Search results for: play therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4772

Search results for: play therapy

572 The Implication of Small Group Therapy on Sexuality in Breast Cancer Survivors

Authors: Cherng-Jye Jeng, Ming-Feng Hou, Hsing-Yuan Liu, Chuan-Feng Chang, Lih-Rong Wang, Yen-Chin Lin

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Introduction: The incidence of breast cancer has gradually increased in Taiwan, and the characteristic of younger ages impact these women in their middle age, and may also cause challenges in terms of family, work, and illness. Breasts are symbols of femininity, as well as of sex. For women, breasts are important organs for the female identity and sexual expression. Losing breasts not only affects the female role, but would also affect sexual attraction and sexual desire. Thus, women with breast cancer who have need for mastectomies experience physical incompletion, which affects women’s self-confidence, physical image, and self-orientation. Purposes: 1. To understand the physical experience of women with breast cancer. 2. To explore the issue of sexual issues on the health effects of women with breast cancer. 3. To construct a domestic sex life issue group model for domestic women with breast cancer. 4. To explore the accompaniment experiences and sexual relationship adjustments of spouses when women have breast cancer. Method: After the research plan passes IRB review, participants will be recruited at breast surgery clinic in the affiliated hospital, to screen suitable subjects for entry into the group. Between March and May 2015, two sexual health and sex life consultation groups were conducted, which were (1) 10 in postoperative groups for women with cancer; (2) 4 married couples group for postoperative women with cancer. After sharing experiences and dialogue, women can achieve mutual support and growth. Data organization and analysis underwent descriptive analysis in qualitative research, and the group process was transcribed into transcripts for overall-content and category-content analysis. Results: Ten women with breast cancer believed that participating in group can help them exchange experiences, and elevate sexual health. The main issues include: (1) after breast cancer surgery, patients generally received chemotherapy or estrogen suppressants, causing early menopause; in particular, vaginal dryness can cause pain or bleeding in intercourse, reducing their desire for sexual activity; (2) breast cancer accentuates original spousal or family and friend relationships; some people have support and care from their family, and spouses emphasize health over the appearance of breasts; however, some people do not have acceptance and support from their family, and some even hear spousal sarcasm about loss of breasts; (3) women with breast cancer have polarized expressions of optimism and pessimism in regards to their emotions, beliefs, and body image regarding cancer; this is related to the women’s original personalities, attribution of causes of cancer, and extent of worry about relapse. Conclusion: The research results can be provided as a reference to medical institutions or breast cancer volunteer teams, to pay attention to maintaining the health of women with breast cancer.

Keywords: women with breast cancer, experiences of objectifying the body, quality of sex life, sexual health

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571 Assessment of the Impact of Regular Pilates Exercises on Static Balance in Healthy Adult Women: Preliminary Report

Authors: Anna Słupik, Krzysztof Jaworski, Anna Mosiołek, Dariusz Białoszewski

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Background: Maintaining the correct body balance is essential in the prevention of falls in the elderly, which is especially important for women because of postmenopausal osteoporosis and the serious consequences of falls. One of the exercise methods which is very popular among adults, and which may affect body balance in a positive way is the pilates method. The aim of the study was to evaluate the effect of regular pilates exercises on the ability to maintain body balance in static conditions in adult healthy women. Material and methods: The study group consisted of 20 healthy women attending pilates twice a week for at least 1 year. The control group consisted of 20 healthy women physically inactive. Women in the age range from 35 to 50 years old without pain in musculoskeletal system or other pain were only qualified to the groups. Body balance was assessed using MatScan VersaTek platform with Sway Analysis Module based on Matscan Clinical 6.7 software. The balance was evaluated under the following conditions: standing on both feet with eyes open, standing on both feet with eyes closed, one-leg standing (separately on the right and left foot) with eyes open. Each test lasted 30 seconds. The following parameters were calculated: estimated size of the ellipse of 95% confidence, the distance covered by the Center of Gravity (COG), the size of the maximum shift in the sagittal and frontal planes and load distribution between the left and right foot, as well as between rear- and forefoot. Results: It was found that there is significant difference between the groups in favor of the study group in the size of the confidence ellipse and maximum shifts of COG in the sagittal plane during standing on both feet, both with the eyes open and closed (p < 0.05). While standing on one leg both on the right and left leg, with eyes opened there was a significant difference in favor of the study group, in terms of the size of confidence ellipse, the size of the maximum shifts in the sagittal and in the frontal plane (p < 0.05). There were no differences between the distribution of load between the right and left foot (standing with both feet), nor between fore- and rear foot (in standing with both feet or one-leg). Conclusions: 1. Static balance in women exercising regularly by pilates method is better than in inactive women, which may in the future prevent falls and their consequences. 2. The observed differences in maintaining balance in frontal plane in one-leg standing may indicate a positive impact of pilates exercises on the ability to maintain global balance in terms of the reduced support surface. 3. Pilates method can be used as a form preventive therapy for all people who are expected to have problems with body balance in the future, for example in chronic neurological disorders or vestibular problems. 4. The results have shown that further prospective randomized research on a larger and more representative group is needed.

Keywords: balance exercises, body balance, pilates, pressure distribution, women

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570 Radar Cross Section Modelling of Lossy Dielectrics

Authors: Ciara Pienaar, J. W. Odendaal, J. Joubert, J. C. Smit

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Radar cross section (RCS) of dielectric objects play an important role in many applications, such as low observability technology development, drone detection, and monitoring as well as coastal surveillance. Various materials are used to construct the targets of interest such as metal, wood, composite materials, radar absorbent materials, and other dielectrics. Since simulated datasets are increasingly being used to supplement infield measurements, as it is more cost effective and a larger variety of targets can be simulated, it is important to have a high level of confidence in the predicted results. Confidence can be attained through validation. Various computational electromagnetic (CEM) methods are capable of predicting the RCS of dielectric targets. This study will extend previous studies by validating full-wave and asymptotic RCS simulations of dielectric targets with measured data. The paper will provide measured RCS data of a number of canonical dielectric targets exhibiting different material properties. As stated previously, these measurements are used to validate numerous CEM methods. The dielectric properties are accurately characterized to reduce the uncertainties in the simulations. Finally, an analysis of the sensitivity of oblique and normal incidence scattering predictions to material characteristics is also presented. In this paper, the ability of several CEM methods, including method of moments (MoM), and physical optics (PO), to calculate the RCS of dielectrics were validated with measured data. A few dielectrics, exhibiting different material properties, were selected and several canonical targets, such as flat plates and cylinders, were manufactured. The RCS of these dielectric targets were measured in a compact range at the University of Pretoria, South Africa, over a frequency range of 2 to 18 GHz and a 360° azimuth angle sweep. This study also investigated the effect of slight variations in the material properties on the calculated RCS results, by varying the material properties within a realistic tolerance range and comparing the calculated RCS results. Interesting measured and simulated results have been obtained. Large discrepancies were observed between the different methods as well as the measured data. It was also observed that the accuracy of the RCS data of the dielectrics can be frequency and angle dependent. The simulated RCS for some of these materials also exhibit high sensitivity to variations in the material properties. Comparison graphs between the measured and simulation RCS datasets will be presented and the validation thereof will be discussed. Finally, the effect that small tolerances in the material properties have on the calculated RCS results will be shown. Thus the importance of accurate dielectric material properties for validation purposes will be discussed.

Keywords: asymptotic, CEM, dielectric scattering, full-wave, measurements, radar cross section, validation

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569 Investigation on Correlation of Earthquake Intensity Parameters with Seismic Response of Reinforced Concrete Structures

Authors: Semra Sirin Kiris

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Nonlinear dynamic analysis is permitted to be used for structures without any restrictions. The important issue is the selection of the design earthquake to conduct the analyses since quite different response may be obtained using ground motion records at the same general area even resulting from the same earthquake. In seismic design codes, the method requires scaling earthquake records based on site response spectrum to a specified hazard level. Many researches have indicated that this limitation about selection can cause a large scatter in response and other charecteristics of ground motion obtained in different manner may demonstrate better correlation with peak seismic response. For this reason influence of eleven different ground motion parameters on the peak displacement of reinforced concrete systems is examined in this paper. From conducting 7020 nonlinear time history analyses for single degree of freedom systems, the most effective earthquake parameters are given for the range of the initial periods and strength ratios of the structures. In this study, a hysteresis model for reinforced concrete called Q-hyst is used not taken into account strength and stiffness degradation. The post-yielding to elastic stiffness ratio is considered as 0.15. The range of initial period, T is from 0.1s to 0.9s with 0.1s time interval and three different strength ratios for structures are used. The magnitude of 260 earthquake records selected is higher than earthquake magnitude, M=6. The earthquake parameters related to the energy content, duration or peak values of ground motion records are PGA(Peak Ground Acceleration), PGV (Peak Ground Velocity), PGD (Peak Ground Displacement), MIV (Maximum Increamental Velocity), EPA(Effective Peak Acceleration), EPV (Effective Peak Velocity), teff (Effective Duration), A95 (Arias Intensity-based Parameter), SPGA (Significant Peak Ground Acceleration), ID (Damage Factor) and Sa (Spectral Response Spectrum).Observing the correlation coefficients between the ground motion parameters and the peak displacement of structures, different earthquake parameters play role in peak displacement demand related to the ranges formed by the different periods and the strength ratio of a reinforced concrete systems. The influence of the Sa tends to decrease for the high values of strength ratio and T=0.3s-0.6s. The ID and PGD is not evaluated as a measure of earthquake effect since high correlation with displacement demand is not observed. The influence of the A95 is high for T=0.1 but low related to the higher values of T and strength ratio. The correlation of PGA, EPA and SPGA shows the highest correlation for T=0.1s but their effectiveness decreases with high T. Considering all range of structural parameters, the MIV is the most effective parameter.

