Search results for: risk measurement
Commenced in January 2007
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Edition: International
Paper Count: 8206

Search results for: risk measurement

1846 Predictive Factors of Healthcare-Associated Infections and Antibiotic Use Patterns: A Cross-Sectional Survey at the Charles Nicolle Hospital of Tunis

Authors: Nouira Mariem, Ennigrou Samir

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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1845 The Relations between Coping Strategies, Caregiver Bonding, and Dating Violence of Emerging Adults: Cross-Cultural Comparison between China and Turkiye

Authors: Zubaidan Yushan, Hudayar Cıhan

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Turkiye and China are countries that have collective cultures, but they have different cultural backgrounds. They have different cultures, different religions, and different levels of economic development. The aim of this study is to test the moderation effect of caregiver bonding on the relationship between dating violence and coping strategies among unmarried emerging adults in China and Turkiye. Participants ages were 19 and 26 years (X=23.66, SD=3.66), unmarried emerging adults Turkish 171 participants (72.5% women, 24% men, 3.5% prefer not to say), Chinese 170 participants (71.8% women, 21.8% men, 6.5% prefer not to say). All participants had been in a relationship for more than six months. Participants completed The Conflict Tactics Scales—(CTS2), The Cope Inventory, and The Parental Bonding Instrument (PBI). Examining the dating violence and coping strategies of the participant's relationship through caregiver bonding moderation analysis was performed using the Jamovi. Significance was tested using the bootstrapping method with bias-corrected confidence estimates. The outcome variable for analysis was dating violence, and the predictor variable for the analysis was coping strategies. The moderator variable evaluated for the analysis was parent attachment. Before the analysis, the mean-centered scores of each variable and moderator were calculated. Furthermore, the moderation analysis was conducted separately for each outcome. The Moderation analysis results show that the sub-dimension of over-protection moderates psychological aggression perpetration and avoidance coping in China. The sub-dimension of care moderates injury victimization and avoidance management in Turkiye; also, over-protection moderates injury victimization and social support coping. Moreover, the sub-dimension of care moderates sexual coercion perpetration and avoidance coping. In the results, caregiver bonding moderates the relationship between coping strategies and dating violence, which may be explained by the fact that our ways of coping with problems are learned, and people are influenced by their parents when they face problems. Therefore, problem-solving is permanently fixed, and each person has his or her fixed solution, which leads to a habit of using solutions to problems. However, sometimes, these solutions become the justification for the injured or abusive person. The quality of the attachment between parents can regulate this state. The results are somewhat similar to and slightly different from those in the previous literature. These mixed results indicate the need for further exploration. Many other factors, such as alcohol, drug violence, and pathological problems, maybe the reasons for these differences. In addition, diverse factors such as the study environment and the applied measurement scales may also affect the results.

Keywords: caregiver bonding, coping strategies, dating violence, emerging adulthood, cross-cultural, comparison

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1844 Shooting in The Foot at The Pulpit; An Analysis of Analysis of The Origin and Progression of Conflict Among the Born-Again Churches in Uganda

Authors: Baguma Charles Abwooli

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Whereas they profess to be comrades in the fight to save souls, Born Again Churches in Uganda are shooting each other in the foot over yet to be understood reasons. For a long time, churches have sustained a bitter divide among themselves. The country has witnessed pastoral scandals, including church leaders dragging each other to court, setting each other’s churches ablaze, and even plotting assassination against each her. The most dreadful was when one pastor called a chest-thumping press conference at the demise of another. There is even an emergence of church-owned radio stations purposed to fuel this conflict. Worse still, the division among pastors has been transferred to their congregations to extent that at the first meeting, congregants ask each other where they pray from perhaps to know how to deal with each other. This has caused the born-again to maintain factions among themselves and keeping ready to fight in case there is a battle. This is quite a risk to peace and stability in the country. This kind of belligerence not only defeats the very existence of churches but is a threat to national peace and security, especially as the churches mushroom across the country. It is feared that the vice could spread to the rest of Eastern Africa and beyond, given the connectivity. There is already evidence to this. One Pastor was heard to call the late Ghanaian Pastor T. B. Joshua, a witch who has been training witches in Uganda. He said this at his demise while referring to pastors that subscribe to T. B. Joshua’s approach to preaching the Gospel. This is an abomination, especially in Africa! There is, therefore, an urgent need to understand the roots of this conflict and design measures to decisively manageit. The present study employs tools based on conflict resolution theory to conduct a deep qualitative analysis of the origin and progression of the Born-Againconflict in Uganda with intend to make recommendations of appropriate measures to resolve it.

Keywords: uganda, shooting, pulpit, born again churches

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1843 Assessment of the Work-Related Stress and Associated Factors among Sanitation Workers in Public Hospitals during COVID-19, Addis Ababa, Ethiopia

Authors: Zerubabel Mihret

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Background: Work-related stress is a pattern of reactions to work demands unmatched by worker’s knowledge, skills, or abilities. Healthcare institutions are considered high-risk and intensive work areas for work-related stress. However, there is the nonexistence of clear and strong data about the magnitude of work-related stress on sanitation workers in hospitals in Ethiopia. The aim of this study was to determine the magnitude of work-related stress among sanitation workers in public hospitals during COVID-19 in Addis Ababa, Ethiopia. Methods: Institution-based cross-sectional study was conducted from October 2021 to February 2022 among 494 sanitation workers who were selected from 4 hospitals. HSE (Health and Safety Executive of UK) standard data collection tool was used, and an interviewer-administered questionnaire was used to collect the data using KOBO collect application. The collected data were cleaned and analyzed using SPSS version 20.0. Both binary and multivariable logistic regression analyses were done to identify important factors having an association with work-related stress. Variables with p-value ≤ 0.25 in the bivariate analysis were entered into the multivariable logistic regression model. A statistically significant level was declared at a p-value ≤ 0.05. Results: This study revealed that the magnitude of work-related stress among sanitation workers was 49.2% (95% CI 45-54). Significant proportions (72.7%) of sanitation workers were dissatisfied with their current job. Sex, age, experience, and chewing khat were significantly associated with work-related stress. Conclusion: Work-related stress is significantly high among sanitation workers. Sex, age, experience, and chewing khat were identified as factors associated with work-related stress. Intervention program focusing on the prevention and control of stress is desired by hospitals.

