Search results for: Arba Minch general hospital
Commenced in January 2007
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Edition: International
Paper Count: 6981

Search results for: Arba Minch general hospital

2181 Evaluation of Role of Surgery in Management of Pediatric Germ Cell Tumors According to Risk Adapted Therapy Protocols

Authors: Ahmed Abdallatif

Abstract:

Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.

Keywords: extragonadal, germ cell tumors, gonadal, pediatric

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2180 Analysis and Control of Camera Type Weft Straightener

Authors: Jae-Yong Lee, Gyu-Hyun Bae, Yun-Soo Chung, Dae-Sub Kim, Jae-Sung Bae

Abstract:

In general, fabric is heat-treated using a stenter machine in order to dry and fix its shape. It is important to shape before the heat treatment because it is difficult to revert back once the fabric is formed. To produce the product of right shape, camera type weft straightener has been applied recently to capture and process fabric images quickly. It is more powerful in determining the final textile quality rather than photo-sensor. Positioning in front of a stenter machine, weft straightener helps to spread fabric evenly and control the angle between warp and weft constantly as right angle by handling skew and bow rollers. To process this tricky procedure, the structural analysis should be carried out in advance, based on which, its control technology can be drawn. A structural analysis is to figure out the specific contact/slippage characteristics between fabric and roller. We already examined the applicability of camera type weft straightener to plain weave fabric and found its possibility and the specific working condition of machine and rollers. In this research, we aimed to explore another applicability of camera type weft straightener. Namely, we tried to figure out camera type weft straightener can be used for fabrics. To find out the optimum condition, we increased the number of rollers. The analysis is done by ANSYS software using Finite Element Analysis method. The control function is demonstrated by experiment. In conclusion, the structural analysis of weft straightener is done to identify a specific characteristic between roller and fabrics. The control of skew and bow roller is done to decrease the error of the angle between warp and weft. Finally, it is proved that camera type straightener can also be used for the special fabrics.

Keywords: camera type weft straightener, structure analysis, control, skew and bow roller

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2179 The Impact of COVID-19 on the Mental Health of Residents of Saudi Arabia

Authors: Khaleel Alyahya, Faizah Alotaibi

Abstract:

The coronavirus disease 19 (COVID-19) pandemic has caused an increase in general fear and anxiety around the globe. With the public health measures, including lockdown and travel restrictions, the COVID-19 period further resulted in a sudden increase in the vulnerability of people too ill mental health. This becomes greater among individuals who have a history of mental illness or are undergoing treatment and do not have easy access to medication and medical consultations. The study aims to measure the impact of COVID-19 and the degree of distress with the DASS scale on the mental health of residents living in Saudi Arabia. The study is a quantitative, observational, and cross-sectional conducted in Saudi Arabia to measure the impact of COVID-19 on the mental health of both citizens and residents of Saudi Arabia during pandemics. The study ran from February 2021 to June 2021, and a validated questionnaire was used. The targeted population of the study was Saudi citizens and non-Saudi residents. A sample size of 800 participants was calculated with a single proportion formula at 95% level of significance and 5% allowable error. The result revealed that participants who were always doing exercise experienced the lowest level of depression, anxiety, and stress. The highest prevalence of severe and extremely severe depression was among participants who sometimes do exercise at 53.2% for each. Similar results were obtained for anxiety and stress, where the extremely severe form was reported by those who sometimes did exercise at 54.8% and 72.2%, respectively. There was an inverse association between physical activity levels and levels of depression, anxiety, and stress during the COVID-19. Similarly, the levels of depression, anxiety, and stress differed significantly according to the exercise frequency during COVID-19.

Keywords: mental, COVID-19, pandemic, lockdown, depression, anxiety, stress

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2178 Muscle and Cerebral Regional Oxygenation in Preterm Infants with Shock Using Near-Infrared Spectroscopy

Authors: Virany Diana, Martono Tri Utomo, Risa Etika

Abstract:

Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal.

Keywords: preterm infant, regional muscle oxygen saturation, regional cerebral oxygen saturation, NIRS, shock

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2177 Exposure to Social Media Shared Video-Clips on Irregularities from the 2023 Election in Nigeria and Audience Perception of the Outcome

Authors: Obiakor Casmir Uchenna, Ikegbunam Peter Chierike, Ezeja Perpetual Chisom

Abstract:

Irregularities have been a major feature of the Nigerian political activities since 1999. The rate at which such impunities thrive in the country has made elections grossly unacceptable among the people because the outcomes have never reflected the wish of the masses. Conscious of this, citizens have subscribed to the use of social media in exposing the ugly faces of the country’s elections which have always been against the less privileged. This study is an exploration of the relationship between exposure to social media shared video-clips and the respondents’ perception of the 2023 presidential election in Nigeria. The general objective of the study is to find out what the respondents make of the election as a result of the video-clips shared on different social media platforms showing electoral irregularities. The study adopted survey research method in studying 378 university undergraduates from NAU, COOU and Paul University selected through purposive sampling technique. The study was premised on the theoretical provision of violation of expectation theory. Findings revealed that the respondents are well exposed to different video-clips showing irregularities on the election. It was also found that the respondents have negative perception of the election. It was concluded that electoral umpire, the government in power and the security apparatus violated the respondents’ expectation from the election based on the pre-election promises made to the citizens. It was recommended among others, that Nigeria must strengthen the various institutions responsible for the conduct of elections if violence will not be made the best option for the poor masses.

