Search results for: treatment outcomes
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11201

Search results for: treatment outcomes

10721 The Efficacy of Preoperative Thermal Pulsation Treatment in Reducing Post Cataract Surgery Dry Eye Disease: A Systematic Review and Meta-analysis

Authors: Lugean K. Alomari, Rahaf K. Sharif, Basil K. Alomari, Hind M. Aljabri, Faisal F. Aljahdali, Amal A. Alomari, Saeed A. Alghamdi

Abstract:

Background: The thermal pulsation system is a therapy that uses heat and massage to treat dry eye disease; thus, some trials have been published to compare it with the conventional treatment. The aim of this study is to conduct a systematic review and meta-analysis comparing the efficacy of thermal pulsation systems with conventional treatment in patients undergoing cataract surgery. Methods: Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for eligible trials. We included three randomized controlled trials (RCTs) that compared the thermal pulsation system with the conventional treatment in patients undergoing cataract surgery. A table of characteristics was plotted, and the Quality of the studies was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). Forest plots were plotted using the Random-effect Inverse Variance method. χ2 test and the Higgins-I-squared (I2) model were used to assess heterogeneity. A total of 201 cataract surgery patients were included, with 105 undergoing preoperative pulsation therapy and 96 receiving conventional treatment. Demographic analysis revealed comparable distributions across groups. Results: All the studies in our analysis are of good quality with a low risk of bias. A total of 201 patients were included in the analysis, out of which 105 underwent pulsation therapy, and 95 were in the control group. Tear Break-up Time (TBUT) analysis revealed no significant baseline differences, except pulsation therapy being better at 1 month. (SMD 0.42 [95%CI 0.14 - 0.70] p=0.004). This positive trend continued at three months (SMD 0.52 [95% CI (0.20 – 0.84)] p=0.002). Corneal fluorescein staining scores and Meibomian gland-yielding secretion scores showed no significant differences at baseline. However, at one month, pulsation therapy significantly improved Meibomian gland function (SMD -0.86 [95% CI (-1.20 - -0.53)] p<0.00001), indicating a reduced risk of dry eye syndrome. Conclusion: Preoperative pulsation therapy appears to enhance post-cataract surgery outcomes, particularly in terms of tear film stability and Meibomian gland secretory function. The sustained positive effects observed at one and three months post-surgery suggest the potential for long-term benefits.

Keywords: lipiflow, cataract, thermal pulsation, dry eye

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10720 Valorization of Argan Residuals for the Treatment of Industrial Effluents

Authors: Salim Ahmed

Abstract:

The aim of this study was to recover a natural residue in the form of activated carbon prepared from Moroccan "argan pits and date pits" plant waste. After preparing the raw material for manufacture, the carbon was carbonised at 300°C and chemically activated with phosphoric acid of purity 85. The various characterisation results (moisture and ash content, specific surface area, pore volume, etc.) showed that the carbons obtained are comparable to those manufactured industrially and could therefore be tested, for example, in water treatment processes and especially for the depollution of effluents used in the agri-food and textile industries.

Keywords: activated carbon, water treatment, adsorption, argan

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10719 Hormone Replacement Therapy (HRT) and Its Impact on the All-Cause Mortality of UK Women: A Matched Cohort Study 1984-2017

Authors: Nurunnahar Akter, Elena Kulinskaya, Nicholas Steel, Ilyas Bakbergenuly

Abstract:

Although Hormone Replacement Therapy (HRT) is an effective treatment in ameliorating menopausal symptoms, it has mixed effects on different health outcomes, increasing, for instance, the risk of breast cancer. Because of this, many symptomatic women are left untreated. Untreated menopausal symptoms may result in other health issues, which eventually put an extra burden and costs to the health care system. All-cause mortality analysis may explain the net benefits and risks of the HRT therapy. However, it received far less attention in HRT studies. This study investigated the impact of HRT on all-cause mortality using electronically recorded primary care data from The Health Improvement Network (THIN) that broadly represents the female population in the United Kingdom (UK). The study entry date for this study was the record of the first HRT prescription from 1984, and patients were followed up until death or transfer to another GP practice or study end date, which was January 2017. 112,354 HRT users (cases) were matched with 245,320 non-users by age at HRT initiation and general practice (GP). The hazards of all-cause mortality associated with HRT were estimated by a parametric Weibull-Cox model adjusting for a wide range of important medical, lifestyle, and socio-demographic factors. The multilevel multiple imputation techniques were used to deal with missing data. This study found that during 32 years of follow-up, combined HRT reduced the hazard ratio (HR) of all-cause mortality by 9% (HR: 0.91; 95% Confidence Interval, 0.88-0.94) in women of age between 46 to 65 at first treatment compared to the non-users of the same age. Age-specific mortality analyses found that combined HRT decreased mortality by 13% (HR: 0.87; 95% CI, 0.82-0.92), 12% (HR: 0.88; 95% CI, 0.82-0.93), and 8% (HR: 0.92; 95% CI, 0.85-0.98), in 51 to 55, 56 to 60, and 61 to 65 age group at first treatment, respectively. There was no association between estrogen-only HRT and women’s all-cause mortality. The findings from this study may help to inform the choices of women at menopause and to further educate the clinicians and resource planners.

