Search results for: Hayatabad Medical Complex
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8490

Search results for: Hayatabad Medical Complex

1290 Blood Pressure Level, Targeted Blood Pressure Control Rate, and Factors Related to Blood Pressure Control in Post-Acute Ischemic Stroke Patients

Authors: Nannapus Saramad, Rewwadee Petsirasan, Jom Suwanno

Abstract:

Background: This retrospective study design was to describe average blood pressure, blood pressure level, target blood pressure control rate post-stroke BP control in the year following discharge from Sichon hospital, Sichon District, Nakhon Si Thammarat province. The secondary data analysis was employed from the patient’s health records with patient or caregiver interview. A total of 232 eligible post-acute ischemic strokes in the year following discharge (2017-2018) were recruited. Methods: Data analyses were applied to identify the relationship values of single variables were determined through univariate analyses: The Chi-square test, Fisher exact test, the variables found to have a p-value < 0.2 were analyzed by the binary logistic regression Results: Most of the patients in this study were men 61.6%, an average age of 65.4 ± 14.8 years. Systolic blood pressure levels were in the grade 1-2 hypertension and diastolic pressure at optimal and normal at all times during the initial treatment through the present. The results revealed 25% among the groups under the age of 60 achieved BP control; 36.3% for older than 60 years group; and 27.9% for diabetic group. The multivariate analysis revealed the final relationship of four significant variables: 1) receiving calcium-channel blocker (p =.027); 2) medication adherence of antihypertensive (p = .024) 3) medication adherence of antiplatelet ( p = .020); and 4) medication behavior ( p = . 010) . Conclusion: The medical nurse and health care provider should promote their adherence to behavior to improve their blood pressure control.

Keywords: acute ischemic stroke, target blood pressure control, medication adherence, recurrence stroke

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1289 Experience of Transfering Critically Ill Patients on a Transport Ventilator in a Lower Middle-Income Country-Uganda

Authors: Baluku Nathan

Abstract:

Transferring critically ill patients from one health facility to another poses a major risk to the patient because of increased oxygen demands. transferring patients with critical COVID-19 from a rural health canter in a rural district to a national referral hospital over 350 km in 7 hours would require three size H oxygen cylinders for successful transfer. It was always difficult to arrange the three size cylinders in the ambulance as workspace was greatly compromised for the ambulance assistant. Purpose: The purpose of this study was to investigate the impact and effectiveness of transport ventilators on the transportation of the critically ill patients from rural health canters to national referral hospitals in Uganda. Methodology: This was a descriptive cross-sectional study conducted in sept 2022 among critical care nurses and ambulance assistants who had used both methods of transportation (ventilators and cylinders). A semi structured questionnaire was used to collect quantitative data after informed consent. Results: From the findings, distribution of transport ventilators to the regional referral hospitals by the Ministry of Health has gradually improved patient transfer as the team requires less than one size oxygen cylinder to successfully transfer a patient. We use two ambulance assistants (a critical care nurse and another nurse who has been trained on use of the ventilator) when transferring patients with critical COVID-19 as the teams have to interchange over the long distance. Conclusions: Transport ventilators are effective and efficient in transferring critically ill patients, therefore should be rolled out to lower levels coupled with user training to improve outcomes of patients transferred in ambulances in lower income countries.

Keywords: emergency medical technician, critically ill, COVID-19, transport ventilator

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1288 Overcoming the Challenges of Subjective Truths in the Post-Truth Age Through a CriticalEthical English Pedagogy

Authors: Farah Vierra

Abstract:

Following the 2016 US presidential election and the advancement of the Brexit referendum, the concept of “post-truth”, defined by Oxford Dictionary as “relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief”, came into prominent use in public, political and educational circles. What this essentially entails is that in this age, individuals are increasingly confronted with subjective perpetuations of truth in their discourse spheres that are informed by beliefs and opinions as opposed to any form of coherence to the reality of those who these truth claims concern. In principle, a subjective delineation of truth is progressive and liberating – especially considering its potential in providing marginalised groups in the diverse communities of our globalised world with the voice to articulate truths that are representative of themselves and their experiences. However, any form of human flourishing that seems to be promised here collapses as the tenets of subjective truths initially in place to liberate has been distorted through post-truth to allow individuals to purport selective and individualistic truth claims that further oppress and silence certain groups within society without due accountability. The evidence of which is prevalent through the conception of terms such as "alternative facts" and "fake news" that we observe individuals declare when their problematic truth claims are questioned. Considering the pervasiveness of post-truth and the ethical issues that accompany it, educators and scholars alike have increasingly noted the need to adapt educational practices and pedagogies to account for the diminishing objectivity of truth in the twenty-first century, especially because students, as digital natives, find themselves in the firing line of post-truth; engulfed in digital societies that proliferate post-truth through the surge of truth claims allowed in various media sites. In an attempt to equip students with the vital skills to navigate the post-truth age and oppose its proliferation of social injustices, English educators find themselves having to devise instructional strategies that not only teach students the ways they can critically and ethically scrutinise truth claims but also teach them to mediate the subjectivity of truth in a manner that does not undermine the voices of diverse communities. In hopes of providing educators with the roadmap to do so, this paper will first examine the challenges that confront students as a result of post-truth. Following which, the paper will elucidate the role English education can play in helping students overcome the complex ramifications of post-truth. Scholars have consistently touted the affordances of literary texts in providing students with imagined spaces to explore societal issues through a critical discernment of language and an ethical engagement with its narrative developments. Therefore, this paper will explain and demonstrate how literary texts, when used alongside a critical-ethical post-truth pedagogy that equips students with interpretive strategies informed by literary traditions such as literary and ethical criticism, can be effective in helping students develop the pertinent skills to comprehensively examine truth claims and overcome the challenges of the post-truth age.

Keywords: post-truth, pedagogy, ethics, English, education

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1287 Pros and Cons of Nanoparticles on Health

Authors: Amber Shahi, Ayesha Tazeen, Abdus Samad, Shama Parveen

Abstract:

Nanoparticles (NPs) are tiny particles. According to the International Organization for Standardization, the size range of NPs is in the nanometer range (1-100 nm). They show distinct properties that are not shown by larger particles of the same material. NPs are currently being used in different fields due to their unique physicochemical nature. NPs are a boon for medical sciences, environmental sciences, electronics, and textile industries. However, there is growing concern about their potential adverse effects on human health. This poster presents a comprehensive review of the current literature on the pros and cons of NPs on human health. The poster will discuss the various types of interactions of NPs with biological systems. There are a number of beneficial uses of NPs in the field of health and environmental welfare. NPs are very useful in disease diagnosis, antimicrobial action, and the treatment of diseases like Alzheimer’s. They can also cross the blood-brain barrier, making them capable of treating brain diseases. Additionally, NPs can target specific tumors and be used for cancer treatment. To treat environmental health, NPs also act as catalytic converters to reduce pollution from the environment. On the other hand, NPs also have some negative impacts on the human body, such as being cytotoxic and genotoxic. They can also affect the reproductive system, such as the testis and ovary, and sexual behavior. The poster will further discuss the routes of exposure of NPs. The poster will conclude with a discussion of the current regulations and guidelines on the use of NPs in various applications. It will highlight the need for further research and the development of standardized toxicity testing methods to ensure the safe use of NPs in various applications. When using NPs in diagnosis and treatment, we should also take into consideration their safe concentration in the body. Overall, this poster aims to provide a comprehensive overview of the pros and cons of NPs on human health and to promote awareness and understanding of the potential risks and benefits associated with their use.

