Search results for: religious months
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3244

Search results for: religious months

2584 Factor Associated with Uncertainty Undergoing Hematopoietic Stem Cell Transplantation

Authors: Sandra Adarve, Jhon Osorio

Abstract:

Uncertainty has been studied in patients with different types of cancer, except in patients with hematologic cancer and undergoing transplantation. The purpose of this study was to identify factors associated with uncertainty in adults patients with malignant hemato-oncology diseases who are scheduled to undergo hematopoietic stem cell transplantation based on Merle Mishel´s Uncertainty theory. This was a cross-sectional study with an analytical purpose. The study sample included 50 patients with leukemia, myeloma, and lymphoma selected by non-probability sampling by convenience and intention. Sociodemographic and clinical variables were measured. Mishel´s Scale of Uncertainty in Illness was used for the measurement of uncertainty. A bivariate and multivariate analyses were performed to explore the relationships and associations between the different variables and uncertainty level. For this analysis, the distribution of the uncertainty scale values was evaluated through the Shapiro-Wilk normality test to identify statistical tests to be used. A multivariate analysis was conducted through a logistic regression using step-by-step technique. Patients were 18-74 years old, with a mean age of 44.8. Over time, the disease course had a median of 9.5 months, an opportunity was found in the performance of the transplantation of < 20 days for 50% of the patients. Regarding the uncertainty scale, a mean score of 95.46 was identified. When the dimensions of the scale were analyzed, the mean score of the framework of stimuli was 25.6, of cognitive ability was 47.4 and structure providers was 22.8. Age was identified to correlate with the total uncertainty score (p=0.012). Additionally, a statistically significant difference was evidenced between different religious creeds and uncertainty score (p=0.023), education level (p=0.012), family history of cancer (p=0.001), the presence of comorbidities (p=0.023) and previous radiotherapy treatment (p=0.022). After performing logistic regression, previous radiotherapy treatment (OR=0.04 IC95% (0.004-0.48)) and family history of cancer (OR=30.7 IC95% (2.7-349)) were found to be factors associated with the high level of uncertainty. Uncertainty is present in high levels in patients who are going to be subjected to bone marrow transplantation, and it is the responsibility of the nurse to assess the levels of uncertainty and the presence of factors that may contribute to their presence. Once it has been valued, the uncertainty must be intervened from the identified associated factors, especially all those that have to do with the cognitive capacity. This implies the implementation and design of intervention strategies to improve the knowledge related to the disease and the therapeutic procedures to which the patients will be subjected. All interventions should favor the adaptation of these patients to their current experience and contribute to seeing uncertainty as an opportunity for growth and transcendence.

Keywords: hematopoietic stem cell transplantation, hematologic diseases, nursing, uncertainty

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2583 Sounds of Power: An Ethnoorganological Approach to Understanding Colonial Music Culture in the Peruvian Andes

Authors: Natascha Reich

Abstract:

In colonial Peru, the Spanish crown relied on religious orders, most notably Dominicans, Franciscans, and Jesuits, for accelerating processes of colonization. The dissemination of Christian art, architecture, and music, and most of all, the agency of indigenous people in their production played a key role in facilitating the acceptance of the new religious and political system. Current research on Peruvian colonial music culture and its role as a vehicle for colonization focus on practices in urban centers. The lack of (written) primary sources seems to turn rural areas into a less attractive research territory for musicologists. This paper advocates for a more inclusive approach. By investigating seventeenth-century pipe organs as material remains of Franciscan missionary music culture, it shows how reactions to colonial forces and Christianization in rural Andean locations could follow tendencies different from those in urban areas. Indigenous musicians in cities tried to 'fit' into the European system in order to be accepted by the ruling Spanish elite. By contrast, the indigenous-built pipe organs in the rural Peruvian Colca-Valley show distinctly native-Andean influences. This paper argues that this syncretism can be interpreted as hybridity in Homi K. Bhabha’s sense, as a means of the colonized to undermine the power of the colonizer and to advance reactionary politics. Not only will it show the necessity of considering rural Peruvian music history in modern scholarship for arriving at a more complete picture of colonial culture, but it will also evidence the advantages of a mixed-methodology approach. Historical organology, combined with concepts from ethnomusicology and post-colonial studies, proves as a useful tool in the absence or scarcity of written primary sources.

Keywords: cultural hybridity, music as reactionary politics, Latin American pipe organs, Peruvian colonial music

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2582 Prospective Study to Determine the Efficacy of Day Hospital Care to Improve Treatment Adherence for Hospitalized Schizophrenic Patients

Authors: Jin Hun Choi, So Hyun Ahn, Seong Keun Wang, Ik-Seung Chee, Jung Lan Kim, Sun Woo Lee

Abstract:

Objectives: The purpose of the study is to investigate the effects of day hospital care in hospitalized schizophrenic patients in terms of treatment adherence and treatment outcomes. Methods: Among schizophrenic patients hospitalized between 2011 and 2012, 23 day hospital care patient and 40 control subjects were included in the study. All candidates underwent Beck Cognitive Insight Scale, Drug Attitude Inventory, World Health Organization Quality of Life Assessment and Psychological Well-Being Scale when their symptoms were stabilized during hospitalization, and after being discharged, 23 patients received day hospital care for two months and then changed to out-patient care while 40 patients received out-patient care immediately after discharge. At the point of two months of out-patient care, the treatment adherence of the two groups was evaluated; tracking observation was performed until February, 2013, and survival rates were compared between the two groups. Results: Treatment adherence was higher in the day hospital care group than in the control group. Kaplan-Meier survival analysis showed a higher survival rate for the day hospital care group compared to the control group. Levels of cognitive insight and quality of life were higher after day hospital care than before day hospital care in the day hospital care group. Conclusions: Through the study, it was confirmed that when hospitalized schizophrenic patients received continuous day hospital care after being discharged, they received further out-patient care more faithfully. The study is considered to aid in the understanding regarding schizophrenic patients’ treatment adherence issues and improvement of treatment outcomes.

Keywords: schizophrenia, day hospital care, adherence, outcomes

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2581 Effect of Omeprazole on the Renal Cortex of Adult Male Albino Rats and the Possible Protective Role of Ginger: Histological and Immunohistochemical study

Authors: Nashwa A. Mohamed

Abstract:

Introduction: Omeprazole is a proton pump inhibitor used commonly in the treatment of acid-peptic disorders. Although omeprazole is generally well tolerated, serious adverse effects such as renal failure have been reported. Ginger is an antioxidant that could play a protective role in models of experimentally induced nephropathies. Aim of the work: The aim of this work was to study the possible histological changes induced by omeprazole on renal cortex and evaluate the possible protective effect of ginger on omeprazole-induced renal damage in adult male albino rats. Materials and methods: Twenty-four adult male albino rats divided into four groups (six rats each) were used in this study. Group I served as the control group. Rats of group II received only an aqueous extract of ginger daily for 3 months through a gastric tube. Rats of group III were received omeprazole orally through a gastric tube for 3 months. Rats of group IV were given both ginger and omeprazole at the same doses and through the same routes as the previous two groups. At the end of the experiment, the rats were sacrificed. Renal tissue samples were processed for light, immunohistochemical and electron microscopic examination. The obtained results were analysed morphometrically and statistically. Results: Omeprazole caused several histological changes in the form of loss of normal appearance of renal cortex with degenerative changes in the renal corpuscle and tubules. Cellular infilteration was also observed. The filteration barrier was markedly affected. Ginger ameliorated the omeprazole-induced histological changes. Conclusion: Omeprazole induced injurious effects on renal cortex. Coadministration of ginger can ameliorate the histological changes induced by omeprazole.