Keywords: hormone replacement therapy, multiple imputations, primary care data, the health improvement network (THIN)

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10718 Long-Term Otitis Media with Effusion and Related Hearing Loss and Its Impact on Developmental Outcomes

Authors: Aleema Rahman

Abstract:

Introduction: This study aims to estimate the prevalence of long-term otitis media with effusion (OME) and hearing loss in a prospective longitudinal cohort studyand to study the relationship between the condition and educational and psychosocial outcomes. Methods: Analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) will be undertaken. ALSPAC is a longitudinal birth cohort study carried out in the UK, which has collected detailed measures of hearing on ~7000 children from the age of seven. A descriptive analysis of the data will be undertaken to estimate the prevalence of OME and hearing loss (defined as having average hearing levels > 20dB and type B tympanogram) at 7, 9, 11, and 15 years as well as that of long-term OME and hearing loss. Logistic and linear regression analyses will be conducted to examine associations between long-term OME and hearing loss and educational outcomes (grades obtained from standardised national attainment tests) and psychosocial outcomes such as anxiety, social fears, and depression at ages 10-11 and 15-16 years. Results: Results will be presented in terms of the prevalence of OME and hearing loss in the population at each age. The prevalence of long-term OME and hearing loss, defined as having OME and hearing loss at two or more time points, will also be reported. Furthermore, any associations between long-term OME and hearing loss and the educational and psychosocial outcomes will be presented. Analyses will take into account demographic factors such as sex and social deprivation and relevant confounders, including socioeconomic status, ethnicity, and IQ. Discussion: Findings from this study will provide new epidemiological information on the prevalence of long-term OME and hearing loss. The research will provide new knowledge on the impact of OME for the small group of children who do not grow out of condition by age 7 but continue to have hearing loss and need clinical care through later childhood. The study could have clinical implications and may influence service delivery for this group of children.

Keywords: educational attainment, hearing loss, otitis media with effusion, psychosocial development

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10717 Effects of Plasma Treatment on Seed Germination

Authors: Yong Ho Jeon, Youn Mi Lee, Yong Yoon Lee

Abstract:

Effects of cold plasma treatment on various plant seed germination were studied. The seeds of hot pepper, cucumber, tomato and arabidopsis were exposed to plasma and the plasma was generated in various devices. The germination speed was evaluated compared to an unexposed control. A positive effect on germination speed was observed in all tested seeds but the effects strongly depended on the type of the used plasma device (Argon-DBD, surface-DBD or MARX generator), time of exposure (6s~10min or 1~10shots) and kind of seeds. The SEM images showed that arrays of gold particles along the cell wall were observed on the surface of cucumber seeds showed a germination-accelerating effect by plasma treatment, which was the same as untreated. However, when treated with the high dose plasma, gold particles were not arrayed at the seed surface, it seems that due to the surface etching. This may suggest that the germination is not promoted by etching or damage of surface caused by the plasma treatment. Seedling growth improvement was also observed by indirect plasma treatment. These lead to an important conclusion that the effect of charged particles on plasma play the essential role in plant germination and indirect plasma treatment offers new perspectives for large scale application.

Keywords: cold plasma, cucumber, germination, SEM

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10716 Treatment Performance of Waste Stabilization Ponds: A Look at Physic-Chemical Parameters in Ghana

Authors: Emmanuel Adu-Ofori, Richard Amfo-Otu, Isaac O. A. Hodgson

Abstract:

The study was conducted to determine the treatment performance of waste stabilization ponds in Akosombo. A total of 15 samples were taken for four consecutive months from the inlet, facultative pond and outlet of maturation pond. The samples were preserved and transported to Water Research Institute for laboratory analysis. The wastewater quality parameters analysed to assess the treatment performance were total suspended solids (TSS), biochemical oxygen demand (BOD), chemical oxygen demand (COD), ammonia and phosphate. The results of the laboratory analysis showed that the ponds achieved TSS, BOD and COD removals of about 30, 82 and 75 per cent respectively. Statistically, the BOD (t = 10.27, p = 6.68 x 10-6) and COD (t = 4.23, p = 0.0029) of the raw sewage were significantly different from the total effluent at 95% confidence interval. The ammonia and phosphate removal was as high as 92% and 84% respectively. The quality parameters analysed for the final effluent from the Waste Stabilisation Pond was within the EPA guideline values. The general treatment performances were very good with respect to the parameters studied and does not pose threat to the receiving water body. A further study to examine the bacteriological treatment performance was recommended.

Keywords: waste stabilization pond, wast water, treatment performance, nutrient, Ghana

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10715 Traditional Chinese Medicine Treatment for Coronary Heart Disease: a Meta-Analysis

Authors: Yuxi Wang, Xuan Gao

Abstract:

Traditional Chinese medicine has been used in the treatment of coronary heart disease (CHD) for centuries, and in recent years, the research data on the efficacy of traditional Chinese medicine through clinical trials has gradually increased to explore its real efficacy and internal pharmacology. However, due to the complexity of traditional Chinese medicine prescriptions, the efficacy of each component is difficult to clarify, and pharmacological research is challenging. This study aims to systematically review and clarify the clinical efficacy of traditional Chinese medicine in the treatment of coronary heart disease through a meta-analysis. Based on PubMed, CNKI database, Wanfang data, and other databases, eleven randomized controlled trials and 1091 CHD subjects were included. Two researchers conducted a systematic review of the papers and conducted a meta-analysis supporting the positive therapeutic effect of traditional Chinese medicine in the treatment of CHD.

Keywords: coronary heart disease, Chinese medicine, treatment, meta-analysis

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10714 Assessment of Treatment Methods to Remove Hazardous Dyes from Synthetic Wastewater

Authors: Abhiram Siva Prasad Pamula

Abstract:

Access to clean drinking water becomes scarce due to the increase in extreme weather events because of the rise in the average global temperatures and climate change. By 2030, approximately 47% of the world’s population will face water shortages due to uncertainty in seasonal rainfall. Over 10000 varieties of synthetic dyes are commercially available in the market and used by textile and paper industries, negatively impacting human health when ingested. Besides humans, textile dyes have a negative impact on aquatic ecosystems by increasing biological oxygen demand and chemical oxygen demand. This study assesses different treatment methods that remove dyes from textile wastewater while focusing on energy, economic, and engineering aspects of the treatment processes.

