Search results for: background count
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5001

Search results for: background count

4551 The Relationship between Characteristics of Nurses and Organizational Commitment of Nurses in Geriatric Intermediate Care Facilities in Japan

Authors: Chiharu Miyata, Hidenori Arai

Abstract:

Background: The quality of care in geriatric intermediate facilities (GIFs) in Japan is not in a satisfied level. To improve it, it is crucial to reconsider nurses’ professionalism. Our goal is to create an organizational system that allows nurses to succeed professionally. To do this, we must first discuss the relationship between nurses’ characteristics and the organization. Objectives: The aim of the present study was to determine the extent to which demographic and work-related factors are related to organizational commitment among nurses in GIFs. Method: A quantitative, cross-sectional method was adopted, using a self-completion questionnaire survey. The questionnaires consisted of 49 items for job satisfaction, the three-dimensional commitment model of organizational commitment and the background information of respondents. Results: A total of 1,189 nurses participated. Of those, 91% (n=1084) were women, and mean age was 48.2 years. Most participants were staff nurses (n=791; 66%). Significant differences in 'affective commitment' (AC) scores were found for age (p < .001), overall work experience (p < .001), and work status (p < .001). For work experience in the current facility, significant differences were found in all organizational commitment scores (p < .001). The group with high job satisfaction scored significantly higher in all types of organizational commitment (p < 0.001). Conclusions: These results led to a conclusion that understanding the expectations of nurses at the workplace to adapt with the organization, and creating a work environment that clarifies contents of tasks, especially allowing for nurses to feel significance and achievement with tasks, would increase AC.

Keywords: geriatric intermediate care facilities, geriatric nursing, job satisfaction, organizational commitment

Procedia PDF Downloads 127
4550 In vivo Evaluation of LAB Probiotic Potential with the Zebrafish Animal Model

Authors: Iñaki Iturria, Pasquale Russo, Montserrat Nacher-Vázquez, Giuseppe Spano, Paloma López, Miguel Angel Pardo

Abstract:

Introduction: It is known that some Lactic Acid Bacteria (LAB) present an interesting probiotic effect. Probiotic bacteria stimulate host resistance to microbial pathogens and thereby aid in immune response, and modulate the host's immune responses to antigens with a potential to down-regulate hypersensitivity reactions. Therefore, probiotic therapy is valuable against intestinal infections and may be beneficial in the treatment of Inflammatory Bowel Disease (IBD). Several in vitro tests are available to evaluate the probiotic potential of a LAB strain. However, an in vivo model is required to understand the interaction between the host immune system and the bacteria. During the last few years, zebrafish (Danio rerio) has gained interest as a promising vertebrate model in this field. This organism has been extensively used to study the interaction between the host and the microbiota, as well as the host immune response under several microbial infections. In this work, we report on the use of the zebrafish model to investigate in vivo the colonizing ability and the immunomodulatory effect of probiotic LAB. Methods: Lactobacillus strains belonging to different LAB species were fluorescently tagged and used to colonize germ-free zebrafish larvae gastrointestinal tract (GIT). Some of the strains had a well-documented probiotic effect (L. acidophilus LA5); while others presented an exopolysaccharide (EPS) producing phenotype, thus allowing evaluating the influence of EPS in the colonization and immunomodulatory effect. Bacteria colonization was monitored for 72 h by direct observation in real time using fluorescent microscopy. CFU count per larva was also evaluated at different times. The immunomodulatory effect was assessed analysing the differential expression of several innate immune system genes (MyD88, NF-κB, Tlr4, Il1β and Il10) by qRT- PCR. The anti-inflammatory effect was evaluated using a chemical enterocolitis zebrafish model. The protective effect against a pathogen was also studied. To that end, a challenge test was developed using a fluorescently tagged pathogen (Vibrio anguillarum-GFP+). The progression of the infection was monitored up to 3 days using a fluorescent stereomicroscope. Mortality rates and CFU counts were also registered. Results and conclusions: Larvae exposed to EPS-producing bacteria showed a higher fluorescence and CFU count than those colonized with no-EPS phenotype LAB. In the same way, qRT-PCR results revealed an immunomodulatory effect on the host after the administration of the strains with probiotic activity. A downregulation of proinflammatory cytoquines as well as other cellular mediators of inflammation was observed. The anti-inflammatory effect was found to be particularly marked following exposure to LA% strain, as well as EPS producing strains. Furthermore, the challenge test revealed a protective effect of probiotic administration. As a matter of fact, larvae fed with probiotics showed a decrease in the mortality rate ranging from 20 to 35%. Discussion: In this work, we developed a promising model, based on the use of gnotobiotic zebrafish coupled with a bacterial fluorescent tagging in order to evaluate the probiotic potential of different LAB strains. We have successfully used this system to monitor in real time the colonization and persistence of exogenous LAB within the gut of zebrafish larvae, to evaluate their immunomodulatory effect and for in vivo competition assays. This approach could bring further insights into the complex microbial-host interactions at intestinal level.

Keywords: gnotobiotic, immune system, lactic acid bacteria, probiotics, zebrafish

Procedia PDF Downloads 299
4549 Study on Measuring Method and Experiment of Arc Fault Detection Device

Authors: Yang Jian-Hong, Zhang Ren-Cheng, Huang Li

Abstract:

Arc fault is one of the main inducements of electric fires. Arc Fault Detection Device (AFDD) can detect arc fault effectively. Arc fault detections and unhooking standards are the keys to AFDD practical application. First, an arc fault continuous production system was developed, which could count the arc half wave number. Then, Combining with the UL1699 standard, ignition probability curve of cotton and unhooking time of various currents intensity were obtained by experiments. The combustion degree of arc fault could be expressed effectively by arc area. Experiments proved that electric fires would be misjudged or missed only using arc half wave number as AFDD unhooking basis. At last, Practical tests were carried out on the self-developed AFDD system. The result showed that actual AFDD unhooking time was the sum of arc half wave cycling number, Arc wave identification time and unhooking mechanical operation time And the first two shared shorter time. Unhooking time standard depended on the shortest mechanical operation time.

