Search results for: sample hospital
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7835

Search results for: sample hospital

3035 Attributable Mortality of Nosocomial Infection: A Nested Case Control Study in Tunisia

Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said

Abstract:

Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.

Keywords: intensive care unit, mortality, nosocomial infection, risk factors

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3034 Industrial Ergonomics Improvement at a Refrigerator Manufacturing Company in Iran: An Approach on Interventional Ergonomics

Authors: Hassan S. Naeini

Abstract:

Nowadays a lot of people are working in several sorts of industrial sectors in which there are some risk factors which threaten human being especially in developing countries. One of the main problems which effect on workers’ health refers to Ergonomics. Ergonomics as multidisciplinary science concerns workers’ health and safety in terms of somatic and mental concepts. Surely ergonomics interventions and improvement make a better condition for workers and change the quality of working life to better condition. In this study, one of the factories in Iran which is producing some kinds of small and medium size of refrigerators was chosen as the sample. The preliminary ergonomics observation of the mentioned factory showed that there are some risk factors in terms of ergonomics aspects, so an ergonomic intervention was defined, then some ergonomic assessment methods such as NMQ,OWAS, and Environmental Ergonomic Assessment were used. Also Anthropometric measurement was done. This study shows that there are some workstations and plants which suffer some degrees of ergonomic problems. Considering with the gathered data, illumination, noise control and workstation design in metal workstation are known as the priority actions. Some parts of the mentioned interventions are ongoing actions. it seems that the mentioned intervention and workstations design make a better condition for workers, because ergonomics make a safer and more sustainable environments for human being.

Keywords: anthropometry, ergonomics, health, NMQ, OWAS

Procedia PDF Downloads 732
3033 Characteristics and Quality of Chilean Abalone Undergoing Different Drying Emerging Technologies

Authors: Mario Pérez-Won, Anais Palma-Acevedo, Luis González-Cavieres, Roberto Lemus-Mondaca, Gipsy Tabilo-Munizaga

Abstract:

The Chilean abalone (Concholepas Concholepas) is a gastropod mollusk; it has a high commercial value due to the qualities of its meat, especially hardness, as a critical acceptance parameter. However, its main problem is its short shelf-life which is usually extended using traditional technologies with high energy consumption. Therefore, applying different technologies for the pre-treatment and drying process is necessary. In this research, pulsed electric field (PEF) was used as a pre-treatment for vacuum microwave drying (VMD), freeze-drying (FD), and hot-air drying (HAD). Drying conditions and characteristics were set according to previous experiments. The Drying samples were analyzed in terms of physical quality (color, texture, microstructure, and rehydration capacity), protein quality (degree of hydrolysis and computer protein efficiency ratio), and energy parameters. Regarding quality, the treatment that obtained lower harness was PEF+FD (195 N ± 10), the lowest change of color was for treatment PEF+VMD (ΔE: 17 ± 1.5), and the best rehydration capacity was for treatment PEF+VMD (1.2 h for equilibrium). For protein quality, the highest Computer-Protein Efficiency Ratio was the sample 2.0 kV/ cm of PEF (index of 4.18 ± 0.26 at the end of the digestion). Moreover, about energetic consumption, results show that VMD decreases the drying process by 97% whether PEF was used or not. Consequently, it is possible to conclude that using PEF as a pre-treatment for VMD and FD treatments has advantages that must be used following the consumer’s needs or preferences.

Keywords: chilean abalone, freeze-drying, proteins, pulsed electric fields

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3032 Synthesis, Characterization and Photocatalytic Performance of Visible Light Induced Materials

Authors: M. Muneer, Waseem Raza

Abstract:

Nano-crystalline materials of pure and metal-doped semiconducting materials have been successfully synthesized using sol gel and hydrothermal methods. The prepared materials were characterized by standard analytical techniques, i.e., XRD, SEM, EDX, UV–vis Spectroscopy and FTIR. The (XRD) analysis showed that the obtained particles are present in partial crystalline nature and exhibit no other impurity phase. The EDX and (SEM) images depicted that metals have been successfully loaded on the surface of the semiconductor. FTIR showed an additional absorption band at 910 cm−1, characteristic of absorption band indicating the incorporation of dopant into the lattice in addition to a broad and strong absorption band in the region of 410–580 cm−1 due to metal–O stretching. The UV–vis absorption spectra of synthesized particles indicate that the doping of metals into the lattice shift the absorption band towards the visible region. Thermal analysis, measurement of the synthesized sample showed that the thermal stability of pure semiconducting material is decreased due to increase in dopant concentration. The photocatalytic activity of the synthesized particles was studied by measuring the change in concentration of three different chromophoric dyes as a function of irradiation time. The photocatalytic activity of doped materials were found to increase with increase in dopant concentration.

Keywords: photocatalysis, metal doped semicondcutors, dye degradation, visible light active materials

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3031 Carbon-Nanodots Modified Glassy Carbon Electrode for the Electroanalysis of Selenium in Water

Authors: Azeez O. Idris, Benjamin O. Orimolade, Potlako J. Mafa, Alex T. Kuvarega, Usisipho Feleni, Bhekie B. Mamba

Abstract:

We report a simple and cheaper method for the electrochemical detection of Se(IV) using carbon nanodots (CNDTs) prepared from oat. The carbon nanodots were synthesised by green and facile approach and characterised using scanning electron microscopy, high-resolution transmission electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, and Raman spectroscopy. The CNDT was used to fabricate an electrochemical sensor for the quantification of Se(IV) in water. The modification of glassy carbon electrode (GCE) with carbon nanodots led to an increase in the electroactive surface area of the electrode, which enhances the redox current peak of [Fe(CN)₆]₃₋/₄‒ in comparison to the bare GCE. Using the square wave voltammetry, the detection limit and quantification limit of 0.05 and 0.167 ppb were obtained under the optimised parameters using deposition potential of -200 mV, 0.1 M HNO₃ electrolyte, electrodeposition time of 60 s, and pH 1. The results further revealed that the GCE-CNDT was not susceptible to many interfering cations except Cu(II) and Pb(II), and Fe(II). The sensor fabrication involves a one-step electrode modification and was used to detect Se(IV) in a real water sample, and the result obtained is in agreement with the inductively coupled plasma technique. Overall, the electrode offers a cheap, fast, and sensitive way of detecting selenium in environmental matrices.

