Search results for: cutaneous signs

Authors: Angeli Marie P. Lagman, Nephtali M. Gorgonio

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Catamenial pneumothorax is defined as a recurrent accumulation of air in the pleural cavity, which occurs in the period of 72 hours before or after menses. In a menstruating woman presenting with the difficulty of breathing and chest pain with concomitant radiographic evidence of pneumothorax, a diagnosis of catamenial pneumothorax should be entertained. Two cases of catamenial pneumothorax were reported in our local literature. This report added two more cases. The first case is 45 years old G1P1, while the second case is 46 years old G2P2. These two patients had a history of pelvic endometriosis in the past. All other signs and symptoms were similar to the previously reported cases. All patients presented with difficulty of breathing associated with chest pain. Imaging studies showed right-sided pneumothorax in all patients. Intraoperatively, subpleural bleb, diaphragmatic fenestrations, and endometriotic implants were found. Three patients underwent video-assisted thoracosurgery (VATS), while one patient underwent open thoracotomy with pleurodesis. Histopathology revealed endometriosis in only two patients. All patients received postoperative hormonal therapy, and there were no recurrences noted in all patients. Endometriosis-related catamenial pneumothorax is a rare condition that needs early recognition of the symptoms. Several theories may be involved to explain the pathogenesis of catamenial pneumothorax. Two cases show a strong significant association between a history of pelvic endometriosis and the development of catamenial pneumothorax, while one case can be explained by the hormonal theory. The difficulty of breathing and chest pain in relation to menses may prompt early diagnosis. One case has shown that pneumothorax may occur even after menstruation. A biopsy of the endometrial implants may not always show endometrial glands and stroma, nor will immunostaining, which will not always show estrogen and progesterone receptors. Video-assisted thoracoscopic surgery is the gold standard in the diagnosis and treatment of catamenial pneumothorax. Postoperative hormonal suppression will further reduce the disease recurrence and facilitate the effectiveness of the surgical treatment.

Keywords: catamenial pneumothorax, endometriosis, menstruation, video assisted thoracosurgery

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Authors: Luísa Pedro, José Pais-Ribeiro, João Páscoa Pinheiro

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Multiple Sclerosis (MS) is a chronic disease of the central nervous system that affects more often young adults in the prime of his career and personal development, with no cure and unknown causes. The most common signs and symptoms are fatigue, muscle weakness, changes in sensation, ataxia, changes in balance, gait difficulties, memory difficulties, cognitive impairment and difficulties in problem solving. MS is a relatively common neurological disorder in which various impairments and disabilities impact strongly on function and daily life activities. The aim of this study is to examine the implications of the program of self-regulation in the perception of illness and mental health (psychological well-being domain) in MS patients. MS is a relatively common neurological disorder in which various impairments and disabilities impact strongly on function and daily life activities. The aim of this study is to examine the implications of the program of self-regulation in the perception of illness and mental health (psychological well-being domain) in MS patients. After this, a set of exercises was implemented to be used in daily life activities, according to studies developed with MS patients. We asked the subjects the question “Please classify the severity of your disease?” and used the domain of psychological well-being, the Mental Health Inventory (MHI-38) at the beginning (time A) and end (time B) of the program of self-regulation. We used the Statistical Package for the Social Sciences (SPSS) version 20. A non-parametric statistical hypothesis test (Wilcoxon test) was used for the variable analysis. The intervention followed the recommendations of the Helsinki Declaration. The age range of the subjects was between 20 and 58 years with a mean age of 44 years. 58.3 % were women, 37.5 % were currently married, 67% were retired and the mean level of education was 12.5 years. In the correlation between the severity of the disease perception and psychological well before the self-regulation program, an obtained result (r = 0.26, p <0.05), then the self-regulation program, was (r = 0.37, p <0.01), from a low to moderate correlation. We conclude that the program of self-regulation for physical activity in patients with MS can improve the relationship between the perception of disease severity and psychological well-being.

Keywords: psychological well-being, multiple sclerosis, self-regulation, physical activity

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Authors: Oktavian Prasetia Wardana, Martono Tri Utomo, Risa Etika, Kartika Darma Handayani, Dina Angelika, Wurry Ayuningtyas

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Background: Critically ill neonates are newborn babies with high-risk factors that potentially cause disability and/or death. Scoring systems for determining the severity of the disease have been widely developed as well as some designs for use in neonates. The SNAPPE-II method, which has been used as a mortality predictor scoring system in several referral centers, was found to be slow in assessing the outcome of critically ill neonates in the Neonatal Intensive Care Unit (NICU). Objective: To analyze the predictive value of MSNS on the outcome of critically ill neonates at the time of arrival up to 24 hours after being admitted to the NICU. Methods: A longitudinal observational analytic study based on medical record data was conducted from January to August 2022. Each sample was recorded from medical record data, including data on gestational age, mode of delivery, APGAR score at birth, resuscitation measures at birth, duration of resuscitation, post-resuscitation ventilation, physical examination at birth (including vital signs and any congenital abnormalities), the results of routine laboratory examinations, as well as the neonatal outcomes. Results: This study involved 105 critically ill neonates who were admitted to the NICU. The outcome of critically ill neonates was 50 (47.6%) neonates died, and 55 (52.4%) neonates lived. There were more males than females (61% vs. 39%). The mean gestational age of the subjects in this study was 33.8 ± 4.28 weeks, with the mean birth weight of the subjects being 1820.31 ± 33.18 g. The mean MSNS score of neonates with a deadly outcome was lower than that of the lived outcome. ROC curve with a cut point MSNS score <10.5 obtained an AUC of 93.5% (95% CI: 88.3-98.6) with a sensitivity value of 84% (95% CI: 80.5-94.9), specificity 80 % (CI 95%: 88.3-98.6), Positive Predictive Value (PPV) 79.2%, Negative Predictive Value (NPV) 84.6%, Risk Ratio (RR) 5.14 with Hosmer & Lemeshow test results p>0.05. Conclusion: The MSNS score has a good predictive value and good calibration of the outcomes of critically ill neonates admitted to the NICU.

