Search results for: regular term
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5143

Search results for: regular term

973 Half Dose Tissue Plasminogen Activator for Intermediate-Risk Pulmonary Embolism

Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson

Abstract:

Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.

Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event

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972 Free Fibular Flaps in Management of Sternal Dehiscence

Authors: H. N. Alyaseen, S. E. Alalawi, T. Cordoba, É. Delisle, C. Cordoba, A. Odobescu

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Sternal dehiscence is defined as the persistent separation of sternal bones that are often complicated with mediastinitis. Etiologies that lead to sternal dehiscence vary, with cardiovascular and thoracic surgeries being the most common. Early diagnosis in susceptible patients is crucial to the management of such cases, as they are associated with high mortality rates. A recent meta-analysis of more than four hundred thousand patients concluded that deep sternal wound infections were the leading cause of mortality and morbidity in patients undergoing cardiac procedures. Long-term complications associated with sternal dehiscence include increased hospitalizations, cardiac infarctions, and renal and respiratory failures. Numerous osteosynthesis methods have been described in the literature. Surgical materials offer enough rigidity to support the sternum and can be flexible enough to allow physiological breathing movements of the chest; however, these materials fall short when managing patients with extensive bone loss, osteopenia, or general poor bone quality, for such cases, flaps offer a better closure system. Early utilization of flaps yields better survival rates compared to delayed closure or to patients treated with sternal rewiring and closed drainage. The utilization of pectoralis major flaps, rectus abdominus, and latissimus muscle flaps have all been described in the literature as great alternatives. Flap selection depends on a variety of factors, mainly the size of the sternal defect, infection, and the availability of local tissues. Free fibular flaps are commonly harvested flaps utilized in reconstruction around the body. In cases regarding sternal reconstruction with free fibular flaps, the literature exclusively discussed the flap applied vertically to the chest wall. We present a different technique applying the free fibular triple barrel flap oriented in a transverse manner, in parallel to the ribs. In our experience, this method could have enhanced results and improved prognosis as it contributes to the normal circumferential shape of the chest wall.

Keywords: sternal dehiscence, management, free fibular flaps, novel surgical techniques

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971 Preliminary Short-Term Results of a Population of Patients Treated with Mitraclip Therapy: One Center Experience

Authors: Rossana Taravella, Gilberto M. Cellura, Giuseppe Cirrincione, Salvatore Asciutto, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Novo

Abstract:

Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effectiveness endpoint. Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study)II trial, the percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age 74±11years, 43 men (69%)] with MR of at least grade3+. Most of the patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+ (primary effectiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients, with a large freedom from death, surgery or recurrent MR in a great portion of patients.

Keywords: MitraClip, mitral regurgitation, heart valves, catheter-based therapy

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970 COVID-19 Case: A Definition of Infodemia through Online Italian Journalism

Authors: Concetta Papapicco

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The spreading of new Coronavirus (COVID-19) in addition to becoming a global phenomenon, following the declaration of a pandemic state, has generated excessive access to information, sometimes not thoroughly screened, which makes it difficult to navigate a given topic because of the difficulty of finding reliable sources. As a result, there is a high level of contagion, understood as the spread of the virus, but also as the spread of information in a viral and harmful way, which prompted the World Health Organization to coin the term Infodemia to give 'a name' the phenomenon of excessive information. With neologism 'Infodemia', the World Health Organization (OMS) wanted, in these days when fear of the coronavirus is raging, point out that perhaps the greatest danger of global society in the age of social media. This phenomenon is the distortion of reality in the rumble of echoes and comments of the global community on real or often invented facts. The general purpose of the exploratory study is to investigate how the coronavirus situation is described from journalistic communication. Starting from La Repubblica online, as a reference journalistic magazine, as a specific objective, the research aims to understand the way in which journalistic communication describes the phenomenon of the COVID-19 virus spread, the spread of contagion and restrictive measures of social distancing in the Italian context. The study starts from the hypothesis that if the circulation of information helps to create a social representation of the phenomenon, the excessive accessibility to sources of information (Infodemia) can be modulated by the 'how' the phenomenon is described by the journalists. The methodology proposed, in fact, in the exploratory study is a quanti-qualitative (mixed) method. A Content Analysis with the SketchEngine software is carried out first. In support of the Content Analysis, a Diatextual Analysis was carried out. The Diatextual Analysis is a qualitative analysis useful to detect in the analyzed texts, that is the online articles of La Repubblica on the topic of coronavirus, Subjectivity, Argomentativity, and Mode. The research focuses mainly on 'Mode' or 'How' are the events related to coronavirus in the online articles of La Repubblica about COVID-19 phenomenon. The results show the presence of the contrast vision about COVID-19 situation in Italy.

Keywords: coronavirus, Italian infodemia, La Republica online, mix method

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969 Study of the Design and Simulation Work for an Artificial Heart

Authors: Mohammed Eltayeb Salih Elamin

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This study discusses the concept of the artificial heart using engineering concepts, of the fluid mechanics and the characteristics of the non-Newtonian fluid. For the purpose to serve heart patients and improve aspects of their lives and since the Statistics review according to world health organization (WHO) says that heart disease and blood vessels are the first cause of death in the world. Statistics shows that 30% of the death cases in the world by the heart disease, so simply we can consider it as the number one leading cause of death in the entire world is heart failure. And since the heart implantation become a very difficult and not always available, the idea of the artificial heart become very essential. So it’s important that we participate in the developing this idea by searching and finding the weakness point in the earlier designs and hoping for improving it for the best of humanity. In this study a pump was designed in order to pump blood to the human body and taking into account all the factors that allows it to replace the human heart, in order to work at the same characteristics and the efficiency of the human heart. The pump was designed on the idea of the diaphragm pump. Three models of blood obtained from the blood real characteristics and all of these models were simulated in order to study the effect of the pumping work on the fluid. After that, we study the properties of this pump by using Ansys15 software to simulate blood flow inside the pump and the amount of stress that it will go under. The 3D geometries modeling was done using SOLID WORKS and the geometries then imported to Ansys design modeler which is used during the pre-processing procedure. The solver used throughout the study is Ansys FLUENT. This is a tool used to analysis the fluid flow troubles and the general well-known term used for this branch of science is known as Computational Fluid Dynamics (CFD). Basically, Design Modeler used during the pre-processing procedure which is a crucial step before the start of the fluid flow problem. Some of the key operations are the geometry creations which specify the domain of the fluid flow problem. Next is mesh generation which means discretization of the domain to solve governing equations at each cell and later, specify the boundary zones to apply boundary conditions for the problem. Finally, the pre–processed work will be saved at the Ansys workbench for future work continuation.