Keywords: carbon nanodots, square wave voltammetry, nanomaterials, selenium, sensor

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3030 Achieving Competitive Advantage Through Internal Resources and Competences

Authors: Ibrahim Alkandi

Abstract:

This study aims at understanding how banks can utilize their resources and capabilities to achieve a competitive advantage. The resource-based approach has been applied to assess the resources and capabilities as well as how the management perceives them as sources of competitive advantages. A quantitative approach was implemented using cross-sectional data. The research population consisted of Top managers in financial companies in Saudi Arabia, and the sample comprised 79 managers. The resources were sub divided into tangible and intangible. Among the variables that will be assessed in the research include propriety rights, trademark which is the brand, communication as well as organizational culture. To achieve the objective of the research, Multivariate analysis through multiple regression was used. The research tool used is a questionnaire whose validity is also assessed. According to the results of the study, there is a significant relationship between bank’s performance and the strategic management of propriety rights, trademark, administrative and financial skills as well as bank culture. Therefore, the research assessed four aspects, among the variables in the model, in relation to the strategic performance of these banks. The aspects considered were trademark, communication, administrative and leadership style as well as the company’s culture. Hence, this paper contributes to the body of literature by providing empirical evidence of the resources influencing both banks’ market and economic performance.

Keywords: competitive advantage, Saudi banks, strategic management, RBV

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3029 Improving the Deficiencies in Entrepreneurship Training for Small Businesses in Emerging Markets

Authors: Eno Jah Tabogo

Abstract:

The aim of this research is to identify and examine current deficiencies in entrepreneurial training in improving the performance of small businesses in sub Saharan Africa economies. This research achieves this by examining the course content, training methods, and profiles of trainers and trainees of small business service providers in Sub Saharan Africa (SSA) to identify training deficiencies in improving small businesses. Data was for the analysis was collected from a sample of four entrepreneurial training providers in SSA. These four providers served an average of 1,500 trainees. Questionnaire was used to collect data via face to face and through telephone. Face validity was determined by distributing the questionnaire among a group of colleagues, followed by a group discussion to strengthen the validity of the questionnaire. Interviews were also held with managers of training programs. Content and descriptive statistics was used to analyse the data collected. The results indicated only 25% of the training content were entrepreneurial. In terms of service provided, both business, entrepreneurial, technical and after-care services were identified. It was also discovered that owners of training firms had no formal entrepreneurship background. The paper contributes by advocating for a comprehensive entrepreneurship-training program for successful small business enterprises. Recommendations that could help sustain emerging small business enterprises and direction for further research are presented.

Keywords: entrepreneurship, emerging markets, small business, training

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3028 Efficient Principal Components Estimation of Large Factor Models

Authors: Rachida Ouysse

Abstract:

This paper proposes a constrained principal components (CnPC) estimator for efficient estimation of large-dimensional factor models when errors are cross sectionally correlated and the number of cross-sections (N) may be larger than the number of observations (T). Although principal components (PC) method is consistent for any path of the panel dimensions, it is inefficient as the errors are treated to be homoskedastic and uncorrelated. The new CnPC exploits the assumption of bounded cross-sectional dependence, which defines Chamberlain and Rothschild’s (1983) approximate factor structure, as an explicit constraint and solves a constrained PC problem. The CnPC method is computationally equivalent to the PC method applied to a regularized form of the data covariance matrix. Unlike maximum likelihood type methods, the CnPC method does not require inverting a large covariance matrix and thus is valid for panels with N ≥ T. The paper derives a convergence rate and an asymptotic normality result for the CnPC estimators of the common factors. We provide feasible estimators and show in a simulation study that they are more accurate than the PC estimator, especially for panels with N larger than T, and the generalized PC type estimators, especially for panels with N almost as large as T.

Keywords: high dimensionality, unknown factors, principal components, cross-sectional correlation, shrinkage regression, regularization, pseudo-out-of-sample forecasting

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3027 Case Report on Sepsis by Alpha-Hemolytic Streptococcus and Mannheimia haemolytica in Neonate Dogs

Authors: Maria L. G. Lourenco, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

Neonatal sepsis is a systemic response of acute infection by bacteria that may lead to high mortality in a litter. This study aims to report a case of sepsis by alpha-hemolytic Streptococcus and Mannheimia haemolytica in neonate dogs. A pregnant, mixed-breed bitch at approximately the 60th day of pregnancy was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, and subjected to a c-section due to uterine atony and fetuses no heartbeats on the ultrasound examination. The mother presented leukopenia of 1.6 thousand leukocytes, and there was no other information regarding previous clinical history. Among the offspring, four were stillborn, and five were born alive. On clinical examination, neonates weighed between 312 and 384 grams. Reflexes were present, and the newborn's body temperature was between 89.9 ºF and 96.4 ºF. Neonates also presented clinical signs of neonatal infection: omphalitis, abdomen, and extremities with cyanotic color, hematuria, and diarrhea (meconium). Complementary tests revealed leukopenia. The presence of alpha hemolytic streptococcus and Mannheimia haemolytica was revealed in the bacterial culture. The bacteria were sensitive to cephalosporins and penicillin on the antibiogram. Treatment for sepsis was instituted with the drug ceftriaxone, at a dose of 50 mg per kilogram, administered intravenous (jugular vein). Subsequently administered subcutaneous, every 12 hours, for seven days. Heated fluid therapy was performed, with Ringer lactate, at a dose of 4 ml per 100 grams of weight, intravenous. Heating measures were instituted. Blood plasma was also administered, at a dose of 2 mL per 100 grams of weight, administered subcutaneous, as a source of passive immunity. A maternal milk substitute was instituted, and lactation was discontinued since the mother was unable to nurse due to the infection. The mother was neutered during the c-section and treated with ceftriaxone (50 mg/kg). After seven days, the newborns presented normal clinical signs and no alterations in the hemogram. Early diagnosis and intervention were essential for the survival of these patients.

