Search results for: automated early warning score
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6206

Search results for: automated early warning score

1556 Challenges of Management of Acute Pancreatitis in Low Resource Setting

Authors: Md. Shakhawat Hossain, Jimma Hossain, Md. Naushad Ali

Abstract:

Acute pancreatitis is a dangerous medical emergency in the practice of gastroenterology. Management of acute pancreatitis needs multidisciplinary approach with support starts from emergency to ICU. So, there is a chance of mismanagement in every steps, especially in low resource settings. Other factors such as patient’s financial condition, education, social custom, transport facility, referral system from periphery may also challenge the current guidelines for management. The present study is intended to determine the clinico-pathological profile, severity assessment and challenges of management of acute pancreatitis in a government laid tertiary care hospital to image the real scenario of management in a low resource place. A total 100 patients of acute pancreatitis were studied in this prospective study, held in the Department of Gastroenterology, Rangpur medical college hospital, Bangladesh from July 2017 to July 2018 within one year. Regarding severity, 85 % of the patients were mild, whereas 13 were moderately severe, and 2 had severe acute pancreatitis according to the revised Atlanta criteria. The most common etiologies of acute pancreatitis in our study were gall stone (15%) and biliary sludge (15%), whereas 54% were idiopathic. The most common challenges we faced were delay in hospital admission (59%) and delay in hospital diagnosis (20%). Others are non-adherence of patient party, and lack of investigation facility, physician’s poor knowledge about current guidelines. We were able to give early aggressive fluid to only 18% of patients as per current guideline. Conclusion: Management of acute pancreatitis as per guideline is challenging when optimum facility is lacking. So, modified guidelines for assessment and management of acute pancreatitis should be prepared for low resource setting.

Keywords: acute pancreatitis, challenges of management, severity, prognosis

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1555 Impact of Adolescent Smoking on the Behaviour, Academic and Health Aspects in Qatar

Authors: Abdelsalam Gomaa, Mahjabeen Ramzan, Tooba Ali Akbar, Huma Nadeem

Abstract:

The use of tobacco and the health risks linked to it are well known in this day and age due to the presence of easily available information through the internet. The media is a powerful platform that is used by many anti-smoking awareness campaigns to reach their target audience; yet, it has been found that adolescents are taking up smoking every passing day. Half of this smoking population of youngsters resides in Asia alone, which includes Qatar, the focus country of this study. As smoking happens to be one of the largest avoidable causes of serious diseases like cancers and heart problems, children are taking up smoking at an alarming rate everywhere including Qatar. Importance of the health of the citizens of Qatar is one of the pillars of the Qatar vision 2030, which is to ensure a healthy population, both physically and mentally. Since the youth makes up a significant percentage of the population and in order to achieve the health objectives of the Qatar vision 2030, it is essential to ensure the health and well-being of this part of the population of the country as they are the future of Qatar. Children, especially boys who tend to be more aggressive by nature, are highly likely to develop behavioral and health issues due to smoking at an early age. Research conducted around the world has also emphasized on this association between the smokers developing a bad behaviour as well as poor social communication skills. However, due to lack of research into this association, very little is known about the extent to which smoking impacts the children’s academics, health and behaviour. Moreover, a study of this nature has not yet been conducted in Qatar previously as most of the studies focus on adult smokers and ways to minimize the number of smoking habits in universities and workplaces. This study solely focuses on identifying a relationship between smoking and its impacts on the adolescents by conducting a research on different schools across Qatar.

Keywords: adolescents, modelling techniques, Qatar, smoking

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1554 Effects of Mental Skill Training Programme on Direct Free Kick of Grassroot Footballers in Lagos, Nigeria

Authors: Mayowa Adeyeye, Kehinde Adeyemo

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The direct free kick is considered a great opportunity to score a goal but this is not always the case amidst Nigerian and other elite footballers. This study, therefore, examined the extent to which an 8 weeks mental skill training programme is effective for improving accuracy in direct free kick in football. Sixty (n-60) students of Pepsi Football Academy participated in the study. They were randomly distributed into two groups of positive self-talk group (intervention n-30) and control group (n-30). The instrument used in the collection of data include a standard football goal post while the research materials include a dummy soccer wall, a cord, an improvised vanishing spray, a clipboard, writing materials, a recording sheet, a self-talk log book, six standard 5 football, cones, an audiotape and a compact disc. The Weinberge and Gould (2011) mental skills training manual was used. The reliability coefficient of the apparatus following a pilot study stood at 0.72. Before the commencement of the mental skills training programme, the participants were asked to take six simulated direct free kick. At the end of each physical skills training session after the pre-test, the researcher spent at least 15 minutes with the groups exposing them to the intervention. The mental skills training programme alongside physical skills training took place in two different locations for the different groups under study, these included Agege Stadium Main bowl Football Pitch (Imagery Group), and Ogba Ijaye (Control Group). The mental skills training programme lasted for eight weeks. After the completion of the mental skills training programme, all the participants were asked to take another six simulated direct free kick attempts using the same field used for the pre-test to determine the efficacy of the treatments. The pre-test and post-test data were analysed using inferential statistics of t-test, while the alpha level was set at 0.05. The result revealed significant differences in t-test for positive self-talk and control group. Based on the findings, it is recommended that athletes should be exposed to positive self-talk alongside their normal physical skills training for quality delivery of accurate direct free kick during training and competition.

