-harvesting contamination of the farmed fish and temperature fluctuations during handling and transportation.

Keywords: fish quality, marketing, aquaculture, Pagrus pagrus

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1515 Correlation Studies in Nutritional Intake, Health Status and Clinical Examination of Young Adult Girls

Authors: Sonal Tuljaram Kame

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Growth and development is based on proper diet. A balanced diet contains all the nutrients in required quantum. Although physical growth is completed by young adulthood, the body tissues remain in a dynamic state with catabolism slightly exceeding anabolism, resulting in a net decrease in the number of cells. After the years of adolescence which cause upheavals in the life of the person, the individual struggle to emerge as an adult who know who he is and what his goals are. During this period nutrients are needed for maintaining the health and energy is required for physical functions and physical activities. The nutritional requirement in young adulthood differs from other periods of life. Iron is needed for haemoglobin synthesis and necessitates by the considerable examination of blood volume. Young adult girls need to ensure adequate intake of iron as they loose 0.5 mg/day by way of menstruation. This is complete awareness about nutritional and health on the other side there is widespread ignorance about nutrition and health among young adult girls. The young adult girls who are aware about nutrition and health seem to be very conscious about nutritional intake and health. Figure consciousness and fear of obesity leads to self imposed intake of nutrients. It may result in various health problems. The study was planned to investigate nutrient intake, find relation between nutritional intake, clinical examination score and health status of young adult girls. The present study is based on the data collected from 120 young adult girls studying in four different competitive exams coaching academies in Akola city of Maharashtra. It was found that nutritional intake of these young adult girls was below the recommended level, nutritional knowledge level and nutritional intake are associated attributes, calories, calcium and protein intake is positively correlated with clinical examination and health status. It was concluded that well planned nutritional counseling for the young adult girls can help prevent nutritional deficiency diseases and disorders which may lead to anaemic condition in young adult girls. Girls need to be educated on intake of iron and vitamin B12.

Keywords: nutritional intake, health status, young adult girls, correlation studies

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1514 Study of Properties of Concretes Made of Local Building Materials and Containing Admixtures, and Their Further Introduction in Construction Operations and Road Building

Authors: Iuri Salukvadze

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Development of Georgian Economy largely depends on its effective use of its transit country potential. The value of Georgia as the part of Europe-Asia corridor has increased; this increases the interest of western and eastern countries to Georgia as to the country that laid on the transit axes that implies transit infrastructure creation and development in Georgia. It is important to use compacted concrete with the additive in modern road construction industry. Even in the 21-century, concrete remains as the main vital constructive building material, therefore innovative, economic and environmentally protected technologies are needed. Georgian construction market requires the use of concrete of new generation, adaptation of nanotechnologies to the local realities that will give the ability to create multifunctional, nano-technological high effective materials. It is highly important to research their physical and mechanical states. The study of compacted concrete with the additives is necessary to use in the road construction in the future and to increase hardness of roads in Georgia. The aim of the research is to study the physical-mechanical properties of the compacted concrete with the additives based on the local materials. Any experimental study needs large number of experiments from one side in order to achieve high accuracy and optimal number of the experiments with minimal charges and in the shortest period of time from the other side. To solve this problem in practice, it is possible to use experiments planning static and mathematical methods. For the materials properties research we will use distribution hypothesis, measurements results by normal law according to which divergence of the obtained results is caused by the error of method and inhomogeneity of the object. As the result of the study, we will get resistible compacted concrete with additives for the motor roads that will improve roads infrastructure and give us saving rate while construction of the roads and their exploitation.

Keywords: construction, seismic protection systems, soil, motor roads, concrete

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1513 Postharvest Studies Beyond Fresh Market Eating Quality: Phytochemical Changes in Peach Fruit During Ripening and Advanced Senescence

Authors: Mukesh Singh Mer, Brij Lal Attri, Raj Narayan, Anil Kumar

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Postharvest studies were conducted under the concept that fruit do not qualify for the fresh market may be used as a source of bioactive compounds. One peach (Prunus persica cvs Red June) were evaluated for their photochemical content and antioxidant capacity during the ripening and over ripening periods (advanced senescence) for 12 and 15 d, respectively. Firmness decreased rapidly during this period from an initial pre –ripe stage of 5.85 lb/in2 for peach until the fruit reached the fully ripe stage of lb/in2. In this study we evaluate the varietal performance in respect of the quality beyond fresh market eating and nutrition levels. The varieties are (T-1 F-16-23), (T-2 Florda king), (T-3 Nectarine), (T-4 Red June). The result pertaining are there the highest fruit length (68.50 mm), fruit breadth (71.38 mm), fruit weight (186.11 g) found in T4 Red June and fruit firmness (8.74 lb/in 2) found in T3-Nectarine. The acidity (1.66 %), ascorbic acid (440 mg/100 g), reducing sugar (19.77 %) and total sugar (51.73 %) found in T4- Red June, T-2 Florda King, T-3 Nectarine at harvesting time but decrease in fruit length ( 60.81 mm), fruit breadth (51.84 mm), fruit weight (143.03 g) found in T4 Red June and fruit firmness (6.29 lb/in 2) found in T3-Nectarine. The acidity (0.80 %), ascorbic acid (329.50 mg/100 g), reducing sugar (34.03 %) and total sugar (26.97 %) found in T1- F-16-23, T-2 Florda King, T-1 F-16-23 and T-3 Nectarine after 15 days in freeze conditions when will have been since reached beyond market. The study reveals that the size and yield good in Red June and the nutritional value higher in Florda King and Nectarine peach. Fruit firmness remained unchanged afterwards. In addition, total soluble solids in peach were basically similar during the ripening and over ripening periods. Further research on secondary metabolism regulation during ripening and advanced senescence is needed to obtain fruit as enriched dietary sources of bioactive compounds or for its use in alternative high value health markets including dietary supplements, functional foods cosmetics and pharmaceuticals.