Keywords: ginger, kidney, omeprazole, rat

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2580 Impact of Sufism on Indian Cinema: A New Cultural Construct for Mediating Conflict

Authors: Ravi Chaturvedi, Ghanshyam Beniwal

Abstract:

Without going much into the detail of long history of Sufism in the world and the etymological definition of the word ‘Sufi’, it will be sufficient to underline that the concept of Sufism was to focus the mystic power on the spiritual dimension of Islam with a view-shielding the believers from the outwardly and unrealistic dogma of the faith. Sufis adopted rather a liberal view in propagating the religious order of Islam suitable to the cultural and social environment of the land. It is, in fact, a mission of higher religious order of any faith, which disdains strife and conflict in any form. The joy of self-realization being the essence of religion is experienced after a long spiritual practice. India had Sufi and Bhakti (devotion) traditions in Islam and Hinduism, respectively. Both Sufism and Bhakti traditions were based on respect for different religions. The poorer and lower caste Hindus and Muslims were greatly influenced by these traditions. Unlike Ulemas and Brahmans, the Sufi and Bhakti saints were highly tolerant and open to the truth in other faiths. They never adopted sectarian attitudes and were never involved in power struggles. They kept away from power structures. Sufism is integrated with the Indian cinema since its initial days. In the earliest Bollywood movies, Sufism was represented in the form of qawwali which made its way from dargahs (shrines). Mixing it with pop influences, Hindi movies began using Sufi music in a big way only in the current decade. However, of late, songs with Sufi influences have become de rigueur in almost every film being released these days, irrespective of the genre, whether it is a romantic Gangster or a cerebral Corporate. 'Sufi is in the DNA of the Indian sub-continent', according to several contemporary filmmakers, critics, and spectators.The inherent theatricality motivates the performer of the 'Sufi' rituals for a dramatic behavior. The theatrical force of these stages of Sufi practice is so powerful that even the spectator cannot resist himself from being moved. In a multi-cultural country like India, the mediating streams have acquired a multi-layered importance in recent history. The second half of Indian post-colonial era has witnessed a regular chain of some conflicting religio-political waves arising from various sectarian camps in the country, which have compelled the counter forces to activate for keeping the spirit of composite cultural ethos alive. The study has revealed that the Sufi practice methodology is also being adapted for inclusion of spirituality in life at par to Yoga practice. This paper, a part of research study, is an attempt to establish that the Sufism in Indian cinema is one such mediating voice which is very active and alive throughout the length and width of the country continuously bridging the gap between various religious and social factions, and have a significant role to play in future as well.

Keywords: Indian cinema, mediating voice, Sufi, yoga practice

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2579 The Role of Rapid Maxillary Expansion in Managing Obstructive Sleep Apnea in Children: A Literature Review

Authors: Suleman Maliha, Suleman Sidra

Abstract:

Obstructive sleep apnea (OSA) is a sleep disorder that can result in behavioral and psychomotor impairments in children. The classical treatment modalities for OSA have been continuous positive airway pressure and adenotonsillectomy. However, orthodontic intervention through rapid maxillary expansion (RME) has also been commonly used to manage skeletal transverse maxillary discrepancies. Aim and objectives: The aim of this study is to determine the efficacy of rapid maxillary expansion in paediatric patients with obstructive sleep apnea by assessing pre and post-treatment mean apnea-hypopnea index (AHI) and oxygen saturations. Methodology: Literature was identified through a rigorous search of the Embase, Pubmed, and CINAHL databases. Articles published from 2012 onwards were selected. The inclusion criteria consisted of patients aged 18 years and under with no systemic disease, adenotonsillar surgery, or hypertrophy who are undergoing RME with AHI measurements before and after treatment. In total, six suitable papers were identified. Results: Three studies assessed patients pre and post-RME at 12 months. The first study consisted of 15 patients with an average age of 7.5 years. Following treatment, they found that RME resulted in both higher oxygen saturations (+ 5.3%) and improved AHI (- 4.2 events). The second study assessed 11 patients aged 5–8 years and also noted improvements, with mean AHI reduction from 6.1 to 2.4 and oxygen saturations increasing from 93.1% to 96.8%. The third study reviewed 14 patients aged 6–9 years and similarly found an AHI reduction from 5.7 to 4.4 and an oxygen saturation increase from 89.8% to 95.5%. All modifications noted in these studies were statistically significant. A long-term study reviewed 23 patients aged 6–12 years post-RME treatment on an annual basis for 12 years. They found that the mean AHI reduced from 12.2 to 0.4, with improved oxygen saturations from 78.9% to 95.1%. Another study assessed 19 patients aged 9-12 years at two months into RME and four months post-treatment. Improvements were also noted at both stages, with an overall reduction of the mean AHI from 16.3 to 0.8 and an overall increase in oxygen saturations from 77.9% to 95.4%. The final study assessed 26 children aged 7-11 years on completion of individual treatment and found an AHI reduction from 6.9 to 5.3. However, the oxygen saturation remained stagnant at 96.0%, but this was not clinically significant. Conclusion: Overall, the current evidence suggests that RME is a promising treatment option for paediatric patients with OSA. It can provide efficient and conservative treatment; however, early diagnosis is crucial. As there are various factors that could be contributing to OSA, it is important that each case is treated on its individual merits. Going forward, there is a need for more randomized control trials with larger cohorts being studied. Research into the long-term effects of RME and potential relapse amongst cases would also be useful.

Keywords: orthodontics, sleep apnea, maxillary expansion, review

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2578 The Adaptation and Evaluation of a Psychoeducational Program for Patients with Depression in General Practices in Germany

Authors: Feyza Gökce, Jochen Gensichen, Antonius Schneider, Karolina de Valerio, Gabriele Pitschel-Walz

Abstract:

People with depressive symptoms often first consult a General Practitioner (GP) before making use of other treatment options. The present study shows the adaptation and evaluation of a psychoeducational program for patients with depressive symptoms that are treated by GPs in Bavaria, Germany. The adaptation of an existing psychoeducational program, that is used in inpatient psychiatric settings, was performed in exchange with experts (psychotherapists, general practitioners, and a patient representative). As a result, a program consisting of 4 psychoeducational sessions was developed, which is carried out in individual settings in GP practices by the practitioners themselves. This program will be compared to treatment as usual that patients with depression receive by GPs. Data is collected at 3 measurement points (baseline, 3-months-follow-up, 6-months-follow-up) using different questionnaires (BDI-II, D-Lit-R German, FERUS, PAM13-D, PHQ-9, GAD-7, PHQ-15, PC-PTSD-5). In addition to the change in depressive symptoms, changes in depression knowledge, self-efficacy, and patient activation will be analyzed, and the feasibility of the program and the subjective benefit for GPs and patients will be assessed. By now, 84 patients have been recruited by 20 cluster-randomized GP practices, with 73.5% of the participants being female and 26.5% being males. The average age was M= 50.1 (SD= 14.67) years. The change in depression symptoms over the 3-month period will be compared between the two study conditions by using a linear mixed model by the end of data collection (December 2023). The subjective benefit for the patients and GPs will be assessed via feedback questionnaires. Results will be presentable by the beginning of 2024 and will provide indications for further development and barriers to the implementation of such a program for GP practices.