Keywords: accuracy, direct free kick, pepsi football academy, positive self-talk

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1553 CAP-Glycine Protein Governs Growth, Differentiation, and the Pathogenicity of Global Meningoencephalitis Fungi

Authors: Kyung-Tae Lee, Li Li Wang, Kwang-Woo Jung, Yong-Sun Bahn

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Microtubules are involved in mechanical support, cytoplasmic organization as well as in a number of cellular processes by interacting with diverse microtubule-associated proteins (MAPs), such as plus-end tracking proteins, motor proteins, and tubulin-folding cofactors. A common feature of these proteins is the presence of a cytoskeleton-associated protein-glycine-rich (CAP-Gly) domain, which is evolutionarily conserved and generally considered to bind to α-tubulin to regulate functions of microtubules. However, there has been a dearth of research on CAP-Gly proteins in fungal pathogens, including Cryptococcus neoformans, which causes fatal meningoencephalitis globally. In this study, we identified five CAP-Gly proteins encoding genes in C. neoformans. Among these, Cgp1, encoded by CNAG_06352, has a unique domain structure that has not been reported before in other eukaryotes. Supporting the role of Cpg1 in microtubule-related functions, we demonstrate that deletion or overexpression of CGP1 alters cellular susceptibility to thiabendazole, a microtubule destabilizer, and Cgp1 is co-localized with cytoplasmic microtubules. Related to the cellular functions of microtubules, Cgp1 also governs maintenance of membrane stability and genotoxic stress responses. Furthermore, we demonstrate that Cgp1 uniquely regulates sexual differentiation of C. neoformans with distinct roles in the early and late stage of mating. Our domain analysis reveals that the CAP-Gly domain plays major roles in all the functions of Cgp1. Finally, the cgp1Δ mutant is attenuated in virulence. In conclusion, this novel CAP-Gly protein, Cgp1, has pleotropic roles in regulating growth, stress responses, differentiation and pathogenicity of C. neoformans.

Keywords: human fungal pathogen, CAP-Glycine protein, microtubule, meningoencephalitis

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1552 The Sensitivity of Electrical Geophysical Methods for Mapping Salt Stores within the Soil Profile

Authors: Fathi Ali Swaid

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Soil salinization is one of the most hazardous phenomenons accelerating the land degradation processes. It either occurs naturally or is human-induced. High levels of soil salinity negatively affect crop growth and productivity leading land degradation ultimately. Thus, it is important to monitor and map soil salinity at an early stage to enact effective soil reclamation program that helps lessen or prevent future increase in soil salinity. Geophysical method has outperformed the traditional method for assessing soil salinity offering more informative and professional rapid assessment techniques for monitoring and mapping soil salinity. Soil sampling, EM38 and 2D conductivity imaging have been evaluated for their ability to delineate and map the level of salinity variations at Second Ponds Creek. The three methods have shown that the subsoil in the study area is saline. Salt variations were successfully observed under either method. However, EM38 reading and 2D inversion data show a clear spatial structure comparing to EC1:5 of soil samples in spite of that all soil samples, EM38 and 2D imaging were collected from the same location. Because EM38 readings and 2D imaging data are a weighted average of electrical soil conductance, it is more representative of soil properties than the soil samples method. The mapping of subsurface soil at the study area has been successful and the resistivity imaging has proven to be an advantage. The soil salinity analysis (EC1:5) correspond well to the true resistivity bringing together a good result of soil salinity. Soil salinity clearly indicated by previous investigation EM38 have been confirmed by the interpretation of the true resistivity at study area.

Keywords: 2D conductivity imaging, EM38 readings, soil salinization, true resistivity, urban salinity

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1551 Don't Just Guess and Slip: Estimating Bayesian Knowledge Tracing Parameters When Observations Are Scant

Authors: Michael Smalenberger

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Intelligent tutoring systems (ITS) are computer-based platforms which can incorporate artificial intelligence to provide step-by-step guidance as students practice problem-solving skills. ITS can replicate and even exceed some benefits of one-on-one tutoring, foster transactivity in collaborative environments, and lead to substantial learning gains when used to supplement the instruction of a teacher or when used as the sole method of instruction. A common facet of many ITS is their use of Bayesian Knowledge Tracing (BKT) to estimate parameters necessary for the implementation of the artificial intelligence component, and for the probability of mastery of a knowledge component relevant to the ITS. While various techniques exist to estimate these parameters and probability of mastery, none directly and reliably ask the user to self-assess these. In this study, 111 undergraduate students used an ITS in a college-level introductory statistics course for which detailed transaction-level observations were recorded, and users were also routinely asked direct questions that would lead to such a self-assessment. Comparisons were made between these self-assessed values and those obtained using commonly used estimation techniques. Our findings show that such self-assessments are particularly relevant at the early stages of ITS usage while transaction level data are scant. Once a user’s transaction level data become available after sufficient ITS usage, these can replace the self-assessments in order to eliminate the identifiability problem in BKT. We discuss how these findings are relevant to the number of exercises necessary to lead to mastery of a knowledge component, the associated implications on learning curves, and its relevance to instruction time.

Keywords: Bayesian Knowledge Tracing, Intelligent Tutoring System, in vivo study, parameter estimation

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1550 Development of Chronic Obstructive Pulmonary Disease (COPD) Proforma (E-ICP) to Improve Guideline Adherence in Emergency Department: Modified Delphi Study

Authors: Hancy Issac, Gerben Keijzers, Ian Yang, Clint Moloney, Jackie Lea, Melissa Taylor

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Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.

Keywords: COPD, electronic proforma, modified delphi study, interdisciplinary, guideline adherence, COPD-X plan

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1549 Leading with Skill Development: A Collaborative and Community Based Approach to Ending Open Defecation in Rural India via Computerized Technical Vocational Education and Training

Authors: Srividya Sheshadri, Christopher Coley, Roa. R. Bhavani

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India currently accounts for 60 percent of the open defecation that is practiced globally. While research in the domain of sanitation development makes it apparent that girls and women living in rural India are disproportionately affected, interventions to address this dilemma are lacking. An important but relatively unexplored connection with poor sanitation is that women living in rural India are not only the largest marginalized group without access to adequate sanitation facilities, they also represent a majority of India’s unskilled workers. By training women to build their own toilets, through an approach that has demonstrated success in empowering marginalized communities through technical and vocational education and training (TVET), a collaborative dynamic emerges that can engage entire communities in the movement towards total sanitation. Designed and implemented by Amrita University, this technology-enhanced, community-based approach to skill development, known as Amrita computerized Vocational Education and Training (or Amrita cVET), has begun to show promise in addressing the struggle to end open defecation, and raise sanitation awareness, as well as strengthen personal and community development among women living in rural India. While Amrita cVET project, known as Women Empowerment: Sanitation, is currently in implementation in seven states throughout India, this paper will discuss early stages of the intervention in rural villages within the Indian states of: Karnataka and Goa, where previous sanitation efforts have failed to take hold.