Keywords: social media shared video-clips, exposure, irregularities, elections, audience perception, outcome

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2176 Analytical Study of Symbolism in Literary Texts: A Pragma-Stylistic Approach

Authors: Hussain Hameed Mayuuf

Abstract:

We may find multiple functions that are required to exist in order for meaning, in any certain context, to manifest and act accordingly. Pragmatic function and symbolic function need to be contributing in a combined effort towards that manifestation in order for meaning to be acquired or achieved from within a structure too complex to detect meaning in it by employing any other means. This paper inspects symbolism pragma-stylistically in literary texts. Thus, it principally aims at showing the ways writers utilize symbolism to contribute to the themes of their works and, consequently, pinpointing the most frequently flouted maxim involved in symbolic interpretations in addition to the reason(s) behind the writer's exploitation of that maxim in the literary work. E. E. Cummings' play Him constitutes rich data for the present study. Thus, to achieve its aims, the present study hypothesizes that the descriptions of scenes, the playwright’s remarks, and the characters’ references are all manipulated symbolically to contribute to the themes of the play. It is also hypothesized that the maxim of manner is the most frequently flouted maxim involved in symbolic interpretations in the play, which comes as a result of the intended ambiguity and obscurity manipulated in the descriptions of the scenes, the playwright’s remarks and the characters’ references. In order to achieve the aims of the study and test its hypotheses, a theoretical background about symbolism in general and symbolism from pragma-stylistic points of view is presented. Then, (six) extracts of Him according to Eco’s (1984) model Semiotics and the Philosophy of Language are analyzed. The findings of the analysis verify the above-mentioned hypotheses.

Keywords: pragmatic function, stylistic function, Symbolism, pragma-stylistics, Cummings

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2175 Neuroimaging Markers for Screening Former NFL Players at Risk for Developing Alzheimer's Disease / Dementia Later in Life

Authors: Vijaykumar M. Baragi, Ramtilak Gattu, Gabriela Trifan, John L. Woodard, K. Meyers, Tim S. Halstead, Eric Hipple, Ewart Mark Haacke, Randall R. Benson

Abstract:

NFL players, by virtue of their exposure to repetitive head injury, are at least twice as likely to develop Alzheimer's disease (AD) and dementia as the general population. Early recognition and intervention prior to onset of clinical symptoms could potentially avert/delay the long-term consequences of these diseases. Since AD is thought to have a long preclinical incubation period, the aim of the current research was to determine whether former NFL players, referred to a depression center, showed evidence of incipient dementia in their structural imaging prior to diagnosis of dementia. Thus, to identify neuroimaging markers of AD, against which former NFL players would be compared, we conducted a comprehensive volumetric analysis using a cohort of early stage AD patients (ADNI) to produce a set of brain regions demonstrating sensitivity to early AD pathology (i.e., the “AD fingerprint”). A cohort of 46 former NFL players’ brain MRIs were then interrogated using the AD fingerprint. Brain scans were done using a T1-weighted MPRAGE sequence. The Free Surfer image analysis suite (version 6.0) was used to obtain the volumetric and cortical thickness data. A total of 55 brain regions demonstrated significant atrophy or ex vacuo dilatation bilaterally in AD patients vs. healthy controls. Of the 46 former NFL players, 19 (41%) demonstrated a greater than expected number of atrophied/dilated AD regions when compared with age-matched controls, presumably reflecting AD pathology.

Keywords: alzheimers, neuroimaging biomarkers, traumatic brain injury, free surfer, ADNI

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2174 Evaluation of Food Safety and Security Practices in Midday Meal Programmes in Rural Areas of Beed District

Authors: Nuzhat Sultana M. B.

Abstract:

Children are high-risk population in terms of food born illnesses. Food safety and security are the most important aspect of the success of midday meal programmes. Improper holding temperatures, cross-contamination and poor personal hygiene of food handlers are the main causes for the prevalence of pathogenic microbes in the food servicing areas. Two hundred and fifty preschool children in the age of 3 to 6 years from urban and rural anganwadies (pre school center) of Beed district were selected. Nutritional status of preschool children were assessed by anthropometrical and clinical measurement. The study assessed the food safety and security with the help of personal hygiene and other safety measures maintained by the food personnel working for midday meal programme, supplying mid meals to children in govt. anganwadies (pre school center). The hygiene level, sanitary condition and microbial quality of food and water, pathological health examination of food handlers were assessed with the help of checklist. A questionnaire was designed to evaluate knowledge, attitude, and practices of food handlers. Results of the study show that the nutritional and health status of rural and urban preschool children was very poor. Many of the food handlers were not aware of general knowledge and hygiene practices to be followed during food preparation areas. An intervention programme of education and importing training at workplaces has shown a positive impact on the outcome of safety and security practices and safe, hygienic practices of food handlers at workplace.

Keywords: food, health, preschool children, safety, security

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2173 A Possible Connection Between Taste Change and Zinc Deficiency after Bariatric Surgery: A Literature Review

Authors: Boshra Mozaffar, Iskandar Idris

Abstract:

Taste change is a common complication after Bariatric surgery (BS). However, the cause of this is still not clear. Since zinc is important fortaste perception, zinc deficiency, which is common after BS, may play an important role for taste change after BS. In this review, we aimto collate evidence relating to taste change and zinc deficiencyin relation to BS; effects of zinc replacement on taste perception in general and thereafter discuss the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted, using four electronic bibliographical databases—EMBASE, PubMed, AMED and MEDLINE. We identified all available and relevant articles published before 30th February 2021.In total, 33 studies were included. The total number of participants analysed was N= 3264. We showed that taste change is a frequent complication after BS, especially after Roux-en-Y gastric bypass RYGBP comparing to other types of procedures. Patients' taste sensitivity differs among studies, but the most important decline in taste preference was observed for sweet food. Twelve studies investigating zinc deficiency following BS showed a significant decrease in zinc levels at six months after surgery. Supplementation with 45–50 mg of zinc sulphate was effective in improving taste, except in cancer patients, who showed no improvement in taste following zinc supplementation. Zinc deficiency appears to be associated with taste change after BS. Supplementation with much higher levels of zinc, at 45–50 mg, was effective in taste change treatment for many cases of taste disorder. The currently recommended levels of zinc replacements currently prescribed to patients following BS were not effective for avoiding zinc deficiency after BS—and thus not effective for averting taste change. It is therefore suggested that taste change following BS is closely related to zinc deficiency induced by the surgery.