Keywords: disease diagnosis, human health, nanoparticles, toxicity testing

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1286 Homosexuality and Culture: A Case Study Depicting the Struggles of a Married Lady

Authors: Athulya Jayakumar, M. Manjula

Abstract:

Though there has been a shift in the understanding of homosexuality from being a sin, crime or pathology in the medical and legal perspectives, the acceptance of homosexuality still remains very scanty in the Indian subcontinent. The present case study is a 24-year-old female who has completed a diploma in polytechnic engineering and residing in the state of Kerala. She initially presented with her husband with complaints of lack of sexual desire and non-cooperation from the index client. After an initial few sessions, the client revealed, in an individual session, about her homosexual orientation which was unknown to her family. She has had multiple short-term relations with females and never had any heterosexual orientation/interest. During her adolescence, she was wondering if she could change herself into a male. However, currently, she accepts her gender. She never wanted a heterosexual marriage; but, had to succumb to the pressure of mother, as a result of a series of unexpected incidents at home and had to agree for the marriage, also with a hope that she may change herself into a bi-sexual. The client was able to bond with the husband emotionally but the multiple attempts at sexual intercourse, at the insistence of the husband, had always been non-pleasurable and induced a sense of disgust. Currently, for several months, there has not been any sexual activity. Also, she actively avoids any chance to have a warm communication with him so that she can avoid chances of him approaching her in a sexual manner. The case study is an attempt to highlight the culture and the struggles of a homosexual individual who comes to therapy for wanting to be a ‘normal wife’ despite having knowledge of legal rights and scenario. There is a scarcity of Indian literature that has systematically investigated issues related to homosexuality. Data on prevalence, emotional problems faced and clinical services available are sparse though it is crucial for increasing understanding of sexual behaviour, orientation and difficulties faced in India.

Keywords: case study, culture, cognitive behavior therapy, female homosexuality

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1285 Phospholipid Cationic and Zwitterionic Compounds as Potential Non-Toxic Antifouling Agents: A Study of Biofilm Formation Assessed by Micro-titer Assays with Marine Bacteria and Eco-toxicological Effect on Marine Microalgae

Authors: D. Malouch, M. Berchel, C. Dreanno, S. Stachowski-Haberkorn, P-A. Jaffres

Abstract:

Biofouling is a complex natural phenomenon that involves biological, physical and chemical properties related to the environment, the submerged surface and the living organisms involved. Bio-colonization of artificial structures can cause various economic and environmental impacts. The increase in costs associated with the over-consumption of fuel from biocolonized vessels has been widely studied. Measurement drifts from submerged sensors, as well as obstructions in heat exchangers, and deterioration of offshore structures are major difficulties that industries are dealing with. Therefore, surfaces that inhibit biocolonization are required in different areas (water treatment, marine paints, etc.) and many efforts have been devoted to produce efficient and eco-compatible antifouling agents. The different steps of surface fouling are widely described in literature. Studying the biofilm and its stages provides a better understanding of how to elaborate more efficient antifouling strategies. Several approaches are currently applied, such as the use of biocide anti-fouling paint (mainly with copper derivatives) and super-hydrophobic coatings. While these two processes are proving to be the most effective, they are not entirely satisfactory, especially in a context of a changing legislation. Nowadays, the challenge is to prevent biofouling with non-biocide compounds, offering a cost effective solution, but with no toxic effects on marine organisms. Since the micro-fouling phase plays an important role in the regulation of the following steps of biofilm formation, it is desired to reduce or delate biofouling of a given surface by inhibiting the micro-fouling at its early stages. In our recent works, we reported that some amphiphilic compounds exhibited bacteriostatic or bactericidal properties at a concentration that did not affect mammalian eukaryotic cells. These remarkable properties invited us to assess this type of bio-inspired phospholipids to prevent the colonization of surfaces by marine bacteria. Of note, other studies reported that amphiphilic compounds interacted with bacteria leading to a reduction of their development. An amphiphilic compound is a molecule consisting of a hydrophobic domain and a polar head (ionic or non-ionic). These compounds appear to have interesting antifouling properties: some ionic compounds have shown antimicrobial activity, and zwitterions can reduce nonspecific adsorption of proteins. Herein, we investigate the potential of amphiphilic compounds as inhibitors of bacterial growth and marine biofilm formation. The aim of this study is to compare the efficacy of four synthetic phospholipids that features a cationic charge or a zwitterionic polar-head group to prevent microfouling with marine bacteria. Toxicity of these compounds was also studied in order to identify the most promising compounds that inhibit biofilm development and show low cytotoxicity on two links representative of coastal marine food webs: phytoplankton and oyster larvae.

Keywords: amphiphilic phospholipids, biofilm, marine fouling, non-toxique assays

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1284 Deep Learning in Chest Computed Tomography to Differentiate COVID-19 from Influenza

Authors: Hongmei Wang, Ziyun Xiang, Ying liu, Li Yu, Dongsheng Yue

Abstract:

Intro: The COVID-19 (Corona Virus Disease 2019) has greatly changed the global economic, political and financial ecology. The mutation of the coronavirus in the UK in December 2020 has brought new panic to the world. Deep learning was performed on Chest Computed tomography (CT) of COVID-19 and Influenza and describes their characteristics. The predominant features of COVID-19 pneumonia was ground-glass opacification, followed by consolidation. Lesion density: most lesions appear as ground-glass shadows, and some lesions coexist with solid lesions. Lesion distribution: the focus is mainly on the dorsal side of the periphery of the lung, with the lower lobe of the lungs as the focus, and it is often close to the pleura. Other features it has are grid-like shadows in ground glass lesions, thickening signs of diseased vessels, air bronchi signs and halo signs. The severe disease involves whole bilateral lungs, showing white lung signs, air bronchograms can be seen, and there can be a small amount of pleural effusion in the bilateral chest cavity. At the same time, this year's flu season could be near its peak after surging throughout the United States for months. Chest CT for Influenza infection is characterized by focal ground glass shadows in the lungs, with or without patchy consolidation, and bronchiole air bronchograms are visible in the concentration. There are patchy ground-glass shadows, consolidation, air bronchus signs, mosaic lung perfusion, etc. The lesions are mostly fused, which is prominent near the hilar and two lungs. Grid-like shadows and small patchy ground-glass shadows are visible. Deep neural networks have great potential in image analysis and diagnosis that traditional machine learning algorithms do not. Method: Aiming at the two major infectious diseases COVID-19 and influenza, which are currently circulating in the world, the chest CT of patients with two infectious diseases is classified and diagnosed using deep learning algorithms. The residual network is proposed to solve the problem of network degradation when there are too many hidden layers in a deep neural network (DNN). The proposed deep residual system (ResNet) is a milestone in the history of the Convolutional neural network (CNN) images, which solves the problem of difficult training of deep CNN models. Many visual tasks can get excellent results through fine-tuning ResNet. The pre-trained convolutional neural network ResNet is introduced as a feature extractor, eliminating the need to design complex models and time-consuming training. Fastai is based on Pytorch, packaging best practices for in-depth learning strategies, and finding the best way to handle diagnoses issues. Based on the one-cycle approach of the Fastai algorithm, the classification diagnosis of lung CT for two infectious diseases is realized, and a higher recognition rate is obtained. Results: A deep learning model was developed to efficiently identify the differences between COVID-19 and influenza using chest CT.

