Search results for: preventable death
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1361

Search results for: preventable death

1331 Dengue Death Review: A Tool to Adjudge the Cause of Dengue Mortality and Use of the Tool for Prevention of Dengue Deaths

Authors: Gagandeep Singh Grover, Vini Mahajan, Bhagmal, Priti Thaware, Jaspreet Takkar

Abstract:

Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The state of Punjab in India shows cyclical and seasonal variation in dengue cases. The Case Fatality Rate of Dengue has ranged from 0.6 to 1.0 in the past years. The department has initiated a review of the cases that have died due to dengue in order to know the exact cause of the death in a case of dengue. The study has been undertaken to know the other associated co-morbidities and factors causing death in a case of dengue. The study used the predesigned proforma on which the records (medical and Lab) were recorded and reviewed by the expert committee of the doctors. This study has revealed that cases of dengue having co-morbidities have a longer stay in the hospital. Fluid overload and co-morbidities have been found as major factors leading to death, however, in a confirmed case of dengue hepatorenal shutdown was found to be a major cause of mortality. The data obtained will help in sensitizing the treating physicians in order to decrease the mortality due to dengue in future.

Keywords: dengue, death, morbidities, DHF, DSS

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1330 The Different Essence of Death in the Elegies of Shelley's Adonais and Lord Tennyson's In Memoriam

Authors: Sulistyaningtyas

Abstract:

The topic about death and dying is interesting to discuss since it is strongly related to every individual life. As represented in its title, Adonais: An Elegy on the Death of John Keats is a mournful poem written in 1821 by Percy Bysshe Shelley to mourn the loss of young poet John Keats. To compare, In Memoriam A.H.H. is an elegy written in 1850 about the death of Lord Tennyson’s dearest friend, Arthur Henry Hallam. Although both elegies were written to grieve the authors’ loved ones, their grief affects differently to the psychological being of the narrators. Thus, this research aims to examine the essence of death in affecting the narrators psychologically. By using psychoanalytic criticism, this research reveals the different essence of death in the two elegies as the result of the analysis. Moreover, these two elegies also portray the concept of the afterlife, immortality, and the figure of God. In Adonais, the grief of the narrator to Keats leads him to question the very purpose of life. The loss of his favorite poet which makes him feel sorrowful and mad along his 55 stanzas brings him to a higher psychological level to understand himself. He even sees himself as a Christ-like figure, which shows the idea that God is imaginable. Different from Adonais, the narrator of In Memoriam finds something more spiritual by doing his passionate mourning to Hallam. Through some contemplation in his 133 cantos, in the end, he is convinced that the dear one now dwells with a great Spirit who controls the world. He believes that all of the creation in the universe has to follow one law which is set by God. Hence, it can be concluded that death might bring different consequence to the psyche of every living creature.

Keywords: elegy, comparative study, psychoanalytic criticism, the essence of death

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1329 Pattern of Valvular Involvement and Demographic Features of Patients on Benzathine Penicillin at Dhulikhel Hospital

Authors: Sanjaya Humagain, Rajendra Koju

Abstract:

Background: Rheumatic heart disease (RHD) is the most common cardiovascular disease in children and young adults. Though declined and almost non-existent in developed nations, RHD is still one of the leading cause for premature death and disability in developing countries. Prevalence of RHD is high in both rural as well as urban area of Nepal. Present study is designed to look at the pattern of valvular involvement and demographic features in RHD. Methods: 326 patients indicated for inj. Benzathine penicillin were selected and echocardiograph performed to see the pattern of vavular involvement. Data analysis was done using SPSS 17. Result: The most common type of lesion was mixed type with mitral valve involvement. MR was the most common isolated lesion. MS was more commonly seen in females whereas AS was more common in males. Secondary prophylaxis was more common than primary prophylaxis. Conclusion: RHD still being a major problem and a preventable disease so extensive screening program is required to identify them early and prevent the complication.

Keywords: acute rheumatic fever, RHD, MS, MR, AS, AR, Inj benzathine penicillin

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1328 Exploring the Association between Race and Attitudes toward Physician-Assisted Death; An Analysis of the Gss Dataset

Authors: Seini G. Kaufusi

Abstract:

Background. Physician-assisted death (PAD) has and continues to be a controversial issue in the U.S. Dying with dignity statutes exists in 9 U.S. jurisdictions that permit competent adults diagnosed with a terminal illness and given a prognosis of 6 month or less to live to request medication to hasten death. Robust advocacy for and against PAD influences policy, and opinions vary. Aim. This study aims to explore the association between race and the attitudes toward physician-assisted death in the U.S. Methods. Data for this study derives from the General Social Survey (GSS) dataset, a national survey conducted by the National Opinion Research Center (NORC) that focuses on the opinions and values of American’s. A cross-sectional design and probability sample from the 2018 data set was used to randomly select respondents. Results. The results indicated that race is significantly associated with attitudes towards physician-assisted death. The level of significance suggests a strong positive association, and the direction indicated that Black and Other racial groups have higher rates of positive decision about PAD. Conclusion. Although attitudes towards PAD varied, Black and other racial groups had favorable decisions for PAD. Further research is crucial in the continuous debate on PAD and understanding the influences of predictors for or against PAD.