Keywords: Artificial heart, computational fluid dynamic heart chamber, design, pump

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968 Impact of the Hayne Royal Commission on the Operating Model of Australian Financial Advice Firms

Authors: Mohammad Abu-Taleb

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The final report of the Royal Commission into Australian financial services misconduct, released in February 2019, has had a significant impact on the financial advice industry. The recommendations released in the Commissioner’s final report include changes to ongoing fee arrangements, a new disciplinary system for financial advisers, and mandatory reporting of compliance concerns. This thesis aims to explore the impact of the Royal Commission’s recommendations on the operating model of financial advice firms in terms of advice products, processes, delivery models, and customer segments. Also, this research seeks to investigate whether the Royal Commission’s outcome has accelerated the use of enhanced technology solutions within the operating model of financial advice firms. And to identify the key challenges confronting financial advice firms whilst implementing the Commissioner’s recommendations across their operating models. In order to achieve the objectives of this thesis, a qualitative research design has been adopted through semi-structured in-depth interviews with 24 financial advisers and managers who are engaged in the operation of financial advice services. The study used the thematic analysis approach to interpret the qualitative data collected from the interviews. The findings of this thesis reveal that customer-centric operating models will become more prominent across the financial advice industry in response to the Commissioner’s final report. And the Royal Commission’s outcome has accelerated the use of advice technology solutions within the operating model of financial advice firms. In addition, financial advice firms have started more than before using simpler and more automated web-based advice services, which enable financial advisers to provide simple advice in a greater scale, and also to accelerate the use of robo-advice models and digital delivery to mass customers in the long term. Furthermore, the study identifies process and technology changes as, long with technical and interpersonal skills development, as the key challenges encountered financial advice firms whilst implementing the Commissioner’s recommendations across their operating models.

Keywords: hayne royal commission, financial planning advice, operating model, advice products, advice processes, delivery models, customer segments, digital advice solutions

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967 Controlling RPV Embrittlement through Wet Annealing in Support of Life Extension

Authors: E. A. Krasikov

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As a main barrier against radioactivity outlet reactor pressure vessel (RPV) is a key component in terms of NPP safety. Therefore, present-day demands in RPV reliability enhance have to be met by all possible actions for RPV in-service embrittlement mitigation. Annealing treatment is known to be the effective measure to restore the RPV metal properties deteriorated by neutron irradiation. There are two approaches to annealing. The first one is so-called ‘dry’ high temperature (~475°C) annealing. It allows obtaining practically complete recovery, but requires the removal of the reactor core and internals. External heat source (furnace) is required to carry out RPV heat treatment. The alternative approach is to anneal RPV at a maximum coolant temperature which can be obtained using the reactor core or primary circuit pumps while operating within the RPV design limits. This low temperature «wet» annealing, although it cannot be expected to produce complete recovery, is more attractive from the practical point of view especially in cases when the removal of the internals is impossible. The first RPV «wet» annealing was done using nuclear heat (US Army SM-1A reactor). The second one was done by means of primary pumps heat (Belgian BR-3 reactor). As a rule, there is no recovery effect up to annealing and irradiation temperature difference of 70°C. It is known, however, that along with radiation embrittlement neutron irradiation may mitigate the radiation damage in metals. Therefore, we have tried to test the possibility to use the effect of radiation-induced ductilization in ‘wet’ annealing technology by means of nuclear heat utilization as heat and neutron irradiation sources at once. In support of the above-mentioned conception the 3-year duration reactor experiment on 15Cr3NiMoV type steel with preliminary irradiation at operating PWR at 270°C and following extra irradiation (87 h at 330°C) at IR-8 test reactor was fulfilled. In fact, embrittlement was partly suppressed up to value equivalent to 1,5 fold neutron fluence decrease. The degree of recovery in case of radiation enhanced annealing is equal to 27% whereas furnace annealing results in zero effect under existing conditions. Mechanism of the radiation-induced damage mitigation is proposed. It is hoped that «wet » annealing technology will help provide a better management of the RPV degradation as a factor affecting the lifetime of nuclear power plants which, together with associated management methods, will help facilitate safe and economic long-term operation of PWRs.

Keywords: controlling, embrittlement, radiation, steel, wet annealing

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966 Parametric Approach for Reserve Liability Estimate in Mortgage Insurance

Authors: Rajinder Singh, Ram Valluru

Abstract:

Chain Ladder (CL) method, Expected Loss Ratio (ELR) method and Bornhuetter-Ferguson (BF) method, in addition to more complex transition-rate modeling, are commonly used actuarial reserving methods in general insurance. There is limited published research about their relative performance in the context of Mortgage Insurance (MI). In our experience, these traditional techniques pose unique challenges and do not provide stable claim estimates for medium to longer term liabilities. The relative strengths and weaknesses among various alternative approaches revolve around: stability in the recent loss development pattern, sufficiency and reliability of loss development data, and agreement/disagreement between reported losses to date and ultimate loss estimate. CL method results in volatile reserve estimates, especially for accident periods with little development experience. The ELR method breaks down especially when ultimate loss ratios are not stable and predictable. While the BF method provides a good tradeoff between the loss development approach (CL) and ELR, the approach generates claim development and ultimate reserves that are disconnected from the ever-to-date (ETD) development experience for some accident years that have more development experience. Further, BF is based on subjective a priori assumption. The fundamental shortcoming of these methods is their inability to model exogenous factors, like the economy, which impact various cohorts at the same chronological time but at staggered points along their life-time development. This paper proposes an alternative approach of parametrizing the loss development curve and using logistic regression to generate the ultimate loss estimate for each homogeneous group (accident year or delinquency period). The methodology was tested on an actual MI claim development dataset where various cohorts followed a sigmoidal trend, but levels varied substantially depending upon the economic and operational conditions during the development period spanning over many years. The proposed approach provides the ability to indirectly incorporate such exogenous factors and produce more stable loss forecasts for reserving purposes as compared to the traditional CL and BF methods.

Keywords: actuarial loss reserving techniques, logistic regression, parametric function, volatility

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965 Anti-Corruption Strategies for Private Sector Development: Case Study for the Brazilian Automotive Industry

Authors: Rogerio Vieira Dos Reis

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Countries like Brazil that despite fighting hard against corruption are not improving their corruption perception, especially due to systemic political corruption, should review their corruption prevention strategies. This thesis brings a case study based on an alternative way of preventing corruption: addressing the corruption drivers in public policies that lead to poor economic performance. After discussing the Brazilian industrial policies adopted recently, especially the measures towards the automotive sector, two corruption issues in this sector are analyzed: facilitating payment for fiscal benefits and buying the extension of fiscal benefits. In-depth interviews conducted with a policymaker and an executive of the automobile sector provide insights for identifying three main corruption drivers: excessive and unnecessary bureaucracy, a complex tax system and the existence of a closed market without setting performance requirements to be achieved by the benefited firms. Both the identification of the drivers of successful industrial policies and the proposal of anti-corruption strategies to ensure developmental outcomes are based on the economic perspective of industrial policy advocated by developmental authors and on the successful South Korean economic development experience. Structural anti-corruption measures include tax reform, the regulation of lobbying and legislation to allow corporate political contribution. Besides improving policymakers’ technical capabilities, measures at the ministry level include redesigning the automotive regimes as long-term policies focused on national investment with simple and clear rules and making fiscal benefits conditional upon performance targets focused on suppliers. This case study is of broader interest because it recommends the importance of adapting performance audits conducted by anti-corruption agencies, to focus not only on the delivery of public services, but also on the identification of potentially highly damaging corruption drivers in public policies that grant fiscal benefits to achieve developmental outcomes.