Keywords: work-related stress, sanitation workers, Likert scale, public hospitals, Ethiopia

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1842 Facilitating Academic Growth of Students With Autism

Authors: Jolanta Jonak

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All students demonstrate various learning preferences and learning styles that range from visual, auditory to kinesthetic preferences. These learning preferences are further impacted by individual cognitive profiles hat characterizes itself in linguistic strengths, logical- special, inter-or intra- personal, just to name a few. Students from culturally and linguistically diverse backgrounds (CLD) have an increased risk of being misunderstood by many school systems and even medical personnel. Students with disability, specifically Autism, are faced with another layer of learning differences. Research indicates that large numbers of students are not provided the type of education and types of supports they need in order to be successful in an academic environment. Multiple research findings indicate that significant numbers of school staff self-reports that they do not feel adequately prepared to work with students with disability and different learing profiles. It is very important for the school staff to be educated about different learning needs of students with autism spectrum disorders. Having the knowledge, school staff can avoid unnecessary referrals for office referrals and avoid inaccurate decisions about restrictive learning environments. This presentation will illustrate the cognitive differences in students with autism, how to recognize them, and how to support them through Differentiated Instruction. One way to ensure successful education for students with disability is by providing Differentiated Instruction (DI). DI is quickly gaining its popularity in the Unites States as a scientific- research based instructional approach for all students. This form of support ensures that regardless of the students’ learning preferences and cognitive learning profiles, they have an opportunity to learn through approaches that are suitable to their needs. It is extremely important for the school staff, especially school psychologists who often are the first experts to be consulted by educators, to be educated about differences due to learning preference styles and differentiation needs.

Keywords: special education, autism, differentiation, differences, differentiated instruction

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1841 Managing Pseudoangiomatous Stromal Hyperplasia Appropriately and Safely: A Retrospective Case Series Review

Authors: C. M. Williams, R. English, P. King, I. M. Brown

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Introduction: Pseudoangiomatous Stromal Hyperplasia (PASH) is a benign fibrous proliferation of breast stroma affecting predominantly premenopausal women with no significant increased risk of breast cancer. Informal recommendations for management have continued to evolve over recent years from surgical excision to observation, although there are no specific national guidelines. This study assesses the safety of a non-surgical approach to PASH management by review of cases at a single centre. Methods: Retrospective case series review (January 2011 – August 2016) was conducted on consecutive PASH cases. Diagnostic classification (clinical, radiological and histological), management outcomes, and breast cancer incidence were recorded. Results: 43 patients were followed up for median of 25 months (3-64) with 75% symptomatic at presentation. 12% of cases (n=5) had a radiological score (BIRADS MMG or US) ≥ 4 of which 3 were confirmed malignant. One further malignancy was detected and proven radiologically occult and contralateral. No patients were diagnosed with a malignancy during follow-up. Treatment evolved from 67% surgical in 2011 to 33% in 2016. Conclusions: The management of PASH has transitioned in line with other published experience. The preliminary findings suggest this appears safe with no evidence of missed malignancies; however, longer follow up is required to confirm long-term safety. Recommendations: PASH with suspicious radiological findings ( ≥ U4/R4) warrants multidisciplinary discussion for excision. In the absence of histological or radiological suspicion of malignancy, PASH can be safely managed without surgery.

Keywords: benign breast disease, conservative management, malignancy, pseudoangiomatous stromal hyperplasia, surgical excision

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1840 The Effects of Supportive Care Interventions with Psychotherapeutic and Exercise Approaches on Depressive Symptoms Among Patients with Lung Cancer: A Meta-Analysis

Authors: Chia-Chen Hsieh, Fei-Hsiu Hsiao

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Objective: To examine the effects of supportive care interventions on depressive symptoms in patients with lung cancer. Methods: The databases of Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and Chinese Electronic Periodical Services (CEPS) were searched from their inception until September 2015. We included the studies with randomized controlled trial design that compared standard care with supportive care interventions using psychotherapeutic or exercises approach. The standardized mean differences (SMD) (Cohen’s d) were calculated to estimate the treatment effects. The Cochrane Risk of Bias Tool was used for quality assessment and subgroup analysis was conducted to identify possible sources of heterogeneity. Results: A total of 1472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74 with 95% CI = -1.07 to -0.41), and the effect was maintained at the 4th, 8th, and 12th weeks of follow-up. Either psychotherapy combined with psychoeducation or exercise alone produced significant improvements in depressive symptoms, while psychoeducation alone did not. The greater improvements in depressive symptoms occurred in lung cancer patients with severe depressive symptoms at baseline, total duration of interventions of less than ten weeks, and intervention provided through face-to-face delivery. Conclusions: Psychotherapy combined with psychoeducation can help patients manage the causes of depressive symptoms, including both symptom distress and psychological trauma due to lung cancer. Exercise can target the impaired respiratory function that is a cause of depressive symptoms in lung cancer patients.

Keywords: supportive care intervention, depressive symptoms, lung cancer, meta-analysis

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1839 Advanced Phosphorus-Containing Polymer Materials towards Eco-Friendly Flame Retardant Epoxy Thermosets

Authors: Ionela-Daniela Carja, Diana Serbezeanu, Tachita Vlad-Bubulac, Corneliu Hamciuc

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Nowadays, epoxy materials are extensively used in ever more areas and under ever more demanding environmental conditions due to their remarkable combination of properties, light weight and ease of processing. However, these materials greatly increase the fire risk due to their flammability and possible release of toxic by-products as a result of their chemical composition which consists mainly from carbon and hydrogen atoms. Therefore, improving the fire retardant behaviour to prevent the loss of life and property is of particular concern among government regulatory bodies, consumers and manufacturers alike. Modification of epoxy resins with organophosphorus compounds, as reactive flame retardants or additives, is the key to achieving non-flammable advanced epoxy materials. Herein, a detailed characterization of fire behaviour for a series of phosphorus-containing epoxy thermosets is reported. A carefully designed phosphorus flame retardant additive was simply blended with a bifunctional bisphenol-A based epoxy resin. Further thermal cross-linking in the presence of various aminic hardeners led to eco-friendly flame retardant epoxy resins. The type of hardener, concentration of flame retardant additive, compatibility between the components of the mixture, char formation and morphology, thermal stability, flame retardant mechanisms were investigated. It was found that even a very low content of phosphorus introduced into the epoxy matrix increased the limiting oxygen index value to about 30%. In addition, the peak of the heat release rate value decreased up to 45% as compared to the one of the neat epoxy system. The main flame retardant mechanism was the condensed-phase one as revealed by SEM and XPS measurements.