Keywords: attitudes, euthanasia, physician-assisted death, race

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1327 Defining Death and Dying in Relation to Information Technology and Advances in Biomedicine

Authors: Evangelos Koumparoudis

Abstract:

The definition of death is a deep philosophical question, and no single meaning can be ascribed to it. This essay focuses on the ontological, epistemological, and ethical aspects of death and dying in view of technological progress in information technology and biomedicine. It starts with the ad hoc 1968 Harvard committee that proposed that the criterion for the definition of death be irreversible coma and then refers to the debate over the whole brain death formula, emphasizing the integrated function of the organism and higher brain formula, taking consciousness and personality as essential human characteristics. It follows with the contribution of information technology in personalized and precision medicine and anti-aging measures aimed at life prolongation. It also touches on the possibility of the creation of human-machine hybrids and how this raises ontological and ethical issues that concern the “cyborgization” of human beings and the conception of the organism and personhood based on a post/transhumanist essence, and, furthermore, if sentient AI capable of autonomous decision-making that might even surpass human intelligence (singularity, superintelligence) deserves moral or legal personhood. Finally, there is the question as to whether death and dying should be redefined at a transcendent level, which is reinforced by already-existing technologies of “virtual after-” life and the possibility of uploading human minds. In the last section, I refer to the current (and future) applications of nanomedicine in diagnostics, therapeutics, implants, and tissue engineering as well as the aspiration to “immortality” by cryonics. The definition of death is reformulated since age and disease elimination may be realized, and the criterion of irreversibility may be challenged.

Keywords: death, posthumanism, infomedicine, nanomedicine, cryonics

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1326 The Parliamentary Intention behind Schedule 21 to the Criminal Justice Act 2003

Authors: George R. Mawhinney

Abstract:

In 2003 Parliament passed statutory sentencing guidelines, the only of their kind, for the sentencing of murder in England and Wales, after the Home Secretary's role in determining sentences for the offence was effectively ended by the House of Lords' decision in Anderson applying Art.6 of the ECHR (European Convention on Human Rights). However, in the parliamentary debates during the passage of the Criminal Justice Act 2003 containing the guidelines, many views were expressed both by government ministers and backbench MPs of various parties concerning the gravity of the offence of murder, principally discussing the harm of death. This paper examines parliamentary debates as recorded in Hansard, to assess whether this was isolated or indeed there was a broader movement at the time to treat the harm of death more seriously by toughening sentencing regimes for other related homicide offences, or even creating new offences concerning the causing of death. Such evidence of valuing the harm of death more seriously than before would shine a new light on what previously has been deemed mere 'popular punitiveness' and offer a principled basis for lengthening the sentences of these kind of crimes.

Keywords: death, desert, gravity, harm, murder, parliamentary intention, Schedule 21, sentencing, seriousness

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1325 An Analysis of Iranian Social Media Users’ Perceptions of Published Images of Coronavirus Deaths

Authors: Ali Gheshmi

Abstract:

The highest rate of death, after World War II, is due to the Coronavirus epidemic and more than 2 million people have died since the epidemic outbreak in December 2019, so the word “death” is one of the highest frequency words in social media; moreover, the use of social media has grown due to quarantine and successive restrictions and lockdowns. The most important aspects of the approach used by this study include the analysis of Iranian social media users’ reactions to the images of those who died due to Coronavirus, investigating if seeing such images via social media is effective on the users’ perception of the closeness of death, and evaluating the extent to which the fear of Coronavirus death is instrumental in persuading users to observe health protocols or causing mental problems in social media users. Since the goal of this study is to discover how social media users perceive and react to the images of people who died of Coronavirus, the cultural studies approach is used Receipt analysis method and in-depth interviews will be used for collecting data from Iranian users; also, snowball sampling is used in this study. The probable results would show that cyberspace users experience the closeness of “death” more than any time else and to cope with these annoying images, avoid viewing them or if they view, it will lead them to suffer from mental problems.

Keywords: death, receipt analysis method, mental health, social media, Covid-19

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1324 The Test of Memory Malingering and Offence Severity

Authors: Kenji Gwee

Abstract:

In Singapore, the death penalty remains in active use for murder and drug trafficking of controlled drugs such as heroin. As such, the psychological assessment of defendants can often be of high stakes. The Test of Memory Malingering (TOMM) is employed by government psychologists to determine the degree of effort invested by defendants, which in turn inform on the veracity of overall psychological findings that can invariably determine the life and death of defendants. The purpose of this study was to find out if defendants facing the death penalty were more likely to invest less effort during psychological assessment (to fake bad in hopes of escaping the death sentence) compared to defendants facing lesser penalties. An archival search of all forensic cases assessed in 2012-2013 by Singapore’s designated forensic psychiatric facility yielded 186 defendants’ TOMM scores. Offence severity, coded into 6 rank-ordered categories, was analyzed in a one-way ANOVA with TOMM score as the dependent variable. There was a statistically significant difference (F(5,87) = 2.473, p = 0.038). A Tukey post-hoc test with Bonferroni correction revealed that defendants facing lower charges (Theft, shoplifting, criminal breach of trust) invested less test-taking effort (TOMM = 37.4±12.3, p = 0.033) compared to those facing the death penalty (TOMM = 46.2±8.1). The surprising finding that those facing death penalties actually invested more test taking effort than those facing relatively minor charges could be due to higher levels of cooperation when faced with death. Alternatively, other legal avenues to escape the death sentence may have been preferred over the mitigatory chance of a psychiatric defence.