Keywords: depression, general practice, psychoeducation, primary care

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2577 Concentrated Whey Protein Drink with Orange Flavor: Protein Modification and Formulation

Authors: Shahram Naghizadeh Raeisi, Ali Alghooneh

Abstract:

The application of whey protein in drink industry to enhance the nutritional value of the products is important. Furthermore, the gelification of protein during thermal treatment and shelf life makes some limitations in its application. So, the main goal of this research is manufacturing of high concentrate whey protein orange drink with appropriate shelf life. In this way, whey protein was 5 to 30% hydrolyzed ( in 5 percent intervals at six stages), then thermal stability of samples with 10% concentration of protein was tested in acidic condition (T= 90 °C, pH=4.2, 5 minutes ) and neutral condition (T=120° C, pH:6.7, 20 minutes.) Furthermore, to study the shelf life of heat treated samples in 4 months at 4 and 24 °C, the time sweep rheological test were done. At neutral conditions, 5 to 20% hydrolyzed sample showed gelling during thermal treatment, whereas at acidic condition, was happened only in 5 to 10 percent hydrolyzed samples. This phenomenon could be related to the difference in hydrodynamic radius and zeta potential of samples with different level of hydrolyzation at acidic and neutral conditions. To study the gelification of heat resistant protein solutions during shelf life, for 4 months with 7 days intervals, the time sweep analysis were performed. Cross over was observed for all heat resistant neutral samples at both storage temperature, while in heat resistant acidic samples with degree of hydrolysis, 25 and 30 percentage at 4 and 20 °C, it was not seen. It could be concluded that the former sample was stable during heat treatment and 4 months storage, which made them a good choice for manufacturing high protein drinks. The Scheffe polynomial model and numerical optimization were employed for modeling and high protein orange drink formula optimization. Scheffe model significantly predicted the overal acceptance index (Pvalue<0.05) of sensorial analysis. The coefficient of determination (R2) of 0.94, the adjusted coefficient of determination (R2Adj) of 0.90, insignificance of the lack-of-fit test and F value of 64.21 showed the accuracy of the model. Moreover, the coefficient of variable (C.V) was 6.8% which suggested the replicability of the experimental data. The desirability function had been achieved to be 0.89, which indicates the high accuracy of optimization. The optimum formulation was found as following: Modified whey protein solution (65.30%), natural orange juice (33.50%), stevia sweetener (0.05%), orange peel oil (0.15%) and citric acid (1 %), respectively. Its worth mentioning that this study made an appropriate model for application of whey protein in drink industry without bitter flavor and gelification during heat treatment and shelf life.

Keywords: croos over, orange beverage, protein modification, optimization

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2576 The Consequences of COVID-19 Crisis on Informal Workers in Brazil: An Analysis of Emergency Aid from the Government

Authors: Michele Romanello

Abstract:

COVID-19 has spread rapidly in Brazil since March 2020, making the country one of the most affected in the world by the pandemic. From an economic point of view, Brazil came from a pre-pandemic period characterized by low or negative growth, with a resulting increase in the number of unemployed and informal workers. This paper considers lockdown implementation in the situation of the large presence of informality in the economy. The objective of the paper is to analyze how the country has tried to help workers affected by economic crisis after the implementation of measures against COVID-19 and whether the emergency assistance from the government has been adequate to contain the increase of informal workers and unemployed. The methodology used in this paper is survival analysis. Through this methodology, the formality – informality, and informality – unemployment transitions are analyzed. This analysis draws data from the Continuous National Household Sample Survey (Continuous PNAD) and from the National Household Sample Survey COVID-19 (PNAD COVID-19) covering the period of January 2020 – July 2020. The results indicate that emergency aid has been not sufficient to reduce the transitions of workers from formal to informal jobs and from informal jobs to unemployment. Emergency aid has been not sufficient considering the previous situation of the country, with levels of poverty and inequality very high. In the next months, another fundamental determinant of the income trajectory in the context of the COVID-19 crisis will be the continuity of the emergency aid, especially considering the fiscal adjustment policy pursued by the government. Therefore, the current negative portrait may be even worse in the coming months.

Keywords: Brazil, COVID-19, informality, survival analysis

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2575 Child Feeding Practices of Mothers (Childbearing) and Exploration of Their Household Food Insecurity in a Coastal Region of Bangladesh

Authors: Md Abdullah Al Mamun

Abstract:

Background: The current situation of Ensuring WHO recommended feeding practices for infant and young children which is becoming a challenge nowadays in many developing countries, especially in areas where household food security is at risk. Because many households of the developing countries often encounter severe food insecurity hence provision of adequate child nutrition is threatened. Aim: The study aimed to assess the child feeding practices of 0-24 months childbearing mothers and explore their household food insecurity in a coastal region of Bangladesh. Methods: This study was conducted in Suborno Char (one of the coastal suburbs in Noakhali District in Bangladesh) from October 2019 to April 2020. A total of 400 mothers were selected with their children of 0-24 months following a cross sectional study sampling procedure of the population. Data were collected through a standard questionnaire and analyzed using statistical tests in SPSS version 20.0.0. Results: The frequency of exclusive breastfeeding, timely initiation of complementary feeding, and giving foods from four food groups to the children were 53.5%, 75.5%, and 22.2%, respectively. Mother's level of education showed a strong association with the child feeding practices of the mothers. Mothers of severely food insecure households showed lower odds in exclusive breastfeeding practice (COR 0.233 at 95% CI 0.083, 0.655; and AOR 0.478 at 95% CI 0.133, 1.713) than mothers of food secured households. Similar results have also been found in case of timely initiation of complementary feeding and minimum dietary diversity of the children.

Keywords: household food insecurity, exclusive breastfeeding, complementary feeding, maternal education, mothers age, household income

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2574 Evaluating the Effects of an Educational Video on Running Shoe Selection and Subjective Perceptions

Authors: Andrew Fife, Jean-Francois Esculier, Codi Ramsey, Kim Hebert-Losier

Abstract:

Objectives: We aimed to identify how an evidence-based educational video influences how runners select shoes, and perceive shoe comfort, satisfaction, and performance over three months in comparison with a control video. Design: Two groups participated in a double-blind randomised controlled trial. Method: Fifty-six runners were randomly assigned to view one of two video presentations prior to purchasing new shoes for road running in speciality stores. Runners completed a survey with regards to their own shoes and one in reference to the new shoes purchased at three timepoints: before first use, onemonth post-purchase, and three-months post-purchase. Perceived shoe comfort, satisfaction, and performance were assessed using 100 mm visual analogue scales. Factors that influenced their shoe purchase were ranked in order of importance. Results: Comfort and satisfaction were not significantly different between groups and timepoints. The perceived performance of new shoes (75.6 mm) was significantly greater than own shoes (mean: 67.6 mm) before first use, but ratings returned to own-shoe levels one month later in both groups. The group receiving the evidence-based presentation reported their purchased shoes as being influenced more by the video (55.4 mm) than the control group (21.8 mm), although both chose the same brand and model as previously worn over half of the time. Runners in both groups prioritised fit, comfort, and choosing similar shoes to the ones they previously used. Conclusions: In contrast to expectations, the evidence-based educational video did not appear to influence running shoe selection, or overall perceived shoe comfort, satisfaction, or performance.