Keywords: neonatal infection, puppies, bacteria, newborn

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3026 Antioxidant Activity, Total Phenolic Contents, and Functional Group Identification of Leaf Extracts among Lemongrass (Cymbopogon citratus) Accessions

Authors: Oyenike A. Adeyemo, Elizabeth Osibote, Adeyemi Adedugba, Olatunde A. Bhadmus, Adeoluwa A. Adeoshun, Mariam O. Allison

Abstract:

Lemongrass leaves are widely used for tea and the treatment of malaria. The present study used Soxhlet extraction with aqueous ethanol (v/v). Fresh and dried leaves of selected ten lemongrasses (Cymbopogon citratus) accessions from different geographical regions in Nigeria were examined for total phenolic contents, and antioxidant activities. Aqueous methanol extraction was carried out and further partitioned into hexane, ethyl acetate, and butanol to obtain fractions according to their polarities. Fourier Transform Infrared Spectroscopy (FTIR) was carried out to identify the functional groups that may be present. Among the ten accessions, the leaf extracts at five different concentrations exhibited increasing antioxidant activities using DPPH (2,2-diphenyl- 1- picrylhydrazyl) radical scavenging test, stronger activities for dried leaves (71.15 ± 0.14 - 89.79 ± 0.16µg/ml) than fresh leaves (71.65 ± 0.45 -81.94 ± 0.84 µg/ml) at 100 µg/ml of sample extract. The total phenolic contents of dried leaf extracts revealed higher amounts in all lines ranging from 19.57±0.57 to 43.17±0.67mg gallic acid equivalent /100 g DW when compared with fresh leaf extracts, where the values ranged from 9.68 ± 2.20 to 28.5 ± 3.90 mg gallic acid equivalent /100 g fresh weight except for two lines which showed greater total phenolic contents than in the dried leaves. High total phenolic content may help contribute to the overall high antioxidant activity of the plant. FTIR identified the presence of major active functional groups including alcohol, ester, amide, alkanes, alkenes, carboxylic acid, ketones, and aldehyde in four partitioning solvents (n-hexane, ethyl acetate, butanol, and methanol) leaf extracts of lemongrass samples.Lemongrass leaves are widely used for tea and the treatment of malaria. The present study used Soxhlet extraction with aqueous ethanol (v/v). Fresh and dried leaves of selected ten lemongrasses (Cymbopogon citratus) accessions from different geographical regions in Nigeria were examined for total phenolic contents, and antioxidant activities. Aqueous methanol extraction was carried out and further partitioned into hexane, ethyl acetate, and butanol to obtain fractions according to their polarities. Fourier Transform Infrared Spectroscopy (FTIR) was carried out to identify the functional groups that may be present. Among the ten accessions, the leaf extracts at five different concentrations exhibited increasing antioxidant activities using DPPH (2,2-diphenyl- 1- picrylhydrazyl) radical scavenging test, stronger activities for dried leaves (71.15 ± 0.14 - 89.79 ± 0.16µg/ml) than fresh leaves (71.65 ± 0.45 -81.94 ± 0.84 µg/ml) at 100 µg/ml of sample extract. The total phenolic contents of dried leaf extracts revealed higher amounts in all lines ranging from 19.57±0.57 to 43.17±0.67mg gallic acid equivalent /100 g DW when compared with fresh leaf extracts, where the values ranged from 9.68 ± 2.20 to 28.5 ± 3.90 mg gallic acid equivalent /100 g fresh weight except for two lines which showed greater total phenolic contents than in the dried leaves. High total phenolic content may help contribute to the overall high antioxidant activity of the plant. FTIR identified the presence of major active functional groups including alcohol, ester, amide, alkanes, alkenes, carboxylic acid, ketones, and aldehyde in four partitioning solvents (n-hexane, ethyl acetate, butanol, and methanol) leaf extracts of lemongrass samples.

Keywords: antioxidant acivity, phenolic content, natural product, FTIR

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3025 An Investigation into the Strategies Adopted by Women Entrepreneurs to Ensure Small Business Success in Nkonkobe Municipality, Eastern Cape Province, South Africa

Authors: Agholor Deborah Ewere, Emmanuel Ade, Seriki Idowu

Abstract:

The role women entrepreneur plays to combat unemployment should not be underestimated, especially in countries with growing unemployment rates such as South Africa. Women entrepreneurs contribute significantly to economic development in South Africa, but their contribution has not been adequately studied and developed. Hence, the study identified business strategies adopted by women entrepreneurs to sustain growth and development of entrepreneurship. Survey research design approach was adopted and convenience sampling method was used for sample selection. The structured questionnaire was used to elicit information from the respondents. The findings revealed some of the operational challenges women entrepreneur faced to include lack of finance, marketing skills and planning and also showed that the strategies adopted by women entrepreneurs have a positive effect on the success of small businesses. It was recommended among others that the women entrepreneurs should take some time to study the nature of challenges other women have faced in business and possibly provide solutions to such issues before starting their own business. It was however concluded that unless the operational challenges named above are resolved, the role of women entrepreneurs in the developing nations will continue to experience deprived economic growth, development and display substandard competitiveness.

Keywords: business, entrepreneurs, small, strategies, success, women

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3024 Purification and Pre-Crystallization of Recombinant PhoR Cytoplasmic Domain Protein from Mycobacterium Tuberculosis H37Rv

Authors: Oktira Roka Aji, Maelita R. Moeis, Ihsanawati, Ernawati A. Giri-Rachman

Abstract:

Globally, tuberculosis (TB) remains a leading cause of death. The emergence of multidrug-resistant strains and extensively drug-resistant strains have become a major public concern. One of the potential candidates for drug target is the cytoplasmic domain of PhoR Histidine Kinase, a part of the Two Component System (TCS) PhoR-PhoP in Mycobacterium tuberculosis (Mtb). TCS PhoR-PhoP relay extracellular signal to control the expression of 114 virulent associated genes in Mtb. The 3D structure of PhoR cytoplasmic domain is needed to screen novel drugs using structure based drug discovery. The PhoR cytoplasmic domain from Mtb H37Rv was overexpressed in E. coli BL21(DE3), then purified using IMAC Ni-NTA Agarose his-tag affinity column and DEAE-ion exchange column chromatography. The molecular weight of the purified protein was estimated to be 37 kDa after SDS-PAGE analysis. This sample was used for pre-crystallization screening by applying sitting drop vapor diffusion method using Natrix (HR2-116) 48 solutions crystal screen kit at 25ºC. Needle-like crystals were observed after the seventh day of incubation in test solution No.47 (0.1 M KCl, 0.01 M MgCl2.6H2O, 0.05 M Tris-Cl pH 8.5, 30% v/v PEG 4000). Further testing is required for confirming the crystal.