Keywords: taste change, taste disorder, bariatric surgery, zinc, zinc sulphate or Zn, deficiency, supplementation, and micro-nutrient deficiencies

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2172 Servant Leadership for Elder Care in St. Camillus Health Systems, USA

Authors: Anthoni Jeorge

Abstract:

Throughout the history of the world, servant leadership has been researched, and favourable results such as individual, team, and organizational have been linked to the construct. This research paper designates St. Camillus de Lellis, a practitioner of servant leadership and founder of the Ministers of the Sick as a servant leader in his approach to care for the sick. Service is the visible face of his servant leadership. First of all, despite many challenges, St. Camillus de Lellis practiced leadership by the example of compassionate service to the sick. Second, he made service to the sick the highest priority of his life. Third, Camillus displayed servant leadership such that his manner of leadership gave birth to a New School of Service to the Sick. The paper identifies the distinctive dimensions and essential elements which characterized his service-centered leadership. Furthermore, discuss the six major characteristics of a servant leader as set forth by St. Camillus’s life example. The research illustrates the transformational power of servant leadership infield healthcare in general and, in doing so, provides servant leadership seekers ways servant leadership can transform elder care in one’s own field (St. Camillus Health Systems). Thus, it ascertains that servant leadership is best-fit for humanized elder care. Supported by the review of literature, the paper ascertains that Camillus, by identifying himself with the sick, gained deeper insights concerning the pain and suffering of the population. Uniquely drawn from his true grit, Camillus’ service-centered leadership is value-based, people-oriented, and compassion-filled. His way of service to the sick is the prolongation of gestures of mercy and compassion. It is hoped that the results of this study will help health care workers and servant leadership practitioners to humanize elder care and cultivate servant leadership attitude in their health care services to the sick. By incorporating such service-oriented elements into their leadership orientation, health care workers will be true servant leaders of the sick.

Keywords: leadership, service, healthcare, compassion

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2171 Relative Effectiveness of Inquiry: Approach and Expository Instructional Methods in Fostering Students’ Retention in Chemistry

Authors: Joy Johnbest Egbo

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The study was designed to investigate the relative effectiveness of inquiry role approach and expository instructional methods in fostering students’ retention in chemistry. Two research questions were answered and three null hypotheses were formulated and tested at 0.05 level of significance. A quasi-experimental (the non-equivalent pretest, posttest control group) design was adopted for the study. The population for the study comprised all senior secondary school class two (SS II) students who were offering Chemistry in single sex schools in Enugu Education Zone. The instrument for data collection was a self-developed Chemistry Retention Test (CRT). Relevant data were collected from a sample of one hundred and forty–one (141) students drawn from two secondary schools (1 male and 1 female schools) using simple random sampling technique. A reliability co-efficient of 0.82 was obtained for the instrument using Kuder Richardson formular20 (K-R20). Mean and Standard deviation scores were used to answer the research questions while two–way analysis of covariance (ANCOVA) was used to test the hypotheses. The findings showed that the students taught with Inquiry role approach retained the chemistry concept significantly higher than their counterparts taught with expository method. Female students retained slightly higher than their male counterparts. There is significant interaction between instructional packages and gender on Chemistry students’ retention. It was recommended, among others, that teachers should be encouraged to employ the use of Inquiry-role approach more in the teaching of chemistry and other subjects in general. By so doing, students’ retention of the subject could be increased.

Keywords: inquiry role approach, retention, exposition method, chemistry

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2170 Mineralogy and Thermobarometry of Xenoliths in Basalt from the Chanthaburi-Trat Gem Fields, Thailand

Authors: Apichet Boonsoong

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In the Chanthaburi-Trat basalts, xenoliths are composed of essentially ultramafic xenoliths (particularly spinel lherzolite) with a few of an aggregate of feldspar. Some 19 ultramafic xenoliths were collected from 13 different locations. They range in size from 3.5 to 60mm across. Most are weathered and oxidized on the surface but fresh samples are obtained from cut surfaces. Chemical analyses were performed on carbon-coated polished thin sections using a fully automated CAMECA SX-50 electron microprobe (EMPA) in wavelength-dispersive mode. In thin section, they are seen to consist of variable amounts of olivine, clinopyroxene, orthopyroxene with minor spinel and plagioclase, and are classed as lherzolite. Modal compositions of the ultramafic nodules vary with olivine (60-75%), clinopyroxene (20-30%), orthopyroxene (0-15%), minor spinel (1-3%) and plagioclase (<1%). The essential minerals form an equigranular, medium- to coarse-grained, granoblastic texture, and all are in mutual contact indicating attainment of equilibrium. Reaction rims are common along the nodule margins and in some are also present along grain boundaries. Zoning occurs in clinopyroxene, and to a lesser extent in orthopyroxene. The homogeneity of mineral compositions in lherzolite xenoliths suggests the attainment of equilibrium. The equilibration temperatures of these xenoliths are estimated to be in the range of 973 to 1063°C. Pressure estimates are not so easily obtained because no suitable barometer exists for garnet-free lherzolites and so an indirect method was used. The general mineral assemblage of the lherzolite xenoliths and the absence of garnet indicate a pressure range of approximately 12–19kbar, which is equivalent to depths approximately of 38 to 60km.