Keywords: critically ill neonate, outcome, MSNS, NICU, predictive value

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Authors: Aamna Tufail, Kajal Kotecha, Iordanis Toursounidis, Ravinder Pabla

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Introduction/Aims: Acute Myeloid Leukaemia (AML) is a part of leukaemic group of hematopoietic disorders with a varying range of presentations, including oro-facial manifestations. Early recognition and management are essential for favourable outcomes. Materials and Methods: We present our experience, clinical presentation, and clinical photographs of a patient with previously undiagnosed AML who presented with oral symptoms to the emergency department of our hospital. An analysis of clinical characteristics, diagnostic investigations, and management modalities was performed. Results/Statistics: A 58-year-old man presented to A&E reporting an 11-day history of right sided facial swelling, acute TMJ symptoms, and oral discomfort. A dentist ruled out acute dental causes one day post onset of symptoms. Initial assessment was anatomically inconsistent and did not reveal a routine oral or maxillofacial etiology. Detailed clinical examination demonstrated fever, generalised pallor, swelling and erythema of right nasolabial region, bilateral masseteric tenderness, intraoral palatal ecchymosis, palatal ulceration, buccal and labial petechiae, cervical lymphadenopathy, and haematoma on dorsum of right hand overlying right 2nd metacarpal joint. Suspecting a systemic medical cause, we requested haematological investigations, which revealed neutropenia, thrombocytopenia, and anaemia. Flow cytometry confirmed CD34 + AML. Oral discomfort was managed symptomatically. The patient was referred to a tertiary care centre for acute haematologic care, where he was treated with IV antibiotics and continuing cycles of chemotherapy. Conclusions/Clinical Relevance: Oro-facial manifestations may be the first clinical sign of AML. Awareness of its features is vital in early diagnosis. In this context, dentists and oral medicine specialists can play an important role in detecting clinical signs of haematological disorders such as AML.

Keywords: acute myeloid leukaemia, oral symptoms, ulceration, diagnosis, management

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Authors: Viviana Manzulli, Luigina Serrecchia, Adelia Donatiello, Valeria Rondinone, Sabine Zange, Alina Tscherne, Antonio Parisi, Antonio Fasanella

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Anthrax is a zoonotic disease that affects a wide range of animal species (primarily ruminant herbivores), and can be transmitted to humans through consumption or handling of contaminated animal products. The etiological agent B.anthracis is able to survive in unfavorable environmental conditions by forming endospore which remain viable in the soil for many decades. Furthermore, B.anthracis is considered as one of the most feared agents to be potentially misused as a biological weapon and the importance of the disease and its treatment in humans has been underscored before the bioterrorism events in the United States in 2001. Due to the often fatal outcome of human cases, antimicrobial susceptibility testing plays especially in the management of anthrax infections an important role. In Italy, animal anthrax is endemic (predominantly found in the southern regions and on islands) and is characterized by sporadic outbreaks occurring mainly during summer. Between 2012 and 2017 single human cases of cutaneous anthrax occurred. In this study, 90 diverse strains of B.anthracis, isolated in Italy from 2001 to 2017, were screened to their susceptibility to sixteen clinically relevant antimicrobial agents by using the broth microdilution method. B.anthracis strains selected for this study belong to the strain collection stored at the Anthrax Reference Institute of Italy located inside the Istituto Zooprofilattico Sperimentale of Puglia and Basilicata. The strains were isolated at different time points and places from various matrices (human, animal and environmental). All strains are a representative of over fifty distinct MLVA 31 genotypes. The following antibiotics were used for testing: gentamicin, ceftriaxone, streptomycin, penicillin G, clindamycin, chloramphenicol, vancomycin, linezolid, cefotaxime, tetracycline, erythromycin, rifampin, amoxicillin, ciprofloxacin, doxycycline and trimethoprim. A standard concentration of each antibiotic was prepared in a specific diluent, which were then twofold serial diluted. Therefore, each wells contained: bacterial suspension of 1–5x104 CFU/mL in Mueller-Hinton Broth (MHB), the antibiotic to be tested at known concentration and resazurin, an indicator of cell growth. After incubation overnight at 37°C, the wells were screened for color changes caused by the resazurin: a change from purple to pink/colorless indicated cell growth. The lowest concentration of antibiotic that prevented growth represented the minimal inhibitory concentration (MIC). This study suggests that B.anthracis remains susceptible in vitro to many antibiotics, in addition to doxycycline (MICs ≤ 0,03 µg/ml), ciprofloxacin (MICs ≤ 0,03 µg/ml) and penicillin G (MICs ≤ 0,06 µg/ml), recommend by CDC for the treatment of human cases and for prophylactic use after exposure to the spores. In fact, the good activity of gentamicin (MICs ≤ 0,25 µg/ml), streptomycin (MICs ≤ 1 µg/ml), clindamycin (MICs ≤ 0,125 µg/ml), chloramphenicol(MICs ≤ 4 µg/ml), vancomycin (MICs ≤ 2 µg/ml), linezolid (MICs ≤ 2 µg/ml), tetracycline (MICs ≤ 0,125 µg/ml), erythromycin (MICs ≤ 0,25 µg/ml), rifampin (MICs ≤ 0,25 µg/ml), amoxicillin (MICs ≤ 0,06 µg/ml), towards all tested B.anthracis strains demonstrates an appropriate alternative choice for prophylaxis and/or treatment. All tested B.anthracis strains showed intermediate susceptibility to the cephalosporins (MICs ≥ 16 µg/ml) and resistance to trimethoprim (MICs ≥ 128 µg/ml).

Keywords: Bacillus anthracis, antibiotic susceptibility, treatment, minimum inhibitory concentration

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Authors: Karen Jacob

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Over the last decades, there has been a rise in the use of CLIL (content and language integrated learning) methodology as a way of reinforcing FL (foreign language) acquisition. CLIL techniques have also been transferred to the formal instruction-based FL classroom where through content-based lessons and project work it can very often say that teachers are ‘clilling’ in the FL classroom. When it comes to motivating students to acquire an FL, we have to take into account that English is not your run-of-the-mill FL: English is an international language (EIL). Consequently, this means that EFL students should be able to use English as an international medium of communication. This leads to the assumption that along with FL competence, speakers of EIL will need to become competent international citizens with knowledge of other societies, both contextually and geographically, and be flexible, open-minded, respectful and sensitive towards other world groups. Rather than ‘intercultural’ competence we should be referring to ‘transcultural’ competence. This paper reports the implementation of a content- and task-based approach to EFL teaching which was applied to two groups of 15 year-olds from two schools on the Spanish island of Mallorca during the school year 2015-2016. Students worked on three units of work that aimed at ‘internationalising’ the classroom by introducing topics that would encourage them to become transculturally aware of the world in which they live. In this paper we discuss the feedback given by the teachers and students on various aspects of the approach in order to answer the following research questions: 1) To what extent were the students motivated by the content and activities of the classes?; 2) Did this motivation have a positive effect on the students’ overall results for the subject; 3) Did the participants show any signs of becoming transculturally aware. Preliminary results from qualitative data show that the students enjoyed the move away from the more traditional EFL content and, as a result, they became more competent in speaking and writing. Students also appeared to become more knowledgeable and respectful towards the ‘other’. The EFL approach described in this paper takes a more qualitative approach to research by describing what is really going on in the EFL classroom and makes a conscious effort to provide real examples of not only the acquisition of linguistic competence but also the acquisition of other important communication skills that are of utmost importance in today's international arena.