Keywords: metabolism, acidity, ascorbic acid, pharmaceuticals

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1512 Problems and Challenges of Implementing Distance Learning against the Background of the COVID-19 Pandemic

Authors: Tinatin Sabauri, Eduard Gelagutashvili, Salome Pataridze

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The COVID-19 pandemic presents a serious challenge to all sectors of the country. Particularly difficult and important was the rapid mobilization of educational institutions to ensure the continuous flow of the educational process and effective fulfillment of the transaction. Developed countries managed to overcome this challenge quickly because, before the pandemic, part of universities had implemented blended learning (a mixture of online and face-to-face learning). The article aims to evaluate the use of electronic platforms by non-Georgian-speaking students and their involvement in the e-learning process at Ilia State University. Based on the phenomenological research design, a comparative analysis has been conducted - what was the use of electronic systems by non-Georgian-speaking students before 2019, and what was it like during the COVID-19 pandemic? Concretely, the phenomenological design was used in the research to evaluate the efficiency of distance learning with non-Georgian speaking students at Ilia State University. Focus groups were created within the phenomenological design. In the focus groups, students answered a pre-designed semi-structured questionnaire. Based on the analysis of the questionnaires, it was revealed that online learning and access to electronic portals were not a particular difficulty for ethnic minorities. The following positive and negative aspects of e-learning were identified in the research. Students named as positive aspects: Enables joining online classes directly from home before the start of the lecture, It saves time and money on travel and accommodation (for some students). It was named as negative aspects: Learning a language online is more difficult than in face-to-face classrooms, lack of teamwork activity, lack of strong and stable internet connections, and audio problems. Based on the results of the research, it was shown that in the post-pandemic period, the involvement of non-Georgian speaking students has significantly increased; therefore, the use of electronic systems by non-Georgian speaking students.

Keywords: electronic system, distance learning, COVID-19, students

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1511 Outcome of Unilateral Retinoblastoma: A Ten Years Experience of Children's Cancer, Hospital Egypt

Authors: Ahmed Elhussein, Hossam El-Zomor, Adel Alieldin, Mahmoud A. Afifi, Abdullah Elhusseiny, Hala Taha, Amal Refaat, Soha Ahmed, Mohamed S. Zagloul

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Background: A majority of children with retinoblastoma (60%) have a disease in one eye only (unilateral disease). This is a retrospective study to evaluate two different treatment modalities in those patients for saving their lives and vision. Methods: Four hundred and four patients were diagnosed with unilateral intraocular retinoblastoma at Children’s Cancer, Hospital Egypt (CCHE) through the period of July/2007 until December/2017. Management strategies included primary enucleation versus ocular salvage treatment. Results: Patients presented with mean age 24.5 months with range (1.2-154.3 months). According to the international retinoblastoma classification, Group D (n=172, 42%) was the most common, followed by group E (n=142, 35%), group C (n=63, 16%), and group B (n=27, 7%). All patients were alive at the end of the study except four patients who died, with 5-years overall survival 98.3% [CI, (96.5-100%)]. Patients presented with advanced disease and poor visual prognosis (n=241, 59.6%) underwent primary enucleation with 6 cycles adjuvant chemotherapy if they had high-risk features in the enucleated eye; only four patients out of 241 ended-up either with extraocular metastasis (n=3) or death (n=1). While systemic chemotherapy and focal therapy were the primary treatment for those who presented with favorable disease status and good visual prognosis (n=163, 40.4%); seventy-seven patients of them (47%) ended up with a pre-defined event (enucleation, EBRT, off protocol chemotherapy or 2ry malignancy). Ocular survival for patients received primary chemotherapy + focal therapy was [50.9% (CI, 43.5-59.6%)] at 3 years and [46.9% (CI,39.3-56%)] at 5 years. Comparison between upfront enucleation and primary chemotherapy for occurrence of extraocular metastasis revealed that there was no statistical difference between them except in group D (p value). While for occurrence of death, no statistical difference in all classification groups. Conclusion: In retinoblastoma, primary chemotherapy is a reasonable option and has a good probability for ocular salvage without increasing the risk of metastasis in comparison to upfront enucleation except in group D.

Keywords: CCHE, chemotherapy, enucleation, retinoblastoma

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1510 Monitoring Peri-Urban Growth and Land Use Dynamics with GIS and Remote Sensing Techniques: A Case Study of Burdwan City, India

Authors: Mohammad Arif, Soumen Chatterjee, Krishnendu Gupta

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The peri-urban interface is an area of transition where the urban and rural areas meet and interact. So the peri-urban areas, which is characterized by strong urban influence, easy access to markets, services and other inputs, are ready supplies of labour but distant from the land paucity and pollution related to urban growth. Hence, the present study is primarily aimed at quantifying the spatio-temporal pattern of land use/land cover change during the last three decades (i.e., 1987 to 2016) in the peri-urban area of Burdwan city. In the recent past, the morphology of the study region has rapid change due to high growth of population and establishment of industries. The change has predominantly taken place along the State and National Highway 2 (NH-2) and around the Burdwan Municipality for meeting both residential and commercial purposes. To ascertain the degree of change in land use and land cover, over the specified time, satellite imageries and topographical sheets are employed. The data is processed through appropriate software packages to arrive at a deduction that most of the land use changes have occurred by obliterating agricultural land & water bodies and substituting them by built area and industrial spaces. Geospatial analysis of study area showed that this area has experienced a steep increase (30%) of built-up areas and excessive decrease (15%) in croplands between 1987 and 2016. Increase in built-up areas is attributed to the increase of out-migration during this period from the core city. This study also examined social, economic and institutional factors that lead to this rapid land use change in peri-urban areas of the Burdwan city by carrying out a field survey of 250 households in peri-urban areas. The research concludes with an urgency for regulating land subdivisions in peri-urban areas to prevent haphazard land use development. It is expected that the findings of the study would go a long way in facilitating better policy making.