Keywords: COVID-19, Fastai, influenza, transfer network

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1283 Improved Elastoplastic Bounding Surface Model for the Mathematical Modeling of Geomaterials

Authors: Andres Nieto-Leal, Victor N. Kaliakin, Tania P. Molina

Abstract:

The nature of most engineering materials is quite complex. It is, therefore, difficult to devise a general mathematical model that will cover all possible ranges and types of excitation and behavior of a given material. As a result, the development of mathematical models is based upon simplifying assumptions regarding material behavior. Such simplifications result in some material idealization; for example, one of the simplest material idealization is to assume that the material behavior obeys the elasticity. However, soils are nonhomogeneous, anisotropic, path-dependent materials that exhibit nonlinear stress-strain relationships, changes in volume under shear, dilatancy, as well as time-, rate- and temperature-dependent behavior. Over the years, many constitutive models, possessing different levels of sophistication, have been developed to simulate the behavior geomaterials, particularly cohesive soils. Early in the development of constitutive models, it became evident that elastic or standard elastoplastic formulations, employing purely isotropic hardening and predicated in the existence of a yield surface surrounding a purely elastic domain, were incapable of realistically simulating the behavior of geomaterials. Accordingly, more sophisticated constitutive models have been developed; for example, the bounding surface elastoplasticity. The essence of the bounding surface concept is the hypothesis that plastic deformations can occur for stress states either within or on the bounding surface. Thus, unlike classical yield surface elastoplasticity, the plastic states are not restricted only to those lying on a surface. Elastoplastic bounding surface models have been improved; however, there is still need to improve their capabilities in simulating the response of anisotropically consolidated cohesive soils, especially the response in extension tests. Thus, in this work an improved constitutive model that can more accurately predict diverse stress-strain phenomena exhibited by cohesive soils was developed. Particularly, an improved rotational hardening rule that better simulate the response of cohesive soils in extension. The generalized definition of the bounding surface model provides a convenient and elegant framework for unifying various previous versions of the model for anisotropically consolidated cohesive soils. The Generalized Bounding Surface Model for cohesive soils is a fully three-dimensional, time-dependent model that accounts for both inherent and stress induced anisotropy employing a non-associative flow rule. The model numerical implementation in a computer code followed an adaptive multistep integration scheme in conjunction with local iteration and radial return. The one-step trapezoidal rule was used to get the stiffness matrix that defines the relationship between the stress increment and the strain increment. After testing the model in simulating the response of cohesive soils through extensive comparisons of model simulations to experimental data, it has been shown to give quite good simulations. The new model successfully simulates the response of different cohesive soils; for example, Cardiff Kaolin, Spestone Kaolin, and Lower Cromer Till. The simulated undrained stress paths, stress-strain response, and excess pore pressures are in very good agreement with the experimental values, especially in extension.

Keywords: bounding surface elastoplasticity, cohesive soils, constitutive model, modeling of geomaterials

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1282 Big Data and Health: An Australian Perspective Which Highlights the Importance of Data Linkage to Support Health Research at a National Level

Authors: James Semmens, James Boyd, Anna Ferrante, Katrina Spilsbury, Sean Randall, Adrian Brown

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‘Big data’ is a relatively new concept that describes data so large and complex that it exceeds the storage or computing capacity of most systems to perform timely and accurate analyses. Health services generate large amounts of data from a wide variety of sources such as administrative records, electronic health records, health insurance claims, and even smart phone health applications. Health data is viewed in Australia and internationally as highly sensitive. Strict ethical requirements must be met for the use of health data to support health research. These requirements differ markedly from those imposed on data use from industry or other government sectors and may have the impact of reducing the capacity of health data to be incorporated into the real time demands of the Big Data environment. This ‘big data revolution’ is increasingly supported by national governments, who have invested significant funds into initiatives designed to develop and capitalize on big data and methods for data integration using record linkage. The benefits to health following research using linked administrative data are recognised internationally and by the Australian Government through the National Collaborative Research Infrastructure Strategy Roadmap, which outlined a multi-million dollar investment strategy to develop national record linkage capabilities. This led to the establishment of the Population Health Research Network (PHRN) to coordinate and champion this initiative. The purpose of the PHRN was to establish record linkage units in all Australian states, to support the implementation of secure data delivery and remote access laboratories for researchers, and to develop the Centre for Data Linkage for the linkage of national and cross-jurisdictional data. The Centre for Data Linkage has been established within Curtin University in Western Australia; it provides essential record linkage infrastructure necessary for large-scale, cross-jurisdictional linkage of health related data in Australia and uses a best practice ‘separation principle’ to support data privacy and security. Privacy preserving record linkage technology is also being developed to link records without the use of names to overcome important legal and privacy constraint. This paper will present the findings of the first ‘Proof of Concept’ project selected to demonstrate the effectiveness of increased record linkage capacity in supporting nationally significant health research. This project explored how cross-jurisdictional linkage can inform the nature and extent of cross-border hospital use and hospital-related deaths. The technical challenges associated with national record linkage, and the extent of cross-border population movements, were explored as part of this pioneering research project. Access to person-level data linked across jurisdictions identified geographical hot spots of cross border hospital use and hospital-related deaths in Australia. This has implications for planning of health service delivery and for longitudinal follow-up studies, particularly those involving mobile populations.

Keywords: data integration, data linkage, health planning, health services research

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1281 Prevalence of SARS-CoV-2 Infection and Associated Risk Factors in Selected Health Facilities of Tigray, Ethiopia: Cross-Sectional Study Design, 2023

Authors: Weldegerima Gebremedhin Hagos

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Background: The Coronavirus disease of 2019 (COVID-19) is a catastrophic emerging global health threat caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 has a wide range of complications and sequels. It is devastating in developing countries, causing serious health and socioeconomic crises as a result of the increasingly overburdened healthcare system. Ethiopia reported the first case of SARS-CoV-2 on 13th March 2020, with community transmission ensuing by mid-May. The aim of this study was conducted to determine the prevalence of SARS-CoV-2 infection in Tigray, Ethiopia. Methods: Facility-based correctional study designs were used on a total of 380 study participants from March 2023 up to May 2023 in two general hospitals and one comprehensive specialized hospital in Tigray, Ethiopia. A pre-structured questionnaire was used to assess information regarding the socio-demographic, clinical data and other risk factors. A nasal swap was taken by trained health professionals, and the laboratory analysis was done by RT-PCR (quant studio 7-flex, applied biosystems) in Tigrai Health Research Institute and Mekelle University Medical Microbiology Research Laboratory. Result: The mean age of the study participants was 31 (SD+/-3.5) years, with 65% being male and 35% female. The overall seropositivity of sars-cov-2 among the study participants was 5.5%. The prevalence was higher in males (6.2%) than females which were (4.7%). Sars-cov-2 infection was significantly associated with a history of lack of vaccination (p-value 0.002). There was no significant association between seropositivity and demographic factors (P > 0.05). Conclusion: The seroprevalence of SARS-CoV-2 among the study participants is high. Those study participants with a previous history of vaccination have a low probability of developing COVID-19 infection. A low SARS-CoV-2 infection rate was recorded in those who frequently use masks.

Keywords: prevalence, SARS-CoV-2, infection, risk factors

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1280 Relationship between Pain, Social Support and Socio-Economic Indicators in Individuals with Spinal Cord Injury

Authors: Zahra Khazaeipour, Ehsan Ahmadipour, Vafa Rahimi-Movaghar, Fereshteh Ahmadipour

Abstract:

Research Objectives: Chronic pain is one of the common problems associated with spinal cord injuries (SCI), which causes many complications. Therefore, this study intended to evaluate the relationship between pain and demographic, injury characteristics, socio-economic and social support in individuals with spinal cord Injury in Iran. Design: Descriptive cross-sectional study. Setting: Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran, between 2012 and 2013. Participants: The participants were 140 individuals with SCI, 101 (72%) men and 39 (28%) women, with mean age of 29.4 ±7.9 years. Main Outcome Measure: The Persian version of the Brief Pain Inventory (BPI) was used to measure the pain, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Results: About 50.7% complained about having pain, which 79.3% had bilateral pain. The most common locations of pain were lower limbs and back. The most quality of pain was described as aching (41.4%), and tingling (32.9%). Patients with a medium level of education had the least pain compared to high and low level of education. SCI individuals with good economic situation reported higher frequency of having pain. There was no significant relationship between pain and social support. There was positive correlation between pain and impairment of mood, normal work, relations with other people and lack of sleep (P < 0.001). Conclusion: These findings revealed the importance of socioeconomic factors such as economic situation and educational level in understanding chronic pain in people with SCI and provide further support for the bio-psychosocial model. Hence, multidisciplinary evaluations and treatment strategies are advocated, including biomedical, psychological, and psycho-social interventions.