Keywords: Brazilian automotive sector, corruption, economic development, industrial policy, Inovar-Auto

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964 Development of a PJWF Cleaning Method for Wet Electrostatic Precipitators

Authors: Hsueh-Hsing Lu, Thi-Cuc Le, Tung-Sheng Tsai, Chuen-Jinn Tsai

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This study designed and tested a novel wet electrostatic precipitators (WEP) system featuring a Pulse-Air-Jet-Assisted Water Flow (PJWF) to shorten water cleaning time, reduce water usage, and maintain high particle removal efficiency. The PJWF injected cleaning water tangentially at the cylinder wall, rapidly enhancing the momentum of the water flow for efficient dust cake removal. Each PJWF cycle uses approximately 4.8 liters of cleaning water in 18 seconds. Comprehensive laboratory tests were conducted using a single-tube WEP prototype within a flow rate range of 3.0 to 6.0 cubic meters per minute(CMM), operating voltages between -35 to -55 kV, and high-frequency power supply. The prototype, consisting of 72 sets of double-spike rigid discharge electrodes, demonstrated that with the PJWF, -35 kV, and 3.0 CMM, the PM2.5 collection efficiency remained as high as the initial value of 88.02±0.92% after loading with Al2O3 particles at 35.75± 2.54 mg/Nm3 for 20-hr continuous operation. In contrast, without the PJWF, the PM2.5 collection efficiency drastically dropped from 87.4% to 53.5%. Theoretical modeling closely matched experimental results, confirming the robustness of the system's design and its scalability for larger industrial applications. Future research will focus on optimizing the PJWF system, exploring its performance with various particulate matter, and ensuring long-term operational stability and reliability under diverse environmental conditions. Recently, this WEP was combined with a preceding CT (cooling tower) and a HWS (honeycomb wet scrubber) and pilot-tested (40 CMM) to remove SO2 and PM2.5 emissions in a sintering plant of an integrated steel making plant. Pilot-test results showed that the removal efficiencies for SO2 and PM2.5 emissions are as high as 99.7 and 99.3 %, respectively, with ultralow emitted concentrations of 0.3 ppm and 0.07 mg/m3, respectively, while the white smoke is also eliminated at the same time. These new technologies are being used in the industry and the application in different fields is expected to be expanded to reduce air pollutant emissions substantially for a better ambient air quality.

Keywords: wet electrostatic precipitator, pulse-air-jet-assisted water flow, particle removal efficiency, air pollution control

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963 Impact of Relaxing Incisions on Maxillofacial Growth Following Sommerlad–Furlow Modified Technique in Patients with Isolated Cleft Palate: A Preliminary Comparative Study

Authors: Sadam Elayah, Yang Li, Bing Shi

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Background: The impact of relaxing incisions on maxillofacial growth during palatoplasty remains a topic of debate, and further research is needed to understand its effects fully. Thus, the current study is the first long-term study that aimed to assess the maxillofacial growth of patients with isolated cleft palate following the Sommerlad-Furlow modified (S.F) technique and to estimate the impact of relaxing incisions on maxillofacial growth following S.F technique in patients with isolated cleft palate. Methods: A total of 85 participants, 55 patients with non-syndromic isolated soft and hard cleft palate underwent primary palatoplasty with our technique (30 patients received the Sommerlad-Furlow modified technique without relaxing incision (S.F+RI group), and 25 received Sommerlad-Furlow modified technique without relaxing (S.F-RI group) with no significant difference found between them regarding the cleft type, cleft width, and age at repair. While the other 30 were normal participants with skeletal class I pattern (C group). The control group was matched with the study group in number, age, and sex. All the study variables were measured using stable landmarks, including 12 linear and 10 angular variants. Results: The mean ages at collection of cephalograms were 6.03±0.80 in the S.F+RI group, 5.96±0.76 in the S.F-RI group, and 5.91±0.87 in the C group. Regarding cranial base, the results showed no statistically significant differences between the three groups in S-N and S-N-Ba. The S.F+R.I group had a significantly shorter S-Ba than the S.F-R.I & C groups (P= 0.01). However, there was no statistically significant difference between the S.F-R.I & C groups (P=0.80). Regarding the skeletal maxilla, there was no significant difference between the S.F+R.I and S.F-R.I groups in all linear measurements (N-ANS, S- PM & SN-PP ) except Co-A, the S.F+R.I group had significantly shorter Co-A than the S.F-R.I & C groups (P= <0.01). While the angular measurement, S.F+R.I group had significantly less SNA angle than the S.F-R.I & C groups (P= <0.01). Regarding mandibular bone, there were no statistically significant differences in all linear and angular mandibular measurements between the S.F+R.I and S.F-R.I groups. Regarding intermaxillary relation, the S.F+R.I group had significant differences in Co-Gn - Co-A and ANB compared to the S.F-R.I & C groups (P= <0.01). There was no statistically significant difference in PP-MP among the three groups. Conclusion: As a preliminary report, the Sommerlad-Furlow modified technique without relaxing incisions was found to have good maxillary positioning in the face and a satisfactory intermaxillary relationship compared to the Sommerlad-Furlow modified technique with relaxing incisions.

Keywords: relaxing incisions, cleft palate, palatoplasty, maxillofacial growth

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962 The Contact between a Rigid Substrate and a Thick Elastic Layer

Authors: Nicola Menga, Giuseppe Carbone

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Although contact mechanics has been widely focused on the study of contacts between half-space, it has been recently pointed out that in presence of finite thickness elastic layers the results of the contact problem show significant difference in terms of the main contact quantities (e.g. contact area, penetration, mean pressure, etc.). Actually, there exist a wide range of industrial application demanding for this kind of studies, such as seals leakage prediction or pressure-sensitive coatings for electrical applications. In this work, we focus on the contact between a rigid profile and an elastic layer of thickness h confined under two different configurations: rigid constrain and applied uniform pressure. The elastic problem at hand has been formalized following Green’s function method and then numerically solved by means of a matrix inversion. We study different contact conditions, both considering and neglecting adhesive interactions at the interface. This leads to different solution techniques: Adhesive contacts equilibrium solution is found, in term of contact area for given penetration, making stationary the total free energy of the system; whereas, adhesiveless contacts are addressed defining an equilibrium criterion, again on the contact area, relying on the fracture mechanics stress intensity factor KI. In particular, we make the KI vanish at the edges of the contact area, as peculiar for adhesiveless elastic contacts. The results are obtained in terms of contact area, penetration, and mean pressure for both adhesive and adhesiveless contact conditions. As expected, in the case of a uniform applied pressure the slab turns out much more compliant than the rigidly constrained one. Indeed, we have observed that the peak value of the contact pressure, for both the adhesive and adhesiveless condition, is much higher for the rigidly constrained configuration than in the case of applied uniform pressure. Furthermore, we observed that, for little contact area, both systems behave the same and the pull-off occurs at approximately the same contact area and mean contact pressure. This is an expected result since in this condition the ratio between the layers thickness and the contact area is very high and both layer configurations recover the half-space behavior where the pull-off occurrence is mainly controlled by the adhesive interactions, which are kept constant among the cases.