Keywords: textile wastewater, dye removal, treatment methods, hazardous pollutants

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10713 COVID-19 and Heart Failure Outcomes: Readmission Insights from the 2020 United States National Readmission Database

Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle

Abstract:

Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.

Keywords: Covid-19, heart failure, national readmission database, readmission outcomes

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10712 Data Mining in Healthcare for Predictive Analytics

Authors: Ruzanna Muradyan

Abstract:

Medical data mining is a crucial field in contemporary healthcare that offers cutting-edge tactics with enormous potential to transform patient care. This abstract examines how sophisticated data mining techniques could transform the healthcare industry, with a special focus on how they might improve patient outcomes. Healthcare data repositories have dynamically evolved, producing a rich tapestry of different, multi-dimensional information that includes genetic profiles, lifestyle markers, electronic health records, and more. By utilizing data mining techniques inside this vast library, a variety of prospects for precision medicine, predictive analytics, and insight production become visible. Predictive modeling for illness prediction, risk stratification, and therapy efficacy evaluations are important points of focus. Healthcare providers may use this abundance of data to tailor treatment plans, identify high-risk patient populations, and forecast disease trajectories by applying machine learning algorithms and predictive analytics. Better patient outcomes, more efficient use of resources, and early treatments are made possible by this proactive strategy. Furthermore, data mining techniques act as catalysts to reveal complex relationships between apparently unrelated data pieces, providing enhanced insights into the cause of disease, genetic susceptibilities, and environmental factors. Healthcare practitioners can get practical insights that guide disease prevention, customized patient counseling, and focused therapies by analyzing these associations. The abstract explores the problems and ethical issues that come with using data mining techniques in the healthcare industry. In order to properly use these approaches, it is essential to find a balance between data privacy, security issues, and the interpretability of complex models. Finally, this abstract demonstrates the revolutionary power of modern data mining methodologies in transforming the healthcare sector. Healthcare practitioners and researchers can uncover unique insights, enhance clinical decision-making, and ultimately elevate patient care to unprecedented levels of precision and efficacy by employing cutting-edge methodologies.

Keywords: data mining, healthcare, patient care, predictive analytics, precision medicine, electronic health records, machine learning, predictive modeling, disease prognosis, risk stratification, treatment efficacy, genetic profiles, precision health

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10711 Improving the Digestibility of Agro-Industrial Co-Products by Treatment with Isolated Fungi in the Meknes-Morocco Region

Authors: Mohamed Benaddou, Mohammed Diouri

Abstract:

country, such as Morocco, generates a high quantity of agricultural and food industry residues. A large portion of these residues is disposed of by burning or landfilling. The valorization of this waste biomass as feed is an interesting alternative because it is therefore considered among the best sources of cheap carbohydrates. However, its nutritional yield without any pre-treatment is very low because lignin protects cellulose, the carbohydrate used as a source of energy by ruminants. Fungal treatment is an environmentally friendly, easy and inexpensive method. This study investigated the treatment of wheat straw (WS), cedar sawdust (CS) and olive pomace (OP) with fungi selected according to the source of Carbon for improving its digestibility. Two were selected in a culture medium in which cellulose was the only source of Carbon: Cosmospora Viridescens (C.vir) and Penicillium crustosum (P.crus), two were selected in a culture medium in which lignin is the only source of Carbon: Fusarium oxysporum (F.oxy) and Fusarium sp. (F. Sp), and two in a culture medium where cellulose and lignin are the two sources of Carbon at the same time: Fusarium solani (F. solani) and Penicillium chrysogenum (P.chryso). P.chryso degraded more CS cellulose. It is very important to notice that the delignification by F. Solani reached 70% after 12 weeks of treatment of wheat straw. Ligninase enzymatic was detected in F.solani, F.sp, F.oxysporum, which made it possible to delignify the treated substrates. Delignification by C.vir is negligible in all three substrates after 12 weeks of treatment. P.crus and P.chryso degraded the lignin very slightly in WC (it did not exceed 12% after 12 weeks of treatment) but in OP this delignification is slight reaching 25% and 13% for P.chryso and P.crus successively. P.chryso allowed 30% degradation of lignin from 4 weeks of treatment. The degradation of the lignin was able to reach the maximum within 8 weeks of treatment for most of the fungi except F. solani who continued the treatment after this period. Digestibility variation (IVTD.variation) is highly very significant from fungus to fungi, duration to time, substrate to substrate and its interactions (P <0.001). indeed, all the fungi increased digestibility after 12 weeks of treatment with a difference in the degree of this increase. F.solani and F.oxy increased digestibility more than the others. this digestibility exceeded 50% in CS and O.P but did not exceed 20% for WS after treatment with F.oxy. IVTD.Var was not exceeded 20% in W.S.cedar treated with P.chryso but reached 45% after 8 weeks of treatment in W.straw.

Keywords: lignin, cellulose, digestibility, fungi, treatment, lignocellulosic biomass

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10710 The Association Between Different Body Mass Index Levels And Midterm Surgical Revascularization Outcomes

Authors: Farzad Masoud Kabir, Jamshid Bagheri, Khosro Barkhordari

Abstract:

This historical cohort study included 17,751 patients patients who underwent isolated CABG at our center between 2007 and 2016. The endpoints of this study were all-cause mortality and major adverse cardio-cerebrovascular events (MACCEs), comprising acute coronary syndromes, cerebrovascular accidents, and all-cause mortality at five years. Our findings suggest that preoperative obesity (BMI>30 kg/m2) in patients who survive early after CABG is associated with an increased risk of 5-year all-cause mortality and 5-year MACCEs.