Keywords: earthquake parameters, earthquake resistant design, nonlinear analysis, reinforced concrete

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568 The Improved Therapeutic Effect of Trans-Cinnamaldehyde on Adipose-Derived Stem Cells without Chemical Induction

Authors: Karthyayani Rajamani, Yi-Chun Lin, Tung-Chou Wen, Jeanne Hsieh, Yi-Maun Subeq, Jen-Wei Liu, Po-Cheng Lin, Horng-Jyh Harn, Shinn-Zong Lin, Tzyy-Wen Chiou

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Assuring cell quality is an essential parameter for the success of stem cell therapy, utilization of various components to improve this potential has been the primary goal of stem cell research. The aim of this study was not only to demonstrate the capacity of trans-cinnamaldehyde (TC) to reverse stress-induced senescence but also improve the therapeutic abilities of stem cells. Because of the availability and the promising application potential in regenerative medicine, adipose-derived stem cells (ADSCs) were chosen for the study. We found that H2O2 treatment resulted in the expression of senescence characteristics in the ADSCs, including decreased proliferation rate, increased senescence-associated- β-galactosidase (SA-β-gal) activity, decreased SIRT1 (silent mating type information regulation 2 homologs) expression and decreased telomerase activity. However, TC treatment was sufficient to rescue or reduce the effects of H2O2 induction, ultimately leading to an increased proliferation rate, a decrease in the percentage of SA-β-gal positive cells, upregulation of SIRT1 expression, and increased telomerase activity of the senescent ADSCs at the cellular level. Further recently it was observed that the ADSCs were treated with TC without induction of senescence, all the before said positives were observed. Moreover, a chemically induced liver fibrosis animal model was used to evaluate the functionality of these rescued cells in vivo. Liver dysfunction was established by injecting 200 mg/kg thioacetamide (TAA) intraperitoneally into Wistar rats every third day for 60 days. The experimental rats were separated into groups; normal group (rats without TAA induction), sham group (without ADSC transplantation), positive control group (transplanted with normal ADSCs); H2O2 group (transplanted with H2O2 -induced senescent ADSCs), H2O2+TC group (transplanted with ADSCs pretreated with H2O2 and then further treated with TC) and TC group (ADSC treated with TC without H2O2 treatment). In the transplantation group, 1 × 106 human ADSCs were introduced into each rat via direct liver injection. Based on the biochemical analysis and immunohistochemical staining results, it was determined that the therapeutic effects on liver fibrosis by the induced senescent ADSCs (H2O2 group) were not as significant as those exerted by the normal ADSCs (the positive control group). However, the H2O2+TC group showed significant reversal of liver damage when compared to the H2O2 group 1 week post-transplantation. Further ADSCs without H2O2 treatment but with just TC treatment performed much better than all the groups. These data confirmed that the TC treatment had the potential to improve the therapeutic effect of ADSCs. It is therefore suggested that TC has potential applications in maintaining stem cell quality and could possibly aid in the treatment of senescence-related disorders.

Keywords: senescence, SIRT1, adipose derived stem cells, liver fibrosis

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567 Academic Goal Setting Practices of University Students in Lagos State, Nigeria: Implications for Counselling

Authors: Asikhia Olubusayo Aduke

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Students’ inability to set data-based (specific, measurable, attainable, reliable, and time-bound) personal improvement goals threatens their academic success. Hence, the study aimed to investigate year-one students’ academic goal-setting practices at Lagos State University of Education, Nigeria. Descriptive survey research was used in carrying out this study. The study population consisted of 3,101 year-one students of the University. A sample size of five hundred (501) participants was selected through a proportional and simple random sampling technique. The Formative Goal Setting Questionnaire (FGSQ) developed by Research Collaboration (2015) was adapted and used as an instrument for the study. Two main research questions were answered, while two null hypotheses were formulated and tested for the study. The study revealed higher data-based goals for all students than personal improvement goals. Nevertheless, data-based and personal improvement goal-setting for female students was higher than for male students. One sample test statistic and Anova used to analyse data for the two hypotheses also revealed that the mean difference between male and female year one students’ data-based and personal improvement goal-setting formation was statistically significant (p < 0.05). This means year one students’ data-based and personal improvement goals showed significant gender differences. Based on the findings of this study, it was recommended, among others, that therapeutic techniques that can help to change students’ faulty thinking and challenge their lack of desire for personal improvement should be sought to treat students who have problems with setting high personal improvement goals. Counsellors also need to advocate continued research into how to increase the goal-setting ability of male students and should focus more on counselling male students’ goal-setting ability. The main contributions of the study are higher institutions must prioritize early intervention in first-year students' academic goal setting. Researching gender differences in this practice reveals a crucial insight: male students often lag behind in setting meaningful goals, impacting their motivation and performance. Focusing on this demographic with data-driven personal improvement goals can be transformative. By promoting goal setting that is specific, measurable, and focused on self-growth (rather than competition), male students can unlock their full potential. Researchers and counselors play a vital role in detecting and supporting students with lower goal-setting tendencies. By prioritizing this intervention, we can empower all students to set ambitious, personalized goals that ignite their passion for learning and pave the way for academic success.

Keywords: academic goal setting, counselling, practice, university, year one students

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566 Achieving Net Zero Energy Building in a Hot Climate Using Integrated Photovoltaic and Parabolic Trough Collectors

Authors: Adel A. Ghoneim

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In most existing buildings in hot climate, cooling loads lead to high primary energy consumption and consequently high CO2 emissions. These can be substantially decreased with integrated renewable energy systems. Kuwait is characterized by its dry hot long summer and short warm winter. Kuwait receives annual total radiation more than 5280 MJ/m2 with approximately 3347 h of sunshine. Solar energy systems consist of PV modules and parabolic trough collectors are considered to satisfy electricity consumption, domestic water heating, and cooling loads of an existing building. This paper presents the results of an extensive program of energy conservation and energy generation using integrated photovoltaic (PV) modules and parabolic trough collectors (PTC). The program conducted on an existing institutional building intending to convert it into a Net-Zero Energy Building (NZEB) or near net Zero Energy Building (nNZEB). The program consists of two phases; the first phase is concerned with energy auditing and energy conservation measures at minimum cost and the second phase considers the installation of photovoltaic modules and parabolic trough collectors. The 2-storey building under consideration is the Applied Sciences Department at the College of Technological Studies, Kuwait. Single effect lithium bromide water absorption chillers are implemented to provide air conditioning load to the building. A numerical model is developed to evaluate the performance of parabolic trough collectors in Kuwait climate. Transient simulation program (TRNSYS) is adapted to simulate the performance of different solar system components. In addition, a numerical model is developed to assess the environmental impacts of building integrated renewable energy systems. Results indicate that efficient energy conservation can play an important role in converting the existing buildings into NZEBs as it saves a significant portion of annual energy consumption of the building. The first phase results in an energy conservation of about 28% of the building consumption. In the second phase, the integrated PV completely covers the lighting and equipment loads of the building. On the other hand, parabolic trough collectors of optimum area of 765 m2 can satisfy a significant portion of the cooling load, i.e about73% of the total building cooling load. The annual avoided CO2 emission is evaluated at the optimum conditions to assess the environmental impacts of renewable energy systems. The total annual avoided CO2 emission is about 680 metric ton/year which confirms the environmental impacts of these systems in Kuwait.

Keywords: building integrated renewable systems, Net-Zero energy building, solar fraction, avoided CO2 emission

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565 Performance Estimation of Small Scale Wind Turbine Rotor for Very Low Wind Regime Condition

Authors: Vilas Warudkar, Dinkar Janghel, Siraj Ahmed

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Rapid development experienced by India requires huge amount of energy. Actual supply capacity additions have been consistently lower than the targets set by the government. According to World Bank 40% of residences are without electricity. In 12th five year plan 30 GW grid interactive renewable capacity is planned in which 17 GW is Wind, 10 GW is from solar and 2.1 GW from small hydro project, and rest is compensated by bio gas. Renewable energy (RE) and energy efficiency (EE) meet not only the environmental and energy security objectives, but also can play a crucial role in reducing chronic power shortages. In remote areas or areas with a weak grid, wind energy can be used for charging batteries or can be combined with a diesel engine to save fuel whenever wind is available. India according to IEC 61400-1 belongs to class IV Wind Condition; it is not possible to set up wind turbine in large scale at every place. So, the best choice is to go for small scale wind turbine at lower height which will have good annual energy production (AEP). Based on the wind characteristic available at MANIT Bhopal, rotor for small scale wind turbine is designed. Various Aero foil data is reviewed for selection of airfoil in the Blade Profile. Airfoil suited of Low wind conditions i.e. at low Reynold’s number is selected based on Coefficient of Lift, Drag and angle of attack. For designing of the rotor blade, standard Blade Element Momentum (BEM) Theory is implanted. Performance of the Blade is estimated using BEM theory in which axial induction factor and angular induction factor is optimized using iterative technique. Rotor performance is estimated for particular designed blade specifically for low wind Conditions. Power production of rotor is determined at different wind speeds for particular pitch angle of the blade. At pitch 15o and velocity 5 m/sec gives good cut in speed of 2 m/sec and power produced is around 350 Watts. Tip speed of the Blade is considered as 6.5 for which Coefficient of Performance of the rotor is calculated 0.35, which is good acceptable value for Small scale Wind turbine. Simple Load Model (SLM, IEC 61400-2) is also discussed to improve the structural strength of the rotor. In SLM, Edge wise Moment and Flap Wise moment is considered which cause bending stress at the root of the blade. Various Load case mentioned in the IEC 61400-2 is calculated and checked for the partial safety factor of the wind turbine blade.