Keywords: pain, social support, socio-economic indicators, spinal cord injury

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1279 The Risk of Post-stroke Pneumonia and Its One-Year Disability in Taiwan

Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: Evidence exists that pneumonia is a frequently encountered complication after stroke which is associated with a higher rate of mortality and increased long-term disability Purpose: To determine the predictors associated with the risk of one-year disability in acute stroke. Methods: Data for this longitudinal follow-up study were extracted from a tertiary referral medical center’s stroke registry database in Northern Taipei. Eligible patients with acute stroke admitted to the hospital and completed a one-year follow up were recruited for analysis. Favorable outcome was defined as a modified Rankin Scale score ≤ 2. SAS version 9.2 was used for the multivariable regression analyses to examine the factors correlated with the one-year disability in stroke patients. Results: From January 2012 to December 2013, a total of 1373 (mean age: 70.49±15.4 years, 913(66.5%) males) consecutively administered acute stroke patients were recruited. Overall, the rate of one-year disability was 37.20%(404/1086) in those without post-stroke pneumonia. It increased to 82.93 %(238/287) in patients developed post-stroke pneumonia. Factors associated with increased risk of disability were age ≧ 75(OR= 4.845, p<.0001), female /gender (OR=1.568, p =.0062), previous stroke (OR= 1.868, p = <. 0001) ,dementia (OR= 2.872, p =.0047), ventilator use (OR= 4.653, p <. 0001),age ≧ 75 /pneumonia (OR=1.236, p <. 0001) , ICU admission (OR=3.314, p <.0001) , nasogastric tube insertion (OR= 4.28, p <.0001), speech therapy (OR= 1.79, p =.0142), urinary tract infection (OR= 1.865, p =.0018), estimated glomerular filtration rate (eGFR > 60 )(OR= 0.525, p= .0029), Admission NIHSS >11 (OR= 2.101, p = .0099), Length of hospitalization > 30(d) (OR= 5.182, p <.0001). Conclusion: Older age, severe neurological deficit, complications, rehabilitation intervention, length of hospitalization >30(d), and cognitive impairment were significantly associated with Post-stroke functional impairment, especially those with post-stroke pneumonia. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, disability

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1278 Optimal Framework of Policy Systems with Innovation: Use of Strategic Design for Evolution of Decisions

Authors: Yuna Lee

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In the current policy process, there has been a growing interest in more open approaches that incorporate creativity and innovation based on the forecasting groups composed by the public and experts together into scientific data-driven foresight methods to implement more effective policymaking. Especially, citizen participation as collective intelligence in policymaking with design and deep scale of innovation at the global level has been developed and human-centred design thinking is considered as one of the most promising methods for strategic foresight. Yet, there is a lack of a common theoretical foundation for a comprehensive approach for the current situation of and post-COVID-19 era, and substantial changes in policymaking practice are insignificant and ongoing with trial and error. This project hypothesized that rigorously developed policy systems and tools that support strategic foresight by considering the public understanding could maximize ways to create new possibilities for a preferable future, however, it must involve a better understating of Behavioural Insights, including individual and cultural values, profit motives and needs, and psychological motivations, for implementing holistic and multilateral foresight and creating more positive possibilities. To what extent is the policymaking system theoretically possible that incorporates the holistic and comprehensive foresight and policy process implementation, assuming that theory and practice, in reality, are different and not connected? What components and environmental conditions should be included in the strategic foresight system to enhance the capacity of decision from policymakers to predict alternative futures, or detect uncertainties of the future more accurately? And, compared to the required environmental condition, what are the environmental vulnerabilities of the current policymaking system? In this light, this research contemplates the question of how effectively policymaking practices have been implemented through the synthesis of scientific, technology-oriented innovation with the strategic design for tackling complex societal challenges and devising more significant insights to make society greener and more liveable. Here, this study conceptualizes the notions of a new collaborative way of strategic foresight that aims to maximize mutual benefits between policy actors and citizens through the cooperation stemming from evolutionary game theory. This study applies mixed methodology, including interviews of policy experts, with the case in which digital transformation and strategic design provided future-oriented solutions or directions to cities’ sustainable development goals and society-wide urgent challenges such as COVID-19. As a result, artistic and sensual interpreting capabilities through strategic design promote a concrete form of ideas toward a stable connection from the present to the future and enhance the understanding and active cooperation among decision-makers, stakeholders, and citizens. Ultimately, an improved theoretical foundation proposed in this study is expected to help strategically respond to the highly interconnected future changes of the post-COVID-19 world.

Keywords: policymaking, strategic design, sustainable innovation, evolution of cooperation

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1277 Stressful Life Events and Their Influence on Childhood Obesity and Emotional Well-Being: Cross-Sectional Study

Authors: M. Rojo, M. Blanco, T. Lacruz, S. Solano, L. Beltran, M. Graell, A. R. Sepulveda.

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There is an association between an early accumulation of Stressful Life Events (SLE) during childhood and various physical and psychological health complications. However, there are only a few studies on this topic in children and adolescents with overweight or obesity. The general aim of the study was to evaluate the accumulation and type of SLE in 200 children from 8 to 12 years old and analyze the relationship with their emotional well-being and weight status (obesity, overweight and normal weight). The children and their families completed an interview. The evaluated variables that are included in this study are sociodemographic measures, medical/psychological history, anthropometric measures (BMI, z-BMI), and psychological variables (children's clinical interview K-SADS-PL(Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version) and battery of questionnaires). Results: Children with overweight and obesity accumulate more stressful events from an early age and have a significantly higher percentage of psychiatric diagnoses, compared to their peers with normal weight. Presenting a child psychiatric disorder is related to greater z-BMI and the total number of SLE (p < 0.001). A higher z-BMI is also related to a greater number of stressful events during childhood. There is also a positive and significant relationship between the total number of SLE and worse emotional well-being (higher levels of anxious and depressive symptoms and low self-esteem of children) (p < 0.01). Conclusion: Children with overweight and obesity grow up in a family, school, and social context where more stressors are accumulated. This is also directly associated with worse emotional well-being. It is necessary to implement multidisciplinary prevention and intervention strategies in different changes (school, family, and health). This study is included in a project funded by the Ministry of Innovation and Science (PSI2011-23127).

Keywords: childhood obesity, emotional well-being, psychopathology, stressful life events

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1276 Digital Image Correlation Based Mechanical Response Characterization of Thin-Walled Composite Cylindrical Shells

Authors: Sthanu Mahadev, Wen Chan, Melanie Lim

Abstract:

Anisotropy dominated continuous-fiber composite materials have garnered attention in numerous mechanical and aerospace structural applications. Tailored mechanical properties in advanced composites can exhibit superiority in terms of stiffness-to-weight ratio, strength-to-weight ratio, low-density characteristics, coupled with significant improvements in fatigue resistance as opposed to metal structure counterparts. Extensive research has demonstrated their core potential as more than just mere lightweight substitutes to conventional materials. Prior work done by Mahadev and Chan focused on formulating a modified composite shell theory based prognosis methodology for investigating the structural response of thin-walled circular cylindrical shell type composite configurations under in-plane mechanical loads respectively. The prime motivation to develop this theory stemmed from its capability to generate simple yet accurate closed-form analytical results that can efficiently characterize circular composite shell construction. It showcased the development of a novel mathematical framework to analytically identify the location of the centroid for thin-walled, open cross-section, curved composite shells that were characterized by circumferential arc angle, thickness-to-mean radius ratio, and total laminate thickness. Ply stress variations for curved cylindrical shells were analytically examined under the application of centric tensile and bending loading. This work presents a cost-effective, small-platform experimental methodology by taking advantage of the full-field measurement capability of digital image correlation (DIC) for an accurate assessment of key mechanical parameters such as in-plane mechanical stresses and strains, centroid location etc. Mechanical property measurement of advanced composite materials can become challenging due to their anisotropy and complex failure mechanisms. Full-field displacement measurements are well suited for characterizing the mechanical properties of composite materials because of the complexity of their deformation. This work encompasses the fabrication of a set of curved cylindrical shell coupons, the design and development of a novel test-fixture design and an innovative experimental methodology that demonstrates the capability to very accurately predict the location of centroid in such curved composite cylindrical strips via employing a DIC based strain measurement technique. Error percentage difference between experimental centroid measurements and previously estimated analytical centroid results are observed to be in good agreement. The developed analytical modified-shell theory provides the capability to understand the fundamental behavior of thin-walled cylindrical shells and offers the potential to generate novel avenues to understand the physics of such structures at a laminate level.