Keywords: comfort, consumer behaviour, consciousness, education, running, shoes

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2573 Effects of Bariatric Surgery on Preventing the Progression of Diabetic Retinopathy

Authors: Yunzi Chen, James Laybourne, Sarah Steven, Peter Carey, David Steel, Maria Sandinha

Abstract:

Introduction: Bariatric surgery is popular with the rising incidence of obesity. Its well-known benefits include significant and rapid glycaemic control. However, cases of paradoxical worsening in diabetic retinopathy (DR) despite improved glycaemic control have been reported. Purpose: clarification on the evolution of diabetic retinopathy after bariatric surgery. Method: retrospective study of 40 patients with Type 2 diabetes who underwent bariatric surgery in a UK specialist bariatric unit between 2009 and 2011. Pre-operative and post-operative visual acuity (VA), weight, HbA1c and annual DRSS screening results were analysed. Median follow up was 50 months. Results: No significant change in VA was found during the post-operative period. 85% of patients improved HbA1c post-operatively of which 53% achieved non-diabetic HbA1c of <6.1% - despite this, 2 patients developed new DR. First post-operative screening showed 80% of patients experienced no change, 8% improved but 13% of patients developed new DR (1 case with sight-threatening maculopathy). 80% of these cases persisted up to 24 months. The proportion of patients developing new or worse DR fluctuated over time, peaking at the 3rd annual screening with 26% (15% regressed, 56% stable). The probability of developing new or worse DR postoperatively was significantly associated with a high pre-operative HbA1c (>8%) and male gender. Conclusions: bariatric surgery does not guarantee long-term improvement or prevention of DR. Asymptomatic changes in DR occurred up to 5 years postoperatively. We therefore consider it prudent to continue screening in this cohort of patients.

Keywords: bariatric surgery, diabetic retinopathy, obesity, type 2 diabetes mellitus

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2572 Evaluation of Magnificent Event of India with Special Reference to Maha Kumbha Mela (Fair) 2013-A Congregation of Millions

Authors: Sharad Kumar Kulshreshtha

Abstract:

India is a great land of cultural and traditional diversity. Its spectrums create a unique ambiance in all over the country. Specially, fairs and festivals are ancient phenomena in Indian culture. In India, there are thousands of such religious, spiritual, cultural fairs organized on auspicious occasions. These fairs reflect the effective and efficient role of social governance and responsibility of Indian society. In this context a mega event known as ‘Kumbha Mela’ literally mean ‘Kumbha Fair’ which is organize after every twelve years at (Prayaag) Allahabad an ancient city of India, now is in the state of Uttar Pradesh. Kumbh Mela is one of the largest human congregations on the Earth. The Kumbha Mela that is held here is considered to be the largest and holiest city among the four cities where Kubha fair organize. According to the Hindu religious scripture a dip for possessing the holy confluence, known as Triveni Sangam, which is a meeting point of the three sacred rivers of India i.e., –Ganges, Yamuna and Saraswati (mythical). During the Kumbha fair the River Ganges is believed to turn to nectar, bringing great blessing to everyone who bathes in it. Other activities include religious discussions, devotional singings and mass feedings pilgrims and poor. The venue for Kumbh Mela (fair) depends on the position Sun, Moon, and Jupiter which holds in that period in different zodiac signs. More than 120 Millions (12 Crore) people visited in the Kumbha Fair-2013 in Allahabad. A temporary tented city was set up for the pilgrims over an area of 2 hectares of the land along the river of Ganges. As many as 5 power substations, temporary police stations, hospitals, bus terminals, stalls were set up for providing various facilities to the visitors and thousands of volunteers participated for assistance of this event. All efforts made by fair administration to provide facility to visitors, such security and sanitation, medical care and frequent water and power supply. The efficient and timely arrangement at the Kumbha Mela attracted the attention of many government and institutions. The Harvard University of USA conducted research to find out how it was made possible. This paper will focuses on effective and efficient planning and preparation of Kumbha Fair which includes facilitation process, role of various coordinating agencies. risk management crisis management strategies Prevention, Preparedness, Response, and Recovery (PPRR Approach), emergency response plan (ERP), safety and security issues, various environmental aspects along with health hazards and hygiene crowd management, evacuation, monitoring, control and evaluation.

Keywords: event planning and facility arrangement, risk management, crowd management, India

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2571 Children's Literature and the Study of the Sociological Approach

Authors: Sulmaz Mozaffari, Zahra Mozaffari, Saman Mozaffari

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Man has always tried to find the Ideal place for life and he has experienced a lot of problems. So many internal and external limits has been on his way. Today man is threatened by so many crisis because of his specific look to the world. Literature as a universal science has not ignored this problem either. Children's literature has tried to present the social, cultural, religious and economical problems in tales and novels. This research tries to analyse social and cultural problems related to 10th century children from social point of criticism.

Keywords: social criticism, crisis, children's literature, tale

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2570 Frenotomy for Tongue Tie: The Unlikely Benefit of Massage

Authors: Kailas Bhandarkar, Talib Dar, Laura Karia, Manasvi Upadhyaya

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Introduction: Frenotomy for tongue tie is commonly performed in breastfed infants who experience difficulty in latching after failed conservative management for tongue tie. However, there is no consensus for the routine use of massage following frenotomy. Our aim was to assess the efficacy of massage in preventing recurrence following frenotomy. Methods: The tongue tie service in our tertiary referral hospital consists of 5 consultants and a breastfeeding (BF) midwife. 3 consultants routinely advice massage post procedure. Babies are assessed by the midwife after the procedure and a follow-up consultation after a week. After due ethical approval, data were collected by two staff members who were independent of TT service on a standardized questionnaire to avoid bias. Fischer exact test was employed (p < 0.05 considered significant). Results: Six hundred and thirty-two babies attended the clinic from January 2018 to December 2018. Thirty-three of these were excluded as the procedure was not needed. Parents were contacted at a median of six months post-procedure (range 2-10 months). 282/599 were advised massage. 92/282 could be contacted. 40/ 92 adhered to massage regimen. None of these had a recurrence. 52/92 (54%), although advised, did not perform massage. Reasons cited for lack of adherence to massage included difficulty in performing massaging and conflicting advice given by other health care professionals involved in patient care like paediatricians and group practice and lack of information on the internet). Overall, 4/599 (0.66%) had recurrences, and this difference was not statistically significant. Conclusion: In our experience, the rate of recurrence after frenotomy is low enough for us to conclude that there is no significant benefit of massage after frenotomy for tongue tie. We could also conclude that among parents who were advised massage more than half failed to adhere to the advice.

Keywords: tongue tie, frenotomy, massage, recurrence

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2569 A Study of the Effect of Early and Late Meal Time on Anthropometric and Biochemical Parameters in Patients of Type 2 Diabetes

Authors: Smriti Rastogi, Narsingh Verma

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Background: A vast body of research exists on the use of oral hypoglycaemic drugs, insulin injections and the like in managing diabetes but no such research exists that has taken into consideration the parameter of time restricted meal intake and its positive effects in managing diabetes. The utility of this project is immense as it offers a solution to the woes of diabetics based on circadian rhythm and normal physiology of the human body. Method: 80 Diabetics, enrolled from the Out Patient Department of Endocrinology, KGMU (King George's Medical University) were randomly divided based on consent to early dinner TRM(time restricted meal) group or not (control group). Follow up was done at six months and 12 months for anthropometric measurement, height, weight, waist-hip ratio, neck size, fasting, postprandial blood sugar, HbA1c, serum urea, serum creatinine, and lipid profile. The patient was given a clear understanding of chronomedicine and how it affects their health. A single intervention was done - the timing of dinner was at or around 7 pm for TRM group. Result: 65% of TRM group and 40 %(non- TRM) had normal HbA1c after 12 months. HbA1c in TRM Group (first visit to second follow up) had a significant p value=0.017. A p value of <0.0001 was observed on comparing the values of blood sugar (fasting) in TRM Group from the first visit and second follow up. The values of blood sugar (postprandial) in TRM Group (first visit and second follow up) showed a p-value <0.0001 (highly significant). Values of the three parameters were non- significant in the control group. Hip size(First Visit to Second Follow Up) TRM Group showed a p-value = 0.0344 (Significant) (Difference between means=2.762 ± 1.261)Detailed results of the above parameters and a few newer ones will be presented at the conference. Conclusion: Time restricted meal intake in diabetics shows promise and is worth exploring further. Time Restricted Meal intake in Type 2 diabetics has a significant effect in controlling and maintaining HbA1c as the reduction in HbA1c value was very significant in the TRM group vs. the control group. Similar highly significant results were obtained in the case of fasting and postprandial values of blood sugar in the TRM group when compared to the control group. The effects of time restricted meal intake in diabetics show promise and are worth exploring further. It is one of the first studies which have been undertaken in Indian diabetics, although the initial data obtained is encouraging yet further research and study are required to corroborate results.

