Search results for: urban flood risk
Commenced in January 2007
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Edition: International
Paper Count: 9702

Search results for: urban flood risk

2172 Relationship between Physical Activity Level and Functional Movement in 16-years old Schoolchildren: A Multilevel Modelling Approach

Authors: Josip Karuc, Marjeta Mišigoj-Duraković, Goran Marković, Vedran Hadžić, Michael J. Duncan, Hrvoje Podnar, Maroje Sorić

Abstract:

As a part of the CRO-PALS longitudinal study, this investigation aimed to examine the association between different levels of physical activity (PA) and movement quality in 16-years old school children. The total number of participants in this research was 725. Movement quality was assessed via the Functional Movement Screen (FMSTM), and the PA level was estimated using the School Health Action, Planning, and Evaluation System (SHAPES) questionnaire. In addition, body fat and socioeconomic status (SES) were assessed. In order to investigate the association between total FMS score and different levels of PA, multilevel modeling was employed for boys (n=359) and girls (n=366) separately. All models were adjusted for age, body fat, and SES. Among boys, MVPA, MPA, and VPA were not significant predictors of the total FMS score (β=0.000, p=0.78; β=-0.002, p=0.455; β=0.004, p=0.158, respectively). On the contrary, among girls, VPA and MVPA showed significant effects on the total FMS score (β=0.011, p=0.001, β=0.005, p=0.006, respectively). The findings of this research provide evidence that the intensity of PA is a minor but relevant factor in describing the association between PA and movement quality in adolescent girls but not in boys. This means that the PA level does not guarantee optimal functional movement patterns. Therefore, practicing functional movement patterns in an isolated manner and at moderate to vigorous intensity could be beneficial in order to reduce the risk of injury incidence and potential orthopedic abnormalities in later life. This work was supported by the Croatian Science Foundation, grant no: IP-2016-06-9926 and grant no: DOK-2018-01-2328.

Keywords: functional movement screen, fundamental movement patterns, movement quality, pediatric

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2171 Mercury Contamination of Wetland Caused by Wastewater from Chlor-Alkali Industry

Authors: Mitsuo Yoshida

Abstract:

A significant mercury contamination of soil/sediment was unveiled by an environmental monitoring program in a wetland along La Plata River, west to Montevideo City, Uruguay. The mercury contamination was caused by industrial wastewater discharged from a chlor-alkali plant using a mercury-cell process. The contamination level is above 60 mg/kg in soil/sediment. Most of mercury (Hg) in the environment is inorganic, but some fractions are converted by bacteria to methylmercury (MeHg), a toxic organic compound. MeHg biologically accumulates through a food-chain and become serious public health risk. In order to clarify the contaminated part for countermeasure operation, an intervention value of mercury contamination of sediment/soil was defined as 15 mg/kg (total Hg) by the authority. According to the intervention value, mercury contaminated area in the La Plata site is approximately 48,280 m² and estimated total volume of contaminated sediments/soils was around 18,750 m³. The countermeasures to contaminated zone were proposed in two stages; (i) mitigation of risks for public health and (ii) site remediation. The first stage is an installation of fens and net around the contamination zone, for mitigating risks of exposure, inhalation, and intake. The food chain among wetland-river ecosystem was also interrupted by the installation of net and fens. The state of mercury contamination in La Plata site and plan of countermeasure was disclosed to local people and the public, and consensus on setting off-limit area was successfully achieved. Mass media also contribute to share the information on the contamination site. The cost for countermeasures was borne by the industry under the polluter-pay-principle.

Keywords: chlor-alkali plant, mercury contamination, polluter pay principle, Uruguay, wetland

Procedia PDF Downloads 138
2170 Examining Patterns in Ethnoracial Diversity in Los Angeles County Neighborhoods, 2016, Using Geographic Information System Analysis and Entropy Measure of Diversity

Authors: Joseph F. Cabrera, Rachael Dela Cruz

Abstract:

This study specifically examines patterns that define ethnoracially diverse neighborhoods. Ethnoracial diversity is important as it facilitates cross-racial interactions within neighborhoods which have been theorized to be associated with such outcomes as intergroup harmony, the reduction of racial and ethnic prejudice and discrimination, and increases in racial tolerance. Los Angeles (LA) is an ideal location to study ethnoracial spatial patterns as it is one of the most ethnoracially diverse cities in the world. A large influx of Latinos, as well as Asians, have contributed to LA’s urban landscape becoming increasingly diverse over several decades. Our dataset contains all census tracts in Los Angeles County in 2016 and incorporates Census and ACS demographic and spatial data. We quantify ethnoracial diversity using a derivative of Simpson’s Diversity Index and utilize this measure to test previous literature that suggests Latinos are one of the key drivers of changing ethnoracial spatial patterns in Los Angeles. Preliminary results suggest that there has been an overall increase in ethnoracial diversity in Los Angeles neighborhoods over the past sixteen years. Patterns associated with this trend include decreases in predominantly white and black neighborhoods, increases in predominantly Latino and Asian neighborhoods, and a general decrease in the white populations of the most diverse neighborhoods. A similar pattern is seen in neighborhoods with large Latino increases- a decrease in white population, but with an increase in Asian and black populations. We also found support for previous research that suggests increases in Latino and Asian populations act as a buffer, allowing for black population increases without a sizeable decrease in the white population. Future research is needed to understand the underlying causes involved in many of the patterns and trends highlighted in this study.

Keywords: race, race and interaction, racial harmony, social interaction

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2169 Prevalence and Associated Factors of Periodontal Disease among Diabetes Patients in Addis Ababa, Ethiopia, 2018

Authors: Addisu Tadesse Sahile, Tennyson Mgutshini

Abstract:

Background: Periodontal disease is a common, complex, inflammatory disease characterized by the destruction of tooth-supporting soft and hard tissues of the periodontium and a major public health problem across developed and developing countries. Objectives: The study was aimed at assessing the prevalence of periodontal disease and associated factors among diabetes patients in Addis Ababa, Ethiopia, 2018. Methods: Institutional based cross-sectional study was conducted on 388 diabetes patients selected by systematic random sampling method from March to May 2018. The study was conducted at two conveniently selected public hospitals in Addis Ababa. Data were collected with pre-tested, structured and translated questionnaire then entered to SPSS version 23 software for analysis. Descriptive statistics as a summary, in line with chi-square and binary logistics regression to identify factors associated with periodontal disease, were applied. A 95% CI with a p-value less than 5% was used as a level of significance. Results: Ninety-one percent (n=353) of participants had periodontal disease while oral examination was done in six regions. While only 9% (n=35) of participants were free of periodontal disease. The number of tooth brushings per day, correct techniques of brushing, malocclusion, and fillings that are defective were associated with periodontal disease at p < 0.05. Conclusion and recommendation: A higher prevalence of periodontal disease among diabetes patient was observed. The frequency of tooth brushing, correct techniques of brushing, malocclusion and defective fillings were associated with periodontal disease. Emphasis has to be given to oral health of diabetes patients by every concerned body so as to control the current higher burden of periodontal disease in diabetes.