Keywords: anisotropy, composites, curved cylindrical shells, digital image correlation

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1275 Acute Respiratory Infections in a Rural Area of the Southwestern Region of Bangladesh: Perceptions, Practices and the Role of First-Time Mothers

Authors: Sonia Mannan

Abstract:

A qualitative study was conducted in a rural area of the southwestern region of Bangladesh to identify perceptions, practices, and the role of first-time mothers surrounding acute respiratory infections (ARI) in infants and children aged under four years. The study reveals that all mothers had knowledge of ARI and were able to identify a number of signs and symptoms. They also recognized pneumonia and thought it to be caused by exposure to cold or weather change, supernatural causes, evil influences, mothers’ negligence, and failure to observe ‘purdah’. They were able to identify chest retractions, difficult breathing, and inability to feed as signs of severe disease needing treatment outside the home. In these cases, spiritual healers were sought, and allopathic treatment was delayed or avoided. Home care practices involved massaging the child with oil and avoiding 'cooling' foods, including water. With the presence of fever and breathing difficulty, mothers tended to increase the number and diversity of medicines, although more concern was expressed about fever than about breathing difficulty. Effective medical care was more likely to be delayed for infants than for older children (they often waited 2-5 days after signs of illness appeared); infants were also more likely to be taken to a spiritual healer as the first-choice provider. The reasons for these perceptions and practices and their implications on the ARI of infants and young children are discussed. Community intervention is identified as viable, effective, and practical to address the body of local socio-cultural knowledge about family practices and the role of the mother regarding the mitigation of ARI in infants and young children.

Keywords: acute respiratory infections , public health, pneumonia, Bangladesh

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1274 The Biosphere as a Supercomputer Directing and Controlling Evolutionary Processes

Authors: Igor A. Krichtafovitch

Abstract:

The evolutionary processes are not linear. Long periods of quiet and slow development turn to rather rapid emergences of new species and even phyla. During Cambrian explosion, 22 new phyla were added to the previously existed 3 phyla. Contrary to the common credence the natural selection or a survival of the fittest cannot be accounted for the dominant evolution vector which is steady and accelerated advent of more complex and more intelligent living organisms. Neither Darwinism nor alternative concepts including panspermia and intelligent design propose a satisfactory solution for these phenomena. The proposed hypothesis offers a logical and plausible explanation of the evolutionary processes in general. It is based on two postulates: a) the Biosphere is a single living organism, all parts of which are interconnected, and b) the Biosphere acts as a giant biological supercomputer, storing and processing the information in digital and analog forms. Such supercomputer surpasses all human-made computers by many orders of magnitude. Living organisms are the product of intelligent creative action of the biosphere supercomputer. The biological evolution is driven by growing amount of information stored in the living organisms and increasing complexity of the biosphere as a single organism. Main evolutionary vector is not a survival of the fittest but an accelerated growth of the computational complexity of the living organisms. The following postulates may summarize the proposed hypothesis: biological evolution as a natural life origin and development is a reality. Evolution is a coordinated and controlled process. One of evolution’s main development vectors is a growing computational complexity of the living organisms and the biosphere’s intelligence. The intelligent matter which conducts and controls global evolution is a gigantic bio-computer combining all living organisms on Earth. The information is acting like a software stored in and controlled by the biosphere. Random mutations trigger this software, as is stipulated by Darwinian Evolution Theories, and it is further stimulated by the growing demand for the Biosphere’s global memory storage and computational complexity. Greater memory volume requires a greater number and more intellectually advanced organisms for storing and handling it. More intricate organisms require the greater computational complexity of biosphere in order to keep control over the living world. This is an endless recursive endeavor with accelerated evolutionary dynamic. New species emerge when two conditions are met: a) crucial environmental changes occur and/or global memory storage volume comes to its limit and b) biosphere computational complexity reaches critical mass capable of producing more advanced creatures. The hypothesis presented here is a naturalistic concept of life creation and evolution. The hypothesis logically resolves many puzzling problems with the current state evolution theory such as speciation, as a result of GM purposeful design, evolution development vector, as a need for growing global intelligence, punctuated equilibrium, happening when two above conditions a) and b) are met, the Cambrian explosion, mass extinctions, happening when more intelligent species should replace outdated creatures.

Keywords: supercomputer, biological evolution, Darwinism, speciation

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1273 The Immunosuppressive Effects of Silymarin with Rapamaycin on the Proliferation and Apoptosis of T Cell

Authors: Nahid Eskandari, Marjan Ghagozolo, Ehsan Almasi

Abstract:

Introduction: Silymarin, as a polyphenolic flavonoid derived from milk thistle (Silybum marianum), is known to have antioxidant, immunomodulatory, antiproliferative, antifibrotic, and antiviral effects. The goal of this study was to determine immunosuppressive effect of Silymarin on proliferation and apoptosis of human T cells in comparison with Rapamycin and FK506. Methods: Peripheral Blood Mononuclear Cells (PBMCs) from healthy individuals were activated with Con A (5µg/ml) and then treated with Silymarin, Rapamycin and FK506 in various concentrations (0.001, 0.01, 0.1, 1, 10,100 and 200M) for 5 days. PBMCs were examined for proliferation using CFSE assay and the concentration that inhibited 50% of the cell proliferation (IC50) was determined for each treatment. For apoptosis assay using flow cytometry, PBMCs were activated with Con A and treated with IC50 dose of Silymarin, Rapamycin and FK506 for 5 days, then cell apoptosis was analysed by FITC-annexin V/PI staining and flow cytometry. The effects of Silymarin, Rapamycin and FK506 on the activation of PARP (poly ADP ribose polymerase) pathway in PBMCs stimulated with Con A and treated with IC50 dose of drugs for 5 days evaluated using the PathScan cleaved PARP sandwich ELISA kit. Results: This study showed that Silymarin had the ability to inhibit T cell proliferation in vitro. Moreover, our results indicated that 100 μM (P < 0.001) and 200 μM (P < 0.001) of Silymarin has more inhibitory effect on T cells proliferation than FK506 and Rapamycin. Our data showed that the effective doses (IC50) of Silymarin, FK506 and Rapamycin were 3×10-5 µM, 10-8 µM and 10-6 µM respectively. Data showed that the inhibitory effect of Silymarin, FK506 and Rapamycin on T cell proliferation was not due to cytotoxicity and none of these drugs at IC50 concentration had not affected the level of cleaved PARP. Conclusion: Silymarin could be a good candidate for immunosuppressive therapy for certain medical conditions with superior efficacy and lesser toxicity in comparison with other immunosuppressive drugs.