Keywords: condensed-phase mechanism, eco-friendly phosphorus flame retardant, epoxy resin, thermal stability

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1838 The Association of Smoking and Body Mass Index with Acne Vulgaris in Adolescents and Young Adults

Authors: Almutazballlah Qablan, Jihan M. Muhaidat, Bana Abu Rajab

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Background: Acne vulgaris is the most common skin condition that general practitioners and dermatologists encounter. It represents a chronic inflammatory disease affecting the pilosebaceous unit. Although acne vulgaris is not a life-threatening condition, it has a considerable psychological impact on the affected person. Acne patients have poor body image, low self-esteem, social isolation, and restricted activities. As part of the emotional impact, increased levels of anxiety, anger, depression, and frustration have also been observed in acne patients. (1) In this study, we want to assess the association between two modifiable risk factors; BMI and smoking, regarding acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Irbid, north Jordan in 2019/2020. A total number of 163 Acne cases were collected and interviewed by the author; on the other hand, there were 162 control cases. Anthropometric measures for Acne patients and control individuals were taken, and BMI was calculated. Both groups were asked about smoking habits. Data on subjects between 14 and 33 years of age were extracted. The characteristics of people who reported acne were compared with those with no acne using univariate and multivariate analysis. The Statistical Package for Social Sciences (SPSS) was relied on to analyze the collected data. The crosstabs methods (chi-square) and odd ratios were relied on to test the study hypothesis. Results: Cigarette smoking was highly associated with no-acne, with an odds ratio of 0.4 (95% CI: 0.2–0.9), P-value = 0.018. BMI and waterpipe smoking were not significantly associated with acne in the multivariate analysis. Conclusion: Cigarette smoking was found to be protective from Acne. No significant relation between BMI nor waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, BMI, smoking, case-control

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1837 Measurement of Fatty Acid Changes in Post-Mortem Belowground Carcass (Sus-scrofa) Decomposition: A Semi-Quantitative Methodology for Determining the Post-Mortem Interval

Authors: Nada R. Abuknesha, John P. Morgan, Andrew J. Searle

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Information regarding post-mortem interval (PMI) in criminal investigations is vital to establish a time frame when reconstructing events. PMI is defined as the time period that has elapsed between the occurrence of death and the discovery of the corpse. Adipocere, commonly referred to as ‘grave-wax’, is formed when post-mortem adipose tissue is converted into a solid material that is heavily comprised of fatty acids. Adipocere is of interest to forensic anthropologists, as its formation is able to slow down the decomposition process. Therefore, analysing the changes in the patterns of fatty acids during the early decomposition process may be able to estimate the period of burial, and hence the PMI. The current study concerned the investigation of the fatty acid composition and patterns in buried pig fat tissue. This was in an attempt to determine whether particular patterns of fatty acid composition can be shown to be associated with the duration of the burial, and hence may be used to estimate PMI. The use of adipose tissue from the abdominal region of domestic pigs (Sus-scrofa), was used to model the human decomposition process. 17 x 20cm piece of pork belly was buried in a shallow artificial grave, and weekly samples (n=3) from the buried pig fat tissue were collected over an 11-week period. Marker fatty acids: palmitic (C16:0), oleic (C18:1n-9) and linoleic (C18:2n-6) acid were extracted from the buried pig fat tissue and analysed as fatty acid methyl esters using the gas chromatography system. Levels of the marker fatty acids were quantified from their respective standards. The concentrations of C16:0 (69.2 mg/mL) and C18:1n-9 (44.3 mg/mL) from time zero exhibited significant fluctuations during the burial period. Levels rose (116 and 60.2 mg/mL, respectively) and fell starting from the second week to reach 19.3 and 18.3 mg/mL, respectively at week 6. Levels showed another increase at week 9 (66.3 and 44.1 mg/mL, respectively) followed by gradual decrease at week 10 (20.4 and 18.5 mg/mL, respectively). A sharp increase was observed in the final week (131.2 and 61.1 mg/mL, respectively). Conversely, the levels of C18:2n-6 remained more or less constant throughout the study. In addition to fluctuations in the concentrations, several new fatty acids appeared in the latter weeks. Other fatty acids which were detectable in the time zero sample, were lost in the latter weeks. There are several probable opportunities to utilise fatty acid analysis as a basic technique for approximating PMI: the quantification of marker fatty acids and the detection of selected fatty acids that either disappear or appear during the burial period. This pilot study indicates that this may be a potential semi-quantitative methodology for determining the PMI. Ideally, the analysis of particular fatty acid patterns in the early stages of decomposition could be an additional tool to the already available techniques or methods in improving the overall processes in estimating PMI of a corpse.

Keywords: adipocere, fatty acids, gas chromatography, post-mortem interval

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1836 Self-Sensing Concrete Nanocomposites for Smart Structures

Authors: A. D'Alessandro, F. Ubertini, A. L. Materazzi

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In the field of civil engineering, Structural Health Monitoring is a topic of growing interest. Effective monitoring instruments permit the control of the working conditions of structures and infrastructures, through the identification of behavioral anomalies due to incipient damages, especially in areas of high environmental hazards as earthquakes. While traditional sensors can be applied only in a limited number of points, providing a partial information for a structural diagnosis, novel transducers may allow a diffuse sensing. Thanks to the new tools and materials provided by nanotechnology, new types of multifunctional sensors are developing in the scientific panorama. In particular, cement-matrix composite materials capable of diagnosing their own state of strain and tension, could be originated by the addition of specific conductive nanofillers. Because of the nature of the material they are made of, these new cementitious nano-modified transducers can be inserted within the concrete elements, transforming the same structures in sets of widespread sensors. This paper is aimed at presenting the results of a research about a new self-sensing nanocomposite and about the implementation of smart sensors for Structural Health Monitoring. The developed nanocomposite has been obtained by inserting multi walled carbon nanotubes within a cementitious matrix. The insertion of such conductive carbon nanofillers provides the base material with piezoresistive characteristics and peculiar sensitivity to mechanical modifications. The self-sensing ability is achieved by correlating the variation of the external stress or strain with the variation of some electrical properties, such as the electrical resistance or conductivity. Through the measurement of such electrical characteristics, the performance and the working conditions of an element or a structure can be monitored. Among conductive carbon nanofillers, carbon nanotubes seem to be particularly promising for the realization of self-sensing cement-matrix materials. Some issues related to the nanofiller dispersion or to the influence of the nano-inclusions amount in the cement matrix need to be carefully investigated: the strain sensitivity of the resulting sensors is influenced by such factors. This work analyzes the dispersion of the carbon nanofillers, the physical properties of the fresh dough, the electrical properties of the hardened composites and the sensing properties of the realized sensors. The experimental campaign focuses specifically on their dynamic characterization and their applicability to the monitoring of full-scale elements. The results of the electromechanical tests with both slow varying and dynamic loads show that the developed nanocomposite sensors can be effectively used for the health monitoring of structures.

