Search results for: novel quarantine-adjusted incidence
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1099

Search results for: novel quarantine-adjusted incidence

529 Clinical Outcomes of Critically Ill Patients with Sepsis Receiving Extended and Standard Meropenem Infusion in Malaysian Hospitals

Authors: Fahmi Hassan, Noorizan Abdul Aziz, Yahaya Hassan, Hazlinda Abu Hassan

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Sepsis incidence in critical care settings is a major problem in health care. Extended antibiotic infusion is thought to be superior to traditional dosing especially when treating critically ill patients with sepsis. We compared clinical outcomes of critically ill patients with sepsis receiving 30-minute meropenem infusion and three-hour meropenem infusion. A retrospective case-control study was conducted among septic patients treated with meropenem infusion in ICUs of three hospitals. Patients included in the study received either extended or standard meropenem infusion as per the practice of individual settings. Outcomes and clinical data were retrospectively collected from the electronic databases and patients’ files. A total of 108 patients received extended meropenem infusion while another 117 patients received standard meropenem infusion. Patients receiving the extended meropenem infusion were found to have a significantly lower shorter length of hospital and ICU stay. It was also found that among those receiving extended meropenem infusion, 54.7% (64/117) had a reduction of SAPS II score, while only 44% (48/108) of patients receiving standard meropenem infusion had reduced scores. This study will strengthen the evidence in using extended meropenem infusion as a standard practice in critical care settings. As this is the first study of its kind done in Malaysia, it proves that prolonged meropenem infusion may be beneficial to critically ill patients with sepsis. However, randomized clinical trials with large sample size should be carried out in local settings in order to minimize other confounders that may influence with the result of the study.

Keywords: antibiotics, beta lactams, critical care, extended infusion, meropenem

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528 Neighborhood Linking Social Capital as a Predictor of Drug Abuse: A Swedish National Cohort Study

Authors: X. Li, J. Sundquist, C. Sjöstedt, M. Winkleby, K. S. Kendler, K. Sundquist

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Aims: This study examines the association between the incidence of drug abuse (DA) and linking (communal) social capital, a theoretical concept describing the amount of trust between individuals and societal institutions. Methods: We present results from an 8-year population-based cohort study that followed all residents in Sweden, aged 15-44, from 2003 through 2010, for a total of 1,700,896 men and 1,642,798 women. Social capital was conceptualized as the proportion of people in a geographically defined neighborhood who voted in local government elections. Multilevel logistic regression was used to estimate odds ratios (ORs) and between-neighborhood variance. Results: We found robust associations between linking social capital (scored as a three level variable) and DA in men and women. For men, the OR for DA in the crude model was 2.11 [95% confidence interval (CI) 2.02-2.21] for those living in areas with the lowest vs. highest level of social capital. After accounting for neighborhood-level deprivation, the OR fell to 1.59 (1.51-1-68), indicating that neighborhood deprivation lies in the pathway between linking social capital and DA. The ORs remained significant after accounting for age, sex, family income, marital status, country of birth, education level, and region of residence, and after further accounting for comorbidities and family history of comorbidities and family history of DA. For women, the OR decreased from 2.15 (2.03-2.27) in the crude model to 1.31 (1.22-1.40) in the final model, adjusted for multiple neighborhood-level and individual-level variables. Conclusions: Our study suggests that low linking social capital may have important independent effects on DA.

Keywords: drug abuse, social linking capital, environment, family

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527 Radioprotective Effects of Selenium and Vitamin-E against 6Mv X-Rays in Human Volunteers Blood Lymphocytes by Micronuclei Assay

Authors: Vahid Changizi, Aram Rostami, Akbar Mosavi

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Purpose of study: Critical macromolecules of cells such as DNA are in exposure to damage of free radicals that induced from interaction of ionizing radiation with biological systems. Selenium and vitamin-E are natural compound that has been shown to be a direct free radical scavenger. The aim of this study was to investigate the in vivo/in vitro radioprotective effect of selenium and vitamin-E separately and synergistically against genotoxicity induced by 6MV x-rays irradiation in cultured blood lymphocytes from 15 human volunteers. Methods: Fifteen volunteers were divided in three groups include A, B and C. These groups were given slenium(800 IU), vitamin-E(100 mg) and selenium(400 IU) + vitamin-E(50 mg), respectively. Peripheral blood samples were collected from each group before(0 hr) and 1, 2 and 3 hr after selenium and vitamin-E administration (separately and synergistically). Then the blood samples were irradiated to 200 cGy of 6 Mv x-rays. After that, lymphocyte samples were cultured with mitogenic stimulation to determine the chromosomal aberrations wih micronucleus assay in cytokinesis-blocked binucleated cells. Results: The lymphocytes in the blood samples collected at 1 hr after ingestion selenium and vitamin-E, exposed in vitro to x-rays exhibited a significant decrease in the incidence of micronuclei, compared with control group at 0 hr. The maximum protection and decrease in frequency of micronuclei(50%) was observed at 1 hr after administration of selenium and vitamin-E synergistically. Conclusion: The data suggest that ingestion of selenium and vitamin-E as a radioprotector substances before exposures may reduce genetic damage caused by x-rays irradiation.

Keywords: x-rays, selenium, vitamin-e, lymphocyte, micronuclei

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526 Predicting Intentions of Physical Activity in Patients with Coronary Artery Disease: Attitudes, Subjective Norms and Perceived Behavioral Control

Authors: Shadi Kanan, Ghada Shahrour, Barbara Broome, Donna Bernert, Muntaha Alibrahim, Dana Hansen

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Coronary artery disease is responsible for over 7 million deaths a year worldwide. In developing countries, such as Jordan, the incidence of coronary artery disease exceeds that of developed countries. One contributing factor to this disparity is decreased physical activity among the population, for reasons related to specific cultural and religious values. Using the theory of planned behaviour, the purpose of this study was to investigate the intentions of Jordanian patients with coronary artery disease regarding physical activity. A total of 109 patients with coronary artery disease were recruited for this cross-sectional study from King Abdullah University Hospital in Jordan. A 15-item questionnaire based on the theory of planned behaviour was used to assess participants’ attitudes, subjective norms, perceived behavioural control and intentions towards engagement in physical activity. Perceived behavioural control was found to have the strongest significant relationship with participants’ intentions to engage in physical activity. Barriers to physical activity included lack of time, lack of support from family or friends, and feelings of exhaustion. Lifestyle interventions for patients with coronary artery disease should focus on fostering a sense of control over the environment to encourage patients to engage in physical activity.