Keywords: contact mechanics, adhesion, friction, thick layer

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961 Concanavaline a Conjugated Bacterial Polyester Based PHBHHx Nanoparticles Loaded with Curcumin for the Ovarian Cancer Therapy

Authors: E. Kilicay, Z. Karahaliloglu, B. Hazer, E. B. Denkbas

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In this study, we have prepared concanavaline A (ConA) functionalized curcumin (CUR) loaded PHBHHx (poly(3-hydroxybutyrate-co-3-hydroxyhexanoate)) nanoparticles as a novel and efficient drug delivery system. CUR is a promising anticancer agent for various cancer types. The aim of this study was to evaluate therapeutic potential of curcumin loaded PHBHHx nanoparticles (CUR-NPs) and concanavaline A conjugated curcumin loaded NPs (ConA-CUR NPs) for ovarian cancer treatment. ConA was covalently connected to the carboxylic group of nanoparticles by EDC/NHS activation method. In the ligand attachment experiment, the binding capacity of ConA on the surface of NPs was found about 90%. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) analysis showed that the prepared nanoparticles were smooth and spherical in shape. The size and zeta potential of prepared NPs were about 228±5 nm and −21.3 mV respectively. ConA-CUR NPs were characterized by FT-IR spectroscopy which confirmed the existence of CUR and ConA in the nanoparticles. The entrapment and loading efficiencies of different polymer/drug weight ratios, 1/0.125 PHBHHx/CUR= 1.25CUR-NPs; 1/0.25 PHBHHx/CUR= 2.5CUR-NPs; 1/0.5 PHBHHx/CUR= 5CUR-NPs, ConA-1.25CUR NPs, ConA-2.5CUR NPs and ConA-5CUR NPs were found to be ≈ 68%-16.8%; 55%-17.7 %; 45%-33.6%; 70%-15.7%; 60%-17%; 51%-30.2% respectively. In vitro drug release showed that the sustained release of curcumin was observed from CUR-NPs and ConA-CUR NPs over a period of 19 days. After binding of ConA, the release rate was slightly increased due to the migration of curcumin to the surface of the nanoparticles and the matrix integrities was decreased because of the conjugation reaction. This functionalized nanoparticles demonstrated high drug loading capacity, sustained drug release profile, and high and long term anticancer efficacy in human cancer cell lines. Anticancer activity of ConA-CUR NPs was proved by MTT assay and reconfirmed by apoptosis and necrosis assay. The anticancer activity of ConA-CUR NPs was measured in ovarian cancer cells (SKOV-3) and the results revealed that the ConA-CUR NPs had better tumor cells decline activity than free curcumin. The nacked nanoparticles have no cytotoxicity against human ovarian carcinoma cells. Thus the developed functionalized nanoformulation could be a promising candidate in cancer therapy.

Keywords: curcumin, curcumin-PHBHHx nanoparticles, concanavalin A, concanavalin A-curcumin PHBHHx nanoparticles, PHBHHx nanoparticles, ovarian cancer cell

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960 Isolation and Molecular Characterization of Lytic Bacteriophage against Carbapenem Resistant Klebsiella pneumoniae

Authors: Guna Raj Dhungana, Roshan Nepal, Apshara Parajuli, , Archana Maharjan, Shyam K. Mishra, Pramod Aryal, Rajani Malla

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Introduction: Klebsiella pneumoniae is a well-known opportunistic human pathogen, primarily causing healthcare-associated infections. The global emergence of carbapenemase-producing K. pneumoniaeis a major public health burden, which is often extensively multidrug resistant.Thus, because of the difficulty to treat these ‘superbug’ and menace and some term as ‘apocalypse’ of post antibiotics era, an alternative approach to controlling this pathogen is prudent and one of the approaches is phage mediated control and/or treatment. Objective: In this study, we aimed to isolate novel bacteriophage against carbapenemase-producing K. pneumoniaeand characterize for potential use inphage therapy. Material and Methods: Twenty lytic phages were isolated from river water using double layer agar assay and purified. Biological features, physiochemical characters, burst size, host specificity and activity spectrum of phages were determined. One most potent phage: Phage TU_Kle10O was selected and characterized by electron microscopy. Whole genome sequences of the phage were analyzed for presence/absence of virulent factors, and other lysin genes. Results: Novel phage TU_Kle10O showed multiple host range within own genus and did not induce any BIM up to 5th generation of host’s life cycle. Electron microscopy confirmed that the phage was tailed and belonged to Caudovirales family. Next generation sequencing revealed its genome to be 166.2 Kb. bioinformatical analysis further confirmed that the phage genome ‘did not’ contain any ‘bacterial genes’ within phage genome, which ruled out the concern for transfer of virulent genes. Specific 'lysin’ enzyme was identified phages which could be used as 'antibiotics'. Conclusion: Extensively multidrug resistant bacteria like carbapenemase-producing K. pneumoniaecould be treated efficiently by phages.Absence of ‘virulent’ genes of bacterial origin and presence of lysin proteins within phage genome makes phages an excellent candidate for therapeutics.

Keywords: bacteriophage, Klebsiella pneumoniae, MDR, phage therapy, carbapenemase,

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959 Using the Smith-Waterman Algorithm to Extract Features in the Classification of Obesity Status

Authors: Rosa Figueroa, Christopher Flores

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Text categorization is the problem of assigning a new document to a set of predetermined categories, on the basis of a training set of free-text data that contains documents whose category membership is known. To train a classification model, it is necessary to extract characteristics in the form of tokens that facilitate the learning and classification process. In text categorization, the feature extraction process involves the use of word sequences also known as N-grams. In general, it is expected that documents belonging to the same category share similar features. The Smith-Waterman (SW) algorithm is a dynamic programming algorithm that performs a local sequence alignment in order to determine similar regions between two strings or protein sequences. This work explores the use of SW algorithm as an alternative to feature extraction in text categorization. The dataset used for this purpose, contains 2,610 annotated documents with the classes Obese/Non-Obese. This dataset was represented in a matrix form using the Bag of Word approach. The score selected to represent the occurrence of the tokens in each document was the term frequency-inverse document frequency (TF-IDF). In order to extract features for classification, four experiments were conducted: the first experiment used SW to extract features, the second one used unigrams (single word), the third one used bigrams (two word sequence) and the last experiment used a combination of unigrams and bigrams to extract features for classification. To test the effectiveness of the extracted feature set for the four experiments, a Support Vector Machine (SVM) classifier was tuned using 20% of the dataset. The remaining 80% of the dataset together with 5-Fold Cross Validation were used to evaluate and compare the performance of the four experiments of feature extraction. Results from the tuning process suggest that SW performs better than the N-gram based feature extraction. These results were confirmed by using the remaining 80% of the dataset, where SW performed the best (accuracy = 97.10%, weighted average F-measure = 97.07%). The second best was obtained by the combination of unigrams-bigrams (accuracy = 96.04, weighted average F-measure = 95.97) closely followed by the bigrams (accuracy = 94.56%, weighted average F-measure = 94.46%) and finally unigrams (accuracy = 92.96%, weighted average F-measure = 92.90%).

Keywords: comorbidities, machine learning, obesity, Smith-Waterman algorithm

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958 Risks for Cyanobacteria Harmful Algal Blooms in Georgia Piedmont Waterbodies Due to Land Management and Climate Interactions

