Search results for: predictor of severity
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1348

Search results for: predictor of severity

568 Analyzing Safety Incidents using the Fatigue Risk Index Calculator as an Indicator of Fatigue within a UK Rail Franchise

Authors: Michael Scott Evans, Andrew Smith

Abstract:

The feeling of fatigue at work could potentially have devastating consequences. The aim of this study was to investigate whether the well-established objective indicator of fatigue – the Fatigue Risk Index (FRI) calculator used by the rail industry is an effective indicator to the number of safety incidents, in which fatigue could have been a contributing factor. The study received ethics approval from Cardiff University’s Ethics Committee (EC.16.06.14.4547). A total of 901 safety incidents were recorded from a single British rail franchise between 1st June 2010 – 31st December 2016, into the Safety Management Information System (SMIS). The safety incident types identified that fatigue could have been a contributing factor were: Signal Passed at Danger (SPAD), Train Protection & Warning System (TPWS) activation, Automatic Warning System (AWS) slow to cancel, failed to call, and station overrun. From the 901 recorded safety incidents, the scheduling system CrewPlan was used to extract the Fatigue Index (FI) score and Risk Index (RI) score of all train drivers on the day of the safety incident. Only the working rosters of 64.2% (N = 578) (550 men and 28 female) ranging in age from 24 – 65 years old (M = 47.13, SD = 7.30) were accessible for analyses. Analysis from all 578 train drivers who were involved in safety incidents revealed that 99.8% (N = 577) of Fatigue Index (FI) scores fell within or below the identified guideline threshold of 45 as well as 97.9% (N = 566) of Risk Index (RI) scores falling below the 1.6 threshold range. Their scores represent good practice within the rail industry. These findings seem to indicate that the current objective indicator, i.e. the FRI calculator used in this study by the British rail franchise was not an effective predictor of train driver’s FI scores and RI scores, as safety incidents in which fatigue could have been a contributing factor represented only 0.2% of FI scores and 2.1% of RI scores. Further research is needed to determine whether there are other contributing factors that could provide a better indication as to why there is such a significantly large proportion of train drivers who are involved in safety incidents, in which fatigue could have been a contributing factor have such low FI and RI scores.

Keywords: fatigue risk index calculator, objective indicator of fatigue, rail industry, safety incident

Procedia PDF Downloads 167
567 Changes in Blood Pressure in a Longitudinal Cohort of Vietnamese Women

Authors: Anh Vo Van Ha, Yun Zhao, Luat Cong Nguyen, Tan Khac Chu, Phung Hoang Nguyen, Minh Ngoc Pham, Colin W. Binns, Andy H. Lee

Abstract:

This study aims to study longitudinal changes in blood pressure (BP) during the 1-year postpartum period and to evaluate the influence of parity, maternal age at delivery, prepregnancy BMI, gestational weight gain, gestational age at delivery and postpartum maternal weight. A prospective longitudinal cohort study of 883 singleton Vietnamese women was conducted in Hanoi, Haiphong, and Ho Chi Minh City, Vietnam during 2015-2017. Women diagnosed with gestational diabetes mellitus at 24-28 weeks of gestation, pre-eclampsia, and hypoglycemia was excluded from analysis. BP was repeatedly measured at discharge, 6 and 12 months postpartum using automatic blood pressure monitors. Linear mixed model with repeated measures was used to describe changes occurring during pregnancy to 1-year postpartum. Parity, self-reported prepregnancy BMI, gestational weight gain, maternal age and gestational age at delivery will be treated as time-invariant variables and measured maternal weight will be treated as a time-varying variable in models. Women with higher measured postpartum weight had higher mean systolic blood pressure (SBP), 0.20 mmHg, 95% CI [0.12, 0.28]. Similarly, women with higher measured postpartum weight had higher mean diastolic blood pressure (DBP), 0.15 mmHg, 95% CI [0.08, 0.23]. These differences were both statistically significant, P < 0.001. There were no differences in SBP and DBP depending on parity, maternal age at delivery, prepregnancy BMI, gestational weight gain and gestational age at delivery. Compared with discharge measurement, SBP was significantly higher in 6 months postpartum, 6.91 mmHg, 95% CI [6.22, 7.59], and 12 months postpartum, 6.39 mmHg, 95% CI [5.64, 7.15]. Similarly, DBP was also significantly higher in 6 and months postpartum than at discharge, 10.46 mmHg 95% CI [9.75, 11.17], and 11.33 mmHg 95% CI [10.54, 12.12]. In conclusion, BP measured repeatedly during the postpartum period (6 and 12 months postpartum) showed a statistically significant increase, compared with after discharge from the hospital. Maternal weight was a significant predictor of postpartum blood pressure over the 1-year postpartum period.