Keywords: body mass index, surgical outcomes, midterm, cardiac surgery patients

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10709 Increased Risk of Adverse Birth Outcomes of Newborns in Arsenic Exposed- Women with Gestational Diabetes

Authors: Tania Mannan, Rahelee Zinnat, Fatema Jebunnesa, Israt Ara Hossain

Abstract:

Background: Exposure to arsenic has known toxic effects but the effect on pregnancy outcomes is not as widely documented especially in women with diabetes. Growing evidence has suggested a potential role of arsenic exposure in the development of gestational diabetes mellitus (GDM). Therefore, we aimed to investigate the association of urinary arsenic (UAs) with birth outcomes in GDM subjects. Methods: Under an observational cross-sectional design a total of 263 GDM subjects (age in years, M±SD, 21±3.7) residing in an arsenic affected area of Bangladesh, were subjected to a 2 sample OGTT at the third trimester of gestation. Among them, 73 GDM and 190 non-GDM subjects enrolled in this study. Clinical and anthropometric measurements were done by standard techniques. Degree of chronic arsenic exposure was assessed by the level of UAs level. According to World Health Organization (WHO) criteria, GDM was diagnosed and neonatal outcomes using APGAR (Activity Pulse Grimace Appearance Respirations) Score, birth weight and size were assessed by a specialist obstetrician. Serum glucose was measured by the Glucose Oxidase method and UAs level was determined by ultraviolet/visible spectrophotometry. Result: Out of the 263 pregnant women, 28% developed GDM. Urinary Arsenic was significantly higher in the GDM as compared to the non-GDM group [UAs, µg/l, M±SD (range), 204.2±67.0 (67.0-377.0) vs 77.3±38.1 (22.0-99.0), p < 0.001]. Activity Pulse Grimace Appearance Respirations Score of the neonates from GDM mothers was significantly lower compared to the neonates from non-GDM mothers [APGAR Score, M±SD, 4.7±0.8 vs. 6.4±0.7, p<0.001]. Pearson’s correlation analysis in GDM subjects revealed that UA levels were found to have a significant positive correlation with both fasting and postprandial serum glucose levels (p < 0.001) and (p < 0.001) respectively. Again, a significant inverse correlation of UAs with birth weight and size was observed (p < 0.001). The APGAR Score of the neonates were found to have a significant negative correlation (p < 0.001) with UAs level. Conclusion: The effect of chronic arsenic exposure is associated with glucose intolerance during pregnancy and it also adversely affects birth outcomes. The study suggests further research on the impact of total arsenic exposure on pregnancy outcomes.

Keywords: APGAR score, arsenic exposure, birth outcome, gestational diabetes mellitus,

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10708 Treatment of NMSC with Traditional Medicine Method

Authors: Aferdita Stroka Koka, Laver Stroka, Juna Musa, Samanda Celaj

Abstract:

Non-melanoma skin cancers (NMSCs) are the most common human malignancies. About 5.4 million basal and squamous cell skin cancers are diagnosed each year in the US and new cases continue to grow. About eight out of ten of these are basal cell cancers. Squamous cell cancers occur less often. NMSC usually are treatable, but treatment is expensive and can leave scars. In 2019, 167 patients of both sexes suffering from NMSC were treated by traditional medicine. Patients who have been diagnosed with Basal Cell Carcinoma were 122 cases, Squamous Cell Carcinoma 32 cases and both of them 13 cases. Of these,122 cases were ulcerated lesions and 45 unulcerated lesions. All patients were treated with the herbal solution called NILS, which contains extracts of some Albanian plants such as Allium sativum, Jugulans regia and Laurus nobilis. The treatment is done locally, on the surface of the tumor, applying the solution until the tumor mass is destroyed and, after that, giving the necessary time to the wound to make the regeneration that coincides with the complete healing of the wound. We have prepared a collection of photos for each case. Since the first sessions, a shrinkage and reduction of the tumor mass were evident, up to the total disappearance of the lesion at the end of treatment. The normal period of treatment lasted 1 to 2 weeks, depending on the size of the tumor, then take care of it until the closure of the wound, taking the whole process from 1 to 3 months. In 7 patients, the lesion failed to be dominated by treatment and they underwent standard treatment with radiotherapy or surgery, while in 10 patients, the lesion recurred and was treated again. The aim of this survey was to put in evidence the good results obtained by treatment of NMSC with Albanian traditional medicine methods.

Keywords: local treatment, nils, NMSC, traditional medicine

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10707 Effect of Bacillus subtilis Pb6 on Growth and Gut Microflora in Clostridium perfringens Challenged Broilers

Authors: A. Khalique, T. Naseem, N. Haque, Z. Rasool

Abstract:

The objective of current study was to investigate the effect of Bacillus subtilis PB6 (CloSTAT) as a probiotic in broilers. The corn-soybean based diet was divided into four treatment groups; T1 (basal diet with no probiotic and no Clostridium perfringens); T2 (basal diet challenged with C. perfringens without probiotic); T3 (basal diet challenged with C. perfringens having 0.05% probiotic); T4 (basal diet challenged with C. perfringens having 0.1% probiotic). Every treatment group had four replicates with 24 birds each. Body weight and feed intake were measured on weekly basis, while ileal bacterial count was recorded on day-28 following Clostridium perfringens challenge. The 0.1% probiotic treatment showed 7.2% increase in average feed intake (P=0.05) and 8% increase in body weight compared to T2. In 0.1% treatment body weight was 5% higher than T3 (P=0.02). It was also observed that 0.1% treatment had improved feed conversion ratio (1.77) on 6th week. No effect of treatment was observed on mortality and ileal bacterial count. The current study indicated that 0.1% use of probiotic had positive response in C. perfringens challenged broilers.