Keywords: community based development, empowerment studies, sanitation in India, computerized vocational training

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1548 The Study on Corpse Floating Time in Shanghai Region of China

Authors: Hang Meng, Wen-Bin Liu, Bi Xiao, Kai-Jun Ma, Jian-Hui Xie, Geng Fei, Tian-Ye Zhang, Lu-Yi Xu, Dong-Chuan Zhang

Abstract:

The victims in water are often found in the coastal region, along river region or the region with lakes. In China, the examination for the bodies of victims in the water is conducted by forensic doctors working in the public security bureau. Because the enter water time for most of the victims are not clear, and often lack of monitor images and other information, so to find out the corpse enter water time for victims is very difficult. After the corpse of the victim enters the water, it sinks first, then corruption gas produces, which can make the density of the corpse to be less than water, and thus rise again. So the factor that determines the corpse floating time is temperature. On the basis of the temperature data obtained in Shanghai region of China (Shanghai is a north subtropical marine monsoon climate, with an average annual temperature of about 17.1℃. The hottest month is July, the average monthly temperature is 28.6℃, and the coldest month is January, the average monthly temperature is 4.8℃). This study selected about 100 cases with definite corpse enter water time and corpse floating time, analyzed the cases and obtained the empirical law of the corpse floating time. For example, in the Shanghai region, on June 15th and October 15th, the corpse floating time is about 1.5 days. In early December, the bodies who entered the water will go up around January 1st of the following year, and the bodies who enter water in late December will float in March of next year. The results of this study can be used to roughly estimate the water enter time of the victims in Shanghai. Forensic doctors around the world can also draw on the results of this study to infer the time when the corpses of the victims in the water go up.

Keywords: corpse enter water time, corpse floating time, drowning, forensic pathology, victims in the water

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1547 Formal Stress Management Teaching Incorporated into the First Year of a Doctor's Practice: A Career Transition Study of British Foundation Year 1 Doctors

Authors: Edward Ridyard, Vinary Varadarajan

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Background and Aims: The first year as a doctor in any country represents a major career transition in any physician's life. During this period, many physicians concentrate on obtaining clinical skills but may not obtain the important skills necessary to cope with stress. In this study we elucidate stress levels amongst FY1 doctors regarding the transitioning into specialty career choices, working in the NHS and anxiety about future career success. Methods: A prospective single blinded analysis of Foundation Year one (FY1) trainees using a non-mandatory online questionnaire was distributed. No exclusion criteria were applied. The only inclusion criteria was the doctor was in a full-time FY1 post and this was their first job in the UK. A total of n= 22 doctors were included in the study. After data collection, statistical analysis using chi-squared testing was applied. Results: The large majority of FY1 doctors (72.7%) already knew what specialty they wished to pursue (p=0.0001). With regards to their future careers 45.5% of FY1 doctors stated "above average" stress levels. The majority of FY1 doctors (64.3%) stated their stress levels working in the NHS were either "above average" or "high". Finally, 81.8% of respondents know colleagues who have been put off from pursuing specialties due to the stress of competition. Conclusions: A large majority of FY1 doctors already know at this early stage what area they would like to specialise in. With this in mind, a large proportion have above "average" levels of stress with regards to securing this future career path. The most worrying finding is that 64.3% of FY1s stated they had "above average" or "high" stress levels working in the NHS. We therefore recommend formal stress management education to be incorporated into the foundation programme curriculum.

Keywords: stress, anxiety, junior doctor, education

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1546 A Self Beheld the Eyes of the Other: Reflections on Montesquieu's Persian Letters

Authors: Seyed Majid Alavi Shooshtari

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As a multi-layered prose piece of artistry and craftsmanship Charles de Secondat, baron de Montesquieu’s Persian Letters (1721) is a satirical work which records the experiences of two Persian noblemen, Usbek and Rica, traveling through France in the early eighteenth century. Montesquieu creates Persian Letters as a critique of the French society, a critical explanation of what was considered to be 'the Orient' in the period, and an invaluable historical document which illustrates the ways Europe and the East understood each other in the first half of the eighteenth century. However, Persian Letters is considered today, in part, an Orientalist text because of it presenting the culture of the East using stereotypical images. Although, when Montesquieu published Persian Letters, the term Orientalist was a harmless word for people who studied or took an interest in it, the ways in which this Western intellectual author exerts his critique of French social and political life through the eyes of Persian protagonists by placing the example of the Orient (the Other) at the service of an ongoing Eighteen century discourse does raise some Eastern eyebrows. The fact that Persian side of the novel is considered by some critics as a fanciful decor, and the letters sent home are seen as literary props, yet these Eastern men intelligently question the rationality of religious, state, military and cultural practices and uncover much of the absurdity, irrationality or frivolity of European life. By drawing on the insight that Montesquieu’s text problematizes the assumption that orientalism monolithically constructs the Orient as the Other, the present paper aims to examine how the innocent gaze of two Eastern travelers mirrors the ways Europe’s identity defines its-Self.

