Search results for: diarrheal predominant irritable bowel syndrome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1284

Search results for: diarrheal predominant irritable bowel syndrome

684 History and Epidemiology of Foot and Mouth Disease in Afghanistan: A Retrospective Study

Authors: Arash Osmani, Ian Robertson, Ihab Habib, Ahmad Aslami

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Foot and Mouth Disease (FMD) is endemic in Afghanistan. A retrospective study of data collected through passive surveillance of outbreaks of FMD from 1995 to 2016 was undertaken. A total of 1471 outbreaks were reported between 1995 and 2008. Of 7776 samples originating from 34 provinces tested between 2009 and 2016 4845 (62.3%) tested positive. The prevalence varied significantly between years (2009 and 2016) (P < 0.001); however, the number of outbreaks did not differ significantly (P = 0.24) between 1995 and 2008. During this period, there was a strong correlation between the number of outbreaks reported and the number of districts with infected animals (r = 0.74, P = 0.002). Serotype O was the predominant serotype detected, although serotypes A and Asia1 were also detected. Cattle were involved in all outbreaks reported. Herat province in the north-west (bordering Iran), Nangarhar province in the east (bordering Pakistan) and Kabul province in the centre of the country had infections detected in all years of the study. The findings from this study provide valuable direction for further research to understand the epidemiology of FMD in Afghanistan.

Keywords: foot and mouth disease, retrospective, epidemiology, Afghanistan

Procedia PDF Downloads 137
683 Eros and Postmodern Nihilism in Don Delillo’s Zero K (2016): A Psychoanalytical Reading

Authors: Wafa Nouioua

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It is broadly accepted that the existence of postmodern individuals is distinguished by a predominant presence of skepticism, anxiety and loneliness. This social unrest is the consequence of a drastic shift in how reality and meaning are conceived, which has been replaced by something that is referred to in media theory and criticism as hyperreality. The purpose of this paper is to investigate the hyperreality that exists in the postmodern nihilistic American community that Don Delillo depicts in Zero K (2016) through the use of Jean Baudrillard notions of Simulacra and Simulations. It is a troubled technological late capitalist society obsessed with immortality and fear of demise, ergo it is an appropriate reading to implement Sigmund Freud’s theory of life drive (Eros), which refers to the life instinct fundamental to all humans and the urge to support productivity and construction. The results obtained from a qualitative analysis of Zero K indicate the presence of a clash between the character’s life drive and fear of mortality. In an effort to escape loneliness and death, the character Ross Lockhart undergoes, after a moment of hesitation, cryonic freezing in the convergence to preserve his life as well as that of his wife Artis, yet his son Jeffery is firmly convinced of the uselessness of combating the inevitable death.

Keywords: Don Dellilo, Eros, Postmodernism Nihilism, Zero K

Procedia PDF Downloads 64
682 Distribution and Comparative Diversity of Nematocera within Four Livestock Types in the Plain of Mitidja Algeria

Authors: Nebri Rachid, Berrouane Fatima, Doumandji Salah Eddine

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During six months, from November 2013 to May 2014, census of Nematocera insects was conducted on four livestock: cattle, sheep, equine and cameline. The census, that took place in a station located in Mitidja plain, Algeria, revealed thirteen Nematocera species that had been observed and identified: Scatopse notata, Chironomus Sp., Sciara bicolor, Psychoda phalaenoïdes, Culex pipiens, Orthocladius Sp., Psycoda alternata, Trichocera regelationis, Culicoïdes Sp., Contarinia Sp., Ectaetia Sp., Tipula Sp., and Culicoïdes coprosus. A factorial correspondence analysis has been performed to study the distribution of the different species captured in colored traps that were placed in the four farms. The results showed the presence of three collections of Nematocera relating to the breeding type where the highest availability is in favor of the equine and the cattle. The analysis of the comparative diversity of Nematocera specimens revealed an indifferent taxonomic structure compared with the hosts. However, in terms of individuals, the supremacy is to the equine’s advantage. On the ecological arrival scale, Psycoda alternata, is undeniably the most predominant on the equines as well as on the cattle.

Keywords: Algeria, availability, biodiversity, census, livestock, nematocera

Procedia PDF Downloads 442
681 Study of Non-hodgkin’s Lymphoma

Authors: Zidani Abla

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Lymphoma is a common type of cancer that affects the lymphatic system, including the lymph nodes, spleen and other associated organs. There are two main types of lymphoma: Hodgkin's lymphoma and non-Hodgkin's lymphoma. The epidemiological, clinical and biological features of lymphoma are poorly studied in Algeria. The main objective of our study is to investigate the epidemiological, clinical, paraclinical, etiological, evolutionary and biological characteristics of non-Hodgkin's lymphoma (NHL) in the hematology department of the University Hospital Center (HUC) of Batna. This is a study of 10 patients diagnosed at Batna University Hospital. 70% were male and 30% female (sex ratio M/F= 2.33). Median age was 51.7 years. Pain, especially abdominal pain, was the main reason for consultation. Stage IV predominated (40%), followed by stage III (20%). Abdominal adenopathies (34%) were the most abundant. Secondary hepatic localization was predominant. Large B-cell NHL predominated, accounting for 60% of cases, followed by small B-cell NHL (30%). Serology for hepatitis B and C, and human immunodeficiency virus (HIV) was negative. Biologically, a predominance of hyperleukocytosis, polynuclear neutrophilic leukocytosis, lymphopenia and hypoalbuminemia were present in the majority of cases. In summary, our results remain to be compared with other works for other periods and other regions in order to generalize lymphoma percentages for the entire Algerian population.

Keywords: non Hodgkin's lymphoma, epidemiology, clinic, biology

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680 Developing a Shadow Port: A Case Study of Bangkok Port and Laem Chabang Port, Thailand

Authors: C. Bamrungbutr, J. Sillitoe

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Maritime transportation has been a crucial part of world economics. Recently, researchers have put effort into studying the mechanisms of how a regional port, in the shadow of a nearby predominant port, can compete and grow. However, limited research has focused on the competition issues for a shadow port which is a capital city port. This study will thus focus on this question of the growth of a capital city port which is under the shadow of the adjacent capital city port by using the two capital city ports of Thailand; Bangkok port (the former main port) and Laem Chabang port (the current main port). For this work, a framework of opportunity capture will be used, and five groups of port development experts (government, council, logistics provider, academia and industry) will be interviewed. The responses will be analysed using the noticing, collecting and thinking model. The resulting analysis will be appropriate for use in developing guidelines for the future management of a range of shadow ports established in a capital city, enabling them to operate in a competitive environment more effectively. The resultant growth of these ports will be a significant factor in increasing the competitiveness of a nation’s maritime transport industry and eventually lead to a boost in the national economy.