Keywords: carbon nanotubes, self-sensing nanocomposites, smart cement-matrix sensors, structural health monitoring

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1835 Investor Beware - Significance of Investor Conduct under the Fair and Equitable Treatment Standard

Authors: Damayanti Sen

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The Fair and Equitable Treatment standard has emerged as a core tenet of a formulated legal structure aimed at encouraging investment through the granting of a secure and stable environment for the investor in the Host State. As an absolute, non-contingent standard, it constitutes an independent and reliable system for the protection of the investor and is frequently invoked and applied in investor-state dispute settlement under bilateral and multilateral investment treaties. Thus far, the standard has been examined principally as a measure for determining the responsibility of host countries towards investors and investments. The conduct of investor in applying the Fair and Equitable Treatment Standard is relatively unexplored. Such an assessment may be necessary in light of the development of new defenses to demands of host governments to confine the application of the standard in order to ensure a proper balance between the protection of investors and the inherent right of a State to regulate economic conduct within its borders. This paper explores the implications of including considerations of investor conduct in the determination of whether an act of the host country’s administrative and/or judicial authorities has breached the fair and equitable treatment principle. The need for such defenses are of special concern for governments of developing countries, whose limited resources can affect their ability to provide an effective evaluation of the nature of the proposed investment, and, subsequently, to ensure that the expected benefits are realized. On the basis of conceptual analysis, and emerging international judicial and arbitral case law, this paper suggests that investor duties such as, the avoidance of unconscionable conduct, the reasonable assessment of investment risk in the host country, and a duty to operate an investment reasonably are leading to a new limit upon the fair and equitable treatment standard- one that can be succinctly captured in the phrase “Caveat Investor”.

Keywords: BITs, FET Standard, investor behavior, arbitral case law

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1834 Study of the Composition of Lipids in Different Kinds of Packaged Food Products

Authors: Zineb Taidirt, Fathia Sebahi, Mohamed Karim Guarchani, Anissa Berkane, Noureddine Smail, Ouahiba Hadjoudj

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Cardiovascular diseases are one of the most important causes of death in Algeria. Several risk factors are responsible for this, including the consumption of foods containing saturated fat and trans fatty acids TFAs. This brief presents the results of a descriptive study of the lipid composition of 251 food products marketed in Algeria. The objective of the study is to describe the nature and composition of lipids and to verify the compliance of saturated and trans fatty acids intakes with the regulations. The study is based on data from the nutrition labelling of marketed food products. The results showed that the lipids in foodstuffs are diverse in nature and of varying amounts, but their nature is not specified on all products. In addition, the required content of saturated fatty acids is mentioned only in 29.48% of the products; 21.62% of them do not comply with the standard. Hydrogenation of fats, which produced Trans fatty acids, is common: 19.92% of products contain hydrogenated fats, and 74.89% may contain them according to the aspect of the lipid (solid fat). However, the trans fatty acid content is only mentioned in 5.18% of the products. The latter is above the limits set by Algerian regulations in 50% of the butter samples studied. The composition of lipids in mono- and polyunsaturated fatty acids essential for the body is insufficient: only 13.94% of the products inform their contents on their labels. It is necessary to adopt mandatory restriction of trans fatty acids, to ban the use of partially-hydrogenated oils, and to require required mandatory labeling of the TFAs and the other fatty acids on packaged foods, and to conduct more studies in order to appreciate the intake of TFAs and saturated fat and appreciate their effects on the Algerian population and to get more informed about the composition of the lipid in packaged foods.

Keywords: cardiovascular diseases, lipids, nutrition labelling, lipids, trans fatty acids

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1833 A Strategic Perspective on a Qualitative Model of Type II Workplace Aggression in Healthcare Sector

Authors: Francesco Ceresia

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Workplace aggression is broadly recognized as a main work-related risk for healthcare organizations the world over. Scholars underlined that nonfatal workplace aggressions can be also produced by Type II workplace aggression, that occur when the aggressor has a legitimate relationship with the organization and commits an act of hostility while being served or cared for by members of the organization. Several reviews and meta-analysis highlighted the main antecedents and consequences of Type II verbal and physical workplace aggression in the healthcare sector, also focusing on its economic and psychosocial costs. However, some scholars emphasized the need for a systemic and multi-factorial approach to deeply understand and effectively respond to such kind of aggression. The main aim of the study is to propose a qualitative model of Type II workplace aggression in a health care organization in accordance with the system thinking and multi-factorial perspective. A case study research approach, conducted in an Italian non-hospital healthcare organization, is presented. Two main data collection methods have been adopted: individual and group interviews with a sample (N = 24) of physicians, nurses and clericals. A causal loop diagram (CLD) that describes the main causal relationships among the key-variables of the proposed model has been outlined. The main feedback loops and the causal link polarities have been also defined to fully describe the structure underlining the Type II workplace aggression phenomenon. The proposed qualitative model shows how the Type II workplace aggression is related with burnout, work performance, job satisfaction, turnover intentions, work motivation and emotional dissonance. Finally, strategies and policies to reduce the strength of workplace aggression’s drivers are suggested.

Keywords: healthcare, system thinking, work motivation, workplace aggression

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1832 The Influence of Dietary Components on Acne; A Case-Control Survey

Authors: Atiya Mahmood, Mubasharah Hanif, Ghazala Butt, Mehwish Zahoor Ahmed

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Acne vulgaris affects millions of adults.Despite extensive research, its food related etiology remains elusive. Objective:To assess the correlation between dietary intake and acne through a case-control survey of 300,15-25 year old respondents living in Pakistan. 50 acne patients and 150 age-and ethnicity-matched controls completed a questionnaire.Cases and controls were separated using SPSS-22 and univariate analysis was performed using the chi-square test. p value < 0.05 was considered statistically significant. We used adjusted odds ratios to assess the strength of associations with 95% confidence intervals. Most of the respondents were females(91.3%).Most(48.7%)acne patients were 20-25 yearsold.Acne severity was mild in 50%,moderate in 34%,severe in14%and very severe in 2%.Frequent low-fat foods(p<0.001)(OR=3.22),fat intake(p=0.03)(OR = 1.629),sweet snacks i.e. biscuits and candies etc. (p=0.013) (OR=1.9254), soft drinks(p= 0.045)(OR= 1.9091),butter(p<0.001) (OR= 1.8185),dairy products(p=0.043)(OR=0.624),salty foods(p= 0.011)(OR=1.961),chocolate (p=0.028)(OR=1.669), were associated with increased acne risk.No association was found with consumption of fried foods, desserts, fruit juices, raw fruit, fast food, vegetables, cheese, soy products, salt, and corn. Increased butter and chocolate consumption were linked to more severe forms of acne(p=0.049 and p=0.005 respectively).Most respondents (n=218) considered themselves to have healthy eating habits, indicating they were not educated about the nutritional aspects of acne treatment.Certain food item intake was significantly higher in acne patients to give an association between the two. Further studies must be conducted to develop a causative relationship. Nutrition aawareness is critical to reduce acne.

