Search results for: negative emotions in crisis
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6122

Search results for: negative emotions in crisis

1742 The Effect of Gender Role Socialization on Marketing of Gendered Products: The Case of Cultural Ghana

Authors: Priscilla Adoley Moffat

Abstract:

One common element of African cultures is gender role socialization. This is a significant component of African cultures because gender roles are considered in these cultures, to define males and females and distinguish males from females. Various studies have established the impact of gender role socialization on individuals, on activities of individuals, including business activities, and on society, in general. This study further examined the effect of gender role socialization on the marketing of gendered products. The study sought to establish whether gender role socialization affects marketing, particularly word-of-mouth marketing, of gender-specific products. For a comprehensive examination of the influence of gender role socialization on word-of-mouth marketing of gendered products, 2150 respondents (1075 males and 1075 females), comprising 550 students of Marketing from various Ghanaian universities/colleges and 1600 other individuals (100 from each of the 16 regions of Ghana, representing the various cultures) were randomly sampled and interviewed. The study found that females are more willing to market male products than males when tasked to market female products. Also, females are more efficient in marketing male products than males in marketing female products. Again, most female audiences feel uncomfortable or embarrassed and are less receptive when approached by a male marketer of female products. Then, the study found that the fear of stigmatization is a major influencer of males’ negative attitude towards marketing of female products and that female marketers of male products, however, suffer less or no stigma. Aside from its addition to the literature on the impact of gender role socialization on marketing and, for that matter, the influence of socialization on marketing, the findings of the study are useful to multinational companies, which become better informed in their strategy when assigning marketing roles, especially in Africa.

Keywords: gender, socialization, marketing, gendered, role, Ghana

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1741 The Impact of Work Stress on Professionals' Life and Health: The Usage of Instant Messaging Applications

Authors: Pui-Lai To, Chechen Liao, Ming-Chi Sung

Abstract:

Work and family life are the most important areas for men and women today. Every professional is required to meet and fulfill the responsibilities of work and family roles. Although the development and popularity of communication technology bring a lot of benefits, including effective and efficient communication, may also generate conflicts between work and family life. Since mobile devices and the applications of mobile devices, such as instant messages, are ubiquitous, the boundaries of work and family roles are increasingly blurred. Professionals may be in the risk of work over-loading and work-family conflict. This study examines the impact of work stress on professionals’ life and health in the context of instant messaging application of smart phone. This study uses a web-based questionnaire to collect samples. The questionnaires are sent via virtual community sites, instant messaging applications, and e-mail. The study develops and empirically validates a work-family conflict model by integrating the pressure theory and technostress factors. The causal relationship between variables in the research model is tested. In terms of data analysis, Partial Least Square (PLS) in Structural Equation Modeling (SEM) is used for sample analysis and research model testing. The results of this study are as follows. First, both the variables of work-related stress and technological violations positively affect the work-family conflict. Second, both the variables of work-loading and technology-overloading have no effect on work-family conflict. Third, work-family conflict has negative effect on job satisfaction, family satisfaction, physical health, and mental health.

Keywords: mental health, physical health, technostress, work-family conflict, work-related stress

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1740 Bacterio-Algal Microbial Fuel Cells for Sustainable Power Production, Wastewater Treatment, and Desalination

Authors: Ann D. Christy, Beenish Saba

Abstract:

The Microbial fuel Cell (MFC) is a successful integrated technology for power production and wastewater treatment. MFCs are recognized for their dual function, but research in this field is still ongoing to increase efficiency and power output. One such effort is successful integration of phototrophic and autotrophic microorganisms to create bacterio-algal MFCs for sustainable electricity production along with wastewater treatment and algal biomass production. An MFC is typically configured with an anaerobic anodic chamber containing exoelectrogenic microorganisms separated by a cation exchange membrane from an adjacent aerobic cathodic chamber. The two electrodes are connected by an external circuit. This conventional MFC can be converted into a phototrophic MFC by introducing photosynthetic microorganisms into the cathode chamber. This study examines adding a third desalination chamber to a two-chamber bacterio-algal MFC. Successful results have been observed from these three-chamber MFCs demonstrating wastewater treatment in the anodic chamber, phototrophic algal growth in the cathodic chamber, and desalination in the middle chamber. The present article will summarize successful results of the bacterio-algal fuel cells and offer insights about the mechanisms involved. Tables summarizing the input substrate along with optimized operational conditions and output performance in terms of power production and efficiencies of water and wastewater treatment will be presented. The negative impacts and challenges will be discussed, along with possible future research directions. Results suggest that the three chamber bacterio-algal desalination cell has potential as a feasible technology for power production, wastewater treatment and desalination, but it needs further investigation under optimized conditions.

Keywords: bacterio-algal MFC, three chamber, microbial fuel cell, wastewater treatment and desalination

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1739 Final Account Closing in Construction Project: The Use of Supply Chain Management to Reduce the Delays

Authors: Zarabizan Zakaria, Syuhaida Ismail, Aminah Md. Yusof

Abstract:

Project management process starts from the planning stage up to the stage of completion (handover of buildings, preparation of the final accounts and the closing balance). This process is not easy to implement efficiently and effectively. The issue of delays in construction is a major problem for construction projects. These delays have been blamed mainly on inefficient traditional construction practices that continue to dominate the current industry. This is due to several factors, such as environments of construction technology, sophisticated design and customer demands that are constantly changing and influencing, either directly or indirectly, the practice of management. Among the identified influences are physical environment, social environment, information environment, political and moral atmosphere. Therefore, this paper is emerged to determine the problem and issues in the final account closing in construction projects, and it establishes the need to embrace Supply Chain Management (SCM) and then elucidates the need and strategies for the development of a delay reduction framework. At the same time, this paper provides effective measures to avoid or at least reduce the delay to the optimum level. Allowing problems in the closure declaration to occur without proper monitoring and control can leave negative impact on the cost and time of delivery to the end user. Besides, it can also affect the reputation or image of the agency/department that manages the implementation of a contract and consequently may reduce customer's trust towards the agencies/departments. It is anticipated that the findings reported in this paper could address root delay contributors and apply SCM tools for their mitigation for the better development of construction project.