Authors: Sam Weber, Deepak Mishra, Susan Wilde, Elizabeth Kramer

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The frequency and severity of cyanobacteria harmful blooms (CyanoHABs) have been increasing over time, with point and non-point source eutrophication and shifting climate paradigms being blamed as the primary culprits. Excessive nutrients, warm temperatures, quiescent water, and heavy and less regular rainfall create more conducive environments for CyanoHABs. CyanoHABs have the potential to produce a spectrum of toxins that cause gastrointestinal stress, organ failure, and even death in humans and animals. To promote enhanced, proactive CyanoHAB management, risk modeling using geospatial tools can act as predictive mechanisms to supplement current CyanoHAB monitoring, management and mitigation efforts. The risk maps would empower water managers to focus their efforts on high risk water bodies in an attempt to prevent CyanoHABs before they occur, and/or more diligently observe those waterbodies. For this research, exploratory spatial data analysis techniques were used to identify the strongest predicators for CyanoHAB blooms based on remote sensing-derived cyanobacteria cell density values for 771 waterbodies in the Georgia Piedmont and landscape characteristics of their watersheds. In-situ datasets for cyanobacteria cell density, nutrients, temperature, and rainfall patterns are not widely available, so free gridded geospatial datasets were used as proxy variables for assessing CyanoHAB risk. For example, the percent of a watershed that is agriculture was used as a proxy for nutrient loading, and the summer precipitation within a watershed was used as a proxy for water quiescence. Cyanobacteria cell density values were calculated using atmospherically corrected images from the European Space Agency’s Sentinel-2A satellite and multispectral instrument sensor at a 10-meter ground resolution. Seventeen explanatory variables were calculated for each watershed utilizing the multi-petabyte geospatial catalogs available within the Google Earth Engine cloud computing interface. The seventeen variables were then used in a multiple linear regression model, and the strongest predictors of cyanobacteria cell density were selected for the final regression model. The seventeen explanatory variables included land cover composition, winter and summer temperature and precipitation data, topographic derivatives, vegetation index anomalies, and soil characteristics. Watershed maximum summer temperature, percent agriculture, percent forest, percent impervious, and waterbody area emerged as the strongest predictors of cyanobacteria cell density with an adjusted R-squared value of 0.31 and a p-value ~ 0. The final regression equation was used to make a normalized cyanobacteria cell density index, and a Jenks Natural Break classification was used to assign waterbodies designations of low, medium, or high risk. Of the 771 waterbodies, 24.38% were low risk, 37.35% were medium risk, and 38.26% were high risk. This study showed that there are significant relationships between free geospatial datasets representing summer maximum temperatures, nutrient loading associated with land use and land cover, and the area of a waterbody with cyanobacteria cell density. This data analytics approach to CyanoHAB risk assessment corroborated the literature-established environmental triggers for CyanoHABs, and presents a novel approach for CyanoHAB risk mapping in waterbodies across the greater southeastern United States.

Keywords: cyanobacteria, land use/land cover, remote sensing, risk mapping

Procedia PDF Downloads 211
957 The Impact of Resettlement Challenges in Seeking Employment on the Mental Health and Well-Being of African Refugee Youth in South Australia

Authors: Elvis Munyoka

Abstract:

While the number of African refugees settling in Australia has significantly increased since the mid-1990s, the marginalisation and exclusion of young people from refugee backgrounds in employment remain a critical challenge. Unemployment or underemployment can negatively impact refugees in multiple areas, such as income, housing, life satisfaction, and social status. Higher rates of unemployment among refugees are linked in part to the intersection of pre-migration and daily challenges like trauma, racism, gender identity, and English language competency, all of which generate multiple employability disadvantages. However, the intersection of gender, race, social class, and age in impacting African refugee youth’s access to employment has received less attention. Using a qualitative case study approach, the presentation will explore how gender, race, social class, and age influence African refugee youth graduates’ access to employment in South Australia. The intersectionality theory and capability approach to social justice is used to explore intersecting factors impacting African refugee youth’s access to employment in South Australia. Participants were 16 African refugee graduates aged 18-30 living in South Australia who took part in the study for one year. Based on the trends in the data, the results suggest that long-term unemployment and underemployment, coupled with ongoing racism and marginalisation, have the potential to make refugees more vulnerable to several mental disorders such as depression, hopelessness, and suicidal thoughts. The analysis also reveals that resettlement challenges may limit refugees’ ability to recover from pre-migration trauma. The impact of resettlement challenges on refugee mental health highlights the need for comprehensive policy interventions to address the barriers refugees face in finding employment in resettlement communities. With African refugees constituting such an important part of Australian society, they should have equal access to meaningful employment, as decent work promotes good mental health, successful resettlement, hope, and self-sufficiency.

Keywords: African refugees, employment, mental health, Australia, underemployment

Procedia PDF Downloads 102
956 Post-Combustion CO₂ Capture: From Membrane Synthesis to Module Intensification

Authors: Imran Khan Swati, Mohammad Younas

Abstract:

This work aims to explore the potential applications of polymeric hydrophobic membranes and green ionic liquids (ILs). Protic and aprotic ILs were synthesized in the lab., characterized, and tested for CO₂/N₂ and CO₂/CH₄ separation using hydrophobic polymeric membranes via supported ionic liquid membrane (SILM). ILs were verified by FTIR spectroscopy. The SILMs were stable at room temperature up to 0.5 MPa. For CO₂, [BSmim][tos] had the greatest coefficient of solubility and permeability, along with all ILs. At 0.5 MPa, IL [BSmim][tos] was found with a selectivity of 56.2 and 47.5 for pure CO₂/N₂ and CO₂/CH₄, respectively. The ILs synthesized for this study are rated as [BSmim][tos]>[BSmpy][tos]>[Bmim][Cl]>[Bpy][Cl] based on their SILM separation performance. Furthermore, high values of selectivity of [BSmim][tos] and [BSmpy][tos] support the use of ILs for CO₂ separation using SILMs. The study was extended to synthesize and test the ammonium-based ILs, [2-HEA][f] and [2-HEA][Hs]. These ILs achieved 50 % less selectivity for CO₂/N₂ as compared to [BSmim][tos] and [BSmpy][tos]. Nevertheless, the permeability of CO₂ achieved with [2-HEA][f] and [2-HEA][Hs] is more than 20 times higher than the [BSmim][tos] and [BSmpy][tos]. Later, the CO₂/N₂ permeability and selectivity study was extended using a flat sheet membrane contactor with recirculated IL. The contact angle effects, liquid entry pressure (LEP), initial CO₂ concentration, and type of solvents and membrane material on the CO₂ capture efficiency and membrane wetting in the post-combustion capture (PCC) process have been experimentally investigated and evaluated. Polytetrafluoroethylene (PTFE) has shown the most hydrophobic property with 6-170 loss in the contact angle. Furthermore, [Omim][BF4] and [Bmim][BF6] have exhibited only 5-8 % loss in LEP using PTFE membrane support. The CO₂ capture efficiency has been achieved as 80.8-99.8 % in different combinations of ILs and membrane support, keeping all other variables constant. While increasing CO₂ concentration from 15 to 45 % vol., an increase of nearly three folds in the CO₂ mass transfer flux was observed. The combination of [Omim][BF4] and PTFE membrane witnessed good long-term stability with only a 20 % loss in CO₂ capture efficiency in 480 min of continuous operation. A 3- D simulation model for non-dispersive solvent absorption in membrane contactors provides insight into the optimum design of a separation system for a specific application minimizing the overall cost and making the process environment-friendly.