Keywords: coronary artery disease, perceived behavioural control, subjective norms, theory of planned behaviour

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525 Correlation of Nutritional Status and Anemia Among School-Aged Children in Indonesian Urban Area

Authors: William Cheng, Yuni Astria, Rini Sekartini

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Background: Prevalence of anemia among school-aged children is relatively high (25.4%). This condition can affect children’s life, including cognitive function. One of the most common factors that is associated with anemia in children is nutritional status. This simple indicator will be very helpful in identifying more population at risk. The aim of this study is to correlate the clinical implication of nutritional status to the prevalence of anemia in children, with intention to determine a more effective nutritional status indicator in detecting anemia. Method: Anthropometric and haemoglobin status were gathered from children between 5 to 7-years-old in one of the urban areas in Jakarta in 2012. We identified children with haemoglobin level under 11.5 as anemia and correlated them to their WHO z-score from each of these indicators: Body Weight for Age (normal weight and underweight), Height for Age (not stunted and stunted), and Body Mass Index for Age (not wasted and wasted). Results: A total of 195 children were included in this research and 57 of them (29,2%) were diagnosed as anemia. The majority of the children had good nutritional status, however, 30 (15,4%) of them were found to be underweight, 33 (16,9%) were stunted, and 1 children (0,5%) was wasted. There were no overweight result found in this population. From the three nutritional status indicators, none proved to be statistically significant in relation to the incidence of anemia (p>0.05). Out of 33 children who were diagnosed as stunted, 36.36 % were found to have anemia, in comparison to 27,7% of children who were not stunted. Meanwhile, among 30 children who were diagnosed as underweight, 33,3 % of them were anemic whereas only 28,4% of the normal weight group were anemic. Conclusion: In this study, there is no significant correlation between anemia with any nutritional status indicator. However, more than a third of the stunted children are proven to have low haemoglobin status. The finding of stunting in children should be given more attention to further investigate for anemia.

Keywords: school-aged children, nutritional status, anemia, pediatrics

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524 Baby Boomers and Millennials: Creating a Specialized Orientation Program

Authors: K. Rowan

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In this paper, the author will discuss how developing a specialized orientation has improved nursing satisfaction and decrease the incidence of incivility among staff. With the predicted shortages in nursing, we must provide an environment that reflects the needs of the current workforce while also focusing on the sustainability of nursing. Each generation has different qualities and methods in which he or she prefers to learn. The Baby Boomer has a desire to share their knowledge. They feel that the quality of undergraduate nursing education has declined. Millennials have grown up with 'helicopter parents' and expect the preceptor to behave in the same manner. This information must be shared with the Baby Boomer, as it is these staff members who are passing the torch of perioperative nursing. Currently, nurse fellows are trained with the Association of periOperative Nurse’s Periop 101 program, with a didactic and clinical observation program. There is no specialized perioperative preceptor program. In creation of a preceptor program, the concept of Novice to Expert, communication techniques, dealing with horizontal violence and generational gap education is reviewed with the preceptor. The fellows are taught communication and de-escalation skills, and generational gaps information. The groups are then brought together for introductions and teamwork exercises. At the program’s core is the knowledge of generational differences. The preceptor training has increased preceptor satisfaction, as well as the new nurse fellows. The creation of a specialized education program has significantly decreased incivility amongst our nurses, all while increasing nursing satisfaction and improving nursing retention. This model of program can translate to all nursing specialties and assist in overcoming the impending shortage.

Keywords: baby boomers, education, generational gap, millennials, nursing, perioperative

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523 Effects of Dust Storm Events on Tuberculosis Incidence Rate in Northwest of China

Authors: Yun Wang, Ruoyu Wang, Tuo Chen, Guangxiu Liu, Guodong Chen, Wei Zhang

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Tuberculosis (TB) is a major public health problem in China. China has the world's second largest tuberculosis epidemic (after India). Xinjiang almost has the highest annual attendance rate of TB in China, and the province is also famous because of its severe dust storms. The epidemic timing starts in February and ends in July, and the dust storm mainly distribute throughout the spring and early summer, which strongly indicate a close linkage between causative agent of TB and dust storm events. However, mechanisms responsible for the observed patterns are still not clearly indentified. By comparing the information on cases of TB from Centers for Disease Control of China annual reports with dust storm atmosphere datasets, we constructed the relationship between the large scale annual occurrence of TB in Xinjiang, a Northwest province of China, and dust storm occurrence. Regional atmospheric indexes of dust storm based on surface wind speed show a clear link between population dynamics of the disease and the climate disaster: the onset of epidemics and the dust storm defined by the atmospheric index share the same mean year. This study is the first that provides a clear demonstration of connections that exist between TB epidemics and dust storm events in China. The development of this study will undoubtedly help early warning for tuberculosis epidemic onset in China and help nationwide and international public health institutions and policy makers to better control TB disease in Norwest China.