Keywords: capital sentencing, offence severity, Singapore, Test of Memory Malingering

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1323 Religion: The Human Entropy

Authors: Abul Kayum Zarzis Alam

Abstract:

Death is not a terminal; it is just a junction. From Agamas to Vedas, from Buddhism to Judaism, all the major scriptures and religions of the world always do converge to this hypothesis of death. Death is the ultimate catastrophe of life and it is the genesis of every religion on this Earth. Several hundred thousand years ago, the Homo Sapiens in Paleolithic age introduced the notion of religion on this Earth in its most primitive form just to escape from death and natural catastrophes through their belief in supernatural things which created the sense of superstition among the Homo Sapiens which has only increased over time. This sense of superstition and belief in supernatural things are building blocks of religion. Religion is like entropy, a degree of disorder. Entropy for an irreversible system like our own Universe always increases. Same is happening to our human civilization where the disorder had been increasing over time. The degree of this disorder of human civilization is religion divides and conquers over the human civilization of Earth. Religion is the human entropy which had been governing and will govern us. Just like entropy, religion is also an essential intrinsic property of the system which makes the system evolved. We have to optimize this ambivalence of the human entropy to make our civilization an inclusive and sustainable one.

Keywords: death, earth, entropy, Homo sapiens, religion and human entropy

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1322 An Interaction between Human and Animal through the Death Experience

Authors: Mindaugas Kazlauskas

Abstract:

In this paper, it is presupposed that the description of the relationship between animal and human should begin with a description of the direct experience of the animal and how, in this experience, the human experiences itself (a self awareness mode). A human is concerned first and foremost with himself as a human through the experience of another as an animal. The questionsare: In the encounter with an animal, how is the animal constituted in the acts of human experience? How does human-animal interaction influence human behavioral patterns, and how does the human identifies itself in this interaction? The paper will present the results of interpretative phenomenological descriptions (IPA) of the relationship between human and animal in the face of death phenomenon through the experience of pet owners who lost their beloved companions and hunters, veterinatians, and farmers who face animal death. The results of IPA analysis reveal different relations such as the identification with an animal, the alienation experience, the experience of resistance, and an experience of detachment. Within these themes, IPA qualitative research results will be presented by highlighting patterns of human behavior, following Friedrich Schlachermacher's hermeneutics methodological principles, and reflecting on changes in value and attitude within society during daily interaction with the animal.

Keywords: animal human interaction, phenomenology, philosophy, death phenomenon

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1321 Executing the Law: The Practical Absence of Law and Its Effects on Death Row Inmates and Their Families in Egypt

Authors: Amira M. Othman

Abstract:

Despite the massive array of literature that engages with the Egyptian legislative system on a theoretical level, very little attention has been dedicated to the comparison between the legislative clauses on the one hand, and the (absence of their) real-world implementation on the other. This paper starts with this discrepancy, focusing on the legal proceedings in some recent cases dubbed ‘political,’ in which defendants received death sentences. Then, it sheds light on the trend of practical disregard of the law on behalf of the criminal justice apparatuses (whether security forces, public prosecution offices, lawyers, judges, prison wardens, and executioners) through the examination of case files and the conduction of interviews with some defense lawyers in the cases in question. It also identifies the resultant state of confusion among prison staff, as manifest in their treatment of defendants even before the death sentences against them is pronounced; in other words, the application of some aspects of the law in certain cases, and their simultaneous disregard of others. Then, the paper explores the effects of such execution of the law on the death row inmates, as it identifies the different strategies through which defendants who are sentenced to death appropriate a number of legal clauses to their benefit, thereby embarrassing - or highly irritating - the judges that pronounce their death sentences. In addition to appropriation, other strategies include the contestation of the law and their presence before the courts in general, as well as the complete disregard and dismissal of the legal system altogether. Finally, the paper investigates the consequent conceptual effect on the first degree families of death row inmates, namely how their daily encounters with the Egyptian legislative system - particularly its emphasis on the absence of the otherwise binding local legislation - continue to shape their conceptions of the ‘law,’ of ‘justice,’ and their trust in the ‘state.’

Keywords: death penalty, Egyptian law absence, justice, political cases

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1320 Compare Anxiety, Stress, Depression, andAttitude towards Death among Breast CancerPatient Undergoing Mastectomy and Breast-Conserving

Authors: Mitra JahangirRad, Sheida Sodagar, Maryam Bahrami Hidaji

Abstract:

This study was conducted with the aim of comparing anxiety, stress, depression and attitude towards death among patients with breast cancer who have undergone mastectomy or breast-conserving surgery. The study method is causal-comparative. Statistical population was all patients with breast cancer referring to Medical Center of Panjom Azar Hospital in Gorgan or oncologists' offices in this city within eight months. They were selected using purposive sampling. Sample size of this study was 45 patients with breast cancer undergoing mastectomy and 70 patients under breast-conserving surgery. Measurement tools in this study were depression, anxiety, and stress scale (Dass-21) as well as Death Attitude Profile-Revised (DAPR). Results of this study in hypotheses investigation showed that anxiety, stress and depression among patients with breast cancer, undergoing mastectomy or breast-conserving surgery is significantly different. However, their attitudes towards death do not differ. From these findings, it can be concluded that although most patients with breast cancer encounter many psychological problems, patients undergoing mastectomy experience more anxiety, stress and depression relative to patients with breast-conserving surgery and it seems that they need more supportive therapy.