Keywords: growth, land use land cover, morphology, peri-urban, policy making

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1509 Numerical Simulation of Production of Microspheres from Polymer Emulsion in Microfluidic Device toward Using in Drug Delivery Systems

Authors: Nizar Jawad Hadi, Sajad Abd Alabbas

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Because of their ability to encapsulate and release drugs in a controlled manner, microspheres fabricated from polymer emulsions using microfluidic devices have shown promise for drug delivery applications. In this study, the effects of velocity, density, viscosity, and surface tension, as well as channel diameter, on microsphere generation were investigated using Fluent Ansys software. The software was programmed with the physical properties of the polymer emulsion such as density, viscosity and surface tension. Simulation will then be performed to predict fluid flow and microsphere production and improve the design of drug delivery applications based on changes in these parameters. The effects of capillary and Weber numbers are also studied. The results of the study showed that the size of the microspheres can be controlled by adjusting the speed and diameter of the channel. Narrower microspheres resulted from narrower channel widths and higher flow rates, which could improve drug delivery efficiency, while smaller microspheres resulted from lower interfacial surface tension. The viscosity and density of the polymer emulsion significantly affected the size of the microspheres, ith higher viscosities and densities producing smaller microspheres. The loading and drug release properties of the microspheres created with the microfluidic technique were also predicted. The results showed that the microspheres can efficiently encapsulate drugs and release them in a controlled manner over a period of time. This is due to the high surface area to volume ratio of the microspheres, which allows for efficient drug diffusion. The ability to tune the manufacturing process using factors such as speed, density, viscosity, channel diameter, and surface tension offers a potential opportunity to design drug delivery systems with greater efficiency and fewer side effects.

Keywords: polymer emulsion, microspheres, numerical simulation, microfluidic device

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1508 Gender Differences in Objectively Assessed Physical Activity among Urban 15-Year-Olds

Authors: Marjeta Misigoj Durakovic, Maroje Soric, Lovro Stefan

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Background and aim: Physical inactivity has been linked with increased morbidity and premature mortality and adolescence has been recognised as the critical period for a decline in physical activity (PA) level. In order to properly direct interventions aimed at increasing PA, high-risk groups of individuals should be identified. Therefore, the aim of this study is to describe gender differences in: a) PA level; b) weekly PA patterns. Methods: This investigation is a part of the CRO-PALS study which is an on-going longitudinal study conducted in a representative sample of urban youth in Zagreb (Croatia). CRO-PALS involves 903 adolescents and for the purpose of this study data from a subgroup of 190 participants with information on objective PA level were analysed (116 girls; mean age [SD]=15.6[0.3] years). Duration of moderate and vigorous PA was measured during 5 consecutive by a multiple-sensor physical activity monitor (SenseWear Armband, BodyMedia inc., Pittsburgh, USA). Gender differences in PA level were evaluated using independent samples t-test. Differences in school week and weekend levels of activity were assessed using mixed ANOVA with gender as between-subjects factor. The amount of vigorous PA had to be log-transformed to achieve normality in the distribution. Results: Boys were more active than girls. Duration of moderate-to-vigorous PA averaged 111±44 min/day in boys and 80±38 min/day in girls (mean difference=31 min/day, 95%CI=20-43 min/day). Vigorous PA was 2.5 times higher in boys compared to girls (95%CI=1.9-3.5). Participants were more active during school days than on weekends. The magnitude of the difference in moderate-to-vigorous PA was similar in both gender (p value for time*gender interaction = 0.79) and averaged 19 min/day (95%CI=11-27 min/day). Similarly, vigorous PA was 36% lower on weekends compared with school days (95%CI=22-46%) with no gender difference (p value for time*gender interaction = 0.52). Conclusion: PA level was higher in boys than in girls throughout the week. Still, in both boys and girls, the amount of PA reduced markedly on weekends compared with school days.

Keywords: adolescence, multiple-sensor physical activity monitor, physical activity level, weekly physical activity pattern

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1507 Sustainability Reporting and Performances of the Companies in the Istanbul Stock Exchange Sustainability Index

Authors: Zeynep Şahin, Züleyha Yılmaz, Fikret Çankaya

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In today's business world, in which it is difficult to survive, the economic life of products, services or knowledge is considerably reduced. Competitors produce similar products or extra-featured ones instantly. In this environment, the contribution of companies to the social and economic environment is a preferred criterion by consumers alongside products or services. Therefore, consumers need to obtain more detailed information about companies. Besides, this drastic change in the market encourages companies to become sustainable. Sustainable business means the company puts consumed products back. Corporate sustainability, corresponds to sustainability at the level of the company, and gives equal importance to company growth and profitability together with environmental and social issues. The BIST Sustainability Index started to be calculated by the Istanbul Stock Exchange (BIST) in 2014 to evaluate the sustainability performance of companies in Turkey. The main objective of this study is to present the importance of sustainability reports in Turkey. To this aim, the performances of 15 companies in the BIST Sustainability Index were compared the periods before and after entering the index. On the other hand, sustainability reporting practices should be encouraged to increase studies on this issue. In this context, to remain on the agenda of the issue is a further objective of this study. To achieve these objectives, the financial data of the companies in the period before and after entering to the BIST Sustainability Index were analyzed using t-test in Statistical Package for the Social Sciences (SPSS) package. The results of the study showed that no significant difference between the performances of the companies in terms of the net profit margin, the return on assets and equity capital in these periods could be found. Therefore, it can be said that insufficient importance is given to sustainability issues in Turkey. The reasons for this situation might be considered as a lack of awareness due to the recent introduction and calculation of the index. It is expected that the awareness of firms and investors about sustainability will increase, and that they will demonstrate the necessary importance to this issue over time.