Keywords: final account closing, construction project, construction delay, supply chain management

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1738 Valorization of a Forest Waste, Modified P-Brutia Cones, by Biosorption of Methyl Geen

Authors: Derradji Chebli, Abdallah Bouguettoucha, Abdelbaki Reffas Khalil Guediri, Abdeltif Amrane

Abstract:

The removal of Methyl Green dye (MG) from aqueous solutions using modified P-brutia cones (PBH and PBN), has been investigated work. The physical parameters such as pH, temperature, initial MG concentration, ionic strength are examined in batch experiments on the sorption of the dye. Adsorption removal of MG was conducted at natural pH 4.5 because the dye is only stable in the range of pH 3.8 to 5. It was observed in experiments that the P-brutia cones treated with NaOH (PBN) exhibited high affinity and adsorption capacity compared to the MG P-brutia cones treated with HCl (PBH) and biosorption capacity of modified P-brutia cones (PBN and PBH) was enhanced by increasing the temperature. This is confirmed by the thermodynamic parameters (ΔG° and ΔH°) which show that the adsorption of MG was spontaneous and endothermic in nature. The positive values of ΔS° suggested an irregular increase in the randomness for both adsorbent (PBN and PBH) during the adsorption process. The kinetic model pseudo-first order, pseudo-second order, and intraparticle diffusion coefficient were examined to analyze the sorption process; they showed that the pseudo-second-order model is the one that best describes the adsorption process (MG) on PBN and PBH with a correlation coefficient R²> 0.999. The ionic strength has shown that it has a negative impact on the adsorption of MG on two supports. A reduction of 68.5% of the adsorption capacity for a value Ce=30 mg/L was found for the PBH, while the PBN did not show a significant influence of the ionic strength on adsorption especially in the presence of NaCl. Among the tested isotherm models, the Langmuir isotherm was found to be the most relevant to describe MG sorption onto modified P-brutia cones with a correlation factor R²>0.999. The capacity adsorption of P-brutia cones, was confirmed for the removal of a dye, MG, from aqueous solution. We note also that P-brutia cones is a material very available in the forest and low-cost biomaterial

Keywords: adsorption, p-brutia cones, forest wastes, dyes, isotherm

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1737 The Study of Tourism Destination Management Factors for Sustainable Tourism: Case Study of Haikou, Hainan Province

Authors: Jiaying Gao, Thammananya Sakcharoen, Wilailuk Niyommaneerat

Abstract:

Haikou is the capital of Hainan, a major tourism province in China with rich ecotourism resources. There is a need to strengthen tourism destination management in Haikou toward sustainable development as a tourism city. The purpose of this study was to investigate the relationship between tourism destination management and sustainable tourism in Haikou. Exploratory factor analysis was used to extract six dimensions of this study. Three dimensions (10 factors) of tourism destination management were analyzed in terms of economic development, social and cultural development, and conservation of ecosystem. Sustainability awareness, tourism development experience, and tourism public infrastructure in three dimensions (12 factors) of sustainable tourism. There were 426 questionnaire respondents, including 225 tourists, 172 residents, 12 tourism agency persons, 10 government persons, 3 self-employed, and 4 others. The Structural equation modeling (SEM) model was finally conducted to test the hypotheses empirically and explore the impact relationship. The study found a significant relationship between tourism destination management and sustainable tourism: social and cultural development had the greatest significant positive impact on the tourism development experience (0.788***). Social and cultural development also showed a significant positive impact and great impetus on tourism public infrastructure (0.561***). A negative effect relationship (-0.096***) emerged between ecosystem conversion and tourism development experience. It showed a positive relationship between economic development and social and cultural development of tourism destination management in promoting sustainable tourism. There are still some gaps for improvement, such as the need for sustainable ecological management to promote local sustainable tourism trends and enhance tourism experience development, which may require a long-term process of mitigation.

Keywords: Haikou (Hainan, China), influence relationship, sustainable tourism, tourism destination management

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1736 Forests, the Sanctuaries to Specialist and Rare Wild Native Bees at the Foothills of Western Himalayas

Authors: Preeti Virkar, V. P. Uniyal, Vinod Kumar Bhatt

Abstract:

With 50% decline in managed honey bee hives in the continents of Europe and America, farmers and landscape managers are turning to native wild bees for their essential ecosystem services of pollination. Wild bees population are too under danger due to the rapid land use changes from anthropogenic activities. With an escalating population reaching 9.0 billion by 2050, human-induced land use changes are predicted to further deteriorate the habitats of numerous species by the turn of this century. The status of bees are uncertain, especially in the tropical regions of the world, which also questions the crisis of global pollinator decline and their essential services to wild and managed flora. Our investigation collectively compares wild native bee diversity and their status in forests and agroecosystems in Doon Valley landscape, situated at the foothills of Himalayan ranges, Uttarakhand, India. We seek to ask whether (1) natural habitat are refuge to richer and rarer bees communities than the agroecosystems, (2) Are agroecosystems closer to natural habitats similar to them than agroecosystems farther away; hence support richer bee communities and hence, (3) Do polyculture farms support richer bee communities than monoculture. The data was collected using observation and pantrap sampling form February to May, 2012 to 2014. We recorded 43 species of bees in Doon Valley. They belonged to 5 families; Megachilidae, Apidae, Andrenidae, Halictidae and Collitidae. A multinomial model approach was used to classify the bees into 2 habitats, in which forests demonstrated to support greater number of specialist (26%, n= 11) species than agroecosystems (7%, n= 3). The valley had many species categorized as the rare (58%, n= 25) and very few generalists (9%, n=4). A linear regression model run on our data demonstrated higher bee diversity in agro-ecosystems in close proximity to forests (H’ for < 200 m = 1.60) compared to those further away (H’ for > 600 m = 0.56) (R2=0.782, SE=0.148, p value=0.004). Organic agriculture supported significantly greater species richness in comparison to conventional farms (Mann-Whitney U test, n1 = 33, n2 = 35; P = 0.001). Forests ecosystems are refuge to rare specialist groups and support bee communities in nearby agroecosystems. The findings of our investigation demonstrate the importance of natural habitats as a potential refuge for rare native wild bee pollinators. Polyculture in the valley behaves similar to natural habitats and supports diverse bee communities in comparison to conventional monocultures. Our study suggests that the farming communities adopt diverse organic agriculture systems to attract wild pollinators beneficial for better crop production. Forests are sanctuaries for bees to nest, forage, and breed. Therefore, our outcome also suggests landscape managers not only preserve protected areas but also enhance the floral diversity in semi-natural and urban areas.