Keywords: anxiety, breast cancer, depression, death, mastectomy

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1319 The Overexpression of Horsegram MURLK Improves Regulation of Cell Death and Defense Responses to Microbial Pathogens

Authors: Shikha Masand, Sudesh Kumar Yadav

Abstract:

Certain protein kinases have been shown to be crucial for plant cell signaling pathways associated with plant immune responses. Here we identified a horsegram [Macrotyloma uniflorum (Lam.) Verdc.] malectin-like leucine rich receptor-like protein kinase (RLK) gene MuRLK. The functional MuRLK protein preferentially binds to mannose and N-acetyl glucosamine residues. MuRLK exists in the cytoplasm and also localizes to the plasma membrane of plant cells via its N-terminus. Over-expression of MuRLK in Arabidopsis enhances the basal resistance to infection with Pseudomonas syringae pv. tomato, Alternaria brassicicola and Hyaloperonospora arabidopsidis, are associated with elevated ROS bursts, MAPK activation, thus ultimately leading to hypersensitive cell death. Moreover, salicylic acid-dependent and jasmonic acid-dependent defense responses are also enhanced in the MuRLK-overexpressed plants that lead to HR-induced cell death. Together, these results suggest that MuRLK plays a key role in the regulation of plant cell death, early and late defense responses after the recognition of microbial pathogens.

Keywords: horsegram, Pseudomonas syringae pv. tomato, MuRLK, ROS burst, cell death, plant defense

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1318 Changes in Kidney Tissue at Postmortem Magnetic Resonance Imaging Depending on the Time of Fetal Death

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

Abstract:

All cases of stillbirth undoubtedly subject to postmortem examination, since it is necessary to find out the cause of the stillbirths, as well as a forecast of future pregnancies and their outcomes. Determination of the time of death is an important issue which is addressed during the examination of the body of a stillborn. It is mean the period from the time of death until the birth of the fetus. The time for fetal deaths determination is based on the assessment of the severity of the processes of maceration. To study the possibilities of postmortem magnetic resonance imaging (MRI) for determining the time of intrauterine fetal death based on the evaluation of maceration in the kidney. We have conducted MRI morphological comparisons of 7 dead fetuses (18-21 gestational weeks) and 26 stillbirths (22-39 gestational weeks), and 15 bodies of died newborns at the age of 2 hours – 36 days. Postmortem MRI 3T was performed before the autopsy. The signal intensity of the kidney tissue (SIK), pleural fluid (SIF), external air (SIA) was determined on T1-WI and T2-WI. Macroscopic and histological signs of maceration severity and time of death were evaluated in the autopsy. Based on the results of the morphological study, the degree of maceration varied from 0 to 4. In 13 cases, the time of intrauterine death was up to 6 hours, in 2 cases - 6-12 hours, in 4 -12-24 hours, in 9 -2-3 days, in 3 -1 week, in 2 -1,5-2 weeks. At 15 dead newborns, signs of maceration were absent, naturally. Based on the data from SIK, SIF, SIA on MR-tomograms, we calculated the coefficient of MR-maceration (M). The calculation of the time of intrauterine death (MP-t) (hours) was performed by our formula: МR-t = 16,87+95,38×М²-75,32×М. A direct positive correlation of MR-t and autopsy data from the dead at the gestational ages 22-40 weeks, with a dead time, not more than 1 week, was received. The maceration at the antenatal fetal death is characterized by changes in T1-WI and T2-WI signals at postmortem MRI. The calculation of MP-t allows defining accurately the time of intrauterine death within one week at the stillbirths who died on 22-40 gestational weeks. Thus, our study convincingly demonstrates that radiological methods can be used for postmortem study of the bodies, in particular, the bodies of stillborn to determine the time of intrauterine death. Postmortem MRI allows for an objective and sufficiently accurate analysis of pathological processes with the possibility of their documentation, storage, and analysis after the burial of the body.

Keywords: intrauterine death, maceration, postmortem MRI, stillborn

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1317 Sudden Death and Chronic Disseminated Intravascular Coagulation (DIC): Two Case Reports

Authors: Saker Lilia, Youcef Mellouki, Lakhdar Sellami, Yacine Zerairia, Abdelhaid Zetili, Fatma Guahria, Fateh Kaious, Nesrine Belkhodja, Abdelhamid Mira

Abstract:

Background: Sudden death is regarded as a suspicious demise necessitating autopsy, as stipulated by legal authorities. Chronic disseminated intravascular coagulation (DIC) is an acquired clinical and biological syndrome characterized by a severe and fatal prognosis, stemming from systemic, uncontrolled, diffuse coagulation activation. Irrespective of their origins, DIC is associated with a diverse spectrum of manifestations, encompassing minor biological coagulation alterations to profoundly severe conditions wherein hemorrhagic complications may take precedence. Simultaneously, microthrombi contribute to the development of multi-organ failures. Objective This study seeks to evaluate the role of autopsy in determining the causes of death. Materials and Methods: We present two instances of sudden death involving females who underwent autopsy at the Forensic Medicine Department of the University Hospital of Annaba, Algeria. These autopsies were performed at the request of the prosecutor, aiming to determine the causes of death and illuminate the exact circumstances surrounding it. Methods Utilized: Analysis of the initial information report; Findings from postmortem examinations; Histological assessments and toxicological analyses. Results: The presence of DIC was noted, affecting nearly all veins with distinct etiologies. Conclusion: For the establishment of a meaningful diagnosis: • Thorough understanding of the subject matter is imperative; • Precise alignment with medicolegal data is essential.