Keywords: arc fault detection device, arc area, arc half wave, unhooking time, arc fault

Procedia PDF Downloads 481
4548 Phytodiversity and Phytogeographic Characterization Stands of Pistacia lentiscus L. in the Coastal Region of Honaine, Tlemcen, Western Algeria

Authors: I. Benmehdi, O. Hasnaoui, N. Hachemi, M. Bouazza

Abstract:

The Understanding of the mechanisms structuring of plant diversity in the region of Tlemcen (western Algeria) is a related problem. The current floristic composition of different groups in Pistacia lentiscus L. resulting from the combination of human and climate action. This study is devoted to biodiversity inventory and phytogeographic characterization of Pistacia lentiscus groups in the Honaine coastal (western Algeria). The floristic inventory (150 levels) made in three stations of the study area allowed to count a 109 species belonging to 44 families of vascular plants. The biogeographical analysis of the Pistacia lentiscus groups reveals the most representative elements. The Mediterranean elements are numerically the most dominant with 39.45% represented by: Pistacia lentiscus, Cistus monspeliensis, Plantago lagopus, Linum strictum, Echium vulgare; followed by the western Mediterranean elements with 10.09% and are represented by: Chamaerops humilis, Lavandula dentata, Ampelodesma mauritanicum and Iris xyphium. However, this phytotaxonomic wealth is exposed to anthropogenic impact causing its disruption see its decline.

Keywords: Pistacia lentiscus L., phytodiversity, phytogeography, honaine, western Algeria

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4547 Effect of Exercise on Sexual Behavior and Semen Quality of Sahiwal Bulls

Authors: Abdelrasoul, Khalid Ahmed Elrabie

Abstract:

The study was conducted on Sahiwal cattle bulls maintained at the Artificial Breeding Complex, NDRI, Karnal, Hayana, India, to determine the effect of exercise on the sexual behavior and semen quality. Fourteen Sahiwal bulls were classified into two groups of seven each. Group-1, bulls were exercised by walking in a bull exerciser once a week one hour before semen collection, whereas bulls in group-2 were exercised daily. Sexual behavior and semen quality traits studied were: Reaction time (RT), Dismounting time (DMT), Total time taken in mounts (TTTM), Flehmen response (FR), Erection Score (ES), Protrusion Score (PS), Intensity of thrust (ITS), Temperament Score (TS), Libido Score (LS), Semen volume, Physical appearance, Mass activity, Initial progressive motility, Non-eosinophilic spermatozoa count (NESC) and post thaw motility percent. Data were analyzed by least squares technique. Group-2 showed significantly (p < 0.01) higher value in RT (sec), DMT (sec), TTTM (sec), ES, PS, ITS, LS, semen volume, semen color density and mass activity.

Keywords: exercise, Sahiwal bulls, semen quality, sexual behavior

Procedia PDF Downloads 307
4546 Changing Trends and Attitudes towards Online Assessment

Authors: Renáta Nagy, Alexandra Csongor, Jon Marquette, Vilmos Warta

Abstract:

The presentation aims at eliciting insight into the results of ongoing research regarding evolving trends and attitudes towards online assessment of English for Medical Purposes. The focus pinpointsonline as one of the most trending formsavailable during the global pandemic. The study was first initiated in 2019 in which its main target was to reveal the intriguing question of students’ and assessors’ attitudes towards online assessment. The research questions the attitudes towards the latest trends, possible online task types, their advantagesand disadvantages through an in-depth experimental process currently undergoing implementation. Material and methods include surveys, needs and wants analysis, and thorough investigations regarding candidates’ and assessors’ attitudes towards online tests in the field of Medicine. The examined test tasks include various online tests drafted in both English and Hungarian by student volunteers at the Medical School of the University of Pécs, Hungary. Over 400 respondents from more than 28 countries participated in the survey, which gives us an international and intercultural insight into how students with different cultural and educational background deal with the evolving online world. The results show the pandemic’s impact, which brought the slumbering online world of assessing roaring alive, fully operational andnowbearsphenomenalrelevancein today’s global education. Undeniably, the results can be used as a perspective in a vast array of contents. The survey hypothesized the generation of the 21st century expect everything readily available online, however, questions whether they are ready for this challenge are lurking in the background.

Keywords: assessment, changes, english, ESP, online assessment, online, trends

Procedia PDF Downloads 167
4545 Impact of Minimalism in Dance Education on the Development of Aesthetic Sensibilities

Authors: Meghamala Nugehally

Abstract:

This paper hypothesises and draws inferences on the impact of minimalism in dance education on the development of artistic and aesthetic sensibilities in individuals in the age group of 5-18 yrs of age. This research and conclusions are within the context of Indian Classical Dance, which is based on Indian theories of aesthetics drawn from the Natyashastra, an ancient treatise on Indian dance and drama. The research employs training methods handed down through a strict one-on-one teacher-student tradition known as the Guru-Shishya Parampara. Aesthetic principles used are defined, and basic theories from the Natyashastra are explained to provide background for the research design. The paper also discusses dance curriculum design and training methodology design within the context of these aesthetic theories. The scope of the research is limited to two genres of Indian classical forms: Bharatanatyam and Odissi. A brief description of these dance forms is given as background and dance aesthetics specific to these forms are described. The research design includes individual case studies of subjects studied, independent predetermined attributes for observations and a qualitative scoring methodology devised for the purpose of the study. The study describes the training techniques used and contrasts minimal solo training techniques with the more elaborate group training techniques. Study groups were divided and the basis for the division are discussed. Study observations are recorded and presented as evidences. The results inform the conclusion and set the stage for further research in this area.

Keywords: dance aesthetics, dance education, Indian classical dance, minimalism

Procedia PDF Downloads 197
4544 A Bibliometric Analysis of Ukrainian Research Articles on SARS-COV-2 (COVID-19) in Compliance with the Standards of Current Research Information Systems

Authors: Sabina Auhunas

Abstract:

These days in Ukraine, Open Science dramatically develops for the sake of scientists of all branches, providing an opportunity to take a more close look on the studies by foreign scientists, as well as to deliver their own scientific data to national and international journals. However, when it comes to the generalization of data on science activities by Ukrainian scientists, these data are often integrated into E-systems that operate inconsistent and barely related information sources. In order to resolve these issues, developed countries productively use E-systems, designed to store and manage research data, such as Current Research Information Systems that enable combining uncompiled data obtained from different sources. An algorithm for selecting SARS-CoV-2 research articles was designed, by means of which we collected the set of papers published by Ukrainian scientists and uploaded by August 1, 2020. Resulting metadata (document type, open access status, citation count, h-index, most cited documents, international research funding, author counts, the bibliographic relationship of journals) were taken from Scopus and Web of Science databases. The study also considered the info from COVID-19/SARS-CoV-2-related documents published from December 2019 to September 2020, directly from documents published by authors depending on territorial affiliation to Ukraine. These databases are enabled to get the necessary information for bibliometric analysis and necessary details: copyright, which may not be available in other databases (e.g., Science Direct). Search criteria and results for each online database were considered according to the WHO classification of the virus and the disease caused by this virus and represented (Table 1). First, we identified 89 research papers that provided us with the final data set after consolidation and removing duplication; however, only 56 papers were used for the analysis. The total number of documents by results from the WoS database came out at 21641 documents (48 affiliated to Ukraine among them) in the Scopus database came out at 32478 documents (41 affiliated to Ukraine among them). According to the publication activity of Ukrainian scientists, the following areas prevailed: Education, educational research (9 documents, 20.58%); Social Sciences, interdisciplinary (6 documents, 11.76%) and Economics (4 documents, 8.82%). The highest publication activity by institution types was reported in the Ministry of Education and Science of Ukraine (its percent of published scientific papers equals 36% or 7 documents), Danylo Halytsky Lviv National Medical University goes next (5 documents, 15%) and P. L. Shupyk National Medical Academy of Postgraduate Education (4 documents, 12%). Basically, research activities by Ukrainian scientists were funded by 5 entities: Belgian Development Cooperation, the National Institutes of Health (NIH, U.S.), The United States Department of Health & Human Services, grant from the Whitney and Betty MacMillan Center for International and Area Studies at Yale, a grant from the Yale Women Faculty Forum. Based on the results of the analysis, we obtained a set of published articles and preprints to be assessed on the variety of features in upcoming studies, including citation count, most cited documents, a bibliographic relationship of journals, reference linking. Further research on the development of the national scientific E-database continues using brand new analytical methods.

Keywords: content analysis, COVID-19, scientometrics, text mining

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4543 In vitro Callus Production from Lantana Camara: A Step towards Biotransformation Studies

Authors: Maged El-Sayed Mohamed

Abstract:

Plant tissue culture practices are presented nowadays as the most promising substitute to a whole plant in the terms of secondary metabolites production. They offer the advantages of high production, tunability and they have less effect on plant ecosystems. Lantana camara is a weed, which is common all over the world as an ornamental plant. Weeds can adapt to any type of soil and climate due to their rich cellular machinery for secondary metabolites’ production. This characteristic is found in Lantana camara as a plant of very rich diversity of secondary metabolites with no dominant class of compounds. Aim: This trait has encouraged the author to develop tissue culture experiments for Lantana camara to be a platform for production and manipulation of secondary metabolites through biotransformation. Methodology: The plant was collected in its flowering stage in September 2014, from which explants were prepared from shoot tip, auxiliary bud and leaf. Different types of culture media were tried as well as four phytohormones and their combinations; NAA, 2,4-D, BAP and kinetin. Explants were grown in dark or in 12 hours dark and light cycles at 25°C. A metabolic profile for the produced callus was made and then compared to the whole plant profile. The metabolic profile was made using GC-MS for volatile constituents (extracted by n-hexane) and by HPLC-MS and capillary electrophoresis-mass spectrometry (CE-MS) for non-volatile constituents (extracted by ethanol and water). Results: The best conditions for the callus induction was achieved using MS media supplied with 30 gm sucrose and NAA/BAP (1:0.2 mg/L). Initiation of callus was favoured by incubation in dark for 20 day. The callus produced under these conditions showed yellow colour, which changed to brownish after 30 days. The rate of callus growth was high, expressed in the callus diameter, which reached to 1.15±0.2 cm in 30 days; however, the induction of callus delayed for 15 days. The metabolic profile for both volatile and non-volatile constituents of callus showed more simple background metabolites than the whole plant with two new (unresolved) peaks in the callus’ nonvolatile constituents’ chromatogram. Conclusion: Lantana camara callus production can be itself a source of new secondary metabolites and could be used for biotransformation studies due to its simple metabolic background, which allow easy identification of newly formed metabolites. The callus production gathered the simple metabolic background with the rich cellular secondary metabolite machinery of the plant, which could be elicited to produce valuable medicinally active products.

Keywords: capillary electrophoresis-mass spectrometry, gas chromatography, metabolic profile, plant tissue culture

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4542 The Motivational Factors of Learning Languages for Specific Purposes

Authors: Janos Farkas, Maria Czeller, Ildiko Tar

Abstract:

A remarkable feature of today’s language teaching is the learners’ language learning motivation. It is always considered as a very important factor and has been widely discussed and investigated. This paper aims to present a research study conducted in higher education institutions among students majoring in business and administration in Hungary. The aim of the research was to investigate the motivational factors of students learning languages for business purposes and set up a multivariate statistical model of language learning motivation, and examine the model's main components by different social background variables. The research question sought to answer the question of whether the motivation of students of business learning LSP could be characterized through some main components. The principal components of LSP have been created, and the correlations with social background variables have been explored. The main principal components of learning a language for business purposes were "professional future", "abroad", "performance", and "external". In the online voluntary questionnaire, 28 questions were asked about students’ motivational attitudes. 449 students have filled in the questionnaire. Descriptive statistical calculations were performed, then the difference between the highest and lowest mean was analyzed by one-sample t-test. The assessment of LSP learning was examined by one-way analysis of variance and Tukey post-hoc test among students of parents with different qualifications. The correlations between student motivation statements and various social background variables and other variables related to LSP learning motivation (gender, place of residence, mother’s education, father’s education, family financial situation, etc.) have also been examined. The attitudes related to motivation were seperated by principal component analysis, and then the different language learning motivation between socio-economic variables and other variables using principal component values were examined using an independent two-sample t-test. The descriptive statistical analysis of language learning motivation revealed that students learn LSP because this knowledge will come in handy in the future. It can be concluded that students consider learning the language for business purposes to be essential and see its future benefits. Therefore, LSP teaching has an important role and place in higher education. The results verify the second linguistic motivational self-system where the ideal linguistic self embraces the ideas and desires that the foreign language learner wants to achieve in the future. One such desire is to recognize that students will need technical language skills in the future, and it is a powerful motivation for them to learn a language.