Keywords: sustainability reporting, sustainability index, firm performance, BIST sustainability index

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1506 Efficacy and Mechanisms of Acupuncture for Depression: A Meta-Analysis of Clinical and Preclinical Evidence

Authors: Yimeng Zhang

Abstract:

Major depressive disorder (MDD) is a prevalent mental health condition with a substantial economic impact and limited treatment options. Acupuncture has gained attention as a promising non-pharmacological intervention for alleviating depressive symptoms. However, its mechanisms and clinical effectiveness remain incompletely understood. This meta-analysis aims to (1) synthesize existing evidence on the mechanisms and clinical effectiveness of acupuncture for depression and (2) compare these findings with pharmacological interventions, providing insights for future research. Evidence from animal models and clinical studies indicates that acupuncture may enhance hippocampal and network neuroplasticity and reduce brain inflammation, potentially alleviating depressive disorders. Clinical studies suggest that acupuncture can effectively relieve primary depression, particularly in milder cases, and is beneficial in managing post-stroke depression, pain-related depression, and postpartum depression, both as a standalone and adjunctive treatment. Notably, combining acupuncture with antidepressant pharmacotherapy appears to enhance treatment outcomes and reduce medication side effects, addressing a critical issue in conventional drug therapy's high dropout rates. This meta-analysis, encompassing 12 studies and 710 participants, draws data from eight digital databases (PubMed, EMBASE, Web of Science, EBSCOhost, CNKI, CBM, Wangfang, and CQVIP) covering the period from 2012 to 2022. Utilizing Stata software 15.0, the meta-analysis employed random-effects and fixed-effects models to assess the distribution of depression in Traditional Chinese Medicine (TCM). The results underscore the substantial evidence supporting acupuncture's beneficial effects on depression. However, the small sample sizes of many clinical trials raise concerns about the generalizability of the findings, indicating a need for further research to validate these outcomes and optimize acupuncture's role in treating depression.

Keywords: Chinese medicine, acupuncture, depression, meta-analysis

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1505 Effects of Sleep Deprivation on Athletic Performance in Nigeria Colleges of Education Games

Authors: Rasheed Owolabi Oloyede, Joseph Olusegun Adelusi, Seun Oluwadare

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Sleep has been found to have many recuperative and restorative beneficial effects on athletic recovery. When a person is deprived of sleep this can have many effects on their immune and endocrine systems. Both of these systems are extremely important for the recovery process of any athlete and when we deprive ourselves of sleep, we are depriving ourselves of recovery. This study examined how sleep deprivation can hinder sport performance among selected athletes representing Adeyemi College of Education at Nigeria Colleges of Education Games (NICEGA) competitions at Minna. A total of 32 athletes were sampled for the study. They were exposed to two different activities. Each activity was performed before and after sleep deprivation, the activities were 100m dash, shuttle relay. The athletes were randomly assigned to two groups that are experimental and control groups. Pretest were conducted on both groups before apply treatment to the other group. A day before the activities to be performed the control group was denied of sleep between 10p.m to 5a.m for a period of 6 weeks. The analysis of the data showed that athletes performance in the two selected activities performed on equal basis before the sleep deprivation. After sleep deprivation the performance of experimental group was a little better than the control group that were denied of sleep. It was concluded that sleep allows the body to spend less energy resources on body processes needed while awake, it was concluded that sleep deprivation enables the body system work effectively. The body can expend needed energy, balance and adequate reaction time if it is allowed to have enough rest. Lack of adequate sleep results to dullness of the brain, nervousness and anxiety which all have negative effect on performance of activities by athletes. Based on the findings, it was recommended that extend nightly sleep for several week to reduce your sleep debt before competition. Maintain a low sleep debt by obtaining a sufficient amount of nightly sleep (seven to eight hours for adults, nine or more hours for teens and young adults). Keep a regular sleep-wake schedule, going to bed and waking up at the same times every day.

Keywords: activities, deprivation, performance, sleep

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1504 Estimating the Timing Interval for Malarial Indoor Residual Spraying: A Modelling Approach

Authors: Levicatus Mugenyi, Joaniter Nankabirwa, Emmanuel Arinaitwe, John Rek, Niel Hens, Moses Kamya, Grant Dorsey

Abstract:

Background: Indoor residual spraying (IRS) reduces vector densities and malaria transmission, however, the most effective spraying intervals for IRS have not been well established. We aim to estimate the optimal timing interval for IRS using a modeling approach. Methods: We use a generalized additive model to estimate the optimal timing interval for IRS using the predicted malaria incidence. The model is applied to post IRS cohort clinical data from children aged 0.5–10 years in selected households in Tororo, historically a high malaria transmission setting in Uganda. Six rounds of IRS were implemented in Tororo during the study period (3 rounds with bendiocarb: December 2014 to December 2015, and 3 rounds with actellic: June 2016 to July 2018). Results: Monthly incidence of malaria from October 2014 to February 2019 decreased from 3.25 to 0.0 per person-years in the children under 5 years, and 1.57 to 0.0 for 5-10 year-olds. The optimal time interval for IRS differed between bendiocarb and actellic and by IRS round. It was estimated to be 17 and 40 weeks after the first round of bendiocarb and actellic, respectively. After the third round of actellic, 36 weeks was estimated to be optimal. However, we could not estimate from the data the optimal time after the second and third rounds of bendiocarb and after the second round of actellic. Conclusion: We conclude that to sustain the effect of IRS in a high-medium transmission setting, the second rounds of bendiocarb need to be applied roughly 17 weeks and actellic 40 weeks after the first round, and the timing differs for subsequent rounds. The amount of rainfall did not influence the trend in malaria incidence after IRS, as well as the IRS timing intervals. Our results suggest that shorter intervals for the IRS application can be more effective compared to the current practice, which is about 24 weeks for bendiocarb and 48 weeks for actellic. However, when considering our findings, one should account for the cost and drug resistance associated with IRS. We also recommend that the timing and incidence should be monitored in the future to improve these estimates.

Keywords: incidence, indoor residual spraying, generalized additive model, malaria

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1503 Organisational Change: The Impact on Employees and Organisational Development

Authors: Maureen Royce, Joshi Jariwala, Sally Kah

Abstract:

Change is inevitable, but the change process is progressive. Organisational change is the process in which an organisation changes strategies, operational methods, systems, culture, and structure to affect something different in the organisation. This process can be continuous or developed over a period and driven by internal and external factors. Organisational change is essential if organisations are to survive in dynamic and uncertain environments. However, evidence from research shows that many change initiatives fail, leading to severe consequences for organisations and their resources. The complex models of third sector organisations, i.e., social enterprise, compounds the levels of change in these organisations. Interestingly, innovation is associated with a change in social enterprises due to the hybridity of product and service development. Furthermore, the creation of social intervention has offered a new process and outcomes to the lifecycle of change. Therefore, different forms of organisational innovation are developed, i.e., total, evolutionary, expansionary, and developmental, which affect the interventions of social enterprises. This raises both theoretical and business concerns on how the competing hybrid nature of social enterprises change, how change is managed, and the impact on these organisations. These perspectives present critical questions for further investigation. In this study, we investigate the impact of organisational change on employees and organisational development at DaDaFest –a disability arts organisation with a social focus based in Liverpool. The three main objectives are to explore the drivers of change and the implementation process; to examine the impact of organisational change on employees and; to identify barriers to organisation change and development. To address the preceding research objectives, qualitative research design is adopted using semi-structured interviews. Data is analysed using a six-step thematic analysis framework, which enables the study to develop themes depicting the impact of change on employees and organisational development. This study presents theoretical and practical contributions for academics and practitioners. The knowledge contributions encapsulate the evolution of change and the change cycle in a social enterprise. However, practical implications provide critical insights into the change management process and the impact of change on employees and organisational development.

Keywords: organisational change, change management, organisational change system, social enterprise

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1502 Collaborative Approaches in Achieving Sustainable Private-Public Transportation Services in Inner-City Areas: A Case of Durban Minibus Taxis

Authors: Lonna Mabandla, Godfrey Musvoto

Abstract:

Transportation is a catalytic feature in cities. Transport and land use activity are interdependent and have a feedback loop between how land is developed and how transportation systems are designed and used. This recursive relationship between land use and transportation is reflected in how public transportation routes internal to the inner-city enhance accessibility, therefore creating spaces that are conducive to business activity, while the business activity also informs public transportation routes. It is for this reason that the focus of this research is on public transportation within inner-city areas where the dynamic is evident. Durban is the chosen case study where the dominating form of public transportation within the central business district (CBD) is minibus taxis. The paradox here is that minibus taxis still form part of the informal economy even though they are the leading form of public transportation in South Africa. There have been many attempts to formalise this industry to follow more regulatory practices, but minibus taxis are privately owned, therefore complicating any proposed intervention. The argument of this study is that the application of collaborative planning through a sustainable partnership between the public and private sectors will improve the social and environmental sustainability of public transportation. One of the major challenges that exist within such collaborative endeavors is power dynamics. As a result, a key focus of the study is on power relations. Practically, power relations should be observed over an extended period, specifically when the different stakeholders engage with each other, to reflect valid data. However, a lengthy data collection process was not possible to observe during the data collection phase of this research. Instead, interviews were conducted focusing on existing procedural planning practices between the inner-city minibus taxi association (South and North Beach Taxi Association), the eThekwini Transport Authority (ETA), and the eThekwini Town Planning Department. Conclusions and recommendations were then generated based on these data.

Keywords: collaborative planning, sustainability, public transport, minibus taxis

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1501 Real World Cancer Pain Incidence and Treatment in Daily Hospital

Authors: Alexandru Grigorescu, Alexandra Protesanu

Abstract:

Background: Approximately 34-67 percent of cancer patients experience an episode of uncontrolled pain during the course of their disease, depending on the stage. The aim is to provide evidence-based data for pain prevalence, diagnosis and treatment recommendations on an integrative model of medical oncology and palliative care for patients with cancer diagnostic in a day hospital. Patients and method: Consultation registers and electronic records of 166 Patients (Pts) were studied from April 2022 to March 2023. Pts with pain syndrome were selected. The pain was objectified by the visual pain scale. To elucidate the causes of the pain, investigations were carried out: bone scintigraphy, CT scan, and PET-CT. The analgesic treatments were represented by weak and strong morphine, radiotherapy, and bisphosphonates. Result: During the mentioned period, 166 oncological patients (74 women and 92 men) were treated in the oncology day hospitalization service. There were 1,500 consultations, 40 of which were only for pain. The neoplastic locations were: gynecological, malignant melanoma, breast, gastric, bronchopulmonary, colorectal, liver, pancreatic, bladder, and kidney. 70 Pts presented pain syndrome. The causes of the pain were represented by bone metastases, compressive tumors, and post-surgical status. Drug treatment: Tramadol 47 Pts, of which 10 switched to a major opioid (Oxycodonum, Morphine sulfate), 20 Pts were treated with Oxycodonum as the first intention. In 5 patients ry to rotated morphine, 20 Pts received palliative radiotherapy, 10 Pts were treated with bisphosphonates. 2 Pts required neurosurgery consultation for an antalgic intervention. 5 Pts had important adverse reactions to morphine. All patients and their families were advised by a medical oncologist and psychologist for a lifestyle change. Conclusions: The prevalence of pain was similar to that described in the literature. In most cases, the pain could be managed in the day hospital. Weak and strong morphine represented the main pain therapy. Palliative radiotherapy was the second most effective therapy. Treatment with bisphosphonates was useful. Surgical interventions were rarely indicated. Discussions with patients and their families regarding the lifestyle change were important.

Keywords: cancer pain, opioids, medical oncology, palliative care

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1500 Epidemiological Correlates of Adherence to Anti-Hypertensive Treatment in Primary Health Care Setting of Ludhiana, Punjab

Authors: Sangeeta Girdhar, Amanat Grewal, Nahush Bansal

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Introduction: There is an increasing burden of hypertension in India. The morbidity and mortality arising from complications are mainly due to non-adherence to medication, unhealthy dietary habits, and lack of physical activity. Non-adherence is a well-recognised factor contributing to inadequate control of high blood pressure. Adherence to pharmacotherapy for hypertension varies from 43% to 88%. Non-adherence is influenced by various socio-demographic factors. Understanding these factors is useful in managing non-adherence. Therefore, the study was planned to determine adherence among hypertensives and factors associated with non-adherence to treatment. Methodology: A cross-sectional study was conducted at Urban Health Training Centre of Dayanand Medical College and Hospital Ludhiana. Patients attending the OPD over a period of 3 months were included in the study. Prior ethical approval was obtained, and informed consent was taken from subjects. A predesigned semi-structured questionnaire was applied, which included socio-demographic profile, treatment-seeking behaviour, adherence to the antihypertensive medication, lifestyle factors (intake of alcohol, smoking, consumption of junk food, high salt intake) contributing to the development of the disease. Reasons for non-adherence to the therapy were also explored. Data was entered into excel, and SPSS 26 version was used for analysis. Results: A total of 186 individuals were interviewed. Out of these, 113 females (60.8%) and 73 males (39.2%) participated in the study. Mean age of participants was 60.9 ± 10.7 years. Adherence to anti-hypertensive treatment was found in 68.3% of the participants. It was observed that adherence was more in literate individuals as compared to illiterate (p value- 0.78). Adherence was lower among smokers (33.3%) and alcohol consumers (53.8%) as compared to non-users (69.4% and 70.6%, respectively). The predominant reasons for skipping medications were discontinuing medication when feeling well, forgetfulness and unawareness. Conclusion: There is a need to generate awareness regarding the importance of adherence to therapy among patients. Intensive health education and counselling of the patients is the need of the hour.

Keywords: hypertension, anti-hypertensive, adherence, counselling

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1499 The Role of Japan's Land-Use Planning in Farmland Conservation: A Statistical Study of Tokyo Metropolitan District

Authors: Ruiyi Zhang, Wanglin Yan

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Strict land-use plan is issued based on city planning act for controlling urbanization and conserving semi-natural landscape. And the agrarian land resource in the suburbs has indispensable socio-economic value and contributes to the sustainability of the regional environment. However, the agrarian hinterland of metropolitan is witnessing severe farmland conversion and abandonment, while the contribution of land-use planning to farmland conservation remains unclear in those areas. Hypothetically, current land-use plan contributes to farmland loss. So, this research investigated the relationship between farmland loss and land-use planning at municipality level to provide base data for zoning in the metropolitan suburbs, and help to develop a sustainable land-use plan that will conserve the agrarian hinterland. As data and methods, 1) Farmland data of Census of Agriculture and Forestry for 2005 to 2015 and population data of 2015 and 2018 were used to investigate spatial distribution feathers of farmland loss in Tokyo Metropolitan District (TMD) for two periods: 2005-2010;2010-2015. 2) And the samples were divided by four urbanization facts. 3) DID data and zoning data for 2006 to 2018 were used to specify urbanization level of zones for describing land-use plan. 4) Then we conducted multiple regression between farmland loss, both abandonment and conversion amounts, and the described land-use plan in each of the urbanization scenario and in each period. As the results, the study reveals land-use plan has unignorable relation with farmland loss in the metropolitan suburbs at ward-city-town-village level. 1) The urban promotion areas planned larger than necessity and unregulated urbanization promote both farmland conversion and abandonment, and the effect weakens from inner suburbs to outer suburbs. 2) And the effect of land-use plan on farmland abandonment is more obvious than that on farmland conversion. The study advocates that, optimizing land-use plan will hopefully help the farmland conservation in metropolitan suburbs, which contributes to sustainable regional policy making.