Keywords: dust storm, tuberculosis, Xinjiang province, epidemic

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522 A Survey of Types and Causes of Medication Errors and Related Factors in Clinical Nurses

Authors: Kouorsh Zarea, Fatemeh Hassani, Samira Beiranvand, Akram Mohamadi

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Background and Objectives: Medication error in hospitals is a major cause of the errors which disrupt the health care system. The aim of this study was to assess the nurses’ medication errors and related factors. Material and methods: This was a descriptive study on 225 nurses in various hospitals, selected through multistage random sampling. Data was collected by three researcher made tools; demographic, medication error and related factors questionnaires. Data was analyzed by descriptive statistics, Chi-square, Kruskal-Wallis, One-way analysis of variance. Results: Based on the results obtained, the type of medication errors giving drugs to patients later or earlier (55.6%), multiple oral medication together regardless of their interactions (36%) and the postoperative analgesic without a prescription (34.2%), respectively. In addition, factors such as the shortage of nurses to patients’ ratio (57.3%), high load functions (51.1%) and fatigue caused by the extra work (40.4%), were the most important factors affecting the incidence of medication errors. The fear of legal issues (40%) are the most important factor is the lack of reported medication errors. Conclusions: Based on the results, effective management and promotion motivate nurses. Therefore, increasing scientific and clinical expertise in the field of nursing medication orders is recommended to prevent medication errors in various states of nursing intervention. Employing experienced staff in areas with high risk of medication errors and also supervising less-experienced staff through competent personnel are also suggested.

Keywords: medication error, nurse, clinical care, drug errors

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521 Identification of Knee Dynamic Profiles in High Performance Athletes with the Use of Motion Tracking

Authors: G. Espriú-Pérez, F. A. Vargas-Oviedo, I. Zenteno-Aguirrezábal, M. D. Moya-Bencomo

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One of the injuries with a higher incidence among university-level athletes in the North of Mexico is presented in the knee. This injury generates absenteeism in training and competitions for at least 8 weeks. There is no active quantitative methodology, or protocol, that directly contributes to the clinical evaluation performed by the medical personnel at the prevalence of knee injuries. The main objective is to contribute with a quantitative tool that allows further development of preventive and corrective measures to these injuries. The study analyzed 55 athletes for 6 weeks, belonging to the disciplines of basketball, volleyball, soccer and swimming. Using a motion capture system (Nexus®, Vicon®), a three-dimensional analysis was developed that allows the measurement of the range of movement of the joint. To focus on the performance of the lower limb, eleven different movements were chosen from the Functional Performance Test, Functional Movement Screen, and the Cincinnati Jump Test. The research identifies the profile of the natural movement of a healthy knee, with the use of medical guidance, and its differences between each sport. The data recovered by the single-leg crossover hop managed to differentiate the type of knee movement among athletes. A maximum difference of 60° of offset was found in the adduction movement between male and female athletes of the same discipline. The research also seeks to serve as a guideline for the implementation of protocols that help identify the recovery level of such injuries.

Keywords: Cincinnati jump test, functional movement screen, functional performance test, knee, motion capture system

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520 Case Report on ‘Primary Adenocarcinoma of Aberrant HER2+ Anogenital Mammary-like Glands in a Male'

Authors: Shivani Kuttuva, James Sampson, Timothy Simmons, Vinayak Thattaruparambil, Holly Burton, Peter Coyne

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Anogenital mammary-like glands were established to be embryological remnants of breast tissue due to failed resolution of the ectodermal mammary ridge. However, recent studies are now considering this to represent normal constituents of the anogenital area with histological resemblance to the orthotopic breast tissue with multiple benign and malignant lesions arising from it. The incidence of the above has been predominant in females in the vulval region. Due to the paucity of cases reported in men, this poses a diagnostic and therapeutic challenge resulting in a delay in treatment and, thereby, poor outcomes. Our patient presented to the dermatology clinic with an itchy, purplish lesion in the peri-anal region which, on punch biopsy, was diagnosed to be Extra-mammary Paget’s disease and taken up for Wide local excision. Immunochemically, staining was positive for HER2, ER and Cytokeratin 7, keeping with the presence of actual breast tissue with no primary breast carcinoma. Due to the invasive nature of the disease, he required Abdominoperineal resection with flap reconstruction. Despite complete surgical clearance and adjuvant radiotherapy, the disease progressed to adjacent inguinal and obturator lymph nodes with origin resembling anogenital type mammary glands but histology negative for hormonal receptors of the breast.

Keywords: anogenital mammary-like glands, abdominoperineal resection, ectopic breast tissue, ectopic male breast carcinoma, peri-anal skin lesion

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519 Civilization and Violence: Islam, the West, and the Rest

Authors: Imbesat Daudi

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One of the most discussed topics of the last century happens to be if Islamic civilization is violent. Many Western intellectuals have promoted the notion that Islamic civilization is violent. Citing 9/11, in which 3000 civilians were killed, they argue that Muslims are prone to violence because Islam promotes violence. However, Muslims reject this notion as nonsense. This topic has not been properly addressed. First, violence of civilizations cannot be proven by citing religious texts, which have been used in discussions over civilizational violence. Secondly, the question of whether Muslims are violent is inappropriate, as there is implicit bias suggesting that Islamic civilization is violent. A proper question should be which civilization is more violent. Third, whether Islamic civilization is indeed violent can only be established if more war-related casualties can be documented within the borders of Islamic civilization than that of their cohorts. This has never been done. Finally, the violent behavior of Muslim countries can be examined by comparing acts of violence committed by Muslim countries with acts of violence of groups of nations belonging to other civilizations by appropriate parameters of violence. Therefore, parameters reflecting group violence have been defined; violent conflicts of various civilizations of the last two centuries were documented, quantified by number of conflicts and number of victims, and compared with each other by following the established principles of statistics. The results show that whereas 80% of genocides and massacres were conducted by Western nations, less than 5% of acts of violence were committed by Muslim countries. Furthermore, the West has the highest incidence (new) and prevalence (new and old) of violent conflicts among all groups of nations. The result is unambiguous and statistically significant. Becoming informed can only be done by a methodical collection of relevant data, objective analysis of data, and unbiased information, a process which this paper follows.