Keywords: higher education, language learning motivation, LSP, statistical analysis

Procedia PDF Downloads 69
4541 Tyrosine Rich Fraction as an Immunomodulatory Agent from Ficus Religiosa Bark

Authors: S. A. Nirmal, G. S. Asane, S. C. Pal, S. C. Mandal

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Objective: Ficus religiosa Linn (Moraceae) is being used in traditional medicine to improve immunity hence present work was undertaken to validate this use scientifically. Material and Methods: Dried, powdered bark of F. religiosa was extracted successively using petroleum ether and 70% ethanol in soxhlet extractor. The extracts obtained were screened for immunomodulatory activity by delayed type hypersensitivity (DTH), neutrophil adhesion test and cyclophosphamide-induced neutropenia in Swiss albino mice at the dose of 50 and 100 mg/kg, i.p. 70% ethanol extract showed significant immunostimulant activity hence subjected to column chromatography to produce tyrosine rich fraction (TRF). TRF obtained was screened for immunomodulatory activity by above methods at the dose of 10 mg/kg, i.p. Results: TRF showed potentiation of DTH response in terms of significant increase in the mean difference in foot-pad thickness and it significantly increased neutrophil adhesion to nylon fibers by 48.20%. Percentage reduction in total leukocyte count and neutrophil by TRF was found to be 43.85% and 18.72%, respectively. Conclusion: Immunostimulant activity of TRF was more pronounced and thus it has great potential as a source for natural health products.

Keywords: Ficus religiosa, immunomodulatory, cyclophosphamide, neutropenia

Procedia PDF Downloads 407
4540 Teachers' Gender-Counts a Lot: Impact of Teachers’ Gender on Students’ Score Achievement at Primary Level

Authors: Aqleem Fatimah

Abstract:

The purpose of study was to find out the impact of teachers’ gender on students’ score achievement. Focusing on primary level’s teachers & students, a survey research was conducted by using convenient sampling technique. All the students of grade four (1500) and fifty-six teachers (equally divided by gender) from the 50 randomly selected coeducational schools from Lahore were taken as sample. The academic performance was operationalized using a t-test on standardized achievement tests of the students in language, science mathematics and social studies. In addition, all those gender based characteristics of teachers that count a lot in classroom interactions (taking Multi-grade classes, classroom strategies, feedback strategies and evaluation method) that influence students’ achievement were also analyzed by using a questionnaire and an observation schedule. The results of the study showed better academic achievement of students (girl &boy) of female teachers comparatively to the students of male teachers. Therefore, as the female teachers’ number lacks in Pakistan, the study suggests policy makers to seek guidelines to induct more specialized and professionally competent female teachers because their induction will prove highly beneficial for the betterment of students’ score achievement.

Keywords: gender, teacher, competency, score achievement

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4539 Electronic Nose Based on Metal Oxide Semiconductor Sensors as an Alternative Technique for the Spoilage Classification of Oat Milk

Authors: A. Deswal, N. S. Deora, H. N. Mishra

Abstract:

The aim of the present study was to develop a rapid method for electronic nose for online quality control of oat milk. Analysis by electronic nose and bacteriological measurements were performed to analyse spoilage kinetics of oat milk samples stored at room temperature and refrigerated conditions for up to 15 days. Principal component analysis (PCA), discriminant factorial analysis (DFA) and soft independent modelling by class analogy (SIMCA) classification techniques were used to differentiate the samples of oat milk at different days. The total plate count (bacteriological method) was selected as the reference method to consistently train the electronic nose system. The e-nose was able to differentiate between the oat milk samples of varying microbial load. The results obtained by the bacteria total viable counts showed that the shelf-life of oat milk stored at room temperature and refrigerated conditions were 20 hours and 13 days, respectively. The models built classified oat milk samples based on the total microbial population into “unspoiled” and “spoiled”.

Keywords: electronic-nose, bacteriological, shelf-life, classification

Procedia PDF Downloads 236
4538 Longan Tree Flowering and Bearing Induction Based on Chemicals and Growing Degree-Days Models

Authors: Hong Li, Tingxian Li, Xudong Wang, Fengliang Zhao

Abstract:

Unreliable flowering of chilling-required longan (Dimocarpus longan) due to increased air-temperatures have been the common concerns in the tropical areas. Our objectives were to assess the efficiency of chemicals in longan tree flowering and bearing using Growing Degree Days (GDD). The 2-year study was contacted in the tropical Haihan Island during 2012-2013. At pruning (August) the GDD values were started to count. The KClO3 treatments were applied to the root zones under the canopies at GDD 1300ºC while KH2PO4 rates were applied to the leaves at fruit setting at GDD 3000ºC and GDD 4000ºC. The results showed that total cumulative GDD was 6050ºC for longan. The GDD-guided KClO3 applications induced significant tree budding and flowering. The GDD-guided KH2PO4 applications stimulated higher leaf photosynthesis, carbonxylation efficiency, marketable fruit yield and quality (K+ and sugar) (P<0.05). It was concluded that the GDD-based model could efficiently support longan reliable flowering and bearing.

Keywords: canopy nutrition, flowering induction, growing degree days, longan, oxidant KClO3, tree physiology

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4537 Growth Performance of New Born Holstein Calves Supplemented with Garlic (Allium sativum) Powder and Probiotics

Authors: T. W. Kekana, J. J. Baloyi, M. C. Muya, F. V. Nherera

Abstract:

Secondary metabolites (thiosulphinates) from Allium sativum are able to stimulate the production of volatile fatty acids. This study was carried out to investigate the effects of feeding Garlic powder or probiotics or a combination of both on feed intake and growth performance of Holstein calves. Neonatal calves were randomly allocated, according to birth weight, to four dietary treatments, each with 8 calves. The treatments were: C control, no additive (C), G: supplemented with either 5g/d garlic powder (G) or 4 g/d probiotics (P) or GP 5g/d garlic powder and 4 g/d probiotics compound (GP) with the total viable count of 1.3 x 107 cfu/g. Garlic and probiotics were diluted in the daily milk allocation from day 4. Commercial (17.5% CP) starter feed and fresh water were available ad libitum from day 4 until day 42 of age. Calves fed GP (0.27 kg day-1) tended (P=0.055) to have higher DMI than C (0.22 kg day-1). Milk, water, CP, fat intake and FCR were not affected (P>0.05) by the treatments. Metibolisable energy (ME) intake for GP group tended (P=0.058) to be higher than C calves. Combination of G and P (60.3 kg) tended (P = 0.056) to be higher than C (56.0 kg) calves on final BW. Garlic, probiotics or their combination did not affect calve’s HG, ADG and BL (P>0.05). The results of the current study indicated that combination of garlic and probiotics may improve nutrients intake and body weight when fed to calves during the first 42 days of life.