Keywords: chanthaburi-trat basalts, spinel lherzolite, xenoliths, 973 to 1063°C, 38 to 60km

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2169 Genetic Polymorphism in the Vitamin D Receptor Gene and 25-Hydroxyvitamin D Serum Levels in East Indian Women with Polycystic Ovary Syndrome

Authors: Dipanshu Sur, Ratnabali Chakravorty

Abstract:

Background: Polycystic ovary syndrome (PCOS) is the most common metabolic abnormality such as changes in lipid profile, diabetes, hypertension and metabolic syndrome occurring in young women of reproductive age. Low vitamin D levels were found to be associated with the development of obesity and insulin resistance in women with PCOS. Variants on vitamin D receptor (VDR) gene have also been related to metabolic comorbidities in general population. Aim: The aim of this case-control study was to investigate whether the VDR gene polymorphisms are associated with susceptibility to PCOS. Methods: Women with PCOS and a control group, all aged 16-40 years, were enrolled. Genotyping of VDR Fok-I (rs2228570), VDR Apa-I (rs7975232) as well as GC (rs2282679), DHCR7 (rs12785878) SNPs between groups were determined by using direct sequencing. Serum 25-hydroxyvitamin D [25(OH)] levels were measured by ELISA. Results: Mean serum 25(OH)D in the PCOS and control samples were 19.08±7 and 23.27±6.03 (p=0.048) which were significantly lower in PCOS patients compared with controls. CC genotype of the VDR Apa-I SNP was same frequent in PCOS (25.6%) and controls (25.6%) (OR: 0.9995; 95%CI: 0.528 to 1.8921; p= 0.9987). The CC genotype was also significantly associated with both lower E2 (p=0.031) and Androstenedione levels (p=0.062). We observed a significant association of GC polymorphism with 25(OH)D levels. PCOS women carrying the GG genotype (in GC genes) had significantly higher risk for vitamin D deficiency than women carrying the TT genotype. Conclusions: In conclusion, data from this study indicate that vitamin D levels are lower, and vitamin D deficiency more frequent, in PCOS than in controls. The present findings suggest that the Apa-I, Fok-I polymorphism of the VDR gene is associated with PCOS and seems to modulate ovarian steroid secretion. Further studies are needed to better clarify the biological mechanisms by which the polymorphism influences PCOS risk.

Keywords: vitamin D receptor, polymorphism, vitamin D, polycystic ovary syndrome

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2168 The Surgical Trainee Perception of the Operating Room Educational Environment

Authors: Neal Rupani

Abstract:

Background: A surgical trainee has limited learning opportunities in the operating room in order to gain an ever-increasing standard of surgical skill, competency, and proficiency. These opportunities continue to decline due to numerous factors such as the European Working Time Directive and increasing requirement for service provision. It is therefore imperative to obtain the highest educational value from each educational opportunity. A measure that has yet to be validated in England on surgical trainees called the Operating Room Educational Environment Measure (OREEM) has been developed to identify and evaluate each component of the educational environment with a view to steer future change in optimising educational events in theatre. Aims: The aims of the study are to assess the reliability of the OREEM within England and to evaluate the surgical trainee’s objective perspective of the current operating room educational environment within one region within England. Methods: Using a quantitative study approach, data was collected over one month from surgical trainees within Health Education Thames Valley (Oxford) using an online questionnaire consisting of demographic data, the OREEM, a global satisfaction score. Results: 140 surgical trainees were invited to the study, with an online response of 54 participants (response rate = 38.6%). The OREEM was shown to have good internal consistency (α = 0.906, variables = 40) and unidimensionality, along with all four of its subgroups. The mean OREEM score was 79.16%. The areas highlighted for improvement predominantly focused on improving learning opportunities (average subscale score = 72.9%) and conducting pre- and post-operative teaching (average score = 70.4%). The trainee perception is most satisfactory for the level of supervision and workload (average subscale score = 82.87%). There was no differences found between gender (U = 191.5, p = 0.535) or type of hospital (U = 258.0, p = 0.099), but the learning environment was favoured towards senior trainees (U = 223.5, p = 0.017). There was strong correlation between OREEM and the global satisfaction score (r = 0.755, p<0.001). Conclusions: The OREEM was shown to be reliable in measuring the educational environment in the operating room. This can be used to identify potentially modifiable components for improvement and as an audit tool to ensure high standards are being met. The current perception of the education environment in Health Education Thames Valley is satisfactory, and modifiable internal and external factors such as reducing service provision requirements, empowering trainees to plan lists, creating a team-working ethic between all personnel, and using tools that maximise learning from each operation have been identified to improve learning in the future. There is a favourable attitude to use of such improvement tools, especially for those currently dissatisfied.