Keywords: Islam and violence, civilizational violence, demonization of Islam

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518 Allopurinol Prophylactic Therapy in the Prevention of Contrast Induced Nephropathy in High Risk Patients Undergoing Coronary Angiography: A Prospective Randomized Controlled Trial

Authors: Seyed Fakhreddin Hejazi, Leili Iranirad, Mohammad Sadeghi, Mohsen Talebizadeh

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Background: Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures. We performed this clinical trial to assess the preventive effect of allopurinol against CIN in high-risk patients undergoing coronary angiography. Methods: In this prospective randomized controlled trial, 140 patients with at least two risk factors for CIN undergoing coronary angiography were randomly assigned to either the allopurinol group or the control group. Patients in the allopurinol group received 300 mg allopurinol 24 hours before a procedure and intravenous hydration for 12 hours before and after coronary angiography, whereas patients in the control group received intravenous hydration. Serum creatinine (SCr), blood urea nitrogen (BUN) and uric acid were measured before contrast exposure and at 48 hours. CIN was defined as an increase of 25% in serum creatinine (SCr) or >0.5 mg/dl 48 hours after contrast administration. Results: CIN occurred in 11 out of 70 (7.9%) patients in the control group and in 8 out of 70 (5.7%) patients in the allopurinol group. There was no significant difference in the incidence of CIN between the two groups at 48 hours after administering the radiocontrast agent (p = 0.459). However, there were significant differences between the two groups in SCr, BUN, uric acid, and eGFR 48 hours after radiocontrast administration (p < 0.05). Conclusion: Our findings revealed that allopurinol had no substantial efficacy over hydration protocol in high-risk patients for the development of CIN.

Keywords: contrast-induced nephropathy, allopurinol, coronary angiography, contrast agent

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517 Convolutional Neural Networks versus Radiomic Analysis for Classification of Breast Mammogram

Authors: Mehwish Asghar

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Breast Cancer (BC) is a common type of cancer among women. Its screening is usually performed using different imaging modalities such as magnetic resonance imaging, mammogram, X-ray, CT, etc. Among these modalities’ mammogram is considered a powerful tool for diagnosis and screening of breast cancer. Sophisticated machine learning approaches have shown promising results in complementing human diagnosis. Generally, machine learning methods can be divided into two major classes: one is Radiomics analysis (RA), where image features are extracted manually; and the other one is the concept of convolutional neural networks (CNN), in which the computer learns to recognize image features on its own. This research aims to improve the incidence of early detection, thus reducing the mortality rate caused by breast cancer through the latest advancements in computer science, in general, and machine learning, in particular. It has also been aimed to ease the burden of doctors by improving and automating the process of breast cancer detection. This research is related to a relative analysis of different techniques for the implementation of different models for detecting and classifying breast cancer. The main goal of this research is to provide a detailed view of results and performances between different techniques. The purpose of this paper is to explore the potential of a convolutional neural network (CNN) w.r.t feature extractor and as a classifier. Also, in this research, it has been aimed to add the module of Radiomics for comparison of its results with deep learning techniques.

Keywords: breast cancer (BC), machine learning (ML), convolutional neural network (CNN), radionics, magnetic resonance imaging, artificial intelligence

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516 Effects of Storage Methods on Proximate Compositions of African Yam Bean (Sphenostylis stenocarpa) Seeds

Authors: Iyabode A. Kehinde, Temitope A. Oyedele, Clement G. Afolabi

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One of the limitations of African yam bean (AYB) (Sphenostylis sternocarpa) is poor storage ability due to the adverse effect of seed-borne fungi. This study was conducted to examine the effects of storage methods on the nutritive composition of AYB seeds stored in three types of storage materials viz; Jute bags, Polypropylene bags, and Plastic Bowls. Freshly harvested seeds of AYB seeds were stored in all the storage materials for 6 months using 2 × 3 factorial (2 AYB cultivars and 3 storage methods) in 3 replicates. The proximate analysis of the stored AYB seeds was carried out at 3 and 6 months after storage using standard methods. The temperature and relative humidity of the storeroom was recorded monthly with Kestrel pocket weather tracker 4000. Seeds stored in jute bags gave the best values for crude protein (24.87%), ash (5.69%) and fat content (6.64%) but recorded least values for crude fibre (2.55%), carbohydrate (50.86%) and moisture content (12.68%) at the 6th month of storage. The temperature of the storeroom decreased from 32.9ºC - 28.3ºC, while the relative humidity increased from 78% - 86%. Decreased incidence of field fungi namely: Rhizopus oryzae, Aspergillus flavus, Geotricum candidum, Aspergillus fumigatus and Mucor meihei was accompanied by the increase in storage fungi viz: Apergillus niger, Mucor hiemalis, Penicillium espansum and Penicillium atrovenetum with prolonged storage. The study showed that of the three storage materials jute bag was more effective at preserving AYB seeds.

Keywords: storage methods, proximate composition, African Yam Bean, fungi

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515 The Role of Cognitive Impairment in Asthma Self-Management Behaviors and Outcomes in Older Adults

Authors: Gali Moritz, Jacqueline H. Becker, Jyoti V. Ankam, Kimberly Arcoleo, Matthew Wysocki, Roee Holtzer, Juan Wisnivesky, Paula J. Busse, Alex D. Federman, Sunit P. Jariwala, Jonathan M. Feldman

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Objective: Cognitive impairment (CI), whose incidence is greater among ethnic/racial minorities, is a significant barrier to asthma self-management (SM) behaviors and outcomes in older adults. The aim of this study was to examine the relationships between CI, assessed using the Montreal Cognitive Assessment (MoCA), and asthma SM behaviors and outcomes in a sample of predominantly Black and Hispanic participants. Additionally, we evaluated whether using two different MoCA cutoff scores influenced the association between CI and study outcomes. Methods: Baseline cross-sectional data were extracted from a longitudinal study of older adults with asthma (N=165) age≥ 60 years and used for analysis. Cognition was assessed using the MoCA. Asthma control, asthma-related quality of life (QOL), inhaled corticosteroid (ICS) dosing, and ICS adherence were assessed using self-report. The inhaler technique was observed and rated. Results: Using established MoCA cutoff scores of 23 and 26 yielded 45% and 74% CI rates, respectively. CI, defined using the 23 cutoff score, was significantly associated with worse asthma control (p=.04) and worse ICS adherence (p=.01). With a cutoff score of 26, only asthma-related QOL was significantly associated with CI (p=.03). Race/ethnicity and education did not moderate the relationships between CI and asthma SM behaviors and outcomes. Conclusions: CI in older adults with asthma is associated with important clinical outcomes, but this relationship is influenced by the cutoff score used to define CI.