Keywords: chronomedicine, diabetes, endocrinology, time restricted meal intake

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2568 Exploring the Profiles of Militants in the SWAT Valley of Pakistan

Authors: Lateef Hakim Zai Khyber, Syed Rashid Ali

Abstract:

In the post 9/11 era, a new trend has developed of terrorist profiling on the basis of the ethnic, religious, political, psychological, social, and economic background of the terrorists to anticipate and assess the possible risk and to prevent and prosecute the suspected before they commit any violent act. The same profiling approach was adopted in different militant or terrorist de-radicalization and rehabilitation programs across the world in order to evaluate and identify the reasons and causes for joining terrorism in terms of push and pull factors. This paper attempts to explore and investigate the profiles of the detainees in the Sabaoon de-radicalization and Emancipation program, which aimed at de-radicalizing the former militants of Tehrik-e-Taliban (TTP) Pakistan in the Swat valley of Pakistan. This research attempted to use qualitative methods for collecting data, including a number of formal and informal open-ended interviews with the former staff members of Sabaoon to explore various aspects of the program, such as various approaches used at Sabaoon for terrorist profiling. It conducts a thorough examination of the profiles of the terrorist through their socioeconomic, ideological, emotional, intellectual, and psychological conditions and orientations, personal details, family issues, social preferences, etc. The study finds out that the majority of the terrorists belonged to the marginalized groups or lower class, including underprivileged tenants and poor laborers, of society having no access to land. They possess almost the same profiles, including low socioeconomic status, absence of a father or strict behavior of parents, large and combined families, lack of education, lack of religious understanding, etc. They also possess some common traits such as anxiety disorder, emotional instability, aggressive impulses and insecurity, depression, inferiority complex, lack of critical thinking and logical reasoning, authority-seeking behavior, and revenge-seeking behavior.

Keywords: terrorist profiling, Sabaoon, de-radicalization, rehabilitation, Swat, Pakistan, juvenile militants

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2567 Effect of Species and Slaughtering Age on Quality Characteristics of Different Meat Cuts of Humped Cattle and Water Buffalo Bulls

Authors: Muhammad Kashif Yar, Muhammad Hayat Jaspal, Muawuz Ijaz, Zafar Hayat, Iftikhar Hussain Badar, Jamal Nasir

Abstract:

Meat quality characteristics such as ultimate pH (pHu), color, cooking loss and shear force of eight wholesale meat cuts of humped cattle (Bos indicus) and water buffalo (Bubalus bubalis) bulls at two age groups were evaluated. A total of 48 animals, 24 of each species and within species 12 from each 18 and 26 months age group were slaughtered. After 24h post-slaughter, eight meat cuts, i.e., tenderloin, sirloin, rump, cube roll, round, topside, silverside and blade were cut from the carcass. The pHu of tenderloin (5.65 vs 5.55), sirloin (5.67 vs 5.60), cube roll (5.68 vs 5.62) and blade (5.88 vs 5.72) was significantly higher (P<0.05) in buffalo than cattle. The tenderloin showed significantly higher (44.63 vs 42.23) and sirloin showed lower (P<0.05) mean L* value (42.28 vs 44.47) in cattle than buffalo whilst the mean L* value of the only tenderloin was affected by animal age. Species had a significant (P<0.05) effect on mean a*, b*, C, and h values of all meat cuts. The shear force of the majority of meat cuts, within species and age groups, varied considerably. The mean shear values of tenderloin, sirloin, cube roll and blade were higher (P<0.05) in buffalo than cattle. The shear values of rump, round, topside and silverside increased significantly (P<0.05) with animal age. In conclusion, primal cuts of cattle showed better meat quality especially tenderness than buffalo. Furthermore, calves should be raised at least up to 26 months of age to maximize profitability by providing better quality meat.

Keywords: buffalo, cattle, meat color, meat quality, slaughtering age, tenderness

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2566 A Kierkegaardian Reading of Iqbal's Poetry as a Communicative Act

Authors: Sevcan Ozturk

Abstract:

The overall aim of this paper is to present a Kierkegaardian approach to Iqbal’s use of literature as a form of communication. Despite belonging to different historical, cultural, and religious backgrounds, the philosophical approaches of Soren Kierkegaard, ‘the father of existentialism,' and Muhammad Iqbal ‘the spiritual father of Pakistan’ present certain parallels. Both Kierkegaard and Iqbal take human existence as the starting point for their reflections, emphasise the subject of becoming genuine religious personalities, and develop a notion of the self. While doing these they both adopt parallel methods, employ literary techniques and poetical forms, and use their literary works as a form of communication. The problem is that Iqbal does not provide a clear account of his method as Kierkegaard does in his works. As a result, Iqbal’s literary approach appears to be a collection of contradictions. This is mainly because despite he writes most of his works in the poetical form, he condemns all kinds of art including poetry. Moreover, while attacking on Islamic mysticism, he, at the same time, uses classical literary forms, and a number of traditional mystical, poetic symbols. This paper will argue that the contradictions found in Iqbal’s approach are actually a significant part of Iqbal’s way of communicating his reader. It is the contention of this paper that with the help of the parallels between the literary and philosophical theories of Kierkegaard and Iqbal, the application of Kierkegaard’s method to Iqbal’s use of poetry as a communicative act will make it possible to dispel the seeming ambiguities in Iqbal’s literary approach. The application of Kierkegaard’s theory to Iqbal’s literary method will include an analysis of the main principles of Kierkegaard’s own literary technique of ‘indirect communication,' which is a crucial term of his existentialist philosophy. Second, the clash between what Iqbal’s says about art and poetry and what he does will be highlighted in the light of Kierkegaardian theory of indirect communication. It will be argued that Iqbal’s literary technique can be considered as a form of ‘indirect communication,' and that reading his technique in this way helps on dispelling the contradictions in his approach. It is hoped that this paper will cultivate a dialogue between those who work in the fields of comparative philosophy Kierkegaard studies, existentialism, contemporary Islamic thought, Iqbal studies, and literary criticism.