Keywords: CLIL, content- and task-based learning, internationalisation, transcultural competence

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Authors: Majse Lind, Carla Sharp, Salome Vanwoerden

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Narrative identity is the dynamic and evolving story individuals create about their personal pasts, presents, and presumed futures. This storied sense of self develops in adolescence and is crucial for fostering a sense of self-unity and purpose in life. A growing body of work has shown that several characteristics of narrative identity are disturbed in adults suffering from borderline personality disorder (BPD). Very little research, however, has explored the stories told by adolescents with BPD features. Investigating narrative identity early in the lifespan and in relation to personality pathology is crucial; BPD is a developmental disorder with early signs appearing already in adolescence. In the current study, we examine narrative identity (focusing on themes of agency and communion) coded from self-defining memories derived from the child attachment interview in 174 inpatient adolescents (M = 15.12, SD = 1.52) at the time of admission. The adolescents’ social cognition was further assessed on the basis of their reactions to movie scenes (i.e., the MASC movie task). They also completed a trauma checklist and self-reported BPD features at three different time points (i.e., at admission, at discharge, and 6 months after admission). Preliminary results show that adolescents who told stories containing themes of agency and communion evinced better social cognition, and lower emotional abuse on the trauma checklist. In addition, adolescents who disclosed stories containing lower levels of agency and communion demonstrated more BPD symptoms at all three time points, even when controlling for the occurrence of traumatic life events. Surprisingly, social cognitive abilities were not significantly associated with BPD features. These preliminary results underscore the importance of narrative identity as an indicator, and potential cause, of incipient personality pathology. Thus, focusing on diminished themes of narrative-based agency and communion in early adolescence could be crucial in preventing the development of personality pathology over time.

Keywords: borderline personality disorder, inpatient adolescents, narrative identity, follow-ups

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Authors: Tania Viju, Bimal P., Naseer M. A.

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This study aims to develop a conceptual framework for the decision support system (DSS), that helps the decision-makers to dynamically choose appropriate safety measures for each identified accident blackspot. An accident blackspot is a segment of road where the frequency of accident occurrence is disproportionately greater than other sections on roadways. According to a report by the World Bank, India accounts for the highest, that is, eleven percent of the global death in road accidents with just one percent of the world’s vehicles. Hence in 2015, the Ministry of Road Transport and Highways of India gave prime importance to the rectification of accident blackspots. To enhance road traffic safety and reduce the traffic accident rate, effectively identifying and rectifying accident blackspots is of great importance. This study helps to understand and evaluate the existing methods in accident blackspot identification and prediction that are used around the world and their application in Indian roadways. The decision support system, with the help of IoT, ICT and smart systems, acts as a management and planning tool for the government for employing efficient and cost-effective rectification strategies. In order to develop a decision criterion, several factors in terms of quantitative as well as qualitative data that influence the safety conditions of the road are analyzed. Factors include past accident severity data, occurrence time, light, weather and road conditions, visibility, driver conditions, junction type, land use, road markings and signs, road geometry, etc. The framework conceptualizes decision-making by classifying blackspot stretches based on factors like accident occurrence time, different climatic and road conditions and suggesting mitigation measures based on these identified factors. The decision support system will help the public administration dynamically manage and plan the necessary safety interventions required to enhance the safety of the road network.

Keywords: decision support system, dynamic management, road accident blackspots, road safety

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Authors: Rita Alfattal, Maryam Alfarhan, Adeeb M. Algaith, Buthaina Albash, Reem M. Elshafie, Asma Alshammari, Ahmad Alahmad, Fatima Dashti, Rasha Alsafi, Hind Alsharhan

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Defects of respiratory chain complex III (CIII) result in characteristic but rare mitochondrial disorders associated with distinct neuroradiological findings. The underlying molecular defects affecting mitochondrial CIII assembly factors are few and yet to be identified. LYRM7 assembly factor is required for proper CIII assembly where it acts as a chaperone for the Rieske iron‐sulfur (UQCRFS1) protein in the mitochondrial matrix and stabilizing it. We present here the seventeenth individual with LYRM7-associated mitochondrial leukoencephalopathy harboring a previously reported rare pathogenic homozygous LYRM 7 variant, c.2T>C, (p.Met1?). Like previously reported individuals, our 4-year-old male proband presented with recurrent metabolic and lactic acidosis, encephalopathy, and myopathy. Further, he has additional, previously unreported features, including an acute stroke like episode with bilateral central blindness and optic neuropathy, recurrent hyperglycemia and hypertension associated with metabolic crisis. However, he has no signs of psychomotor regression. He has been stable clinically with residual left-sided reduced visual acuity and amblyopia, and no more metabolic crises for 2-year-period while on the mitochondrial cocktail. Although the reported brain MRI findings in other affected individuals are homogenous, it is slightly different in our index, revealing evidence of bilateral almost symmetric multifocal periventricular T2 hyperintensities with hyperintensities of the optic nerves, optic chiasm, and corona radiata but with no cavitation or cystic changes. This report describes new clinical and radiological findings of LYRM7-associated disease. The report also summarizes the clinical and molecular data of previously reported individuals describing the full phenotypic spectrum.