Keywords: Agrarian land resource, land-use planning, urbanization level, multiple regression

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1498 Determining the Policy Space of the Partido Socialista Obrero Español Government in Managing Spain's Economic and Financial Crisis

Authors: A. Pascual Ramsay

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Accounts of the management of the economic and euro crisis in Spain have been dominated by an emphasis on external constraints. However, this approach leaves unanswered important questions about the role of domestic political factors. Using systematic qualitative primary research and employing elite interviewing and process tracing, this paper aims to fill this gap for the period of the Partido Socialista Obrero Español (PSOE) administration. The paper shows that domestic politics played a crucial role in the management of the crisis, most importantly by determining the shape of the measures undertaken. In its three distinct stages – downplaying/inaction, reaction/stimulus, and austerity/reform – the PSOE's response was certainly constrained by external factors, most notably EMU membership and the actions of sovereign-bond investors, the ECB and Germany. Yet while these external constraints forced the government to act, domestic political factors fundamentally shaped the content of key measures: the fiscal stimulus, the labour, financial and pension reforms, the refusal to accept a bailout or the reform of the Constitution. Seven factors were particularly influential: i) electoral and political cost, ii) party and partisanship, iii) organised interests, iv) domestic institutions, v) ideological preferences, vi) ineffective decision-making, and vii) judgement and personal characteristics of decision-makers. In conclusion, domestic politics played an important role in the management of the crisis, a role that has been underestimated by dominant approaches focusing on external constraints and weak domestic policy autonomy. The findings provide empirical evidence to support research agendas that identify significant state discretion in the face of international economic integration and an important role for domestic political factors such as institutions, material interests, partisanship and ideology in shaping economic outcomes.

Keywords: economic crisis, Euro, PSOE, Spain

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1497 Development of Entrepreneurship in Industry on the Basis of Regulation of Transnational Production Chains in the Russian Arctic

Authors: E. N. Vetrova, L.V. Lapochkina, N. V. Nikulina

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In the national economy, entrepreneurship plays the role of a buffer between economy and policy for it contributes to improving budget effectiveness and decreasing dependence of economy on the state. Entrepreneurship in industry makes it possible to increase the added value that is formed in production chains and to decrease dependence on import. Under the current circumstances, when sanctions are being imposed, this is especially relevant for Russia and for the realization of projects in the Russian Arctic. However, development of entrepreneurship in industry requires an enlightened state policy. The purpose of the research is elaboration of recommendations for improving economic effectiveness of the realization of the Arctic projects on the basis of conceptual proposals for the development of entrepreneurship in industry. The paper presents the studies of the extractive industry role in the Russian economy and proves its raw material character. The analysis of production chains in industry on the basis of the conception of the added value global chains demonstrated a low added value formed by Russian companies. The study of changes in the structure of economy based on systemic, statistical and comparative analyses revealed no positive changes in the structure of economy over the period under consideration. This is a manifestation of ineffectiveness of the Russian industrial policy in general and within the Arctic region in particular. The authors identified the problems information and implementation of the state industrial policy in the Arctic region and in the development of national entrepreneurship, analyzed the shortcomings of the current state policy in the sphere of the Russian industry. On the basis of the conducted studies, the authors formulated conceptual approaches to change the state policy in the Arctic. The basic idea of the authors is to substantiate the focus of the state regulation on the development of entrepreneurship in industry in the process of the Russian Arctic exploration. At the same time another problem is solved–that of the development of the manufacturing industry in the southern regions of the northwestern part of Russia. The criterion of effectiveness in this case is the economic effectiveness.

Keywords: entrepreneurship in industry, global chains of the added value, government regulation, industrial policies, production chains in the arctic region, economic effectiveness

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1496 Telemedicine and Telemonitoring for Interstitial Lung Disease Patients with Nintedanib

Authors: M. Brockes, S. Beck, A. Sigaroudi, C. Brockes

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Over the last few years, telemedicine and telemonitoring have become popular ways of treatment, especially in other chronic diseases. Therefore, this type of treatment methodology was also implemented in patients with interstitial lung disease (ILD). In January 2024, a new service for patients with interstitial lung disease (ILD) treated with Nintedanib was established, which contains daily telemonitoring (home spirometry, pulse oximetry, and daily level of activity), daily evaluation of parameters as well as a telemedical availability answered by doctors and telemedical specialists throughout 365 days per year. The main motivational points of this service are the early detection of first signs of exacerbations and/or other symptoms/complications, as well as easier access to healthcare professionals. The evaluation of the patient’s quality of life and the subjective feeling of safetyness was measured through patient-reported experience measurements (PREMs) and patient-reported outcome measurements (PROMs). Patients were introduced to the telemedical and telemonitoring service six months ago. Within this period, every sixty days, the questionnaires were conducted by the scientific employees. Due to the unlimited time frame of the long-term service, the evaluation has not been completed. The first analysis of patient-reported experience measurements (PREMs) and patient reported outcome measurements (PROMs) had shown an increased positive effect on the patients' quality of life as well as an increased positive effect on the subjective feeling of safety at home, plus a reduction and avoidance of secondary damages (e.g., exacerbations, deterioration of typical interstitial lung disease ILD symptoms and pharmaceutical side effects). The first results have shown a tendency that the telemedical treatment combined with telemonitoring at home and the encouragement of patients to actively participate in their healthcare has a positive effect on the patient’s overall well-being and could be implemented as a complementation of the traditional standard of care.