Keywords: periodontal disease, risk factors, diabetes mellitus, Addis Ababa

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2168 Inhibitory Activity of Lactic Acid Bacteria on the Growth and Biogenic Amines Production by Foodborne Pathogens and Food Spoilage Bacteria

Authors: Abderrezzak khatib

Abstract:

Biogenic amines are low molecular weight nitrogenous compounds that have the potential to accumulate in food, posing a significant risk to food safety and human health. In this study, we investigated the inhibitory activity of three strains of lactic acid bacteria (LAB), against the growth and production of biogenic amines by both foodborne pathogens and food spoilage bacteria. The foodborne pathogens studied included Staphylococcus aureus, Pseudomonas aeruginosa, and Salmonella Paratyphi, while the food spoilage bacteria comprised Enterobacter cloacae and Proteus mirabilis. The methodology involved bacterial growth determination in petri dishes, bacterial culture extraction and derivatization, and biogenic amine analysis using HPLC. Our findings revealed that the inhibitory effects of LAB on these pathogens varied, with all three LAB strains demonstrating a remarkable reduction in the total bacterial count when combined with most pathogens, compared to the individual cultures of the pathogens. Furthermore, the presence of LAB in co-cultures with the pathogens resulted in a significant decrease in the production of tyramine and other biogenic amines by the pathogens themselves. These results suggest that LAB strains hold considerable promise in preventing the accumulation of biogenic amines in food products, thereby enhancing food safety. This study provides insights into the potential utilization of LAB in the context of preserving and ensuring the safety of food products. It highlights the significance of conducting additional research endeavors to elucidate the underlying mechanisms involved and to identify the precise bioactive compounds that are responsible for the observed inhibitory effects.

Keywords: food safety, lactic acid bacteria, foodborne pathogens, food spoilage bacteria, biogenic amines, tyrosine

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2167 Conciliation Bodies as an Effective Tool for the Enforcement of Air Passenger Rights: Examination of an Exemplary Model in Germany

Authors: C. Hipp

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The EU Regulation (EC) No 261/2004 under which air passengers can claim compensation in the event of denied boarding, cancellation or long delay of flights has to be regarded as a substantial progress for the consumer protection in the field of air transport since it went into force in February 2005. Nevertheless, different reviews of its effective functioning demonstrate that most passengers affected by service disruptions do not enforce their complaints and claims towards the airline. The main cause of this is not only the unclear legal situation due to the fact that the regulation itself suffers from many undetermined terms and loopholes it is also attributable to the strategy of the airlines which do not handle the complaints of the passengers or exclude their duty to compensate them. Economically contemplated, reasons like the long duration of a trial and the cost risk in relation to the amount of compensation make it comprehensible that passengers are deterred from enforcing their rights by filing a lawsuit. The paper focusses on the alternative dispute resolution namely the recently established conciliation bodies which deal with air passenger rights. In this paper, the Conciliation Body for Public Transport in Germany (Schlichtungsstelle für den öffentlichen Personenverkehr – SÖP) is examined as a successful example of independent consumer arbitration service. It was founded in 2009 and deals with complaints in the field of air passenger rights since November 2013. According to the current situation one has to admit that due to its structure and operation it meets on the one hand the needs of the airlines by giving them an efficient tool of their customer relation management and on the other hand that it contributes to the enforcement of air passenger rights effectively.

Keywords: air passenger rights, alternative dispute resolution, consumer protection, EU law regulation (EC) 261/2004

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2166 Prevalence and Associated Factors of Stunting among 6-59 Months Children in Pastoral Community of Korahay Zone, Somali Regional State, Ethiopia 2016

Authors: Sisay Shine, Frew Tadesse, Zemenu Shiferaw, Lema Mideksa

Abstract:

Background: Stunting is one of the most important public health problems in Ethiopia with an estimated 44.4% of children less than five years of age are stunted. Thus, this study aimed to assess prevalence and associated factors of stunting among 6-59 months children in pastoral community of Korahay Zone, Somali Regional State, Ethiopia. Objective of the study: To assess prevalence and associated factors of stunting among 6-59 months children in pastoral community of Korahay Zone, Somali Regional State, Ethiopia, 2016. Methods: Community based cross sectional study design was done among 770 children in pastoral community of Korahay Zone. Systematic sampling techniques were used to select households and took child mother pair from each selected households. Data was collected using pre-tested and structured questionnaire. Odds ratio with 95% confidence interval was used to assess level of significance. Result: Prevalence of stunting among 6-59 months age children was 31.9%. Sex (AOR: 1.47, 95%CI 1.02, 2.11), age (AOR: 2.10, 95%CI 1.16, 3.80), maternal education (AOR: 3.42, 95%CI 1.58, 7.41), maternal occupation (AOR: 3.10, 95%CI 1.85, 5.19), monthly income (AOR: 1.47, 95%CI 1.03, 2.09), PNC visits (AOR: 1.59, 95%CI 1.07, 2.37), source of water (AOR: 3.41, 95%CI 1.96, 5.93), toilet availability (AOR: 1.71, 95%CI 1.13, 2.58), first milk feeding (AOR: 3.37, 95%CI 2.27, 5.02) and bottle feeding (AOR: 2.07, 95%CI 1.34, 3.18) were significant predictors of stunting. Conclusion and recommendations: Prevalence of stunting among 6-59 months children was high 31.9%. Lack maternal education, not feeding first milk, unsafe water supply, absence toilet availability and bottle feeding can increase the risk of stunting. So, educating mothers on child feeding practice, sanitation and important of first milk can reduce stunting.