Keywords: chronic disseminated intravascular coagulation, sudden death, autopsy, causes of death

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1316 Experiences and Coping of Adults with Death of Siblings during Childhood in Chinese Context: Implications for Therapeutic Interventions

Authors: Sze Yee Lee

Abstract:

The death of a sibling in childhood leads to significant impacts on both the personal and family development of the surviving siblings. Yet, the effects of sibling loss in Chinese societies such as Hong Kong have been inadequately documented in the literature. In particular, there is a gap in the literature about the long term impacts on surviving siblings. This paper explores the experience of adult siblings encountering siblings’ death during childhood with the use of in-depth interviews. Through thematic analysis and in-depth interviews, the author explores the impacts on surviving siblings’ emotions, coping styles, struggles and challenges, and personal development. Furthermore, the influences on family dynamics are explored thoroughly, including the changes in a family atmosphere, family roles, family relationships, family communication, and parenting styles. More importantly, the author identifies (i) existing continuing bonds, (ii) crying, (iii) adequate social support, (iv) hiding own emotions as a gesture of protecting parents as the crucial elements pertinent to surviving siblings’ successful adaptation in the face of sibling loss. In addition, 'child-centered' and 'family-centered' interventions for families with siblings' death in a Chinese context are discussed. With the use of age-appropriate language and children’s participation in the preparation of death and after-death arrangements, surviving siblings could be assisted in transforming bereavement into opportunities for growth. In addition, the bereaved family could better cope with grief with open communication platforms, adequate social support, and family education resources. Meanwhile, life-and-death education at both school and community levels could enhance the public’s awareness and understanding of the bereaved individuals to prevent creating further harm to them.

Keywords: children and adolescent bereavement, children-centered, family-centered, sibling’s death

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1315 Difference in the Expression of CIRBP, RBM3 and HSP70 in the Myocardium and Cerebellum after Death by Hypothermi a and Carbon Monoxide Poisoning

Authors: Satoshi Furukawa, Satomu Morita, Lisa Wingenfeld, Katsuji Nishi, Masahito Hitosugi

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We studied the expression of hypoxia-related antigens (e.g., cold-inducible antigens and apoptotic antigens) in the myocardium and the cerebellumthat were obtained from individuals after death by carbon monoxide or hypothermia. The immunohistochemistry results revealed that expression of cold-inducible RNA binding protein (CIRBP) and RNA-binding protein 3 (RBM3) may be associated with hpyothermic and the hypoxic conditions. The expression of CIRBP and RBM3 in the myocardium was different from their expression in the cerebellum, especially in the Purkinje cells. The results indicate that agonal duration influences antigen expression. In the hypothermic condition, the myocardium uses more ATP since the force of the excitation-contraction coupling of the myocardium increases by more than 400% when the experimental temperature is reduced from 35°C to 25°C. The results obtained in this study indicate that physicians should pay attention to the myocardium when cooling the patient’s body to protect the brain.

Keywords: carbon monoxide death, cerebellum, CIRBP, hypothermic death, myocardium, RBM3

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1314 The Experiences of Hong Kong Chinese Divorced Wives in Facing the Cancer Death of Their Ex-Husbands

Authors: M. L. Yeung

Abstract:

With the surge of divorce rate and male cancer onset/death rates, the phenomenon of divorced wives in the facing cancer death of their ex-husbands is not uncommon in Hong Kong. Yet, there is a dearth of study on the experiences of bereaved-divorced wives in the Hong Kong cultural context. This project fills the knowledge gap by conducting a qualitative study for having interviewed four bereaved ex-wives, who returned to ex-husbands’ end-of-life caregiving and eventually grieved for the ex-spousal’s death. From the perspectives of attachment theory and disenfranchised grief in the Hong Kong cultural context, a ‘double-loss’ experience is found in which interviewees suffer from the first loss of divorce and the second loss of ex-husbands’ death. Traumatic childhood experiences, attachment needs, role ambiguity, unresolved emotions and unrecognized grief are found significant in their lived experiences which alert the ‘double-loss’ is worthy of attention. Extending a family-centered end-of-life and bereavement care services to divorced couples is called for, in which validation on the attachment needs, ex-couple reconciliation, and acknowledgement on the disenfranchised grief are essential for social work practice on this group of clienteles specifically in Hong Kong cultural context.

Keywords: changing family, disenfranchised grief, divorce, ex-spousal death, marriage

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1313 Determination Power and Sample Size Zero-Inflated Negative Binomial Dependent Death Rate of Age Model (ZINBD): Regression Analysis Mortality Acquired Immune Deficiency De ciency Syndrome (AIDS)

Authors: Mohd Asrul Affendi Bin Abdullah

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Sample size calculation is especially important for zero inflated models because a large sample size is required to detect a significant effect with this model. This paper verify how to present percentage of power approximation for categorical and then extended to zero inflated models. Wald test was chosen to determine power sample size of AIDS death rate because it is frequently used due to its approachability and its natural for several major recent contribution in sample size calculation for this test. Power calculation can be conducted when covariates are used in the modeling ‘excessing zero’ data and assist categorical covariate. Analysis of AIDS death rate study is used for this paper. Aims of this study to determine the power of sample size (N = 945) categorical death rate based on parameter estimate in the simulation of the study.

Keywords: power sample size, Wald test, standardize rate, ZINBDR

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1312 Sociodemographic Risk Factors of Cervical Cancer in Imphal, Manipur

Authors: Arundhati Devi Maibam, K. Ingocha Singh

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Cervical cancer is preventable if detected early. Determination of risk factors is essential to plan screening programmes to prevent the disease. To study the demographic risk factors of cervical cancer among Manipuri women, information on age, marital status, educational level, monthly family income and socioeconomic status were collected through a pre-tested interview schedule. In this study, 64 incident cases registered at the RT Dept, RIMS (Regional Institute of Medical Sciences), Imphal, Manipur, India during 2008-09 participated. Data were entered in Microsoft Excel and the results were expressed in percentages. Among the 64 patients with cervical cancer, 56 (88.9%) were in the age group of 40+ years. The majority of the patients were from rural areas (68.75%) and 31.25% were from urban areas. The majority of the patients were Hindus (73%), 55(85.9%) were of low educational level, 43(67.2%) were married, and 36 (56.25%) belonged to Class IV socioeconomic status. In conclusion, if detected early, cervical cancer is preventable and curable. The potential risk factors need to be identified and women in the risk group need to be motivated for screening. Affordable screening programmes and health care resources will help in lessening the burden of the disease.