Keywords: native bees, pollinators, polyculture, agroecosystem, natural habitat, diversity, monoculture, specialists, generalists

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1735 Using Game Engines in Lightning Shielding: The Application of the Rolling Spheres Method on Virtual As-Built Power Substations

Authors: Yuri A. Gruber, Matheus Rosendo, Ulisses G. A. Casemiro, Klaus de Geus, Rafael T. Bee

Abstract:

Lightning strikes can cause severe negative impacts to the electrical sector causing direct damage to equipment as well as shutdowns, especially when occurring in power substations. In order to mitigate this problem, a meticulous planning of the power substation protection system is of vital importance. A critical part of this is the distribution of shielding wires through the substation, which creates a 3D imaginary protection mesh similar to a circus tarpaulin. Equipment enclosed in the volume defined by that 3D mesh is considered protected against lightning strikes. The use of traditional methods of longitudinal cutting analysis based on 2D CAD tools makes the process laborious and the results obtained may not guarantee satisfactory protection of electrical equipment. This work describes the application of a Game Engine to the problem of lightning protection of power substations providing the visualization of the 3D protection mesh, the amount of protected components and the highlight of equipment which remain unprotected. In addition, aspects regarding the implementation and the advantages of approaching the problem using Unreal® Engine 4 are described. In order to validate results, a comparison with traditional 2D methods is applied to the same case study to which the proposed technique has been applied. Finally, a comparative study involving different levels of protection using the technique developed in this work is presented, showing that modern game engines can be a powerful accessory for simulations in several areas of engineering.

Keywords: game engine, rolling spheres method, substation protection, UE4, Unreal Engine 4

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1734 The Impact of Financial Literacy, Perception of Debt, and Perception of Risk Toward Student Willingness to Use Online Student Loan

Authors: Irni Rahmayani Johan, Ira Kamelia

Abstract:

One of the impacts of the rapid advancement of technology is the rise of digital finance, including peer-to-peer lending (P2P). P2P lending has been widely marketed, including an online student loan that used the P2P platform. This study aims to analyze the effect of financial literacy, perception of debt, and perception of risk toward student willingness to use the online student loan (P2P lending). Using a cross-sectional study design, in collecting the data this study employed an online survey method, with a total sample of 280 undergraduate students of IPB university, Indonesia. This study found that financial literacy, perception of debt, perception of risk, and interest in using online student loans are categorized as low level. While the level of knowledge is found to be the lowest, the first-year students showed a higher level in terms of willingness to use the online student loan. In addition, the second year students recorded a positive perception toward debt. This study showed that level of study, attendance in personal finance course, and student’ GPA is positively related to financial knowledge. While debt perception is negatively related to financial attitudes. Similarly, the negative relationship is found between risk perception and the willingness to use the online student loan. The determinant factor of the willingness to use online student loans is the level of study, debt perception, financial risk perception, and time risk perception. Students with a higher level of study are more likely to have a lower interest in using online student loans. Moreover, students who perceived debt as a financial stimulator, as well as those with higher level of financial risk perceptions and time risk perceptions, tend to show more interest to use the loan.

Keywords: financial literacy, willingness to use, online student loan, perception of risk, perception of debt

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1733 Significance of Life Values in Relationship: A Detailed Analysis of Teenage Population

Authors: Preeti Nakhat

Abstract:

Background: Values are essential part of one's life. They are inculcated since the early years of life and shape the personality of the individual. They play a tremendous role in decision making. Teenagers are seen perplexed about the values of their life. The challenge faced by majority of the teenage population in choosing between a positive and negative value is high. The values they adopt remain throughout their life and in every decision, hence it is a crucial topic of research. Research Methodology: This research aimed at finding out the value conflict of teenagers in relations. Hypothesis of the study are: H₀- There is no significant association between the life values and value conflict of higher secondary students; H₁– There is a significant association between the life values and value conflict of higher secondary students. For the same, the standardized tool, value conflict scale by R. L. Bhardwaj has been used. The tool consists 24 questions of different life situations with multiple choice options. Findings: There is 96% variation in value conflict due to evasion vs. fortitude, dependence vs. self-reliance, selfishness vs. probity, hate vs. love, fear vs. assertion and pragmatism vs. idealism life values. There is a positive association between all the life values and value conflict of higher secondary school students. Percentages of association are: 0.17% between value conflict and evasion vs. fortitude value, 0.16% between value conflict and dependence vs. self-reliance value, 0.17% between value conflict and selfishness vs. probity value, 0.16% between value conflict and hate vs. love value, 0.17% between value conflict and fear vs. assertion, 0.17% between value conflict and pragmatism vs. idealism value. Discussions: The dilemma faced by the students regarding value conflict is high. Bewilderment of being honest or lying, of loving or hating family and friends, being pragmatic or idealistic in life decision, being selfish or selfless is seen among the students. It is the challenge for the future. Teaching of values with a practical aspect should be added in the school curriculum.

Keywords: dilemma, conflict, school, values

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1732 Relationships between Chinese Talented Educated Women

Authors: Jianghe Niu, Zhu Xiao Di

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This research uses a qualitative case study of the literature review approach to explore and analyze the relationship between three pairs of famous and talented women in China and uncovers certain regularities. From all kinds of available Chinese materials, such as biographies, memoirs, and news reports, both in papers and from the internet, we carefully selected the following 3 pairs of 6 Chinese women, whose relationships went through upheavals from friendship to jealousy and hostility, and we analyzed many factors contributing to this kind of relationship. (1) Hong Huang and Su Mang, both are leaders in the contemporary Chinese fashion industry as editors-in-chief of major fashion magazines. (2) Lin Huiyin and Xie Bingxin, both are phenomenally successful women in the field of literature and/or architecture throughout most of the 20th century. They are also quite similar in terms of age, family background, professional achievements, and celebrity status, but the former has multiple men's pursuit and admiration, while the latter has fewer. (3) Zhang Ailing and Su Qing, their achievements in the field of literature are remarkably similar, as top two female authors in metropolitan Shanghai during 1940s. They once admired each other's talents very much. Zhang’s husband used to have a relationship with Su Qing, and it was through Su Qing that he met Zhang Ailing. Major Findings: (1) Across the three pairs of case studies, it is observed that the more they are similar to each other in age, family background, education level, career positions, and social statues, the more they are likely to be in discord, jealousy, and hostility. (2) In the relationship between Chinese women, especially between talented, educated women, if there are men involved and one is more adored and favored by men than the other, such as in the 2nd and third pairs, the resulting jealousy deepens the negative relationship between them. (3) The relationship between talented and successful Chinese women, as shown in the third example, where a man was introduced by a woman to her close female friend, and then the man fell in love with her and married her, would undoubtedly deteriorate until jealousy, hatred, and hostility reached climax.