Keywords: cognition, respiratory, elderly, testing, adherence, validity

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514 Mechanical and Optical Properties of Doped Aluminum Nitride Thin Films

Authors: Padmalochan Panda, R. Ramaseshan

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Aluminum nitride (AlN) is a potential candidate for semiconductor industry due to its wide band gap (6.2 eV), high thermal conductivity and low thermal coefficient of expansion. A-plane oriented AlN film finds an important role in deep UV-LED with higher isotropic light extraction efficiency. Also, Cr-doped AlN films exhibit dilute magnetic semiconductor property with high Curie temperature (300 K), and thus compatible with modern day microelectronics. In this work, highly a-axis oriented wurtzite AlN and Al1-xMxN (M = Cr, Ti) films have synthesized by reactive co-sputtering technique at different concentration. Crystal structure of these films is studied by Grazing incidence X-ray diffraction (GIXRD) and Transmission electron microscopy (TEM). Identification of binding energy and concentration (x) in these films is carried out by X-ray photoelectron spectroscopy (XPS). Local crystal structure around the Cr and Ti atom of these films are investigated by X-ray absorption spectroscopy (XAS). It is found that Cr and Ti replace the Al atom in AlN lattice and the bond lengths in first and second coordination sphere with N and Al, respectively, decrease concerning doping concentration due to strong p-d hybridization. The nano-indentation hardness of Cr and Ti-doped AlN films seems to increase from 17.5 GPa (AlN) to around 23 and 27.5 GPa, respectively. An-isotropic optical properties of these films are studied by the Spectroscopic Ellipsometry technique. Refractive index and extinction coefficient of these films are enhanced in normal dispersion region as compared to the parent AlN film. The optical band gap energies also seem to vary between deep UV to UV regions with the addition of Cr, thus by bringing out the usefulness of these films in the area of optoelectronic device applications.

Keywords: ellipsometry, GIXRD, hardness, XAS

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513 Assessing the Perceptions toward the Impacts of Tourism in Poverty Alleviation: A Basis for Pro-Poor Tourism Policy in Sta. Lucia, Guimba, Nueva Ecija

Authors: Lady Salvador Purganan, Jojo M. Villamin, Noel L. Lansang

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Tourism is a multifaceted but interdependent industry. This industry is composed of four major players, the public sector, the private sector, the local community, and the tourists. Each player has a vital role in the success of delivering high-quality tourism products and activities. There are various manifestations of positive economic outcomes that benefit the local community. Pro-poor tourism development approach has a great potential to serve as an avenue for capacity building leading to economic independence since natural attractions and cultural resources are assets that can be capitalized on, especially by the poor, because it is more accessible to them compared to financial resources. In the National Tourism Development Plan 2016-2022, specific mechanisms are not reflected to combat and lower poverty incidence through tourism. The researcher used the multidimensional poverty theory and sustainable tourism theory to formulate indicators in the research instrument and social exchange theory. The expected output of the study is to unlock opportunities, specifically in Brgy. Sta. Lucia, Guimba, Nueva Ecija, by crafting policies taking into utmost consideration local community involvement and participation in the process of tourism development which is essential in attaining inclusive growth and sustainability. This study will apply the sequential explanatory design mixed-method approach.

Keywords: pro-poor tourism, poverty alleviation, livelihood opportunities, tourism development plan

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512 Study of Therapeutic Potential of Dodonaea Viscosa Against Rheumatoid Arthritis in Collagen Induced Arthritic Mouse Model

Authors: Peter John, Zainab Ali, Attya Bhatti

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Rheumatoid Arthritis (RA) is a systemic autoimmune inflammatory disease that primarily affects the joints. RA is caused in many cases by the interaction between genes and environmental factors, including tobacco, that primarily involves synovial joints. It typically starts in small peripheral joints, is usually symmetric, and progresses to involve proximal joints if left untreated. The prevalence of rheumatoid arthritis varies substantially around the globe, ranging from 0·25% to 1%.3. Rheumatoid arthritis can affect individuals of any age, with an increased incidence in people older than 40 years. Women are affected two to three times more frequently than men. The present work involved evaluating the toxicity and therapeutic potential of Dodonaea viscosa in a collagen-induced arthritic mouse model. Chemical analysis exhibited that Dodonaea viscosa has high levels of beneficial compounds, including phenols, flavonoids, and other phytochemicals. The Dodonaea viscosa showed significant antioxidant, anti-inflammatory, and anti-arthritic potential without toxic effects. Arthritic mice treated with Dodonaea viscosa showed reduced levels of rheumatoid factor and paw edema, while no significant effects on spleen indices and radiological examination of paws were found compared to control untreated arthritic mice. In summary, the Dodonaea viscosa treatment results in improvement in Arthritic Mice Model for which further studies are required.