Keywords: avoidance of secondary damages, interstitial lung disease, telemedicine and telemonitoring, subjective feeling of safety

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1495 Catamenial Pneumothorax: Report of Two Cases and Review of the Local Literature

Authors: Angeli Marie P. Lagman, Nephtali M. Gorgonio

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Catamenial pneumothorax is defined as a recurrent accumulation of air in the pleural cavity, which occurs in the period of 72 hours before or after menses. In a menstruating woman presenting with the difficulty of breathing and chest pain with concomitant radiographic evidence of pneumothorax, a diagnosis of catamenial pneumothorax should be entertained. Two cases of catamenial pneumothorax were reported in our local literature. This report added two more cases. The first case is 45 years old G1P1, while the second case is 46 years old G2P2. These two patients had a history of pelvic endometriosis in the past. All other signs and symptoms were similar to the previously reported cases. All patients presented with difficulty of breathing associated with chest pain. Imaging studies showed right-sided pneumothorax in all patients. Intraoperatively, subpleural bleb, diaphragmatic fenestrations, and endometriotic implants were found. Three patients underwent video-assisted thoracosurgery (VATS), while one patient underwent open thoracotomy with pleurodesis. Histopathology revealed endometriosis in only two patients. All patients received postoperative hormonal therapy, and there were no recurrences noted in all patients. Endometriosis-related catamenial pneumothorax is a rare condition that needs early recognition of the symptoms. Several theories may be involved to explain the pathogenesis of catamenial pneumothorax. Two cases show a strong significant association between a history of pelvic endometriosis and the development of catamenial pneumothorax, while one case can be explained by the hormonal theory. The difficulty of breathing and chest pain in relation to menses may prompt early diagnosis. One case has shown that pneumothorax may occur even after menstruation. A biopsy of the endometrial implants may not always show endometrial glands and stroma, nor will immunostaining, which will not always show estrogen and progesterone receptors. Video-assisted thoracoscopic surgery is the gold standard in the diagnosis and treatment of catamenial pneumothorax. Postoperative hormonal suppression will further reduce the disease recurrence and facilitate the effectiveness of the surgical treatment.

Keywords: catamenial pneumothorax, endometriosis, menstruation, video assisted thoracosurgery

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1494 Development of a Microfluidic Device for Low-Volume Sample Lysis

Authors: Abbas Ali Husseini, Ali Mohammad Yazdani, Fatemeh Ghadiri, Alper Şişman

Abstract:

We developed a microchip device that uses surface acoustic waves for rapid lysis of low level of cell samples. The device incorporates sharp-edge glass microparticles for improved performance. We optimized the lysis conditions for high efficiency and evaluated the device's feasibility for point-of-care applications. The microchip contains a 13-finger pair interdigital transducer with a 30-degree focused angle. It generates high-intensity acoustic beams that converge 6 mm away. The microchip operates at a frequency of 16 MHz, exciting Rayleigh waves with a 250 µm wavelength on the LiNbO3 substrate. Cell lysis occurs when Candida albicans cells and glass particles are placed within the focal area. The high-intensity surface acoustic waves induce centrifugal forces on the cells and glass particles, resulting in cell lysis through lateral forces from the sharp-edge glass particles. We conducted 42 pilot cell lysis experiments to optimize the surface acoustic wave-induced streaming. We varied electrical power, droplet volume, glass particle size, concentration, and lysis time. A regression machine-learning model determined the impact of each parameter on lysis efficiency. Based on these findings, we predicted optimal conditions: electrical signal of 2.5 W, sample volume of 20 µl, glass particle size below 10 µm, concentration of 0.2 µg, and a 5-minute lysis period. Downstream analysis successfully amplified a DNA target fragment directly from the lysate. The study presents an efficient microchip-based cell lysis method employing acoustic streaming and microparticle collisions within microdroplets. Integration of a surface acoustic wave-based lysis chip with an isothermal amplification method enables swift point-of-care applications.

Keywords: cell lysis, surface acoustic wave, micro-glass particle, droplet

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1493 Montelukast Doesn’t Decrease the Risk of Cardiovascular Disease in Asthma Patients in Taiwan

Authors: Sheng Yu Chen, Shi-Heng Wang

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Aim: Based on human, animal experiments, and genetic studies, cysteinyl leukotrienes, LTC4, LTD4, and LTE4, are inflammatory substances that are metabolized by 5-lipooxygenase from arachidonic acid, and these substances trigger asthma. In addition, the synthetic pathway of cysteinyl leukotriene is relevant to the increase in cardiovascular diseases such as myocardial ischemia and stroke. Given the situation, we aim to investigate whether cysteinyl leukotrienes receptor antagonist (LTRA), montelukast which cures those who have asthma has potential protective effects on cardiovascular diseases. Method: We conducted a cohort study, and enrolled participants which are newly diagnosed with asthma (ICD-9 CM code 493. X) between 2002 to 2011. The data source is from Taiwan National Health Insurance Research Database Patients with a previous history of myocardial infarction or ischemic stroke were excluded. Among the remaining participants, every montelukast user was matched with two randomly non-users by sex, and age. The incident cardiovascular diseases, including myocardial infarction and ischemic stroke, were regarded as outcomes. We followed the participants until outcomes come first or the end of the following period. To explore the protective effect of montelukast on the risk of cardiovascular disease, we use multivariable Cox regression to estimate the hazard ratio with adjustment for potential confounding factors. Result: There are 55876 newly diagnosed asthma patients who had at least one claim of inpatient admission or at least three claims of outpatient records. We enrolled 5350 montelukast users and 10700 non-users in this cohort study. The following mean (±SD) time of the Montelukast group is 5 (±2.19 )years, and the non-users group is 6.2 5.47 (± 2.641) years. By using multivariable Cox regression, our analysis indicated that the risk of incident cardiovascular diseases between montelukast users (n=43, 0.8%) and non-users (n=111, 1.04%) is approximately equal. [adjusted hazard ratio 0.992; P-value:0.9643] Conclusion: In this population-based study, we found that the use of montelukast is not associated with a decrease in incident MI or IS.

Keywords: asthma, inflammation, montelukast, insurance research database, cardiovascular diseases

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