Keywords: shadow port, Bangkok Port, Laem Chabang Port, port competition

Procedia PDF Downloads 163
679 Efficacy of TiO₂ in the Removal of an Acid Dye by Photo Catalytic Degradation

Authors: Laila Mahtout, Kerami Ahmed, Rabhi Souhila

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The objective of this work is to reduce the impact on the environment of an acid dye (Black Eriochrome T) using catalytic photo-degradation in the presence of the semiconductor powder (TiO₂) previously characterized. A series of tests have been carried out in order to demonstrate the influence of certain parameters on the degree of dye degradation by titanium dioxide in the presence of UV rays, such as contact time, the powder mass and the pH of the solution. X-ray diffraction analysis of the powder showed that the anatase structure is predominant and the rutile phase is presented by peaks of low intensity. The various chemical groups which characterize the presence of the bands corresponding to the anatase and rutile form and other chemical functions have been detected by the Fourier Transform Infrared spectroscopy. The photo degradation of the NET by TiO₂ is very interesting because it gives encouraging results. The study of photo-degradation at different concentrations of the dye showed that the lower concentrations give better removal rates. The degree of degradation of the dye increases with increasing pH; it reaches the maximum value at pH = 9. The ideal mass of TiO₂ which gives the high removal rate is 1.2 g/l. Thermal treatment of TiO₂ with the addition of CuO with contents of 5%, 10%, and 15% respectively gives better results of degradation of the NET dye. The high percentage of elimination is observed at a CuO content of 15%.

Keywords: acid dye, ultraviolet rays, degradation, photocatalyse

Procedia PDF Downloads 183
678 Diversity of Enterovirus Genotypes Circulating in Pediatric Patients with Acute Gastroenteritis in Thailand from 2019 to 2022

Authors: Zhenfeng Xie

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Acute gastroenteritis (AGE) is a common cause of morbidity and mortality in infants and young children worldwide, especially in developing countries. Enterovirus(EVs) have been identified in patients with AGE in many countries around the world, and some studies have revealed that EV infection is associated with gastrointestinal symptoms and plays a role in AGE. As a potential causative pathogen of AGE in humans, continuous detection and identification of EVs in pediatric patients with AGE is needed. In this study, we aimed to investigate the prevalence, seasonal distribution, and molecular characteristics of EVs circulating in pediatric patients with AGE in Thailand from 2019 to 2022. A total of 1422 stool specimens were collected for this study. RT-PCR amplification of the 5'UTR was used to screen for EV positive samples. EV genotyping was determined based on nucleotide sequence and phylogenetic analysis of the VP1 sequences. EV prevalence in pediatric AGE patients was 8.3% (118 out of 1,422). Among these, 35.6% of EV infection cases were caused by species A, followed by species C and B (33.1% and 30.5%, respectively). A total of 26 EV genotypes were identified in this study. Poliovirus 3 and coxsackievirus A2 were the predominant genotypes detected(14% and 13%, respectively). EV was detected all year round with higher prevalence between July and December. In summary, this study reports EV's prevalence and genotype diversity in pediatric patients with AGE in Thailand during 2019-2022.

Keywords: enterovirus, epidemiology, acute gastroenteritis, genotype

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677 Aberrant Acetylation/Methylation of Homeobox (HOX) Family Genes in Cumulus Cells of Infertile Women with Polycystic Ovary Syndrome (PCOS)

Authors: P. Asiabi, M. Shahhoseini, R. Favaedi, F. Hassani, N. Nassiri, B. Movaghar, L. Karimian, P. Eftekhariyazdi

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Introduction: Polycystic Ovary Syndrome is a common gynecologic disorder. Many factors including environment, metabolism, hormones and genetics are involved in etiopathogenesis of PCOS. Of genes that have altered expression in human reproductive system disorders are HOX family genes which act as transcription factors in regulation of cell proliferation, differentiation, adhesion and migration. Since recent evidences consider epigenetic factors as causative mechanisms of PCOS, evaluation of association between known epigenetic marks of acetylation/methylation of histone 3 (H3K9ac/me) with regulatory regions of these genes can represent better insight about PCOS. In the current study, cumulus cells (CCs) which have critical roles during folliculogenesis, oocyte maturation, ovulation and fertilization were aimed to monitor epigenetic alterations of HOX genes. Material and methods: CCs were collected from 20 PCOS patients and 20 fertile women (18-36 year) with male infertility problems referred to the Royan Institute to have ICSI under GnRH antagonist protocol. Informed consents were obtained from the participants. Thirty six hours after hCG injection, ovaries were punctured and cumulus oocyte complexes were dissected. Soluble chromatin were extracted from CCs and Chromatin Immune precipitation (ChIP) coupled with Real Time PCR was performed to quantify the epigenetic marks of histone H3K9 acetylation/methylation (H3K9ac/me) on regulatory regions of 15 members of HOX genes from A-D subfamily. Results: Obtained data showed significant increase of H3K9ac epigenetic mark on regulatory regions of HOXA1, HOXB2, HOXC4, HOXD1, HOXD3 and HOXD4 (P < 0.01) and HOXC5 (P < 0.05) and also significant decrease of H3K9ac into regulatory regions of HOXA2, HOXA4, HOXA5, HOXB1 and HOXB5 (P < 0.01) and HOXB3 (P<0.05) in PCOS patients vs. control group. On the other side, there was a significant decrease in incorporation of H3K9me level on regulatory region of HOXA2, HOXA3, HOXA4, HOXA5, HOXB3 and HOXC4 (P≤0.01) and HOXB5 (P < 0.05) in PCOS patients vs. control group. This epigenetic mark (H3K9me2) has significant increase on regulatory region of HOXB1, HOXB2, HOXC5, HOXD1, HOXD3 and HOXD4 (P ≤ 0.01) and HOXB4 (P < 0.05) in patients vs. control group. There were no significant changes in acetylation/methylation levels of H3K9 on regulatory regions of the other studied genes. Conclusion: Current study suggests that epigenetic alterations of HOX genes can be correlated with PCOS and consequently female infertility. This finding might offer additional definitions of PCOS, and eventually provides insight for novel treatments with epidrugs for this disease.