Keywords: Post-combustion CO2 capture, membrane synthesis, process development, permeability and selectivity, ionic liquids

Procedia PDF Downloads 70
955 Occupational Health Services (OHS) in Hong Kong Hospitals and the Experience of Nurses: A Mixed Methods Study

Authors: Wong Yat Cheung Maggie

Abstract:

Occupational Safety and Health Ordinance (OS&HO) (Chap 509) was enacted in 1997, OHS in HK should be growing and maturing, with a holistic approach to occupational health and safety in the workplace including physical, mental, social and spiritual well-being. The question is “How effective are OHSPs in meeting the current needs of HK health workers?” This study was designed to explore the issue for the first time, to empirically analyse the views of those who work in the system. The study employed a mixed method approach to collect various data from Occupational Health Service Providers (OHSPs), Occupational Health Service Consumers (OHSC): Registered nurses working in the hospital setting. This study was designed in two phases and two stages. Phase I Stage I was a paper survey to collect the data on OHSP. Then Phase I Stage II was a follow-up interview. Phase II Stage I was a paper survey to collect the data on OHSC. Then Phase II Stage II was a follow-up focus group study on OHSC for further clarification of the Phase II and Stage I result. The Phase I result reflects HK OHSPs point of view and their experience in the existing OHS practice in the local hospitals. It reflects various styles of reporting systems, staff profiles background and resource in providing OHS in HK hospitals. However, the basic OHS concern is similar between hospitals. In general, the OHS policies and procedures are available on site even though they may have different foci. The Phase II result is reflecting the HKs OHSCs echoes the OHSP feedback at providing of OHS, OHS concern and related policies and procedure are available on site. However, the most significant feedback from the OHSC at Phase II Stage II shows, nurses experienced various OHS concern most commonly work stress, workplace harassment and back strain without formal or official report to the related parties. The lack of reporting was due to the management handling attitude, stakeholders’ compliance and term of definition still have room to be improved even the related policies and procedures are available on site.

Keywords: occupational health service, registered nurse, Hong Kong hospital, mixed method

Procedia PDF Downloads 332
954 The Role of Leisure in Older Adults Transitioning to New Homes

Authors: Kristin Prentice, Carri Hand

Abstract:

As the Canadian population ages and chronic health conditions continue to escalate, older adults will require various types of housing, such as long term care or retirement homes. Moving to a new home may require a change in leisure activities and social networks, which could be challenging to maintain identity and create a sense of home. Leisure has been known to help older adults maintain or increase their quality of life and life satisfaction and may help older adults in moving to new homes. Sense of home and identity within older adults' transitions to new homes are concepts that may also relate to leisure engagement. Literature is scant regarding the role of leisure in older adults moving to new homes and how the sense of home and identity inter-relate. This study aims to explore how leisure may play a role in older adults' transitioning to new homes, including how sense of home and identity inter-relate. An ethnographic approach will be used to understand the culture of older adults transitioning to new homes. This study will involve older adults who have recently relocated to a mid-sized city in Ontario, Canada. The study will focus on the older adult’s interactions with and connections to their home environment through leisure. Data collection will take place via video-conferencing and will include a narrative interview and two other interviews to discuss an activity diary of leisure engagement pre and post move and mental maps to capture spaces where participants engaged in leisure. Participants will be encouraged to share photographs of leisure engagement taken inside and outside their home to help understand the social spaces the participants refer to in their activity diaries and mental maps. Older adults attempt to adjust to their new homes by maintaining their identity, developing a sense of home through creating attachment to place, and maintaining social networks, all of which have been linked to engaging in leisure. This research will provide insight into the role of leisure in this transition process and the extent that the home and community can contribute to aiding their transition to the new home. This research will contribute to existing literature on the inter-relationships of leisure, sense of home, and identity and how they relate to older adults moving to new homes. This research also has potential for influencing policy and practice for meeting the housing needs of older adults.

Keywords: leisure, older adults, transition, identity

Procedia PDF Downloads 120
953 Analysis of Composite Health Risk Indicators Built at a Regional Scale and Fine Resolution to Detect Hotspot Areas

Authors: Julien Caudeville, Muriel Ismert

Abstract:

Analyzing the relationship between environment and health has become a major preoccupation for public health as evidenced by the emergence of the French national plans for health and environment. These plans have identified the following two priorities: (1) to identify and manage geographic areas, where hotspot exposures are suspected to generate a potential hazard to human health; (2) to reduce exposure inequalities. At a regional scale and fine resolution of exposure outcome prerequisite, environmental monitoring networks are not sufficient to characterize the multidimensionality of the exposure concept. In an attempt to increase representativeness of spatial exposure assessment approaches, risk composite indicators could be built using additional available databases and theoretical framework approaches to combine factor risks. To achieve those objectives, combining data process and transfer modeling with a spatial approach is a fundamental prerequisite that implies the need to first overcome different scientific limitations: to define interest variables and indicators that could be built to associate and describe the global source-effect chain; to link and process data from different sources and different spatial supports; to develop adapted methods in order to improve spatial data representativeness and resolution. A GIS-based modeling platform for quantifying human exposure to chemical substances (PLAINE: environmental inequalities analysis platform) was used to build health risk indicators within the Lorraine region (France). Those indicators combined chemical substances (in soil, air and water) and noise risk factors. Tools have been developed using modeling, spatial analysis and geostatistic methods to build and discretize interest variables from different supports and resolutions on a 1 km2 regular grid within the Lorraine region. By example, surface soil concentrations have been estimated by developing a Kriging method able to integrate surface and point spatial supports. Then, an exposure model developed by INERIS was used to assess the transfer from soil to individual exposure through ingestion pathways. We used distance from polluted soil site to build a proxy for contaminated site. Air indicator combined modeled concentrations and estimated emissions to take in account 30 polluants in the analysis. For water, drinking water concentrations were compared to drinking water standards to build a score spatialized using a distribution unit serve map. The Lden (day-evening-night) indicator was used to map noise around road infrastructures. Aggregation of the different factor risks was made using different methodologies to discuss weighting and aggregation procedures impact on the effectiveness of risk maps to take decisions for safeguarding citizen health. Results permit to identify pollutant sources, determinants of exposure, and potential hotspots areas. A diagnostic tool was developed for stakeholders to visualize and analyze the composite indicators in an operational and accurate manner. The designed support system will be used in many applications and contexts: (1) mapping environmental disparities throughout the Lorraine region; (2) identifying vulnerable population and determinants of exposure to set priorities and target for pollution prevention, regulation and remediation; (3) providing exposure database to quantify relationships between environmental indicators and cancer mortality data provided by French Regional Health Observatories.

Keywords: health risk, environment, composite indicator, hotspot areas

Procedia PDF Downloads 247
952 Comparative Effect of Self-Myofascial Release as a Warm-Up Exercise on Functional Fitness of Young Adults

Authors: Gopal Chandra Saha, Sumanta Daw

Abstract:

Warm-up is an essential component for optimizing performance in various sports before a physical fitness training session. This study investigated the immediate comparative effect of Self-Myofascial Release through vibration rolling (VR), non-vibration rolling (NVR), and static stretching as a part of a warm-up treatment on the functional fitness of young adults. Functional fitness is a classification of training that prepares the body for real-life movements and activities. For the present study 20male physical education students were selected as subjects. The age of the subjects was ranged from 20-25 years. The functional fitness variables undertaken in the present study were flexibility, muscle strength, agility, static and dynamic balance of the lower extremity. Each of the three warm-up protocol was administered on consecutive days, i.e. 24 hr time gap and all tests were administered in the morning. The mean and SD were used as descriptive statistics. The significance of statistical differences among the groups was measured by applying ‘F’-test, and to find out the exact location of difference, Post Hoc Test (Least Significant Difference) was applied. It was found from the study that only flexibility showed significant difference among three types of warm-up exercise. The observed result depicted that VR has more impact on myofascial release in flexibility in comparison with NVR and stretching as a part of warm-up exercise as ‘p’ value was less than 0.05. In the present study, within the three means of warm-up exercises, vibration roller showed better mean difference in terms of NVR, and static stretching exercise on functional fitness of young physical education practitioners, although the results were found insignificant in case of muscle strength, agility, static and dynamic balance of the lower extremity. These findings suggest that sports professionals and coaches may take VR into account for designing more efficient and effective pre-performance routine for long term to improve exercise performances. VR has high potential to interpret into an on-field practical application means.