Keywords: rheumatoid arthritis, dodonaea viscisa, anti-inflammatory, anti-rheumatic

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511 Satellite Statistical Data Approach for Upwelling Identification and Prediction in South of East Java and Bali Sea

Authors: Hary Aprianto Wijaya Siahaan, Bayu Edo Pratama

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Sea fishery's potential to become one of the nation's assets which very contributed to Indonesia's economy. This fishery potential not in spite of the availability of the chlorophyll in the territorial waters of Indonesia. The research was conducted using three methods, namely: statistics, comparative and analytical. The data used include MODIS sea temperature data imaging results in Aqua satellite with a resolution of 4 km in 2002-2015, MODIS data of chlorophyll-a imaging results in Aqua satellite with a resolution of 4 km in 2002-2015, and Imaging results data ASCAT on MetOp and NOAA satellites with 27 km resolution in 2002-2015. The results of the processing of the data show that the incidence of upwelling in the south of East Java Sea began to happen in June identified with sea surface temperature anomaly below normal, the mass of the air that moves from the East to the West, and chlorophyll-a concentrations are high. In July the region upwelling events are increasingly expanding towards the West and reached its peak in August. Chlorophyll-a concentration prediction using multiple linear regression equations demonstrate excellent results to chlorophyll-a concentrations prediction in 2002 until 2015 with the correlation of predicted chlorophyll-a concentration indicate a value of 0.8 and 0.3 with RMSE value. On the chlorophyll-a concentration prediction in 2016 indicate good results despite a decline in the value of the correlation, where the correlation of predicted chlorophyll-a concentration in the year 2016 indicate a value 0.6, but showed improvement in RMSE values with 0.2.

Keywords: satellite, sea surface temperature, upwelling, wind stress

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510 Psychology Behind Aesthetic Rhinoplasty–Introducing the Term Sifon

Authors: Komal Saeed

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Introduction: Rhinoplasty is considered one of the challenging aesthetic procedures. Psychosocial concerns motivate the urge for aesthetic procedures especially rhinoplasty. Males who fall in this category are designated as single, immature, male, over expectant and narcissistic (SIMON) in literature. As of yet, there is no term that depicts females showing similar characteristics. The purpose of this study is to evaluate the incidence of body dysmorphic disorder (BDD) in females seeking rhinoplasty and to introduce a term for such individuals. Materials and Methods: A prospective, questionnaire based, qualitative study was conducted in the Department Of Plastic Surgery between March 2018 and March 2020. 110 female candidates seeking aesthetic rhinoplasty were included in the study. BDD was evaluated using the Dysmorphic Concerns Questionnaire, DCQ. Data were analyzed using SPSS version 25 software and correlation between the groups was evaluated. Results: Out of 110 female subjects, 77.3% (n=85) were single, 16.4% (n=18) were married and 6.4% (n=7) were divorced. BDD was found in 41.8% (n=46) of the candidates, majority being single (n=41, 89.1%) and having educational status above diploma (n=39, 84.8%). There was a statistically higher percentage of young adults between 24 and 28 years (n=33, 71.7%) having BDD (p= 0.0001). Conclusion: Considering the high frequency of BDD among females seeking rhinoplasty, a standardized term ‘SIFON’ is introduced to describe such individuals who are S; single, I; immature, F; female, O; over expectant, N; narcissistic as apposed to SIMON in males. These individuals perceive aesthetic procedures as a solution to their body dissatisfaction. Therefore, preoperative counseling seems necessary to avoid unsatisfactory outcomes secondary to mental health.

Keywords: aesthetic rhinoplasty, body dismorphic disorder, single, immature, obsessive

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509 Preparing a Library of Abnormal Masses for Designing a Long-Lasting Anatomical Breast Phantom for Ultrasonography Training

Authors: Nasibullina A., Leonov D.

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The ultrasonography method is actively used for the early diagnosis of various le-sions in the human body, including the mammary gland. The incidence of breast cancer has increased by more than 20%, and mortality by 14% since 2008. The correctness of the diagnosis often directly depends on the qualifications and expe-rience of a diagnostic medical sonographer. That is why special attention should be paid to the practical training of future specialists. Anatomical phantoms are ex-cellent teaching tools because they accurately imitate the characteristics of real hu-man tissues and organs. The purpose of this work is to create a breast phantom for practicing ultrasound diagnostic skills in grayscale and elastography imaging, as well as ultrasound-guided biopsy sampling. We used silicone-like compounds ranging from 3 to 17 on the Shore scale hardness units to simulate soft tissue and lesions. Impurities with experimentally selected concentrations were added to give the phantom the necessary attenuation and reflection parameters. We used 3D modeling programs and 3D printing with PLA plastic to create the casting mold. We developed a breast phantom with inclusions of varying shape, elasticity and echogenicity. After testing the created phantom in B-mode and elastography mode, we performed a survey asking 19 participants how realistic the sonograms of the phantom were. The results showed that the closest to real was the model of the cyst with 9.5 on the 0-10 similarity scale. Thus, the developed breast phantom can be used for ultrasonography, elastography, and ultrasound-guided biopsy training.

Keywords: breast ultrasound, mammary gland, mammography, training phantom, tissue-mimicking materials

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508 Co-payment Strategies for Chronic Medications: A Qualitative and Comparative Analysis at European Level

Authors: Pedro M. Abreu, Bruno R. Mendes

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The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Keywords: clinical pharmacy, co-payments, healthcare, medicines

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507 Improvement of Sleep Quality Through Manual and Non-Pharmacological Treatment

Authors: Andreas Aceranti, Sergio Romanò, Simonetta Vernocchi, Silvia Arnaboldi, Emilio Mazza

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As a result of the Sars-Cov2 pandemic, the incidence of thymism disorders has significantly increased and, often, patients are reluctant to want to take drugs aimed at stabilizing mood. In order to provide an alternative approach to drug therapies, we have prepared a study in order to evaluate the possibility of improving the quality of life of these subjects through osteopathic treatment. Patients were divided into visceral and fascial manual treatment with the aim of increasing serotonin levels and stimulating the vagus nerve through validated techniques. The results were evaluated through the administration of targeted questionnaires in order to assess quality of life, mood, sleep and intestinal functioning. At a first endpoint we found, in patients undergoing fascial treatment, an increase in quality of life and sleep: in fact, they report a decrease in the number of nocturnal awakenings; a reduction in falling asleep times and greater rest upon waking. In contrast, patients undergoing visceral treatment, as well as those included in the control group, did not show significant improvements. Patients in the fascial group have, in fact, reported an improvement in thymism and subjective quality of life with a generalized improvement in function. Although the study is still ongoing, based on the results of the first endpoint we can hypothesize that fascial stimulation of the vagus nerve with manual and osteopathic techniques may be a valid alternative to pharmacological treatments in mood and sleep disorders.