Keywords: correlation between dietary components and acne, dietary components, acne, nutrition

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1831 Early Gastric Cancer Prediction from Diet and Epidemiological Data Using Machine Learning in Mizoram Population

Authors: Brindha Senthil Kumar, Payel Chakraborty, Senthil Kumar Nachimuthu, Arindam Maitra, Prem Nath

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Gastric cancer is predominantly caused by demographic and diet factors as compared to other cancer types. The aim of the study is to predict Early Gastric Cancer (ECG) from diet and lifestyle factors using supervised machine learning algorithms. For this study, 160 healthy individual and 80 cases were selected who had been followed for 3 years (2016-2019), at Civil Hospital, Aizawl, Mizoram. A dataset containing 11 features that are core risk factors for the gastric cancer were extracted. Supervised machine algorithms: Logistic Regression, Naive Bayes, Support Vector Machine (SVM), Multilayer perceptron, and Random Forest were used to analyze the dataset using Python Jupyter Notebook Version 3. The obtained classified results had been evaluated using metrics parameters: minimum_false_positives, brier_score, accuracy, precision, recall, F1_score, and Receiver Operating Characteristics (ROC) curve. Data analysis results showed Naive Bayes - 88, 0.11; Random Forest - 83, 0.16; SVM - 77, 0.22; Logistic Regression - 75, 0.25 and Multilayer perceptron - 72, 0.27 with respect to accuracy and brier_score in percent. Naive Bayes algorithm out performs with very low false positive rates as well as brier_score and good accuracy. Naive Bayes algorithm classification results in predicting ECG showed very satisfactory results using only diet cum lifestyle factors which will be very helpful for the physicians to educate the patients and public, thereby mortality of gastric cancer can be reduced/avoided with this knowledge mining work.

Keywords: Early Gastric cancer, Machine Learning, Diet, Lifestyle Characteristics

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1830 Exploring Challenges Faced by People Living with HIV/AIDS After Disclosure in Sub-Saharan Countries

Authors: Veliswa Nonfundo Hoho, Jabulani Gilford Kheswa

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HIV/AIDS has been a long-term condition worldwide, which does not only affect physical health but also causes psychological and social challenges in people living with this condition. In Sub-Saharan countries, namely; Nigeria, Uganda, Zimbabwe and South Africa, people living with HIV/AIDS come across different challenges especially after one has disclosed his/her status. They experience stigma and discrimination, isolation, lack of accessing and receiving treatment, lack of support and experience psychological distress. By using the evidence-based systematic review as a form of methodology, journal articles, dissertations, internet, and books were explored. This paper seeks to describe the challenges faced by people living with HIV/AIDS after disclosure, which forms a critical component of HIV/AIDS prevention and treatment interventions. The disclosure process model is used to underpin the study. This theory allows one to understand when and why interpersonal and verbal self-disclosure is beneficial for individuals who live with concealable stigmatized identities such as HIV/AIDS. Literature findings advocate that both negative and positive results were noted after disclosing one’s HIV status and psychosocial well-being of the majority of people living with HIV/AIDS also get affected especially in societies which subscribe HIV/AIDS pandemic to witchcraft. As for the infected homosexuals, research indicates that they suffer in silence and to cover their emotional emptiness due to ostracism, they often report low- self-efficacy with regard to condom use and become susceptible to reinfections which further place their lives at heightened risk for low immune system. In this regard, this paper challenges the policies which protect the dignity of people living with HIV/AIDS and calls for unity and financial support in favour of psychoeducational programmes and support groups aimed at curbing discrimination.

Keywords: disclosure, discrimination, homosexuality, self-efficacy

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1829 Assessing the Blood-Brain Barrier (BBB) Permeability in PEA-15 Mutant Cat Brain using Magnetization Transfer (MT) Effect at 7T

Authors: Sultan Z. Mahmud, Emily C. Graff, Adil Bashir

Abstract:

Phosphoprotein enriched in astrocytes 15 kDa (PEA-15) is a multifunctional adapter protein which is associated with the regulation of apoptotic cell death. Recently it has been discovered that PEA-15 is crucial in normal neurodevelopment of domestic cats, a gyrencephalic animal model, although the exact function of PEA-15 in neurodevelopment is unknown. This study investigates how PEA-15 affects the blood-brain barrier (BBB) permeability in cat brain, which can cause abnormalities in tissue metabolite and energy supplies. Severe polymicrogyria and microcephaly have been observed in cats with a loss of function PEA-15 mutation, affecting the normal neurodevelopment of the cat. This suggests that the vital role of PEA-15 in neurodevelopment is associated with gyrification. Neurodevelopment is a highly energy demanding process. The mammalian brain depends on glucose as its main energy source. PEA-15 plays a very important role in glucose uptake and utilization by interacting with phospholipase D1 (PLD1). Mitochondria also plays a critical role in bioenergetics and essential to supply adequate energy needed for neurodevelopment. Cerebral blood flow regulates adequate metabolite supply and recent findings also showed that blood plasma contains mitochondria as well. So the BBB can play a very important role in regulating metabolite and energy supply in the brain. In this study the blood-brain permeability in cat brain was measured using MRI magnetization transfer (MT) effect on the perfusion signal. Perfusion is the tissue mass normalized supply of blood to the capillary bed. Perfusion also accommodates the supply of oxygen and other metabolites to the tissue. A fraction of the arterial blood can diffuse to the tissue, which depends on the BBB permeability. This fraction is known as water extraction fraction (EF). MT is a process of saturating the macromolecules, which has an effect on the blood that has been diffused into the tissue while having minimal effect on intravascular blood water that has not been exchanged with the tissue. Measurement of perfusion signal with and without MT enables to estimate the microvascular blood flow, EF and permeability surface area product (PS) in the brain. All the experiments were performed with Siemens 7T Magnetom with 32 channel head coil. Three control cats and three PEA-15 mutant cats were used for the study. Average EF in white and gray matter was 0.9±0.1 and 0.86±0.15 respectively, perfusion in white and gray matter was 85±15 mL/100g/min and 97±20 mL/100g/min respectively, PS in white and gray matter was 201±25 mL/100g/min and 225±35 mL/100g/min respectively for control cats. For PEA-15 mutant cats, average EF in white and gray matter was 0.81±0.15 and 0.77±0.2 respectively, perfusion in white and gray matter was 140±25 mL/100g/min and 165±18 mL/100g/min respectively, PS in white and gray matter was 240±30 mL/100g/min and 259±21 mL/100g/min respectively. This results show that BBB is compromised in PEA-15 mutant cat brain, where EF is decreased and perfusion as well as PS are increased in the mutant cats compared to the control cats. This findings might further explain the function of PEA-15 in neurodevelopment.