Keywords: Bacillus subtilis PB6, antibiotic growth promoters, Clostridium perfringens, broilers

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10706 Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome: Postoperative Complications in Patients on Anticoagulation

Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

Abstract:

Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

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10705 Industrial Wastewater Sludge Treatment in Chongqing, China

Authors: Victor Emery David Jr., Jiang Wenchao, Yasinta John, Md. Sahadat Hossain

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Sludge originates from the process of treatment of wastewater. It is the byproduct of wastewater treatment containing concentrated heavy metals and poorly biodegradable trace organic compounds, as well as potentially pathogenic organisms (viruses, bacteria, etc.) which are usually difficult to treat or dispose of. China, like other countries, is no stranger to the challenges posed by an increase of wastewater. Treatment and disposal of sludge have been a problem for most cities in China. However, this problem has been exacerbated by other issues such as lack of technology, funding, and other factors. Suitable methods for such climatic conditions are still unavailable for modern cities in China. Against this background, this paper seeks to describe the methods used for treatment and disposal of sludge from industries and suggest a suitable method for treatment and disposal in Chongqing/China. From the research conducted, it was discovered that the highest treatment rate of sludge in Chongqing was 10.08%. The industrial waste piping system is not separated from the domestic system. Considering the proliferation of industry and urbanization, there is a likelihood that the production of sludge in Chongqing will increase. If the sludge produced is not properly managed, this may lead to adverse health and environmental effects. Disposal costs and methods for Chongqing were also included in this paper’s analysis. Research showed that incineration is the most expensive method of sludge disposal in China/Chongqing. Subsequent research, therefore, considered optional alternatives such as composting. Composting represents a relatively cheap waste disposal method considering the vast population, current technology and economic conditions of Chongqing, as well as China at large.

Keywords: Chongqing/China, disposal, industrial, sludge, treatment

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10704 A Cognitive Behavioural Therapy for Post-Traumatic Stress Disorders

Authors: Ryotaro Ishikawa

Abstract:

INTRODUCTION: Post-traumatic stress disorder (PTSD) is a psychiatric label for a collection of psychological symptoms following a traumatic event. PTSD is as a result of a traumatic experience such as rape or sexual assault. A victim may have PTSD if she/he has experienced the following symptoms for at least a month: a) Stressor, b) Intrusion symptoms, c) Avoidance, d) Negative alterations in cognitions and mood, e) Alterations in arousal and reactivity. Studies on the cognitive theory of PTSD emphasized the roles of (a) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (b) disorganized trauma memories in the development of PTSD. Mental contamination is primarily caused by experiences involving humans (e.g. violators or perpetrators) as opposed to substances (e.g. dirt or bodily fluids). Feelings of mental contamination may evoke following experiences of ill-treatment, sexual assault, domination, degradation, manipulation, betrayal, or humiliation. Some studies have demonstrated that traumatic thoughts related to sexual assault are particularly strong predictors of mental contamination. Treatment protocols based on cognitive-behavioral therapy appear to be beneficial in reducing the severity of PTSD and mental contamination. Studies on the cognitive theory of PTSD emphasized the roles of (A) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (B) disorganized trauma memories in the development of PTSD. We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. METHOD: The single-arm trial is a group setting CBT intervention. The primary outcome is the self-rated Posttraumatic Stress Diagnostic Scale, with secondary measurements of depressive severity and mental pollution questionnaire. Assessments are conducted at baseline, after a waiting period before CBT, during CBT, and after CBT. RESULTS: Participants are eligible for the study and complete the outcome measures at all assessment points. In our hypothesis, receiving CBT would lead to improvements in primary and secondary PTSD severity. CONCLUSION: We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. Our treatment would achieve favorable treatment outcomes for PTSD with mental contamination in Japanese clinical settings.

Keywords: CBT, cognitive theory, PTSD, mental pollution

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10703 In silico Repopulation Model of Various Tumour Cells during Treatment Breaks in Head and Neck Cancer Radiotherapy

Authors: Loredana G. Marcu, David Marcu, Sanda M. Filip

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Advanced head and neck cancers are aggressive tumours, which require aggressive treatment. Treatment efficiency is often hindered by cancer cell repopulation during radiotherapy, which is due to various mechanisms triggered by the loss of tumour cells and involves both stem and differentiated cells. The aim of the current paper is to present in silico simulations of radiotherapy schedules on a virtual head and neck tumour grown with biologically realistic kinetic parameters. Using the linear quadratic formalism of cell survival after radiotherapy, altered fractionation schedules employing various treatment breaks for normal tissue recovery are simulated and repopulation mechanism implemented in order to evaluate the impact of various cancer cell contribution on tumour behaviour during irradiation. The model has shown that the timing of treatment breaks is an important factor influencing tumour control in rapidly proliferating tissues such as squamous cell carcinomas of the head and neck. Furthermore, not only stem cells but also differentiated cells, via the mechanism of abortive division, can contribute to malignant cell repopulation during treatment.

Keywords: radiation, tumour repopulation, squamous cell carcinoma, stem cell

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10702 Oncoplastic Augmentation Mastopexy: Aesthetic Revisional Surgery in Breast Conserving Therapy

Authors: Bar Y. Ainuz, Harry M. Salinas, Aleeza Ali, Eli B. Levitt, Austin J. Pourmoussa, Antoun Bouz, Miguel A. Medina

Abstract:

Introduction: Breast conservation therapy remains the mainstay surgical treatment for early breast cancer. Oncoplastic techniques, in conjunction with lumpectomy and adjuvant radiotherapy, have been demonstrated to achieve good aesthetic results without adversely affecting cancer outcomes in the treatment of patients with macromastia or significant ptosis. In our patient population, many women present for breast conservation with pre-existing cosmetic implants or with breast volumes too small for soft tissue, only oncoplastic techniques. Our study evaluated a consecutive series of patients presenting for breast conservation undergoing concomitant oncoplastic-augmentation-mastopexy (OAM) with a contralateral augmentation-mastopexy for symmetry. Methods: OAM surgical technique involves simultaneous lumpectomy with exchange or placement of implants, oncoplastic mastopexy, and concomitant contralateral augmentation mastopexy for symmetry. Patients undergoing lumpectomy for breast conservation as outpatients were identified via retrospective chart review at a high volume private academic affiliated community-based cancer center. Patients with ptosis and either pre-existing breast implants or insufficient breast volume undergoing oncoplastic implant placement (or exchange) and mastopexy were included in the study. Operative details, aesthetic outcomes, and complications were assessed. Results: Over a continuous three-year period, with a two-surgeon cohort, 30 consecutive patients (56 breasts, 4 unilateral procedures) were identified. Patients had an average age of 52.5 years and an average BMI of 27.5, with 40% smokers or former smokers. The average operative time was 2.5 hours, the average implant size removed was 352 cc, and the average implant size placed was 300 cc. All new implants were smooth silicone, with the majority (92%) placed in a retropectoral fashion. 40% of patients received chemotherapy, and 80% of patients received whole breast adjuvant photon radiotherapy with a total radiation dose of either 42.56 or 52.56 Gy. The average and median length of follow-up were both 8.2 months. Of the 24 patients that received radiotherapy, 21% had asymmetry due to capsular contracture. A total of 7 patients (29.2%) underwent revisions for either positive margins (12.5%), capsular contracture (8.3%), implant loss (4.2%), or cosmetic concerns (4.2%). One patient developed a pulmonary embolism in the acute postoperative period and was treated with anticoagulant therapy. Conclusion: Oncoplastic augmentation mastopexy is a safe technique with good aesthetic outcomes and acceptable complication rates for ptotic patients with breast cancer and a paucity of breast volume or pre-existing implants who wish to pursue breast-conserving therapy. The revision rates compare favorably with single-stage cosmetic augmentation procedures as well as other oncoplastic techniques described in the literature. The short-term capsular contracture rates seem lower than the rates in patients undergoing radiation after mastectomy and implant-based reconstruction. Long term capsular contractures and revision rates are too early to know in this cohort.

Keywords: breast conserving therapy, oncoplastic augmentation mastopexy, capsular contracture, breast reconstruction

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10701 Crossbite Unilateral Correction Using Transpalatal Arch with Extension Arm Modification

Authors: Hanifa Maryani Ahmad, Muslim Yusuf

Abstract:

Background: Unilateral crossbite can be defined as an abnormal transverse relationship between the upper and lower teeth where the mandibular buccal cusp occluding to the maxillary buccal cusp and which involves only one side of the arch. This report describes the treatment of an adolescent female with Class III malocclussion unilateral crossbite resulting from a mildly constricted maxillary arch. The patient had a Class III skeletal relationship, Class III molar relationships, unilateral crossbite on the left side, and deviated midlines. Objectives: The treatment objectives were to correct the abnormal transverse relationship, achieve proper dental inclination, and correct the unilateral crossbites to improve the facial profile. Case management: The treatment protocol was using transpalatal arch with extension arm modification to expand the maxillary arch. Following the levelling and aligning stage of treatment, using a vertical loop while mandibular arch was expanded after getting an end to end relationship on the anterior side. Results: Corrections of the unilateral crossbite were achieved in 4 months. The treatment is still on process because the canines relationship were not corrected. Conclusions: This report highlights a treatment using transpalatal arch with extension arm modification that can be used to expand the transverse width of an arch to correct the discrepancy. Even though the treatment processes were still ongoing, the correction of the unilateral crossbite have been achieved in 4 months by only using the transpalatal arch.

Keywords: crossbite unilateral, late growing, non-extraction, transpalatal arch

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10700 Predictors and 3-Year Outcomes of Compromised Left Circumflex Coronary Artery After Left Main Crossover Stenting

Authors: Hameed Ullah, Karim Elakabawi, Han KE, Najeeb Ullah, Habib Ullah, Sardar Ali Shah, Hamad Haider Khan, Muhammad Asad Khan, Ning Guo, Zuyi Yuan

Abstract:

Background: Predictors of decreased fractional flow reserve at left circumflex coronary artery after left main (LM) crossover stenting are still lacking. The objectives of the present study were to provide the predictors for low Fractional flow reserve (FFR) at coronary artery (LCx) and the possible treatment strategies for the compromised LCx-together with their long term outcomes. Methods: A total of 563 included patients out of 1974 patients admitted to our hospital from February 2015 to November 2020 with significant distal LM-bifurcation lesions. The enrolled patients underwent single-stent cross-over PCI under IVUS guidance with further LCx intervention as indicated by measured FFR. Results: The included patients showed angiographic significant LCx ostial affection after LM-stenting, but only 116 (20.6%) patients had FFR <0.8. The 3-year composite MACE rates were comparable between the high and low FFR groups (16.8% vs. 15.5%, respectively; P=0.744). In a multivariable analysis, a low FFR in the LCx was associated with post-stenting MLA of the LCx (OR: 0.032, P <0.001), post-stenting LCx-plaque burden (OR: 1.166, P <0.001), post-stenting LM-MLA (OR: 0.821, P =0.038) and pre-stenting LCx-MLA (OR: 0.371, P =0.044). In patients with low FFR, management of compromised LCx with DEB had the lowest 3-year MACE rate (8.1%) as compared to either KBI (17.5%) or stenting group (20.5%), P =0.299. Conclusion: FFR-guided LCx intervention can avoid unnecessary LCx intervention. The post-stenting predictors of low FFR include post-stenting MLA and plaque burden of the LCx and MV stent length. The 3-year MACE rates were comparable between high FFR patients and patients who had low FFR and were adequately managed.