Keywords: LYRM7 gene defect, mitochondrial disease, , lactic acidosis, , genetic disorder

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Authors: Martina Dickson, Hanadi Kadbey, Melissa Mcminn

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Research has shown that anxiety and trepidation towards learning about science is prevalent among elementary school teachers in Western countries. It has also been shown repeatedly that pre-service and in-service teachers who show signs of anxiety towards science are; a) less likely to teach it at all, where they have some autonomy over this, b) less likely to teach it effectively c) ultimately that their students have lower attainment scores in science. It is therefore critically important to gauge pre-service teachers’ science anxiety levels early on whilst there are still possibilities to overturn some of the reasons behind these fears and avert these serious issues occurring later on. This study takes place in the capital of the United Arab Emirates (U.A.E.) in the context of training local elementary school teachers. In the U.A.E., where Emirati teachers are already in the vast minority and attrition rates are high, it is important to offer as much support to pre-service teachers as possible. If pre-service teachers are graduating with high levels of science anxiety unabated, according to the research there is a very real concern that as generalist primary school teachers, their science teaching will be far from optimal. The aims of this research study were to ascertain the science anxiety levels of pre-service elementary teachers and to identify particular areas of their science anxiety, if appropriate. We surveyed 200 Emirati pre-service teachers and found that levels of science anxiety were directly related to their perceptions of performance in science exams, laboratory experiments and inquiry approaches to science learning. Whilst some studies have shown that science anxiety can decrease as students gain confidence in science knowledge by studying courses, we did not see this effect in our study. This is based upon a theoretical framework which holds that in some cases, science anxiety is related to lack of exposure to, or insecurity with science content itself which in some cases is alleviated by the students’ covering of material and greater confidence in the subject. Exploring this variable allowed us to explore whether students educated in schools influenced by the educational reform in Abu Dhabi have differing science anxiety levels from those who were educated prior to the reforms. We discuss the possible implications of these findings to the future teaching of science in Abu Dhabi public schools.

Keywords: pre-service teachers, science anxiety, United Arab Emirates, educational reform

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Authors: Muhammad Nawaz, Waqas Ahmad

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Dimension stone is used in construction since prehistoric time; however, its use in the construction has gained significant attention for the last few decades. The present study is designed to investigate the physical and strength properties of volcanic rocks from the Kohistan Island Arc to assess their use as dimension stone. On the basis of the composition, color and texture, five varieties of andesites (MMA, PMA-1, PMA-2, CMA and FMA) and two varieties of agglomerates (AG-1 and AG-2) were identified. These were characterized in terms of their petrography (compositional and textural), physical properties (specific gravity, water absorption, porosity) and strength properties (Unconfined compressive strength and Unconfined tensile strength). Two non-destructive tests (Ultrasonic pulse velocity test and Schmidt Hammer) were conducted and the degree of polishing was evaluated. In addition, correlation analyses were carried out to establish possible relationships among these parameters. The presence of chlorite, epidote, sericite and recrystallized quartz showed the signs of low-grade metamorphism in andesites. The results showed feldspar, amphibole and quartz imparted good physical and strength properties to the samples MMA, CMA, FMA, AG1 and AG2. Whereas, the abundance of alteration products such as chlorite, sericite and epidote in PMA-1 and PMA-2 reduced the physical and strength properties. The unconfined compressive strength showed a strong correlation with ultrasonic pulse velocity, dry density, porosity and water absorption. The values of ultrasonic pulse velocity and Schmidt hammer were considerably affected by the weathering grade. The samples PMA-1 and PMA-2, due to their high water absorption and low strength values, were not recommended for use in load-bearing masonry units and outdoor applications. Whereas, the excellent properties, i.e. high strength and good polishing, the samples, FMA and MMA suggested their use as a decorative and facing stone, in the external pavement, ashlar, rubbles and load-bearing masonry units etc.

Keywords: Physico-mechanical properties, Volcanic rocks, Kohistan Island Arc, Pakistan

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Authors: Pablo Cid Galache, Laura Zamorano Bonilla

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Mauriac syndrome (MS) is a rare complication of type 1 diabetes mellitus (DM1). It is rela-ted to low insulin concentrations. Therefore is a complication mainly found in developing countries. The main clinical features are hepatomegaly, edema, growth and puberty delay, and the presence of elevated transaminases and serum lipids. The MS incidence is de-creasing due to the new types of insulin and intensive glycemic control. Therefore is a rare diagnosis in Europe nowadays, being described mainly in developing countries or with so-cioeconomic limitations to guarantee an adequate management of diabetes. Edema secondary to fluid retention is a rare complication of insulin treatment, especially in young patients. Its severity is variable and is mainly related to the start of a proper treatment and the improvement in glycemic control after diagnosis or after periods of poor metabolic control. Edema resolves spontaneously without requiring treatment in most cases. The Pediatric Endocrinology Unit of Hospital Motril could diagnose a 14-year-old girl who presented very poor metabolic control during the last 3 years as a consequence of the socioeconomic conditions of the country of origin during the last years. Presents up to 4 admissions for ketoacidosis during the last 12 months. After the family moved to Spain our patient began to be followed up in our Hospital. Initially presented glycated hemoglobin figures of 11%. One week after the start of treatment, the patient was admitted in the emergency room due to the appearance of generalized edema and pain in the limbs. The main laboratory abnormalities include: blood glucose 225mg/dl; HbA1C 10.8% triglycerides 543 mg/dl, total cholesterol 339 mg/dl (LDL 225) GOT 124 U/l, GPT 89U/l. Abdominal ultrasound shows mild hepatomegaly and no signs of ascites were shown. The patient presented a progressive improvement with resolution of the edema and analitical abnormalities during the next two weeks. During admission, the family received diabetes education, achieving adequate glycemic control at discharge. Nowadays the patient has a good glycemic control having glycated hemoglobin levels around 7%.