Keywords: ostheopathy, insomnia, noctural awakening, thymism

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506 Pale, Firm and Non-Exudative (PFN): An Emerging Major Broiler Breast Meat Group

Authors: Cintia Midori Kaminishikawahara, Fernanda Jéssica Mendonça, Moisés Grespan, Elza Iouko Ida, Massami Shimokomaki, Adriana Lourenço Soares

Abstract:

The quality of broiler breast meat is changing as a result of continuing emphasis on genetically bird’s selection for efficiently higher meat production. The consumer is experiencing a cooked product that is drier and less juicy when consumed. Breast meat has been classified as PSE (pale, soft, exudative), DFD (dark, firm, dry) and normal color meat. However, recently variations of this color have been observed and they are not in line with the specificity of the meat functional properties. Thus, the objective of this work was to report the finding of a new pale meat color group characterized as Pale, Firm and Non-exudative (PFN) based on its pH, color, meat functional properties and micro structural evaluation. Breast meat fillets samples (n=1045) from commercial line were classified into PSE (pH ≤5.8, L* ≥ 53.0), PFN (pH > 5.8 and L* ≥ 53.0) and Normal (pH >5.8 and L* < 53.0), based on pH and L* values. In sequence, a total of 30 samples of each group were analyzed for the water holding capacity (WHC) and shear force (SF). The incidence was 9.1% for PSE meat, 85.7% for PFN and 5.2% for Normal meat. The PSE meat presented lower values of WHC (P ≤ 0.05) followed in sequence by PFN and Normal samples and also the SF values of fresh PFN was higher than PSE meat (P ≤ 0.05) and similar to Normal samples. Under optical microscopy, the cell diameter was 10% higher for PFN in relation to PSE meat and similar to Normal meat. These preliminary results indicate an emerging group of breast meat and it should be considered that the Pale, Firm and Non-exudative should be considered as an ideal broiler breast meat quality.

Keywords: broiler PSE meat, light microscopy, texture, water holding capacity

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505 Understanding the Mechanisms of Salmonella typhimurium Resistance to Cannabidiol

Authors: Iddrisu Ibrahim, Joseph Atia Ayariga, Junhuan Xu, Daniel Abugri, Boakai Robertson, Olufemi S. Ajayi

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The emergence of multidrug resistance poses a huge risk to public health globally. Yet these recalcitrant pathogens continue to rise in incidence rate, with resistance rates significantly outpacing the speed of antibiotic development. This, therefore, presents an aura of related health issues such as untreatable nosocomial infections arising from organ transplants and surgeries, as well as community-acquired infections that are related to people with compromised immunity, e.g., diabetic and HIV patients, etc. There is a global effort to fight multidrug-resistant pathogens spearheaded by the World Health Organization, thus calling for research into novel antimicrobial agents to fight multiple drug resistance. Previously, our laboratory demonstrated that Cannabidiol (CBD) was an effective antimicrobial against Salmonella typhimurium (S. typhimurium). However, we observed resistance development over time. To understand the mechanisms S. typhimurium uses to develop resistance to Cannabidiol (CBD), we studied the abundance of bacteria lipopolysaccharide (LPS) and membrane sterols of both susceptible and resistant S. typhimurium. Using real-time quantitative polymerase chain reaction (RT-qPCR), we also analyzed the expression of selected genes known for aiding resistance development in S. typhimurium. We discovered that there was a significantly higher expression of blaTEM, fimA, fimZ, and integrons in the CBD-resistant bacteria, and these were also accompanied by a shift in abundance in cell surface molecules such as lipopolysaccharide (LPS) and sterols.

Keywords: antimicrobials, resistance, cannabidiol, gram-negative bacteria, integrons, blaTEM, Fim, LPS, ergosterols

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504 In silico Analysis of a Causative Mutation in Cadherin-23 Gene Identified in an Omani Family with Hearing Loss

Authors: Mohammed N. Al Kindi, Mazin Al Khabouri, Khalsa Al Lamki, Tommasso Pappuci, Giovani Romeo, Nadia Al Wardy

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Hereditary hearing loss is a heterogeneous group of complex disorders with an overall incidence of one in every five hundred newborns presented as syndromic and non-syndromic forms. Cadherin-related 23 (CDH23) is one of the listed deafness causative genes. CDH23 is found to be expressed in the stereocilia of hair cells and the retina photoreceptor cells. Defective CDH23 has been associated mostly with prelingual severe-to-profound sensorineural hearing loss (SNHL) in either syndromic (USH1D) or non-syndromic SNHL (DFNB12). An Omani family diagnosed clinically with severe-profound sensorineural hearing loss was genetically analysed by whole exome sequencing technique. A novel homozygous missense variant, c.A7451C (p.D2484A), in exon 53 of CDH23 was detected. One hundred and thirty control samples were analysed where all were negative for the detected variant. The variant was analysed in silico for pathogenicity verification using several mutation prediction software. The variant proved to be a pathogenic mutation and is reported for the first time in Oman and worldwide. It is concluded that in silico mutation prediction analysis might be used as a useful molecular diagnostics tool benefiting both genetic counseling and mutation verification. The aspartic acid 2484 alanine missense substitution might be the main disease-causing mutation that damages CDH23 function and could be used as a genetic hearing loss marker for this particular Omani family.