Keywords: blood pressure, maternal weight, postpartum, Vietnam

Procedia PDF Downloads 189
566 Clara Cell Secretory Protein 16 Serum Level Decreases in Patients with Non-Smoking-Related Chronic Obstructive Pulmonary Diseases (COPD)

Authors: Lian Wu, Mervyn Merrilees

Abstract:

Chronic Obstructive Pulmonary Disease (COPD) is a worldwide problem, characterized by irreversible and progressive airflow obstruction. In New Zealand, it is currently the 4th commonest cause of death and exacerbations of COPD are a frequent cause of admission to hospital. Serum levels of Clara cell secretory protein-16 (CC-16) are believed to represent Clara cell toxicity. More recently, CC-16 has been found to be associated with smoker COPD. It is produced almost exclusively by non-ciliated Clara cells in the airways, and its primary function is to protect the lungs against oxidative stress and carcinogenesis. After acute exposure to cigarette smoke, serum levels of CC-16 become elevated. CC16 is a potent natural immune-suppressor and anti-inflammatory agent. In vitro, CC16 inhibits both monocyte and polymorphonuclear neutrophils chemotaxis and phagocytosis. CC16 also inhibits fibroblast chemotaxis. However, the role of CC-16 in non-smoking related COPD is still not clear. In this study, we investigated serum CC-16 levels in non-smoking related COPD. Methods: We compared non-smoker patients with COPD (FEV1<60% of predicted, FEV1/FVC <0.7, n=100) and individuals with normal lung function FEV1≥ 80% of predicted and FEV1/FVC≥ 0.7, n=80). All subjects had no smoking history. CC-16 was measured by ELISA. Results and conclusion: Serum CC-16 levels are reduced in individuals with non-smoking related COPD, and there is a weak correlation with disease severity in non-smoking related COPD group compared to non-smoker controls.

Keywords: COPD, CC-16, ELISA, non-smoking-related COPD

Procedia PDF Downloads 367
565 Sports Preference Intervention as a Predictor of Sustainable Participation at Risk Teenagers in Ibadan Metropolis, Ibadan Nigerian

Authors: Felix Olajide Ibikunle

Abstract:

Introductory Statement: Sustainable participation of teenagers in sports requires deliberate and concerted plans and managerial policy rooted in the “philosophy of catch them young.” At risk, teenagers need proper integration into societal aspiration: This direction will go a long way to streamline them into security breaches and attractive nuisance free lifestyles. Basic Methodology: The population consists of children between 13-19 years old. A proportionate sampling size technique of 60% was adopted to select seven zones out of 11 geo-political zones in the Ibadan metropolis. Qualitative information and interview were used to collect needed information. The majority of the teenagers were out of school, street hawkers, motor pack touts and unserious vocation apprentices. These groups have the potential for security breaches in the metropolis and beyond. Five hundred and thirty-four (534) respondents were used for the study. They were drawn from Ojoo, Akingbile and Moniya axis = 72; Agbowo, Ajibode and Apete axis = 74; Akobo, Basorun and Idi-ape axis 79; Wofun, Monatan and Iyana-Church axis = 78; Molete, Oke-ado and Oke-Bola axis = 75; Beere, Odinjo, Elekuro axis = 77; Eleyele, Ologuneru and Alesinloye axis = 79. Major Findings: Multiple regression was used to analyze the independent variables and percentages. The respondents' average age was 15.6 years old, and 100% were male. The instrument (questionnaire) used yielded; sport preference (r = 0.72), intervention (r = 0.68), and sustainable participation (r = 0.70). The relative contributions of sport preference on the participation of at risk teenagers was (F-ratio = 1.067); Intervention contribution of sport on the participation of at risk teenagers = produced (F-ratio of 12.095) was significant while, sustainable participation of at risk teenagers produced (F-ratio = 1.062) was significant. Closing Statement: The respondents’ sport preference stimulated their participation in sports. The intervention exposed at risk-teenagers to coaching, which activated their interest and participation in sports. At the same time, sustainable participation contributed positively to evolving at risk teenagers' participation in their preferred sport.

Keywords: sport, preference, intervention, teenagers, sustainable, participation and risk teenagers

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564 Ear Protectors and Their Action in Protecting Hearing System of Workers against Occupational Noise

Authors: F. Forouharmajd, S. Pourabdian, N. Ziayi Ghahnavieh

Abstract:

For many years, the ear protectors have been used to preventing the audio and non-audio effects of received noise from occupation environments. Despite performing hearing protection programs, there are many people which still suffer from noise-induced hearing loss. This study was conducted with the aim of determination of human hearing system response to received noise and the effectiveness of ear protectors on preventing of noise-induced hearing loss. Sound pressure microphones were placed in a simulated ear canal. The severity of noise measured inside and outside of ear canal. The noise reduction values due to installing ear protectors were calculated in the octave band frequencies and LabVIEW programmer. The results of noise measurement inside and outside of ear canal showed a different in received sound levels by ear canal. The effectiveness of ear protectors has been considerably reduced for the low frequency limits. A change in resonance frequency also was observed after using ear protectors. The study indicated the ear canal structure may affect the received noise and it may lead a difference between the received sound from the measured sound by a sound level meter, and hearing system. It means the human hearing system may probably respond different from a sound level meter. Hearing protectors’ efficiency declines by increasing the noise levels, and thus, they are not suitable to protect workers against industrial noise particularly low frequency noise. Hearing protectors may be solely a reason to damaging of hearing system in a special frequency via changing of human hearing system acoustical structure. We need developing the subjective method of hearing protectors testing, because their evaluation is not designed based on industrial noise or in the field.

Keywords: ear protector, hearing system, occupational noise, workers

Procedia PDF Downloads 154
563 Profile of Cross-Reactivity Allergens Highlighted by Multiplex Technology “Alex Microchip Technique” in the Diagnosis of Type I Hypersensitivity

Authors: Gadiri Sabiha

Abstract:

Introduction: Current allergy diagnostic tools using Multiplex technology have made it possible to increase the efficiency of the search for specific IgE. This opportunity is provided by the newly developed “Alex Biochip”, consisting of a panel of 282 allergens in native and molecular form, a CCD inhibitor, and the potential for detecting cross-reactive allergens. We evaluated the performance of this technology in detecting cross-reactivity in previously explored patients. Material/Method: The sera of 39 patients presenting sensitization and polysensitization profiles were explored. The search for specific IgE is carried out by the Alex ® IgE Biochip, and the results are analyzed by nature and by molecular family of allergens using specific software. Results/Discussion: The analysis gave a particular profile of cross-reactivity allergens: 33% for the Ole e1 family, 31% for NPC2, 26% for storage proteins, 20% for Tropomyosin, 10% for LTPs, 10% for Arginine Kinase and 10% for Uteroglobin CCDs were absent in all patients. The “Ole e1” allergen is responsible for a pollen-pollen cross allergy. The storage proteins found and LTP are not species-specific, causing cross-pollen-food allergy. The nDer p2 of the NPC2 family is responsible for cross-reactivity between mite species. Conclusion: The cross-reactivities responsible for mixed syndromes at diagnosis in our patients were dominated by pollen-pollen and pollen-food syndromes. They allow the identification of severity factors linked to the prognosis and the best-adapted immunotherapy.