Keywords: dietary, environmental, healthcare, socio-demographic, stunting

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2165 A Cross-Sectional Study on the Correlation between Body Mass Index and Self-Esteem among Children Ages 9-12 Years Old in a Public Elementary School in Makati, Philippines

Authors: Jerickson Abbie Flores, Jana Fragante, Jan Paolo Dipasupil, Jan Jorge Francisco

Abstract:

Malnutrition is one of the rapidly growing health problems affecting the world at present. Children affected are not only at risk for significant health problems, but are also faced with psychological and social consequences, including low self-esteem. School-age children are specifically vulnerable to develop poor self-esteem especially when their peers find them physically unattractive. Thus, malnutrition, whether obesity or undernourishment, contributes a significant role to a developing child’s health and behavior. This research aims to determine if there is a significant difference on the level of self-esteem among Filipino children ages 9-12 years old with abnormal body mass index (BMI) and those children with desirable BMI. Using a cross-sectional study design, the correlation between body mass index (BMI) and self-esteem was observed among children ages 9-12 years old. Participants took the Hare self esteem questionnaire, which is specifically designed to measure self-esteem in school age children. The lowest possible score is 15 and the highest possible score is 45. A total of 1140 students with ages 9-12 years old from Cembo Elementary School (public school) participated in the study. Among the participants, 239 out of the 1140 have desirable body mass index, 878 are underweight, and 23 are overweight. Using the test questionnaire, the computed mean scores were 36.599, 36.045 and 36.583 for normal, underweight and overweight categories respectively. Using Pearson’s Correlation Test and Spearman’s Correlation Coefficient Test, the study showed positive correlation (p value of 0.047 and 0.004 respectively) between BMI and Self-esteem scores which indicates that the higher the BMI, the higher the self-esteem of the participants.

Keywords: body mass index, malnutrition, school-age children, self-esteem

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2164 Application of Observational Medical Outcomes Partnership-Common Data Model (OMOP-CDM) Database in Nursing Health Problems with Prostate Cancer-a Pilot Study

Authors: Hung Lin-Zin, Lai Mei-Yen

Abstract:

Prostate cancer is the most commonly diagnosed male cancer in the U.S. The prevalence is around 1 in 8. The etiology of prostate cancer is still unknown, but some predisposing factors, such as age, black race, family history, and obesity, may increase the risk of the disease. In 2020, a total of 7,178 Taiwanese people were nearly diagnosed with prostate cancer, accounting for 5.88% of all cancer cases, and the incidence rate ranked fifth among men. In that year, the total number of deaths from prostate cancer was 1,730, accounting for 3.45% of all cancer deaths, and the death rate ranked 6th among men, accounting for 94.34% of the cases of male reproductive organs. Looking for domestic and foreign literature on the use of OMOP (Observational Medical Outcomes Partnership, hereinafter referred to as OMOP) database analysis, there are currently nearly a hundred literature published related to nursing-related health problems and nursing measures built in the OMOP general data model database of medical institutions are extremely rare. The OMOP common data model construction analysis platform is a system developed by the FDA in 2007, using a common data model (common data model, CDM) to analyze and monitor healthcare data. It is important to build up relevant nursing information from the OMOP- CDM database to assist our daily practice. Therefore, we choose prostate cancer patients who are our popular care objects and use the OMOP- CDM database to explore the common associated health problems. With the assistance of OMOP-CDM database analysis, we can expect early diagnosis and prevention of prostate cancer patients' comorbidities to improve patient care.

Keywords: OMOP, nursing diagnosis, health problem, prostate cancer

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2163 HLA-DPB1 Matching on the Outcome of Unrelated Donor Hematopoietic Stem Cell Transplantation

Authors: Shi-xia Xu, Zai-wen Zhang, Ru-xue Chen, Shan Zhou, Xiang-feng Tang

Abstract:

Objective: The clinical influence of HLA-DPB1 mismatches on clinical outcome of HSCT is less clear. This is the first meta-analysis to study the HLA-DPB1 matching statues on clinical outcomes after unrelated donor HSCT. Methods: We searched the CIBMTR, Cochrane Central Register of Controlled Trials (CENTRAL) and related databases (1995.01–2017.06) for all relevant articles. Comparative studies were used to investigate the HLA-DPB1 loci mismatches on clinical outcomes after unrelated donor HSCT, such as the disease-free survival (DFS), overall survival, GVHD, relapse, and transplant-related mortality (TRM). We performed meta-analysis using Review Manager 5.2 software and funnel plot to assess the bias. Results: At first, 1246 articles were retrieved, and 18 studies totaling 26368 patients analyzed. Pooled comparisons of studies found that the HLA-DPB1 mismatched group had a lower rate of DFS than the DPB1-matched group, and lower OS in non-T cell depleted transplantation. The DPB1 mismatched group has a higher incidence of aGVHD and more severe ( ≥ III degree) aGvHD, lower rate of relapse and higher TRM. Moreover, compared with 1-antigen mismatch, 2-antigen mismatched led to a higher risk of TRM and lower relapse rate. Conclusions: This meta-analysis indicated HLA-DPB1 has important influence on survival and transplant-related complications during unrelated donor HSCT and HLA-DPB1 donor selection strategies have been proposed based on a personalized algorithm.

Keywords: human leukocyte antigen, DPB1, transplant, meta-analysis, outcome

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2162 The Impact of Work Stress on Professionals' Life and Health: The Usage of Instant Messaging Applications

Authors: Pui-Lai To, Chechen Liao, Ming-Chi Sung

Abstract:

Work and family life are the most important areas for men and women today. Every professional is required to meet and fulfill the responsibilities of work and family roles. Although the development and popularity of communication technology bring a lot of benefits, including effective and efficient communication, may also generate conflicts between work and family life. Since mobile devices and the applications of mobile devices, such as instant messages, are ubiquitous, the boundaries of work and family roles are increasingly blurred. Professionals may be in the risk of work over-loading and work-family conflict. This study examines the impact of work stress on professionals’ life and health in the context of instant messaging application of smart phone. This study uses a web-based questionnaire to collect samples. The questionnaires are sent via virtual community sites, instant messaging applications, and e-mail. The study develops and empirically validates a work-family conflict model by integrating the pressure theory and technostress factors. The causal relationship between variables in the research model is tested. In terms of data analysis, Partial Least Square (PLS) in Structural Equation Modeling (SEM) is used for sample analysis and research model testing. The results of this study are as follows. First, both the variables of work-related stress and technological violations positively affect the work-family conflict. Second, both the variables of work-loading and technology-overloading have no effect on work-family conflict. Third, work-family conflict has negative effect on job satisfaction, family satisfaction, physical health, and mental health.