Keywords: education environment, surgery, post-graduate education, OREEM

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2167 Evaluation of Goji By-Product as a Value-Added Ingredient for the Functional Food Industry

Authors: Sanaa Ragaee, Paragyani Bora, Wee Teng Tan, Xin Hu

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Goji berry (Lycium barbarum) is a member of the family Solanaceae which is grown widely in China, Tibet, and other parts of Asia. Its fruits are 1–2 cm-long, bright orange-red ellipsoid berries and it has a long tradition as a food and medicinal plant. Goji berries are believed to boost immune system properties. The berries are considered an excellent source of macronutrients, micronutrients, vitamins, minerals and several bioactive components. Studies have shown effects of goji fruit on aging, neuroprotection, general well-being, fatigue/endurance, metabolism/energy expenditure, glucose control in diabetics and glaucoma, antioxidant properties, immunomodulation and anti-tumor activity. Goji berries are being used to prepare Goji beverage, and the remaining solid material is considered as by-product. The by-product is currently unused and disposed as waste despite its potential as a value-added food ingredient. Therefore, this study is intended to evaluate nutritional properties of Goji by-product and its potential applications in the baking industry. The Goji by-product was freeze dried and ground to pass through 1 mm screen prior to evaluation and food use. The Goji by-product was found to be a rich source of fiber (54%) and free phenolic components (1,307 µg/g), protein (13.6%), ash (3.3%) and fat (10%). Incorporation of the Goji by-product in muffins and cookies at various levels (10-40%) significantly improved the nutritional quality of the baked products. The baked products were generally accepted and highly rated by panelists at 20% replacement level. The results indicate the potential of Goji by-product as a value-added ingredient in particular as a source of dietary fiber and protein.

Keywords: Goji, by-product, phenolics, fibers, baked products

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2166 Culture, Consumption, and Markets of Aesthetics: A10-Year Literature Review

Authors: Chin-Hsiang Chu

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This article review the literature in the field among the marketing and aesthetics, the current market and customer-oriented product sales, and gradually from the practical functionality, transformed into the visual appearance of the concept note and the importance of marketing experience substance 'economic Aesthetics' trend. How to introduce the concept of aesthetic and differentiate products have become an important content of marketing management in for an organization in marketing.In previous studies,marketing aesthetic related researches are rare.Therefore, the purpose of this study to explore the connection between aesthetics and marketing of the market economy, and aggregated content through literature review, trying to find related research implications for the management of marketing aesthetics, market-oriented and customer value and development of the product. In this study, the problem statement and background, the development of the theory of evolution, as well as methods and results of discovery stage, literature review was conducted to explore. The results found: (1) Study of Aesthetics will help deepen the shopping environment and service environment commonly understood. (2) the perceived value of products imported aesthetic, consumer willingness to buy, and even premium products will be more attractive. (3) marketing personnel for general marketing management with a high degree of aesthetic identity. (4) management in marketing aesthetics connotation, aesthetic characteristics of five elements is greatly valued by the real-time, complex, specificity, attract sexual and richness. (5) allows consumers to experience through the process due to stimulate the senses, the mind and thinking with the corporate brand or have a deeper link. Results of this study can be used as business in a competitive market, new product development and design of the guide.

Keywords: marketing aesthetics, aesthetics economic, aesthetic, experiential marketing

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2165 Intensification of Process Kinetics for Conversion of Organic Volatiles into Syngas Using Non-Thermal Plasma

Authors: Palash Kumar Mollick, Leire Olazar, Laura Santamaria, Pablo Comendador, Manomita Mollick, Gartzen Lopez, Martin Olazar

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The entire world is skeptical towards a silver line technology of converting plastic waste into valuable synthetic gas. At this junction, besides an adequately studied conventional catalytic process for steam reforming, a non-thermal plasma is being introduced. Organic volatiles are produced in the first step, pyrolysing the plastic materials. Resultant lightweight olefins and carbon monoxide are the major components that undergo a steam reforming process to achieve syngas. A non-thermal plasma consists of ionized gases and free electrons with an electronic temperature as high as 10³ K. Organic volatiles are, in general, endorganics inactive and thus demand huge bond-breaking energy. Conventional catalyst is incapable of providing the required activation energy, leading to poor thermodynamic equilibrium, whereas a non-thermal plasma can actively collide with reactants to produce a rich mix of reactive species, including vibrationally or electronically excited molecules, radicals, atoms, and ions. In addition, non-thermal plasma provides nonequilibrium conditions leading to electric discharge only in certain degrees of freedom without affecting the intrinsic chemical conditions of the participating reactants and products. In this work, we report thermodynamic and kinetic aspects of the conversion of organic volatiles into syngas using a non-thermal plasma. Detailed characteristics of plasma and its effect on the overall yield of the process will be presented.

Keywords: non thermal plasma, plasma catalysis, steam reforming, syngas, plastic waste, green energy

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2164 Wettability Properties of Pineapple Leaf Fibers and Banana Pseudostem Fibers Treated by Cold Plasma

Authors: Tatiana Franco, Hugo A. Estupinan

Abstract:

Banana pseudostem fiber (BPF) and pineapple leaf fiber (PLF) for their excellent mechanical properties and biodegradability characteristics arouse interest in different areas of research. F In tropical regions, where the banana pseudostem and the pineapple leaf are transformed into hard-to-handle solid waste, they can be low-cost raw material and environmentally sustainable in research for composite materials. In terms of functionality of this type of fiber, an open structure would allow the adsorption and retention of organic, inorganic and metallic species. In general, natural fibers have closed structures on their surface with intricate internal arrangements that can be used for the solution of environmental problems and other technological uses, however it is not possible to access their internal structure and sublayers, exposing the fibers in the natural state. An alternative method to chemical and enzymatic treatment are the processes with the plasma treatments, which are known to be clean, economical and controlled. In this type of treatment, a gas contained in a reactor in the form of plasma acts on the fiber generating changes in its structure, morphology and topography. This work compares the effects on fibers of PLF and BPF treated with cold argon plasma, alternating time and current. These fibers are grown in the regions of Antioquia-Colombia. The morphological, compositional and wettability properties of the fibers were analyzed by Raman microscopy, contact angle measurements, scanning electron microscopy (SEM) and atomic force microscopy analysis (AFM). The treatment with cold plasma on PLF and BPF allowed increasing its wettability, the topography and the microstructural relationship between lignin and cellulose.