Keywords: BBB, cat brain, magnetization transfer, PEA-15

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1828 Microalgae as Promising Biostimulants of Plant Tolerance Against Heavy Metals

Authors: Soufiane Fal, Abderahim Aasfar, Ali Ouhssain, Hasnae Choukri, Abelaziz Smouni, Hicham El Arroussi

Abstract:

Heavy metals contamination is a major environmental concern around the world. It has a harmful impact on plant productivity and poses a serious risk to humans and animals health. In the present study, the effect of Microalgae Crude Extract (MCE) on tomato growth and nutrients uptake exposed to 2 mM Pb2+ and Cd2+ was investigated. In results, 2 mM Pb2+ and Cd2+ showed a significant reduction of tomatobiomass and perturbation in nutrients absorption. Moreover, MCE application in tomato plant exposed to Pb2+ and Cd2+ showed a significant enhancement of biomass compared to tomato plants under Pb2+ and Cd2+. On the other hand, MCE application favoured heavy metals accumulation in root and inhibited their translocation to shoot as phytostabilisation mechanism. Tomato plants showed biochemical responses to Pb2+ and Cd2+ stress with elevation of scavenging enzymes and molecules such as POD, CAT, SOD, Proline, and polyphenols, etc. In addition, the treatment by MCE showed a significant reduction level of the majority of these parameters. Furthermore, the metabolomic analysis revealed a significant change in important metabolites. Pb2+ and Cd2+ showed decrease in SFA and increase of UFA, VLFA, alkanes, alkenes, sterols, which known accumulated as tolerance and resistance mechanism to heavy metal (H.M) stress. However, MCE treatment showed the inverse of these response to return tomato plants to normal state and enhanced tolerance and resistance to heavy metal stress. In the present study, we emphasized that MCE can alleviate H.M stress, enhance tomato plant growth nutrients absorption and improve biochemical responses.

Keywords: microalgae crude extract, heavy metal stress, nutrient uptake, metabolomic analysis, solanum lycopersicum (Tomato), phytostabilisation

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1827 Lower Limb Oedema in Beckwith-Wiedemann Syndrome

Authors: Mihai-Ionut Firescu, Mark A. P. Carson

Abstract:

We present a case of inferior vena cava agenesis (IVCA) associated with bilateral deep venous thrombosis (DVT) in a patient with Beckwith-Wiedemann syndrome (BWS). In adult patients with BWS presenting with bilateral lower limb oedema, specific aetiological factors should be considered. These include cardiomyopathy and intraabdominal tumours. Congenital malformations of the IVC, through causing relative venous stasis, can lead to lower limb oedema either directly or indirectly by favouring lower limb venous thromboembolism; however, they are yet to be reported as an associated feature of BWS. Given its life-threatening potential, the prompt initiation of treatment for bilateral DVT is paramount. In BWS patients, however, this can prove more complicated. Due to overgrowth, the above-average birth weight can continue throughout childhood. In this case, the patient’s weight reached 170 kg, impacting on anticoagulation choice, as direct oral anticoagulants have a limited evidence base in patients with a body mass above 120 kg. Furthermore, the presence of IVCA leads to a long-term increased venous thrombosis risk. Therefore, patients with IVCA and bilateral DVT warrant specialist consideration and may benefit from multidisciplinary team management, with hematology and vascular surgery input. Conclusion: Here, we showcased a rare cause for bilateral lower limb oedema, respectively bilateral deep venous thrombosis complicating IVCA in a patient with Beckwith-Wiedemann syndrome. The importance of this case lies in its novelty, as the association between IVC agenesis and BWS has not yet been described. Furthermore, the treatment of DVT in such situations requires special consideration, taking into account the patient’s weight and the presence of a significant, predisposing vascular abnormality.

Keywords: Beckwith-Wiedemann syndrome, bilateral deep venous thrombosis, inferior vena cava agenesis, venous thromboembolism

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1826 Advanced Techniques in Robotic Mitral Valve Repair

Authors: Abraham J. Rizkalla, Tristan D. Yan

Abstract:

Purpose: Durable mitral valve repair is preferred to a replacement, avoiding the need for anticoagulation or re-intervention, with a reduced risk of endocarditis. Robotic mitral repair has been gaining favour globally as a safe, effective, and reproducible method of minimally invasive valve repair. In this work, we showcase the use of the Davinci© Xi robotic platform to perform several advanced techniques, working synergistically to achieve successful mitral repair in advanced mitral disease. Techniques: We present the case of a Barlow type mitral valve disease with a tall and redundant posterior leaflet resulting in severe mitral regurgitation and systolic anterior motion. Firstly, quadrangular resection of P2 is performed to remove the excess and redundant leaflet. Secondly, a sliding leaflet plasty of P1 and P3 is used to reconstruct the posterior leaflet. To anchor the newly formed posterior leaflet to the papillary muscle, CV-4 Goretex neochordae are fashioned using the innovative string, ruler, and bulldog technique. Finally, mitral valve annuloplasty and closure of a patent foramen ovale complete the repair. Results: There was no significant residual mitral regurgitation and complete resolution of the systolic anterior motion of the mitral valve on post operative transoesophageal echocardiography. Conclusion: This work highlights the robotic approach to complex repair techniques for advanced mitral valve disease. Familiarity with resection and sliding plasty, neochord implantation, and annuloplasty allows the modern cardiac surgeon to achieve a minimally-invasive and durable mitral valve repair when faced with complex mitral valve pathology.

Keywords: robotic mitral valve repair, Barlow's valve, sliding plasty, neochord, annuloplasty, quadrangular resection

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1825 Economics of Fish-Plantain Integrated Farm Enterprise in Southern Nigeria

Authors: S. O. Obasa, J. A. Soaga, O. I. Afolabi, N. A. Bamidele, O. E. Babalola

Abstract:

Attempt to improve the income of the rural population is a welcome development in Nigeria. Integrated fish-crop farming has been suggested as a means of raising farm income, reducing wastage and mitigating the risk component in production through the complementarity gain. A feeding trial was carried out to investigate the replacement of maize with fermented unripe plantain (Musa paradisiaca) peel meal in the diet of Nile tilapia, Oreochromis niloticus. The economics of the integrated enterprise was assessed using budgetary analysis techniques. The analysis incorporated the material and labour costs as well as the returns from sale of matured fish and plantain. A total of 60 fingerlings of Nile tilapia (1.70±0.1 g) were stocked at 10 per plastic tank. Two iso-nitrogenous diets containing 35% crude protein in which maize meal was replaced by fermented unripe plantain peel meal at 0% (FUP0/Control diet), and 100% (FUP100) were formulated and prepared. The fingerlings were fed at 5% body weight per day for 56 days. Lowest feed conversion ratio of 1.39 in fish fed diet FUP100 was not significantly different (P > 0.05) from the highest 1.42 of fish fed the Control diet. The highest percentage profit of 88.85% in fish fed diet FUP100 was significantly higher than 66.68% in fish fed diet FUP0, while the profit index of 1.89 in fish fed diet FUP100 was significantly different from 1.67 in fish fed diet FUP0. Therefore, fermented unripe plantain peel meal can completely replace maize in the diet of O. niloticus fingerlings. Profitability assessment shows that the net income from the integration was ₦ 463,000 per hectare and the integration resulted to an increase of ₦ 87,750.00 representing a 12.2% increase than in separate production.