Keywords: mental health, physical health, technostress, work-family conflict, work-related stress

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2161 Is Class Struggle Still Useful for the Street Children Who Are Working and Committing Crimes in the Urban City of Bangladesh?

Authors: Shidratul Moontaha Suha

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Violence is organized and utilized differently in various communities across the globe. The capacity to employ violence in numerous societies is largely limited to the apparatus of the state, like law enforcement officers, and in a small share of contexts, it is controlled within the state institutions as per the rule of law. Contrastingly, in many other societies, a broad array of players, mainly organized criminal gangs, are using violence on a substantial scale to agitate against social ills or attain personal interests. The present paper examined the role of social injustice in driving children living off and on the streets of Dhaka, Bangladesh, into joining organized criminal gangs and committing crimes. The study entailed a comprehensive review of existing literature with theoretical analyses based on three theories: the Marxist’s theory of capitalism and class struggle, the Weberian model of social stratification theory, and the social disorganization theory. The analysis revealed that, in Dhaka, Bangladesh, criminal gangs emerged from social disorganization of communities characterized by absolute poverty, residential mobility, and population heterogeneity, which promote deviance among the youth, and subsequently, led to the rise of organized gangs and delinquency. Although the latter was formed as a response to class struggle, they have been employed by the state and police as the tools of exploitation and oppression to rule the working class. The criminal gangs exploit the vulnerability of street children by using them as sources of cheap labor to peddle drugs, extort, or kill specific individuals who are against their ideals. In retrospect, the street children receive individual, group, and social protection. Therefore, social class struggle plays a central role in the proliferation of organized criminal gangs and the engagement of street children in criminal activities in Dhaka, Bangladesh.

Keywords: cheap labor, organized crimes, poverty, social stratification, social children

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2160 Social Ties and Integration of the Offenders

Authors: C. Chaillou

Abstract:

The dominant theoretical approaches in Criminology are interested in the phenomenon of delinquency from the question of the management of the risks incurred by the population. Thus, this research advocate prevention of this phenomenon by a tracking of early disorders in children. Treatments offered to rely on medical research (genetics and biology are cited as a reference) and assuming a high naturalization of delinquent behaviour. Programs that are offered also reduce to a recovery of the deviant behaviour, and rely readily on behavioral guidelines, with an educational grant. Public policy then rely on these programs to prevent unwanted behaviour within a given population and to reduce the risk for the company. This is the case in France, with national institutes making (juvenile) violence a public health problem. We consider that other approaches, issues of sociology, are more relevant to the treatment of offenders. These approaches are moving, not on its prevention, but from its inputs and its outputs. Several modalities of entries and exits of delinquency can find and analyze in terms of process. We assume that there is a dynamic inherent in the individual and it is important to take into account the environment of the offender. These different types of processes can illuminate from the derived work of the Psychoanalytical psychopathology and lead to more effective treatment of delinquent acts. Psychoanalytic concepts have enabled us to offer a new look means to treat delinquency, placing several types of relationship with the other and relating to the clinical structure and the uniqueness of the case, we have been able to enter subjective and unconscious logics at work in delinquent acts. This research has facilitated the reduction of these types of subjective responses and proposed others, opening to a reintegration of offenders in a social link them being more favourable and in a longer term.

Keywords: delinquency, insertion, social link, unconscious

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2159 Anemia Among Pregnant Women in Kuwait: Findings from Kuwait Birth Cohort Study

Authors: Majeda Hammoud

Abstract:

Background: Anemia during pregnancy increases the risk of delivery by cesarean section, low birth weight, preterm birth, perinatal mortality, stillbirth, and maternal mortality. In this study, we aimed to assess the prevalence of anemia in pregnant women and its associated factors in the Kuwait birth cohort study. Methods: The Kuwait birth cohort (N=1108) was a prospective cohort study in which pregnant women were recruited in the third trimester. Data were collected through personal interviews with mothers who attend antenatal care visits, including data on socio-economic status and lifestyle factors. Blood samples were taken after the recruitment to measure multiple laboratory indicators. Clinical data were extracted from the medical records by a clinician including data on comorbidities. Anemia was defined as having Hemoglobin (Hb) <110 g/L with further classification as mild (100-109 g/L), moderate (70-99 g/L), or severe (<70 g/L). Predictors of anemia were classified as underlying or direct factors, and logistic regression was used to investigate their association with anemia. Results: The mean Hb level in the study group was 115.21 g/L (95%CI: 114.56- 115.87 g/L), with significant differences between age groups (p=0.034). The prevalence of anemia was 28.16% (95%CI: 25.53-30.91%), with no significant difference by age group (p=0.164). Of all 1108 pregnant women, 8.75% had moderate anemia, and 19.40% had mild anemia, but no pregnant women had severe anemia. In multivariable analysis, getting pregnant while using contraception, adjusted odds ratio (AOR) 1.73(95%CI:1.01-2.96); p=0.046 and current use of supplements, AOR 0.50 (95%CI: 0.26-0.95); p=0.035 were significantly associated with anemia (underlying factors). From the direct factors group, only iron and ferritin levels were significantly associated with anemia (P<0.001). Conclusion: Although the severe form of anemia is low among pregnant women in Kuwait, mild and moderate anemia remains a significant health problem despite free access to antenatal care.