Keywords: Mauriac, diabetes, complication, developing countries

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Authors: Hamza A. Pantami, Khozizah Shaari, Intan S. Ismail, Chong C. Min

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Introduction: Tilapia is the second-highest harvested freshwater fish species in Malaysia, available in almost all fish farms and markets. Unfortunately, tilapia culture in Malaysia is highly affected by Aeromonas hydrophila and Streptococcus agalactiae, which affect the production rate and consequently pose a direct negative economic impact. Reliance on drugs to control or reduce bacterial infections has been led to contamination of water bodies and development of drug resistance, as well as gave rise to toxicity issues in downstream fish products. Resorting to vaccines have helped curb the problem to a certain extent, but a more effective solution is still required. Using microalgae-based feed to enhance the fish immunity against bacterial infection offers a promising alternative. Objectives: This study aims to evaluate the efficacy of Chlorella vulgaris at lower percentage incorporation in feeds for an immune boost of tilapia in a shorter time. Methods: The study was in two phases. The safety concentration studies at 500 mg/kg-1 and the administration of cultured C. vulgaris biomass via incorporation into fish feed for five different groups in three weeks. Group 1 was the control (0% incorporation), whereas group 2, 3, 4 and 5 received 0.625%, 1.25%, 2.5% and 5% incorporation respectively. The parameters evaluated were the blood profile, serum lysozyme activity (SLA), serum bactericidal activity (SBA), phagocytosis activity (PA), respiratory burst activity (RBA), and lymphoproliferation activity (LPA). The data were analyzed via ANOVA using SPSS (version 16). Further testing was done using Tukey’s test. All tests were performed at the 95% confidence interval (p < 0.05). Results: There were no toxic signs in tilapia fish at 500 mg/kg-1. Treated groups showed significantly better immune parameters compared to the control group (p < 0.05). Conclusions: C. vulgaris crude biomass in a fish meal at a lower incorporation level of 5% can increase specific and non-specific immunity in tilapia fish in a shorter time duration.

Keywords: Chlorella vulgaris, hematology profile, immune boost, lymphoproliferation

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Authors: Thomas P. Carroll

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The phenomenon of mindfulness has become ever more popular in an increasingly pluralist Western society. Mindfulness practice has penetrated secular contexts that would otherwise be closed to religious influence, including state schools, hospitals, and commerce. The contemporary understanding of mindfulness has its origins in Buddhist meditation. However, since Jon Kabat-Zinn’s pioneering work in Mindfulness-Based Interventions, the concept has developed and sometimes mutated into various forms of practice which are disembedded from their original spiritual philosophy. This project will explore the spiritual climate within which mindfulness is currently flourishing through dialogue with three interlocutors. The first interlocutor is the Canadian philosopher Charles Taylor whose seminal work, ‘A Secular Age’, outlines three distinct modes of secularity. Taylor examines how the conditions of belief have changed and how the self seeks meaning in an age where belief in the divine is no longer axiomatic. The next interlocutor is Czech theologian and psychotherapist Tomáš Halík who offers a unique perspective of a Catholic who belongs to a section of society outnumbered by secular counterparts, with a theological hermeneutic best described as 'Den Fremden verstehen- understanding the stranger'. Finally, Irish theologian Michael Paul Gallagher offers a theological perspective on how the Christian faith can be translated into dialogue with Irish secular culture, as well as addressing the crisis of imagination and culture rather than the crisis of faith in Ireland. These interlocutors will illustrate that there are sometimes striking differences in how to interpret the religious signs of the times. However, these approaches also reveal significant similarities in how they address and explore the meaning of religious belief and experience today. In this way, themes will emerge that will help to frame the conversation about mindfulness in the West. These themes will include; the failure of the secularization thesis to pass, the growth of a diverse marketplace of religions and beliefs and the growth of a demographic who identify as spiritual but not religious. Such research is paramount in enabling a richer dialogue between Christian faith and mindfulness in a fragmented, postmodern Western context.

Keywords: culture, mindfulness, secularism, spirituality

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Authors: Shammael Selorfia

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The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.

Keywords: delirium, surgery, quality, improvement

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Authors: Abd El Rahman Mohamed

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Canopic jars made by the ancient Egyptians from different materials were used to preserve the viscera during the mummification process. The canopic jar studied here dates back to the Late Period (712-332 BC). It is found in the Grand Egyptian Museum (GEM), Giza, Egypt. This jar was carved from limestone and covered with a monkey head lid with painted eyes and ears with red pigment and surrounded with black pigment. The jar contains bandages of textile containing mummy viscera with resin and black resin blocks. The canopic jars were made using the sculpting tools that were used by the ancient Egyptians, such as metal chisels (made of copper) and hammers and emptying the mass of the jar from the inside using a tool invented by the ancient Egyptians, which called the emptying drill. This study also aims to use analytical techniques to identify the components of the jar, its contents, pigments, and previous restoration materials and to understand its deterioration aspects. Visual assessment, isolation and identification of fungi, optical microscopy (OM), scanning electron microscopy (SEM), X-ray fluorescence spectroscopy (XRF), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR) were used in our study. The jar showed different signs of deterioration, such as dust, dirt, stains, scratches, classifications, missing parts, and breaks; previous conservation materials include using iron wire, completion mortar and an adhesive for assembly. The results revealed that the jar was carved from Dolomite Limestone, red Hematite pigment, Mastic resin, and Linen textile bandages. The previous adhesive was Animal Glue and used Gypsum for the previous completion. The most dominant Microbial infection on the jar was found in the fungi of (Penicillium waksmanii), (Nigrospora sphaerica), (Actinomycetes sp) and (Spore-Forming Gram-Positive Bacilli). Conservation procedures have been applied with high accuracy to conserve the jar, including mechanical and chemical cleaning, re-assembling, completion and consolidation.

Keywords: Canopic jar, Consolidation, Mummification, Resin, Viscera.

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Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

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Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

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Authors: Nicole M. Martino

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Reinforced concrete bridge deck condition assessments primarily use visual inspection methods, where an inspector looks for and records locations of cracks, potholes, efflorescence and other signs of probable deterioration. Sounding is another technique used to diagnose the condition of a bridge deck, however this method listens for damage within the subsurface as the surface is struck with a hammer or chain. Even though extensive procedures are in place for using these inspection techniques, neither one provides the inspector with a comprehensive understanding of the internal condition of a bridge deck – the location where damage originates from.  In order to make accurate estimates of repair locations and quantities, in addition to allocating the necessary funding, a total understanding of the deck’s deteriorated state is key. The research presented in this paper collected infrared thermography and ground penetrating radar data from reinforced concrete bridge decks without an asphalt overlay. These decks were of various ages and their condition varied from brand new, to in need of replacement. The goals of this work were to first verify that these nondestructive evaluation methods could identify similar areas of healthy and damaged concrete, and then to see if combining the results of both methods would provide a higher confidence than if the condition assessment was completed using only one method. The results from each method were presented as plan view color contour plots. The results from one of the decks assessed as a part of this research, including these plan view plots, are presented in this paper. Furthermore, in order to answer the interest of transportation agencies throughout the United States, this research developed a step-by-step guide which demonstrates how to collect and assess a bridge deck using these nondestructive evaluation methods. This guide addresses setup procedures on the deck during the day of data collection, system setups and settings for different bridge decks, data post-processing for each method, and data visualization and quantification.