Keywords: comparative philosophy, existentialism, indirect communication, intercultural philosophy, literary communication, Muhammad Iqbal, Soren Kierkegaard

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2565 The 10,000 Fold Effect of Retrograde Neurotransmission: A New Concept for Cerebral Palsy Revival by the Use of Nitric Oxide Donars

Authors: V. K. Tewari, M. Hussain, H. K. D. Gupta

Abstract:

Background: Nitric Oxide Donars (NODs) (intrathecal sodium nitroprusside (ITSNP) and oral tadalafil 20mg post ITSNP) has been studied in this context in cerebral palsy patients for fast recovery. This work proposes two mechanisms for acute cases and one mechanism for chronic cases, which are interrelated, for physiological recovery. a) Retrograde Neurotransmission (acute cases): 1) Normal excitatory impulse: at the synaptic level, glutamate activates NMDA receptors, with nitric oxide synthetase (NOS) on the postsynaptic membrane, for further propagation by the calcium-calmodulin complex. Nitric oxide (NO, produced by NOS) travels backward across the chemical synapse and binds the axon-terminal NO receptor/sGC of a presynaptic neuron, regulating anterograde neurotransmission (ANT) via retrograde neurotransmission (RNT). Heme is the ligand-binding site of the NO receptor/sGC. Heme exhibits > 10,000-fold higher affinity for NO than for oxygen (the 10,000-fold effect) and is completed in 20 msec. 2) Pathological conditions: normal synaptic activity, including both ANT and RNT, is absent. A NO donor (SNP) releases NO from NOS in the postsynaptic region. NO travels backward across a chemical synapse to bind to the heme of a NO receptor in the axon terminal of a presynaptic neuron, generating an impulse, as under normal conditions. b) Vasopasm: (acute cases) Perforators show vasospastic activity. NO vasodilates the perforators via the NO-cAMP pathway. c) Long-Term Potentiation (LTP): (chronic cases) The NO–cGMP-pathway plays a role in LTP at many synapses throughout the CNS and at the neuromuscular junction. LTP has been reviewed both generally and with respect to brain regions specific for memory/learning. Aims/Study Design: The principles of “generation of impulses from the presynaptic region to the postsynaptic region by very potent RNT (10,000-fold effect)” and “vasodilation of arteriolar perforators” are the basis of the authors’ hypothesis to treat cerebral palsy cases. Case-control prospective study. Materials and Methods: The experimental population included 82 cerebral palsy patients (10 patients were given control treatments without NOD or with 5% dextrose superfusion, and 72 patients comprised the NOD group). The mean time for superfusion was 5 months post-cerebral palsy. Pre- and post-NOD status was monitored by Gross Motor Function Classification System for Cerebral Palsy (GMFCS), MRI, and TCD studies. Results: After 7 days in the NOD group, the mean change in the GMFCS score was an increase of 1.2 points mean; after 3 months, there was an increase of 3.4 points mean, compared to the control-group increase of 0.1 points at 3 months. MRI and TCD documented the improvements. Conclusions: NOD (ITSNP boosts up the recovery and oral tadalafil maintains the recovery to a well-desired level) acts swiftly in the treatment of CP, acting within 7 days on 5 months post-cerebral palsy either of the three mechanisms.

Keywords: cerebral palsy, intrathecal sodium nitroprusside, oral tadalafil, perforators, vasodilations, retrograde transmission, the 10, 000-fold effect, long-term potantiation

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2564 Role of Zinc in Catch-Up Growth of Low-Birth Weight Neonates

Authors: M. A. Abdel-Wahed, Nayera Elmorsi Hassan, Safaa Shafik Imam, Ola G. El-Farghali, Khadija M. Alian

Abstract:

Low-birth-weight is a challenging public health problem. Aim: to clarify role of zinc on enhancing catch-up growth of low-birth-weight and find out a proposed relationship between zinc effect on growth and the main growth hormone mediator, IGF-1. Methods: Study is a double-blind-randomized-placebo-controlled trial conducted on low-birth-weight-neonates delivered at Ain Shams University Maternity Hospital. It comprised 200 Low-birth-weight-neonates selected from those admitted to NICU. Neonates were randomly allocated into one of the following two groups: group I: low-birth-weight; AGA or SGA on oral zinc therapy at dose of 10 mg/day; group II: Low-birth-weight; AGA or SGA on placebo. Anthropometric measurements were taken including birth weight, length; head, waist, chest, mid-upper arm circumferences, triceps and sub-scapular skin-fold thicknesses. Results: At 12-month-old follow-up visit, mean weight, length; head (HC), waist, chest, mid-upper arm circumferences and triceps; also, infant’s proportions had values ≥ 10th percentile for weight, length and HC were significantly higher among infants of group I when compared to those of group II. Oral zinc therapy was associated with 24.88%, 25.98% and 19.6% higher proportion of values ≥ 10th percentile regarding weight, length and HC at 12-month-old visit, respectively [NNT = 4, 4 and 5, respectively]. Median IGF-1 levels measured at 6 months were significantly higher in group I compared to group II (median (range): 90 (19 – 130) ng/ml vs. 74 (21 – 130) ng/ml, respectively, p=0.023). Conclusion: Oral zinc therapy in low-birth-weight neonates was associated with significantly more catch-up growth at 12-months-old and significantly higher serum IGF-1 at 6-month-old.

Keywords: low-birth-weight, zinc, catch-up growth, neonates

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2563 Low Enrollment in Antiretroviral Treatment among Pregnant Women Screened HIV Infected in Informal Health Centers in Cameroon

Authors: Lydie Audrey Amboua Schouame, Sylvie Kwedi Nolna, Antoine Socpa, Alexandre Benjamin Nkoum

Abstract:

Background: Despite the struggle of the Cameroonian Ministry of Public Health against informal health centers (IHCs) because of their illegality, IHCs are booming in Cameroon and a large part of the population uses them. In 2017, more than 3.000 IHCs were counted across the country. Most of these IHCs have antenatal clinics and they screen pregnant women for HIV. However, there is no data on the Prevention of Mother-To-Child Transmission of HIV (PMTCT) in this informal health sector in Cameroon. This study aimed to investigate the initiation of Antiretroviral treatment (ART) in pregnant women screened HIV positive in IHCs and associated factors. Methods: From January 01, 2018, to June 30, 2020, we carried out a cohort study of pregnant women attending their first antenatal visit and screened HIV positive in informal health centers in the cities of Douala and Ebolowa in Cameroon. Consenting participants were interviewed at two points: at least one week after delivery of the HIV result and three months later. The collected data were entered into Kobo collected and analyzed in SPSS V23.0 software. Results: A total of 182 HIV-infected pregnant women were enrolled in the study. The median age at enrollment was 30 years (IQR, 24-34) and the median gestational age at first ANC was 25 weeks (IQR, 19-31). Overall 61% (111/182) had a secondary level of education, 65% (118/182) were married/in a common-law relationship and 69% (126/182) had no income activity. At their first ANC, 91% (166/182) were naïve to ARV treatment. Among them, only 45% (74/166) initiated ART. The median delay in initiating ARV treatment was 5 days (IQR, 0-25). Of those who have started ART, only 64% (48/74) remained on treatment 3 months later. Conclusion: In order to eliminate mother-to-child transmission of HIV, attention should be paid to IHCs.