Keywords: garlic powder, probiotics, intake, growth, Holstein calves

Procedia PDF Downloads 634
4536 Influence of Age and Religion on Sexual Behaviours of Undergraduates in Southwest, Nigeria

Authors: Tosin Emmanuel Akinduyo, F. O. Ojewola

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This study investigated the influence of age and religion on the sexual behaviours of undergraduates in southwest Nigeria. The aim of this study is to examine the sexual behaviour of undergraduates based on moderating variables of age and religion. The research design was a descriptive research design of the survey type. The sample for the study was 1,200 undergraduates selected through a multi-stage sampling procedure. A self-constructed questionnaire titled “Sexual Behaviours Questionnaire” (SBCUQ) with Pearson reliability (r) of 0.68 was used to elicit information from the respondents. Two research questions were answered using frequency count, percentage, means, and standard deviation. The two hypotheses were tested using t-test and ANOVA. Where the result of ANOVA showed a significant difference, the Scheffe Posthoc test was used to show where the significant difference (s) occurred. The findings of the study revealed that age and religion influenced undergraduates’ sexual behaviour. Based on the findings, the government at all tiers, in collaboration with the university management, should introduce sex education as a course to enlighten undergraduates and inform them of moderation needed as expected in their sexual expressions. Professional counsellors and religious organizations should always line up seminars and workshops for undergraduates on acceptable engagement in their sexual behaviours.

Keywords: age, religion, sexual behaviuors, undergraduates

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4535 Testing a Dose-Response Model of Intergenerational Transmission of Family Violence

Authors: Katherine Maurer

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Background and purpose: Violence that occurs within families is a global social problem. Children who are victims or witness to family violence are at risk for many negative effects both proximally and distally. One of the most disconcerting long-term effects occurs when child victims become adult perpetrators: the intergenerational transmission of family violence (ITFV). Early identification of those children most at risk for ITFV is needed to inform interventions to prevent future family violence perpetration and victimization. Only about 25-30% of child family violence victims become perpetrators of adult family violence (either child abuse, partner abuse, or both). Prior research has primarily been conducted using dichotomous measures of exposure (yes; no) to predict ITFV, given the low incidence rate in community samples. It is often assumed that exposure to greater amounts of violence predicts greater risk of ITFV. However, no previous longitudinal study with a community sample has tested a dose-response model of exposure to physical child abuse and parental physical intimate partner violence (IPV) using count data of frequency and severity of violence to predict adult ITFV. The current study used advanced statistical methods to test if increased childhood exposure would predict greater risk of ITFV. Methods: The study utilized 3 panels of prospective data from a cohort of 15 year olds (N=338) from the Project on Human Development in Chicago Neighborhoods longitudinal study. The data were comprised of a stratified probability sample of seven ethnic/racial categories and three socio-economic status levels. Structural equation modeling was employed to test a hurdle regression model of dose-response to predict ITFV. A version of the Conflict Tactics Scale was used to measure physical violence victimization, witnessing parental IPV and young adult IPV perpetration and victimization. Results: Consistent with previous findings, past 12 months incidence rates severity and frequency of interpersonal violence were highly skewed. While rates of parental and young adult IPV were about 40%, an unusually high rate of physical child abuse (57%) was reported. The vast majority of a number of acts of violence, whether minor or severe, were in the 1-3 range in the past 12 months. Reported frequencies of more than 5 times in the past year were rare, with less than 10% of those reporting more than six acts of minor or severe physical violence. As expected, minor acts of violence were much more common than acts of severe violence. Overall, regression analyses were not significant for the dose-response model of ITFV. Conclusions and implications: The results of the dose-response model were not significant due to a lack of power in the final sample (N=338). Nonetheless, the value of the approach was confirmed for the future research given the bi-modal nature of the distributions which suggest that in the context of both child physical abuse and physical IPV, there are at least two classes when frequency of acts is considered. Taking frequency into account in predictive models may help to better understand the relationship of exposure to ITFV outcomes. Further testing using hurdle regression models is suggested.

Keywords: intergenerational transmission of family violence, physical child abuse, intimate partner violence, structural equation modeling

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4534 Impact of Coccidia on Mortality and Weight Growth in Japanese Quail Coturnix japonica (Aves, Phasianidae) in Algeria

Authors: Amina Smai, Fairouz Haddadj, Habiba Saadi-Idouhar, Meriem Aissi, Safia Zenia, Salaheddine Doumandji

Abstract:

Coccidiosis is a very common intestinal parasitic disease caused by a worldwide distributed protozoan of the genus Eimeria. This disease is very common in young birds beyond the second week of life, especially in land-based breeding. The study was carried out in a hunting center of Zeralda located in the north-east of Algiers. The objective of our work is to study the evolution of coccidiosis in quails from 1 to 35 days old by collecting their droppings daily. These are analyzed in the laboratory using the flotation method and the Mac Master one to count coccidia. Weight changes are taken into account as well as mortality in parallel with certain zootechnical parameters such as density. The species of coccidia recovered is Eimeria coturnicis. The results showed that there is an average evolution of mortality of individuals with a rate of 13.33% due to the presence of coccidia with a significant regression (p=0.031). The weight of the quails increases with the age of the animal with a rapid growth rate from the 3rd week onwards. Indeed, the statistical analysis reveals that the evolution of the number did not affect the evolution of the weight (p=0.70) and the GMQ (R=0.52).

Keywords: coccidiosis, Coturnix japonica, daily average gain, weight

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4533 Feature Extractions of EMG Signals during a Constant Workload Pedaling Exercise

Authors: Bing-Wen Chen, Alvin W. Y. Su, Yu-Lin Wang

Abstract:

Electromyography (EMG) is one of the important indicators during exercise, as it is closely related to the level of muscle activations. This work quantifies the muscle conditions of the lower limbs in a constant workload exercise. Surface EMG signals of the vastus laterals (VL), vastus medialis (VM), rectus femoris (RF), gastrocnemius medianus (GM), gastrocnemius lateral (GL) and Soleus (SOL) were recorded from fourteen healthy males. The EMG signals were segmented in two phases: activation segment (AS) and relaxation segment (RS). Period entropy (PE), peak count (PC), zero crossing (ZC), wave length (WL), mean power frequency (MPF), median frequency (MDF) and root mean square (RMS) are calculated to provide the quantitative information of the measured EMG segments. The outcomes reveal that the PE, PC, ZC and RMS have significantly changed (p<.001); WL presents moderately changed (p<.01); MPF and MDF show no changed (p>.05) during exercise. The results also suggest that the RS is also preferred for performance evaluation, while the results of the extracted features in AS are usually affected directly by the amplitudes. It is further found that the VL exhibits the most significant changes within six muscles during pedaling exercise. The proposed work could be applied to quantify the stamina analysis and to predict the instant muscle status in athletes.