Keywords: cold plasma, contact angle, natural fibers, Raman, SEM, wettability

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2163 Cloud Based Supply Chain Traceability

Authors: Kedar J. Mahadeshwar

Abstract:

Concept introduction: This paper talks about how an innovative cloud based analytics enabled solution that could address a major industry challenge that is approaching all of us globally faster than what one would think. The world of supply chain for drugs and devices is changing today at a rapid speed. In the US, the Drug Supply Chain Security Act (DSCSA) is a new law for Tracing, Verification and Serialization phasing in starting Jan 1, 2015 for manufacturers, repackagers, wholesalers and pharmacies / clinics. Similarly we are seeing pressures building up in Europe, China and many countries that would require an absolute traceability of every drug and device end to end. Companies (both manufacturers and distributors) can use this opportunity not only to be compliant but to differentiate themselves over competition. And moreover a country such as UAE can be the leader in coming up with a global solution that brings innovation in this industry. Problem definition and timing: The problem of counterfeit drug market, recognized by FDA, causes billions of dollars loss every year. Even in UAE, the concerns over prevalence of counterfeit drugs, which enter through ports such as Dubai remains a big concern, as per UAE pharma and healthcare report, Q1 2015. Distribution of drugs and devices involves multiple processes and systems that do not talk to each other. Consumer confidence is at risk due to this lack of traceability and any leading provider is at risk of losing its reputation. Globally there is an increasing pressure by government and regulatory bodies to trace serial numbers and lot numbers of every drug and medical devices throughout a supply chain. Though many of large corporations use some form of ERP (enterprise resource planning) software, it is far from having a capability to trace a lot and serial number beyond the enterprise and making this information easily available real time. Solution: The solution here talks about a service provider that allows all subscribers to take advantage of this service. The solution allows a service provider regardless of its physical location, to host this cloud based traceability and analytics solution of millions of distribution transactions that capture lots of each drug and device. The solution platform will capture a movement of every medical device and drug end to end from its manufacturer to a hospital or a doctor through a series of distributor or retail network. The platform also provides advanced analytics solution to do some intelligent reporting online. Why Dubai? Opportunity exists with huge investment done in Dubai healthcare city also with using technology and infrastructure to attract more FDI to provide such a service. UAE and countries similar will be facing this pressure from regulators globally in near future. But more interestingly, Dubai can attract such innovators/companies to run and host such a cloud based solution and become a hub of such traceability globally.

Keywords: cloud, pharmaceutical, supply chain, tracking

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2162 A 20 Year Comparison of Australian Childhood Bicycle Injuries – Have We Made a Difference?

Authors: Bronwyn Griffin, Caroline Acton, Tona Gillen, Roy Kimble

Abstract:

Background: Bicycle riding is a common recreational activity enjoyed by many children throughout Australia that has been associated with the usual caveat of benefits related to exercise and recreation. Given Australia was the first country in the world to introduce cyclist helmet laws in 1991, very few publications have reviewed paediatric cycling injuries (fatal or non-fatal) since. Objectives: To identify trends in children (0-16 years) who required admission for greater than 24 hours following a bicycle-related injury (fatal and non-fatal) in Queensland. Further, to discuss changes that have occurred in paediatric cycling injury trends in Queensland since a prominent local study/publication in 1995. This paper aims to establish evidence to inform interventions promoting safer riding to parents, children and communities. Methods: Data on paediatric (0-16 years) cycling injuries in Queensland resulting in hospital admission more than 24 hours across three tertiary paediatric hospitals in Brisbane between November 2008-June 2015 was compiled by the Paediatric Trauma Data Registry for non-fatal injuries. The Child Death Review Team at the Queensland Families and Childhood Commission provided data on fatalities in children <17years from (June 2004 –June 2015). Comparing trends to a local study published in 1995 Results: Between 2008-2015 there were 197 patients admitted for greater than 24 hours following a cycling injury. The median age was 11 years, with males more frequently involved (n=139, 87%) compared to females. Mean length of stay was three days, with 47 (28%) children admitted to PICU, location of injury was most often the street (n=63, 37%). Between 2004 –2015 there were 15 fatalities (Incidence rate 0.25/100,000); all were male, 14/15 occurred on the street, with eight stated to have not been wearing a helmet, 11/15 children came from the least advantaged socio-economic group (SEIFA) compared to a local publication in 1995, finding of 94 fatalities between (1981-1992). Conclusions: There has been a notable decrease in incidence of fatalities between the two time periods with incidence rates dropping from 1.75-0.25/100,000. More statistics need to be run to ascertain if this is a true reduction or perhaps a decrease in children riding bicycles. Injuries that occur on the street that come in contact with a car remain of serious concern. The purpose of this paper is not to discourage bicycle riding among child and adolescent populations, rather, inform parents and the wider community about the risks associated with cycling in order to reduce injuries associated with this sport, whilst promoting safe cycling.