Keywords: montesquieu, persian letters, ‘the orint’, identity politics, self, the other

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1545 Tractography Analysis of the Evolutionary Origin of Schizophrenia

Authors: Asmaa Tahiri, Mouktafi Amine

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A substantial number of traditional medical research has been put forward to managing and treating mental disorders. At the present time, to our best knowledge, it is believed that fundamental understanding of the underlying causes of the majority psychological disorders needs to be explored further to inform early diagnosis, managing symptoms and treatment. The emerging field of evolutionary psychology is a promising prospect to address the origin of mental disorders, potentially leading to more effective treatments. Schizophrenia as a topical mental disorder has been linked to the evolutionary adaptation of the human brain represented in the brain connectivity and asymmetry directly linked to humans higher brain cognition in contrast to other primates being our direct living representation of the structure and connectivity of our earliest common African ancestors. As proposed in the evolutionary psychology scientific literature the pathophysiology of schizophrenia is expressed and directly linked to altered connectivity between the Hippocampal Formation (HF) and Dorsolateral Prefrontal Cortex (DLPFC). This research paper presents the results of the use of tractography analysis using multiple open access Diffusion Weighted Imaging (DWI) datasets of healthy subjects, schizophrenia-affected subjects and primates to illustrate the relevance of the aforementioned brain regions connectivity and the underlying evolutionary changes in the human brain. Deterministic fiber tracking and streamline analysis were used to generate connectivity matrices from the DWI datasets overlaid to compute distances and highlight disconnectivity patterns in conjunction with other fiber tracking metrics; Fractional Anisotropy (FA), Mean Diffusivity (MD) and Radial Diffusivity (RD).

Keywords: tractography, evolutionary psychology, schizophrenia, brain connectivity

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1544 Assessing the Social Impacts of a Circular Economy in the Global South

Authors: Dolores Sucozhañay, Gustavo Pacheco, Paul Vanegas

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In the context of sustainable development and the transition towards a sustainable circular economy (CE), evaluating the social dimension remains a challenge. Therefore, developing a respective methodology is highly important. First, the change of the economic model may cause significant social effects, which today remain unaddressed. Second, following the current level of globalization, CE implementation requires targeting global material cycles and causes social impacts on potentially vulnerable social groups. A promising methodology is the Social Life Cycle Assessment (SLCA), which embraces the philosophy of life cycle thinking and provides complementary information to environmental and economic assessments. In this context, the present work uses the updated Social Life Cycle Assessment (SLCA) Guidelines 2020 to assess the social performance of the recycling system of Cuenca, Ecuador, to exemplify a social assessment method. Like many other developing countries, Ecuador heavily depends on the work of informal waste pickers (recyclers), who, even contributing to a CE, face harsh socio-economic circumstances, including inappropriate working conditions, social exclusion, exploitation, etc. Under a Reference Scale approach (Type 1), 12 impact subcategories were assessed through 73 site-specific inventory indicators, using an ascending reference scale ranging from -2 to +2. Findings reveal a social performance below compliance levels with local and international laws, basic societal expectations, and practices in the recycling sector; only eight and five indicators present a positive score. In addition, a social hotspot analysis depicts collection as the most time-consuming lifecycle stage and the one with the most hotspots, mainly related to working hours and health and safety aspects. This study provides an integrated view of the recyclers’ contributions, challenges, and opportunities within the recycling system while highlighting the relevance of assessing the social dimension of CE practices. It also fosters an understanding of the social impact of CE operations in developing countries, highlights the need for a close north-south relationship in CE, and enables the connection among the environmental, economic, and social dimensions.

Keywords: SLCA, circular economy, recycling, social impact assessment

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1543 Tectono-Thermal Evolution of Ningwu-Jingle Basin in North China Craton: Constraints from Apatite (U–Th-Sm)/He and Fission Track Thermochronology

Authors: Zhibin Lei, Minghui Yang

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Ningwu-Jingle basin is a structural syncline which has undergone a complex tectono-thermal history since Cretaceous. It stretches along the strike of the northern Lvliang Mountains which are the most important mountains in the middle and west of North China Craton. The Mesozoic units make up of the core of Ningwu-Jingle Basin, with pre-Mesozoic units making up of its flanks. The available low-temperature thermochronology implies that Ningwu-Jingle Basin has experienced two stages of uplifting: 94±7Ma to 111±8Ma (Albian to Cenomanian) and 62±4 to 75±5Ma (Danian to Maastrichtian). In order to constrain its tectono-thermal history in the Cenozoic, both apatite (U-Th-Sm)/He and fission track dating analysis are applied on 3 Middle Jurassic and 3 Upper Triassic sandstone samples. The central fission track ages range from 74.4±8.8Ma to 66.0±8.0Ma (Campanian to Maastrichtian) which matches well with previous data. The central He ages range from 20.1±1.2Ma to 49.1±3.0Ma (Ypresian to Burdigalian). Inverse thermal modeling is established based on both apatite fission track data and (U-Th-Sm)/He data. The thermal history obtained reveals that all 6 sandstone samples cross the high-temperature limit of fission track partial annealing zone by the uppermost Cretaceous and that of He partial retention zone by the uppermost Eocene to the early Oligocene. The result indicates that the middle and west of North China Craton is not stable in the Cenozoic.

Keywords: apatite fission track thermochronology, apatite (u–th)/he thermochronology, Ningwu-Jingle basin, North China craton, tectono-thermal history

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1542 Investigating the Prevalence of HCV from Laboratory Centers in Tehran City - Iran by Electrochemiluminescence (ECL) and PCR Techniques

Authors: Zahra Rakhshan Masoudi, Sona Rostampour Yasouri

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Considering that the only way to save the lives of patients and healthy people who have suffered sudden accidents is blood transfusion, what is important is the presence of the known HCV virus as the most important cause of the disease after blood transfusion. HCV is one of the major global problems, and its transmission through blood causes life-threatening complications and extensive legal, social and economic consequences. On the one hand, unfortunately, there is still no effective vaccine available to prevent HCV. In Iran, the exact statistics of the prevalence of this disease have not yet been fully announced. The main purpose of this study is to investigate the prevalence rate and rapid diagnosis of HCV among those who refer to laboratory centers in Tehran. From spring to winter of 1401 (2022-2023), 2166 blood samples were collected from laboratory centers in Tehran. Blood samples were evaluated for the presence of HCV by Electrochemiluminescence (ECL) and PCR techniques along with specific HCV primers. In general, 36 samples (1.6%) were tested positive by the mentioned techniques. The results indicated that the ECL technique is a sensitive and specific diagnostic method for detecting HCV in the early stages of the disease and can be very helpful and provide the possibility of starting the treatment steps to prevent the exacerbation of the disease earlier. Also, the results of PCR technique showed that PCR is an accurate, sensitive and fast method for definitive diagnosis of HCV. It seems that the incidence rate of this disease is increasing in Iran, and investigating the spread of the disease throughout Iran for a longer period of time in the continuation of our research can be helpful in the future to take the necessary measures to prevent the transmission of the disease to people and the rapid onset Treatment steps for patients with HCV should be carried out.