Keywords: self-myofascial release, functional fitness, foam roller, physical education

Procedia PDF Downloads 133
951 Cognitive Performance and Physiological Stress during an Expedition in Antarctica

Authors: Andrée-Anne Parent, Alain-Steve Comtois

Abstract:

The Antarctica environment can be a great challenge for human exploration. Explorers need to be focused on the task and require the physical abilities to succeed and survive in complete autonomy in this hostile environment. The aim of this study was to observe cognitive performance and physiological stress with a biomarker (cortisol) and hand grip strength during an expedition in Antarctica. A total of 6 explorers were in complete autonomous exploration on the Forbidden Plateau in Antarctica to reach unknown summits during a 30 day period. The Stroop Test, a simple reaction time, and mood scale (PANAS) tests were performed every week during the expedition. Saliva samples were taken before sailing to Antarctica, the first day on the continent, after the mission on the continent and on the boat return trip. Furthermore, hair samples were taken before and after the expedition. The results were analyzed with SPSS using ANOVA repeated measures. The Stroop and mood scale results are presented in the following order: 1) before sailing to Antarctica, 2) the first day on the continent, 3) after the mission on the continent and 4) on the boat return trip. No significant difference was observed with the Stroop (759±166 ms, 850±114 ms, 772±179 ms and 833±105 ms, respectively) and the PANAS (39.5 ±5.7, 40.5±5, 41.8±6.9, 37.3±5.8 positive emotions, and 17.5±2.3, 18.2±5, 18.3±8.6, 15.8±5.4 negative emotions, respectively) (p>0.05). However, there appears to be an improvement at the end of the second week. Furthermore, the simple reaction time was significantly lower at the end of the second week, a moment where important decisions were taken about the mission, vs the week before (416±39 ms vs 459.8±39 ms respectively; p=0.030). Furthermore, the saliva cortisol was not significantly different (p>0.05) possibly due to important variations and seemed to reach a peak on the first day on the continent. However, the cortisol from the hair pre and post expedition increased significantly (2.4±0.5 pg/mg pre-expedition and 16.7±9.2 pg/mg post-expedition, p=0.013) showing important stress during the expedition. Moreover, no significant difference was observed on the grip strength except between after the mission on the continent and after the boat return trip (91.5±21 kg vs 85±19 kg, p=0.20). In conclusion, the cognitive performance does not seem to be affected during the expedition. Furthermore, it seems to increase for specific important events where the crew seemed to focus on the present task. The physiological stress does not seem to change significantly at specific moments, however, a global pre-post mission measure can be important and for this reason, for long-term missions, a pre-expedition baseline measure is important for crewmembers.

Keywords: Antarctica, cognitive performance, expedition, physiological adaptation, reaction time

Procedia PDF Downloads 243
950 Prenatal Can Reduce the Burden of Preterm Birth and Low Birthweight from Maternal Sexually Transmitted Infections: US National Data

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

Abstract:

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

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

Procedia PDF Downloads 173
949 The Impact of Resettlement Challenges in Seeking Employment on the Mental Health and Well-Being of African Refugee Youth in South Australia

Authors: Elvis Munyoka

Abstract:

While the number of African refugees settling in Australia has significantly increased since the mid-1990s, the marginalisation and exclusion of young people from refugee backgrounds in employment remain a critical challenge. Unemployment or underemployment can negatively impact refugees in multiple areas, such as income, housing, life satisfaction, and social status. Higher rates of unemployment among refugees are linked in part to the intersection of pre-migration and daily challenges like trauma, racism, gender identity, and English language competency, all of which generate multiple employability disadvantages. However, the intersection of gender, race, social class, and age in impacting African refugee youth’s access to employment has received less attention. Using a qualitative case study approach, the paper will explore how gender, race, social class, and age influence African refugee youth graduates’ access to employment in South Australia. The intersectionality theory and capability approach to social justice is used to explore intersecting factors impacting African refugee youth’s access to employment in South Australia. Participants were 16 African refugee graduates aged 18-30 living in South Australia who took part in the study for one year. Based on the trends in the data, the results suggest that long-term unemployment and underemployment, coupled with ongoing racism and marginalisation, have the potential to make refugees more vulnerable to several mental disorders such as depression, hopelessness, and suicidal thoughts. The analysis also reveals that resettlement challenges may limit refugees’ ability to recover from pre-migration trauma. The impact of resettlement challenges on refugee mental health highlights the need for comprehensive policy interventions to address the barriers refugees face in finding employment in resettlement communities. With African refugees constituting such an important part of Australian society, they should have equal access to meaningful employment, as decent work promotes good mental health, successful resettlement, hope, and self-sufficiency.

Keywords: African refugee youth, mental health, employment, resettlement, racism

Procedia PDF Downloads 69
948 Australian Football Supporters Engagement Patterns; Manchester United vs a-League

Authors: Trevor R. Higgins, Ben Lopez

Abstract:

Australian football fans have a tendency to indulge in foreign football clubs, often assigning a greater value to foreign clubs, in preference to the Australian National football competition; the A-League. There currently exists a gap in the knowledge available in relation to football fans in Australia, their engagement with foreign football teams and the impact that this may have with their engagement with A-League. The purpose of this study was to compare the engagement of the members of the Manchester United Supporters Club - Australia (MUSC-Aus) with Manchester United and the A-League. An online survey was implemented to gather the relevant data from members of the MUSC-Aus. Results from completed surveys were collected, and analyzed in relation to engagement levels with Manchester United and the A-League. Members of MUSC-Aus who responded to the survey were predominantly male (94%) and born in Australia (46%), England (25%), Ireland (7%), were greatly influenced in their choice of Manchester United by family (43%) and team history (16%), whereas location was the overwhelming influence in supporting the A-League (88%). Importantly, there was a reduced level of engagement in the A-League on two accounts. Firstly, only 64% of MUSC-Aus engaged with the A-League, reporting perceptions of low standard as the major reason (50%). Secondly, MUSC-Aus members who engaged in the A-League reported reduced engagement in the A-League, identified through spending patterns. MUSC-Aus members’ expenditure on Manchester United engagement was 400% greater than expenditure on A-League engagement. Furthermore, additional survey responses indicated that the level of commitment towards the A-League overall was less than Manchester United. The greatest impact on fan engagement in the A-League by MUSC-Aus can be attributed to several primary factors; family support, team history and perceptions to on-field performance and quality of players. Currently, there is little that can be done in regards to enhancing family and history as the A-League is still in its infancy. Therefore, perceptions of on-field performances and player quality should be addressed. Introducing short-term international marquee contracts to A-League rosters, across the entire competition, may provide the platform to raise the perception of the A-League player quality with minimal impact on local player development. In addition, a national marketing campaign promoting the success of A-League clubs in the ACL, as well as promoting the skill on display in the A-League may address the negative association with the standard of the A-League competition.