Keywords: epigenetic, HOX genes, PCOS, female infertility

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676 Investigation of the Recycling of Geopolymer Cement Wastes as Fine Aggregates in Mortar Mixes

Authors: Napoleana-Anna Chaliasou, Andrew Heath, Kevin Paine

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Fly ash-slag based Geopolymer Cement (GPC) is presenting mechanical properties and environmental advantages that make it the predominant “green” alternative to Portland Cement (PC). Although numerous life-cycle analyses praising its environmental advantages, disposal after the end of its life remains as an issue that has been barely explored. The present study is investigating the recyclability of fly ash-slag GPC as aggregate in mortars. The purpose of the study was to evaluate the effect of GPC fine Recycled Aggregates (RA), at replacement levels of 25% and 50%, on the main mechanical properties of PC and GPC mortar mixes. The results were compared with those obtained by corresponding mixes incorporating natural and PC-RA. The main physical properties of GPC-RA were examined and proven to be comparable to those of PC-RA and slightly inferior to those of natural sand. A negligible effect was observed at 28-day compressive and flexural strength of PC mortars with GPC aggregates having a milder effect than PC. As far as GPC mortars are concerned, the influence of GPC aggregates was enhancing for the investigated mechanical properties. Additionally, a screening test showed that recycled geopolymer aggregates are not prone of inducing alkali silica reaction.

Keywords: concrete recycling, geopolymer cement, fly ash, construction wastes

Procedia PDF Downloads 310
675 A New and Simple Method of Plotting Binocular Single Vision Field (BSVF) using the Cervical Range of Motion - CROM - Device

Authors: Mihir Kothari, Heena Khan, Vivek Rathod

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Assessment of binocular single vision field (BSVF) is traditionally done using a Goldmann perimeter. The measurement of BSVF is important for the management of incomitant strabismus, viz. orbital fractures, thyroid orbitopathy, oculomotor cranial nerve palsies, Duane syndrome etc. In this paper, we describe a new technique for measuring BSVF using a CROM device. Goldmann perimeter is very bulky and expensive (Euro 5000.00 or more) instrument which is 'almost' obsolete from the contemporary ophthalmology practice. Whereas, CROM can be easily made in the DIY (do it yourself) manner for the fraction of the price of the perimeter (only Euro 15.00). Moreover, CROM is useful for the accurate measurement of ocular torticollis vis. nystagmus, paralytic or incomitant squint etc, and it is highly portable.

Keywords: binocular single vision, perimetry, cervical rgen of motion, visual field, binocular single vision field

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674 Impact of HIV/AIDS on Food Security in Pala Sub-Location, Bondo District, Kenya

Authors: S. B. Otieno, Were Fred, E. W. Kabiru, K. Waza

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Background: HIV/AIDS is leading to the loss of labor through sickness and subsequent death, this is leading to the neglect of farm and off-farm activities, with the subsequent loss of potential income and food security. The situation is sensitive to seasonal labour peaks in agriculture. This study was done to determine the impact of high HIV prevalence in farming systems and food security in Pala Bondo District, Kenya. Methods: In this study, 386 respondents were randomly chosen in Pala Sub-Location. The respondents and key informants were interviewed using structured questionnaire. The data were entered and analyzed using SPSS version 16. Results: It was established that majority of respondents (67%) were between 18 and 35 years {χ2 = (1, N = 386) = 13.430, p = 0.000} (chimney effect). The study also established that 83.5% of respondents were married {χ2 = (1, N= 370) = 166.277 p = 0.000} and predominant occupation being farming and fishing (61%), while 52.8% of farm labour was by hand, 26% by oxen, and 4.9% mechanized. 73.2% of respondents only farm 0.25 to 2 acres, 48% mentioned lack of labour in land preparation {χ2 ((1,N = 321) = 113.146, p = 0.000), in planting {χ2 (1, N = 321) = 29.28, p = 0.000}. Majority of respondents lack food from January to June, during which 93% buy food. Conclusion: The high HIV prevalence in Pala has affected the farm labour leading to food insecurity.

Keywords: food security, HIV, AIDS, labour

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673 Mass Production of Endemic Diatoms in Polk County, Florida Concomitant with Biofuel Extraction

Authors: Melba D. Horton

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Algae are identified as an alternative source of biofuel because of their ubiquitous distribution in aquatic environments. Diatoms are unique forms of algae characterized by silicified cell walls which have gained prominence in various technological applications. Polk County is home to a multitude of ponds and lakes but has not been explored for the presence of diatoms. Considering the condition of the waters brought about by predominant phosphate mining activities in the area, this research was conducted to determine if endemic diatoms are present and explore their potential for low-cost mass production. Using custom-built photobioreactors, water samples from various lakes provided by the Polk County Parks and Recreation and from nearby ponds were used as the source of diatoms together with other algae obtained during collection. Results of the initial culture cycles were successful, but later an overgrowth of other algae crashed the diatom population. Experiments were conducted in the laboratory to tease out some factors possibly contributing to the die-off. Generally, the total biomass declines after two culture cycles and the causative factors need further investigation. The lipid yield is minimum; however, the high frustule production after die-off adds value to the overall benefit of the harvest.

Keywords: diatoms, algae, biofuel, lipid, photobioreactor, frustule

Procedia PDF Downloads 176
672 Green Synthesis of Nicotine Analogues via Cycloaddition Reactions

Authors: Agnieszka Fryźlewicz, Jowita Kras, Mikołaj Sadowski, Agnieszka Łapczuk-Krygier, Agnieszka Kącka-Zych Radomir Jasiński

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Nicotines are a group of compounds containing conjugated pyridine and pyrrolidine molecular segments. They are widely applied in medicine, pharmacy, and agriculture. Namely as researched treatment of Alzheimer, depression, Parkinson's, Tourette syndrome, general nervous and mental disorders. Furthermore, nicotine itself is used as a stimulant, animal repellent and was widely applied as an insecticide. In our work, we obtained nicotine analogues with possible applications in agriculture. The synthesis employed [3+2] cycloaddition (32CA) reactions, occurring between pirydyl-functionalised nitrones and conjugated nitroalkenes, that allowed us to fully regio- and stereoselectively obtain product. Moreover, cycloaddition reaction realizes rapidly in mild conditions with the full atomic economy, thus fitting into “green chemistry” trends.