Keywords: electromyographic feature extraction, muscle status, pedaling exercise, relaxation segment

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4532 The Effects of Nanoemulsions Based on Commercial Oils: Sunflower, Canola, Corn, Olive, Soybean, and Hazelnut Oils for the Quality of Farmed Sea Bass at 2±2°C

Authors: Yesim Ozogul, Mustafa Durmuş, Fatih Ozogul, Esmeray Kuley Boğa, Yılmaz Uçar, Hatice Yazgan

Abstract:

The effects of oil-in-water nanoemulsions on the sensory, chemical (total volatile basic nitrogen (TVB-N), thiobarbituric acid (TBA), peroxide value (PV) and free fatty acids (FFA), and microbiological qualities (total viable count (TVC), total psychrophilic bacteria, and total Enterbactericaea bacteria) of sea bream fillets stored at 2 ± 2°C were investigated. Physical properties of emulsions (viscosity, the particle size of droplet, thermodynamic stability, refractive index and surface tension) were determined. The results showed that the use of nanoemulsion extended the shelf life of fish 2 days when compared with the control. Treatment with nanoemulsions significantly (p<0.05) decreased the values of biochemical parameters during storage period. Bacterial growth was inhibited by the use of nanoemulsions. Based on the results, it can be concluded that nanoemulsions based on commercial oils extended the shelf life and improved the quality of sea bass fillets during storage period.

Keywords: lipid oxidation, nanoemulsion, sea bass, quality parameters

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4531 Comparative Analysis of Ranunculus muricatus and Typha latifolia as Wetland Plants Applied for Domestic Wastewater Treatment in a Mesocosm Scale Study

Authors: Sadia Aziz, Mahwish Ali, Safia Ahmed

Abstract:

Comparing other methods of waste water treatment, constructed wetlands are one of the most fascinating practices because being a natural process they are eco-friendly have low construction and maintenance cost and have considerable capability of wastewater treatment. The current research was focused mainly on comparison of Ranunculus muricatus and Typha latifolia as wetland plants for domestic wastewater treatment by designing and constructing efficient pilot scale HSSF mesocosms. Parameters like COD, BOD5, PO4, SO4, NO3, NO2, and pathogenic indicator microbes were studied continuously with successive treatments. Treatment efficiency of the system increases with passage of time and with increase in temperature. Efficiency of T. latifolia planted setups in open environment was fairly good for parameters like COD and BOD5 which was showing up to 82.5% for COD and 82.6% for BOD5 while DO was increased up to 125%. Efficiency of R. muricatus vegetated setup was also good but lowers than that of T. latifolia planted showing 80.95% removal of COD and BOD5. Ranunculus muricatus was found effective in reducing bacterial count in wastewater. Both macrophytes were found promising in wastewater treatment.

Keywords: wastewater treatment, wetland, mesocosms study, wetland plants

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4530 Investigating the Impact of Migration Background on Pregnancy Outcomes During the End of Period of COVID-19 Pandemic: A Mixed-Method Study

Authors: Charlotte Bach, Albrecht Jahn, Mahnaz Motamedi, Maryam Karimi-Ghahfarokhi

Abstract:

Background: Maternal and infant deaths are most prevalent in the first month after birth, emphasizing the critical need for quality healthcare services during this period. Immigrant women, who are more susceptible to adverse pregnancy outcomes, often face neglect in accessing proper healthcare. The lack of adequate postpartum care significantly contributes to mortality rates. Therefore, utilizing maternal health care services and implementing postpartum care is crucial in reducing maternal and child mortality. Aims: This study aims to evaluate the assessment of pre- and postnatal care among women with and without migration background. In addition, the study explores the impact of COVID-19 procedures on women's experiences during pregnancy, birth, and the postpartum period. Methods: This research employs a cross-sectional Mixed-Method design. Data collection was facilitated through structured questionnaires administered to participants, alongside the utilization of patient bases, including Maternity and child medical records. Following the assumption that the investigator aimed to gain comprehensive insights, qualitative sampling focused on individuals with substantial experiences related to COVID-19, regarded as rich cases. Results: our study highlighted the influence of educational level, marital status, and consensual partnerships on the likelihood of Cesarean deliveries. Regarding breastfeeding practices, migrant women exhibited higher rates of breastfeeding initiation and continuation. Contraception utilization revealed interesting patterns, with non-migrants displaying higher odds of contraceptive use. The qualitative component of our research adds depth to the exploration of women's experiences during the COVID-19 pandemic, revealing nuanced challenges related to anxiety, hospital restrictions, breastfeeding support, and postnatal ward routines. Conclusion: Dissimilarity among studies toward cesarean rate between migrants and non-migrants underscores the importance of targeted interventions considering the diverse needs of distinct population groups. It also acknowledges potential cultural, contextual, and healthcare system influences on the association between mode of delivery and infant feeding practices. Studies acknowledge the influence of contextual variables on contraceptive preferences among migrants and non-migrants, emphasizing the need for tailored healthcare policies. The findings contribute to existing research, highlighting the need for a nuanced understanding of the impact of birth preparation courses on maternal and infant outcomes. Furthermore, they emphasize the universality of certain maternity care experiences, regardless of pandemic contexts, reinforcing the importance of patient-centred approaches in healthcare delivery.

Keywords: migration background, pregnancy outcome, covid-19, postpartum

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4529 Effectiveness of Selected Anthementics on Nematode Parasites of Sheep in KwaZulu-Natal, South Africa

Authors: M. A. Ahmed, N. Basha, I. V. Nsahlai

Abstract:

This study determined the effectiveness of selected anthementics (Ivermectin 1% (IVM), Closantel 7.5% (CST) and a combination Abamectin 0.08% and Praziquantel 1.5% (CAP) currently being used in SA. Gender, initial egg per gram (EPG) and initial live weight aided in blocking animals into groups, each group was randomly treated with one of four drug treatments comprising: the untreated control (D0), IVM, CST, and CAP. Animals grazed throughout on infested pasture. Rectal faeces were collected on days 0, 7, 14, and 21 for determining EPG. Faeces were mixed per group and incubated to identify and determine the abundance of larval forms of Haemonchus, Trichostrongylus, Strongyloides, Namatodirus, and Cooperia species. Differences between treatments changed over time. On day7 IVM, CST, and CAP depressed EPG to 0.66, 0.37 and 0.80 of their respective starting values whilst EPG increased 1.39 times for D0. Thereafter, EPG increased consistently for all drugs; CST recorded the lowest values. Haemonchus, Trichostrongylus, Strongyloides, Namatodirus and Coperia species contributed respectively 60%, 30%, 6%, 3%, and 1% of the larval forms on day 0; and 78%, 8%, 11%, 1%, 2% on day 21. Larval forms increased for Haemonchus species but decreased for Trichostrongylus species over time. Closantel was the most effective dewormer. Haemonchus Spp. were least affected whilst Trichostrongylus Spp. were the most affect by all drugs.