Keywords: annual energy production, Blade Element Momentum Theory, low wind Conditions, selection of airfoil

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564 Multicomponent Positive Psychology Intervention for Health Promotion of Retirees: A Feasibility Study

Authors: Helen Durgante, Mariana F. Sparremberger, Flavia C. Bernardes, Debora D. DellAglio

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Health promotion programmes for retirees, based on Positive Psychology perspectives for the development of strengths and virtues, demand broadened empirical investigation in Brazil. In the case of evidence-based applied research, it is suggested feasibility studies are conducted prior to efficacy trials of the intervention, in order to identify and rectify possible faults in the design and implementation of the intervention. The aim of this study was to evaluate the feasibility of a multicomponent Positive Psychology programme for health promotion of retirees, based on Cognitive Behavioural Therapy and Positive Psychology perspectives. The programme structure included six weekly group sessions (two hours each) encompassing strengths such as Values and self-care, Optimism, Empathy, Gratitude, Forgiveness, and Meaning of life and work. The feasibility criteria evaluated were: Demand, Acceptability, Satisfaction with the programme and with the moderator, Comprehension/Generalization of contents, Evaluation of the moderator (Social Skills and Integrity/Fidelity), Adherence, and programme implementation. Overall, 11 retirees (F=11), age range 54-75, from the metropolitan region of Porto Alegre-RS-Brazil took part in the study. The instruments used were: Qualitative Admission Questionnaire; Moderator Field Diary; the Programme Evaluation Form to assess participants satisfaction with the programme and with the moderator (a six-item 4-point likert scale), and Comprehension/Generalization of contents (a three-item 4-point likert scale); Observers’ Evaluation Form to assess the moderator Social Skills (a five-item 4-point likert scale), Integrity/Fidelity (a 10 item 4-point likert scale), and Adherence (a nine-item 5-point likert scale). Qualitative data were analyzed using content analysis. Descriptive statistics as well as Intraclass Correlations coefficients were used for quantitative data and inter-rater reliability analysis. The results revealed high demand (N = 55 interested people) and acceptability (n = 10 concluded the programme with overall 88.3% frequency rate), satisfaction with the program and with the moderator (X = 3.76, SD = .34), and participants self-report of Comprehension/Generalization of contents provided in the programme (X = 2.82, SD = .51). In terms of the moderator Social Skills (X = 3.93; SD = .40; ICC = .752 [IC = .429-.919]), Integrity/Fidelity (X = 3.93; SD = .31; ICC = .936 [IC = .854-.981]), and participants Adherence (X = 4.90; SD = .29; ICC = .906 [IC = .783-.969]), evaluated by two independent observers present in each session of the programme, descriptive and Intraclass Correlation results were considered adequate. Structural changes were introduced in the intervention design and implementation methods, as well as the removal of items from questionnaires and evaluation forms. The obtained results were satisfactory, allowing changes to be made for further efficacy trials of the programme. Results are discussed taking cultural and contextual demands in Brazil into account.

Keywords: feasibility study, health promotion, positive psychology intervention, programme evaluation, retirees

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563 The Psychologist's Role in a Social Assistance Reference Center: A Case of Violence and Child Sexual Abuse in Northeastern Brazil

Authors: G. Melo, J. Felix, S. Maciel, C. Fernandes, W. Rodrigues

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In Brazilian public policy, the Centres of Reference for Social Assistance (CRAS in Portuguese) are part of the Unified Social Assistance System (SUAS in Portuguese). SUAS is responsible for addressing spontaneous or currently active cases that are brought forth from other services in the social assistance network. The following case was reviewed by CRAS’s team in Recife, Brazil, after a complaint of child abuse was filed against the mother of a 7-year-old girl by the girl’s aunt. The girl is the daughter of an incestuous relationship between her mother and her older brother. The complaint was registered by service staff and five interventions were subsequently carried out on behalf of the child. These interventions provided a secure place for dialogue with both the child and her family and allowed for an investigation of the abuse to proceed. They took place in the child’s school as well as her aunt’s residence. At school, the child (with her classmates) watched a video and listened to a song about the prevention of child abuse. This was followed up with a second intervention to determine any signs of Post-Traumatic Stress Disorder (PTSD), by having the child play with the mobile app ‘My Angela’. Books on the themes of family and fear were also read to the child on different occasions at her school – after every intervention she was asked to draw something related to fear and her concept of a family. After the interventions and discussing the case as a team, we reached several conclusions: 1) The child did not appear to show any symptoms of PTSD; 2) She normally fantasized about her future and life story; 3) She did not allow herself to be touched by strangers with whom she lacks a close relationship (such as classmates or her teacher); 4) Through her drawings, she reproduced the conversations she had had with the staff; 5) She habitually covered her drawings when asked questions about the abuse. In this particular clinical case, we want to highlight that the role of the Psychologist’s intervention at CRAS is to attempt to resolve the issue promptly (and not to develop a prolonged clinical study based on traditional methods), by making use of the available tools from the social assistance network, and by making referrals to the relevant authorities, such as the Public Ministry, so that final protective actions can be taken and enforced. In this case, the Guardian Council of the Brazilian Public Ministry was asked to transfer the custody of the child to her uncle. The mother of the child was sent to a CAPS (Centre for Psychosocial Care), having been diagnosed with psychopathology. The child would then participate in NGO programs that allow for a gradual reduction of social exposure to her mother before being transferred to her uncle’s custody in Sao Paulo.

Keywords: child abuse, intervention, social psychology, violence

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562 Linguistic Analysis of Borderline Personality Disorder: Using Language to Predict Maladaptive Thoughts and Behaviours

Authors: Charlotte Entwistle, Ryan Boyd

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Recent developments in information retrieval techniques and natural language processing have allowed for greater exploration of psychological and social processes. Linguistic analysis methods for understanding behaviour have provided useful insights within the field of mental health. One area within mental health that has received little attention though, is borderline personality disorder (BPD). BPD is a common mental health disorder characterised by instability of interpersonal relationships, self-image and affect. It also manifests through maladaptive behaviours, such as impulsivity and self-harm. Examination of language patterns associated with BPD could allow for a greater understanding of the disorder and its links to maladaptive thoughts and behaviours. Language analysis methods could also be used in a predictive way, such as by identifying indicators of BPD or predicting maladaptive thoughts, emotions and behaviours. Additionally, associations that are uncovered between language and maladaptive thoughts and behaviours could then be applied at a more general level. This study explores linguistic characteristics of BPD, and their links to maladaptive thoughts and behaviours, through the analysis of social media data. Data were collected from a large corpus of posts from the publicly available social media platform Reddit, namely, from the ‘r/BPD’ subreddit whereby people identify as having BPD. Data were collected using the Python Reddit API Wrapper and included all users which had posted within the BPD subreddit. All posts were manually inspected to ensure that they were not posted by someone who clearly did not have BPD, such as people posting about a loved one with BPD. These users were then tracked across all other subreddits of which they had posted in and data from these subreddits were also collected. Additionally, data were collected from a random control group of Reddit users. Disorder-relevant behaviours, such as self-harming or aggression-related behaviours, outlined within Reddit posts were coded to by expert raters. All posts and comments were aggregated by user and split by subreddit. Language data were then analysed using the Linguistic Inquiry and Word Count (LIWC) 2015 software. LIWC is a text analysis program that identifies and categorises words based on linguistic and paralinguistic dimensions, psychological constructs and personal concern categories. Statistical analyses of linguistic features could then be conducted. Findings revealed distinct linguistic features associated with BPD, based on Reddit posts, which differentiated these users from a control group. Language patterns were also found to be associated with the occurrence of maladaptive thoughts and behaviours. Thus, this study demonstrates that there are indeed linguistic markers of BPD present on social media. It also implies that language could be predictive of maladaptive thoughts and behaviours associated with BPD. These findings are of importance as they suggest potential for clinical interventions to be provided based on the language of people with BPD to try to reduce the likelihood of maladaptive thoughts and behaviours occurring. For example, by social media tracking or engaging people with BPD in expressive writing therapy. Overall, this study has provided a greater understanding of the disorder and how it manifests through language and behaviour.

Keywords: behaviour analysis, borderline personality disorder, natural language processing, social media data

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561 Correlation Between Cytokine Levels and Lung Injury in the Syrian Hamster (Mesocricetus Auratus) Covid-19 Model

Authors: Gleb Fomin, Kairat Tabynov, Nurkeldy Turebekov, Dinara Turegeldiyeva, Rinat Islamov

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The level of major cytokines in the blood of patients with COVID-19 varies greatly depending on age, gender, duration and severity of infection, and comorbidity. There are two clinically significant cytokines, IL-6 and TNF-α, which increase in levels in patients with severe COVID-19. However, in a model of COVID-19 in hamsters, TNF-α levels are unchanged or reduced, while the expression of other cytokines reflects the profile of cytokines found in patients’ plasma. The aim of our study was to evaluate the relationship between the level of cytokines in the blood, lungs, and lung damage in the model of the Syrian hamster (Mesocricetus auratus) infected with the SARS-CoV-2 strain. The study used outbred female and male Syrian hamsters (n=36, 4 groups) weighing 80-110 g and 5 months old (protocol IACUC, #4, 09/22/2020). Animals were infected intranasally with the hCoV-19/Kazakhstan/KazNAU-NSCEDI-481/2020 strain and euthanized at 3 d.p.i. The level of cytokines IL-6, TNF-α, IFN-α, and IFN-γ was determined by ELISA MyBioSourse (USA) for hamsters. Lung samples were subjected to histological processing. The presence of pathological changes in histological preparations was assessed on a 3-point scale. The work was carried out in the ABSL-3 laboratory. The data were analyzed in GraphPad Prism 6.00 (GraphPad Software, La Jolla, California, USA). The work was supported by the MES RK grant (AP09259865). In the blood, the level of TNF-α increased in males (p=0.0012) and IFN-γ in males and females (p=0.0001). On the contrary, IFN-α production decreased (p=0.0006). Only TNF-α level increased in lung tissues (p=0.0011). Correlation analysis showed a negative relationship between the level of IL-6 in the blood and lung damage in males (r -0.71, p=0.0001) and females (r-0.57, p=0.025). On the contrary, in males, the level of IL-6 in the lungs and score is positively correlated (r 0.80, p=0.01). The level of IFN-γ in the blood (r -0.64, p=0.035) and lungs (r-0.72, p=0.017) in males has a negative correlation with lung damage. No links were found for TNF-α and IFN-α. The study showed a positive association between lung injury and tissue levels of IL-6 in male hamsters. It is known that in humans, high concentrations of IL-6 in the lungs are associated with suppression of cellular immunity and, as a result, with an increase in the severity of COVID-19. TNF-α and IFN-γ play a key role in the pathogenesis of COVID-19 in hamsters. However, the mechanisms of their activity require more detailed study. IFN-α plays a lesser role in direct lung injury in a Syrian hamster model. We have shown the significance of tissue IL-6 and IFN-γ as predictors of the severity of lung damage in COVID-19 in the Syrian hamster model. Changes in the level of cytokines in the blood may not always reflect pathological processes in the lungs with COVID-19.