Keywords: nicotine, isoxazolidine, 1-3-dipolar cycloaddition, green chemistry, biological and pharmacological activity

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671 To Access the Knowledge, Awareness and Factors Associated With Diabetes Mellitus in Buea, Cameroon

Authors: Franck Acho

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This is a chronic metabolic disorder which is a fast-growing global problem with a huge social, health, and economic consequences. It is estimated that in 2010 there were globally 285 million people (approximately 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 430 million in the absence of better control or cure. An ageing population and obesity are two main reasons for the increase. Diabetes mellitus is a chronic heterogeneous metabolic disorder with a complex pathogenesis. It is characterized by elevated blood glucose levels or hyperglycemia, which results from abnormalities in either insulin secretion or insulin action or both. Hyperglycemia manifests in various forms with a varied presentation and results in carbohydrate, fat, and protein metabolic dysfunctions. Long-term hyperglycemia often leads to various microvascular and macrovascular diabetic complications, which are mainly responsible for diabetes-associated morbidity and mortality. Hyperglycemia serves as the primary biomarker for the diagnosis of diabetes as well. Furthermore, it has been shown that almost 50% of the putative diabetics are not diagnosed until 10 years after onset of the disease, hence the real prevalence of global diabetes must be astronomically high. This study was conducted in a locality to access the level of knowledge, awareness and risk factors associated with people leaving with diabetes mellitus. A month before the screening was to be conducted, a health screening in some selected churches and on the local community radio as well as on relevant WhatsApp groups were advertised. A general health talk was delivered by the head of the screening unit to all attendees who were all educated on the procedure to be carried out with benefits and any possible discomforts after which the attendee’s consent was obtained. Evaluation of the participants for any leads to the diabetes selected for the screening was done by taking adequate history and physical examinations such as excessive thirst, increased urination, tiredness, hunger, unexplained weight loss, feeling irritable or having other mood changes, having blurry vision, having slow-healing sores, getting a lot of infections, such as gum, skin and vaginal infections. Out of the 94 participants the finding show that 78 were females and 16 were males, 70.21% of participants with diabetes were between the ages of 60-69yrs.The study found that only 10.63% of respondents declared a good level of knowledge of diabetes. Out of 3 symptoms of diabetes analyzed in this study, high blood sugar (58.5%) and chronic fatigue (36.17%) were the most recognized. Out of 4 diabetes risk factors analyzed in this study, obesity (21.27%) and unhealthy diet (60.63%) were the most recognized diabetes risk factors, while only 10.6% of respondents indicated tobacco use. The diabetic foot was the most recognized diabetes complication (50.57%), but some the participants indicated vision problems (30.8%),or cardiovascular diseases (20.21%) as diabetes complications.

Keywords: diabetes mellitus, non comunicable disease, general health talk, hyperglycemia

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670 Prevalence Determination of Hepatitis D Virus Genotypes among HBsAg Positive Patients in Kerman Province of Iran

Authors: Khabat Barkhordari, Ali Mohammad Arabzadeh

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Hepatitis delta virus (HDV) is a RNA virus that needs the function of hepatitis B virus (HBV) for its propagation and assembly. Infection by HDV can occur spontaneously with HBV infection and cause acute hepatitis or develop as secondary infection in HBV suffering patients. Based on genome sequence analysis, HDV has several genotypes which show broad geographic and diverse clinical features. The aim of current study is determine the prevalence of hepatitis delta virus genotype in patients with positive HBsAg in Kerman province of Iran. This cross-sectional study a total of 400 patients with HBV infection attending the clinic center of Besat from 2012 to 2014 were included. We carried out ELISA to detect anti-HDV antibodies. Those testing positive were analyzed further for HDV-RNA and for genotyping using restriction fragment length polymorphism (RFLP) and RT-nested PCR- sequencing. Among 400 patients in this study, 67 cases (16.75 %) were containing anti-HDV antibody which we found HDV RNA in just 7 (1.75%) serum samples. Analysis of these 7 positive HDV showed that all of them have genotype I. According to current study the HDV prevalence in Kerman is higher than the reported prevalence of 6.6% for Iran as a whole and clade 1 (genotype 1) is the predominant clade of HDV in Kerman.

Keywords: genotyping, hepatitis delta virus, molecular epidemiology, Kerman, Iran

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669 Heart Failure Identification and Progression by Classifying Cardiac Patients

Authors: Muhammad Saqlain, Nazar Abbas Saqib, Muazzam A. Khan

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Heart Failure (HF) has become the major health problem in our society. The prevalence of HF has increased as the patient’s ages and it is the major cause of the high mortality rate in adults. A successful identification and progression of HF can be helpful to reduce the individual and social burden from this syndrome. In this study, we use a real data set of cardiac patients to propose a classification model for the identification and progression of HF. The data set has divided into three age groups, namely young, adult, and old and then each age group have further classified into four classes according to patient’s current physical condition. Contemporary Data Mining classification algorithms have been applied to each individual class of every age group to identify the HF. Decision Tree (DT) gives the highest accuracy of 90% and outperform all other algorithms. Our model accurately diagnoses different stages of HF for each age group and it can be very useful for the early prediction of HF.