Keywords: relationship, Chinese, women, men

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1731 Monitoring Vaginal Electrical Resistance, Follicular Wave and Hormonal Profile during Estrus Cycle in Indigenous Sheep

Authors: T. A. Rosy, M. R. I. Talukdar, N. S. Juyena, F. Y. Bari, M. N. Islam

Abstract:

The ovarian follicular dynamics, vaginal electrical resistance (VER) and progesterone (P4) and estrogen (E2) profiles were investigated during estrus cycle in four indigenous ewes. Daily VER values were recorded with heat detector. The follicles were observed and measured by trans-rectal ultrasonography. Blood was collected daily for hormonal profiles. Results showed a significant variation in VER values (P<0.05) at estrus in regards to ewes and cycles. The day difference between two successive lower values in VER waves ranged from 13-17 days which might indicate the estrus cycle in indigenous ewes. Trans-rectal ultrasonography of ovaries revealed the presence of two to four waves of follicular growth during the study period. Results also showed that follicular diameter was negatively correlated with VER values. Study of hormonal profiles by ELISA revealed a positive correlation between E2 concentration and development of follicle and negative correlation between P4 concentration and development of follicle. The concentrations of estradiol increased at the time of estrus and then fall down in a basal level. Development of follicular size was accompanied by an increase in the concentration of serum estradiol. Inversely, when follicles heed to ovulation concentration of progesterone starts to fall down and after ovulation it turns its way to the zenith and remains at this state until next ovulatory follicle comes to its maximum diameter. This study could help scientists to set up a manipulative reproductive technique for improving genetic values of sheep in Bangladesh.

Keywords: ovarian follicle, hormonal profile, sheep, ultrasonography, vaginal electrical resistance

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1730 Urban Design and Social Capital in Spontaneous Settlements

Authors: Vilar, Katila

Abstract:

Rapid urbanization have made of spontaneous settlements one of the dominant´s social subjects of the XXIst century. Currently, it´s recognized that these territories cannot easily be eradicated and are a way of life to many populations of emergent countries. Since late 90s, there is an urgent concern in finding planning and efficient urban design strategies to poverty reduction, spatial integration and social inclusion of low-income communities. The article aims to identify, understand and evaluate the social inclusion´s processes through the urban transformation that has been undertaken in Moravia and how they affected the community´s social capital. To achieve this objective, we start to analyse the PPMIM´s planning discourse in which prevails the sustainability´s concept, to further identify, through the analysis of the project carried out, the urban design strategies implemented and their impact on the perception and on the community´s experience, and, finally, how these focused on the social capital. It relies on concepts such as urban design, social capital, local development and sustainability. At the urban design level it starts on the current principles of “making places”, on the new urbanism concepts and on the practices on the ground carried out by a new generation of architects/planners whose have the main ethical approach in order to create more opportunities and greater social impact to these territories. At the social capital´s level and on the development´s theory, relies on authors such as Coleman, Putman Kliksberg and Amartya Sen. Finally, it aims to address a general discussion about the positive and negative implications of slum upgrading programmes and some necessary recommendations for urban design and social capital can really be translated into real resources for the self sustainable development of low-income communities and their future generations.

Keywords: local and sustainable development, social capital, spontaneous settlements, urban design

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1729 The Impact of the Training Program Provided by the Saudi Archery Federation on the Electromyography of the Bow Arm Muscles

Authors: Hana Aljumayi, Mohammed Issa

Abstract:

The aim of this study was to investigate the effect of the training program for professional athletes at the Saudi Archery Federation on the electrical activity of the muscles involved in pulling the bowstring, maximum muscle strength (MVC) and to identify the relationship between the electrical activity of these muscles and accuracy in shooting among female archers. The researcher used a descriptive approach that was suitable for the nature of the study, and a sample of nine female archers was selected using purposive sampling. An EMG device was used to measure signal amplitude, signal frequency, spectral energy signal, and MVC. The results showed statistically significant differences in signal amplitude among muscles, with F(8,1)=5.91 and a significance level of 0.02. There were also statistically significant differences between muscles in terms of signal frequency, with F(8,1)=8.23 and a significance level of 0.02. Bonferroni test results indicated statistically significant differences between measurements at a significance level of 0.05, with anterior measurements showing an average difference of 16.4 compared to other measurements. Furthermore, there was a significant negative correlation between signal amplitude in the calf muscle and accuracy in shooting (r=-0.78) at a significance level of 0.02. There was also a significant positive correlation between signal frequency in the calf muscle and accuracy in shooting (r=0.72) at a significance level of 0.04. In conclusion, it appears that the training program for archery athletes focused more on skill development than physical aspects such as muscle activity and strength development. However, it did have a statistically significant effect on signal amplitude but not on signal frequency or MVC development in muscles involved in pulling the bowstring.