Keywords: cervical cancer, Manipuri women, RIIMS, socio-demographic risk factors

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1311 Isolation and Identification of Fungal Pathogens in Palm Groves of Oued Righ

Authors: Lakhdari Wassima, Ouffroukh Ammar, Dahliz Abderrahmène, Soud Adila, Hammi Hamida, M’lik Randa

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Prospected palm groves of Oued Righ regions (Ouargla, Algeria) allowed us to observe sudden death of palm trees aged between 05 and 70 years. Field examinations revealed abnormal clinical signs with sometimes a quick death of affected trees. Entomologic investigations have confirmed the absence of phytophagous insects on dead trees. Further investigations by questioning farmers on the global management of palm groves visited (Irrigation, water quality used, soil type, etc.) did not establish any relationship between these aspects and the death of palm trees, which naturally pushed us to focus our investigations for research on fungal pathogens. Thus, laboratory studies were conducted to know the real causes of this phenomenon, 13 fungi were found on different parts of the dead palm trees. The flowing fungal types were identified: 1-Diplodia phoenicum, 2-Theilaviopsis paradoxa, 3-Phytophthora sp, 4-Helminthosporium sp, 5-Stemphylium botryosum, 6-Alternaria sp, 7-Aspergillus niger, 8-Aspergillus sp.

Keywords: palm tree, death, fungal pathogens, Oued Righ

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1310 Analysis of Maternal Death Surveillance and Response: Causes and Contributing Factors in Addis Ababa, Ethiopia, 2022

Authors: Sisay Tiroro Salato

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Background: Ethiopia has been implementing the maternal death surveillance and response system to provide real-time actionable information, including causes of death and contributing factors. Analysis of maternal mortality surveillance data was conducted to identify the causes and underlying factors in Addis Ababa, Ethiopia. Methods: We carried out a retrospective surveillance data analysis of 324 maternal deaths reported in Addis Ababa, Ethiopia, from 2017 to 2021. The data were extracted from the national maternal death surveillance and response database, including information from case investigation, verbal autopsy, and facility extraction forms. The data were analyzed by computing frequency and presented in numbers, proportions, and ratios. Results: Of 324 maternal deaths, 92% died in the health facilities, 6.2% in transit, and 1.5% at home. The mean age at death was 28 years, ranging from 17 to 45. The maternal mortality ratio per 100,000 live births was 77for the five years, ranging from 126 in 2017 to 21 in 2021. The direct and indirect causes of death were responsible for 87% and 13%, respectively. The direct causes included obstetric haemorrhage, hypertensive disorders in pregnancy, puerperal sepsis, embolism, obstructed labour, and abortion. The third delay (delay in receiving care after reaching health facilities) accounted for 57% of deaths, while the first delay (delay in deciding to seek health care) and the second delay (delay in reaching health facilities) and accounted for 34% and 24%, respectively. Late arrival to the referral facility, delayed management after admission, andnon-recognition of danger signs were underlying factors. Conclusion: Over 86% of maternal deaths were attributed by avoidable direct causes. The majority of women do try to reach health services when an emergency occurs, but the third delays present a major problem. Improving the quality of care at the healthcare facility level will help to reduce maternal death.

Keywords: maternal death, surveillance, delays, factors

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1309 Association of the Time in Targeted Blood Glucose Range of 3.9–10 Mmol/L with the Mortality of Critically Ill Patients with or without Diabetes

Authors: Guo Yu, Haoming Ma, Peiru Zhou

Abstract:

BACKGROUND: In addition to hyperglycemia, hypoglycemia, and glycemic variability, a decrease in the time in the targeted blood glucose range (TIR) may be associated with an increased risk of death for critically ill patients. However, the relationship between the TIR and mortality may be influenced by the presence of diabetes and glycemic variability. METHODS: A total of 998 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The TIR is defined as the percentage of time spent in the target blood glucose range of 3.9–10.0 mmol/L within 24 hours. The relationship between TIR and in-hospital in diabetic and non-diabetic patients was analyzed. The effect of glycemic variability was also analyzed. RESULTS: The binary logistic regression model showed that there was a significant association between the TIR as a continuous variable and the in-hospital death of severely ill non-diabetic patients (OR=0.991, P=0.015). As a classification variable, TIR≥70% was significantly associated with in-hospital death (OR=0.581, P=0.003). Specifically, TIR≥70% was a protective factor for the in-hospital death of severely ill non-diabetic patients. The TIR of severely ill diabetic patients was not significantly associated with in-hospital death; however, glycemic variability was significantly and independently associated with in-hospital death (OR=1.042, P=0.027). Binary logistic regression analysis of comprehensive indices showed that for non-diabetic patients, the C3 index (low TIR & high CV) was a risk factor for increased mortality (OR=1.642, P<0.001). In addition, for diabetic patients, the C3 index was an independent risk factor for death (OR=1.994, P=0.008), and the C4 index (low TIR & low CV) was independently associated with increased survival. CONCLUSIONS: The TIR of non-diabetic patients during ICU hospitalization was associated with in-hospital death even after adjusting for disease severity and glycemic variability. There was no significant association between the TIR and mortality of diabetic patients. However, for both diabetic and non-diabetic critically ill patients, the combined effect of high TIR and low CV was significantly associated with ICU mortality. Diabetic patients seem to have higher blood glucose fluctuations and can tolerate a large TIR range. Both diabetic and non-diabetic critically ill patients should maintain blood glucose levels within the target range to reduce mortality.