Keywords: tuberculosis, two component system, histidine kinase, needle-like crystals

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3023 A Study to Assess the Employment Ambitions of Graduating Students from College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

Authors: J. George, M. Al Mutairi, W. Aljuryyad, A. Alhussanan, A. Alkashan, T. Aldoghiri, Z. Alamari, A. Albakr

Abstract:

Introduction: Students make plans for their career and are keen in exploring options of employment in those carriers. They make their employment choice based on their desires and preferences. This study aims to identify if students of King Saud Bin Abdulaziz for Health Sciences, College of Applied Medical Sciences after obtaining appropriate education prefer to work as clinicians, university faculty, or full-time researchers. There are limited studies in Saudi Arabia exploring the university student’s employment choices and preferences. This study would help employers to build the required job positions and prevent misleading employers from opening undesired positions in the job market. Methodology: The study included 394 students from third and fourth years both male and female among the eighth programs of college of applied medical sciences, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh campus. A prospective quantitative cross-sectional study was conducted; data were collected by distributing a seven item questionnaire and analyzed using SPSS. Results: Among the participants, 358 (90.9%) of them chose one of the three listed career choices, 263 (66.8%) decided to work as hospital staff after their education, 75 students (19.0%) chose to work as a faculty member in a university after obtaining appropriate degree, 20 students (5.1%) preferred to work as full-time researcher after obtaining appropriate degree, the remaining 36 students (9.1%) had different career goals, such as obtaining a master degree after graduating, to obtain a bachelor of medicine and bachelor in surgery degree, and working in the private sector. The most recurrent reason behind the participants' choice was "career goal", where 276 (70.1%) chose it as a reason. Conclusion: The findings of the study showed that most student’s preferred to work in hospitals as clinicians, followed by choice of working as a faculty in a university, the least choice was to be working as full-time researchers.

Keywords: College of Applied Medical Sciences, employment ambitions, graduating students, King Saud bin Abdulaziz University for Health Sciences

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3022 Review of the Safety of Discharge on the First Postoperative Day Following Carotid Surgery: A Retrospective Analysis

Authors: John Yahng, Hansraj Riteesh Bookun

Abstract:

Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

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3021 Correlation Test of Psychomotor Vigilance Test Fatigue Scores on Sleep Quality at Home in Oil and Gas Tanker Driver: A Diagnostic Study

Authors: Pandega Gama Mahardika, Muhammad Rifki Al Iksan, Datuk Fachrul Razy

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Oil And Gas Tanker Driver is a high-risk jobdesc. drivers drive with sleep circadian rhythm disturbances. Therefore, FAMOUS (Fatigue Management Online Ultimate System) conducted a diagnostic test on the effectiveness and accuracy of the Psychomotor vigilance test (PVT) in the field to capture the fatigue level of Oil And Gas Tanker Driver. Fatigue examination with the PVP method for 3 minutes using the Pertamina FAMOUS system (Fatigue Management Online Ultimate System). The research sample was Oil And Gas Tanker Driver Elnusa petrofin drivers as many as 2205 people. PVT is categorical data that states a driver has a low or high fatigue level. The quality of sleep at home was recorded by filling in a score of 1 = not well, 2 = not well, 3 = well, per person. A total of 1852 (84%) driver had a low fatigue level, while 353 (16%) driver had a high fatigue level. Poor sleep quality was experienced by 68 (79%) driver who had a high fatigue level. Oil And Gas Tanker Driver who slept soundly at home as many as 1804 (87%) had a low fatigue level. The correlation coefficient of sleep quality home and fatigue level is significant because it shows a probability value of 0.00 (p <5%). Fatigue level can be diagnosed through examining sleep quality, using FAMOUS Program for occupational medicine, particularly in the oil and gas sector.

Keywords: psychomotor vigilance test, fatigue, sleep, oil and gas tanker driver drivers, pertamina FAMOUS

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3020 Mechanical Properties of Spark Plasma Sintered 2024 AA Reinforced with TiB₂ and Nano Yttrium

Authors: Suresh Vidyasagar Chevuri, D. B. Karunakar Chevuri

Abstract:

The main advantages of 'Metal Matrix Nano Composites (MMNCs)' include excellent mechanical performance, good wear resistance, low creep rate, etc. The method of fabrication of MMNCs is quite a challenge, which includes processing techniques like Spark Plasma Sintering (SPS), etc. The objective of the present work is to fabricate aluminum based MMNCs with the addition of small amounts of yttrium using Spark Plasma Sintering and to evaluate their mechanical and microstructure properties. Samples of 2024 AA with yttrium ranging from 0.1% to 0.5 wt% keeping 1 wt% TiB2 constant are fabricated by Spark Plasma Sintering (SPS). The mechanical property like hardness is determined using Vickers hardness testing machine. The metallurgical characterization of the samples is evaluated by Optical Microscopy (OM), Field Emission Scanning Electron Microscopy (FE-SEM) and X-Ray Diffraction (XRD). Unreinforced 2024 AA sample is also fabricated as a benchmark to compare its properties with that of the composite developed. It is found that the yttrium addition increases the above-mentioned properties to some extent and then decreases gradually when yttrium wt% increases beyond a point between 0.3 and 0.4 wt%. High density is achieved in the samples fabricated by spark plasma sintering when compared to any other fabrication route, and uniform distribution of yttrium is observed.