Keywords: electrical activity of muscles, archery sport, shooting accuracy, muscles

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1728 Characteristics and Drivers of Greenhouse Gas (GHG) emissions from China’s Manufacturing Industry: A Threshold Analysis

Authors: Rong Yuan, Zhao Tao

Abstract:

Only a handful of literature have used to non-linear model to investigate the influencing factors of greenhouse gas (GHG) emissions in China’s manufacturing sectors. And there is a limit in investigating quantitatively and systematically the mechanism of correlation between economic development and GHG emissions considering inherent differences among manufacturing sub-sectors. Considering the sectorial characteristics, the manufacturing sub-sectors with various impacts of output on GHG emissions may be explained by different development modes in each manufacturing sub-sector, such as investment scale, technology level and the level of international competition. In order to assess the environmental impact associated with any specific level of economic development and explore the factors that affect GHG emissions in China’s manufacturing industry during the process of economic growth, using the threshold Stochastic Impacts by Regression on Population, Affluence and Technology (STIRPAT) model, this paper investigated the influence impacts of GHG emissions for China’s manufacturing sectors of different stages of economic development. A data set from 28 manufacturing sectors covering an 18-year period was used. Results demonstrate that output per capita and investment scale contribute to increasing GHG emissions while energy efficiency, R&D intensity and FDI mitigate GHG emissions. Results also verify the nonlinear effect of output per capita on emissions as: (1) the Environmental Kuznets Curve (EKC) hypothesis is supported when threshold point RMB 31.19 million is surpassed; (2) the driving strength of output per capita on GHG emissions becomes stronger as increasing investment scale; (3) the threshold exists for energy efficiency with the positive coefficient first and negative coefficient later; (4) the coefficient of output per capita on GHG emissions decreases as R&D intensity increases. (5) FDI shows a reduction in elasticity when the threshold is compassed.

Keywords: China, GHG emissions, manufacturing industry, threshold STIRPAT model

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1727 Gethuk Marillo: The New Product Development of Anti-Cancer Snacks Utilizing Xanthones and Anthocyanin in Mangosteen Pericarp and Tamarillo Fruit

Authors: Desi Meriyanti, Delina Puspa Rosana Firdaus, Ristia Rinati

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Nowadays, the presence of free radicals become a big concern due to its negative impact to the body, which can triggers the formation of degenerative diseases such as cancer, heart disease cardiovascular, diabetic mellitus and others. Free radical oxidation can be prevented by the presence of antioxidants. Naturally, the human body produces its own antioxidants. Because of the free radicals exposure are so intense, especially from the environment, it is necessary to supply antioxidants needed from outside, through the consumption of functional foods with high antioxidant content. Gethuk is one of the traditional snacks in Indonesia. Gethuk is made from cassava with minimal processing such as boiling, destructing, and forming. Gethuk is classified as a familiar snack in the community, so it has a potential for developing, especially into a functional food. The low content of antioxidants in gethuk can be overcome with the development of a product called Gethuk Marillo. Gethuk Marillo is gethuk with the addition of natural antioxidants from mangosteen pericarp extract which has a high content of xanthones, these compounds are classified into flavonoids and act as antioxidants in the body. Gethuk Marillo served along with tamarillo fruit sauce which is also high in antioxidants such as anthocyanin. The combination between 300 grams gethuk Marillo and sauce contain flavonoid about 31% of human antioxidant needs per day. Gethuk Marillo called as a functional food because of high flavonoids content which can prevent degenerative diseases namely cancer, as many studies that the xanthone and anthocyanins compounds can effectively prevent the formation of cancer cells in human body.

Keywords: Gethuk marillo, xanthones, anthocyanin, high antioxidants, anti-cancer

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1726 Malignant Idiopathic Intracranial Hypertension Revealed a Hidden Primary Spinal Leptomeningeal Medulloblastoma

Authors: Naim Izet Kajtazi

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Context: Frequently, the cause of raised intracranial pressure remains unresolved and rarely is related to spinal tumors, moreover less to spinal medulloblastoma without primary brain focus. Process: An 18-year-old woman had a 3-month history of headaches and impaired vision. Neurological examination revealed bilateral sixth cranial nerve palsies with bilateral papilloedema of grade III. No focal brain or spine lesion was found on imaging. Consecutive lumbar punctures showed high opening pressure and subsequent increasing protein level. The meningeal biopsy was negative. At one point, she developed an increasing headache, vomiting and back pain. Spine MRI showed diffuse nodular leptomeningeal enhancement with the largest nodule at T6–T7. Malignant cells were detected in cerebrospinal fluid. She underwent laminectomy with excisional biopsy, and pathology showed medulloblastoma WHO grade IV. Outcome: She was treated with chemotherapy and craniospinal irradiation and made a good recovery. Relevance: Primary spinal leptomeningeal medulloblastoma is extremely rare, especially without primary brain focus, but may cause increased intracranial pressure, even in the early microscopic phases, and it should be considered in the differential diagnosis if conventional and aggressive treatment of idiopathic intracranial hypertension fails. We assume that arachnoiditis from tumor seeding caused increased intracranial pressure. Appropriate neurosurgical intervention and surgical biopsy are mandated if a suspicious lesion is detected. Consider proper rescreening of the whole neuroaxis in refractory cases of intracranial hypertension.

Keywords: CNS infection, IIH, headache, primary spinal leptomeningeal medulloblastoma

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1725 China's BRI and Germany's Baghdad Railroad – a Realist Analysis of Hegemonic Conflict and the Circumvention of Maritime Power

Authors: Kamen Kirov

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In the late 19th and early 20th centuries, Britain dominated global trade and finance in large part due to its maritime superiority. Germany, a land power, sought to undermine Britain’s position as the primary hegemon but ultimately could not challenge Britain’s maritime position or capabilities. This drove Germany to seek alternative strategies to weaken Britain’s position. Notably, it pushed Germany to create a reliable overland link through the Balkans to the Middle East via railroad. This article will seek to draw parallels between the German-British hegemonic conflict of the early 20th century and the Chinese-American hegemonic conflict taking place today using both secondary historical sources and current scholarly discussions of the changing international sphere. In doing so, it will provide useful insights into how China might attempt to outflank American power. The article will demonstrate that in many ways, the strategic positions and approaches of the early-20th century Germany and modern China are similar. Both countries were faced with a vastly superior foe with respect to maritime and economic power, and in both cases, their response was to undermine their rival hegemon by creating new overland infrastructure. Furthermore, in both cases, a major goal of creating new overland links was to gain further access to and control over Middle Eastern energy markets. It seems that in the modern day, China is conducting such a policy on a much grander scale than Germany did in the early 20th century—which may result in negative consequences for the US strategic position.