Keywords: bridge deck deterioration, ground penetrating radar, infrared thermography, NDT of bridge decks

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Authors: Saikat Datta

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Incompressible laminar time-varying flow is investigated over a rounded backward-facing step for a triangular piston motion at the inlet of a straight channel with very high acceleration, followed by a slow deceleration experimentally and through numerical simulation. The backward-facing step is an important test-case as it embodies important flow characteristics such as separation point, reattachment length, and recirculation of flow. A sliding piston imparts two successive triangular velocities at the inlet, constant acceleration from rest, 0≤t≤t0, and constant deceleration to rest, t0≤tKeywords: laminar boundary layer separation, rounded backward facing step, separation bubble, unsteady separation, unsteady vortex flows

Procedia PDF Downloads 46

Authors: Ilana Margalith, Adaya Meirowitz, Sigalit Cohavi

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Violence against health professionals by patients and their families have recently become a disturbing phenomenon worldwide, exacting psychological as well as economic tolls. Health workplaces in Israel (e.g. hospitals and H.M.O clinics) provide workshops for their employees, supplying them with coping strategies. However, these workshops do not focus on nursing students, who are also subjected to this violence. Their learning environment is no longer as protective as it used to be. Furthermore, coping with violence was not part of the curriculum for Israeli nursing students. Thus, based on human aggression theories which depict the pivotal role of the professional's correct response in preventing the onset of an aggressive response or the escalation of violence, a workshop was developed for undergraduate nursing students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel. The workshop aimed at reducing students' anxiety vis a vis the aggressive patient or family in addition to strengthening their ability to cope with such situations. The students practiced interpersonal skills, especially relevant to early detection of potential violence, as well as ‘a correct response’ reaction to the violence, thus developing the necessary steps to be implemented when encountering violence in the workplace. In order to assess the efficiency of the workshop, the participants filled out a questionnaire comprising knowledge and self-efficacy scales. Moreover, the replies of the 23 participants in this workshop were compared with those of 24 students who attended a standard course on interpersonal communication. Students' self-efficacy and knowledge were measured in both groups before and after the course. A statistically significant interaction was found between group (workshop/standard course) and time (before/after) as to the influence on students' self-efficacy (p=0.004) and knowledge (p=0.007). Nursing students, who participated in this ‘coping with workplace violence’ workshop, gained knowledge, confidence and a sense of self-efficacy with regard to workplace violence. Early detection of signs of imminent violence amongst patients or families and the prevention of its escalation, as well as the ability to manage the threatening situation when occurring, are acquired skills. Encouraging nursing students to learn and practice these skills may enhance their ability to cope with these unfortunate occurrences.

Keywords: early detection of violence, nursing students, patient aggression, self-efficacy, workplace violence

Procedia PDF Downloads 116

Authors: Md, MCS, MPH Munyangi Wa Nkola Jerome

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The pandemic of COVID-19, a recently discovered contagious respiratory disease called SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus 2 Majority of people infected with SARS-CoV-2: Asymptomatic or mildly ill 14% of patients will develop severe illness requiring hospitalization and oxygen support, and 5% of these will be transferred to an intensive care unit, Urgent need for new treatments that can be used quickly to avoid transfer of patients to intensive care and death. Objective: To evaluate the clinical activity (efficacy) of ArtiCovid Hypothesis: Administration of 3 times a teaspoon per day by COVID patients (symptomatic, mild, or moderate forms) results in the disappearance of symptoms and improvement of biological parameters (including viral suppression). Clinical efficacy: the disappearance of clinical signs after seven days of treatment; reduction in the rate of patients transferred to intensive care units for mechanical ventilation and a decrease in mortality related to this infection Paraclinical efficacy: improvement of biological parameters (mainly d-dimer, CRP) Virological efficacy: suppression of the viral load after seven days of treatment (control test on the seventh day is negative) Pilot study using a standardized solution based on Artemisia annua (ARTICOVID) Obtaining authorization from the health authorities of the province of Central Kongo Recruitment of volunteer patients, mainly in the Kinkanda HospitalCarrying out tests before and after treatment as well as analyses before and after treatment. The protocol obtained the approval of the ethics committee 50 patients who completed the treatment were aged between 2 and 70 years, with an average age of 36 yearsMore half were male (56%). One in four patients was a health professional (25%) Of the 12 health professionals, 4 were physicians. For those who reported the date of onset of the disease, the average duration between the appearance of the first symptoms and the medical consultation was 5 days. The 50 patients put on ARTICOVID were discharged alive with CRP levels substantially normalizedAfter seven to eight days, the control test came back negative. This pilot study suggests that ARTICOVID may be effective against COVID-19 infection.

Keywords: artiCovid, DRC, Covid-19, SARS_COV_2

Procedia PDF Downloads 97

Authors: C. E. Laburu, M. A. Barros, A. F. Zompero, O. H. M. Silva

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The work presents a teaching strategy that employs syntagmatic and paradigmatic linguistic relations in order to monitor the understanding of physics students’ concepts. Syntagmatic and paradigmatic relations are theoretical elements of semiotics studies and our research circumstances and justified them within the research program of multi-modal representations. Among the multi-modal representations to learning scientific knowledge, the scope of action of syntagmatic and paradigmatic relations belongs to the discursive writing form. The use of such relations has the purpose to seek innovate didactic work with discourse representation in the write form before translate to another different representational form. The research was conducted with a sample of first year high school students. The students were asked to produce syntagmatic and paradigmatic of Newton’ first law statement. This statement was delivered in paper for each student that should individually write the relations. The student’s records were collected for analysis. It was possible observed in one student used here as example that their monemes replaced and rearrangements produced by, respectively, syntagmatic and paradigmatic relations, kept the original meaning of the law. In paradigmatic production he specified relevant significant units of the linguistic signs, the monemas, which constitute the first articulation and each word substituted kept equivalence to the original meaning of original monema. Also, it was noted a number of diverse and many monemas were chosen, with balanced combination of grammatical (grammatical monema is what changes the meaning of a word, in certain positions of the syntagma, along with a relatively small number of other monemes. It is the smallest linguistic unit that has grammatical meaning) and lexical (lexical monema is what belongs to unlimited inventories; is the monema endowed with lexical meaning) monemas. In syntagmatic production, monemas ordinations were syntactically coherent, being linked with semantic conservation and preserved number. In general, the results showed that the written representation mode based on linguistic relations paradigmatic and syntagmatic qualifies itself to be used in the classroom as a potential identifier and accompanist of meanings acquired from students in the process of scientific inquiry.