Keywords: informal health centers, human immunodeficiency, antiretroviral treatment, pregnant women

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2562 Examining Efficacy of the Islamic Cooperatives Society as a ShariᶜAh Based Economic Outfit: A Case Study of Kwasu Al-Halal Cooperative Society, Malete, Nigeria

Authors: Abdus-Samiᶜi Imam Arikewuyo

Abstract:

Islam enjoins the spirit of cooperation among fellow mankind. This is particularly entrenched in the brotherhood phenomenon advocated by Islam. With cooperation, a group of people with diverse qualities and opportunities can facilitate a breakthrough in what is seemingly difficult, if not impossible. This understanding underscores the initiative of establishing multi-purpose cooperative societies for thrifts and savings among bonafide members, especially in developing nations. The spirit and objectives of the Multi-Purpose Cooperatives Societies gave birth to the founding of several of these organizations as a plausible economic outfit in Nigeria to provide succor to the socio-economic predicaments of members. Pertinently, many Islamic cooperative societies sprang up, carving a niche for themselves as Shariᶜah-based economic outfits to accommodate the yearnings of the Muslim populace. KWASU Al-Halal Cooperative Society, Malete, Nigeria, is one such organization that is not only Shariᶜah inclined but also institutional-based. This paper, therefore, aims to examine the operations and activities of this society with a view to determining its strength as a Shariᶜah-based economic outfit for the survival of its clients in a competitive multi-religious atmosphere. The study is both historical and descriptive; thus, it employed interview, observation, focus group discussion and hermeneutical methods as pertinent research tools. The research findings indicated that adopting the Shariᶜah prescriptions, KWASU Al-Halal Cooperative Society, as a representation of the Islamic cooperatives society, fulfilled the essence and goal of its establishment, serving as an outlet for meeting the socio-economic demands of its members regardless of religious inclinations. The paper recommended that stronger efforts should be made on proper record keeping, the conscientiousness of beneficiaries on loan refunds or payments on purchases and education of the loanees and guarantors.

Keywords: efficacy, Islamic cooperatives society, Kwasu al-halal cooperative society, shariᶜah

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2561 'Value-Based Re-Framing' in Identity-Based Conflicts: A Skill for Mediators in Multi-Cultural Societies

Authors: Hami-Ziniman Revital, Ashwall Rachelly

Abstract:

The conflict resolution realm has developed tremendously during the last half-decade. Three main approaches should be mentioned: an Alternative Dispute Resolution (ADR) suggesting processes such as Arbitration or Interests-based Negotiation was developed as an answer to obligations and rights-based conflicts. The Pragmatic mediation approach focuses on the gap between interests and needs of disputants. The Transformative mediation approach focusses on relations and suits identity-based conflicts. In the current study, we examine the conflictual relations between religious and non-religious Jews in Israel and the impact of three transformative mechanisms: Inter-group recognition, In-group empowerment and Value-based reframing on the relations between the participants. The research was conducted during four facilitated joint mediation classes. A unique finding was found. Using both transformative mechanisms and the Contact Hypothesis criteria, we identify transformation in participants’ relations and a considerable change from anger, alienation, and suspiciousness to an increased understanding, affection and interpersonal concern towards the out-group members. Intergroup Recognition, In-group empowerment, and Values-based reframing were the skills discovered as the main enablers of the change in the relations and the research participants’ fostered mutual recognition of the out-group values and identity-based issues. We conclude this transformation was possible due to a constant intergroup contact, based on the Contact Hypothesis criteria. In addition, as Interests-based mediation uses “Reframing” as a skill to acknowledge both mutual and opposite needs of the disputants, we suggest the use of “Value-based Reframing” in intergroup identity-based conflicts, as a skill contributes to the empowerment and the recognition of both mutual and different out-group values. We offer to implement those insights and skills to assist conflict resolution facilitators in various intergroup identity-based conflicts resolution efforts and to establish further research and knowledge.

Keywords: empowerment, identity-based conflict, intergroup recognition, intergroup relations, mediation skills, multi-cultural society, reframing, value-based recognition

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2560 Improving Screening and Treatment of Binge Eating Disorders in Pediatric Weight Management Clinic through a Quality Improvement Framework

Authors: Cristina Fernandez, Felix Amparano, John Tumberger, Stephani Stancil, Sarah Hampl, Brooke Sweeney, Amy R. Beck, Helena H Laroche, Jared Tucker, Eileen Chaves, Sara Gould, Matthew Lindquist, Lora Edwards, Renee Arensberg, Meredith Dreyer, Jazmine Cedeno, Alleen Cummins, Jennifer Lisondra, Katie Cox, Kelsey Dean, Rachel Perera, Nicholas A. Clark

Abstract:

Background: Adolescents with obesity are at higher risk of disordered eating than the general population. Detection of eating disorders (ED) is difficult. Screening questionnaires may aid in early detection of ED. Our team’s prior efforts focused on increasing ED screening rates to ≥90% using a validated 10-question adolescent binge eating disorder screening questionnaire (ADO-BED). This aim was achieved. We then aimed to improve treatment plan initiation of patients ≥12 years of age who screen positive for BED within our WMC from 33% to 70% within 12 months. Methods: Our WMC is within a tertiary-care, free-standing children’s hospital. A3, an improvement framework, was used. A multidisciplinary team (physicians, nurses, registered dietitians, psychologists, and exercise physiologists) was created. The outcome measure was documentation of treatment plan initiation of those who screen positive (goal 70%). The process measure was ADO-BED screening rate of WMC patients (goal ≥90%). Plan-Do-Study-Act (PDSA) cycle 1 included provider education on current literature and treatment plan initiation based upon ADO-BED responses. PDSA 2 involved increasing documentation of treatment plan and retrain process to providers. Pre-defined treatment plans were: 1) repeat screen in 3-6 months, 2) resources provided only, or 3) comprehensive multidisciplinary weight management team evaluation. Run charts monitored impact over time. Results: Within 9 months, 166 patients were seen in WMC. Process measure showed sustained performance above goal (mean 98%). Outcome measure showed special cause improvement from mean of 33% to 100% (n=31). Of treatment plans provided, 45% received Plan 1, 4% Plan 2, and 46% Plan 3. Conclusion: Through a multidisciplinary improvement team approach, we maintained sustained ADO-BED screening performance, and, prior to our 12-month timeline, achieved our project aim. Our efforts may serve as a model for other multidisciplinary WMCs. Next steps may include expanding project scope to other WM programs.

Keywords: obesity, pediatrics, clinic, eating disorder

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2559 3D-printing for Ablation Planning in Patients Undergoing Atrial Fibrillation Ablation: 3D-GALA Trial

Authors: Terentes Printzios Dimitrios, Loanna Gourgouli, Vlachopoulos Charalambos

Abstract:

Aims: Atrial fibrillation (AF) remains one of the major causes of stroke, heart failure, sudden death and cardiovascular morbidity. Ablation techniques are becoming more appealing after the latest results of randomized trials showing the overall clinical benefit. On the other hand, imaging techniques and the frontier application of 3D printing are emerging as a valuable ally for cardiac procedures. However, no randomized trial has directly assessed the impact of preprocedural imaging and especially 3D printing guidance for AF ablation. The present study is designed to investigate for the first time the effect of 3D printing of the heart on the safety and effectiveness of the ablation procedure. Methods and design: The 3D-GALA trial is a randomized, open-label, controlled, multicentre clinical trial of 2 parallel groups designed to enroll a total of 100 patients undergoing ablation using cryo-balloon for paroxysmal and persistent AF. Patients will be randomized with a patient allocation ratio of 1: 1 to preprocedural MRI scan of the heart and 3D printing of left atrium and pulmonary veins and cryoablation versus standard cryoablation without imaging. Patients will be followed up to 6 months after the index procedure. The primary outcome measure is the reduction of radiation dose and contrast amount during pulmonary veins isolation. Secondary endpoints will include the percentage of atrial fibrillation relapse at 24h-Holter electrocardiogram monitoring at 6 months after initial treatment. Discussion: To our knowledge, the 3D-GALA trial will be the first study to provide evidence about the clinical impact of preprocedural imaging and 3D printing before cryoablation.