Keywords: anthementics, faecal egg count, L3 larvae, sheep

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4528 Development and Characterization of Double Liposomes Based Dual Drug Delivery System for H. Pylori Targeting

Authors: Ashish Kumar Jain, Deepak Mishra

Abstract:

The objective of the present investigation was to prepare and evaluate a vesicular dual drug delivery system for effective management of mucosal ulcer. Inner encapsulating and Double liposomes were prepared by glass bead and reverse phase evaporation method respectively. The formulation consisted of inner liposomes bearing Ranitidine Bismuth Citrate (RBC) and outer liposomes encapsulating Amoxicillin trihydrate (AMOX). The optimized inner liposomes and double liposomes were extensively characterized for vesicle size, morphology, zeta potential, vesicles count, entrapment efficiency and in vitro drug release. In vitro, the double liposomes demonstrated a sustained release of AMOX and RBC viz 91.4±1.8% and 77.2±2.1% respectively at the end of 72 hr. Furthermore binding specificity and targeting propensity toward H. pylori (SKP-56) was confirmed by agglutination and in situ adherence assay. Reduction of the absolute alcohol induced ulcerogenic index from 3.01 ± 0.25 to 0.31 ± 0.09 and 100% H. pylori clearance rate was observed. These results suggested that double liposomes are potential vector for the development of dual drug delivery for effective treatment of H. pylori-associated peptic ulcer.

Keywords: double liposomes, H. pylori targeting, PE liposomes, glass-beads method, peptic ulcers

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4527 Cognitive Decline in People Living with HIV in India and Correlation with Neurometabolites Using 3T Magnetic Resonance Spectroscopy (MRS): A Cross-Sectional Study

Authors: Kartik Gupta, Virendra Kumar, Sanjeev Sinha, N. Jagannathan

Abstract:

Introduction: A significant number of patients having human immunodeficiency virus (HIV) infection show a neurocognitive decline (NCD) ranging from minor cognitive impairment to severe dementia. The possible causes of NCD in HIV-infected patients include brain injury by HIV before cART, neurotoxic viral proteins and metabolic abnormalities. In the present study, we compared the level of NCD in asymptomatic HIV-infected patients with changes in brain metabolites measured by using magnetic resonance spectroscopy (MRS). Methods: 43 HIV-positive patients (30 males and 13 females) coming to ART center of the hospital and HIV-seronegative healthy subjects were recruited for the study. All the participants completed MRI and MRS examination, detailed clinical assessments and a battery of neuropsychological tests. All the MR investigations were carried out at 3.0T MRI scanner (Ingenia/Achieva, Philips, Netherlands). MRI examination protocol included the acquisition of T2-weighted imaging in axial, coronal and sagittal planes, T1-weighted, FLAIR, and DWI images in the axial plane. Patients who showed any apparent lesion on MRI were excluded from the study. T2-weighted images in three orthogonal planes were used to localize the voxel in left frontal lobe white matter (FWM) and left basal ganglia (BG) for single voxel MRS. Single voxel MRS spectra were acquired with a point resolved spectroscopy (PRESS) localization pulse sequence at an echo time (TE) of 35 ms and a repetition time (TR) of 2000 ms with 64 or 128 scans. Automated preprocessing and determination of absolute concentrations of metabolites were estimated using LCModel by water scaling method and the Cramer-Rao lower bounds for all metabolites analyzed in the study were below 15\%. Levels of total N-acetyl aspartate (tNAA), total choline (tCho), glutamate + glutamine (Glx), total creatine (tCr), were measured. Cognition was tested using a battery of tests validated for Indian population. The cognitive domains tested were the memory, attention-information processing, abstraction-executive, simple and complex perceptual motor skills. Z-scores normalized according to age, sex and education standard were used to calculate dysfunction in these individual domains. The NCD was defined as dysfunction with Z-score ≤ 2 in at least two domains. One-way ANOVA was used to compare the difference in brain metabolites between the patients and healthy subjects. Results: NCD was found in 23 (53%) patients. There was no significant difference in age, CD4 count and viral load between the two groups. Maximum impairment was found in the domains of memory and simple motor skills i.e., 19/43 (44%). The prevalence of deficit in attention-information processing, complex perceptual motor skills and abstraction-executive function was 37%, 35%, 33% respectively. Subjects with NCD had a higher level of Glutamate in the Frontal region (8.03 ± 2.30 v/s. 10.26 ± 5.24, p-value 0.001). Conclusion: Among newly diagnosed, ART-naïve retroviral disease patients from India, cognitive decline was found in 53\% patients using tests validated for this population. Those with neurocognitive decline had a significantly higher level of Glutamate in the left frontal region. There was no significant difference in age, CD4 count and viral load at initiation of ART between the two groups.

Keywords: HIV, neurocognitive decline, neurometabolites, magnetic resonance spectroscopy

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4526 Evaluation of Social Media Customer Engagement: A Content Analysis of Automobile Brand Pages

Authors: Adithya Jaikumar, Sudarsan Jayasingh

Abstract:

The dramatic technology led changes that continue to take place at the market place has led to the emergence and implication of online brand pages on social media networks. The Facebook brand page has become extremely popular among different brands. The primary aim of this study was to identify the impact of post formats and content type on customer engagement in Facebook brand pages. Methodology used for this study was to analyze and categorize 9037 content messages posted by 20 automobile brands in India during April 2014 to March 2015 and the customer activity it generated in return. The data was obtained from Fanpage karma- an online tool used for social media analytics. The statistical technique used to analyze the count data was negative binomial regression. The study indicates that there is a statistically significant relationship between the type of post and the customer engagement. The study shows that photos are the most posted format and highest engagement is found to be related to videos. The finding also reveals that social events and entertainment related content increases engagement with the message.