Keywords: paediatric, cycling, trauma, prevention, emergency

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2161 Africa and the Gas Supply Crisis to European Countries under the Russian-Ukrainian War: A Study on the Nigerian-Algerian Gas Pipeline project Importance

Authors: Mohammed Lamine Benaouda

Abstract:

This paper seeks to shed light on the African continent role with the crisis of natural gas supplies to European countries, which resulted from the repercussions of the Russian-Ukrainian war, by examining the case of re-launching the Trans-Saharan Gas Pipeline project Nigeria-Algeria, and clarifying the strategic importance This project is mutually beneficial in the long run. The paper relied on the analytical and statistical method in order to find out the the impact that the project represents on the huge needs of the European gas market on the one hand, and monitoring the various economic gains for Algeria and Nigeria on the other hand, in addition, the comparative approach to assess the possible effects of the success and feasibility of the project economy for all its beneficiaries. The paper founds that the complexity has multiplied in the global energy market in general and the European one in particular, following what the world witnessed from the repercussions of the Russian-Ukrainian war, as well as the extreme importance of the poles of African countries in the arena of the international struggle over resources, which allows them a margin From maneuvering and regional and global influence in various fields. With regard to the research outcoms and the future scope, the researcher believes that the African continent, in light of international competition and conflict, as well as what the world is witnessing in terms of restoring balances of power in the current international system, will play very important roles, especially with its enormous natural and human capabilities, which enable it to Weighting future conflicts over energy and spheres of influence.

Keywords: algeria, nigeria, west africa, ECOWAS, gas supplies, russia, ukrain

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2160 Neuroecological Approach for Anthropological Studies in Archaeology

Authors: Kalangi Rodrigo

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The term Neuroecology elucidates the study of customizable variation in cognition and the brain. Subject marked the birth since 1980s, when researches began to apply methods of comparative evolutionary biology to cognitive processes and the underlying neural mechanisms of cognition. In Archaeology and Anthropology, we observe behaviors such as social learning skills, innovative feeding and foraging, tool use and social manipulation to determine the cognitive processes of ancient mankind. Depending on the brainstem size was used as a control variable, and phylogeny was controlled using independent contrasts. Both disciplines need to enriched with comparative literature and neurological experimental, behavioral studies among tribal peoples as well as primate groups which will lead the research to a potential end. Neuroecology examines the relations between ecological selection pressure and mankind or sex differences in cognition and the brain. The goal of neuroecology is to understand how natural law acts on perception and its neural apparatus. Furthermore, neuroecology will eventually lead both principal disciplines to Ethology, where human behaviors and social management studies from a biological perspective. It can be either ethnoarchaeological or prehistoric. Archaeology should adopt general approach of neuroecology, phylogenetic comparative methods can be used in the field, and new findings on the cognitive mechanisms and brain structures involved mating systems, social organization, communication and foraging. The contribution of neuroecology to archaeology and anthropology is the information it provides on the selective pressures that have influenced the evolution of cognition and brain structure of the mankind. It will shed a new light to the path of evolutionary studies including behavioral ecology, primate archaeology and cognitive archaeology.

Keywords: Neuroecology, Archaeology, Brain Evolution, Cognitive Archaeology

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2159 The Impact of Strategic Information in Developing the Target Cost Approach to achieve Competitive Advantage

Authors: Rizgar Abdullah Sabir Jaf, Bayan Sedeeq Azeez Hussin, Dler Moosa Ahmed Karim

Abstract:

Presently, economic and technological developments are growing faster in an unparalleled way. The result of that is innovative changing a great deal of a great deal of assumption, concepts, transactions, and high of competition between companies all over the world. The title of the thesis is one of the subjects that get large concerns in the financial and business world in the present time. That is because many competitive firms have appeared in the regional and global markets and the rapid changes that covered all fields of life. The subjects of the dissertation have a special importance in making the firm's businesses succeed in general and the industrial firms especially. Thus, the basic purpose of this study is to determine whether target costing is used in the costing application process in their customer expectation, profit margin, cost and price determination, cost reduction and management operations. In today’s intensely competitive and highly volatile business environment, consistent development of low cost and high quality products meeting the functional requirements is a key to a company's survival. Companies continuously strive to reduce the costs while still producing quality products to stay ahead in the competition. Many companies have turned to target costing to achieve this objective. The results indicate that there is a significant positive relationship (at the significance level less than 0.05) between the factors competitive advantage and management accounting techniques in the firm's sample study.

Keywords: strategic information, target cost, competitive advantage, Iraqi soft drink firms

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2158 Survey of Some Important Nepalese and Russian Anti-Diabetic Herbs

Authors: Ram Prasad Baral, Vinogradov Dmitriy Valerievich, Rameshwar Adhikari

Abstract:

Diabetes has posed a great threat to the human health worldwide, both in developed and developing countries. The disease has basically rooted from the dramatically changed way of living of the present day human civilization as our living has deviated from what the nature has adapted us for. In this context, due to availability of wide range of climatic condition and hence the wide spectrum of biodiversity, Nepal is blessed with a valuable reservoir of medicinal herbs. These assets have been utilized and developed practices in traditional medicines and Ayurvedic way of treatment over several thousand years in the region. It has been established since ancient times that each and every plant has a specific medicinal value. There are many plants’ products which have been utilized in Ayurvedic medicine for the effective treatment of diabetes. The medicaments are less expensive and pose practically no side effects. In this work, we report a general survey of anti-diabetic properties of some medicinal herbs with pronounced effects and their applications. The plants covered in this study originate from far western region of Nepal and include Ficus racemosa, Momordica charantia, Azadirachta indica, Helieteres isora, Saraca asoca, Ichnocarpus frutescens, Tinospora sinensis, Commiphora mukul, Coccinia grandis, and Hippophae salicifolia.