Keywords: spark plasma sintering, 2024 AA, yttrium addition, microstructure characterization, mechanical properties

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3019 Unlocking Health Insights: Studying Data for Better Care

Authors: Valentina Marutyan

Abstract:

Healthcare data mining is a rapidly developing field at the intersection of technology and medicine that has the potential to change our understanding and approach to providing healthcare. Healthcare and data mining is the process of examining huge amounts of data to extract useful information that can be applied in order to improve patient care, treatment effectiveness, and overall healthcare delivery. This field looks for patterns, trends, and correlations in a variety of healthcare datasets, such as electronic health records (EHRs), medical imaging, patient demographics, and treatment histories. To accomplish this, it uses advanced analytical approaches. Predictive analysis using historical patient data is a major area of interest in healthcare data mining. This enables doctors to get involved early to prevent problems or improve results for patients. It also assists in early disease detection and customized treatment planning for every person. Doctors can customize a patient's care by looking at their medical history, genetic profile, current and previous therapies. In this way, treatments can be more effective and have fewer negative consequences. Moreover, helping patients, it improves the efficiency of hospitals. It helps them determine the number of beds or doctors they require in regard to the number of patients they expect. In this project are used models like logistic regression, random forests, and neural networks for predicting diseases and analyzing medical images. Patients were helped by algorithms such as k-means, and connections between treatments and patient responses were identified by association rule mining. Time series techniques helped in resource management by predicting patient admissions. These methods improved healthcare decision-making and personalized treatment. Also, healthcare data mining must deal with difficulties such as bad data quality, privacy challenges, managing large and complicated datasets, ensuring the reliability of models, managing biases, limited data sharing, and regulatory compliance. Finally, secret code of data mining in healthcare helps medical professionals and hospitals make better decisions, treat patients more efficiently, and work more efficiently. It ultimately comes down to using data to improve treatment, make better choices, and simplify hospital operations for all patients.

Keywords: data mining, healthcare, big data, large amounts of data

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3018 Grandiose Narcissists’ Adaptive Trade-Offs: Mating, Parental, and Somatic Investment

Authors: Jasmine H. Gagnon

Abstract:

The present study examined how grandiose narcissists make adaptive trade-offs between mating investment, parenting investment, and somatic investment relative to individuals without narcissistic personalities. A sample of 509 males and females between the ages of 24 and 35 years old (49.31% female) completed a personality inventory assessing Honesty-Humility, Emotionality, Extraversion, Agreeableness, Conscientiousness, and Openness to Experience. In a Latent Profile Analysis (LPA), personality inventory scores were used to classify participants into latent groups. The model of best fit identified one grandiose narcissist group and three groups with non-narcissistic personalities. Covariate analyses revealed that individuals with narcissistic traits made significantly more significant somatic investments in comparison to two of the three non-narcissistic latent groups. No other significant differences between the narcissistic and non-pathological groups were found. Thus, grandiose narcissists trade off parenting and mating investments to make more significant somatic investments. That is, they expend a larger portion of their energetic resources on maintaining their physical health and careers and similar quantities of energetic resources on maintaining relationships with their offspring and potential romantic partners as individuals without narcissistic personalities.

Keywords: narcissism, grandiose narcissism, HEXACO, trade-offs, mating, parenting, somatic, dark triad

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3017 Cognitive Development Theories as Determinant of Children's Brand Recall and Ad Recognition: An Indian Perspective

Authors: Ruchika Sharma

Abstract:

In the past decade, there has been an explosion of research that has examined children’s understanding of TV advertisements and its persuasive intent, socialization of child consumer and child psychology. However, it is evident from the literature review that no studies in this area have covered advertising messages and its impact on children’s brand recall and ad recognition. Copywriters use various creative devices to lure the consumers and very impressionable consumers such as children face far more drastic effects of these creative ways of persuasion. On the basis of Piaget’s theory of cognitive development as a theoretical basis for predicting/understanding children’s response and understanding, a quasi-experiment was carried out for the study, that manipulated measurement timing and advertising messages (familiar vs. unfamiliar) keeping gender and age group as two prominent factors. This study also examines children’s understanding of Advertisements and its elements, predominantly - Language, keeping in view Fishbein’s model. Study revealed significant associations between above mentioned factors and children’s brand recall and ad identification. Further, to test the reliability of the findings on larger sample, bootstrap simulation technique was used. The simulation results are in accordance with the findings of experiment, suggesting that the conclusions obtained from the study can be generalized for entire children’s (as consumers) market in India.

Keywords: advertising, brand recall, cognitive development, preferences

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3016 Enhancement of Pool Boiling Regimes by Sand Deposition

Authors: G. Mazor, I. Ladizhensky, A. Shapiro, D. Nemirovsky

Abstract:

A lot of researches was dedicated to the evaluation of the efficiency of the uniform constant and temporary coatings enhancing a heat transfer rate. Our goal is an investigation of the sand coatings distributed by both uniform and non-uniform forms. The sand of different sizes (0.2-0.4-0.6 mm) was attached to a copper ball (30 mm diameter) surface by means of PVA adhesive as a uniform layer. At the next stage, sand spots were distributed over the ball surface with an areal density that ranges between one spot per 1.18 cm² (for low-density spots) and one spot per 0.51 cm² (for high-density spots). The spot's diameter value varied from 3 to 6.5 mm and height from 0.5 to 1.5 mm. All coatings serve as a heat transfer enhancer during the quenching in liquid nitrogen. Highest heat flux densities, achieved during quenching, lie in the range 10.8-20.2 W/cm², depending on the sand layer structure. Application of the enhancing coating increases an amount of heat, evacuated by highly effective nucleate and transition boiling, by a factor of 4.5 as compared to the bare sample. The non-uniform sand coatings were increasing the heat transfer rate value under all pool boiling conditions: nucleate boiling, transfer boiling and the most severe film boiling. A combination of uniform sand coating together with high-density sand spots increased the average heat transfer rate by a factor of 3.