Keywords: electrochemiluminescence, HCV, PCR, prevalence

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1541 Impact of a Novel Technique of S-Shaped Tracheostoma in Pediatric Tracheostomy in Intensive Care Unit on Success and Procedure Related Complications

Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh

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Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.

Keywords: peatrics, tracheostomy, ICU, tracheostoma

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1540 Text Mining of Veterinary Forums for Epidemiological Surveillance Supplementation

Authors: Samuel Munaf, Kevin Swingler, Franz Brülisauer, Anthony O’Hare, George Gunn, Aaron Reeves

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Web scraping and text mining are popular computer science methods deployed by public health researchers to augment traditional epidemiological surveillance. However, within veterinary disease surveillance, such techniques are still in the early stages of development and have not yet been fully utilised. This study presents an exploration into the utility of incorporating internet-based data to better understand the smallholder farming communities within Scotland by using online text extraction and the subsequent mining of this data. Web scraping of the livestock fora was conducted in conjunction with text mining of the data in search of common themes, words, and topics found within the text. Results from bi-grams and topic modelling uncover four main topics of interest within the data pertaining to aspects of livestock husbandry: feeding, breeding, slaughter, and disposal. These topics were found amongst both the poultry and pig sub-forums. Topic modeling appears to be a useful method of unsupervised classification regarding this form of data, as it has produced clusters that relate to biosecurity and animal welfare. Internet data can be a very effective tool in aiding traditional veterinary surveillance methods, but the requirement for human validation of said data is crucial. This opens avenues of research via the incorporation of other dynamic social media data, namely Twitter and Facebook/Meta, in addition to time series analysis to highlight temporal patterns.

Keywords: veterinary epidemiology, disease surveillance, infodemiology, infoveillance, smallholding, social media, web scraping, sentiment analysis, geolocation, text mining, NLP

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1539 Nurses' Knowledge and Practice Regarding Care of Patients Connected to Intra-Aortic Balloon Pump at Cairo University Hospitals

Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

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1538 A Study of Challenges Faced and Support Systems Available for Emirati Student Mothers Post-Childbirth

Authors: Martina Dickson, Lilly Tennant

Abstract:

The young Emirati female university students of today are the first generation of women in the UAE for whom higher education as become not only a possibility, but almost an expectation. Young women in the UAE today make up around 77% of students in higher education institutes in the country. However, the societal expectations placed upon these women in terms of early marriage, child-bearing and rearing are similar to those placed upon their mothers and grandmothers in a time where women were not expected to go to university. A large proportion of female university students in the UAE are mothers of young children, or become mothers whilst at the university. This creates a challenging situation for young student mothers, where two weeks’ maternity leave is typical across institutions. The context of this study is in one such institution in the UAE. We have employed a mixed method approach to gathering interview data from twenty mothers, and survey data from over one hundred mothers. The main findings indicate that mothers have strong desires for their institution to support them more, for example by the provision of nursery facilities and resting areas for new mothers, and giving them greater flexibility over course selections and schedules including the provision of online learning. However, the majority felt supported on a personal level by their tutors. The major challenges which they identified in returning to college after only two weeks’ leave included the inevitable health and lack of sleep issues when caring for a newborn, struggling to catch up with missed college work and handling their course load. We also explored the women's’ home support systems which were provided from a variety of extended family, spouses and paid domestic help.

Keywords: student mothers, challenges, supports, United Arab Emirates

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1537 Analysis of Taxonomic Compositions, Metabolic Pathways and Antibiotic Resistance Genes in Fish Gut Microbiome by Shotgun Metagenomics

Authors: Anuj Tyagi, Balwinder Singh, Naveen Kumar B. T., Niraj K. Singh

Abstract:

Characterization of diverse microbial communities in specific environment plays a crucial role in the better understanding of their functional relationship with the ecosystem. It is now well established that gut microbiome of fish is not the simple replication of microbiota of surrounding local habitat, and extensive species, dietary, physiological and metabolic variations in fishes may have a significant impact on its composition. Moreover, overuse of antibiotics in human, veterinary and aquaculture medicine has led to rapid emergence and propagation of antibiotic resistance genes (ARGs) in the aquatic environment. Microbial communities harboring specific ARGs not only get a preferential edge during selective antibiotic exposure but also possess the significant risk of ARGs transfer to other non-resistance bacteria within the confined environments. This phenomenon may lead to the emergence of habitat-specific microbial resistomes and subsequent emergence of virulent antibiotic-resistant pathogens with severe fish and consumer health consequences. In this study, gut microbiota of freshwater carp (Labeo rohita) was investigated by shotgun metagenomics to understand its taxonomic composition and functional capabilities. Metagenomic DNA, extracted from the fish gut, was subjected to sequencing on Illumina NextSeq to generate paired-end (PE) 2 x 150 bp sequencing reads. After the QC of raw sequencing data by Trimmomatic, taxonomic analysis by Kraken2 taxonomic sequence classification system revealed the presence of 36 phyla, 326 families and 985 genera in the fish gut microbiome. At phylum level, Proteobacteria accounted for more than three-fourths of total bacterial populations followed by Actinobacteria (14%) and Cyanobacteria (3%). Commonly used probiotic bacteria (Bacillus, Lactobacillus, Streptococcus, and Lactococcus) were found to be very less prevalent in fish gut. After sequencing data assembly by MEGAHIT v1.1.2 assembler and PROKKA automated analysis pipeline, pathway analysis revealed the presence of 1,608 Metacyc pathways in the fish gut microbiome. Biosynthesis pathways were found to be the most dominant (51%) followed by degradation (39%), energy-metabolism (4%) and fermentation (2%). Almost one-third (33%) of biosynthesis pathways were involved in the synthesis of secondary metabolites. Metabolic pathways for the biosynthesis of 35 antibiotic types were also present, and these accounted for 5% of overall metabolic pathways in the fish gut microbiome. Fifty-one different types of antibiotic resistance genes (ARGs) belonging to 15 antimicrobial resistance (AMR) gene families and conferring resistance against 24 antibiotic types were detected in fish gut. More than 90% ARGs in fish gut microbiome were against beta-lactams (penicillins, cephalosporins, penems, and monobactams). Resistance against tetracycline, macrolides, fluoroquinolones, and phenicols ranged from 0.7% to 1.3%. Some of the ARGs for multi-drug resistance were also found to be located on sequences of plasmid origin. The presence of pathogenic bacteria and ARGs on plasmid sequences suggested the potential risk due to horizontal gene transfer in the confined gut environment.