Keywords: fish-crop, income, Nile tilapia, waste management

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1824 Externalised Migration Controls and the Deportation of Minors and Potential Refugees from Mexico

Authors: Vickie Knox

Abstract:

Since the ‘urgent humanitarian crisis’ of the arrival of tens of thousands of Central American minors at the Mexico-US border in early 2014, the USA has increasingly externalised migration controls to Mexico. Although the resulting policy ‘Plan Frontera Sur’ claimed to protect migrants’ human rights, it has manifested as harshly delivered in-country controls and an alarming increase in deportations, particularly of minors. This is of particular concern given the ongoing situation of forced migration caused by criminal violence in Central America because these deportations do not all comply with Mexico’s international obligations and with its own legal framework for international protection that allows inter alia verbal asylum claims and grants minors additional protection against deportation. Notably, the volume of deportations, the speed with which they are carried out and the lack of adequate screening indicate non-compliance with the principle of non-refoulement and the right to claim asylum or other forms of protection. Based on qualitative data gathered in fieldwork in 2015 and quantitative data covering the period 2014-2016, this research details three types of adverse outcome resulting from these externalised controls: human rights violations perpetrated in order to deliver the policy–namely, deportations that may not comply with the principle of non-refoulement or the protection of minors; human rights violations perpetrated in the execution of policy–such as violations by state actors during apprehension and detention; and adverse consequences of the policy – such as increased risk during transit. This research has particular resonance as the Trump era brings tighter enforcement in the region, and has broader relevance for the study of externalisation tools on a global level.

Keywords: deportation, externalisation, forced migration, non-refoulement

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1823 Difficulties in the Emotional Processing of Intimate Partner Violence Perpetrators

Authors: Javier Comes Fayos, Isabel RodríGuez Moreno, Sara Bressanutti, Marisol Lila, Angel Romero MartíNez, Luis Moya Albiol

Abstract:

Given the great impact produced by gender-based violence, its comprehensive approach seems essential. Consequently, research has focused on risk factors for violent behaviour, linking various psychosocial variables, as well as cognitive and neuropsychological deficits with the aggressors. However, studies on affective processing are scarce, so the present study investigates possible emotional alterations in men convicted of gender violence. The participants were 51 aggressors, who attended the CONTEXTO program with sentences of less than two years, and 47 men with no history of violence. The sample did not differ in age, socioeconomic level, education, or alcohol and other substances consumption. Anger, alexithymia and facial recognition of other people´s emotions were assessed through the State-Trait Anger Expression Inventory (STAXI-2), the Toronto Alexithymia Scale (TAS-20) and Reading the mind in the eyes (REM), respectively. Men convicted of gender-based violence showed higher scores on the anger trait and temperament dimensions, as well as on the anger expression index. They also scored higher on alexithymia and in the identification and emotional expression subscales. In addition, they showed greater difficulties in the facial recognition of emotions by having a lower score in the REM. These results seem to show difficulties in different affective areas in men condemned for gender violence. The deficits are reflected in greater difficulty in identifying and expressing emotions, in processing anger and in recognizing the emotions of others. All these difficulties have been related to the use of violent behavior. Consequently, it is essential and necessary to include emotional regulation in intervention programs for men who have been convicted of gender-based violence.

Keywords: alexithymia, anger, emotional processing, emotional recognition, empathy, intimate partner violence

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1822 Safety Testing of Commercial Lithium-Ion Batteries and Failure Modes Analysis

Authors: Romeo Malik, Yashraj Tripathy, Anup Barai

Abstract:

Transportation safety is a major concern for vehicle electrification on a large-scale. The failure cost of lithium-ion batteries is substantial and is significantly impacted by higher liability and replacement cost. With continuous advancement on the material front in terms of higher energy density, upgrading safety characteristics are becoming more crucial for broader integration of lithium-ion batteries. Understanding and impeding thermal runaway is the prime issue for battery safety researchers. In this study, a comprehensive comparison of thermal runaway mechanisms for two different cathode types, Li(Ni₀.₃Co₀.₃Mn₀.₃)O₂ and Li(Ni₀.₈Co₀.₁₅Al₀.₀₅)O₂ is explored. Both the chemistries were studied for different states of charge, and the various abuse scenarios that lead to thermal runaway is investigated. Abuse tests include mechanical abuse, electrical abuse, and thermal abuse. Batteries undergo thermal runaway due to a series of combustible reactions taking place internally; this is observed as multiple jets of flame reaching temperatures of the order of 1000ºC. The physicochemical characterisation was performed on cells, prior to and after abuse. Battery’s state of charge and chemistry have a significant effect on the flame temperature profiles which is otherwise quantified as heat released. Majority of the failures during transportation is due to these external short circuit. Finally, a mitigation approach is proposed to impede the thermal runaway hazard. Transporting lithium-ion batteries under low states of charge is proposed as a way forward. Batteries at low states of charge have demonstrated minimal heat release under thermal runaway reducing the risk of secondary hazards such as thermal runaway propagation.

Keywords: battery reliability, lithium-ion batteries, thermal runaway characterisation, tomography

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1821 Medical Diagnosis of Retinal Diseases Using Artificial Intelligence Deep Learning Models

Authors: Ethan James

Abstract:

Over one billion people worldwide suffer from some level of vision loss or blindness as a result of progressive retinal diseases. Many patients, particularly in developing areas, are incorrectly diagnosed or undiagnosed whatsoever due to unconventional diagnostic tools and screening methods. Artificial intelligence (AI) based on deep learning (DL) convolutional neural networks (CNN) have recently gained a high interest in ophthalmology for its computer-imaging diagnosis, disease prognosis, and risk assessment. Optical coherence tomography (OCT) is a popular imaging technique used to capture high-resolution cross-sections of retinas. In ophthalmology, DL has been applied to fundus photographs, optical coherence tomography, and visual fields, achieving robust classification performance in the detection of various retinal diseases including macular degeneration, diabetic retinopathy, and retinitis pigmentosa. However, there is no complete diagnostic model to analyze these retinal images that provide a diagnostic accuracy above 90%. Thus, the purpose of this project was to develop an AI model that utilizes machine learning techniques to automatically diagnose specific retinal diseases from OCT scans. The algorithm consists of neural network architecture that was trained from a dataset of over 20,000 real-world OCT images to train the robust model to utilize residual neural networks with cyclic pooling. This DL model can ultimately aid ophthalmologists in diagnosing patients with these retinal diseases more quickly and more accurately, therefore facilitating earlier treatment, which results in improved post-treatment outcomes.