Keywords: decision tree, heart failure, data mining, classification model

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668 Surgical Site Infections Post Ventriculoperitoneal (VP) Shunting: A Matched Healthcare Cost and Length of Stay Study

Authors: Issa M. Hweidi, Saba W. Al-Ibraheem

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This study aimed to assess the increased hospital length of stay and healthcare costs associated with SSIs among ventriculoperitoneal shunting surgery patients in Jordan. This study adopted a retrospective and nested 1:1 matched case-control design. A non-probability convenient sample of 48 VP shunt patients was recruited for the purpose of the study. The targeted groups of the study basically used to cross-match the variables investigated to minimize the risk of confounding. Information was extracted from the text of patients' electronic health records. As compared to the non-SSI group, the SSI group had an extra mean healthcare cost of $13,696.53 (p=0.001) and longer hospital length of stay (22.64 mean additional days). Furthermore, Acinetobacter baumannii and Klebsiella pneumonia were identified as being the most predominant causative agents of SSIs. The results of this study may provide baseline data for national and regional benchmarking to evaluate the quality of care provided to likewise patients. Adherence to infection control strategies and protocols considering new surveillance methods of SSIs is encouraged.

Keywords: ventriculoperitoneal shunt, health care cost, length of stay, neurosurgery, surgical site infections

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667 Reviews of Chief Complaints and Treatments [in an Early Street Medicine Program]

Authors: A. Hoppe, T. Kagele, B. Hall, A. Nichols, B. Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to members of Spokane, Washington, experiencing homelessness. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to the underserved homeless population. In this analysis, clinical charts from street and shelter encounters made by the Spokane Street Medicine Program in early 2021 were reviewed in order to better understand the healthcare inequities prevalent among people experiencing homelessness in Spokane, WA. Pain, wound-care, and follow-up efforts were predominant concerns among the homeless population. More than half of the conditions addressed were acute, and almost a quarter of all chief complaints involved chronic unmanaged conditions. This analysis gives reason for the priorities of the SSM Program to be focused on pain, wound-care, and follow-up efforts. Understanding the specific medical needs of this population will allow for better resource allocation and improved health outcomes among people experiencing homelessness.

Keywords: equity issues in public health, health disparities, health services accessibility, medical public health, street medicine

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666 The Importance of Functioning and Disability Status Follow-Up in People with Multiple Sclerosis

Authors: Sanela Slavkovic, Congor Nad, Spela Golubovic

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Background: The diagnosis of multiple sclerosis (MS) is a major life challenge and has repercussions on all aspects of the daily functioning of those attained by it – personal activities, social participation, and quality of life. Regular follow-up of only the neurological status is not informative enough so that it could provide data on the sort of support and rehabilitation that is required. Objective: The aim of this study was to establish the current level of functioning of persons attained by MS and the factors that influence it. Methods: The study was conducted in Serbia, on a sample of 108 persons with relapse-remitting form of MS, aged 20 to 53 (mean 39.86 years; SD 8.20 years). All participants were fully ambulatory. Methods applied in the study include Expanded Disability Status Scale-EDSS and World Health Organization Disability Assessment Schedule, WHODAS 2.0 (36-item version, self-administered). Results: Participants were found to experience the most problems in the domains of Participation, Mobility, Life activities and Cognition. The least difficulties were found in the domain of Self-care. Symptom duration was the only control variable with a significant partial contribution to the prediction of the WHODAS scale score (β=0.30, p < 0.05). The total EDSS score correlated with the total WHODAS 2.0 score (r=0.34, p=0.00). Statistically significant differences in the domain of EDSS 0-5.5 were found within categories (0-1.5; 2-3.5; 4-5.5). The more pronounced a participant’s EDSS score was, although not indicative of large changes in the neurological status, the more apparent the changes in the functional domain, i.e. in all areas covered by WHODAS 2.0. Pyramidal (β=0.34, p < 0.05) and Bowel and bladder (β=0.24, p < 0.05) functional systems were found to have a significant partial contribution to the prediction of the WHODAS score. Conclusion: Measuring functioning and disability is important in the follow-up of persons suffering from MS in order to plan rehabilitation and define areas in which additional support is needed.

Keywords: disability, functionality, multiple sclerosis, rehabilitation

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665 Pattern Of Polymorphism SLC22A1 Gene In Children With Diabetes Mellitus Type 2

Authors: Elly Usman, S. Dante, Diah Purnamasari

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Type 2 diabetes mellitus ( T2DM ) is a syndrome characterized by a state of increased blood sugar levels due to chronic disorders of insulin secretion by pancreatic beta cells and insulin action or a combination of both. The organic cation transporter 1, encoded by the SLC22A1 gene, responsible for the uptake of the antihyperglycemic drug, metformin, in the hepatocyte. We assessed whether a genetic variation in the SLC22A1 gene was associated with the glucose - lowering effect of metformin. Method case study research design. Samples are children with type 2 diabetes mellitus who meet the inclusion criteria. The results proportions SLC22A1 gene polymorphisms in children with diabetes mellitus type 2 amounted to 52.04 % at position 400T/C, there is one heterozygous and one at position 595T/C Conclusion The presence of SLC22A1 gene polymorphisms in children with diabetes mellitus type 2.

Keywords: diabetes Mellitus type 2, metformin, organic cation transporter 1, pharmacogenomics

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664 Procalcitonin and Other Biomarkers in Sepsis Patients: A Prospective Study

Authors: Neda Valizadeh, Soudabeh Shafiee Ardestani, Arvin Najafi

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Objectives: The aim of this study is to evaluate the association of mid-regional pro-atrial natriuretic peptide (MRproANP), procalcitonin (PCT), proendothelin-1 (proET-1) levels with sepsis severity in Emergency ward patients. Materials and Methods: We assessed the predictive value of MRproANP, PCT, copeptin, and proET-1 in early sepsis among patients referring to the emergency ward with a suspected sepsis. Results-132 patients were enrolled in this study. 45 (34%) patients had a final diagnosis of sepsis. A higher percentage of patients with definite sepsis had systemic inflammatory response syndrome (SIRS) criteria at initial visit in comparison with no-sepsis patients (P<0.05) and were admitted to the hospital (P<0.05). PCT levels were higher in sepsis patients [P<0.05]. There was no significant differences for MRproANP or proET-1 in sepsis patients (P=0.47). Conclusion: A combination of SIRS criteria and PCT levels is beneficial for the early sepsis diagnosis in emergency ward patients with a suspicious infection disease.