Keywords: Cdh23, d2484a, in silico, Oman

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503 Computerized Analysis of Phonological Structure of 10,400 Brazilian Sign Language Signs

Authors: Wanessa G. Oliveira, Fernando C. Capovilla

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Capovilla and Raphael’s Libras Dictionary documents a corpus of 4,200 Brazilian Sign Language (Libras) signs. Duduchi and Capovilla’s software SignTracking permits users to retrieve signs even when ignoring the gloss corresponding to it and to discover the meaning of all 4,200 signs sign simply by clicking on graphic menus of the sign characteristics (phonemes). Duduchi and Capovilla have discovered that the ease with which any given sign can be retrieved is an inverse function of the average popularity of its component phonemes. Thus, signs composed of rare (distinct) phonemes are easier to retrieve than are those composed of common phonemes. SignTracking offers a means of computing the average popularity of the phonemes that make up each one of 4,200 signs. It provides a precise measure of the degree of ease with which signs can be retrieved, and sign meanings can be discovered. Duduchi and Capovilla’s logarithmic model proved valid: The degree with which any given sign can be retrieved is an inverse function of the arithmetic mean of the logarithm of the popularity of each component phoneme. Capovilla, Raphael and Mauricio’s New Libras Dictionary documents a corpus of 10,400 Libras signs. The present analysis revealed Libras DNA structure by mapping the incidence of 501 sign phonemes resulting from the layered distribution of five parameters: 163 handshape phonemes (CherEmes-ManusIculi); 34 finger shape phonemes (DactilEmes-DigitumIculi); 55 hand placement phonemes (ArtrotoToposEmes-ArticulatiLocusIculi); 173 movement dimension phonemes (CinesEmes-MotusIculi) pertaining to direction, frequency, and type; and 76 Facial Expression phonemes (MascarEmes-PersonalIculi).

Keywords: Brazilian sign language, lexical retrieval, libras sign, sign phonology

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502 Pulsed Laser Deposition of Fe-Based Metallic Glasses with Enhanced Mechanical Strength and Corrosion Resistance

Authors: Ali Obeydavi, Majid Rahimi

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This study explores the synthesis and characterization of Fe-Cr-Mo-Co-C-B-Si thin film metallic glasses fabricated using the pulsed laser deposition (PLD) technique on silicon wafers and 304 stainless steel substrates. We systematically varied the laser pulse numbers (20,000; 30,000; 40,000) and energies (130, 165, 190 mJ) to investigate their effects on the microstructural, mechanical, and corrosion properties of the deposited films. Comprehensive characterization techniques, including grazing incidence X-ray diffraction, field emission scanning electron microscopy, atomic force microscopy, and transmission electron microscopy with selected area electron diffraction, were utilized to assess the amorphous structure and surface morphology. Results indicated that increased pulse numbers and laser energies led to enhanced deposition rates and film thicknesses. Nanoindentation tests demonstrated that the hardness and elastic modulus of the amorphous thin films significantly surpassed those of the 304 stainless steel substrate. Additionally, electrochemical polarization and impedance spectroscopy revealed that the Fe-based metallic glass coatings exhibited superior corrosion resistance compared to the stainless steel substrate. The observed improvements in mechanical and corrosion properties are attributed to the unique amorphous structure achieved through the PLD process, highlighting the potential of these materials for protective coatings in aggressive environments

Keywords: silicon wafer, laser energies, corrosion resistance, Fe-based metallic glass

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501 Whether Buffer Zone Community Forests’ Benefits Are Distributed Fairly to Low-Income Users: Reflection From the Buffer Zone Community Forests in Bardia National Park, Nepal

Authors: Keshav Raj Acharya, Thakur Silwal, Neelam C. Poudyal

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Buffer zones, the peripheral areas around the national parks and wildlife reserves, are available for the purpose of benefitting the local inhabitants by providing forest products for subsistence needs of basic forest products outside the protected areas. The forest area within the buffer zone has been managed as a buffer zone community forest (BZCF) for the last 25 years after the approval of the buffer zone management regulation 1996. With a case study of select BZCF in Bardia National Park, this study aims to analyze whether the benefit provided by BZCF is equally available to poor users among other socioeconomic classes of the users. The findings are based on the analysis of cross-sectional data involving household surveys (n=305) and key informants’ interviews (n=10) as well as office records available at different 5 buffer zone community forest user groups offices. Results indicate that despite the provisions of subsidized rates for poor; poor households were more deprived due to higher forest products price particularly, the timber price in buffer zone. Evidence also indicate that due to the increased forest coverage, the incidence of wildlife damage has also increased and impacted the poor more due to lack of land ownership as well as limited alternatives. Clear community forest management guidelines with equitable benefit sharing and compensatory mechanisms to the users of poor socioeconomic class have been identified as a solution to increase the benefit to poor users in BZCFUGs.

Keywords: crop depredation, forest products, users, wellbeing ranking

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500 Guidance and Counseling Programmes among Tertiary Institutions in Lagos State, Nigeria

Authors: Olubusayo Asikhia

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The purpose of the study was to compare the incidence of indiscipline and guidance and counseling programmes among federal and state-owned tertiary institutions in Lagos State, Southwest, Nigeria. This study was borne out of persistent students’ revolt and unrest in Nigerian tertiary institutions with its concomitant breakdown of law and order, disruption of academic activities, closure of institutions and the disruption of lives and property among others. A sample of 300 students, 270 staff (including academic and non-academic, heads of disciplinary committees, deans of student affairs and counselors) from 6 federal and state-owned tertiary institutions were selected through stratified random sampling. Three structured questionnaires with reliability coefficients that range from 0.78 to 0.91 were used to collect data for the study. The data were tested at 0.05 level of significance and analyzed using descriptive, paired samples statistics and regression analysis. Findings from the four hypotheses generated for the study revealed that student indiscipline occurs more in state colleges of education and polytechnics than in their federal counterparts. It was also higher in federal universities than the state. The study also revealed a significant difference in the causes of indiscipline and assessment of guidance and counseling programmes in state and federal universities and no significant difference in state and federal colleges and polytechnics. It was recommended that the guidance and counseling department in tertiary institutions should create a well-structured program that will enable it to address issues of indiscipline among students and that counselors should use small-group counseling approach and student-focused interventions.

Keywords: colleges of education, guidance and counseling, indiscipline, polytechnics, students and universities

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