Keywords: belt and road Initiative, hegemonic conflict, maritime power, realism

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1724 Development of 4-Allylpyrocatechol Loaded Self-Nanoemulsifying Drug Delivery System for Enhancing Water Solubility and Antibacterial Activity against Oral Pathogenic Bacteria

Authors: Pimpak Phumat, Sakornrat Khongkhunthian, Thomas Rades, Anette Müllertz, Siriporn Okonogi

Abstract:

Self-nanoemulsifying drug delivery systems (SNEDDS) containing 4-allylpyrocatechol (AP) extracted from Piper betle were developed to enhance water solubility of AP by using modeling and design (MODDE) program. The amount of AP in each SNEDDS formulation was determined by using high-performance liquid chromatography. The formulation consisted of 20% Miglyol®812N, 40 % Kolliphor®RH40, 30 % Maisine®35-1 and 10 % ethanol was found to be the best SNEDDS that provided the highest loading capacity of AP. (141.48±15.64 mg/g SNEDDS). The system also showed miscibility with water. The particle shape and size of the AP-SNEDDS after dispersing in water was investigated by using a transmission electron microscope and photon correlation spectrophotometer, respectively. The results showed that they were a spherical shape, having a particle size of 34.27 ± 1.14 nm with a narrow size distribution of 0.17 ± 0.04. The particles showed negative zeta potential with a value of -21.66 ± 2.09 mV. Antibacterial activity of AP-SNEDDS containing 1.5 mg/mL of AP was investigated against Streptococcus intermedius. The effect of this system on S. intermedius cells was observed by a scanning electron microscope (SEM). The results from SEM revealed that the bacterial cells were obviously destroyed. Killing kinetic study of AP-SNEDDS was carried out. It was found that the killing rate of AP-SNEDDS against S. intermedius was dose-dependent and the bacterial reduction was 79.86 ± 0.45 % within 30 min. In comparison with chlorhexidine (CHX), AP-SNEDDS showed similar antibacterial effects against S. intermedius. It is concluded that SNEDDS is a potential system for enhancing water solubility of AP. The antibacterial study reveals that AP-SNEDDS can be a promising system to treat bacterial infection caused by S. intermedius.

Keywords: SNEDDS, 4-allylpyrocathecol, solubility, antibacterial activity, Streptococcus intermedius

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1723 Prevalence and Pattern of Abnormalities Pap Smear Examination in Women Attending Fertility Clinic in Uniosun Teaching Hospitals, Osun State, Nigeria

Authors: Ayodeji Blessing Ajileye

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

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

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1722 The Effect of Malaysia’s Outward FDI on Manufacturing Exports

Authors: Teo Yen Nee, Tham Siew Yean, Andrew Kam Jia Yi

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There are growing concerns about the effect of increasing outward foreign direct investment (OFDI) from Malaysia. These concerns emerged when OFDI surpassed inward FDI for the first time in 2007 and in the subsequent years as well. From a theoretical point of view, the effect of OFDI on exports remains inconclusive depending on the types and/or motivations of investment. Therefore, the objective of this paper is to investigate the effect of Malaysia’s OFDI on manufacturing exports, using a reduced form exports model. The manufacturing data used in this study covered 24 manufacturing industries for the period 2003-2010. The manufacturing sector is the fourth largest sector invested by Malaysia’s OFDI abroad. However, this sector is chosen for this study because total manufacturing trade contributed significantly to Malaysia’s economy growth as reflected by its significant share in the country’s gross domestic product (138.7%) in 2013. Furthermore, Malaysia’s exports are dominated by manufacturing goods. Consequently, the drastic increase in OFDI added concerns about its impact on the country’s exports. Since OFDI activities are still relatively new in Malaysia, this study is exploratory in nature due to a lack of firm level data. Using industry level panel data, the value added of this paper is to meet the research gap by examining the effect of Malaysia’s outward FDI on manufacturing exports. Overall, the findings show that lagged inward FDI, technology development, and industry size are found to positive and significantly influence manufacturing exports as compared to other factors. The insignificant impact of OFDI on manufacturing exports suggests market seeking investment is the main form of OFDI from Malaysia and the destination markets are not served by exports before so that there are no new exports created or displacement of exports. While the results show that there is no need to worry about OFDI’s negative impact on exports, policies should be undertaken to encourage OFDI from Malaysia to create new exports for the country.

Keywords: OFDI, manufacturing industries, exports, Malaysia

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1721 Hemato-Biochemical Studies on Naturally Infected Camels with Trypanosomiasis

Authors: Khalid Mehmood, Riaz Hussain, Rao Z. Abbas, Tariq Abbas, Abdul Ghaffar, Ahmad J. Sabir

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Blood born diseases such as trypanosomiasis have negative impacts on health, production and working efficiency of camels in different camel-rearing areas of the world including Pakistan. In present study blood samples were collected from camels kept at the desert condition of cholistan to estimate the prevalence of trypanosomiasis and hemato-biochemical changes in naturally infected cases. Results showed an overall 9.31% prevalence of trypanosomiasis in camels. Various clinical signs such as pyrexia, occasional shivering, inappetence, urticaria, swelling, lethargy, going down in condition and edema of pads were observed in few cases. The statistical analysis did not show significant association of age and sex with trypanosomiasis. However, results revealed significantly decreased values of total erythrocyte counts, packed cell volume, hemoglobin concentration, mean corpuscular hemoglobin concentration, serum total proteins and albumin while increased values of mean corpuscular volume was recorded in infected animals as compared to healthy. A significant (P<0.01) increased values of total leukocyte count, monocyte, lymphocyte, neutrophils, and eosinophils was recorded in infected animals. Moreover, microscopic examination of blood films obtained from naturally infected cases showed the presence of parasite and various morphological changes in cells such as stomatocyte, hyperchromasia, and polychromasia. Significantly increased values of different hepatic enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were also recorded.