Keywords: syrian hamster, COVID-19, cytokines, biological model

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560 Optimization of MAG Welding Process Parameters Using Taguchi Design Method on Dead Mild Steel

Authors: Tadele Tesfaw, Ajit Pal Singh, Abebaw Mekonnen Gezahegn

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Welding is a basic manufacturing process for making components or assemblies. Recent welding economics research has focused on developing the reliable machinery database to ensure optimum production. Research on welding of materials like steel is still critical and ongoing. Welding input parameters play a very significant role in determining the quality of a weld joint. The metal active gas (MAG) welding parameters are the most important factors affecting the quality, productivity and cost of welding in many industrial operations. The aim of this study is to investigate the optimization process parameters for metal active gas welding for 60x60x5mm dead mild steel plate work-piece using Taguchi method to formulate the statistical experimental design using semi-automatic welding machine. An experimental study was conducted at Bishoftu Automotive Industry, Bishoftu, Ethiopia. This study presents the influence of four welding parameters (control factors) like welding voltage (volt), welding current (ampere), wire speed (m/min.), and gas (CO2) flow rate (lit./min.) with three different levels for variability in the welding hardness. The objective functions have been chosen in relation to parameters of MAG welding i.e., welding hardness in final products. Nine experimental runs based on an L9 orthogonal array Taguchi method were performed. An orthogonal array, signal-to-noise (S/N) ratio and analysis of variance (ANOVA) are employed to investigate the welding characteristics of dead mild steel plate and used in order to obtain optimum levels for every input parameter at 95% confidence level. The optimal parameters setting was found is welding voltage at 22 volts, welding current at 125 ampere, wire speed at 2.15 m/min and gas flow rate at 19 l/min by using the Taguchi experimental design method within the constraints of the production process. Finally, six conformations welding have been carried out to compare the existing values; the predicated values with the experimental values confirm its effectiveness in the analysis of welding hardness (quality) in final products. It is found that welding current has a major influence on the quality of welded joints. Experimental result for optimum setting gave a better hardness of welding condition than initial setting. This study is valuable for different material and thickness variation of welding plate for Ethiopian industries.

Keywords: Weld quality, metal active gas welding, dead mild steel plate, orthogonal array, analysis of variance, Taguchi method

Procedia PDF Downloads 472
559 Assessing the Blood-Brain Barrier (BBB) Permeability in PEA-15 Mutant Cat Brain using Magnetization Transfer (MT) Effect at 7T

Authors: Sultan Z. Mahmud, Emily C. Graff, Adil Bashir

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Phosphoprotein enriched in astrocytes 15 kDa (PEA-15) is a multifunctional adapter protein which is associated with the regulation of apoptotic cell death. Recently it has been discovered that PEA-15 is crucial in normal neurodevelopment of domestic cats, a gyrencephalic animal model, although the exact function of PEA-15 in neurodevelopment is unknown. This study investigates how PEA-15 affects the blood-brain barrier (BBB) permeability in cat brain, which can cause abnormalities in tissue metabolite and energy supplies. Severe polymicrogyria and microcephaly have been observed in cats with a loss of function PEA-15 mutation, affecting the normal neurodevelopment of the cat. This suggests that the vital role of PEA-15 in neurodevelopment is associated with gyrification. Neurodevelopment is a highly energy demanding process. The mammalian brain depends on glucose as its main energy source. PEA-15 plays a very important role in glucose uptake and utilization by interacting with phospholipase D1 (PLD1). Mitochondria also plays a critical role in bioenergetics and essential to supply adequate energy needed for neurodevelopment. Cerebral blood flow regulates adequate metabolite supply and recent findings also showed that blood plasma contains mitochondria as well. So the BBB can play a very important role in regulating metabolite and energy supply in the brain. In this study the blood-brain permeability in cat brain was measured using MRI magnetization transfer (MT) effect on the perfusion signal. Perfusion is the tissue mass normalized supply of blood to the capillary bed. Perfusion also accommodates the supply of oxygen and other metabolites to the tissue. A fraction of the arterial blood can diffuse to the tissue, which depends on the BBB permeability. This fraction is known as water extraction fraction (EF). MT is a process of saturating the macromolecules, which has an effect on the blood that has been diffused into the tissue while having minimal effect on intravascular blood water that has not been exchanged with the tissue. Measurement of perfusion signal with and without MT enables to estimate the microvascular blood flow, EF and permeability surface area product (PS) in the brain. All the experiments were performed with Siemens 7T Magnetom with 32 channel head coil. Three control cats and three PEA-15 mutant cats were used for the study. Average EF in white and gray matter was 0.9±0.1 and 0.86±0.15 respectively, perfusion in white and gray matter was 85±15 mL/100g/min and 97±20 mL/100g/min respectively, PS in white and gray matter was 201±25 mL/100g/min and 225±35 mL/100g/min respectively for control cats. For PEA-15 mutant cats, average EF in white and gray matter was 0.81±0.15 and 0.77±0.2 respectively, perfusion in white and gray matter was 140±25 mL/100g/min and 165±18 mL/100g/min respectively, PS in white and gray matter was 240±30 mL/100g/min and 259±21 mL/100g/min respectively. This results show that BBB is compromised in PEA-15 mutant cat brain, where EF is decreased and perfusion as well as PS are increased in the mutant cats compared to the control cats. This findings might further explain the function of PEA-15 in neurodevelopment.

Keywords: BBB, cat brain, magnetization transfer, PEA-15

Procedia PDF Downloads 125
558 Nacre Deposition Rate in Japanese and Hybrid Mother Oysters, Pinctada Fucata, and Its Relationship with Their Respective Pearls

Authors: Gunawan Muhammad, Takashi Atsumi, Akira Komaru

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Pinctada fucata has been the most important pearl culture species in Japan and known as Japanese Akoya Pearl Oyster. However, during summer 1994, mass mortality devastated pearl culture in most parts of Japan. Therefore, pearl farmers started to import Chinese Pearl Oysters from Hainan Island that came from the same species because they are believed to be more resistant towards high water temperature, despite their lack of ability in producing high-quality pearls. The local farmers were then hybridized Japanese and Chinese pearl oysters and currently known as Hybrid pearl oysters, as an attempt to produce a new oyster's strain which is more resistant towards high temperature but also able to produce higher quality pearls. However, despite both strains were implanted by mantle tissues from the same group of donors, the thickness of pearl nacre produced by both strains was different, even though tablet thickness shows a rather similar pattern. Hence, this leads to a question of whether mother oysters play a major role in both nacre deposition rate and tablet thickness of pearls or not. This study first describes the nacre deposition rate of the shells of Japanese and Hybrid mother oysters towards the water temperature condition in Ago Bay, Mie Prefecture, Japan. Later, a comparative study was conducted among 4 shell positions that had been chosen according to the mantle tissue location and shell growth directions. A correlative study was then taken between shells and pearls nacre deposition rate to know whether mother oyster ability in depositing nacre on their shells is related to that of pearls. All the four shell positions were significantly different in shell nacre growth rate (Kruskal-Wallis, p-value < 0.05), and the third position have faster nacre growth among the other three both in Japanese and Hybrid strains, especially in warm temperature. The ability to deposit nacre between Japanese and Hybrid during warm water conditions (August and September) is also significantly different in almost all positions (Mann Whitney U, p-value < 0.01), Japanese oyster growth faster than Hybrid in all four positions. This leads to a different total growth among the two strains and a higher possibility of thicker nacre thickness in Japanese shell nacre. Tablet thickness is significantly different among all positions of shells (Kruskal-Wallis, p-value < 0.01), the 2nd position deposited rather thinner tablet thickness than the other three, including on the 6th month of culture which is more desirable in producing pearls with good luster. This result gives us new information that pearl growth rate is highly affected by the mother oysters; however, nacre tablet thickness might be the result of the shell matrix expressed by different mantle position from donor oysters.