Keywords: Ficus racemosa, Momordica charantia, Azadirachta indica, Helieteres isora, Saraca asoca, Ichnocarpus frutescens, Tinospora sinensis, Commiphora mukul, Coccinia grandis, Hippophae salicifolia

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2157 Improving Sample Analysis and Interpretation Using QIAGENs Latest Investigator STR Multiplex PCR Assays with a Novel Quality Sensor

Authors: Daniel Mueller, Melanie Breitbach, Stefan Cornelius, Sarah Pakulla-Dickel, Margaretha Koenig, Anke Prochnow, Mario Scherer

Abstract:

The European STR standard set (ESS) of loci as well as the new expanded CODIS core loci set as recommended by the CODIS Core Loci Working Group, has led to a higher standardization and harmonization in STR analysis across borders. Various multiplex PCRs assays have since been developed for the analysis of these 17 ESS or 23 CODIS expansion STR markers that all meet high technical demands. However, forensic analysts are often faced with difficult STR results and the questions thereupon. What is the reason that no peaks are visible in the electropherogram? Did the PCR fail? Was the DNA concentration too low? QIAGEN’s newest Investigator STR kits contain a novel Quality Sensor (QS) that acts as internal performance control and gives useful information for evaluating the amplification efficiency of the PCR. QS indicates if the reaction has worked in general and furthermore allows discriminating between the presence of inhibitors or DNA degradation as a cause for the typical ski slope effect observed in STR profiles of such challenging samples. This information can be used to choose the most appropriate rework strategy.Based on the latest PCR chemistry called FRM 2.0, QIAGEN now provides the next technological generation for STR analysis, the Investigator ESSplex SE QS and Investigator 24plex QS Kits. The new PCR chemistry ensures robust and fast PCR amplification with improved inhibitor resistance and easy handling for a manual or automated setup. The short cycling time of 60 min reduces the duration of the total PCR analysis to make a whole workflow analysis in one day more likely. To facilitate the interpretation of STR results a smart primer design was applied for best possible marker distribution, highest concordance rates and a robust gender typing.

Keywords: PCR, QIAGEN, quality sensor, STR

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2156 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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2155 Determinants of Pastoral Women's Demand for Credit: Evidence from Northern Kenya

Authors: Anne Gesare Timu, Megan Sheahan, Andrew Gache Mude, Rupsha Banerjee

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Women headed households are among the most vulnerable to negative climatic shocks and are often left poorer as a result. Credit provision has been recognized as one way of alleviating rural poverty and developing poor rural households’ resilience to shocks. Much has been documented about credit demand in small-holder agriculture settings in Kenya. However, little is known about demand for credit among pastoral women. This paper analyzes the determinants of demand for credit in the pastoral regions of Marsabit District of Northern Kenya. Using a five wave balanced panel data set of 820 households, a double hurdle model is employed to analyze if shocks, financial literacy and risk aversion affect credit demand among female and male headed households differently. The results show that borrowing goods on credit and monetary credit from informal market segments are the most common sources of credit in the study area. The impact of livestock loss and financial literacy on the decision to borrow and how much to borrow vary with gender. While the paper suggests that provision of credit is particularly valuable in the aftermath of a negative shock and more so for female-headed households, it also explores alternatives to the provision of credit where credit access is a constraint. It recommends further understanding of systems and institutions which could enhance access to credit, and particularly during times of stress, to enable households in the study area in particular and Northern Kenya in general to invest, engage in meaningful development and growth, and be resilient to persistent shocks.

Keywords: female headed households, pastoralism, rural financing, double hurdle model

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2154 Person-Centered Approaches in Face-to-Face Interventions to Support Enrolment in Cardiac Rehabilitation: A Scoping Review Study

Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

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BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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2153 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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2152 Preliminary Studies on the Potentials of Bambara nut (Voandzeia substerranea) and Pigeon pea (Cajanus cajan) as Imitation Milk

Authors: Onuoha Gideon

Abstract:

The preliminary studies on the potentials of Bambara nut and pigeon pea as imitation milk were investigated. Bambara nut and Pigeon pea milk were produced from two separate unit operations; Bambara nut seed was cooked, dehulled, milled and strained to milk (BCM) and another batch was toasted at moderate temperature, dehulled, milled and strained to milk (BTM). Pigeon pea seed was cooked, dehulled, milled and strained to milk (PCM) and another batch was toasted at moderate temperature, dehulled, milled and strained to milk (PTM). The result of the proximate analysis on the milk samples on wet basis showed that the protein content ranged from 28.56 – 26.77, the crude fibre ranged from 6.28 – 1.85, the ash content ranged from 5.22 – 1.17, the fat content ranged from 2.71 – 1.12, the moisture content ranged from 95.93 – 93.83, the carbohydrate content ranged from 67.62 – 58.83. The functional analysis on the milk samples showed that emulsification capacity ranged from 43.21 – 38.66, emulsion stability ranged from 34.10 – 25.00, the specific gravity ranged from 997.50 – 945.00, the foaming capacity ranged from 3,500 to 2,250, the measurement of viscosity ranged from 0.017 – 0.007, the pH range from 5.55 – 5.25, the measurement of dispersibility range from 11.00 – 7.00, the total soluble solid ranged from 4.00 to 1.75, the total titratable acidity ranged from 0.314 – 0.328. The sensory evaluation report showed that in terms of flavor, sample BCM and PCM value were significantly different from sample BTM and PTM. In terms of colour, sample BCM showed a significant difference from samples BTM, PCM and PTM. In term of texture, sample BCM was significantly different from samples BTM, PCM and PTM. The general acceptability shows that sample BCM was significantly different from other the samples and was the most accepted. The microbial analysis indicated that the microbial load increases with time. Bacterial count ranged from 1.3 x 105 – 1.20 x 106 to 1.6 x 105 – 1.06 x 106, fungal count ranged from 4.0 x 105 – 8.0 x 105 to 4.0 x 105 – 7.0 x 105. The studies showed that BCM was the most preferred.

Keywords: imitation milk, Bambara nut, Pigeon pea, proximate composition

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