Keywords: fractional flow reserve, left main stem, percutaneous coronary interventions, intravascular ultrasound

Procedia PDF Downloads 43
10699 Effect Different Moisture States of Surface-treated Recycled Concrete Aggregate on Properties of Fresh and Hardened Concrete

Authors: Sallehan Ismail, Mahyuddin Ramli

Abstract:

This study examined the properties of fresh and hardened concretes as influenced by the moisture state of the coarse recycled concrete aggregates (RCA) after surface treatment. Surface treatment was performed by immersing the coarse RCA in a calcium metasilicate (CM) solution. The treated coarse RCA was maintained in three controlled moisture states, namely, air-dried, oven-dried, and saturated surface-dried (SSD), prior to its use in a concrete mix. The physical properties of coarse RCA were evaluated after surface treatment during the first phase of the experiment to determine the density and the water absorption characteristics of the RCA. The second phase involved the evaluation of the slump, slump loss, density, and compressive strength of the concretes that were prepared with different proportions of natural and treated coarse RCA. Controlling the moisture state of the coarse RCA after surface treatment was found to significantly influence the properties of the fresh and hardened concretes.

Keywords: moisture state, recycled concrete aggregate, surface treatment

Procedia PDF Downloads 263
10698 Influence of Sodium Acetate on Electroless Ni-P Deposits and Effect of Heat Treatment on Corrosion Behavior

Authors: Y. El Kaissi, M. Allam, A. Koulou, M. Galai, M. Ebn Touhami

Abstract:

The aim of our work is to develop an industrial bath of nickel alloy deposit on mild steel. The optimization of the operating parameters made it possible to obtain a stable Ni-P alloy deposition formulation. To understand the reaction mechanism of the deposition process, a kinetic study was performed by cyclic voltammetry and by electrochemical impedance spectroscopy (EIS). The coatings obtained have a very high corrosion resistance in a very aggressive acid medium which increases with the heat treatment.

Keywords: cyclic voltammetry, EIS, electroless Ni–P coating, heat treatment, potentiodynamic polarization

Procedia PDF Downloads 303
10697 Application of EEG Wavelet Power to Prediction of Antidepressant Treatment Response

Authors: Dorota Witkowska, Paweł Gosek, Lukasz Swiecicki, Wojciech Jernajczyk, Bruce J. West, Miroslaw Latka

Abstract:

In clinical practice, the selection of an antidepressant often degrades to lengthy trial-and-error. In this work we employ a normalized wavelet power of alpha waves as a biomarker of antidepressant treatment response. This novel EEG metric takes into account both non-stationarity and intersubject variability of alpha waves. We recorded resting, 19-channel EEG (closed eyes) in 22 inpatients suffering from unipolar (UD, n=10) or bipolar (BD, n=12) depression. The EEG measurement was done at the end of the short washout period which followed previously unsuccessful pharmacotherapy. The normalized alpha wavelet power of 11 responders was markedly different than that of 11 nonresponders at several, mostly temporoparietal sites. Using the prediction of treatment response based on the normalized alpha wavelet power, we achieved 81.8% sensitivity and 81.8% specificity for channel T4.

Keywords: alpha waves, antidepressant, treatment outcome, wavelet

Procedia PDF Downloads 316
10696 Learning Materials of Atmospheric Pressure Plasma Process: Application in Wrinkle-Resistant Finishing of Cotton Fabric

Authors: C. W. Kan

Abstract:

Cotton fibre is a commonly-used natural fibre because of its good fibre strength, high moisture absorption behaviour and minimal static problems. However, one of the main drawbacks of cotton fibre is wrinkling after washing, which is recently overcome by wrinkle-resistant treatment. 1,2,3,4-butanetetracarboxylic acid (BTCA) could improve the wrinkle-resistant properties of cotton fibre. Although the BTCA process is an effective method for wrinkle resistant application of cotton fabrics, reduced fabric strength was observed after treatment. Therefore, this paper would explore the use of atmospheric pressure plasma treatment under different discharge powers as a pretreatment process to enhance the application of BTCA process on cotton fabric without generating adverse effect. The aim of this study is to provide learning information to the users to know how the atmospheric pressure plasma treatment can be incorporated in textile finishing process with positive impact.

Keywords: learning materials, atmospheric pressure plasma treatment, cotton, wrinkle-resistant, BTCA

Procedia PDF Downloads 306
10695 Effect of Dietarty Diversity on Maternal Dietary Diversity of Anemia of the Mother during Pregnancy and Prenatal Outcomes: Prospective Cohort Study in Rural Central Ethiopia

Authors: Taddese Alemu Zerfu, Melaku Umeta Deressa, Kaleab Baye

Abstract:

Background: Maternal and child under-nutrition is the underlying cause of 3•5 million annual deaths, globally. Anemia during pregnancy is among the leading nutritional disorders with serious short and long term consequences to both the mother and fetus. Objective: Examine the effect of dietary diversity on maternal anemia, nutritional status and key pregnancy outcomes of pregnancy. Methods: A prospective cohort study design, involving a total of 432 eligible pregnant women, in their second antenatal care visit was conducted between August 2014 to March, 2015. The individual dietary diversity status of mothers was used as the exposure variable to select, enroll and follow the mothers. All mothers were enrolled during second antenatal care visit and followed until delivery. Epi-data, SPSS and STATA software are used to enter and analyze the data. Chi-square test, independent 't'-test, and GLM are used to calculate risk, association and differences between key variables at P < 0.05. Results: Study participants did not differ in many of the basic characteristics (p < 0.05). The incidence of maternal anemia increased significantly from 28.6% to 32.1% between baseline and term. Pregnant mothers with inadequate dietary diversity groups had more (56% at baseline and 68% at term) risk of anemia than the comparison (adequate) groups, (RR, 1.56 and 1.68; 95% CI, 1.24 - 1.83 and 1.39 - 2.04). The overall incidence of still birth, low birth weight and pre-term birth was 4.5%, 9.1% and 13.6%, respectively. The variation of these outcomes was significant across study groups (P < 0.05). Conclusion and recommendations: Dietary diversity status of pregnant mothers has significant effect on the incidence of anemia and key pregnancy outcomes in resource limited settings, like rural Ethiopia. Therefore, apart from the ongoing routine IFA supplementation, special emphasis should be given to dietary diversity of mothers to improve related outcomes of pregnancy and maternal health.