Keywords: severe disease, diabetes, blood glucose control, time in targeted blood glucose range, glycemic variability, mortality

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1308 Existential Absurdity, Alienation and Death in Charles Forsman’s The End of the Fxxxing World, I Am Not Okay With This, and Slasher

Authors: Renukha Devi Anandan

Abstract:

Charles Forsman’s The End of The Fxxxing World, I Am Not Okay With This, and Slasher invariably deals with existential themes. They reflect the perplexed situation of the characters torn between the search for existence and the constraints of human conditions that impede them from such realization, ensuing a dilemma deeply-rooted in absurdity and alienation. These characters are social misfits who fail to fashion their existence and develop harmoniously. Therefore, the present paper adopts an Existential approach to examine the vignettes of alienation and absurdity vis-à-vis the characters’ speech, actions, and thoughts. Furthermore, this paper explores the role of death either as a self-destructive behavior or the eternal freedom of man in graphic novels. Findings portrayed how the characters’ absurd existence surrounded by the void, would eventually develop into death. Finally, the study revealed that Forsman’s distinctive serial illustration not only unveiled the predicaments of the characters through their hard-boiled smokescreens in the 21st-century social paradigm but also established graphic novels as part and parcel of a literary genre.

Keywords: existentialism, absurdity, alienation, death, self-destruction, eternal freedom

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1307 Causes of Death in Neuromuscular Disease Patients: 15-Year Experience in a Tertiary Care Hospital

Authors: Po-Ching Chou, Wen-Chen Liang, I. Chen Chen, Jong-Hau Hsu, Yuh-Jyh Jong

Abstract:

Background:Cardiopulmonary complications seem to cause high morbidity and mortality in patients with neuromuscular diseases (NMD) but so far there is no domestic data reported in Taiwan. We, therefore attempted to analyze the factors to cause the death in NMD patients from our cohort. Methods:From 1998 to 2013, we retrospectively collected the information of the NMD patients treated and followed up in Kaohsiung Medical University Hospital. Forty-two patients with NMD who expired during these fifteen years were enrolled. The medical records of these patients were reviewed and the causes of death and the associated affecting factors were analyzed. Results:Eighteen patients with NMD (mean age=13.3, SD=12.4) with complete medical record and detailed information were finally included in this study, including spinal muscular atrophy (SMA) (n=9, 7/9: type 1), Duchenne muscular dystrophy (n=6), congenital muscular dystrophy (n=1), carnitine acyl-carnitine translocase (CACT) deficiency (n=1) and spinal muscular atrophy with respiratory distress (SMARD)(n=1). The place of death was in ICU (n=11, 61%), emergency room (n=3, 16.6%) or home (n=4, 22.2%). For SMA type 1 patients, most of them (71.4%, 5/7) died in emergency room or home and the other two expired during an ICU admission. The causes of death included acute respiratory failure due to pneumonia (n=13, 72.2 %), ventilator failure or dislocation (n=2, 11.1%), suffocation/choking (n=2, 11.1%), and heart failure with hypertrophic cardiomyopathy (n=1, 5.55%). Among the 15 patients died of respiratory failure or choking, 73.3% of the patients (n=11) received no ventilator care at home. 80% of the patients (n=12) received no cough assist at home. The patient died of cardiomyopathy received no medications for heart failure until the last admission. Conclusion: Respiratory failure and choking are the leading causes of death in NMD patients. Appropriate respiratory support and airway clearance play the critical role to reduce the mortality.

Keywords: neuromuscular disease, cause of death, tertiary care hospital, medical sciences

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1306 The Population Death Model and Influencing Factors from the Data of The "Sixth Census": Zhangwan District Case Study

Authors: Zhou Shangcheng, Yi Sicen

Abstract:

Objective: To understand the mortality patterns of Zhangwan District in 2010 and provide the basis for the development of scientific and rational health policy. Methods: Data are collected from the Sixth Census of Zhangwan District and disease surveillance system. The statistical analysis include death difference between age, gender, region and time and the related factors. Methods developed for the Global Burden of Disease (GBD) Study by the World Bank and World Health Organization (WHO) were adapted and applied to Zhangwan District population health data. DALY rate per 1,000 was calculated for varied causes of death. SPSS 16 is used by statistic analysis. Results: From the data of death population of Zhangwan District we know the crude mortality rate was 6.03 ‰. There are significant differences of mortality rate in male and female population which was respectively 7.37 ‰ and 4.68 ‰. 0 age group population life expectancy in Zhangwan District in 2010 was 78.40 years old(Male 75.93, Female 81.03). The five leading causes of YLL in descending order were: cardiovascular diseases(42.63DALY/1000), malignant neoplasm (23.73DALY/1000), unintentional injuries (5.84DALY/1000), Respiratory diseases(5.43 DALY/1000), Respiratory infections (2.44DALY/1000). In addition, there are strong relation between the marital status , educational level and mortality in some to a certain extend. Conclusion Zhangwan District, as city level, is at lower mortality levels. The mortality of the total population of Zhangwan District has a downward trend and life expectancy is rising.