Keywords: specific IgE, allergy, cross reactivity, molecular allergens

Procedia PDF Downloads 52
562 Effect of Wavy Leading-Edges on Wings in Different Planetary Atmospheres

Authors: Vatasta Koul, Ayush Gupta, Vaibhav Sharma, Rajesh Yadav

Abstract:

Today we are unmarking the secrets of the universe by exploring different stars and planets and most of the space exploration is done by unmanned space robots. In addition to our planet Earth, there are pieces of evidence that show other astronomical objects in our solar system such as Venus, Mars, Saturn’s moon Titan and Uranus support the flight of fixed wing air vehicles. In this paper, we take forward the concept of presence of large rounded tubercles along the leading edge of a wing and use it as a passive flow control device that will help in improving its aerodynamic performance and maneuverability. Furthermore, in this research, aerodynamic measurements and performance analysis of wavy leading tubercles on the fixed wings at 5-degree angle of attack are carried out after determination of the flow conditions on the selected planetary bodies. Wavelength and amplitude for the sinusoidal modifications on the leading edge are analyzed and simulations are carried out for three-dimensional NACA 0012 airfoil maintaining unity AR (Aspect Ratio). Tubercles have consistently demonstrated the ability to delay and decrease the severity of stall as per the studies were done in the Earth’s atmosphere. Implementing the same design on the leading edges of Micro-Air Vehicles (MAVs) and UAVs could make these aircrafts more stable over a greater range of angles of attack in different planetary environments of our solar system.

Keywords: amplitude, NACA0012, tubercles, unmanned space robots

Procedia PDF Downloads 127
561 An Artificial Intelligence Framework to Forecast Air Quality

Authors: Richard Ren

Abstract:

Air pollution is a serious danger to international well-being and economies - it will kill an estimated 7 million people every year, costing world economies $2.6 trillion by 2060 due to sick days, healthcare costs, and reduced productivity. In the United States alone, 60,000 premature deaths are caused by poor air quality. For this reason, there is a crucial need to develop effective methods to forecast air quality, which can mitigate air pollution’s detrimental public health effects and associated costs by helping people plan ahead and avoid exposure. The goal of this study is to propose an artificial intelligence framework for predicting future air quality based on timing variables (i.e. season, weekday/weekend), future weather forecasts, as well as past pollutant and air quality measurements. The proposed framework utilizes multiple machine learning algorithms (logistic regression, random forest, neural network) with different specifications and averages the results of the three top-performing models to eliminate inaccuracies, weaknesses, and biases from any one individual model. Over time, the proposed framework uses new data to self-adjust model parameters and increase prediction accuracy. To demonstrate its applicability, a prototype of this framework was created to forecast air quality in Los Angeles, California using datasets from the RP4 weather data repository and EPA pollutant measurement data. The results showed good agreement between the framework’s predictions and real-life observations, with an overall 92% model accuracy. The combined model is able to predict more accurately than any of the individual models, and it is able to reliably forecast season-based variations in air quality levels. Top air quality predictor variables were identified through the measurement of mean decrease in accuracy. This study proposed and demonstrated the efficacy of a comprehensive air quality prediction framework leveraging multiple machine learning algorithms to overcome individual algorithm shortcomings. Future enhancements should focus on expanding and testing a greater variety of modeling techniques within the proposed framework, testing the framework in different locations, and developing a platform to automatically publish future predictions in the form of a web or mobile application. Accurate predictions from this artificial intelligence framework can in turn be used to save and improve lives by allowing individuals to protect their health and allowing governments to implement effective pollution control measures.Air pollution is a serious danger to international wellbeing and economies - it will kill an estimated 7 million people every year, costing world economies $2.6 trillion by 2060 due to sick days, healthcare costs, and reduced productivity. In the United States alone, 60,000 premature deaths are caused by poor air quality. For this reason, there is a crucial need to develop effective methods to forecast air quality, which can mitigate air pollution’s detrimental public health effects and associated costs by helping people plan ahead and avoid exposure. The goal of this study is to propose an artificial intelligence framework for predicting future air quality based on timing variables (i.e. season, weekday/weekend), future weather forecasts, as well as past pollutant and air quality measurements. The proposed framework utilizes multiple machine learning algorithms (logistic regression, random forest, neural network) with different specifications and averages the results of the three top-performing models to eliminate inaccuracies, weaknesses, and biases from any one individual model. Over time, the proposed framework uses new data to self-adjust model parameters and increase prediction accuracy. To demonstrate its applicability, a prototype of this framework was created to forecast air quality in Los Angeles, California using datasets from the RP4 weather data repository and EPA pollutant measurement data. The results showed good agreement between the framework’s predictions and real-life observations, with an overall 92% model accuracy. The combined model is able to predict more accurately than any of the individual models, and it is able to reliably forecast season-based variations in air quality levels. Top air quality predictor variables were identified through the measurement of mean decrease in accuracy. This study proposed and demonstrated the efficacy of a comprehensive air quality prediction framework leveraging multiple machine learning algorithms to overcome individual algorithm shortcomings. Future enhancements should focus on expanding and testing a greater variety of modeling techniques within the proposed framework, testing the framework in different locations, and developing a platform to automatically publish future predictions in the form of a web or mobile application. Accurate predictions from this artificial intelligence framework can in turn be used to save and improve lives by allowing individuals to protect their health and allowing governments to implement effective pollution control measures.Air pollution is a serious danger to international wellbeing and economies - it will kill an estimated 7 million people every year, costing world economies $2.6 trillion by 2060 due to sick days, healthcare costs, and reduced productivity. In the United States alone, 60,000 premature deaths are caused by poor air quality. For this reason, there is a crucial need to develop effective methods to forecast air quality, which can mitigate air pollution’s detrimental public health effects and associated costs by helping people plan ahead and avoid exposure. The goal of this study is to propose an artificial intelligence framework for predicting future air quality based on timing variables (i.e. season, weekday/weekend), future weather forecasts, as well as past pollutant and air quality measurements. The proposed framework utilizes multiple machine learning algorithms (logistic regression, random forest, neural network) with different specifications and averages the results of the three top-performing models to eliminate inaccuracies, weaknesses, and biases from any one individual model. Over time, the proposed framework uses new data to self-adjust model parameters and increase prediction accuracy. To demonstrate its applicability, a prototype of this framework was created to forecast air quality in Los Angeles, California using datasets from the RP4 weather data repository and EPA pollutant measurement data. The results showed good agreement between the framework’s predictions and real-life observations, with an overall 92% model accuracy. The combined model is able to predict more accurately than any of the individual models, and it is able to reliably forecast season-based variations in air quality levels. Top air quality predictor variables were identified through the measurement of mean decrease in accuracy. This study proposed and demonstrated the efficacy of a comprehensive air quality prediction framework leveraging multiple machine learning algorithms to overcome individual algorithm shortcomings. Future enhancements should focus on expanding and testing a greater variety of modeling techniques within the proposed framework, testing the framework in different locations, and developing a platform to automatically publish future predictions in the form of a web or mobile application. Accurate predictions from this artificial intelligence framework can in turn be used to save and improve lives by allowing individuals to protect their health and allowing governments to implement effective pollution control measures.