Keywords: anemia, birth weight, dietary diversity, pregnancy, pregnancy outcome

Procedia PDF Downloads 363
10694 The New Propensity Score Method and Assessment of Propensity Score: A Simulation Study

Authors: Azam Najafkouchak, David Todem, Dorothy Pathak, Pramod Pathak, Joseph Gardiner

Abstract:

Propensity score (PS) methods have recently become the standard analysis tool for causal inference in observational studies where exposure is not randomly assigned. Thus, confounding can impact the estimation of treatment effect on the outcome. Due to the dangers of discretizing continuous variables, the focus of this paper will be on how the variation in cut-points or boundaries will affect the average treatment effect utilizing the stratification of the PS method. In this study, we will develop a new methodology to improve the efficiency of the PS analysis through stratification and simulation study. We will also explore the property of empirical distribution of average treatment effect theoretically, including asymptotic distribution, variance estimation and 95% confident Intervals.

Keywords: propensity score, stratification, emprical distribution, average treatment effect

Procedia PDF Downloads 99
10693 Textile Wastewater Ecotoxicity Abatement after Aerobic Granular Sludge Treatment and Advanced Oxidation Process

Authors: Ana M. T. Mata, Alexiane Ligneul

Abstract:

Textile effluents are usually heavily loaded with organic carbon and color compounds, the latter being azo dyes in an estimated 70% of the case effluent posing a major challenge in environmental protection. In this study, the ecotoxicity of simulated textile effluent after biological treatment with anaerobic and aerobic phase (aerobic granular sludge, AGS) and after advanced oxidation processes (AOP) namely ozonation and UV irradiation as post-treatment, were tested to evaluate the fitness of this treatments for ecotoxicity abatement. AGS treatment achieved an 80% removal in both COD and color. AOP was applied with the intention to mineralize the metabolites resulting from biodecolorization of the azo dye Acid Red 14, especially the stable aromatic amine (4-amino-1-naphthalenesulfonic acid, 4A1NS). The ecotoxicity evaluation was based on growth inhibition of the algae Pseudokirchneriella subcapitata following OECD TG 201 except regarding the medium, MBL medium was used instead. Five replicate control cultures and samples were performed with an average STD of 2.7% regarding specific algae growth rate determination. It was found that untreated textile effluent holds an inhibition of specific growth rate of 82%. AGS treatment by itself is able to lower ecotoxicity to 53%. This is probably due to the high color removal of the treatment. AOP post-treatment with Ozone and UV irradiation improves the ecotoxicity abatment to 49 and 43% inhibition respectively, less significantly than previously thought. Since over 85% of 4A1NS was removed by either of the AOP (followed by HPLC), an individual ecotoxicity test of 4A1NS was performed showing that 4A1NS does not inhibit algae growth (0% inhibition). It was concluded that AGS treatment is able by itself to achieve a significant ecotoxicity abatement of textile effluent. The cost-benefit of AOP as a post-treatment have to be better accessed since their application resulted in an improvement of only 10% regarding ecotoxicity effluent removal. It was also found that the 4A1NS amine had no apparent effect on ecotoxicity. Further studies will be conducted to study where ecotoxicity is coming from after AGS biological treatment and how to eliminate it.

Keywords: textile wastewate, ecotoxicity, aerobic granular sludge, AOP

Procedia PDF Downloads 165
10692 Effects of Application of Rice Husk Charcoal-Coated Urea and Rice Straw Compost on Growth, Yield, and Properties of Lowland Rice

Authors: D. A. S. Gamage, B. F. A. Basnayake, W.A.J.M. De Costa

Abstract:

Rice is the staple food of Sri Lankans thus; rice cultivation is the major agricultural activity of the country. The application of inorganic fertilizer has become a burden to the country. The excessive application of organic and inorganic fertilizers can potentially lead to deterioration of the quality of water. In mixing both urea and rice husk charcoal and rice straw compost in soils causes a slow release of nitrogen fertilizer, thus reducing the cost of importations of nitrogen based fertilizers per unit area of cultivation. Objective of this study was to evaluate rice husk charcoal coated urea as a slow releasing fertilizer and compare the total N,P, K, organic matter in soil and yield of rice production. Five treatments were used for twenty pots (pot size 30 cm diameter and 45 cm height) each replicated four times as: inorganic fertilizer only (Urea, TSP and MOP) (Treatment 1); rice husk charcoal coated urea, TSP and MOP (Treatment 2); inorganic fertilizer (Urea, TSP and MOP) with rice straw compost only (Treatment 3); rice husk charcoal urea, TSP and MOP with rice straw compost (Treatment 4); and no fertilizer as the control (Treatment 5). Rice grain yield was significantly higher in treatment 4 where rice husk charcoal coated urea, TSP and MOP with rice straw compost. The lowest yield was observed in control (treatment 5). The lower the value of the nitrogen to phosphorous ratio in soil, it indicates higher uptake of phosphorous. Charcoal can be used as a soil amendment and organic fertilizer, but adjustment of pH was required at high application rates. K content of soil of treatment 3 and 4 were the highest with compared to the treatment 1. Rice husk charcoal coated urea can potentially be used as a slow releasing nitrogen fertilizer.

Keywords: charcoal, rice husk, nitrogen to phosphorous ratio, soil amendment

Procedia PDF Downloads 308