Keywords: anemia, pregnancy, hemoglobin, ferritin

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2158 Optimal Approach for Siewert Type Ⅱ Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Metanalysis

Authors: Maatouk Mohamed, Nouira Mariem

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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2157 Harmonizing Spatial Plans: A Methodology to Integrate Sustainable Mobility and Energy Plans to Promote Resilient City Planning

Authors: B. Sanchez, D. Zambrana-Vasquez, J. Fresner, C. Krenn, F. Morea, L. Mercatelli

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Local administrations are facing established targets on sustainable development from different disciplines at the heart of different city departments. Nevertheless, some of these targets, such as CO2 reduction, relate to two or more disciplines, as it is the case of sustainable mobility and energy plans (SUMP & SECAP/SEAP). This opens up the possibility to efficiently cooperate among different city departments and to create and develop harmonized spatial plans by using available resources and together achieving more ambitious goals in cities. The steps of the harmonization processes developed result in the identification of areas to achieve common strategic objectives. Harmonization, in other words, helps different departments in local authorities to work together and optimize the use or resources by sharing the same vision, involving key stakeholders, and promoting common data assessment to better optimize the resources. A methodology to promote resilient city planning via the harmonization of sustainable mobility and energy plans is presented in this paper. In order to validate the proposed methodology, a representative city engaged in an innovation process in efficient spatial planning is used as a case study. The harmonization process of sustainable mobility and energy plans covers identifying matching targets between different fields, developing different spatial plans with dual benefit and common indicators guaranteeing the continuous improvement of the harmonized plans. The proposed methodology supports local administrations in consistent spatial planning, considering both energy efficiency and sustainable mobility. Thus, municipalities can use their human and economic resources efficiently. This guarantees an efficient upgrade of land use plans integrating energy and mobility aspects in order to achieve sustainability targets, as well as to improve the wellbeing of its citizens.

Keywords: integrated multi-sector planning, spatial plans harmonization, sustainable energy and climate action plan, sustainable urban mobility plan

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2156 The Effect of Eight-Week Medium Intensity Interval Training and Curcumin Intake on ICMA-1 and VCAM-1 Levels in Menopausal Fat Rats

Authors: Abdolrasoul Daneshjoo, Fatemeh Akbari Ghara

Abstract:

Background and Purpose: Obesity is an increasing factor in cardiovascular disease and serum levels of cellular adhesion molecule. It plays an important role in predicting risk for coronary artery disease. The purpose of this research was to study the effect of eight weeks moderate intensity interval training and curcumin intake on ICAM-1 & VCAM-1 levels of menopausal fat rats. Materials and methods: in this study, 28 Wistar Menopausal fat rats aged 6-8 weeks with an average weight of 250-300 (gr) were randomly divided into four groups: control, curcumin supplement, moderate intensity interval training and moderate intensity interval training + curcumin supplement. (7 rats each group). The training program was planned as 8 weeks and 3 sessions per week. Each session consisted of 10 one-min sets with 50 percent intensity and the 2-minutes interval between sets in the first week. Subjects started with 14 meters per minute, and 2 (m/min) was added to increase their speed weekly until the speed of 28 (m/min) in the 8th week. Blood samples were taken 48 hours after the last training session, and ICAM-1 A and VCAM-1 levels were measured. SPSS software, one-way analysis of variance (ANOVA) and Pearson correlation coefficient were used to assess the results. Results: The results showed that eight weeks of training and taking curcumin had significant effects on ICAM-1 levels of the rats (p ≤ 0.05). However, it had no significant effect on VCAM-1 levels in menopausal obese rates (p ≥ 0.05). There was no significant correlation between the levels of ICAM-1 and VCAM-1 in eight weeks training and taking curcumin. Conclusion: Implementation of moderate intensity interval training and the use of curcumin decreased ICAM-1 significantly.

Keywords: curcumin, interval training , ICMA, VCAM

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2155 Double-Spear 1-H2-1 Oncolytic-Immunotherapy for Refractory and Relapsing High-Risk Human Neuroblastoma and Glioma

Authors: Lian Zeng

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Double-Spear 1-H2-1 (DS1-H2-1) is an oncolytic virus and an innovative biological drug candidate. The chemical composition of the drug product is a live attenuated West Nile virus (WNV) containing the human T cell costimulator (CD86) gene. After intratumoral injection, the virus can rapidly self-replicate in the injected site and lyse/kill the tumor by repeated infection among tumor cells. We also established xenograft tumor models in mice to evaluate the drug candidate's efficacy on those tumors. The results from preclinical studies on transplanted tumors in immunodeficient mice showed that DS1-H2-1 had significant oncolytic effects on human-origin cancers: it completely (100%) shrieked human glioma; limited human neuroblastoma growth reached as high as 95% growth inhibition rate (%TGITW). The safety data of preclinical animal experiments confirmed that DS1-H2-1 is safe as a biological drug for clinical use. In the preclinical drug efficacy experiment, virus-drug administration with different doses did not show abnormal signs and disease symptoms in more than 300 tested mice, and no side effects or death occurred through various administration routes. Intravenous administration did not cause acute infectious disease or other side effects. However, the replication capacity of the virus in tumor tissue via intravenous administration is only 1% of that of direct intratumoral administration. The direct intratumoral administration of DS1-H2-1 had a higher rate of viral replication. Therefore, choosing direct intratumoral injection can ensure both efficacy and safety.

Keywords: oncolytic virus, WNV-CD86, immunotherapy drugs, glioma, neuroblastoma

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2154 Ray’s Use of the Liminal Space and the Female Gaze: A Reading of Oscillating Moralities in ‘Charulata’ and ‘Bimala’

Authors: Rajlekha Sil

Abstract:

This paper aims to investigate Ray’s portrayal of liminality and the female gaze in ‘Charulata’ (1964) and ‘Ghare Baire’ (1984), both of which primarily articulates the stories of two women (Charu and Bimala respectively), entangled within the cobwebs of their seething, unfulfilled sexuality, amidst a newly-globalised urban culture, punctuated with political turmoils and ideological conflicts. Their tempestuous interactions with the societal space, both tangible and intangible, that surrounds them, and the men in their lives makes them dwell in a liminal space, filled with an ambiguous sense of virtue. In Ray’s films, this sexual ambivalence is characterised by the liminality between the scenic and extrascenic spaces, which, in turn, defines the female gaze as the director’s lenses paint a picture of the new wave of socio-political and socio-cultural movements in early twentieth-century Bengal. Brinda Bose’s essay on ‘Modernity, Globality, Sexuality, and the City: A Reading of Indian Cinema’, analyses the ‘necessary’ process of urbanisation as a marker of ‘moral degeneracy of the nation easily analogous with female sexual transgression/ promiscuity with the nation personified as a woman, by using the concept of the liminal space, a site of both empowerment through transgression and containment through regulation.’ My paper, however, would focus on the liminal space propagated by Ray through his contrasting depiction of scenic and extrascenic spaces to satiate the equivocal voices in Charu and Bimala, along with their way of ‘gazing’ into an equally disheveled society - a gaze that helps them transcend the barriers of politics and urbanization into a state of universal uniformity, symmetrical with their sexual immorality. The first section of the paper would explore Ray’s usage of these theatrical spaces through his character sketches, shots and dialogues, while the second section of the paper would delve into the ‘female gaze’ on a newly revolutionised society.