Keywords: nacre, deposition, biomineralization, pearl aquaculture, pearl oyster, Akoya pearl, pearl

Procedia PDF Downloads 132
557 MTT Assay-Guided Isolation of a Cytotoxic Lead from Hedyotis umbellata and Its Mechanism of Action against Non-Small Cell Lung Cancer A549 Cells

Authors: Kirti Hira, A. Sajeli Begum, S. Mahibalan, Poorna Chandra Rao

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Introduction: Cancer is one of the leading causes of death worldwide. Although existing therapy effectively kills cancer cells, they do affect normal growing cells leading to many undesirable side effects. Hence there is need to develop effective as well as safe drug molecules to combat cancer, which is possible through phyto-research. The currently available plant-derived blockbuster drugs are the example for this. In view of this, an investigation was done to identify cytotoxic lead molecules from Hedyotis umbellata (Family Rubiaceae), a widely distributed weed in India. Materials and Methods: The methanolic extract of the whole plant of H. umbellata (MHU), prepared through Soxhlet extraction method was further fractionated with diethyl ether and n-butanol, successively. MHU, ether fraction (EMHU) and butanol fraction (BMHU) were lyophilized and were tested for the cytotoxic effect using 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay against non-small cell lung cancer (NSCLC) A549 cell lines. The potentially active EMHU was subjected to chromatographic purification using normal-phase silica columns, in order to isolate the responsible bioactive compounds. The isolated pure compounds were tested for their cytotoxic effect by MTT assay against A549 cells. Compound-3, which was found to be most active, was characterized using IR, 1H- and 13C-NMR and MS analysis. The study was further extended to decipher the mechanism of action of cytotoxicity of compound-3 against A549 cells through various in vitro cellular models. Cell cycle analysis was done using flow cytometry following PI (Propidium Iodide) staining. Protein analysis was done using Western blot technique. Results: Among MHU, EMHU, and BMHU, the non-polar fraction EMHU demonstrated a significant dose-dependent cytotoxic effect with IC50 of 67.7μg/ml. Chromatography of EMHU yielded seven compounds. MTT assay of isolated compounds explored compound-3 as potentially active one, which inhibited the growth of A549 cells with IC50value of 14.2μM. Further, compound-3 was identified as cedrelopsin, a coumarin derivative having molecular weight of 260. Results of in vitro mechanistic studies explained that cedrelopsin induced cell cycle arrest at G2/M phase and down-regulated the expression of G2/M regulatory proteins such as cyclin B1, cdc2, and cdc25C, dose dependently. This is the first report that explores the cytotoxic mechanism of cedrelopsin. Conclusion: Thus a potential small lead molecule, cedrelopsin isolated from H. umbellata, showing antiproliferative effect mediated by G2/M arrest in A549 cells was discovered. The effect of cedrelopsin against other cancer cell lines followed by in vivo studies can be performed in future to develop a new drug candidate.

Keywords: A549, cedrelopsin, G2/M phase, Hedyotis umbellata

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556 MCD-017: Potential Candidate from the Class of Nitroimidazoles to Treat Tuberculosis

Authors: Gurleen Kour, Mowkshi Khullar, B. K. Chandan, Parvinder Pal Singh, Kushalava Reddy Yumpalla, Gurunadham Munagala, Ram A. Vishwakarma, Zabeer Ahmed

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New chemotherapeutic compounds against multidrug-resistant Mycobacterium tuberculosis (Mtb) are urgently needed to combat drug resistance in tuberculosis (TB). Apart from in-vitro potency against the target, physiochemical properties and pharmacokinetic properties play an imperative role in the process of drug discovery. We have identified novel nitroimidazole derivatives with potential activity against mycobacterium tuberculosis. One lead candidates, MCD-017, which showed potent activity against H37Rv strain (MIC=0.5µg/ml) and was further evaluated in the process of drug development. Methods: Basic physicochemical parameters like solubility and lipophilicity (LogP) were evaluated. Thermodynamic solubility was determined in PBS buffer (pH 7.4) using LC/MS-MS. The partition coefficient (Log P) of the compound was determined between octanol and phosphate buffered saline (PBS at pH 7.4) at 25°C by the microscale shake flask method. The compound followed Lipinski’s rule of five, which is predictive of good oral bioavailability and was further evaluated for metabolic stability. In-vitro metabolic stability was determined in rat liver microsomes. The hepatotoxicity of the compound was also determined in HepG2 cell line. In vivo pharmacokinetic profile of the compound after oral dosing was also obtained using balb/c mice. Results: The compound exhibited favorable solubility and lipophilicity. The physical and chemical properties of the compound were made use of as the first determination of drug-like properties. The compound obeyed Lipinski’s rule of five, with molecular weight < 500, number of hydrogen bond donors (HBD) < 5 and number of hydrogen bond acceptors(HBA) not more then 10. The log P of the compound was less than 5 and therefore the compound is predictive of exhibiting good absorption and permeation. Pooled rat liver microsomes were prepared from rat liver homogenate for measuring the metabolic stability. 99% of the compound was not metabolized and remained intact. The compound did not exhibit cytoxicity in hepG2 cells upto 40 µg/ml. The compound revealed good pharmacokinetic profile at a dose of 5mg/kg administered orally with a half life (t1/2) of 1.15 hours, Cmax of 642ng/ml, clearance of 4.84 ml/min/kg and a volume of distribution of 8.05 l/kg. Conclusion : The emergence of multi drug resistance (MDR) and extensively drug resistant (XDR) Tuberculosis emphasize the requirement of novel drugs active against tuberculosis. Thus, the need to evaluate physicochemical and pharmacokinetic properties in the early stages of drug discovery is required to reduce the attrition associated with poor drug exposure. In summary, it can be concluded that MCD-017 may be considered a good candidate for further preclinical and clinical evaluations.

Keywords: mycobacterium tuberculosis, pharmacokinetics, physicochemical properties, hepatotoxicity

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555 The Different Effects of Mindfulness-Based Relapse Prevention Group Therapy on QEEG Measures in Various Severity Substance Use Disorder Involuntary Clients

Authors: Yu-Chi Liao, Nai-Wen Guo, Chun‑Hung Lee, Yung-Chin Lu, Cheng-Hung Ko

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Objective: The incidence of behavioral addictions, especially substance use disorders (SUDs), is gradually be taken seriously with various physical health problems. Mindfulness-based relapse prevention (MBRP) is a treatment option for promoting long-term health behavior change in recent years. MBRP is a structured protocol that integrates formal meditation practices with the cognitive-behavioral approach of relapse prevention treatment by teaching participants not to engage in reappraisal or savoring techniques. However, considering SUDs as a complex brain disease, questionnaires and symptom evaluation are not sufficient to evaluate the effect of MBRP. Neurophysiological biomarkers such as quantitative electroencephalogram (QEEG) may improve accurately represent the curative effects. This study attempted to find out the neurophysiological indicator of MBRP in various severity SUD involuntary clients. Participants and Methods: Thirteen participants (all males) completed 8-week mindfulness-based treatment provided by trained, licensed clinical psychologists. The behavioral data were from the Severity of Dependence Scale (SDS) and Negative Mood Regulation Scale (NMR) before and afterMBRP treatment. The QEEG data were simultaneously recorded with executive attention tasks, called comprehensive nonverbal attention test(CNAT). The two-way repeated-measures (treatment * severity) ANOVA and independent t-test were used for statistical analysis. Results: Thirteen participants regrouped into high substance dependence (HS) and low substance dependence (LS) by SDS cut-off. The HS group showed more SDS total score and lower gamma wave in the Go/No Go task of CNAT at pretest. Both groups showed the main effect that they had a lower frontal theta/beta ratio (TBR) during the simple reaction time task of CNAT. The main effect showed that the delay errors of CNAT were lower after MBRP. There was no other difference in CNAT between groups. However, after MBRP, compared to LS, the HS group have resonant progress in improving SDS and NMR scores. The neurophysiological index, the frontal TBR of the HS during the Go/No Go task of CNATdecreased than that of the LS group. Otherwise, the LS group’s gamma wave was a significant reduction on the Go/No Go task of CNAT. Conclusion: The QEEG data supports the MBRP can restore the prefrontal function of involuntary addicts and lower their errors in executive attention tasks. However, the improvement of MBRPfor the addict with high addiction severity is significantly more than that with low severity, including QEEG’s indicators and negative emotion regulation. Future directions include investigating the reasons for differences in efficacy among different severity of the addiction.

Keywords: mindfulness, involuntary clients, QEEG, emotion regulation

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554 Retrospective Assessment of the Safety and Efficacy of Percutaneous Microwave Ablation in the Management of Hepatic Lesions

Authors: Suang K. Lau, Ismail Goolam, Rafid Al-Asady

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Background: The majority of patients with hepatocellular carcinoma (HCC) are not suitable for curative treatment, in the form of surgical resection or transplantation, due to tumour extent and underlying liver dysfunction. In these non-resectable cases, a variety of non-surgical therapies are available, including microwave ablation (MWA), which has shown increasing popularity due to its low morbidity, low reported complication rate, and the ability to perform multiple ablations simultaneously. Objective: The aim of this study was to evaluate the validity of MWA as a viable treatment option in the management of HCC and hepatic metastatic disease, by assessing its efficacy and complication rate at a tertiary hospital situated in Westmead (Australia). Methods: A retrospective observational study was performed evaluating patients that underwent MWA between 1/1/2017–31/12/2018 at Westmead Hospital, NSW, Australia. Outcome measures, including residual disease, recurrence rates, as well as major and minor complication rates, were retrospectively analysed over a 12-months period following MWA treatment. Excluded patients included those whose lesions were treated on the basis of residual or recurrent disease from previous treatment, which occurred prior to the study window (11 patients) and those who were lost to follow up (2 patients). Results: Following treatment of 106 new hepatic lesions, the complete response rate (CR) was 86% (91/106) at 12 months follow up. 10 patients had the residual disease at post-treatment follow up imaging, corresponding to an incomplete response (ICR) rate of 9.4% (10/106). The local recurrence rate (LRR) was 4.6% (5/106) with follow-up period up to 12 months. The minor complication rate was 9.4% (10/106) including asymptomatic pneumothorax (n=2), asymptomatic pleural effusions (n=2), right lower lobe pneumonia (n=3), pain requiring admission (n=1), hypotension (n=1), cellulitis (n=1) and intraparenchymal hematoma (n=1). There was 1 major complication reported, with pleuro-peritoneal fistula causing recurrent large pleural effusion necessitating repeated thoracocentesis (n=1). There was no statistically significant association between tumour size, location or ablation factors, and risk of recurrence or residual disease. A subset analysis identified 6 segment VIII lesions, which were treated via a trans-pleural approach. This cohort demonstrated an overall complication rate of 33% (2/6), including 1 minor complication of asymptomatic pneumothorax and 1 major complication of pleuro-peritoneal fistula. Conclusions: Microwave ablation therapy is an effective and safe treatment option in cases of non-resectable hepatocellular carcinoma and liver metastases, with good local tumour control and low complication rates. A trans-pleural approach for high segment VIII lesions is associated with a higher complication rate and warrants greater caution.