Keywords: emergency, prolactin, sepsis, biomarkers

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663 Choosing Mountains Over the Beach: Evaluating the Effect of Altitude on Covid Brain Severity and Treatment

Authors: Kennedy Zinn, Chris Anderson

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Chronic Covid syndrome (CCS) is a condition in which individuals who test positive for Covid-19 experience persistent symptoms after recovering from the virus. CCS affects every organ system, including the central nervous system. Neurological “long-haul” symptoms last from a few weeks to several months and include brain fog, chronic fatigue, dyspnea, mood dysregulation, and headaches. Data suggest that 10-30% of individuals testing positive for Covid-19 develop CCS. Current literature indicates a decreased quality of life in persistent symptoms. CCS is a pervasive and pernicious COVID-19 sequelae. More research is needed to understand risk factors, impact, and possible interventions. Research frequently cites cytokine storming as noteworthy etiology in CCS. Cytokine storming is a malfunctional immune response and facilitates multidimensional interconnected physiological responses. The most prominent responses include abnormal blood flow, hypoxia/hypoxemia, inflammation, and endothelial damage. Neurological impairments and pathogenesis in CCS parallel that of traumatic brain injury (TBI). Both exhibit impairments in memory, cognition, mood, sustained attention, and chronic fatigue. Evidence suggests abnormal blood flow, inflammation, and hypoxemia as shared causal factors. Cytokine storming is also typical in mTBI. The shared characteristics in symptoms and etiology suggest potential parallel routes of investigation that allow for better understanding of CCS. Research on the effect of altitude in mTBI varies. Literature finds decreased rates of concussions at higher altitudes. Other studies suggest that at a higher altitude, pre-existing mTBI symptoms are exacerbated. This may mean that in CCS, the geographical location where individuals live and the location where individuals experienced acute Covid-19 symptoms may influence the severity and risk of developing CCS. It also suggests that clinics which treat mTBI patients could also provide benefits for those with CCS. This study aims to examine the relationships between altitude and CCS as a risk factor and investigate the longevity and severity of symptoms in different altitudes. Existing patient data from a concussion clinic using fMRI scans and self-reported symptoms will be used for approximately 30 individuals with CCS symptoms. The association between acclimated altitude and CCS severity will be analyzed. Patients will be classified into low, medium, and high altitude groups and compared for differences on fMRI severity scores and self-reported measures. It is anticipated that individuals living in lower altitudes are at higher risk of developing more severe neuropsychological symptoms in CCS. It is also anticipated that a treatment approach for mTBI will also be beneficial to those with CCS.

Keywords: altitude, chronic covid syndrome, concussion, covid brain, EPIC treatment, fMRI, traumatic brain injury

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662 [Keynote Talk]: Analysis of Intelligent Based Fault Tolerant Capability System for Solar Photovoltaic Energy Conversion

Authors: Albert Alexander Stonier

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Due to the fossil fuel exhaustion and environmental pollution, renewable energy sources especially solar photovoltaic system plays a predominant role in providing energy to the consumers. It has been estimated that by 2050 the renewable energy sources will satisfy 50% of the total energy requirement of the world. In this context, the faults in the conversion process require a special attention which is considered as a major problem. A fault which remains even for a few seconds will cause undesirable effects to the system. The presentation comprises of the analysis, causes, effects and mitigation methods of various faults occurring in the entire solar photovoltaic energy conversion process. In order to overcome the faults in the system, an intelligent based artificial neural networks and fuzzy logic are proposed which can significantly mitigate the faults. Hence the presentation intends to find the problem in renewable energy and provides the possible solution to overcome it with simulation and experimental results. The work performed in a 3kWp solar photovoltaic plant whose results cites the improvement in reliability, availability, power quality and fault tolerant ability.

Keywords: solar photovoltaic, power electronics, power quality, PWM

Procedia PDF Downloads 269
661 Safety Profile of Human Papillomavirus Vaccines: A Post-Licensure Analysis of the Vaccine Adverse Events Reporting System, 2007-2017

Authors: Giulia Bonaldo, Alberto Vaccheri, Ottavio D'Annibali, Domenico Motola

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The Human Papilloma Virus (HPV) was shown to be the cause of different types of carcinomas, first of all of the cervical intraepithelial neoplasia. Since the early 80s to today, thanks first to the preventive screening campaigns (pap-test) and following to the introduction of HPV vaccines on the market; the number of new cases of cervical cancer has decreased significantly. The HPV vaccines currently approved are three: Cervarix® (HPV2 - virus type: 16 and 18), Gardasil® (HPV4 - 6, 11, 16, 18) and Gardasil 9® (HPV9 - 6, 11, 16, 18, 31, 33, 45, 52, 58), which all protect against the two high-risk HPVs (6, 11) that are mainly involved in cervical cancers. Despite the remarkable effectiveness of these vaccines has been demonstrated, in the recent years, there have been many complaints about their risk-benefit profile due to Adverse Events Following Immunization (AEFI). The purpose of this study is to provide a support about the ongoing discussion on the safety profile of HPV vaccines based on real life data deriving from spontaneous reports of suspected AEFIs collected in the Vaccine Adverse Events Reporting System (VAERS). VAERS is a freely-available national vaccine safety surveillance database of AEFI, co-administered by the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA). We collected all the reports between January 2007 to December 2017 related to the HPV vaccines with a brand name (HPV2, HPV4, HPV9) or without (HPVX). A disproportionality analysis using Reporting Odds Ratio (ROR) with 95% confidence interval and p value ≤ 0.05 was performed. Over the 10-year period, 54889 reports of AEFI related to HPV vaccines reported in VAERS, corresponding to 224863 vaccine-event pairs, were retrieved. The highest number of reports was related to Gardasil (n = 42244), followed by Gardasil 9 (7212) and Cervarix (3904). The brand name of the HPV vaccine was not reported in 1529 cases. The two events more frequently reported and statistically significant for each vaccine were: dizziness (n = 5053) ROR = 1.28 (CI95% 1.24 – 1.31) and syncope (4808) ROR = 1.21 (1.17 – 1.25) for Gardasil. For Gardasil 9, injection site pain (305) ROR = 1.40 (1.25 – 1.57) and injection site erythema (297) ROR = 1.88 (1.67 – 2.10) and for Cervarix, headache (672) ROR = 1.14 (1.06 – 1.23) and loss of consciousness (528) ROR = 1.71 (1.57 – 1.87). In total, we collected 406 reports of death and 2461 cases of permanent disability in the ten-year period. The events consisting of incorrect vaccine storage or incorrect administration were not considered. The AEFI analysis showed that the most frequently reported events are non-serious and listed in the corresponding SmPCs. In addition to these, potential safety signals arose regarding less frequent and severe AEFIs that would deserve further investigation. This already happened with the referral of the European Medicines Agency (EMA) for the adverse events POTS (Postural Orthostatic Tachycardia Syndrome) and CRPS (Complex Regional Pain Syndrome) associated with anti-papillomavirus vaccines.