Keywords: satyajit ray, space, gaze, female sexuality, charulata, ghare baire

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2153 Greenlight Laser Prostatectomy: A Safe and Effective Day Case Option for Bladder Outlet Obstruction in the Elderly Population

Authors: Gordon Weight, Hermione Tsoi, Patrick Cutinha, Sanjay Rajpal

Abstract:

Aim: Greenlight-laser prostatectomy (GLLP) is becoming a popular treatment option for bladder outlet obstruction and lower urinary tract symptoms (LUTS). In this retrospective study, we aim to explore the patient selection, perioperative morbidity, and functional outcomes of GLLP. Methods: Patients who underwent GLLP at a UK tertiary centre between June 2018 and November 2021 were included in this study. Retrospective data covering patient demographics, perioperative parameters and postoperative outcomes were collected using the electronic records systems. Results: 305 patients were included in this study with a mean age of 73 (range 30-90) years. The most common indication (62.6%) for the procedure was patient’s wish to be free from long-term catheters (LTC) or intermittent catheterisation (ISC), followed by failed medical therapy for LUTS (36.4%). 84.6% of patients had an ASA ≥2, and 32.1% took anticoagulant or antiplatelet therapy. Inpatient stays were minimal, with the majority (68.2%) of patients were performed as day case, and only 10.5% of patients requiring more than a single night admission. The 3-month readmission rate was 10.8%, with the most common causes being haematuria and urinary-tract infection. The successful TWOC rate at follow up was 91.2%. Amongst the 19 patients who failed TWOC, 14 had LTC prior to the procedure and 4 had been performing ISC. Conclusions: Our study shows that GLLP is a safe and effective day case treatment and can be suitable for elderly and comorbid patients. Patients requiring LTC or ISC pre-operatively should be counselled carefully about the risk of not being catheter-free post procedure.

Keywords: urology, endourology, prostate, bladder outlet obstruction, laser

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2152 Variation In Gastrocnemius and Hamstring Muscle Activity During Peak Knee Flexor Torque After Anterior Cruciate Ligament Reconstruction with Hamstring Graft

Authors: Luna Sequier, Florian Forelli, Maude Traulle, Amaury Vandebrouck, Pascal Duffiet, Louis Ratte, Jean Mazeas

Abstract:

The study's objective is to compare the muscular activity of the flexor knee muscle in patients who underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals who have not undergone surgery. Methods: The participants were divided into two groups: a healthy group and an experimental group who had undergone an anterior cruciate ligament reconstruction with a hamstring graft. All participants had to perform a knee flexion strength test on an isokinetic dynamometer. The medial Gastrocnemius, lateral Gastrocnemius, Biceps femoris, and medial Hamstring muscle activity were measured during this test. Each group’s mean muscle activity was tested with statistical analysis, and a muscle activity ratio of gastrocnemius and hamstring muscles was calculated Results: The results showed a significant difference in activity of the medial gastrocnemius (p = 0,004901), the biceps femoris (p = 5,394.10-6), and the semitendinosus muscles (p = 1,822.10-6), with a higher Biceps femoris and Semitendinosus activity for the experimental group. It is however noticeable that inter-subject differences were important. Conclusion: This study has shown a difference in the gastrocnemius and hamstring muscle activity between patients who underwent an anterior cruciate ligament reconstruction surgery and healthy participants. With further results, this could show a modification of muscle activity patterns after surgery which could lead to compensatory behaviors at a return to sport and eventually explain a higher injury risk for our patients.

Keywords: anterior cruciate ligament, electromyography, muscle activity, physiotherapy

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2151 The Risk of In-work Poverty and Family Coping Strategies

Authors: A. Banovcinova, M. Zakova

Abstract:

Labor market activity and paid employment should be a key factor in protecting individuals and families from falling into poverty and providing them with sufficient resources to meet the needs of their members. However, due to various processes in the labor market as well as the influence of individual factors and often insufficient social capital, there is a relatively large group of households that cannot eliminate paid employment and find themselves in a state of so-called working poverty. The aim of the research was to find out what strategies families use in managing poverty and meeting their needs and which of these strategies prevail in the Slovak population. A quantitative research strategy was chosen. The method of data collection was a structured interview focused on finding out the use of individual management strategies and also selected demographic indicators. The research sample consisted of members of families in which at least one member has a paid job. The condition for inclusion in the research was that the family's income did not exceed 60% of the national median equalized disposable income. The analysis of the results showed 5 basic areas to which management strategies are related - work, financial security, needs, social contacts and perception of the current situation. The prevailing strategies were strategies aimed at increasing and streamlining labor market activity and the planned and effective management of the family budget. Strategies that were rejected were mainly related to debt creation. The results make it possible to identify the preferred ways of managing poverty in individual areas of life, as well as the factors that influence this behavior. This information is important for working with families living in a state of working poverty and can help professionals develop positive ways of coping for families.