Keywords: silymarin, immunosuppressive effect, rapamycin, immunology

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1272 Discrimination and Classification of Vestibular Neuritis Using Combined Fisher and Support Vector Machine Model

Authors: Amine Ben Slama, Aymen Mouelhi, Sondes Manoubi, Chiraz Mbarek, Hedi Trabelsi, Mounir Sayadi, Farhat Fnaiech

Abstract:

Vertigo is a sensation of feeling off balance; the cause of this symptom is very difficult to interpret and needs a complementary exam. Generally, vertigo is caused by an ear problem. Some of the most common causes include: benign paroxysmal positional vertigo (BPPV), Meniere's disease and vestibular neuritis (VN). In clinical practice, different tests of videonystagmographic (VNG) technique are used to detect the presence of vestibular neuritis (VN). The topographical diagnosis of this disease presents a large diversity in its characteristics that confirm a mixture of problems for usual etiological analysis methods. In this study, a vestibular neuritis analysis method is proposed with videonystagmography (VNG) applications using an estimation of pupil movements in the case of an uncontrolled motion to obtain an efficient and reliable diagnosis results. First, an estimation of the pupil displacement vectors using with Hough Transform (HT) is performed to approximate the location of pupil region. Then, temporal and frequency features are computed from the rotation angle variation of the pupil motion. Finally, optimized features are selected using Fisher criterion evaluation for discrimination and classification of the VN disease.Experimental results are analyzed using two categories: normal and pathologic. By classifying the reduced features using the Support Vector Machine (SVM), 94% is achieved as classification accuracy. Compared to recent studies, the proposed expert system is extremely helpful and highly effective to resolve the problem of VNG analysis and provide an accurate diagnostic for medical devices.

Keywords: nystagmus, vestibular neuritis, videonystagmographic system, VNG, Fisher criterion, support vector machine, SVM

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1271 The Gender Criteria of Film Criticism: Creating the ‘Big’, Avoiding the Important

Authors: Eleni Karasavvidou

Abstract:

Social and anthropological research, parallel to Gender Studies, highlighted the relationship between social structures and symbolic forms as an important field of interaction and recording of 'social trends.' Since the study of representations can contribute to the understanding of the social functions and power relations, they encompass. This ‘mirage,’ however, has not only to do with the representations themselves but also with the ways they are received and the film or critical narratives that are established as dominant or alternative. Cinema and the criticism of its cultural products are no exception. Even in the rapidly changing media landscape of the 21st century, movies remain an integral and widespread part of popular culture, making films an extremely powerful means of 'legitimizing' or 'delegitimizing' visions of domination and commonsensical gender stereotypes throughout society. And yet it is film criticism, the 'language per se,' that legitimizes, reinforces, rewards and reproduces (or at least ignores) the stereotypical depictions of female roles that remain common in the realm of film images. This creates the need for this issue to have emerged (also) in academic research questioning gender criteria in film reviews as part of the effort for an inclusive art and society. Qualitative content analysis is used to examine female roles in selected Oscar-nominated films against their reviews from leading websites and newspapers. This method was chosen because of the complex nature of the depictions in the films and the narratives they evoke. The films were divided into basic scenes depicting social functions, such as love and work relationships, positions of power and their function, which were analyzed by content analysis, with borrowings from structuralism (Gennette) and the local/universal images of intercultural philology (Wierlacher). In addition to the measurement of the general ‘representation-time’ by gender, other qualitative characteristics were also analyzed, such as: speaking time, sayings or key actions, overall quality of the character's action in relation to the development of the scenario and social representations in general, as well as quantitatively (insufficient number of female lead roles, fewer key supporting roles, relatively few female directors and people in the production chain and how they might affect screen representations. The quantitative analysis in this study was used to complement the qualitative content analysis. Then the focus shifted to the criteria of film criticism and to the rhetorical narratives that exclude or highlight in relation to gender identities and functions. In the criteria and language of film criticism, stereotypes are often reproduced or allegedly overturned within the framework of apolitical "identity politics," which mainly addresses the surface of a self-referential cultural-consumer product without connecting it more deeply with the material and cultural life. One of the prime examples of this failure is the Bechtel Test, which tracks whether female characters speak in a film regardless of whether women's stories are represented or not in the films analyzed. If perceived unbiased male filmmakers still fail to tell truly feminist stories, the same is the case with the criteria of criticism and the related interventions.

Keywords: representations, context analysis, reviews, sexist stereotypes

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1270 'Get the DNR': Exploring the Impact of an Educational eModule on Internal Medicine Residents' Attitudes and Approaches to Goals of Care Conversations

Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

Abstract:

Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

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1269 Effect of Non-Surgical Periodontal Therapy According to Periodontal Severity

Authors: Jungbin Lim, Bohee Kang, Heelim Lee, Sunjin Kim, GeumHee Choi, Jae-Suk Jung, Suk Ji

Abstract:

Nonsurgical periodontal therapies have, for several decades, been the basis of periodontal treatment concepts. The aim of this paper is to investigate the effectiveness of non-surgical periodontal therapy according to the severity of periodontitis disease. Methods: Retrospective data of patients who visited Department of periodontics in Ajou University Medical Center from 2016 to 2022 were collected. Among the patients, those who took full mouth examination of clinical parameters and non-surgical periodontal therapy were chosen for this study. Selected patients were divided into initial, moderate, and severe periodontitis based on severity and complexity of management (2018 World Workshop EFP/AAP consensus). Recall visits with clinical periodontal examination were scheduled for 1,2,3 months or 1,3,6 months after the treatment. The results were evaluated by recordings of mean probing pocket depth (mean PD), mean clinical attachment levels (mean CAL), bleeding on probing (BOP%), mean gingival index (mean GI), mean regression, mean sulcus bleeding index (mean SBI), mean plaque scores (mean PI). All statistical analyses were performed with R software, version 4.3.0. A level of significance, P<0.05, was considered to be statistically significant. Results: A total of 92 patients were included in this study. 15 patients were diagnosed as initial periodontitis, 14 moderate periodontitis, and 63 severe periodontitis. The all parameters except for mean recession decreased over time in all groups. The amount of mean PD decreased were the greatest in severe periodontitis group followed by moderate and initial, which was found to be statistically significant. The changes of mean PD were 0.15±0.05 mm, 0.37±0.06 mm, and 1.01±0.07 mm (initial, moderate, and severe, respectively, P<0.001). When comparing before and after treatment, the reductions in BOP(%), mean GI, mean SBI, and mean PI were statistically significant. Conclusion: All patients who received non-surgical periodontal therapy showed periodontal healing in terms of improvements in clinical parameters, and it was greater in the severe group.

Keywords: periodontology, clinical periodontology, oral treatment, comprehensive preventive dentistry, non-surgical periodontal therapy

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1268 Menstruating Bodies and Social Control – Insights From Dignity Without Danger: Collaboratively Analysing Menstrual Stigma and Taboos in Nepal

Authors: Sara Parker, Kay Standing

Abstract:

This paper will share insights into how menstruators bodies in Nepal are viewed and controlled in Nepal due to the deeply held stigmas and taboos that exist that frame menstrual blood as impure and polluting. It draws on a British Academy Global Challenges Research (BA/GCRF) funded project, ‘Dignity Without Danger,’ that ran from December 2019 to 2022. In Nepal, beliefs and myths around menstrual related practices prevail and vary in accordance to time, generation, caste and class. Physical seclusion and/or restrictions include the consumption of certain foods, the ability to touch certain people and objects, and restricted access to water sources. These restrictions not only put women at risk of poor health outcomes, but they also promote discrimination and challenge fundamental human rights. Despite the pandemic, a wealth of field research and creative outputs have been generated to help break the silence that surrounds menstruation and also highlights the complexity of addressing the harms associated with the exclusion from sacred and profane spaces that menstruators face. Working with locally recruited female research assistants, NGOS and brining together academics from the UK and Nepal, we explore the intersecting factors that impact on menstrual experiences and how they vary throughout Nepal. WE concur with Tamang that there is no such thing as a ‘Nepali Woman’, and there is no one narrative that captures the experiences of menstruators in Nepal. These deeply held beliefs and practices mean that menstruators are denied their right to a dignified menstruation. By being excluded from public and private spaces, such as temples and religious sites, as well as from kitchens and your own bedroom in your own home, these beliefs impact on individuals in complex and interesting ways. Existing research in Nepal by academics and activists demonstrates current programmes and initiatives do not fully address the misconceptions that underpin the exclusionary practices impacting on sexual and reproductive health, a sense of well being and highlight more work is needed in this area. Research has been conducted in all 7 provinces and through exploring and connecting disparate stories, artefacts and narratives, we will deepen understanding of the complexity of menstrual practices enabling local stakeholders to challenge exclusionary practices. By using creative methods to engage with stakeholders and share our research findings as well as highlighting the wealth of activism in Nepal. We highlight the importance of working with local communities, leaders and cutting across disciplines and agencies to promote menstrual justice and dignity. Our research findings and creative outputs that we share on social media channels such as Dignity Without Danger Facebook, Instagram and you tube stress the value of employing a collaborative action research approach to generate material which helps local people take control of their own narrative and change social relations that lead to harmful practices.