Keywords: heat transfer enhancement, nucleate boiling, film boiling, transfer boiling

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3015 Evaluation of the Internal Quality for Pineapple Based on the Spectroscopy Approach and Neural Network

Authors: Nonlapun Meenil, Pisitpong Intarapong, Thitima Wongsheree, Pranchalee Samanpiboon

Abstract:

In Thailand, once pineapples are harvested, they must be classified into two classes based on their sweetness: sweet and unsweet. This paper has studied and developed the assessment of internal quality of pineapples using a low-cost compact spectroscopy sensor according to the Spectroscopy approach and Neural Network (NN). During the experiments, Batavia pineapples were utilized, generating 100 samples. The extracted pineapple juice of each sample was used to determine the Soluble Solid Content (SSC) labeling into sweet and unsweet classes. In terms of experimental equipment, the sensor cover was specifically designed to install the sensor and light source to read the reflectance at a five mm depth from pineapple flesh. By using a spectroscopy sensor, data on visible and near-infrared reflectance (Vis-NIR) were collected. The NN was used to classify the pineapple classes. Before the classification step, the preprocessing methods, which are Class balancing, Data shuffling, and Standardization were applied. The 510 nm and 900 nm reflectance values of the middle parts of pineapples were used as features of the NN. With the Sequential model and Relu activation function, 100% accuracy of the training set and 76.67% accuracy of the test set were achieved. According to the abovementioned information, using a low-cost compact spectroscopy sensor has achieved favorable results in classifying the sweetness of the two classes of pineapples.

Keywords: neural network, pineapple, soluble solid content, spectroscopy

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3014 Early Initiation of Breastfeeding among Postpartum Mothers at Two Rwandan Hospitals

Authors: Joella Mukashyaka, Rose Mukarubayiza, Emmanuel Habumugisha, Francois-Xavier Sunday, Kellen Muganwa, Valens Mbarushimana, Pamela Meharry

Abstract:

Background: Breastfeeding in the first hour post-birth can decrease neonatal morbidity and mortality. Disease prevention and health outcomes differ immensely between newborns who receive human milk and those who do not. Rwanda has high breastfeeding rates, though factors associated with early initiation of breastfeeding (EIBF) are unknown. Objective: To assess factors associated with EIBF among mothers in immediate postpartum units at two hospitals. Methods: A cross-sectional study design and a convenience sample of 187 mothers were used. An interviewer-administered questionnaire was used for data collection. A Chi-square test showed the relationship between EIBF and sociodemographic factors. Results: The findings showed less than one quarter (20.5%) breastfed within the first hour after birth. The majority was < 25 years (52.4%), had some primary education (27.7%) employed (66.7%), urban dweller (58.1%), attendance of one ANC visit or more (81.3%), vaginal birth (58.8%), and did not receive EIBF health education (92.0%). The majority (78.5%) was too tired to initiate breastfeeding, and many supplemented (41.9%) due to perceived insufficient breastmilk. Conclusion: Most mothers did not initiate breastfeeding within the first hour after birth. Sociodemographic factors were associated with EIBF. A program to promote, protect, and support EIBF is urgently needed the community.

Keywords: breastfeeding, early initiation, neonates, morbidity, mortality, sub-Saharan Africa

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3013 Clinical Course and Prognosis of Cutaneous Manifestations of COVID-19: A Systematic Review of Reported Cases

Authors: Hilary Modir, Kyle Dutton, Michelle Swab, Shabnam Asghari

Abstract:

Since its emergence, the cutaneous manifestations of COVID-19 have been documented in the literature. However, the majority are case reports with significant limitations in appraisal quality, thus leaving the role of dermatological manifestations of COVID-19 erroneously underexplored. The primary aim of this review was to systematically examine clinical patterns of dermatological manifestations as reported in the literature. This study was designed as a systematic review of case reports. The inclusion criteria consisted of all published reports and articles regarding COVID-19 in English, from September 1st, 2019, until June 22nd, 2020. The population consisted of confirmed cases of COVID-19 with associated cutaneous signs and symptoms. Exclusion criteria included research in planning stages, protocols, book reviews, news articles, review studies, and policy analyses. With the collaboration of a librarian, a search strategy was created consisting of a mixture of keyword terms and controlled vocabulary. Electronic databases searched were MEDLINE via PubMed, EMBASE, CINAHL, Web of Science, LILACS, PsycINFO, WHO Global Literature on Coronavirus Disease, Cochrane Library, Campbell Collaboration, Prospero, WHO International Clinical Trials Registry Platform, Australian and New Zealand Clinical Trials Registry, U.S. Institutes of Health Ongoing Trials Register, AAD Registry, OSF preprints, SSRN, MedRxiV and BioRxiV. The study selection featured an initial pre-screening of titles and abstracts by one independent reviewer. Results were verified by re-examining a random sample of 1% of excluded articles. Eligible studies progressed for full-text review by two calibrated independent reviewers. Covidence was used to store and extract data, such as citation information and findings pertaining to COVID-19 and cutaneous signs and symptoms. Data analysis and summarization methodology reflect the framework proposed by PRISMA and recommendations set out by Cochrane and Joanna Brigg’s Institute for conducting systematic reviews. The Oxford Centre for Evidence-Based Medicine’s level of evidence was used to appraise the quality of individual studies. The literature search revealed a total of 1221 articles. After the abstract and full-text screening, only 95 studies met the eligibility criteria, proceeding to data extraction. Studies were divided into 58% case reports and 42% series. A total of 833 manifestations were reported in 723 confirmed COVID-19 cases. The most frequent lesions were 23% maculopapular, 15% urticarial and 13% pseudo-chilblains, with 46% of lesions reporting pruritus, 16% erythema, 14% pain, 12% burning sensation, and 4% edema. The most common lesion locations were 20% trunk, 19.5% lower limbs, and 17.7% upper limbs. The time to resolution of lesions was between one and twenty-one days. In conclusion, over half of the reported cutaneous presentations in COVID-19 positive patients were maculopapular, urticarial and pseudo-chilblains, with the majority of lesions distributed to the extremities and trunk. As this review’s sample size only contained COVID-19 confirmed cases with skin presentations, it becomes difficult to deduce the direct relationship between skin findings and COVID-19. However, it can be correlated that acute onset of skin lesions, such as chilblains-like, may be associated with or may warrant consideration of COVID-19 as part of the differential diagnosis.