Keywords: artificial intelligence, deep learning, imaging, medical devices, ophthalmic devices, ophthalmology, retina

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1820 Mistranslation in Cross Cultural Communication: A Discourse Analysis on Former President Bush’s Speech in 2001

Authors: Lowai Abed

Abstract:

The differences in languages play a big role in cross-cultural communication. If meanings are not translated accurately, the risk can be crucial not only on an interpersonal level, but also on the international and political levels. The use of metaphorical language by politicians can cause great confusion, often leading to statements being misconstrued. In these situations, it is the translators who struggle to put forward the intended meaning with clarity and this makes translation an important field to study and analyze when it comes to cross-cultural communication. Owing to the growing importance of language and the power of translation in politics, this research analyzes part of President Bush’s speech in 2001 in which he used the word “Crusade” which caused his statement to be misconstrued. The research uses a discourse analysis of cross-cultural communication literature which provides answers supported by historical, linguistic, and communicative perspectives. The first finding indicates that the word ‘crusade’ carries different meaning and significance in the narratives of the Western world when compared to the Middle East. The second one is that, linguistically, maintaining cultural meanings through translation is quite difficult and challenging. Third, when it comes to the cross-cultural communication perspective, the common and frequent usage of literal translation is a sign of poor strategies being followed in translation training. Based on the example of Bush’s speech, this paper hopes to highlight the weak practices in translation in cross-cultural communication which are still commonly used across the world. Translation studies have to take issues such as this seriously and attempt to find a solution. In every language, there are words and phrases that have cultural, historical and social meanings that are woven into the language. Literal translation is not the solution for this problem because that strategy is unable to convey these meanings in the target language.

Keywords: crusade, metaphor, mistranslation, war in terror

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1819 Genetics of Atopic Dermatitis: Role of Cytokines Genes Polymorphisms

Authors: Ghaleb Bin Huraib, Fahad Al Harthi, Misbahul Arfin, Abdulrahman Al-Asmari

Abstract:

Atopic dermatitis (AD), also known as atopic eczema, is a chronic inflammatory skin disease characterized by severe itching and recurrent relapsing eczema-like skin lesions, affecting up to 20% of children and 10% of adults in industrialized countries. AD is a complex multifactorial disease, and its exact etiology and pathogenesis have not been fully elucidated. The aim of this study was to investigate the impact of gene polymorphisms of T helper cell subtype Th1 and Th2 cytokines, interferon-gamma (IFN-γ), interleukin-6 (IL-6) and transforming growth factor (TGF)-β1on AD susceptibility in a Saudi cohort. One hundred four unrelated patients with AD and 195 healthy controls were genotyped for IFN-γ (874A/T), IL-6 (174G/C) and TGF-β1 (509C/T) polymorphisms using ARMS-PCR and PCR-RFLP technique. The frequency of genotypes AA and AT of IFN-γ (874A/T) differed significantly among patients and controls (P 0.001). The genotype AT was increased while genotype AA was decreased in AD patients as compared to controls. AD patients also had higher frequency of T containing genotypes (AT+TT) than controls (P = 0.001). The frequencies of allele T and A were statistically different in patients and controls (P = 0.04). The frequencies of genotype GG and allele G of IL-6 (174G/C) were significantly higher while genotype GC and allele C were lower in AD patients than controls. There was no significant difference in the frequencies of alleles and genotypes of TGF-β1 (509C/T) polymorphism between patient and control groups. These results showed that susceptibility to AD is influenced by presence or absence of genotypes of IFN-γ (874A/T) and IL-6 (174G/C) polymorphisms. It is concluded that T-allele and T-containing genotypes (AT+TT) of IFN-γ (874A/T) and G-allele and GG genotype ofIL-6 (174G/C) polymorphisms are susceptible to AD in Saudis.On the other hand, the TGF-β1 (509C/T) polymorphism may not be associated with AD risk in Saudi population however further studies with large sample size are required to confirm these findings.

Keywords: atopic dermatitis, interferon-γ, interleukin-6, transforming growth factor-β1, polymorphism

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1818 Novel Use of a Quality Assurance Tool for Integrating Technology to HSE

Authors: Ragi Poyyara, V. Vivek, Ashish Khaparde

Abstract:

The Product Development Process (PDP) in the technology group plays a very important role in the launch of any product. While a manufacturing process encourages the use of certain measures to reduce Health, Safety and Environmental (HSE) risks on the shop floor, the PDP concentrates on the use of Geometric Dimensioning and Tolerancing (GD&T) to develop a flawless design. Furthermore, PDP distributes and coordinates activities between different departments such as marketing, purchasing, and manufacturing. However, it is seldom realized that PDP makes a significant contribution to developing a product that reduces HSE risks by encouraging the Technology group to use effective GD&T. The GD&T is a precise communication tool that uses a set of symbols, rules, and definitions to mathematically define parts to be manufactured. It is a quality assurance method widely used in the oil and gas sector. Traditionally it is used to ensure the interchangeability of a part without affecting its form, fit, and function. Parts that do not meet these requirements are rejected during quality audits. This paper discusses how the Technology group integrates this quality assurance tool into the PDP and how the tool plays a major role in helping the HSE department in its goal towards eliminating HSE incidents. The PDP involves a thorough risk assessment and establishes a method to address those risks during the design stage. An illustration shows how GD&T helped reduce safety risks by ergonomically improving assembling operations. A brief discussion explains how tolerances provided on a part help prevent finger injury. This tool has equipped Technology to produce fixtures, which are used daily in operations as well as manufacturing. By applying GD&T to create good fits, HSE risks are mitigated for operating personnel. Both customers and service providers benefit from reduced safety risks.

Keywords: HSE risks, product development process, geometric dimensioning and tolerances, mechanical engineering

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1817 Development of an Online Raw-Vegan Eating Program to Reduce Sugar Intake

Authors: Sara D. Garduno-Diaz, Lorena Loriato

Abstract:

Food selection is one of the main modifiable risk factors for the avoidance of several detrimental health conditions. Excessive and regular sugar intake has been identified as highly unfavorable, yet a highly occurring practice. A proposed approach to modify this eating practice is the online program developed here. The program targets a modification of mindset and lifestyle habits around food, through a four week raw-vegan guided eating program. While the focus of the program is to set up sustainable changes in sugar intake reduction, it also aims to promote a plant-based eating style. Three pilot sessions have been run with participants from seven different countries. Participants are guided through the program via a combination of daily e-mails, a 24-hour support platform, and by-weekly remote live sessions. Meal preparation techniques, as well as cooking instructions, are provided, following set menus developed by a team of professional chefs and nutritionists. Goal setting, as well as alternatives to specific food-related challenges, is addressed. While the program is intended for both women and men, the majority of participants to date have been female. Feedback has been positive, with changes in eating habits have included an elimination of added sugars, an increase in home cooking and vegetable intake, and a reduction in foods of animal origin. Difficulties in following the program have been reported as unavailability of certain ingredients depending on the country of residence of the participants, social and cultural hurdles, and time restrictions. Nevertheless, the results obtained to date indicate this to be a highly interactive program with the potential to be scaled up and applied to various populations as a public health measure on the way to better health.

Keywords: eating habits, food addiction, nutrition education, plant-based, remote practice

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