Keywords: menstruation, Nepal, stigma, social norms

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1267 Assessment of Nurses’ Knowledge of the Glasgow Coma Scale in a Saudi Tertiary Care Hospital: A Cross-Sectional Study

Authors: Roaa Al Sharif, Salsabil Abo Al-Azayem, Nimah Alsomali, Wjoud Alsaeed, Nawal Alshammari, Abdulaziz Alwatban, Yaseen Alrabae, Razan Orfali, Faisal Alqarni, Ahmad Alrasheedi

Abstract:

from various countries have revealed that nurses possess only a basic understanding of the GCS. Regarding this matter, limited knowledge is available about the situation in Saudi Arabia. Overall, the available research suggests that there is room for improvement in the knowledge of the GCS among nurses in Saudi Arabia. Further training and education programs may be beneficial in enhancing nurses' understanding and application of the GCS in clinical practice. Objective: To determine the level of knowledge and competence in assessing the GCS among staff nurses and to identify factors that might influence their knowledge at King Fahd Medical City in Riyadh, Saudi Arabia. Methods: A descriptive, cross-sectional survey involving 199 KFMC staff nurses was conducted. Nurses were provided with a structured questionnaire, and data were collected and analyzed using SPSS version 16, employing descriptive statistics and Chi-square tests. Results: The majority, 81.4% of nurses, had an average level of knowledge in assessing the Glasgow Coma Scale (GCS). The mean score for measuring the level of knowledge among staff nurses in GCS assessment was 8.8 ± 1.826. Overall, 13.6% of respondents demonstrated good knowledge of the GCS, scoring between 11 and 15 points, while only 5% of nurses exhibited poor knowledge of the GCS assessment. There was a significant correlation between knowledge and nurses' departments (χ2(2) = 19.184, p < 0.001). χ2(2) = 19.184," representing a Chi-square statistic with 2 degrees of freedom used to test the association between categorical variables in the data analysis. Conclusion: The findings indicate that knowledge of GCS assessment among staff nurses in a single center in Saudi Arabia is moderate. Therefore, there is a need for continuous education programs to enhance their competence in using this assessment.

Keywords: Glasgow Coma Scale, brain injury, nurses’ knowledge assessment, continuous education programs

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1266 Ultrasound Disintegration as a Potential Method for the Pre-Treatment of Virginia Fanpetals (Sida hermaphrodita) Biomass before Methane Fermentation Process

Authors: Marcin Dębowski, Marcin Zieliński, Mirosław Krzemieniewski

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As methane fermentation is a complex series of successive biochemical transformations, its subsequent stages are determined, to a various extent, by physical and chemical factors. A specific state of equilibrium is being settled in the functioning fermentation system between environmental conditions and the rate of biochemical reactions and products of successive transformations. In the case of physical factors that influence the effectiveness of methane fermentation transformations, the key significance is ascribed to temperature and intensity of biomass agitation. Among the chemical factors, significant are pH value, type, and availability of the culture medium (to put it simply: the C/N ratio) as well as the presence of toxic substances. One of the important elements which influence the effectiveness of methane fermentation is the pre-treatment of organic substrates and the mode in which the organic matter is made available to anaerobes. Out of all known and described methods for organic substrate pre-treatment before methane fermentation process, the ultrasound disintegration is one of the most interesting technologies. Investigations undertaken on the ultrasound field and the use of installations operating on the existing systems result principally from very wide and universal technological possibilities offered by the sonication process. This physical factor may induce deep physicochemical changes in ultrasonicated substrates that are highly beneficial from the viewpoint of methane fermentation processes. In this case, special role is ascribed to disintegration of biomass that is further subjected to methane fermentation. Once cell walls are damaged, cytoplasm and cellular enzymes are released. The released substances – either in dissolved or colloidal form – are immediately available to anaerobic bacteria for biodegradation. To ensure the maximal release of organic matter from dead biomass cells, disintegration processes are aimed to achieve particle size below 50 μm. It has been demonstrated in many research works and in systems operating in the technical scale that immediately after substrate supersonication the content of organic matter (characterized by COD, BOD5 and TOC indices) was increasing in the dissolved phase of sedimentation water. This phenomenon points to the immediate sonolysis of solid substances contained in the biomass and to the release of cell material, and consequently to the intensification of the hydrolytic phase of fermentation. It results in a significant reduction of fermentation time and increased effectiveness of production of gaseous metabolites of anaerobic bacteria. Because disintegration of Virginia fanpetals biomass via ultrasounds applied in order to intensify its conversion is a novel technique, it is often underestimated by exploiters of agri-biogas works. It has, however, many advantages that have a direct impact on its technological and economical superiority over thus far applied methods of biomass conversion. As for now, ultrasound disintegrators for biomass conversion are not produced on the mass-scale, but by specialized groups in scientific or R&D centers. Therefore, their quality and effectiveness are to a large extent determined by their manufacturers’ knowledge and skills in the fields of acoustics and electronic engineering.

Keywords: ultrasound disintegration, biomass, methane fermentation, biogas, Virginia fanpetals

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1265 Evaluation of Alternative Approaches for Additional Damping in Dynamic Calculations of Railway Bridges under High-Speed Traffic

Authors: Lara Bettinelli, Bernhard Glatz, Josef Fink

Abstract:

Planning engineers and researchers use various calculation models with different levels of complexity, calculation efficiency and accuracy in dynamic calculations of railway bridges under high-speed traffic. When choosing a vehicle model to depict the dynamic loading on the bridge structure caused by passing high-speed trains, different goals are pursued: On the one hand, the selected vehicle models should allow the calculation of a bridge’s vibrations as realistic as possible. On the other hand, the computational efficiency and manageability of the models should be preferably high to enable a wide range of applications. The commonly adopted and straightforward vehicle model is the moving load model (MLM), which simplifies the train to a sequence of static axle loads moving at a constant speed over the structure. However, the MLM can significantly overestimate the structure vibrations, especially when resonance events occur. More complex vehicle models, which depict the train as a system of oscillating and coupled masses, can reproduce the interaction dynamics between the vehicle and the bridge superstructure to some extent and enable the calculation of more realistic bridge accelerations. At the same time, such multi-body models require significantly greater processing capacities and precise knowledge of various vehicle properties. The European standards allow for applying the so-called additional damping method when simple load models, such as the MLM, are used in dynamic calculations. An additional damping factor depending on the bridge span, which should take into account the vibration-reducing benefits of the vehicle-bridge interaction, is assigned to the supporting structure in the calculations. However, numerous studies show that when the current standard specifications are applied, the calculation results for the bridge accelerations are in many cases still too high compared to the measured bridge accelerations, while in other cases, they are not on the safe side. A proposal to calculate the additional damping based on extensive dynamic calculations for a parametric field of simply supported bridges with a ballasted track was developed to address this issue. In this contribution, several different approaches to determine the additional damping of the supporting structure considering the vehicle-bridge interaction when using the MLM are compared with one another. Besides the standard specifications, this includes the approach mentioned above and two additional recently published alternative formulations derived from analytical approaches. For a bridge catalogue of 65 existing bridges in Austria in steel, concrete or composite construction, calculations are carried out with the MLM for two different high-speed trains and the different approaches for additional damping. The results are compared with the calculation results obtained by applying a more sophisticated multi-body model of the trains used. The evaluation and comparison of the results allow assessing the benefits of different calculation concepts for the additional damping regarding their accuracy and possible applications. The evaluation shows that by applying one of the recently published redesigned additional damping methods, the calculation results can reflect the influence of the vehicle-bridge interaction on the design-relevant structural accelerations considerably more reliable than by using normative specifications.