Keywords: engagement, football, perceptions of performance, team

Procedia PDF Downloads 281
947 Assessment of the Effect of Orally Administered Itopride on Gall Bladder Ejection Fraction by a Fatty Meal Cholescintigraphy in Patients with Diabetes

Authors: Avani Jain, Hasmukh Jain, S. Shelley, M. Indirani, Shilpa Kalal, Jayakanth Amalachandran

Abstract:

Aim of the Study: To assess the effect of orally administered Itopride on gall bladder ejection fraction by fatty meal cholescintigraphy in patients with diabetes. Materials and Methods: Thirty patients (20 males, 10 females, mean age 46+10 yrs) with history of diabetes mellitus (mean duration 4.8+4.1 yrs, fasting blood glucose level 130+35 mg/dl and 2-hours post-prandial blood glucose level 196+76 mg/dl) and found to have gall bladder dysfunction on fatty-meal stimulated cholescintigraphy were selected for this study. These patients underwent a repeat cholescintigraphy similar to baseline study, with 50 mg of Itopride orally along with fatty meal. Pre- and post-Itopride GBEF were then compared to assess the effect of Itopride on gall bladder contraction. Results: Out of these 30 patients, 2 had dyskinetic, 4 had akinetic, 22 had moderately hypokinetic and the remaining 2 had hypokinetic gall bladder function in the baseline study with > 60% GBEF being taken as the normal value. Mean percentage of GBEF in the baseline study was 32%+13% and the mean percentage of GBEF in the post-Itopride study was 57%+17% with change in mean percentage of GBEF being 24%+21%. GBEF of the “baseline study” was significantly lower as compared to GBEF in the “post-Itopride study” (p < 0.05). Conclusion: Diabetic patients with biliary-type pain often tend to have impaired gallbladder function. Cholescintigraphy with fatty meal-stimulation is a simple, cheap and useful investigation for assessment of gallbladder dysfunction in these patients, before any structural changes occur within the lumen or wall of the gall bladder. Improvement in gallbladder ejection fraction after oral administration of a single dose of Itopride, a newer prokinetic drug with fewer side effects, as assessed by cholescintigraphy, provides enough evidence of future therapeutic response. Administration of Itopride, in therapeutic dosage, therefore may be expected to cause significant improvement in gallbladder ejection fraction and hence prolong stone formation within the gall bladder and also prevent the associated long term complications. Hence, based on scintigraphic evidence, Itopride may be recommended, by clinicians, for management of symptomatic diabetic patients having gallbladder dysfunction.

Keywords: itopride, gall bladder ejection fraction, fatty meal, cholescintigraphy, diabetes

Procedia PDF Downloads 425
946 Outcome of Emergency Response Team System in In-Hospital Cardiac Arrest

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

Abstract:

Introduction: To improve early detection and mortality rate of In- Hospital Cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditions and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90mmHg, respiratory rate <8 or > 28 breaths per minute, O2 saturation < 90%, acute change in conscious state, acute chest pain or worried about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in In-Hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in In-Hospital cardiac arrest and overall hospital mortality rate. We conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed Chi -square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010 ,139 calls in 2011 and 245 calls in 2012.The number of ERT calls per 1000 admissions in year 2009-10 was 7.69, 5.61 in 2011 and 9.38 in 2013. The number of Code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, But we have not found difference in overall hospital mortality rate.

Keywords: emergency response team, ERT, cardiac arrest, emergency medicine

Procedia PDF Downloads 310
945 Rapid and Long-term Alien Language Analysis - Forming Frameworks for the Interpretation of Alien Communication for More Intelligent Life

Authors: Samiksha Raviraja, Junaid Arif

Abstract:

One of the most important abilities in species is the ability to communicate. This paper proposes steps to take when and if aliens came in contact with humans, and how humans would communicate with them. The situation would be a time-sensitive scenario, meaning that communication is at the utmost importance if such an event were to happen. First, humans would need to establish mutual peace by conveying that there is no threat to the alien race. Second, the aliens would need to acknowledge this understanding and reciprocate. This would be extremely difficult to do regardless of their intelligence level unless they are very human-like and have similarities to our way of communicating. The first step towards understanding their mind is to analyze their level of intelligence - Level 1-Low intelligence, Level 2-Human-like intelligence or Level 3-Advanced or High Intelligence. These three levels go hand in hand with the Kardashev scale. Further, the Barrow scale will also be used to categorize alien species in hopes of developing a common universal language to communicate in. This paper will delve into how the level of intelligence can be used toward achieving communication with aliens by predicting various possible scenarios and outcomes by proposing an intensive categorization system. This can be achieved by studying their Emotional and Intelligence Quotient (along with technological and scientific knowledge/intelligence). The limitations and capabilities of their intelligence must also be studied. By observing how they respond and react (expressions and senses) to different kinds of scenarios, items and people, the data will help enable good categorisation. It can be hypothesised that the more human-like aliens are or can relate to humans, the more likely it is that communication is possible. Depending on the situation, either human can teach aliens a human language, or humans can learn an alien language, or both races work together to develop a mutual understanding or mode of communication. There are three possible ways of contact. Aliens visit Earth, or humans discover aliens while on space exploration or through technology in the form of signals. A much rarer case would be humans and aliens running into each other during a space expedition of their own. The first two possibilities allow a more in-depth analysis of the alien life and enhanced results compared. The importance of finding a method of talking with aliens is important in order to not only protect Earth and humans but rather for the advancement of Science through the shared knowledge between the two species.

Keywords: intelligence, Kardashev scale, Barrow scale, alien civilizations, emotional and intelligence quotient

Procedia PDF Downloads 72
944 Analysis of Anti-Tuberculosis Immune Response Induced in Lungs by Intranasal Immunization with Mycobacterium indicus pranii

Authors: Ananya Gupta, Sangeeta Bhaskar

Abstract:

Mycobacterium indicus pranii (MIP) is a saprophytic mycobacterium. It is a predecessor of M. avium complex (MAC). Whole genome analysis and growth kinetics studies have placed MIP in between pathogenic and non-pathogenic species. It shares significant antigenic repertoire with M. tuberculosis and have unique immunomodulatory properties. MIP provides better protection than BCG against pulmonary tuberculosis in animal models. Immunization with MIP by aerosol route provides significantly higher protection as compared to immunization by subcutaneous (s.c.) route. However, mechanism behind differential protection has not been studied. In this study, using mice model we have evaluated and compared the M.tb specific immune response in lung compartments (airway lumen / lung interstitium) as well as spleen following MIP immunization via nasal (i.n.) and s.c. route. MIP i.n. vaccination resulted in increased seeding of memory T cells (CD4+ and CD8+ T-cells) in the airway lumen. Frequency of CD4+ T cells expressing Th1 migratory marker (CXCR3) and activation marker (CD69) were also high in airway lumen of MIP i.n. group. Significantly high ex vivo secretion of cytokines- IFN-, IL-12, IL-17 and TNF- from cells of airway luminal spaces provides evidence of antigen-specific lung immune response, besides generating systemic immunity comparable to MIP s.c. group. Analysis of T cell response on per cell basis revealed that antigen specific T-cells of MIP i.n. group were functionally superior as higher percentage of these cells simultaneously secreted IFN-gamma, IL-2 and TNF-alpha cytokines as compared to MIP s.c. group. T-cells secreting more than one of the cytokines simultaneously are believed to have robust effector response and crucial for protection, compared with single cytokine secreting T-cells. Adoptive transfer of airway luminal T-cells from MIP i.n. group into trachea of naive B6 mice revealed that MIP induced CD8 T-cells play crucial role in providing long term protection. Thus the study demonstrates that MIP intranasal vaccination induces M.tb specific memory T-cells in the airway lumen that results in an early and robust recall response against M.tb infection.

Keywords: airway lumen, Mycobacterium indicus pranii, Th1 migratory markers, vaccination

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