Keywords: content analysis, customer engagement, digital engagement, facebook brand pages, social media

Procedia PDF Downloads 295
4525 Banana Peels as an Eco-Sorbent for Manganese Ions

Authors: M. S. Mahmoud

Abstract:

This study was conducted to evaluate the manganese removal from aqueous solution using Banana peels activated carbon (BPAC). Batch experiments have been carried out to determine the influence of parameters such as pH, biosorbent dose, initial metal ion concentrations and contact times on the biosorption process. From these investigations, a significant increase in percentage removal of manganese 97.4 % is observed at pH value 5.0, biosorbent dose 0.8 g, initial concentration 20 ppm, temperature 25 ± 2 °C, stirring rate 200 rpm and contact time 2 h. The equilibrium concentration and the adsorption capacity at equilibrium of the experimental results were fitted to the Langmuir and Freundlich isotherm models; the Langmuir isotherm was found to well represent the measured adsorption data implying BPAC had heterogeneous surface. A raw groundwater samples were collected from Baharmos groundwater treatment plant network at Embaba and Manshiet Elkanater City/District-Giza, Egypt, for treatment at the best conditions that reached at first phase by BPAC. The treatment with BPAC could reduce iron and manganese value of raw groundwater by 91.4 % and 97.1 %, respectively and the effect of the treatment process on the microbiological properties of groundwater sample showed decrease of total bacterial count either at 22°C or at 37°C to 85.7 % and 82.4 %, respectively. Also, BPAC was characterized using SEM and FTIR spectroscopy.

Keywords: biosorption, banana peels, isothermal models, manganese

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4524 A Study on Hospital Acquired Infections Among Patients in University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State in Southern Part of Nigeria

Authors: Ibeku Bernadine Ezenwanyi

Abstract:

Hospital-Acquired Infections (HAI), also called ‘Nosocomial Infection’ is an infection you get while in the hospital for another reason. They are an important cause of morbidity and mortality. This study examined the epidemiology, clinical outcomes of some instruments used on patients especially catheter that was passed on them during their stay in the hospital. It was discovered that they had catheter–associated urinary tract infection (CAUTI). An observational study was carried out from January to March, 2022, on 180 patients (80 males and 100 females) admitted in the surgical wards, medical wards, dialysis unit and intensive care unit (ICU) of the hospital. The patient’s urine samples were collected for urine culture and the isolation was carried out using plate count agar medium and macconkey agar. Among the 80 males, 45 had Urinary Tract Infections (UTI) mostly proteus infection and among the 100 females, 70 also had (UTI) and the most common was caused by Escherichia coli. Other strain of microorganisms such as Klebsiella, Staphylococcus aureus and Pseudomonas aeruginosa. It is important to follow up patients that these devices were used on with antibiotics to make sure that these infections are not developed because the rate of these infections (UTI) are high especially in females.

Keywords: catheter, urinary tract infection, nosocomial infection, microorganisms

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4523 Shoring System Selection for Deep Excavation

Authors: Faouzi Ahtchi-Ali, Marcus Vitiello

Abstract:

A study was conducted in the east region of the Middle East to assess the constructability of a shoring system for a 12-meter deep excavation. Several shoring systems were considered in this study including secant concrete piling, contiguous concrete piling, and sheet-piling. The excavation was carried out in a very dense sand with the groundwater level located at 3 meters below ground surface. The study included conducting a pilot test for each shoring system listed above. The secant concrete piling included overlapping concrete piles to a depth of 16 meters. Drilling method with full steel casing was utilized to install the concrete piles. The verticality of the piles was a concern for the overlap. The contiguous concrete piling required the installation of micro-piles to seal the gap between the concrete piles. This method revealed that the gap between the piles was not fully sealed as observed by the groundwater penetration to the excavation. The sheet-piling method required pre-drilling due to the high blow count of the penetrated layer of saturated sand. This study concluded that the sheet-piling method with pre-drilling was the most cost effective and recommended a method for the shoring system.

Keywords: excavation, shoring system, middle east, Drilling method

Procedia PDF Downloads 446
4522 A Case of Severe Iatrogenic Cushing’s Syndrome Followed by Adrenal Crisis, Multifocal Pneumonia, Sepsis, Pulmonary Embolism and Prolonged Adrenal Insufficiency

Authors: Jelena Maletkovic

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Background: Endogenous Cushing’s syndrome is a rare disease, but iatrogenic or drug related Cushing syndrome from glucocorticoid products is commonly seen in clinical practice. With high dose and long term use of glucocorticoids, patients can develop isolated hypothalamic-pituitary-adrenal (HPA) suppression, or HPA axis suppression can be accompanied by overt iatrogenic Cushing’s syndrome. This is a rare case where severe Cushing’s syndrome developed from an unknown medication and was followed by severe and prolonged adrenal insufficiency and multiple potentially fatal complications. Case: This is a 37-year-old woman who is presented to Emergency Room (ER) with shortness of breath and chest pain. Four months prior to this presentation the patient was a generally healthy woman who was looking for improvement in her appearance and visited local Rejuvenation Clinic. After initial consultation with a nurse, she was contacted by a physician over the phone and was advised to start taking multiple injectable medications that will arrive by mail. Medications without any labels on bottles were delivered and the patient started daily intramuscular injections. Over the next two months, she noticed rounding of her face and swelling around her eyes. She gained 20 pounds, mostly abdominal fat and became extremely fatigued. Her muscles on legs were visibly decreasing in size and she felt significant muscle weakness. Unexplained bruising occurred. She started growing hair on face and developed secondary amenorrhea. New severe back pain started. She developed depression and headaches. Finally, over a few days, a number of red-purple stretch marks that were sensitive and painful appeared over her abdomen, upper part of arms and legs. She then became suspicious that these dramatic symptoms are caused by injectable medication and she discontinued injections. Over the next few days she presented to ER with low blood pressure and oxygen saturation of 75%. Studies revealed extensive pneumonia as well as multiple pulmonary emboli. Her white blood count was elevated with 32 000 and she also had acute kidney failure on admission. She was treated for sepsis and was also given stress dose steroids. Steroids were tapered over 48 hours and discontinued. After being discharged to home, on her first visit to endocrinology clinic she had undetectable ACTH of < 2pg/mL and undetectable 8am cortisol of < 0.2mcg/dL. She did not respond to an intramuscular injection of cosyntropin 250mcg and her repeated cortisol after 60 minutes was only 1mcg/dL. The patient was diagnosed with adrenal insufficiency and was started on hydrocortisone 20mg+10mg. It took close to 2 years of slow tapering for recovery of this patient’s HPA axis and resolve all the sequelae from Cushing’s syndrome. Conclusion: Misuse and abuse of glucocorticoids have been present almost since these medications were discovered. This is a rare case where not only severe Cushing’s syndrome in full clinical picture developed but also the patient suffered multiple potentially fatal complications and prolonged adrenal insufficiency. Visits to herbal, rejuvenation, esthetic, and similar clinics are becoming more and more popular and physicians need to be aware of possible non-benign nature of medications that their patients may be using.

Keywords: iatrogenic, Cushing's syndrome, adrenal crisis, steroid abuse

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