Keywords: Additional Damping Method, Bridge Dynamics, High-Speed Railway Traffic, Vehicle-Bridge-Interaction

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1264 Filled Polymer Composite

Authors: Adishirin Mammadov

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Polymers and polymer composites play vital roles in diverse industries, including food and beverage packaging, transportation innovations, and medical advancements. However, the advancements in polymer technology bring certain risks, particularly concerning water and soil pollution due to the presence of polymers. The creation of new polymers is a critical aspect of this field. While the primary focus is on improving their physical and chemical properties, ensuring their ecological compatibility is equally important. An advanced method for developing innovative polymer types involves integrating fillers with diverse characteristics, offering advantages such as cost reduction and improved quality indicators. In the conducted research, efforts were made to enhance environmental aspects by employing waste fillers. Specifically, low-density polyethylene (LDPE) was used as the polymer, and waste from cocoon factories was chosen as the filler. Following a process of cleaning, drying, and crushing the filler to specific dimensions, it was incorporated into polyethylene through a mechanical-chemical method under laboratory conditions. The varied rheological properties of the resulting polyethylene compositions examined at temperatures ranging from 145 to 165 degrees Celsius. These compositions demonstrated different rheological properties at various temperature intervals. Achieving homogeneity in the obtained compositions is crucial in the polymers mechanochemical process. Beyond rheological properties, swelling rates in different environments and percentages of mass loss at different temperatures learned using the differential thermal analysis method. The research revealed that, to a certain extent, the physico-chemical properties of polyethylene were not significantly affected by the polymer compositions. This suggests that incorporating cocoon waste enables cost reduction in composite production while positively impacting the environment.

Keywords: polyethylene, polymer, composites, filler, reology

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1263 Feasibility and Efficacy of Matrix Model in Arabic Countries

Authors: Yasin Ibrahim, Hisham Almohandes, Chia Hsu, Regina Baronia, Jesse Worsham, Sara Abdelgawad, Mansour Shawky, Mohammed Abdelfattah, Nesif Alhemiary

Abstract:

Background: The matrix model (MM) is an evidence-based program for treating substance use disorders. Since first translated into Arabic in 2010, the MM has been gaining popularity in Arabic countries. However, there is no published data as pertains to its efficacy and feasibility in Arabic communities. Here we aimed at exploring providers’ perspectives on its feasibility and efficacy. Methods: Eight addiction treatment centers from four Arabic countries, namely Egypt, Kingdom of Saudi Arabia, the United Arab Emirates, and Iraq, were contacted via email. They were asked to fill in a 21-item questionnaire. Results: Matrix model continues to be utilized in 6 out of the 8 contacted programs. One center in Egypt has discontinued the MM as the providers felt it was not suitable for substance disorders other than stimulants, which are not common in Egypt. Baghdad University Medical Center has substituted MM with Colombo Program as there have been more training opportunities available for it. Data showed wide variability in regards to number of clients treated with the MM (from 300 to 2500). The Arabic version was utilized for training providers in 5 out of the 8 centers while the providers of the other 3 have been trained in the United States. All providers reported that MM made their job significantly easier, and seven providers believed that MM has favorably affected the relapse rate. In all of the six centers, MM is being utilized for many substance use disorders in addition to stimulant use disorders. Reported challenges included the acceptability of patients and their families, difficulty understanding some concepts, and high drop rates in some centers. Conclusion: Matrix model seems to be a valuable modality for the treatment of substance use disorders in Arabic countries. It has its own challenges and limitations that call for more culturally adapted versions.

Keywords: addiction, Arabic countries, developing countries, matrix model

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1262 Automatic Near-Infrared Image Colorization Using Synthetic Images

Authors: Yoganathan Karthik, Guhanathan Poravi

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Colorizing near-infrared (NIR) images poses unique challenges due to the absence of color information and the nuances in light absorption. In this paper, we present an approach to NIR image colorization utilizing a synthetic dataset generated from visible light images. Our method addresses two major challenges encountered in NIR image colorization: accurately colorizing objects with color variations and avoiding over/under saturation in dimly lit scenes. To tackle these challenges, we propose a Generative Adversarial Network (GAN)-based framework that learns to map NIR images to their corresponding colorized versions. The synthetic dataset ensures diverse color representations, enabling the model to effectively handle objects with varying hues and shades. Furthermore, the GAN architecture facilitates the generation of realistic colorizations while preserving the integrity of dimly lit scenes, thus mitigating issues related to over/under saturation. Experimental results on benchmark NIR image datasets demonstrate the efficacy of our approach in producing high-quality colorizations with improved color accuracy and naturalness. Quantitative evaluations and comparative studies validate the superiority of our method over existing techniques, showcasing its robustness and generalization capability across diverse NIR image scenarios. Our research not only contributes to advancing NIR image colorization but also underscores the importance of synthetic datasets and GANs in addressing domain-specific challenges in image processing tasks. The proposed framework holds promise for various applications in remote sensing, medical imaging, and surveillance where accurate color representation of NIR imagery is crucial for analysis and interpretation.

Keywords: computer vision, near-infrared images, automatic image colorization, generative adversarial networks, synthetic data

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1261 Determinants of Child Malnutrition in Sub-Saharan Africa

Authors: Habtamu Fufa, Yemane Berhane

Abstract:

Child under nutrition has long-term consequences for intellectual ability, economic productivity, reproductive performance and susceptibility to metabolic and cardiovascular disease. The unacceptably high prevalence of malnutrition in young children of the region has not changed much over the last decades, which could make the achievement of the corresponding Millennium Development Goals very unlikely. Despite the well-documented problems of child malnutrition in Sub-Saharan Africa, there is few systematic review of evidences on determinants of child malnutrition in the region. The current available evidence on determinants of child under nutrition in Sub-Saharan Africa is systematically reviewed. The method used in searching relevant literature was using bio medical databases PUBMED, Google scholar and the website of the World Health Organization on nutrition using the following key words: "Determinants “, "Child Malnutrition", and "Sub- Saharan Africa". The search was limited to articles published in and after 1995 up to date. In all the reviewed articles, the data were analyzed using multivariate regression analysis and or odds ratios for significance of determinants in child malnutrition. Synthesis of 40 published articles from various countries of the region is done and noted that household economic status, maternal education, disease, breastfeeding practices, age and sex of a child, birth interval and residential areas were found to be determinants of child under nutrition. Poverty remains the main factor of malnutrition in Sub-Saharan Africa and poor education of parents aggravates the malnutrition through perpetuation of poor nutrition practices. Male children under five years are the most affected ones. Understanding of these determinants of poor nutritional attainment would provide insights in designing interventions for reducing the high levels of child malnutrition in this region. Large-scale multi-sectoral community-based interventions are urgently needed for a sustainable improvement of child nutritional & health status in Sub-Saharan Africa.

Keywords: child malnutrition, determinants, Sub-Saharan Africa, health status

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