Keywords: COVID-19, cutaneous manifestations, cutaneous signs, general dermatology, medical dermatology, Sars-Cov-2, skin and infectious disease, skin findings, skin manifestations

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3012 Genotyping of Rotaviruses in Pediatric Patients with Gastroenteritis by Using Real-Time Reverse Transcription Polymerase Chain Reaction

Authors: Recep Kesli, Cengiz Demir, Riza Durmaz, Zekiye Bakkaloglu, Aysegul Bukulmez

Abstract:

Objective: Acute diarrhea disease in children is a major cause of morbidity worldwide and is a leading cause of mortality, and it is the most common agent responsible for acute gastroenteritis in developing countries. With hospitalized children suffering from acute enteric disease up to 50% of the analyzed specimen were positive for rotavirus. Further molecular surveillance could provide a sound basis for improving the response to epidemic gastroenteritis and could provide data needed for the introduction of vaccination programmes in the country. The aim of this study was to investigate the prevalence of viral etiology of the gastroenteritis in children aged 0-6 years with acute gastroenteritis and to determine predominant genotypes of rotaviruses in the province of Afyonkarahisar, Turkey. Methods: An epidemiological study on rotavirus was carried out during 2016. Fecal samples obtained from the 144 rotavirus positive children with 0-6 years of ages and applied to the Pediatric Diseases Outpatient of ANS Research and Practice Hospital, Afyon Kocatepe University with the complaint of diarrhea. Bacterial agents causing gastroenteritis were excluded by using bacteriological culture methods and finally, no growth observed. Rotavirus antigen was examined by both the immunochromatographic (One Step Rotavirus and Adenovirus Combo Test, China) and ELISA (Premier Rotaclone, USA) methods in stool samples. Rotavirus RNA was detected by using one step real-time reverse transcription-polymerase chain reaction (RT-PCR). G and P genotypes were determined using RT-PCR with consensus primers of VP7 and VP4 genes, followed by semi nested type-specific multiplex PCR. Results: Of the total 144 rotavirus antigen-positive samples with RT-PCR, 4 (2,8%) were rejected, 95 (66%) were examined, and 45 (31,2%) have not been examined for PCR yet. Ninety-one (95,8%) of the 95 examined samples were found to be rotavirus positive with RT-PCR. Rotavirus subgenotyping distributions in G, P and G/P genotype groups were determined as; G1:45%, G2:27%, G3:13%, G9:13%, G4:1% and G12:1% for G genotype, and P[4]:33%, P[8]:66%, P[10]:1% for P genotype, and G1P[8]:%37, G2P[4]:%21, G3P[8]:%10, G4P[8]:%1, G9P[8]:%8, G2P[8]:%3 for G/P genotype . Not common genotype combination were %20 in G/P genotype. Conclusions: This study subscribes to the global agreement of the molecular epidemiology of rotavirus which will be useful in guiding the alternative and application of rotavirus vaccines or effective control and interception. Determining the diversity and rates of rotavirus genotypes will definitely provide guidelines for developing the most suitable vaccine.

Keywords: gastroenteritis, genotyping, rotavirus, RT-PCR

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3011 Open and Distance Learning (ODL) Education in Nigeria: Challenge of Academic Quality

Authors: Edu Marcelina, Sule Sheidu A., Nsor Eunice

Abstract:

As open and distance education is gradually becoming an acceptable means of solving the problem of access in higher education, quality has now become one of the main concerns among institutions and stakeholders of open and distance learning (ODL) and the education sector in general. This study assessed the challenges of academic quality in the open and distance learning (ODL) education in Nigeria using Distance Learning Institute (DLI), University of Lagos and National Open University of Nigeria as a case. In carrying out the study, a descriptive survey research design was employed. A researcher-designed and validated questionnaire was used to elicit responses that translated to the quantitative data for this study. The sample comprised 665 students of the Distance Learning Institute (DLI), and National Open University of Nigeria (NOUN), carefully selected through the method of simple random sampling. Data collected from the study were analyzed using Chi-Square (X2) at 0.05 Level of significance. The results of the analysis revealed that; the use of ICT tools is a factor in ensuring quality in the Open and Distance Learning (ODL) operations; the quality of the materials made available to ODL students will determine the quality of education that will be received by the students; and the time scheduled for students for self-study, online lecturing/interaction and face to face study and the quality of education in Open and Distance Learning Institutions has a lot of impact on the quality of education the students receive. Based on the findings, a number of recommendations were made.

Keywords: open and distance learning, quality, ICT, face-to-face interaction

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3010 Investigation of Optical, Film Formation and Magnetic Properties of PS Lates/MNPs Composites

Authors: Saziye Ugur

Abstract:

In this study, optical, film formation, morphological and the magnetic properties of a nanocomposite system, composed of polystyrene (PS) latex polymer and core-shell magnetic nanoparticles (MNPs) is presented. Nine different mixtures were prepared by mixing of PS latex dispersion with different amount of MNPs in the range of (0- 100 wt%). PS/MNPs films were prepared from these mixtures on glass substrates by drop casting method. After drying at room temperature, each film sample was separately annealed at temperatures from 100 to 250 °C for 10 min. In order to monitor film formation process, the transmittance of these composites was measured after each annealing step as a function of MNPs content. Below a critical MNPs content (30 wt%), it was found that PS percolates into the MNPs hard phase and forms an interconnected network upon annealing. The transmission results showed above this critical value, PS latexes were no longer film forming at all temperatures. Besides, the PS/MNPs composite films also showed excellent magnetic properties. All composite films showed superparamagnetic behaviors. The saturation magnetisation (Ms) first increased up to 0.014 emu in the range of (0-50) wt% MNPs content and then decreased to 0.010 emu with increasing MNPs content. The highest value of Ms was approximately 0.020 emu and was obtained for the film filled with 85 wt% MNPs content. These results indicated that the optical, film formation and magnetic properties of PS/MNPs composite films can be readily tuned by varying loading content of MNPs nanoparticles.

Keywords: composite film, film formation, magnetic nanoparticles, ps latex, transmission

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3009 Emerging Challenges with Collective Bargaining Agreements In Kenya: The Introduction of Salary and Remuneration Commission Through The Constitution of Kenya 2010

Authors: Benard Omogo

Abstract:

The Kenyan Constitution 2010 introduced various commissions to devolve the powers that were previously centralized through the imperial Presidency. One of the commissions that directly determine the levels of remuneration and terms of service of Kenyan workers is the Salary and Remuneration Commission (SRC). Article 230 of the Kenyan Constitution 2010 mandates this commission to regularly review the remuneration and benefits of all the state officers and to advise the national and county governments on the remuneration and benefits of all other public officers. At the same time, article 54 of the Kenyan Labor Relations Act 2007 provides for the recognition of trade unions and collective bargaining agreements. The emerging challenges, therefore, originate from the conflicts of the mandate of the Salary and Remuneration Commission, whose advice is almost adopted as the order and this undermines the outcome of the Collective Bargaining Agreements. This has seen so many trade unions in Kenya being rendered irrelevant. This research paper is therefore going to sample the various trade unions of Kenya to assess the challenges that result from the position of the Salary and Remuneration Commission. We will also extend it by purposively sampling several trade unions in Africa to determine how they handle such challenges. The results from this paper will be useful to the Kenyan Lawmakers and Africa at large and may inform them to consider reviewing the laws and acts that relate to the trade unions for prosperity.