Keywords: hepatocellular carcinoma, liver metastases, microwave ablation, trans-pleural approach

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553 Community Singing, a Pathway to Social Capital: A Cross-Cultural Comparative Assessment of the Benefits of Singing Communities in South Tyrol and South Africa

Authors: Johannes Van Der Sandt

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This quantitative study investigates different approaches of community singing, in building social capital in South Tyrol, Italy, and South Africa. The impact of the various approaches of community singing is examined by investigating the main components of social capital, namely, social norms and obligations, social networks and associations and trust, and how these components are manifested in two different societies. The research is based on the premise that community singing is an important agent for the development of social capital. It seeks to establish in what form community singing can best enhance the social capital of communities in South Tyrol that are undergoing significant changes in the ways in which social capital is generally being generated on account of demographic, economic, technological and cultural changes. South Tyrol and South Africa share some similarities in the management of their multi-cultural composition. By comparing the different approaches to community singing in two multi-cultural societies, it is hoped to gain insight, and an understanding of the connections between culture, social cohesion, identity and therefore to be able to add to the understanding of the building of social capital through community singing. Participation in music contributes to the growth of social capital in communities, this is amongst others the finding of an ever increasing amount of research. In sociological discourses on social capital generation, the dimension of community music making is recognized as an important factor. Trust and mutual cooperation are products when people listen to each other, when they work or play together, and when they care about each other. This is how social capital develops as an important shared resource. Scholars of Community Music still do not agree on a short and concise definition for Community Music. For the purpose of this research, the author concurs with the definition of Community Music of the Community Music Activity commission of the International Society of Music Education as having the following characteristics: decentralization, accessibility, equal opportunity, and active participation in music-making. These principles are social and political ones, and there can be no doubt that community music activity is more than a purely musical one. Trust, shared norms and values civic and community involvement, networks, knowledge resources, contact with families and friends, and fellowship are key components in fostering group cohesion and social capital development in a community. The research will show that there is no better place for these factors to flourish than in a community singing group. Through this comparative study, it is the aim to identify, analyze and explain similarities and differences in approaches to community across societies that find themselves in a rapid transition from traditional cultural to global cultural habits characterized by a plurality of orientation points, with the aim to gain a better understanding of the various directions South Tyrolean singing culture can take.

Keywords: community music, multicultural, singing, social capital

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552 Investigation of the Function of Chemotaxonomy of White Tea on the Regulatory Function of Genes in Pathway of Colon Cancer

Authors: Fereydoon Bondarian, Samira Shaygan

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Today, many nutritionists recommend the consumption of plants, fruits, and vegetables to provide the antioxidants needed by the body because the use of plant antioxidants usually causes fewer side effects and better treatment. Natural antioxidants increase the power of plasma antioxidants and reduce the incidence of some diseases, such as cancer. Bad lifestyles and environmental factors play an important role in increasing the incidence of cancer. In this study, different extracts of white teas taken from two types of tea available in Iran (clone 100 and Chinese hybrid) due to the presence of a hydroxyl functional group in their structure to inhibit free radicals and anticancer properties, using 3 aqueous, methanolic and aqueous-methanolic methods were used. The total polyphenolic content was calculated using the Folin-Ciocalcu method, and the percentage of inhibition and trapping of free radicals in each of the extracts was calculated using the DPPH method. With the help of high-performance liquid chromatography, a small amount of each catechin in the tea samples was obtained. Clone 100 white tea was found to be the best sample of tea in terms of all the examined attributes (total polyphenol content, antioxidant properties, and individual amount of each catechin). The results showed that aqueous and aqueous-methanolic extracts of Clone 100 white tea have the highest total polyphenol content with 27.59±0.08 and 36.67±0.54 (equivalent gallic acid per gram dry weight of leaves), respectively. Due to having the highest level of different groups of catechin compounds, these extracts have the highest property of inhibiting and trapping free radicals with 66.61±0.27 and 71.74±0.27% (mg/l) of the extracted sample against ascorbic acid). Using the MTT test, the inhibitory effect of clone 100 white tea extract in inhibiting the growth of HCT-116 colon cancer cells was investigated and the best time and concentration treatments were 500, 150 and 1000 micrograms in 8, 16 and 24 hours, respectively. To investigate gene expression changes, selected genes, including tumorigenic genes, proto-oncogenes, tumor suppressors, and genes involved in apoptosis, were selected and analyzed using the real-time PCR method and in the presence of concentrations obtained for white tea. White tea extract at a concentration of 1000 μg/ml 3 times 16, 8, and 24 hours showed the highest growth inhibition in cancer cells with 53.27, 55.8, and 86.06%. The concentration of 1000 μg/ml aqueous extract of white tea under 24-hour treatment increased the expression of tumor suppressor genes compared to the normal sample.

Keywords: catechin, gene expression, suppressor genes, colon cell line

Procedia PDF Downloads 48
551 Investigation of the IL23R Psoriasis/PsA Susceptibility Locus

Authors: Shraddha Rane, Richard Warren, Stephen Eyre

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L-23 is a pro-inflammatory molecule that signals T cells to release cytokines such as IL-17A and IL-22. Psoriasis is driven by a dysregulated immune response, within which IL-23 is now thought to play a key role. Genome-wide association studies (GWAS) have identified a number of genetic risk loci that support the involvement of IL-23 signalling in psoriasis; in particular a robust susceptibility locus at a gene encoding a subunit of the IL-23 receptor (IL23R) (Stuart et al., 2015; Tsoi et al., 2012). The lead psoriasis-associated SNP rs9988642 is located approximately 500 bp downstream of IL23R but is in tight linkage disequilibrium (LD) with a missense SNP rs11209026 (R381Q) within IL23R (r2 = 0.85). The minor (G) allele of rs11209026 is present in approximately 7% of the population and is protective for psoriasis and several other autoimmune diseases including IBD, ankylosing spondylitis, RA and asthma. The psoriasis-associated missense SNP R381Q causes an arginine to glutamine substitution in a region of the IL23R protein between the transmembrane domain and the putative JAK2 binding site in the cytoplasmic portion. This substitution is expected to affect the receptor’s surface localisation or signalling ability, rather than IL23R expression. Recent studies have also identified a psoriatic arthritis (PsA)-specific signal at IL23R; thought to be independent from the psoriasis association (Bowes et al., 2015; Budu-Aggrey et al., 2016). The lead PsA-associated SNP rs12044149 is intronic to IL23R and is in LD with likely causal SNPs intersecting promoter and enhancer marks in memory CD8+ T cells (Budu-Aggrey et al., 2016). It is therefore likely that the PsA-specific SNPs affect IL23R function via a different mechanism compared with the psoriasis-specific SNPs. It could be hypothesised that the risk allele for PsA located within the IL23R promoter causes an increase IL23R expression, relative to the protective allele. An increased expression of IL23R might then lead to an exaggerated immune response. The independent genetic signals identified for psoriasis and PsA in this locus indicate that different mechanisms underlie these two conditions; although likely both affecting the function of IL23R. It is very important to further characterise these mechanisms in order to better understand how the IL-23 receptor and its downstream signalling is affected in both diseases. This will help to determine how psoriasis and PsA patients might differentially respond to therapies, particularly IL-23 biologics. To investigate this further we have developed an in vitro model using CD4 T cells which express either wild type IL23R and IL12Rβ1 or mutant IL23R (R381Q) and IL12Rβ1. Model expressing different isotypes of IL23R is also underway to investigate the effects on IL23R expression. We propose to further investigate the variants for Ps and PsA and characterise key intracellular processes related to the variants.

Keywords: IL23R, psoriasis, psoriatic arthritis, SNP

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550 Combined Pneumomediastinum and Pneumothorax Due to Hyperemesis Gravidarum