Keywords: antibiotic resistance, fish gut, metabolic pathways, microbial diversity

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1536 L-Carnitine vs Extracorporeal Elimination for Acute Valproic Acid Intoxication: A Systemic Review

Authors: Byung Keun Yang, Jae Eun Ku, Young Seon Joo, Je Sung You, Sung Phil Chung, Hahn Shick Lee

Abstract:

The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication. PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs. 11 days) in case of delayed extracorporeal therapy. Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.

Keywords: carnitine, overdose, poisoning, renal dialysis, valproic acid

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1535 Influence of Parent’s Food Habits on Nutrition Behaviours of Children under 7 Years in Tehran, Iran

Authors: Katayoun Bagheri, Farzad Berahmandpour

Abstract:

Several studies about food habits in diverse population show, early living years play significant role in building of current food habits. Suitable nutrition in children is also influenced by parent’s food habits. The aim of study is to survey the role of parent’s food habits to form of nutrition behaviours in children under 7 years in Tehran - Iran. The study is a Descriptive study. The participants were 19 children under 7 years with their mothers from a kindergarten in the central Tehran. The sampling method was random sampling. The data was collected by food habits questionnaires and implementation of consultation meetings with the mothers. The data analysis was qualitative analysis. The findings show that 79% children and their parents have eaten enough and variety breakfast, but food choices of children were depended on food choices of parents. In the other meals, the majority of children enjoyed to eat dinner (58%), because the more families could eat dinner together. According to mother opinions, the children enjoy eating macaroni, chicken, fried potatoes, chips and fruit juices. The researchers argue that mother’s role is unavoidable in the food preferences among children. Fortunately, the results believe that children tend to drink simple milk (79%). Moreover, their parents lead them to chocolate milk consumption (42%) instead of other flavored milk. Finally, despite popular belief claim that mothers influence on nutrition behavior of children, but the study argues that the fathers have more effects on children’s nutrition behaviours. In conclusion, it seems that the general trainings about promoting healthy nutrition behavior for parents by mass media can improve nutrition habits and behaviours of pre school children.

Keywords: food habits, parents, nutrition behaviours, children, promoting nutrition

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1534 Application of Laser-Induced Breakdown Spectroscopy for the Evaluation of Concrete on the Construction Site and in the Laboratory

Authors: Gerd Wilsch, Tobias Guenther, Tobias Voelker

Abstract:

In view of the ageing of vital infrastructure facilities, a reliable condition assessment of concrete structures is becoming of increasing interest for asset owners to plan timely and appropriate maintenance and repair interventions. For concrete structures, reinforcement corrosion induced by penetrating chlorides is the dominant deterioration mechanism affecting the serviceability and, eventually, structural performance. The determination of the quantitative chloride ingress is required not only to provide valuable information on the present condition of a structure, but the data obtained can also be used for the prediction of its future development and associated risks. At present, wet chemical analysis of ground concrete samples by a laboratory is the most common test procedure for the determination of the chloride content. As the chloride content is expressed by the mass of the binder, the analysis should involve determination of both the amount of binder and the amount of chloride contained in a concrete sample. This procedure is laborious, time-consuming, and costly. The chloride profile obtained is based on depth intervals of 10 mm. LIBS is an economically viable alternative providing chloride contents at depth intervals of 1 mm or less. It provides two-dimensional maps of quantitative element distributions and can locate spots of higher concentrations like in a crack. The results are correlated directly to the mass of the binder, and it can be applied on-site to deliver instantaneous results for the evaluation of the structure. Examples for the application of the method in the laboratory for the investigation of diffusion and migration of chlorides, sulfates, and alkalis are presented. An example for the visualization of the Li transport in concrete is also shown. These examples show the potential of the method for a fast, reliable, and automated two-dimensional investigation of transport processes. Due to the better spatial resolution, more accurate input parameters for model calculations are determined. By the simultaneous detection of elements such as carbon, chlorine, sodium, and potassium, the mutual influence of the different processes can be determined in only one measurement. Furthermore, the application of a mobile LIBS system in a parking garage is demonstrated. It uses a diode-pumped low energy laser (3 mJ, 1.5 ns, 100 Hz) and a compact NIR spectrometer. A portable scanner allows a two-dimensional quantitative element mapping. Results show the quantitative chloride analysis on wall and floor surfaces. To determine the 2-D distribution of harmful elements (Cl, C), concrete cores were drilled, split, and analyzed directly on-site. Results obtained were compared and verified with laboratory measurements. The results presented show that the LIBS method is a valuable addition to the standard procedures - the wet chemical analysis of ground concrete samples. Currently, work is underway to develop a technical code of practice for the application of the method for the determination of chloride concentration in concrete.