Keywords: semiotics, language, high school, physics teaching

Procedia PDF Downloads 111

Authors: Mahdokht Sadeghvishkaei, Azizah Abdul-Hamid, Amin Ismail, Nazamid Saari

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Hypertension is a common and serious chronic health problem and known as the most important risk factor for development of many diseases such as stroke. Since angiotensin I-converting enzyme (ACE) is the key enzyme involved in blood pressure, one of the well accepted mechanisms to control hypertension is through ACE inhibition. The ACE inhibitory effect of Actinopyga lecanora (stone fish) proteolysate in vitro had been reported. Hence, this study aimed to evaluate the ACE inhibitory potential of Actinopyga lecanora proteolysate in vivo in normotensive rats. Therefore the ACE inhibitory capability of the proteolysate to prevent increasing systolic blood pressure, after inducing hypertension by angiotensin I was examined. The pre-fed rats with the proteolysates at various doses (200, 400, 800 mg/kg body weight) revealed the significant (p ≤ 0.05) suppression effect compared with control groups. Furthermore, different doses of the proteolysate (200, 400, 800 mg/kg body weight) were examined to find its optimum effective dose. Results depicted that 800 mg proteolysate/kg body weight significantly reduced systolic blood pressure without negative effect on normal blood pressure (p ≤ 0.05). Furthermore, Sub-acute toxicity study based on OECD guideline demonstrated the safety of the proteolysate in vivo. The present study indicated that the proteolysate at a dose of 1000 mg/kg daily for 14 days did not cause toxicity signs such as death, changes in activity, or piloerection. Since there are no significant differences between treated groups and control groups, hematological and biochemical analysis confirmed safety of the proteolysate (p > 0.05). In addition, there were no significant differences between organs weights of the treated groups and the control groups. Morphologically, neither histopathological changes, nor gross abnormalities were observed. However, the proteolysate caused significant decrease in body weight in relation to the control groups (p ≤ 0.05) probably due to appetite stimulation by the proteolysate, leading to decreased food consumption in sub-acute group. It is concluded that the proteolysate generated from Actinopyga lecanora possess a significant anti-hypertensive effect and would be potentially used as natural alternative of ACE inhibitors.

Keywords: ACE inhibition, Actinopyga lecanora, anti-hypertensive activity, bioactive peptides, normotensive rats

Procedia PDF Downloads 410

Authors: Uliana N. Tumanova, Viacheslav M. Lyapin, Vladimir G. Bychenko, Alexandr I. Shchegolev, Gennady T. Sukhikh

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It is well known that the gas formed as a result of postmortem decomposition of tissues can be detected already 24-48 hours after death. In addition, the conditions of keeping and storage of the corpse (temperature and humidity of the environment) significantly determine the rate of occurrence and development of posthumous changes. The presence of sepsis is accompanied by faster postmortem decomposition and decay of the organs and tissues of the body. The presence of gas in the vessels and cavities can be revealed fully at postmortem CT. Radiologists must certainly report on the detection of intraorganic or intravascular gas, wich was detected at postmortem CT, to forensic experts or pathologists before the autopsy. This gas can not be detected during autopsy, but it can be very important for establishing a diagnosis. To explore the possibility of postmortem CT for the evaluation of gas accumulations in the newborns' vessels, who died from congenital sepsis. Researched of 44 newborns bodies (25 male and 19 female sex, at the age from 6 hours to 27 days) after 6 - 12 hours of death. The bodies were stored in the refrigerator at a temperature of +4°C in the supine position. Grouped 12 bodies of newborns that died from congenital sepsis. The control group consisted of 32 bodies of newborns that died without signs of sepsis. Postmortem CT examination was performed at the GEMINI TF TOF16 device, before the autopsy. The localizations of gas accumulations in the vessels were determined on the CT tomograms. The sepsis diagnosis was on the basis of clinical and laboratory data and autopsy results. Gases in the vessels were detected in 33.3% of cases in the group with sepsis, and in the control group - in 34.4%. A group with sepsis most often the gas localized in the heart and liver vessels - 50% each, of observations number with the detected gas in the vessels. In the heart cavities, aorta and mesenteric vessels - 25% each. In control most often gas was detected in the liver (63.6%) and abdominal cavity (54.5%) vessels. In 45.5% the gas localized in the cavities, and in 36.4% in the vessels of the heart. In the cerebral vessels and in the aorta gas was detected in 27.3% and 9.1%, respectively. Postmortem CT has high diagnostic capabilities to detect free gas in vessels. Postmortem changes in newborns that died from sepsis do not affect intravascular gas production within 6-12 hours. Radiation methods should be used as a supplement to the autopsy, including as a kind of ‘guide’, with the indication to the forensic medical expert of certain changes identified during CT studies, for better definition of pathological processes during the autopsy. Postmortem CT can be recommend as a first stage of autopsy.