Authors: Fayez Hanna, Viet Tran

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A 20 years old lady- primigravida 6 weeks pregnant with unremarkable past history, presented to the emergency department at the Royal Hobart Hospital, Tasmania, Australia, with hyperemesis gravidarum associated with, dehydration and complicated with hematemesis and chest pain resistant. Accordingly, we conducted laboratory investigations which revealed: FBC: WBC 23.9, unremarkable U&E, LFT, lipase and her VBG showed a pH 7.4, pCo2 36.7, cK+ 3.2, cNa+ 142. The decision was made to do a chest X-ray (CXR) after explaining the risks/benefit of performing radiographic investigations during pregnancy and considering the patient's plan for the termination of the pregnancy as she was not ready for motherhood for shared decision-making and consent to look for pneumoperitoneum to suggest perforated viscus that might cause the hematemesis. However, the CXR showed pneumomediastinum but no evidence of pneumoperitoneum or pneumothorax. Consequently, a decision was made to proceed with CT oesophagography with imaging pre and post oral contrast administration to identify a potential oesophageal tear since it could not be excluded using a plain film of the CXR. The CT oesophagography could not find a leak for the administered oral contrast and thus, no oesophageal tear could be confirmed but could not exclude the Mallory-Weiss tear (lower oesophageal tear). Further, the CT oesophagography showed an extensive pneumomediastinum that could not be confirmed to be pulmonary in origin noting the presence of bilateral pulmonary interstitial emphysema and pneumothorax in the apex of the right lung that was small. The patient was admitted to the Emergency Department Inpatient Unit for monitoring, supportive therapy, and symptomatic management. Her hyperemesis was well controlled with ondansetron 8mg IV, metoclopramide 10mg IV, doxylamine 25mg PO, pyridoxine 25mg PO, esomeprazole 40mg IV and oxycodone 5mg PO was given for pain control and 2 litter of IV fluid. The patient was stabilized after 24 hours and discharged home on ondansetron 8mg every 8 hours whereas the patient had a plan for medical termination of pregnancy. Three weeks later, the patient represented with nausea and vomiting complicated by a frank hematemesis. Her observation chart showed HR 117- other vital signs were normal. Pathology showed WBC 14.3 with normal U&E and Hb. The patient was managed in the Emergency Department with the same previous regimen and was discharged home on same previous regimes. Five days later, she presented again with nausea, vomiting and hematemesis and was admitted under obstetrics and gynaecology for stabilization then discharged home with a plan for surgical termination of pregnancy after 3-days rather than the previously planned medical termination of pregnancy to avoid extension of potential oesophageal tear. The surgical termination and follow up period were uneventful. The case is considered rare as pneumomediastinum is a very rare complication of hyperemesis gravidarum where vomiting-induced barotrauma leads to a ruptured oesophagus and air leak into the mediastinum. However no rupture oesophagus in our case. Although the combination of pneumothorax and pneumomediastinum without oesophageal tear was reported only 8 times in the literature, but none of them was due to hyperemesis gravidarum.

Keywords: Pneumothorax, pneumomediastinum, hyperemesis gravidarum, pneumopericardium

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549 A Preliminary Randomized Controlled Trial of Pure L-Ascorbic Acid with Using a Needle-Free and Micro-Needle Mesotherapy in Treatment of Anti-Aging Procedure

Authors: M. Zasada, A. Markiewicz, A. Erkiert-Polguj, E. Budzisz

Abstract:

The epidermis is a keratinized stratified squamous epithelium covered by the hydro-lipid barrier. Therefore, active substances should be able to penetrate through this hydro-lipid coating. L-ascorbic acid is one of the vitamins which plays an important role in stimulation fibroblast to produce collagen type I and in hyperpigmentation lightening. Vitamin C is a water-soluble antioxidant, which protects skin from oxidation damage and rejuvenates photoaged skin. No-needle mesotherapy is a non-invasive rejuvenation technique depending on electric pulses, electroporation, and ultrasounds. These physicals factors result in deeper penetration of cosmetics. It is important to increase the penetration of L-ascorbic acid, thereby increasing the spectrum of its activity. The aim of the work was to assess the effectiveness of pure L-ascorbic acid activity in anti-aging therapy using a needle-free and micro-needling mesotherapy. The study was performed on a group of 35 healthy volunteers in accordance with the Declaration of Helsinki of 1964 and agreement of the Ethics Commissions no RNN/281/16/KE 2017. Women were randomized to mesotherapy or control group. Control group applied topically 2,5 ml serum containing 20% L-ascorbic acid with hydrate from strawberries, every 10 days for a period of 9 weeks. No-needle mesotherapy, on the left half of the face and micro-needling on the right with the same serum, was done in mesotherapy group. The pH of serum was 3.5-4, and the serum was prepared directly prior to the facial treatment. The skin parameters were measured at the beginning and before each treatment. The measurement of the forehead skin was done using Cutometer® (measurement of skin elasticity and firmness), Corneometer® (skin hydration measurement), Mexameter® (skin tone measurement). Also, the photographs were taken by Fotomedicus system. Additionally, the volunteers fulfilled the questionnaire. Serum was tested for microbiological purity and stability after the opening of the cosmetic. During the study, all of the volunteers were taken care of a dermatologist. The regular application of the serum has caused improvement of the skin parameters. Respectively, after 4 and 8 weeks improvement in hydration and elasticity has been seen (Corneometer®, Cutometer® results). Moreover, the number of hyper-pigmentated spots has decreased (Mexameter®). After 8 weeks the volunteers has claimed that the tested product has smoothing and moisturizing features. Subjective opinions indicted significant improvement of skin color and elasticity. The product containing the L-ascorbic acid used with intercellular penetration promoters demonstrates higher anti-aging efficiency than control. In vivo studies confirmed the effectiveness of serum and the impact of the active substance on skin firmness and elasticity, the degree of hydration and skin tone. Mesotherapy with pure L-ascorbic acid provides better diffusion of active substances through the skin.

Keywords: anti-aging, l-ascorbic acid, mesotherapy, promoters

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548 Exploring the Differences between Self-Harming and Suicidal Behaviour in Women with Complex Mental Health Needs

Authors: Sophie Oakes-Rogers, Di Bailey, Karen Slade

Abstract:

Female offenders are a uniquely vulnerable group, who are at high risk of suicide. Whilst the prevention of self-harm and suicide remains a key global priority, we need to better understand the relationship between these challenging behaviours that constitute a pressing problem, particularly in environments designed to prioritise safety and security. Method choice is unlikely to be random, and is instead influenced by a range of cultural, social, psychological and environmental factors, which change over time and between countries. A key aspect of self-harm and suicide in women receiving forensic care is the lack of free access to methods. At a time where self-harm and suicide rates continue to rise internationally, understanding the role of these influencing factors and the impact of current suicide prevention strategies on the use of near-lethal methods is crucial. This poster presentation will present findings from 25 interviews and 3 focus groups, which enlisted a Participatory Action Research approach to explore the differences between self-harming and suicidal behavior. A key element of this research was using the lived experiences of women receiving forensic care from one forensic pathway in the UK, and the staffs who care for them, to discuss the role of near-lethal self-harm (NLSH). The findings and suggestions from the lived accounts of the women and staff will inform a draft assessment tool, which better assesses the risk of suicide based on the lethality of methods. This tool will be the first of its kind, which specifically captures the needs of women receiving forensic services. Preliminary findings indicate women engage in NLSH for two key reasons and is determined by their history of self-harm. Women who have a history of superficial non-life threatening self-harm appear to engage in NLSH in response to a significant life event such as family bereavement or sentencing. For these women, suicide appears to be a realistic option to overcome their distress. This, however, differs from women who appear to have a lifetime history of NLSH, who engage in such behavior in a bid to overcome the grief and shame associated with historical abuse. NLSH in these women reflects a lifetime of suicidality and indicates they pose the greatest risk of completed suicide. Findings also indicate differences in method selection between forensic provisions. Restriction of means appears to play a role in method selection, and findings suggest it causes method substitution. Implications will be discussed relating to the screening of female forensic patients and improvements to the current suicide prevention strategies.

Keywords: forensic mental health, method substitution, restriction of means, suicide

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547 Gap between Knowledge and Behaviour in Recycling Domestic Solid Waste: Evidence from Manipal, India

Authors: Vidya Pratap, Seena Biju, Keshavdev A.

Abstract:

In the educational town of Manipal (located in southern India) households dispose their wastes without segregation. Mixed wastes (organic, inorganic and hazardous items) are collected either by private collectors or by the local municipal body in trucks and taken to dump yards. These collectors select certain recyclables from the collected trash and sell them to scrap merchants to earn some extra money. Rag pickers play a major role in picking up card board boxes, glass bottles and milk sachets from dump yards and public areas and scrap iron from construction sites for recycling. In keeping with the Indian Prime Minister’s mission of Swachh Bharat (A Clean India), the local municipal administration is taking efforts to ensure segregation of domestic waste at source. With this in mind, each household in a residential area in Manipal was given two buckets – for wet and dry wastes (wet waste referred to organic waste while dry waste included recyclable and hazardous items). A study was conducted in this locality covering a cluster of 145 households to assess the residents’ knowledge of recyclable, organic and hazardous items commonly disposed by households. Another objective of this research was to evaluate the extent to which the residents actually dispose their wastes appropriately. Questionnaires were self-administered to a member of each household with the assistance of individuals speaking the local language whenever needed. Respondents’ knowledge of whether an item was organic, inorganic or hazardous was captured through a questionnaire containing a list of 50 common items. Their behaviour was captured by asking how they disposed these items. Results show that more than 70% of respondents are aware that banana and orange peels, potato skin, egg shells and dried leaves are organic; similarly, more than 70% of them consider newspapers, notebook and printed paper are recyclable. Less than 65% of respondents are aware that plastic bags and covers and plastic bottles are recyclable. However, the results of the respondents’ recycling behaviour is less impressive. Fewer than 35% of respondents recycle card board boxes, milk sachets and glass bottles. Unfortunately, since plastic items like plastic bags and covers and plastic bottles are not accepted by scrap merchants, they are not recycled. This study shows that the local municipal authorities must find ways to recycle plastic into products, alternate fuel etc.