Keywords: copying strategies, family, in-work poverty, quantitative research

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2150 Vulnerability of People to Climate Change: Influence of Methods and Computation Approaches on Assessment Outcomes

Authors: Adandé Belarmain Fandohan

Abstract:

Climate change has become a major concern globally, particularly in rural communities that have to find rapid coping solutions. Several vulnerability assessment approaches have been developed in the last decades. This comes along with a higher risk for different methods to result in different conclusions, thereby making comparisons difficult and decision-making non-consistent across areas. The effect of methods and computational approaches on estimates of people’s vulnerability was assessed using data collected from the Gambia. Twenty-four indicators reflecting vulnerability components: (exposure, sensitivity, and adaptive capacity) were selected for this purpose. Data were collected through household surveys and key informant interviews. One hundred and fifteen respondents were surveyed across six communities and two administrative districts. Results were compared over three computational approaches: the maximum value transformation normalization, the z-score transformation normalization, and simple averaging. Regardless of the approaches used, communities that have high exposure to climate change and extreme events were the most vulnerable. Furthermore, the vulnerability was strongly related to the socio-economic characteristics of farmers. The survey evidenced variability in vulnerability among communities and administrative districts. Comparing output across approaches, overall, people in the study area were found to be highly vulnerable using the simple average and maximum value transformation, whereas they were only moderately vulnerable using the z-score transformation approach. It is suggested that assessment approach-induced discrepancies be accounted for in international debates to harmonize/standardize assessment approaches to the end of making outputs comparable across regions. This will also likely increase the relevance of decision-making for adaptation policies.

Keywords: maximum value transformation, simple averaging, vulnerability assessment, West Africa, z-score transformation

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2149 A Hybrid Energy Storage Module for the Emergency Energy System of the Community Shelter in Yucatán, México

Authors: María Reveles-Miranda, Daniella Pacheco-Catalán

Abstract:

Sierra Papacal commissary is located north of Merida, Yucatan, México, where the indigenous Maya population predominates. Due to its location, the region has an elevation of fewer than 4.5 meters above sea level, with a high risk of flooding associated with storms and hurricanes and a high vulnerability of infrastructure and housing in the presence of strong gusts of wind. In environmental contingencies, the challenge is providing an autonomous electrical supply using renewable energy sources that cover vulnerable populations' health, food, and water pumping needs. To address this challenge, a hybrid energy storage module is proposed for the emergency photovoltaic (PV) system of the community shelter in Sierra Papacal, Yucatán, which combines high-energy-density batteries and high-power-density supercapacitors (SC) in a single module, providing a quick response to energy demand, reducing the thermal stress on batteries and extending their useful life. Incorporating SC in energy storage modules can provide fast response times to power variations and balanced energy extraction, ensuring a more extended period of electrical supply to vulnerable populations during contingencies. The implemented control strategy increases the module's overall performance by ensuring the optimal use of devices and balanced energy exploitation. The operation of the module with the control algorithm is validated with MATLAB/Simulink® and experimental tests.

Keywords: batteries, community shelter, environmental contingencies, hybrid energy storage, isolated photovoltaic system, supercapacitors

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2148 Application Difference between Cox and Logistic Regression Models

Authors: Idrissa Kayijuka

Abstract:

The logistic regression and Cox regression models (proportional hazard model) at present are being employed in the analysis of prospective epidemiologic research looking into risk factors in their application on chronic diseases. However, a theoretical relationship between the two models has been studied. By definition, Cox regression model also called Cox proportional hazard model is a procedure that is used in modeling data regarding time leading up to an event where censored cases exist. Whereas the Logistic regression model is mostly applicable in cases where the independent variables consist of numerical as well as nominal values while the resultant variable is binary (dichotomous). Arguments and findings of many researchers focused on the overview of Cox and Logistic regression models and their different applications in different areas. In this work, the analysis is done on secondary data whose source is SPSS exercise data on BREAST CANCER with a sample size of 1121 women where the main objective is to show the application difference between Cox regression model and logistic regression model based on factors that cause women to die due to breast cancer. Thus we did some analysis manually i.e. on lymph nodes status, and SPSS software helped to analyze the mentioned data. This study found out that there is an application difference between Cox and Logistic regression models which is Cox regression model is used if one wishes to analyze data which also include the follow-up time whereas Logistic regression model analyzes data without follow-up-time. Also, they have measurements of association which is different: hazard ratio and odds ratio for Cox and logistic regression models respectively. A similarity between the two models is that they are both applicable in the prediction of the upshot of a categorical variable i.e. a variable that can accommodate only a restricted number of categories. In conclusion, Cox regression model differs from logistic regression by assessing a rate instead of proportion. The two models can be applied in many other researches since they are suitable methods for analyzing data but the more recommended is the Cox, regression model.

Keywords: logistic regression model, Cox regression model, survival analysis, hazard ratio

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2147 Ecological and Biological Effects of Pollution and Dredging Activities on Fisheries and Fisheries Products in Niger Delta Ecological Zone

Authors: Ikpesu, Thomas Ohwofasa, Babtunde Ilesanmi

Abstract:

The effects of anthropogenic activities on fish and fisheries products in Niger Delta water bodies were investigated. The rivers were selected based on their close proximity to contaminants and dredging activities. Three stations were chosen per river. The stations chosen to depicting downstream and upstream stations were visited and samples collected on monthly basis. The down streams stations are the polluted and heavily dredged sites, where the upstream station is far, without any evidence of pollution or human activities. During these periods, the fishes of the same species were collected and analyzed for morphological and physiological changes, after which they were returned back to the rivers. The physico-chemicals parameters of these stations were also taken. Morphological changes such as skin ulcerations and other lesions, as well as fungi infections were observed in the down streams fishes. The fish in up streams look healthier and bigger (though the age could not be affirmed) than the downstream fishes. The physico-chemical parameters between the up streams and down streams stations vary significantly (p < 0.01). These anthropogenic effects must have interfere with the normal migration pattern of these fishes, because there were changes in the composition of population and species diversity in the samples sites, with the upstream having true species diversity. The release of pollutants into the water in the Niger Delta areas may triggers off naturally occurring bio toxicity cycles and other fish poisoning. There is risk of biomagnifications of these poisons along the tropic level. This makes the normally valuable food resource dangerous for human consumption and thereby instances of human death caused by such poisoning.