Keywords: camel, hematological indices, serum enzymes, Trypanosomiasis

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1720 Calpain-Mediated, Cisplain-Induced Apoptosis in Breast Cancer Cells

Authors: Shadia Al-Bahlani, Khadija Al-Bulushi, Zuweina Al-Hadidi, Buthaina Al-Dhahl, Nadia Al-Abri

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Breast cancer is the most common cancer in women worldwide. Triple-Negative Breast Cancer (TNBC) is an aggressive type of breast cancer, which is defined by the absence of Estrogen (ER), Progesterone (PR) and human epidermal growth factor (Her-2) receptors. The calpain system plays an important role in many cellular processes including apoptosis, necrosis, cell signaling and proliferation. However, the role of calpain in cisplatin (CDDP)-induced apoptosis in TNBC cells is not fully understood. Here, TNBC (MDA-MB231) cells were treated with different concentration of CDDP (0, 20 & 40 µM) and calpain activation and apoptosis were measured by western blot and Hoechst Stain respectively. In addition, calpain modulation by either activation and/or inhibition and its effect on CDDP-induced apoptosis were assessed by the same above approaches. Our findings showed that CDDP induced endoplasmic reticulum stress and thus Calcium release and subsequently activate calpain α-fodrin cleavage indicated by the increase in GRP78 and Calmodulin protein expression and respectively in MDA-MB231 cells. It also induced apoptosis as measured by Hoechst stain and caspase-12 cleavage. Calpain activation by both Cyclopiazonic acid and Thapsigargin showed similar effect and enhanced the sensitivity of these cells to CDDP treatment. On the other hand, calpain inhibition by either specific siRNA and/or exogenous inhibitor (Calpeptin) had an adverse effect where it attenuated calpain activation and thus CDDP- induced apoptosis in these cells. Altogether, these findings suggested that calpain activation play an essential role in sensitizing the TNBC cells to CDDP-induced apoptosis. This might lead to the discovery of novel treatment to over this aggressive type of breast cancer.

Keywords: calpain, cisplatin, apoptosis, breast cancer

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1719 Effects of Environmental Parameters on Salmonella Contaminated in Harvested Oysters (Crassostrea lugubris and Crassostrea belcheri)

Authors: Varangkana Thaotumpitak, Jarukorn Sripradite, Saharuetai Jeamsripong

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Environmental contamination from wastewater discharges originated from anthropogenic activities introduces the accumulation of enteropathogenic bacteria in aquatic animals, especially in oysters, and in shellfish harvesting areas. The consumption of raw or partially cooked oysters can be a risk for seafood-borne diseases in human. This study aimed to evaluate the relationship between the presence of Salmonella in oyster meat samples, and environmental factors (ambient air temperature, relative humidity, gust wind speed, average wind speed, tidal condition, precipitation and season) by using the principal component analysis (PCA). One hundred and forty-four oyster meat samples were collected from four oyster harvesting areas in Phang Nga province, Thailand from March 2016 to February 2017. The prevalence of Salmonella of each site was ranged from 25.0-36.11% in oyster meat. The results of PCA showed that ambient air temperature, relative humidity, and precipitation were main factors correlated with Salmonella detection in these oysters. Positive relationship was observed between positive Salmonella in the oysters and relative humidity (PC1=0.413) and precipitation (PC1=0.607), while the negative association was found between ambient air temperature (PC1=0.338) and the presence of Salmonella in oyster samples. These results suggested that lower temperature and higher precipitation and higher relative humidity will possibly effect on Salmonella contamination of oyster meat. During the high risk period, harvesting of oysters should be prohibited to reduce pathogenic bacteria contamination and to minimize a hazard of humans from Salmonellosis.

Keywords: oyster, Phang Nga Bay, principal component analysis, Salmonella

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1718 Attitudes of Young Adults with Physical Disabilities towards Occupational Preferences

Authors: Limor Gadot, Orly Sarid

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Integration of young adults with disabilities (YAWD) into workplaces provides an opportunity for social and occupational mobility, enabling them to financial independence. To enhance integration, it is important to understand their occupational preferences as well as the factors that influencing it such as demographic variables, self-assessed health, beliefs about work, subjective norms, and self-efficacy. Planned behavior theory was chosen as a basis for this study. A cross-sectional study, based on preliminary sample of 37 YAWD who have been recognized by the National Insurance Institute and are engaged in a year of national service. The finding shows that most of the participants were single (97%) women (60%); average age was 22(+ 2) years, approximately half were secular. Most of the participants had disabilities resulting from CP (96%). Self-assessed health was correlated positively and significantly with behavioral intentions to work in the free market (r = .33, p = .05), and significant negative correlation with behavioral intentions to work in supported settings (r =.-40, p = .01), and sheltered settings (r =-.36, p = .03): individuals who perceived themselves as having more severe disabilities showed a greater tendency to choose a workplace with more rehabilitative inputs. Furthermore, women showed a greater tendency than men to perceive their disability as impairing their future intention to work: t (36) = 2.23, p < .05. Beliefs about work were positively associated with normative beliefs (r = .308, p = .06). The findings indicate that, especially with women, perceptions of health are related to occupational preferences. Moreover, the findings indicate that the relationship between subjective norms about work and normative beliefs about integrating in a workplace that prevail in the individual's environment affects occupational preferences. The contribution of the study lies in the development of new responses and interventions to encourage adults with disabilities to work.

Keywords: young adults, disabilities, work preferences, occupational preferences

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1717 Modelling Urban Rigidity and Elasticity Growth Boundaries: A Spatial Constraints-Suitability Based Perspective

Authors: Xueqing Sun, Pengcheng Xiang, Jr. Dong Ngoduy

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In the context of rapid urbanization, urban sprawl has brought about extensive negative impacts on ecosystems and the environment, resulting in a gradual shift from "incremental growth" to ‘stock growth’ in cities. A detailed urban growth boundary is a prerequisite for urban renewal and management. This study takes Shenyang City, China, as the study area and evaluates the spatial distribution of urban spatial suitability in the study area from the perspective of spatial constraints-suitability using multi-source data and simulates the future rigid and elastic growth boundaries of the city in the study area using the CA-Markov model. The results show that (1) the suitable construction area and moderate construction area in the study area account for 8.76% and 19.01% of the total area, respectively, and the suitable construction area and moderate construction area show a trend of distribution from the urban centre to the periphery, mainly in Shenhe District, the southern part of Heping District, the western part of Dongling District, and the central part of Dadong District; (2) the area of expansion of construction land in the study area in the period of 2023-2030 is 153274.6977hm2, accounting for 44.39% of the total area of the study area; (3) the rigid boundary of the study area occupies an area of 153274.6977 hm2, accounting for 44.39% of the total area of the study area, and the elastic boundary of the study area contains an area of 75362.61 hm2, accounting for 21.69% of the total area of the study area. The study constructed a method for urban growth boundary delineation, which helps to apply remote sensing to guide future urban spatial growth management and urban renewal.