Keywords: adverse drug reactions, pharmacovigilance, safety, vaccines

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660 Quantification of Extent of Pollution from Total Lead in the Shooting Ranges Found in Southern and Central Botswana: A Pioneering Study

Authors: Nicholas Sehube, Rosemary Kelebemang, Pogisego Dinake

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The extent of Pb contamination of shooting range soils has never been ascertained in Botswana, this was the first attempt in evaluating the deposition of Pb into the soils emanating from munitions. A total of 8 military shooting ranges were used for this study. Soil samples were collected at each of the 8 shooting ranges at the berm (stop butt), target line, 50 and 100 m from the berm. In all of the shooting ranges investigated the highest concentrations were found in the berm soils. The highest Pb concentrations of 38 406.87 mg/Kg were found in the berm soils of Thebephatshwa shooting range which is enclosed within a military camp with staff residential dwelling only a kilometre away. Most of the shooting ranges soils contained elevated levels of Pb in the ranges above 2000 mg/kg far exceeding the United States Environmental Protection Agency (USEPA) critical value of 400 mg/Kg. Mobilization of lead at high pH is attributed to low organic matter and such was the case with Thebephatshwa shooting range with a percept organic matter of 0.35±0.08. The predominant weathering products in these shooting ranges were cerussite (PbCO3), hydrocerussite (Pb(CO3)2(OH)2 and massicot (PbO). The detailed examination and characterization of the extent of pollution will help in the development and implementation of scientifically sound remediation and restoration of shooting ranges soils.

Keywords: ammunition, Botswana, Pb, pollution, soil

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659 Concentrations of Leptin, C-Peptide and Insulin in Cord Blood as Fetal Origins of Insulin Resistance and Their Effect on the Birth Weight of the Newborn

Authors: R. P. Hewawasam, M. H. A. D. de Silva, M. A. G. Iresha

Abstract:

Obesity is associated with an increased risk of developing insulin resistance. Insulin resistance often progresses to type-2 diabetes mellitus and is linked to a wide variety of other pathophysiological features including hypertension, hyperlipidemia, atherosclerosis (metabolic syndrome) and polycystic ovarian syndrome. Macrosomia is common in infants born to not only women with gestational diabetes mellitus but also non-diabetic obese women. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age (LGA) are more likely to be obese in childhood. It is also established from previous studies that Asian populations have higher percentage body fat at a lower body mass index compared to Caucasians. High leptin levels in cord blood have been reported to correlate with fetal adiposity at birth. Previous studies have also shown that cord blood C-peptide and insulin levels are significantly and positively correlated with birth weight. Therefore, the objective of this preliminary study was to determine the relationship between parameters of fetal insulin resistance such as leptin, C-peptide and insulin and the birth weight of the newborn in a study population in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns and the concentration of insulin, leptin, and C-peptide were measured by ELISA technique. Birth weight, length, occipital frontal, chest, hip and calf circumferences of newborns were measured and characteristics of the mother such as age, height, weight before pregnancy and weight gain were collected. The relationship between insulin, leptin, C-peptide, and anthropometrics were assessed by Pearson’s correlation while the Mann-Whitney U test was used to assess the differences in cord blood leptin, C-peptide, and insulin levels between groups. A significant difference (p < 0.001) was observed between the insulin levels of infants born LGA (18.73 ± 0.64 µlU/ml) and AGA (13.08 ± 0.43 µlU/ml). Consistently, A significant increase in concentration (p < 0.001) was observed in C-peptide levels of infants born LGA (9.32 ± 0.77 ng/ml) compared to AGA (5.44 ± 0.19 ng/ml). Cord blood leptin concentration of LGA infants (12.67 ng/mL ± 1.62) was significantly higher (p < 0.001) compared to the AGA infants (7.10 ng/mL ± 0.97). Significant positive correlations (p < 0.05) were observed among cord leptin levels and the birth weight, pre-pregnancy maternal weight and BMI between the infants of AGA and LGA. Consistently, a significant positive correlation (p < 0.05) was observed between the birth weight and the C peptide concentration. Significantly high concentrations of leptin, C-peptide and insulin levels in the cord blood of LGA infants suggest that they may be involved in regulating fetal growth. Although previous studies suggest comparatively high levels of body fat in the Asian population, values obtained in this study are not significantly different from values previously reported from Caucasian populations. According to this preliminary study, maternal pre-pregnancy BMI and weight may contribute as significant indicators of cord blood parameters of insulin resistance and possibly the birth weight of the newborn.

Keywords: large for gestational age, leptin, C-peptide, insulin

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658 Proximate Analysis of Muscle of Helix aspersa Living in Konya, Turkey

Authors: Ozcan Baris Citil

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The aim of the present study is the determination of the effects of variations in the proximate analysis, cholesterol content and fatty acid compositions of Helix aspersa. Garden snails (Helix aspersa) were picked up by hand from the Central Anatolia Region of Turkey, in autumn (November) in 2015. Fatty acid methyl esters (FAMEs) and cholesterol analysis were analyzed by gas chromatography (GC). The protein contents of snail muscle were determined with Kjeldahl distillation units. Statistical comparisons were made by using SPSS Software (version 16.0). Thirty different fatty acids of different saturation levels were detected. As the predominant fatty acids, stearic acid (C18:0), oleic acid (C18:1ω9), linoleic acid (C18:2ω6), palmitic acid (C16:0), arachidonic acid (C20:4ω6), eicosadienoic acid (C20:2) and linolenic acid (C18:3ω3) were found in Helix aspersa. Palmitic acid (C16:0) was identified as the major SFA in autumn. Linoleic acid (C18:2ω6), eicosadienoic acid (C20:2) and arachidonic acid (C20:4ω6) have the highest levels among the PUFAs. In the present study, ω3 were found 5.48% in autumn. Linolenic acid and omega-3 fatty acid amounts in the autumn decreased significantly but cholesterol content was not affected in Helix aspersa in autumn (November) in 2015.