Keywords: sixth census, Zhangwan district, death level differences, influencing factors, cause of death

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1305 Metal Nanoparticles Caused Death of Metastatic MDA-MB-231 Cells

Authors: O. S. Adeyemi, C. G. Whiteley

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The present study determined the toxic potential of metal nanoparticles in cell culture system. Silver and gold nanoparticles were synthesized and characterized following established "green" protocols. The synthesized nanoparticles, in varying concentrations ranging from 0.1–100 µM were evaluated for toxicity in metastatic MDA-MB-231 cells. The nanoparticles promoted a generation of reactive oxygen species and reduced cell viability to less than 50% in the demonstration of cellular toxicity. The nanoparticles; gold and the silver-gold mixture had IC50 values of 56.65 and 18.44 µM respectively. The IC50 concentration for silver nanoparticles could not be determined. Furthermore, the probe of the cell death using flow cytometry and confocal microscopy revealed the partial involvement of apoptosis as well as necrosis. Our results revealed cellular toxicity caused by the nanoparticles but the mechanism remains yet undefined.

Keywords: cell death, nanomedicine, nanotoxicology, toxicity

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1304 An Investigation of the Compliance of Kermanian College Students' Diet with Who/Fao Nutrition Targets

Authors: Farideh Doostan, Sahar Mohseni Taklloo, Mohammad Nosrati

Abstract:

Chronic diseases are non-communicable and largely preventable by lifestyle changes including healthy diet consumption. They are the most common cause of death in the world and projected to increase by 15% globally between 2010 and 2020.The hazardous effects of behavioral and dietary risk factors on chronic disease have been established in prospective cohort studies and randomized trials. Because of some changes occur in college students’ lifestyle, assessment of dietary risk factors is important in these populations. Objective: This research was the first study that conducted to evaluate dietary intakes of Kermanian college students with WHO/FAO nutritional objectives. Material and Methods: In this descriptive cross-sectional study, 229 healthy college students of health faculty in Kerman University of Medical Sciences that do not intake any medical drugs were recruited using multistage sampling in 2013.Usual dietary intake was collected using a valid Food Frequency Questionnaire (FFQ) and diet quality was calculated based on WHO nutrient goals. To analysis of data between two groups, independent sample t. test and man whitney were applied. Results: Two hundred and twenty-nine college students; 151 females (65.9%) and 78 males (34.1%), the mean age of 21.9 years were studied. The mean of the Body Mass Index (Kg/m2) and Waist Circumference (cm) in males were 22.34 ±3.52 and 80.76±11.16 and in females were 21.19±2.62 and 73.67±7.65 respectively. Mean of daily cholesterol intake in males was significantly more than females (305±101 VS 268±98; P=0.008) and more than WHO/FAO recommendation (less than 300 mg/day). The mean of daily sodium intake in men and women were 10.4±1 and 10.9±5.3 respectively. These amounts were more than WHO/FAO recommendation (less than 2g/day). In addition, women were consumed fruit and vegetables more than men (839±336 VS 638±281; p ‹ 0.001) and these amounts were more than WHO/FAO recommendation (more than 400g/day) in both groups. Other intake indices were in the range of WHO/FAO recommendations, So that Percent of calories intake from total fat, saturated fatty acids, polyunsaturated fatty acids and added sugar were in compliance with WHO/FAO recommendations. Conclusion: Cholesterol intake in men and sodium intake in all participants were more than WHO/FAO recommendation. These dietary components are the most important causes of cardiovascular disease (one of the main causes of death in our population). These results indicated that proper nutritional education and interventions are needed in this population.

Keywords: college students, food intake, WHO /FAO nutrient intake goals, Kerman

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1303 Integrated Machine Learning Framework for At-Home Patients Personalized Risk Prediction Using Activities, Biometric, and Demographic Features

Authors: Claire Xu, Welton Wang, Manasvi Pinnaka, Anqi Pan, Michael Han

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Hospitalizations account for one-third of the total health care spending in the US. Early risk detection and intervention can reduce this high cost and increase the satisfaction of both patients and physicians. Due to the lack of awareness of the potential arising risks in home environment, the opportunities for patients to seek early actions of clinical visits are dramatically reduced. This research aims to offer a highly personalized remote patients monitoring and risk assessment AI framework to identify the potentially preventable hospitalization for both acute as well as chronic diseases. A hybrid-AI framework is trained with data from clinical setting, patients surveys, as well as online databases. 20+ risk factors are analyzed ranging from activities, biometric info, demographic info, socio-economic info, hospitalization history, medication info, lifestyle info, etc. The AI model yields high performance of 87% accuracy and 88 sensitivity with 20+ features. This hybrid-AI framework is proven to be effective in identifying the potentially preventable hospitalization. Further, the high indicative features are identified by the models which guide us to a healthy lifestyle and early intervention suggestions.

Keywords: hospitalization prevention, machine learning, remote patient monitoring, risk prediction

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1302 Self Immolation and the Deactivation of State Necropower

Authors: Kate L. Yusi

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This paper is an attempt to theoretically reframe the act of self-immolation beyond violence/non-violence discourse, to differentiate it from other paradigmatic examples of necropolitical activism like suicide bombing, in order to highlight its particular ontopolitical statement in relation to life and death and to re-energize its deactivating power. In this paper, the writer seeks to focus on self-immolation by Tibetan monks and other activists against Chinese imperialism, its continuing ethnic cleansing of the Tibetan people, forced assimilation, and territorial occupation. Here, the main driving force is this question: what does self-immolation mean to a people who are forced to live in deathspace? In other words, if one is reduced to nothingness that their deaths (as is their lives) become insignificant, in what ways does the reclamation of death/dying become a “way out” of this state-imposed enclave of death? To answer these questions, the writer engages with and put in conversation the works of Achille Mbembe, Elias Cannetti, and Giorgio Agamben.

Keywords: necropolitics, self immolation, tibetan people, chinese imperialism

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