Keywords: urban growth boundary, spatial constraints, spatial suitability, urban sprawl

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1716 Impacts of Online Behaviors on Empathy in Medical Students

Authors: Ling-Lang Huang, Yih-Jer Wu

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Empathy is crucial for a patient-physician relationship and medical professionalism. Internet activity, gaming, or even addiction, have been more and more common among medical students. However, there’s been no report showing whether internet behavior has a substantial impact on empathy in medical students to our best knowledge. All year-2 medical students taking the optional course 'Narrative, Comprehension, and Communication' were enrolled. Internet behaviors are divided into two groups, 'internet users without online gaming (IU)' and 'internet users with online gaming (IG)', each group was further divided into 3 groups according to their average online retention time each day (< 2, 2 - 6, > 6 hours). Empathy was evaluated by the scores of the reports and humanities reflection after watching indicated movies, and by self-measured empathy questionnaire. All students taking the year-2 optional course 'Narrative, Comprehension, and Communication' were enrolled. As compared with students in the IU group, those in the IG group had significantly lower scores for the reports (81.3 ± 3.7 vs. 86.4 ± 5.1, P = 0.014). If further dividing the students into 5 groups (IU < 2, IU 2-6, IG < 2, IG 2 - 6, and IG > 6 hours), the scores were significantly and negatively correlated to online gaming with longer hours (r = -0.556, P = 0.006). However, there was no significant difference between IU and IG groups (33.0 ± 5.4 vs. 34.8 ± 3.2, P = n.s.), in terms of scores in the self-measured empathy questionnaire, neither was there any significant trend of scores along with longer online hours across the 5 groups (r = -0.164, P = n.s.). To date, there has been no evidence showing whether different internet behaviors (with or without online gaming) have distinct impacts on empathy. Although all of the medical students had a similarly good self-perception for empathy, our data suggested that online gaming did have a negative impact on their actual expression of empathy. Our observation has brought up an important issue for pondering: May IT- or gaming-assisted medical learning actually harm students’ empathy? In conclusion, this data suggests that long hours of online gaming harms expression of empathy, though all medics think themselves a person of high empathy.

Keywords: empathy. Internet, medical students, online gaming

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1715 The Architectural Conservation and Restoration Problems of Istanbul’s “Yalı” Waterfront Mansions

Authors: Zeynep Tanrıverdi

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The Bosphorus is an international waterway in Istanbul city of Turkey connecting the Sea of Marmara and the Black Sea. The Bosphorus, which has formed an important part of the silhouette of Istanbul throughout history, has also influenced the design of the coastal structures built around it. The waterfront mansions, which are located on both sides of the Bosphorus by the sea, and can be generally of two or three storeys, are called “yalı”. The yalı buildings with their architectural characteristics of the traditional Turkish House are the most grandiose examples of Ottoman residential architecture. However, the classical Ottoman yalı architecture of the 18th century can only be seen in engravings, and today only the modest and smaller yalı examples from the 19th century can be seen because of their disappearance over time. The study aims to reveal the architectural conservation and restoration problems of waterfront mansions and propose solutions for them. Firstly, the development of the waterfront mansion architecture in Bosphorus was evaluated in its historical process. Secondly, the waterfront mansions and their architectural features were explained. Thirdly, the architectural conservation and restoration problems that caused the disappearance of waterfront mansions were discussed. These problems include disruptions in legal regulations and practices about the Bosphorus, dramatic changes in Turkey’s socio-cultural life from the Ottoman Empire to the present, inadequacies in economic resources, negative environmental effects, and errors in restoration works. Finally, solution suggestions were proposed for the problems that threaten the protection of waterfront mansions. In the study, literature on waterfront mansions was reviewed using historical reports, photographs, maps, and drawings in archival documents. It is hoped that this study will contribute the conservation of the “Yalı” waterfront mansions, which occupy a particular role in the cultural heritage of Turkey, and to their transmission with their authentic values to the next generation.

Keywords: bosphorus architecture, conservation, heritage, Istanbul, waterfront mansions (yalı)

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1714 Irritable Bowel Syndrome Prevalence and Associated Risk Factors Among Medical Students And Intern Doctors in Sudan

Authors: Zainab Alghali Elsaid Muhammed

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Background : IBS is a gastrointestinal disorder characterized by a variety of symptoms that occur concurrently. It is very common and is associated with high levels of psychiatric comorbidities, all of which have a negative impact on the patient's quality of life. Abdominal pain, diarrhea, constipation, excess gas, and bloating are common symptoms of IBS. Objectives : The purpose of this study is to determine the prevalence of IBS among medical students and intern doctors in Sudan, as well as the risk factors associated with it. Study design: This cross-sectional study was carried out in Sudan from April to July 2022. All participants completed a six-part online questionnaire. The ROME IV criteria questionnaire was used to make an IBS diagnosis. Participants completed the hospital anxiety and depression questionnaire in order to be diagnosed with anxiety and depression. Results : 600 participants filled out the questionnaire. The overall prevalence of IBS was found to be 42%, with females being the most affected. Intern doctors had higher IBS rates (30.0%) than medical students, but this was not statistically significant. Single status (p =0.079), good GPAs (p =0.00), had significant associations with IBS occurrence. Other significantly associated habits were sleeping less than 8 hours (p =0.013), two cups or less of coffee per day (p = 0.109), No smoking (p =0.001), and No exercise (p =0.00, IBS participants were also found to have a significant relationship with abnormal anxiety (p =0.00) and borderline depression (p=0.0156). Conclusion : The high prevalence of IBS in this study suggests that medical students and interns are unable to recognize their symptoms. The main IBS predictors in this study were suffering from anxiety or depression, having an insufficient income, sleeping less than 8 hours per day, working/ studying more than 8 hours per day, and not performing any type of exercise.

Keywords: irritable bowel syndrome, sudan, HADS, rome IV, medical students

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1713 External Vacuum Dressing: Optimising Non-Operative Management of Flail Sternum Post CPR

Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

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