Keywords: behaviour, knowledge, plastic waste management, recyclables

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546 Building a Framework for Digital Emergency Response System for Aged, Long Term Care and Chronic Disease Patients in Asia Pacific Region

Authors: Nadeem Yousuf Khan

Abstract:

This paper proposes the formation of a digital emergency response system (dERS) in the aged, long-term care, and chronic disease setups in the post-COVID healthcare ecosystem, focusing on the Asia Pacific market where the aging population is increasing significantly. It focuses on the use of digital technologies such as wearables, a global positioning system (GPS), and mobile applications to build an integrated care system for old folks with co-morbidities and other chronic diseases. The paper presents a conceptual framework of a connected digital health ecosystem that not only provides proactive care to registered patients but also prevents the damages due to sudden conditions such as strokes by alerting and treating the patients in a digitally connected and coordinated manner. A detailed review of existing digital health technologies such as wearables, GPS, and mobile apps was conducted in context with the new post-COVID healthcare paradigm, along with a detailed literature review on the digital health policies and usability. A good amount of research papers is available in the application of digital health, but very few of them discuss the formation of a new framework for a connected digital ecosystem for the aged care population, which is increasing around the globe. A connected digital emergency response system has been proposed by the author whereby all registered patients (chronic disease and aged/long term care) will be connected to the proposed digital emergency response system (dERS). In the proposed ecosystem, patients will be provided with a tracking wrist band and a mobile app through which the control room will be monitoring the mobility and vitals such as atrial fibrillation (AF), blood sugar, blood pressure, and other vital signs. In addition to that, an alert in case if the patient falls down will add value to this system. In case of any variation in the vitals, an alert is sent to the dERS 24/7, and dERS clinical staff immediately trigger that alert which goes to the connected hospital and the adulatory service providers, and the patient is escorted to the nearest connected tertiary care hospital. By the time, the patient reaches the hospital, dERS team is ready to take appropriate clinical action to save the life of the patient. Strokes or myocardial infarction patients can be prevented from disaster if they are accessible to engagement healthcare. This dERS will play an effective role in saving the lives of aged patients or patients with chronic co-morbidities.

Keywords: aged care, atrial fibrillation, digital health, digital emergency response system, digital technology

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545 Coprophagus Beetles (Scarabaeidae: Coleoptera) of Buxa Tiger Reserve, West Bengal, India

Authors: Subhankar Kumar Sarkar

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Scarab beetles composing the family Scarabaeidae is one of the largest families in the order Coleoptera. The family is comprised of 11 subfamilies. Of these, the subfamily Scarabaeinae includes 13 tribes globally. Indian species are however considered within 2 tribes Scarabaeini and Coprini. Scarab beetles under this subfamily also known as Coprophagus beetles play an indispensable role in forestry and agriculture. Both adults and larvae of these beetles do a remarkable job of carrying excrement into the soil thus enriching the soil to a great extent. Eastern and North Eastern states of India are heavily rich in diversity of organisms as this region exhibits the tropical rain forests of the eastern Himalayas, which exhibits one of the 18 biodiversity hotspots of the world and one of the three of India. Buxa Tiger Reserve located in Dooars between latitudes 26°30” to 26°55” North & longitudes 89°20” to 89°35” East is one such fine example of rain forests of the eastern Himalayas. Despite this, the subfamily is poorly known, particularly from this part of the globe and demands serious revisionary studies. It is with this background; the attempt is being made to assess the Scarabaeinae fauna of the forest. Both extensive and intensive surveys were conducted in different beats under different ranges of Buxa Tiger Reserve. For collection sweep nets, bush beating and collection in inverted umbrella, hand picking techniques were used. Several pit fall traps were laid in the collection localities of the Reserve to trap ground dwelling scarabs. Dung of various animals was also examined to make collections. In the evening hours UV light, trap was used to collect nocturnal beetles. The collected samples were studied under Stereozoom Binocular Microscopes Zeiss SV6, SV11 and Olympus SZ 30. The faunistic investigation of the forest revealed in the recognition of 19 species under 6 genera distributed over 2 tribes. Of these Heliocopris tyrannus Thomson, 1859 was recorded new from the Country, while Catharsius javanus Lansberge, 1886, Copris corpulentus Gillet, 1910, C. doriae Harold, 1877 and C. sarpedon Harold, 1868 from the state. 4 species are recorded as endemic to India. The forest is dominated by the members of the Genus Onthophagus, of which Onthophagus (Colobonthophagus) dama (Fabricius, 1798) is represented by highest number of individuals. Their seasonal distribution is most during Premonsoon followed by Monsoon and Postmonsoon. Zoogeographically all the recorded species are of oriental distribution.

Keywords: buxa tiger reserve, diversity, India, new records, scarabaeinae, scarabaeidae

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544 Food Insecurity and Other Correlates of Individual Components of Metabolic Syndrome in Women Living with HIV (WLWH) in the United States

Authors: E. Wairimu Mwangi, Daniel Sarpong

Abstract:

Background: Access to effective antiretroviral therapy in the United States has resulted in the rise in longevity in people living with HIV (PLHIV). Despite the progress, women living with HIV (WLWH) experience increasing rates of cardiometabolic disorders compared with their HIV-negative counterparts. Studies focusing on the predictors of metabolic disorders in this population have largely focused on the composite measure of metabolic syndrome (METs). This study seeks to identify the predictors of composite and individual METs factors in a nationally representative sample of WLWH. In particular, the study also examines the role of food security in predicting METs. Methods: The study comprised 1800 women, a subset of participants from the Women’s Interagency HIV Study (WIHS). The primary exposure variable, food security, was measured using the U.S. 10-item Household Food Security Survey Module. The outcome measures are the five metabolic syndrome indicators (elevated blood pressure [systolic BP > 130 mmHg and diastolic BP ≥ 85 mmHg], elevated fasting glucose [≥ 110 mg/dL], elevated fasting triglyceride [≥ 150 mg/dL], reduced HDL cholesterol [< 50 mg/dL], and waist circumference > 88 cm) and the composite measure - Metabolic Syndrome (METs) Status. Each metabolic syndrome indicator was coded one if yes and 0 otherwise. The values of the five indicators were summed, and participants with a total score of 3 or greater were classified as having metabolic syndrome. Participants classified as having metabolic syndrome were assigned a code of 1 and 0 otherwise for analysis. The covariates accounted for in this study fell into sociodemographic factors and behavioral and health characteristics. Results: The participants' mean (SD) age was 47.1 (9.1) years, with 71.4% Blacks and 10.9% Whites. About a third (33.1%) had less than a high school (HS) diploma, 60.4% were married, 32.8% were employed, and 53.7% were low-income. The prevalence of worst dietary diversity, low, moderate, and high food security were 24.1%, 26.6%, 17.0%, and 56.4%, respectively. The correlate profile of the five individual METs factors plus the composite measure of METs differ significantly, with METs based on HDL having the most correlates (Age, Education, Drinking Status, Low Income, Body Mass Index, and Health Perception). Additionally, metabolic syndrome based on waist circumference was the only metabolic factor where food security was significantly correlated (Food Security, Age, and Body Mass Index). Age was a significant predictor of all five individual METs factors plus the composite METs measure. Except for METs based on Fasting Triglycerides, body mass index (BMI) was a significant correlate of the various measures of metabolic syndrome. Conclusion: High-density Lipoprotein (HDL) cholesterol significantly correlated with most predictors. BMI was a significant predictor of all METs factors except Fasting Triglycerides. Food insecurity, the primary predictor, was only significantly associated with waist circumference.

Keywords: blood pressure, food insecurity, fasting glucose, fasting triglyceride, high-density lipoprotein, metabolic syndrome, waist circumference, women living with HIV

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543 Comparative Economic Evaluation of Additional Respiratory Resources Utilized after Methylxanthine Initiation for the Treatment of Apnea of Prematurity in a South Asian Country

Authors: Shivakumar M, Leslie Edward S Lewis, Shashikala Devadiga, Sonia Khurana

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Introduction: Methylxanthines are used for the treatment of AOP, to facilitate extubation and as a prophylactic agent to prevent apnea. Though the popularity of Caffeine has risen, it is expensive in a resource constrained developing countries like India. Objective: To evaluate the cost-effectiveness of Caffeine compared with Aminophylline treatment for AOP with respect to additional ventilatory resource utilized in different birth weight categorization. Design, Settings and Participants – Single centered, retrospective economic evaluation was done. Participants included preterm newborns with < 34 completed weeks of gestation age that were recruited under an Indian Council of Medical Research funded randomized clinical trial. Per protocol data was included from Neonatal Intensive Care Unit, Kasturba Hospital, Manipal, India between April 2012 and December 2014. Exposure: Preterm neonates were randomly allocated to either Caffeine or Aminophylline as per the trial protocol. Outcomes and Measures – We assessed surfactant requirement, duration of Invasive and Non-Invasive Ventilation, Total Methylxanthine cost and additional cost for respiratory support bared by the payers per day during hospital stay. For the purpose of this study Newborns were stratified as Category A – < 1000g, Category B – 1001 to 1500g and Category C – 1501 to 2500g. Results: Total 146 (Caffeine -72 and Aminophylline – 74) babies with Mean ± SD gestation age of 29.63 ± 1.89 weeks were assessed. 32.19% constitute of Category A, 55.48% were B and 12.33% were C. The difference in median duration of additional NIV and IMV support was statistically insignificant. However 60% of neonates who received Caffeine required additional surfactant therapy (p=0.02). The total median (IQR) cost of Caffeine was significantly high with Rs.10535 (Q3-6317.50, Q1-15992.50) where against Aminophylline cost was Rs.352 (Q3-236, Q1-709) (p < 0.001). The additional costs spent on respiratory support per day in neonates on either Methylxanthines were found to be statistically insignificant in the entire weight based category of our study. Whereas in Category B, the median O2 charges per day were found to have more in Caffeine treated newborns (p=0.05) with border line significance. In category A, providing one day NIV or IMV support significantly increases the unit log cost of Caffeine by 13.6% (CI – 95% ranging from 4 to 24; p=0.005) over log cost of Aminophylline. Conclusion: Cost of Caffeine is expensive than Aminophylline. It was found to be equally efficacious in reducing the number duration of NIV or IMV support. However adjusted with the NIV and IMV days of support, neonates fall in category A and category B who were on Caffeine pays excess amount of respiratory charges per day over aminophylline. In perspective of resource poor settings Aminophylline is cost saving and economically approachable.

Keywords: methylxanthines include caffeine and aminophylline, AOP (apnea of prematurity), IMV (invasive mechanical ventilation), NIV (non invasive ventilation), category a – <1000g, category b – 1001 to 1500g and category c – 1501 to 2500g

Procedia PDF Downloads 421