Keywords: salary, remuneration, collective, bargaining, labor laws

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3008 The Effect of the Dramas on the Egyptian Public Opinion Regarding the State of Israel: A Survey Study on the Egyptian Youth at Cairo University

Authors: Dana Hisham Mohamed Abdrabo

Abstract:

The paper examines the effect of Drama works on the Egyptian public opinion regarding the religion of Judaism, Israel as a state and the Jew's image to Egyptian Muslims. The paper examines the role of Media and in particular, Dramas on achieving interreligious dialogue between Judaism and Islam and its role in making peace between the Egyptian Muslims -and Arabs in general- on the one hand, and the Jew on the other hand, and the implications of this on the relationship between Arab countries and Israel as a state. The research uses the Survey method with Egyptian Muslims as a main sample for the research to examine such effect. Dramas have a role in presenting the Jew, Judaism, and Israel as a state and as a political system in various ways. The paper is related to multidisciplinary fields; it is related to political sciences, political sociology, communication, social change, and cognitive sociology fields. The research adds a new analytical study for a new tool for the peacemaking process in the Middle East region through adopting an interdisciplinary approach which is needed in the studies aim to achieve stability and peace in the Middle East region and its neighboring countries.

Keywords: dramas tool, Egyptian public opinion, interreligious dialogue, Israel & Egyptian relations , Judaism

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3007 Extracorporeal Co2 Removal (Ecco2r): An Option for Treatment for Refractory Hypercapnic Respiratory Failure

Authors: Shweh Fern Loo, Jun Yin Ong, Than Zaw Oo

Abstract:

Acute respiratory distress syndrome (ARDS) is a common serious condition of bilateral lung infiltrates that develops secondary to various underlying conditions such as diseases or injuries. ARDS with severe hypercapnia is associated with higher ICU mortality and morbidity. Venovenous Extracorporeal membrane oxygenation (VV-ECMO) support has been established to avert life-threatening hypoxemia and hypercapnic respiratory failure despite optimal conventional mechanical ventilation. However, VV-ECMO is relatively not advisable in particular groups of patients, especially in multi-organ failure, advanced age, hemorrhagic complications and irreversible central nervous system pathology. We presented a case of a 79-year-old Chinese lady without any pre-existing lung disease admitted to our hospital intensive care unit (ICU) after acute presentation of breathlessness and chest pain. After extensive workup, she was diagnosed with rapidly progressing acute interstitial pneumonia with ARDS and hypercapnia respiratory failure. The patient received lung protective strategies of mechanical ventilation and neuromuscular blockage therapy as per clinical guidelines. However, hypercapnia respiratory failure was refractory, and she was deemed not a good candidate for VV-ECMO support given her advanced age and high vasopressor requirements from shock. Alternative therapy with extracorporeal CO2 removal (ECCO2R) was considered and implemented. The patient received 12 days of ECCO2R paired with muscle paralysis, optimization of lung-protective mechanical ventilation and dialysis. Unfortunately, the patient still had refractory hypercapnic respiratory failure with dual vasopressor support despite prolonged therapy. Given failed and futile medical treatment, the family opted for withdrawal of care, a conservative approach, and comfort care, which led to her demise. The effectivity of extracorporeal CO2 removal may depend on disease burden, involvement and severity of the disease. There is insufficient data to make strong recommendations about its benefit-risk ratio for ECCO2R devices, and further studies and data would be required. Nonetheless, ECCO2R can be considered an alternative treatment for refractory hypercapnic respiratory failure patients who are unsuitable for initiating venovenous ECMO.

Keywords: extracorporeal CO2 removal (ECCO2R), acute respiratory distress syndrome (ARDS), acute interstitial pneumonia (AIP), hypercapnic respiratory failure

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3006 Disposition Kinetics of Ciprofloxacin after Intramuscular Administration in Lohi Sheep

Authors: Zahid Iqbal, Ijaz Javed, Riaz Hussain, Ibadullah Jan, Amir Ali Khan

Abstract:

This study was conducted to investigate the disposition kinetics of ciprofloxacin and calculate its optimal dosage in Pakistani sheep of Lohi breed. Injectable preparation of ciprofloxacin was given intramuscularly to eight sheep at a dose of 5 mg/Kg. Before administration of drug blood sample was drawn from each animal. Post drug administration, blood samples were also drawn at various predetermined time periods. Drug concentration in the blood samples was assessed through high performance liquid chromatograph (HPLC). Data were best described by two compartment open model and different pharmacokinetic (PK) parameters were calculated. Cmax of 1.97 ± 0.15 µg/ml was reached at Tmax of 0.88 ± 0.09 hours. Half life of absorption (t1/2 abs) was observed to be 0.63 ± 0.16 hours while t1/2 α (distribution half life) and t1/2 ß (elimination half life) were found to be 0.46 ± 0.05 and 2.93 ± 0.45 hours, respectively. Vd (apparent volume of distribution) was calculated as 2.89 ± 0.30 L/kg while AUC (area under the curve) was 7.19 ± 0.38 µg.hr/mL and CL (total body clearance) was 0.75 ± 0.04 L/hr/kg. Using these parameters, an optimal intramuscular dosage of ciprofloxacin in adult Lohi sheep was calculated as 21.43 mg/kg, advised to be repeated after 24 hours. From this, we came to the conclusion that calculated dose was much higher than the dose advised by the foreign manufacturer and to avoid antimicrobial resistance, it is advised that this locally investigated dosage regimen should be strictly followed in local sheep.

Keywords: pharmacokinetics, dosage regimen, ciprofloxacin, HPLC, sheep

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