Keywords: congenital sepsis, gas, newborn, postmortem CT

Procedia PDF Downloads 126

Authors: Aadila Cayenne, Hinrich Uellendahl

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Optimization of the anaerobic digestion (AD) process of halophytic plants is essential as the biomass contains a high salt content that can inhibit the AD process. Anaerobic co-digestion, together with manure, can resolve the inhibitory effects of saline biomass in order to dilute the salt concentration and establish favorable conditions for the microbial consortia of the AD process. The present laboratory study investigated the co-digestion of S. ramosissima (Sram), and pig manure (PM) in batch and semi-continuous stirred tank reactors (CSTR) under mesophilic (38oC) conditions. The 0.5L batch reactor experiments were in mono- and co-digestion of Sram: PM using different percent volatile solid (VS) based ratios (0:100, 15:85, 25:75, 35:65, 50:50, 100:0) with an inoculum to substate (I/R) ratio of 2. Two 5L CSTR systems (R1 and R2) were operated for 133 days with a feed of PM in a control reactor (R1) and with a co-digestion feed in an increasing Sram VS ratio of Sram: PM of 15:85, 25:75, 35:65 in reactor R2 at an organic loading rate (OLR) of 2 gVS/L/d and hydraulic retention time (HRT) of 20 days. After a start-up phase of 8 weeks for both reactors R1 and R2 with PM feed alone, the halophyte biomass Sram was added to the feed of R2 in an increasing ratio of 15 – 35 %VS Sram over an 11-week period. The process performance was monitored by pH, total solid (TS), VS, total nitrogen (TN), ammonium-nitrogen (NH4 – N), volatile fatty acids (VFA), and biomethane production. In the batch experiments, biomethane yields of 423, 418, 392, 365, 315, and 214 mL-CH4/gVS were achieved for mixtures of 0:100, 15:85, 25:75, 35:65, 50:50, 100:0 %VS Sram: PM, respectively. In the semi-continuous reactor processes, the average biomethane yields were 235, 387, and 365 mL-CH4/gVS for the phase of a co-digestion feed ratio in R2 of 15:85, 25:75, and 35:65 %VS Sram: PM, respectively. The methane yield of PM alone in R1 was in the corresponding phases on average 260, 388, and 446 mL-CH4/gVS. Accordingly, in the continuous AD process, the methane yield of the halophyte Sram was highest at 386 mL-CH4/gVS in the co-digestion ratio of 25:75%VS Sram: PM and significantly lower at 15:85 %VS Sram: PM (100 mL-CH4/gVS) and at 35:65 %VS Sram (214 mL-CH4/gVS). The co-digestion process showed no signs of inhibition at 2 – 4 g/L NH4 – N, 3.5 – 4.5 g/L TN, and total VFA of 0.45 – 2.6 g/L (based on Acetic, Propionic, Butyric and Valeric acid). This study demonstrates that a stable co-digestion process of S. ramosissima and pig manure can be achieved with a feed of 25%VS Sram at HRT of 20 d and OLR of 2 gVS/L/d.

Keywords: anaerobic co-digestion, biomethane production, halophytes, pig manure, salicornia ramosissima

Procedia PDF Downloads 116

Authors: Chin-Hsiang Lo, Wey Chia, Shih-Tien Hsu

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Introduction: Since 2016, the annual number of passengers on commercial flights at Taoyuan International Airport (TIA) has been ~40 million. Due to the outbreak and spread of COVID-19, the number of international flights sharply diminished in recent years. However, TIA is located at an East-Asian flight transportation junction; thus, many commercial and cargo flights continue service. When severe medical events happen on a commercial airliner, the decision to divert or not is based on consideration of both medical and operational issues. This study discusses the events related to the diversion of airplanes or reentry after taxiing for medical emergencies at Taoyuan International Airport. Background: We analyzed emergency medical records from the medical clinic of TIA from January 1, 2017, to December 31, 2022, for patients who needed emergency medical services but were unable to reach the airport clinic by themselves. We also collected data for patients treated after diversion from other airports or reentry after taxiing due to medical emergencies. Information such as when and where the event occurred, chief signs and symptoms, the tentative diagnosis (using the ICD-9-CM), management, and the sociodemographic features of the passengers were extracted from the medical records. Summary of Cases: TIA handled approximately 152 million passengers and 1,093,762 flights during the study period; a total of 2,804 emergencies occurred during this time period. Thirty-three medical emergencies warranted diversion (21 cases) or reentry (12 cases); 13 cases were diverted from Asia-Pacific flights and five from Asia-North America flights. The age of the passengers with diversion emergencies ranged from 2–85 years (mean, 46±20-years-old). Twenty-seven patients were transported to an emergency department, and four patients died. For all cases of diversion or reentry, the most common diagnoses were neurogenic problems (42.4%), Out-of-hospital cardiac arrest (OHCA) (15.2%), and cardiovascular problems (12.1%). Discussion: Most aircraft diversions were related to syncope, seizure, and OHCA. The decision to divert depends on medical and operational considerations. Emergency conditions are often serious; thus, improvement of the effectiveness of cooperation between airlines and medical teams remains a challenge.

Keywords: diversion, syncope, seizure, OHCA

Procedia PDF Downloads 59

Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

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Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

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Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

Procedia PDF Downloads 247

Authors: Fabian Nde Fon

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Decolonisation is one of the hottest topics in most African Universities; this is because many researchers focus on research that does not speak to their immediate community. This research looked at postgraduate research projects that can take students to the community to apply the knowledge that they have learned as an attempt to transform their community. In regards to this, an honours project was designed to try and provide a cheaper and continuous source of protein (egg) using amber-link layers and to investigate the potential of the project to promote postgraduate student development and entrepreneurship. Two ban layer production systems were created: (1) Production system one on a Hill (PS-I) and (2) Production system two in a valley, closer to a dam (PS-II) at Nqutshini, Gingindlovu, KwaZulu-Natal Province. Forty point-of-lay (18 weeks old) amber links were bought at Inverness Rearers and divided into PS-I (20), and PS-II (20), and each of the production systems was further divided into two groups of ten (PS-I-1 and PS-II-1 (partially supplemented) and PS-I-2 and PS-II-2 (supplemented with layer mash)) by a random selection. Birds' weights were balanced in each group to avoid bias. The two groups in each production system were caged separately (1.5x1.5m² for ten birds) and in close proximity. Partially supplemented birds received 0.6 kg of layer mash (60g/per bird/day) and kitchen leftovers daily, and supplemented birds were fed 1.2 kg of layer mash (120g/per bird/day). Egg collection was daily after feeding in the morning while was given ad libitium. The eggs were assessed for internal and external quality after weighing before recording. Egg production from fully supplemented birds (PS-I-2 and PS-II-2) was generally higher (P<0.05) than those of PS-I-1 and PS-II-1. The difference in production was only 6% in the valley while on the Hill, it was only 3%. However, some of the birds in the valley showed signs of respiratory infections, which was not observed with those on the Hill. There are no differences in the internal and external qualities of eggs (york colour and egg shell) determined. This implies that both systems were sustainable. It was suggested members in the community living at the valley or Hill can use these hardy layers as a cheaper source of protein and preferable to the partially supplemented systems because it is relatively cheaper. The smallholder farmers are still pursuing the project long after the students graduate; hence the benefit of the project is reciprocal for both the university and the community (entrepreneurship).

Keywords: animal nutrition, ban layer, production, postgraduate curricula, entrepreneurship

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Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

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Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

Procedia PDF Downloads 171