Keywords: anthropogenic, dredging, fisheries, niger delta, pollution, rivers

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2146 Monitoring Spatial Distribution of Blue-Green Algae Blooms with Underwater Drones

Authors: R. L. P. De Lima, F. C. B. Boogaard, R. E. De Graaf-Van Dinther

Abstract:

Blue-green algae blooms (cyanobacteria) is currently a relevant ecological problem that is being addressed by most water authorities in the Netherlands. These can affect recreation areas by originating unpleasant smells and toxins that can poison humans and animals (e.g. fish, ducks, dogs). Contamination events usually take place during summer months, and their frequency is increasing with climate change. Traditional monitoring of this bacteria is expensive, labor-intensive and provides only limited (point sampling) information about the spatial distribution of algae concentrations. Recently, a novel handheld sensor allowed water authorities to quicken their algae surveying and alarm systems. This study converted the mentioned algae sensor into a mobile platform, by combining it with an underwater remotely operated vehicle (also equipped with other sensors and cameras). This provides a spatial visualization (mapping) of algae concentrations variations within the area covered with the drone, and also in depth. Measurements took place in different locations in the Netherlands: i) lake with thick silt layers at the bottom, very eutrophic former bottom of the sea and frequent / intense mowing regime; ii) outlet of waste water into large reservoir; iii) urban canal system. Results allowed to identify probable dominant causes of blooms (i), provide recommendations for the placement of an outlet, day-night differences in algae behavior (ii), or the highlight / pinpoint higher algae concentration areas (iii). Although further research is still needed to fully characterize these processes and to optimize the measuring tool (underwater drone developments / improvements), the method here presented can already provide valuable information about algae behavior and spatial / temporal variability and shows potential as an efficient monitoring system.

Keywords: blue-green algae, cyanobacteria, underwater drones / ROV / AUV, water quality monitoring

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2145 Improving Efficiency and Effectiveness of FMEA Studies

Authors: Joshua Loiselle

Abstract:

This paper discusses the challenges engineering teams face in conducting Failure Modes and Effects Analysis (FMEA) studies. This paper focuses on the specific topic of improving the efficiency and effectiveness of FMEA studies. Modern economic needs and increased business competition require engineers to constantly develop newer and better solutions within shorter timeframes and tighter margins. In addition, documentation requirements for meeting standards/regulatory compliance and customer needs are becoming increasingly complex and verbose. Managing open actions and continuous improvement activities across all projects, product variations, and processes in addition to daily engineering tasks is cumbersome, time consuming, and is susceptible to errors, omissions, and non-conformances. FMEA studies are proven methods for improving products and processes while subsequently reducing engineering workload and improving machine and resource availability through a pre-emptive, systematic approach of identifying, analyzing, and improving high-risk components. If implemented correctly, FMEA studies significantly reduce costs and improve productivity. However, the value of an effective FMEA is often shrouded by a lack of clarity and structure, misconceptions, and previous experiences and, as such, FMEA studies are frequently grouped with the other required information and documented retrospectively in preparation of customer requirements or audits. Performing studies in this way only adds cost to a project and perpetuates the misnomer that FMEA studies are not value-added activities. This paper discusses the benefits of effective FMEA studies, the challenges related to conducting FMEA studies, best practices for efficiently overcoming challenges via structure and automation, and the benefits of implementing those practices.

Keywords: FMEA, quality, APQP, PPAP

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2144 Overexpression of CAS8 Enhances Necroptosis and Metastasis in Iranian Sporadic Colorectal Cancer

Authors: Sayed Ali Garossi, Azar Heidarizadi, Shahla Mohammad Ganji

Abstract:

Context: Colorectal cancer is the second type of cancer-related mortality globally. Expression of cas8 (caspase 8) is closely connected to growth and metastasis of colorectal cancer.Cas8/Rip1 plays a vital role in the apoptosis pathway and resistance to chemotherapy. The aim of the present study is to investigate the pattern of gene expression in colorectal cancer and compare the differences using Real-Time PCR to find a potential biomarker candidate for colorectal cancer. Methodology: This study conducted real-time PCR to evaluate gene expression of Cas8 in colorectal cancer patients. The gene-specific primer sequences exon–exon junction was designed by OLIGO7 software for the expression of the gene under investigation. Forty-six patient samples without any chemotherapy were selected, including tumoral tissue and adjacent normal tissue samples. The age of the patients was 50 and the size of the tumors was 5.5 cm. The categories were before and after age 50. Findings: Here, we found that Caspase 8 was overexpressed in CRC tissues compared to corresponding adjacent colon tissues (Cas8: 5.2 vs. 1 ratio); high expression of Cas8 was associated with poor overall survival and independent risk factors for the prognosis of CRC patients. Conclusion: In conclusion, our study pioneered the reporting of high Casp8 expression as a predictor of poor prognosis and chemical resistance in CRC patients.Cas8 overexpression suppressed Cas 8 / Rip1-dependent apoptosis and activated the proliferation of tumor cells by activating necroptosis. The necroptosis pathway has also emerged as a new approach to anti-tumor in cancer treatment.

Keywords: Cas8, necroptosis, apoptosis, Real-Time PCR

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2143 Role of Ologen in Previously Failed Trabeculectomy in Advanced Glaucoma

Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi

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Purpose: Advanced Glaucoma with Failed trab is not an uncommon sight in glaucoma clinic, and such cases usually tend to present with high intraocular pressure (IOP) and advanced cupping, or even glaucomatous atrophy stage. Re-surgery is needed for such cases, and wound modulation poses a major challenge in these cases. We share our experience in this case series with the use of Ologen (collagen matrix implant) along with MMC 0.04% used in surgery. The purpose of the study was to evaluate the efficacy and outcome of collagen matrix implant in re-trabeculectomy in advanced glaucoma cases. Methodology: Eleven eyes of 11 patients (one eye of one patient) underwent re-trabeculectomy surgery with MMC and Ologen. Ologen implant was used in sub scleral and subconjunctival space, as a spacer and wound modulator. In five cases, triple modulation with implant soaked in anti-VEGF was used. Results: All patients had cupping more than 0.9, and one case was GOA. All cases were on maximal medication at presentation and majority were on systemic anti-glaucoma therapy also. Post-surgery, follow-up ranged from 13 – 34 months, and all cases had a follow longer than the gap between previous surgery (which was failed) and re-trab. One case needed AC reformation and one needling was done. Phaco was done at same sitting in four cases. All cases had their IOP lowered post surgery, and vision was maintained in all, however one case was considered as failed re-surgery case. Topical medication was needed in seven cases post-surgery also. Conclusion: Ologen as adjuvant should be considered in all re-trab cases and all high risk and advanced cases, and triple modulation can be next step in these cases. Aggressive IOP control and non- reluctance to continue topical medications post second surgery should be considered in such cases, to give them best possible vision.

Keywords: failed trabeculectomy, ologen, trabeculectomy, advanced glaucoma

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