Keywords: Helix aspersa, fatty acid, SFA, PUFA, cholesterol

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657 Restless Leg Syndrome as the Presenting Symptom of Neuroendocrine Tumor

Authors: Mustafa Cam, Nedim Ongun, Ufuk Kutluana

Abstract:

Introduction: Restless LegsSyndrome (RLS) is a common, under-recognized disorder disrupts sleep and diminishes quality of life (1). The most common conditions highly associated with RLS include renalfailure, iron and folic acid deficiency, peripheral neuropathy, pregnancy, celiacdisease, Crohn’sdiseaseandrarelymalignancy (2).Despite a clear relation between low peripheral iron and increased prevalence and severity of RLS, the prevalence and clinical significance of RLS in iron-deficientanemic populations is unknown (2). We report here a case of RLS due to iron deficiency in the setting of neuroendocrinetumor. Report of Case: A 35 year-old man was referred to our clinic with general weakness, weight loss (10 kg in 2 months)and 2-month history of uncomfortable sensations in his legs with urge to move, partially relieved by movement. The symptoms were presented very day, worsening in the evening; the discomfort forced the patient to getup and walk around at night. RLS was severe, with a score of 22 at the International RLS ratingscale. The patient had no past medical history. The patient underwent a complete set of blood analyses and the following ab normal values were found (normal limitswithinbrackets): hemoglobin 9.9 g/dl (14-18), MCV 70 fL (80-94), ferritin 3,5 ng/mL (13-150). Brain and spinemagnetic resonance imaging was normal. The patient consultated with gastroenterology clinic and gastointestinal systemendoscopy was performed for theetiology of the iron deficiency anemia. After the gastricbiopsy, results allowed us to reach the diagnosis of neuroen docrine tumor and the patient referred to oncology clinic. Discussion: The first important consideration from this case report is that the patient was referred to our clinic because of his severe RLS symptoms dramatically reducing his quality of life. However, our clinical study clearly demonstrated that RLS was not the primary disease. Considering the information available for this patient, we believe that the most likely possibility is that RLS was secondary to iron deficiency, a very well-known and established cause of RLS in theliterature (3,4). Neuroendocrine tumors (NETs) are rare epithelial neoplasms with neuroendocrine differentiation that most commonly originate in the lungs and gastrointestinal tract (5). NETs vary widely in their clinical presentation; symptoms are often nonspecific and can be mistaken for those of other more common conditions (6). 50% of patients with reported disease stage have either regional or distant metastases at diagnosis (7). Accurate and earlier NET diagnosis is the first step in shortening the time to optimal care and improved outcomes for patients (8). The most important message from this case report is that RLS symptoms can sometimes be thesign of a life-threatening condition. Conclusion: Careful and complete collection of clinical and laboratory data should be carried out in RLS patients. Inparticular, if RLS onset coincides with weight loss and iron deficieny anemia, gastricendos copy should be performed. It is known about that malignancy is a rare etiology in RLS patients and to our knowledge; it is the first case with neuro endocrine tumor presenting with RLS.

Keywords: neurology, neuroendocrine tumor, restless legs syndrome, sleep

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656 Hybrid Treatment Method for Decolorization of Mixed Dyes: Rhodamine-B, Brilliant Green and Congo Red

Authors: D. Naresh Yadav, K. Anand Kishore, Bhaskar Bethi, Shirish H. Sonawane, D. Bhagawan

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The untreated industrial wastewater discharged into the environment causes the contamination of soil, water and air. Advanced treatment methods for enhanced wastewater treatment are attracting substantial interest among the currently employed unit processes in wastewater treatment. The textile industry is one of the predominant in wastewater production at current industrialized situation. The refused dyes at textile industry need to be treated in proper manner before its discharge into water bodies. In the present investigation, hybrid treatment process has been developed for the treatment of synthetic mixed dye wastewater. Photocatalysis and ceramic nanoporous membrane are mainly used for process integration to minimize the fouling and increase the flux. Commercial semiconducting powders (TiO2 and ZnO) has used as a nano photocatalyst for the degradation of mixed dye in the hybrid system. Commercial ceramic nanoporous tubular membranes have been used for the rejection of dye and suspended catalysts. Photocatalysis with catalyst has shown the average of 34% of decolorization (RB-32%, BG-34% and CR-36%), whereas ceramic nanofiltration has shown the 56% (RB-54%, BG-56% and CR-58%) of decolorization. Integration of photocatalysis and ceramic nanofiltration has shown 96% (RB-94%, BG-96% and CR-98%) of dye decolorization over 90 min of operation.

Keywords: photocatalysis, ceramic nanoporous membrane, wastewater treatment, advanced oxidation process, process integration

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655 Carriage of 675 4G/5G Polymorphism in PAI-1 Gene and Its Association with Early Pregnancy Losses in Patients with Polycystic Ovary Syndrome

Authors: R. Komsa-Penkova, G. Golemanov, G. Georgieva, K. Popovski, N. Slavov, P. Ivanov, K. Kovacheva, S. Rathee, E. Konova, A. Blajev

Abstract:

Leptin and PAI-1 are important cytokines and may play a role in the regulation of PCOS development. PCOS is frequently associated with obesity, high BMI index and consequently with increased risk of metabolic disorders. The aim of the present study was to evaluate PAI-1 levels, genetic influence of the carriage of 675 4G/5G polymorphism in PAI-1 gene and leptin as a marker of obesity in the development of PCOS. Methods: Genotyping in 84 patients with PCOS and PCO and 100 healthy control subjects to detect single nucleotide deletion 675 G in the promoter of PAI-1 gene. The present study provides evidence that SNP 4G in the PAI-1 gene is associated with early pregnancy losses in patients with polycystosis. Further to this, there is a correlation between leptin levels, PAI-1 levels and BMI in the patients with PCOS, which confirms the role of obesity as a risk factor for PCOS.

Keywords: carriage of 675 4G/5G polymorphism, PCOS, early pregnancy losses, PAI-1 gene

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