Keywords: atrial fibrillation, cardiac MRI, cryoablation, 3-d printing

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2558 An Exploration of The Patterns of Transcendence in Indian and Hopkins’s Aesthetics

Authors: Lima Antony

Abstract:

In G. M. Hopkins’s poetics and aesthetics there is scope for a comparative study with Indian discourses on aesthetics, an area not adequately explored so far. This exploration will enrich the field of comparative study of diverse cultural expressions and their areas of similarity. A comparative study of aesthetic and religious experiences in diverse cultures will open up avenues for the discovery of similarities in self-experiences and their transcendence. Such explorations will reveal similar patterns in aesthetic and religious experiences. The present paper intends to prove this in the theories of Hopkins and Indian aesthetics. From the time of the Vedas Indian sages have believed that aesthetic enjoyment could develop into a spiritual realm. From the Natyasastra of Bharata, Indian aesthetics develops and reaches its culmination in later centuries into a consciousness of union with the mystery of the Ultimate Being, especially in Dhvanaāloka of Anandavardhana and Locana of Abhinavagupta. Dhvanyaloka elaborates the original ideas of rasa (mood or flavor) and dhvani (power of suggestion) in Indian literary theory and aesthetics. Hopkins was successful, like the ancient Indian alankarikas, in creating aesthetically superb patterns at various levels of sound and sense for which he coined the term ‘inscape’. So Hopkins’s aesthetic theory becomes suitable for transcultural comparative study with Indian aesthetics especially the dhvani theories of Anandavardhana and Abhinavagupta. Hopkins’s innovative approach to poetics and his selection of themes are quite suitable for analysis in the light of Indian literary theories. Indian philosophy views the ultimate reality called Brahman, as the 'soul,' or inner essence, of all reality. We see in Hopkins also a search for the essence of things and the chiming of their individuality with the Ultimate Being in multidimensional patterns of sound, sense and ecstatic experience. This search culminates in the realization of a synthesis of the individual self with the Ultimate Being. This is achieved through an act of surrender of the individuality of the self before the Supreme Being. Attempts to reconcile the immanent and transcendent aspects of the Ultimate Being can be traced in the Indian as well as Hopkins’s aesthetics which can contribute to greater understanding and harmony between cultures.

Keywords: Dhvani, Indian aesthetics, transcultural studies, Rasa

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2557 Projection of Climate Change over the Upper Ping River Basin Using Regional Climate Model

Authors: Chakrit Chotamonsak, Eric P. Salathé Jr, Jiemjai Kreasuwan

Abstract:

Dynamical downscaling of the ECHAM5 global climate model is applied at 20-km horizontal resolution using the WRF regional climate model (WRF-ECHAM5), to project changes from 1990–2009 to 2045–2064 of temperature and precipitation over the Upper Ping River Basin. The analysis found that monthly changes in daily temperature and precipitation over the basin for the 2045-2064 compared to the 1990-2009 are revealed over the basin all months, with the largest warmer in December and the smallest warmer in February. The future simulated precipitation is smaller than that of the baseline value in May, July and August, while increasing of precipitation is revealed during pre-monsoon (April) and late monsoon (September and October). This means that the rainy season likely becomes longer and less intensified during the rainy season. During the cool-dry season and hot-dry season, precipitation is substantial increasing over the basin. For the annual cycle of changes in daily temperature and precipitation over the upper Ping River basin, the largest warmer in the mean temperature over the basin is 1.93 °C in December and the smallest is 0.77 °C in February. Increase in nighttime temperature (minimum temperature) is larger than that of daytime temperature (maximum temperature) during the dry season, especially in wintertime (November to February), resulted in decreasing the diurnal temperature range. The annual and seasonal changes in daily temperature and precipitation averaged over the basin. The annual mean rising are 1.43, 1.54 and 1.30 °C for mean temperature, maximum temperature and minimum temperature, respectively. The increasing of maximum temperature is larger than that of minimum temperature in all months during the dry season (November to April).

Keywords: climate change, regional climate model, upper Ping River basin, WRF

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2556 The Effect of Low and High Dose Curcumin Supplementation on Prevention and Treatment of Sarcopenia: The Concept of Hormesis

Authors: Sevana Daneghian, Leila Chodari, Sahar Mehranfar, Shadi Mohammadpour-Asl, Diman Mahdi

Abstract:

Sarcopenia is an age-related muscle disease. Lack of antioxidant protection, and cumulative oxidative damage to skeletal muscle are recognized mechanisms. Curcumin is a hormetin as it has a stimulating effect in low doses and an inhibitory effect in high doses. The purpose of this study was to examine the effects of four weeks of curcumin supplementation in presarcopenic and sarcopenic rats, and likelihood of potential negative effects while co-exist with sarcopenia. The rats were divided into 7 groups: young sham rats, 18 months old; presarcopenic control, supplemented with 400 and 1500 mg/kg/day, 24 months old; Sarcopenia control, sarcopenia supplemented with 400 and 1500 mg/kg/day. MDA levels were significantly reduced in the low-dose pre-sarcopenic group compared to the control group. Compared to the corresponding control groups, SOD levels decreased in the groups treated with low-dose presarcopenic supplementation and increased in the high-dose sarcopenic supplemented. GPx levels increased at both doses only in the sarcopenic group compared to the control group. SIRT-1 only increased at low doses in the sarcopenic groups and PGC-1α in both pre-sarcopenia groups compared to the corresponding control. IGF-1 increased compared to the control group at both doses in the pre-sarcopenic group and at high doses in sarcopenic group. Considering the hormetic effects of curcumin, it can be argued that, curcumin supplementation has some positive effects not only at low but also at high doses in both groups. This means that the high doses of curcumin have no negative synergistic effects in addition to oxidative stress during sarcopenia and high-dose supplementation in patients already suffering from high oxidative stress due to sarcopenia is safe and could be considered hormetic.

Keywords: curcumin, hormesis, sarcopenia, muscular atrophy, PGC protein, Sirtuins

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2555 Characterization and Degradation of 3D Printed Polycaprolactone-Freeze Dried Bone Matrix Constructs for Use in Critical Sized Bone Defects

Authors: Samantha Meyr, Eman Mirdamadi, Martha Wang, Tao Lowe, Ryan Smith, Quinn Burke

Abstract:

Critical-sized bone defects (CSD) treatment options remain a major clinical orthopedic challenge. They are uniquely contoured diseased or damaged bones and can be defined as those that will not heal spontaneously and require surgical intervention. Autografts are the current gold standard CSD treatment, which are histocompatible and provoke a minimal immunogenic response; however, they can cause donor site morbidity and will not suffice for the size required for replacement. As an alternative to traditional surgical methods, bone tissue engineering will be implemented via 3D printing methods. A freeze-dried bone matrix (FDBM) is a type of graft material available but will only function as desired when in the presence of bone growth factors. Polycaprolactone (PCL) is a known biodegradable material with good biocompatibility that has been proven manageable in 3D printing as a medical device. A 3D-extrusion printing strategy is introduced to print these materials into scaffolds for bone grafting purposes, which could be more accessible and rapid than the current standard. Mechanical, thermal, cytotoxic, and physical properties were investigated throughout a degradation period of 6 months using fibroblasts and dental pulp stem cells. PCL-FDBM scaffolds were successfully printed with high print fidelity in their respective pore sizes and allograft content. Additionally, we have created a method for evaluating PCL using differential scanning calorimetry (DSC) and have evaluated PCL degradation over roughly 6 months.

Keywords: 3D printing, bone tissue engineering, cytotoxicity, degradation, scaffolds

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