Keywords: chemical analysis, concrete, LIBS, spectroscopy

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1533 Performance of the New Laboratory-Based Algorithm for HIV Diagnosis in Southwestern China

Authors: Yanhua Zhao, Chenli Rao, Dongdong Li, Chuanmin Tao

Abstract:

The Chinese Centers for Disease Control and Prevention (CCDC) issued a new laboratory-based algorithm for HIV diagnosis on April 2016, which initially screens with a combination HIV-1/HIV-2 antigen/antibody fourth-generation immunoassay (IA) followed, when reactive, an HIV-1/HIV-2 undifferentiated antibody IA in duplicate. Reactive specimens with concordant results undergo supplemental tests with western blots, or HIV-1 nucleic acid tests (NATs) and non-reactive specimens with discordant results receive HIV-1 NATs or p24 antigen tests or 2-4 weeks follow-up tests. However, little data evaluating the application of the new algorithm have been reported to date. The study was to evaluate the performance of new laboratory-based HIV diagnostic algorithm in an inpatient population of Southwest China over the initial 6 months by compared with the old algorithm. Plasma specimens collected from inpatients from May 1, 2016, to October 31, 2016, are submitted to the laboratory for screening HIV infection performed by both the new HIV testing algorithm and the old version. The sensitivity and specificity of the algorithms and the difference of the categorized numbers of plasmas were calculated. Under the new algorithm for HIV diagnosis, 170 of the total 52 749 plasma specimens were confirmed as positively HIV-infected (0.32%). The sensitivity and specificity of the new algorithm were 100% (170/170) and 100% (52 579/52 579), respectively; while 167 HIV-1 positive specimens were identified by the old algorithm with sensitivity 98.24% (167/170) and 100% (52 579/52 579), respectively. Three acute HIV-1 infections (AHIs) and two early HIV-1 infections (EHIs) were identified by the new algorithm; the former was missed by old procedure. Compared with the old version, the new algorithm produced fewer WB-indeterminate results (2 vs. 16, p = 0.001), which led to fewer follow-up tests. Therefore, the new HIV testing algorithm is more sensitive for detecting acute HIV-1 infections with maintaining the ability to verify the established HIV-1 infections and can dramatically decrease the greater number of WB-indeterminate specimens.

Keywords: algorithm, diagnosis, HIV, laboratory

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1532 Validation of a Placebo Method with Potential for Blinding in Ultrasound-Guided Dry Needling

Authors: Johnson C. Y. Pang, Bo Peng, Kara K. L. Reeves, Allan C. L. Fud

Abstract:

Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding is potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26 ± 5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms, and quality of life (QOL), were analyzed by repeated measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: ultrasound-guided dry needling, dry needling, knee osteoarthritis, physiotheraphy

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1531 Numerical Studies on 2D and 3D Boundary Layer Blockage and External Flow Choking at Wing in Ground Effect

Authors: K. Dhanalakshmi, N. Deepak, E. Manikandan, S. Kanagaraj, M. Sulthan Ariff Rahman, P. Chilambarasan C. Abhimanyu, C. A. Akaash Emmanuel Raj, V. R. Sanal Kumar

Abstract:

In this paper using a validated double precision, density-based implicit standard k-ε model, the detailed 2D and 3D numerical studies have been carried out to examine the external flow choking at wing-in-ground (WIG) effect craft. The CFD code is calibrated using the exact solution based on the Sanal flow choking condition for adiabatic flows. We observed that at the identical WIG effect conditions the numerically predicted 2D boundary layer blockage is significantly higher than the 3D case and as a result, the airfoil exhibited an early external flow choking than the corresponding wing, which is corroborated with the exact solution. We concluded that, in lieu of the conventional 2D numerical simulation, it is invariably beneficial to go for a realistic 3D simulation of the wing in ground effect, which is analogous and would have the aspects of a real-time parametric flow. We inferred that under the identical flying conditions the chances of external flow choking at WIG effect is higher for conventional aircraft than an aircraft facilitating a divergent channel effect at the bottom surface of the fuselage as proposed herein. We concluded that the fuselage and wings integrated geometry optimization can improve the overall aerodynamic performance of WIG craft. This study is a pointer to the designers and/or pilots for perceiving the zone of danger a priori due to the anticipated external flow choking at WIG effect craft for safe flying at the close proximity of the terrain and the dynamic surface of the marine.

Keywords: boundary layer blockage, chord dominated ground effect, external flow choking, WIG effect

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1530 Barriers of the Development and Implementation of Health Information Systems in Iran

Authors: Abbas Sheikhtaheri, Nasim Hashemi

Abstract:

Health information systems have great benefits for clinical and managerial processes of health care organizations. However, identifying and removing constraints and barriers of implementing and using health information systems before any implementation is essential. Physicians are one of the main users of health information systems, therefore, identifying the causes of their resistance and concerns about the barriers of the implementation of these systems is very important. So the purpose of this study was to determine the barriers of the development and implementation of health information systems in terms of the Iranian physicians’ perspectives. In this study conducted in 8 selected hospitals affiliated to Tehran and Iran Universities of Medical Sciences, Tehran, Iran in 2014, physicians (GPs, residents, interns, specialists) in these hospitals were surveyed. In order to collect data, a research made questionnaire was used (Cronbach’s α = 0.95). The instrument included 25 about organizational (9), personal (4), moral and legal (3) and technical barriers (9). Participants were asked to answer the questions using 5 point scale Likert (completely disagree=1 to completely agree=5). By using a simple random sampling method, 200 physicians (from 600) were invited to study that eventually 163 questionnaires were returned. We used mean score and t-test and ANOVA to analyze the data using SPSS software version 17. 52.1% of respondents were female. The mean age was 30.18 ± 7.29. The work experience years for most of them were between 1 to 5 years (80.4 percent). The most important barriers were organizational ones (3.4 ± 0.89), followed by ethical (3.18 ± 0.98), technical (3.06 ± 0.8) and personal (3.04 ± 1.2). Lack of easy access to a fast Internet (3.67±1.91) and the lack of exchanging information (3.61±1.2) were the most important technical barriers. Among organizational barriers, the lack of efficient planning for the development and implementation systems (3.56±1.32) and was the most important ones. Lack of awareness and knowledge of health care providers about the health information systems features (3.33±1.28) and the lack of physician participation in planning phase (3.27±1.2) as well as concerns regarding the security and confidentiality of health information (3.15 ± 1.31) were the most important personal and ethical barriers, respectively. Women (P = 0.02) and those with less experience (P = 0.002) were more concerned about personal barriers. GPs also were more concerned about technical barriers (P = 0.02). According to the study, technical and ethics barriers were considered as the most important barriers however, lack of awareness in target population is also considered as one of the main barriers. Ignoring issues such as personal and ethical barriers, even if the necessary infrastructure and technical requirements were provided, may result in failure. Therefore, along with the creating infrastructure and resolving organizational barriers, special attention to education and awareness of physicians and providing solution for ethics concerns are necessary.

Keywords: barriers, development health information systems, implementation, physicians

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1529 An Evaluation of Different Weed Management Techniques in Organic Arable Systems

Authors: Nicola D. Cannon

Abstract:

A range of field experiments have been conducted since 1991 to 2017 on organic land at the Royal Agricultural University’s Harnhill Manor Farm near Cirencester, UK to explore the impact of different management practices on weed infestation in organic winter and spring wheat. The experiments were designed using randomised complete block and some with split plot arrangements. Sowing date, variety choice, crop height and crop establishment technique have all shown a significant impact on weed infestations. Other techniques have also been investigated but with less clear, but, still often significant effects on weed control including grazing with sheep, undersowing with different legumes and mechanical weeding techniques. Tillage treatments included traditional plough based systems, minimum tillage and direct drilling. Direct drilling had significantly higher weed dry matter than the other two techniques. Taller wheat varieties which do not contain Rht1 or Rht2 had higher weed populations than the wheat without dwarfing genes. Early sown winter wheat had greater weed dry matter than later sown wheat. Grazing with sheep interacted strongly with sowing date, with shorter varieties and also late sowing dates providing much less forage but, grazing did reduce weed biomass in June. Undersowing had mixed impacts which were related to the success of establishment of the undersown legume crop. Weeds are most successfully controlled when a range of techniques are implemented to give the wheat crop the greatest chance of competing with weeds.

Keywords: crop establishment, drilling date, grazing, undersowing, varieties, weeds

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1528 Feeding Practices and Malnutrition among under Five Children in Communities of Kuje Area Council, Federal Capital Territory Abuja, Nigeria

Authors: Clementina Ebere Okoro, Olumuyiwa Adeyemi Owolabi, Doris Bola James, Aloysius Nwabugo Maduforo, Andrew Lingililani Mbewe, Christopher Osaruwanmwen Isokpunwu

Abstract:

Poor dietary practices and malnutrition, including severe acute malnutrition among under-five children in Nigeria has remained a great public health concern. This study assessed infant and young child feeding practices and nutritional status of under-five children to determine the prevalence of malnutrition of under-five children in Kuje area council, Abuja. The study was a cross-sectional study. Multi-stage sampling techniques was used in selecting the population that was studied. Probability proportion by size was applied in choosing 30 clusters for the survey using ENA for SMART software 2011 version. Questionnaires were used to obtain information from the population, while appropriate equipment was used for measurements of anthropometric parameters. The data was also subjected to statistical analysis. Results were presented in tables and figures. The result showed that 96.7% of the children were breastfed, 30.6% had early initiation to breastfeeding within first hour of birth and 22.4% were breastfed exclusively up to 6 months, 69.8% fed infants’ colostrum, while 30.2% discarded colostrum. About half of the respondents (49.1%) introduced complementary feeding before six months and 23.2% introduced it after six months while 27.7% had age appropriate timely introduction of complementary feeding. The anthropometric result showed that the prevalence of global acute malnutrition (GAM) was 12.8%, severe wasting prevalence was 5.4%, moderate wasting was 7.4%, underweight was 24.4%, stunting was 40.3% and overweight was 7.0%. The result showed that there is a high prevalence of malnutrition among under-five children in Kuje

Keywords: malnutrition, under five children, breastfeeding, complementary feeding

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1527 Application of Adaptive Architecture in Building Technologies: A Case Study of Neuhoff Site in Nashville, Tennessee

Authors: Shohreh Moshiri, Hossein Alimohammadi

Abstract:

Building construction has a great impact on climate change. Adaptive design strategies were developed to provide new life and purpose to old buildings and create new environments with economic benefits to meet resident needs. The role of smart material systems is undeniable in providing adaptivity of the architectural environments and their effects on creating better adaptive building environments. In this research, a case study named Neuhoff site located near Cumberland River in the Germantown neighborhood in the city of Nashville, Tennessee, was considered. This building in the early 1920s was constructed as a meat-packing facility and then served as a mixed-use space; however, New City has partnered with world-class architects to reinvent this site to be changed to mixed-use waterfront development. The future office space will be designed with LEED certification as a goal. Environmentally friendly sensitive materials and designs will offer for all adaptive reuse of the building. The smart materials and their applications, especially in the field of building technology and architecture, were emphasized in providing a renovation plan for the site. The advantages and qualities of smart material systems were targeted to explore in this research on the field of architecture. Also, this research helps to understand better the effects of smart material systems on the construction and design processes, exploration of the way to make architecture with better adaptive characteristics, plus provide optimal environmental situations for the users, which reflect on the climatic, structural, and architectural performances.

Keywords: adaptive architecture, building technology, case study, smart material systems

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