Keywords: air quality prediction, air pollution, artificial intelligence, machine learning algorithms

Procedia PDF Downloads 102
560 Implementation of Risk Management System to Improve the Quality of Higher Education Institutes

Authors: Muhammad Wasif, Asif Ahmed Shaikh, Sarosh Hashmat Lodi, Muhammad Aslam Bhutto, Riazuddin

Abstract:

Risk Management System is quite popular in profit- based organizations, health and safety and project management fields since the last few decades. But due to rapidly changing environment and requirement of ISO 9001:2015 standards, public-sector institution, especially higher education institutes are also performing risk assessment to monitor the performance of the institution and aligning it with the latest benchmark. In this context, NED University of Engineering and Technology performed research and developed a Standard Operating Procedure (SOP) for the risk assessment, its monitoring and control. In this research, risks are broken into the four sources, namely; Internal Academics Risks, External Academics Risks, Internal Non-academic Risks, External Non-academic Risks. Risks are identified by the management at all levels. Severity and likelihood of the risks are assigned based on the previous audit results and the customer complains. Risk Ratings are calculated to orderly arrange the risk according to the Risk Rating, and controls for the risks are designed, which are assigned to the responsible person. At the end of the article, result and analysis on the different sources of risk are discussed in details and the conclusion is drawn. Discussion on few sample risks are presented in this article. Hence it is presented in the research that the Risk Management System can be applied in a Higher Education Institute to effectively control the risks which might affect the scope and Quality Management System of an organization.

Keywords: higher education, quality management system, risk assessment, risk management

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559 Fully Coupled Porous Media Model

Authors: Nia Mair Fry, Matthew Profit, Chenfeng Li

Abstract:

This work focuses on the development and implementation of a fully implicit-implicit, coupled mechanical deformation and porous flow, finite element software tool. The fully implicit software accurately predicts classical fundamental analytical solutions such as the Terzaghi consolidation problem. Furthermore, it can capture other analytical solutions less well known in the literature, such as Gibson’s sedimentation rate problem and Coussy’s problems investigating wellbore stability for poroelastic rocks. The mechanical volume strains are transferred to the porous flow governing equation in an implicit framework. This will overcome some of the many current industrial issues, which use explicit solvers for the mechanical governing equations and only implicit solvers on the porous flow side. This can potentially lead to instability and non-convergence issues in the coupled system, plus giving results with an accountable degree of error. The specification of a fully monolithic implicit-implicit coupled porous media code sees the solution of both seepage-mechanical equations in one matrix system, under a unified time-stepping scheme, which makes the problem definition much easier. When using an explicit solver, additional input such as the damping coefficient and mass scaling factor is required, which are circumvented with a fully implicit solution. Further, improved accuracy is achieved as the solution is not dependent on predictor-corrector methods for the pore fluid pressure solution, but at the potential cost of reduced stability. In testing of this fully monolithic porous media code, there is the comparison of the fully implicit coupled scheme against an existing staggered explicit-implicit coupled scheme solution across a range of geotechnical problems. These cases include 1) Biot coefficient calculation, 2) consolidation theory with Terzaghi analytical solution, 3) sedimentation theory with Gibson analytical solution, and 4) Coussy well-bore poroelastic analytical solutions.

Keywords: coupled, implicit, monolithic, porous media

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558 A Varicella Outbreak in a Highly Vaccinated School Population in Voluntary 2-Dose Era in Beijing, China

Authors: Chengbin Wang, Li Lu, Luodan Suo, Qinghai Wang, Fan Yang, Xu Wang, Mona Marin

Abstract:

Background: Two-dose varicella vaccination has been recommended in Beijing since November 2012. We investigated a varicella outbreak in a highly vaccinated elementary school population to examine transmission patterns and risk factors for vaccine failure. Methods: A varicella case was defined as an acute generalized maculopapulovesicular rash without other apparent cause in a student attending the school from March 28 to May 17, 2015. Breakthrough varicella was defined as varicella >42 days after last vaccine dose. Vaccination information was collected from immunization records. Information on prior disease and clinical presentation was collected via survey of students’ parents. Results: Of the 1056 school students, 1028 (97.3%) reported no varicella history, of whom 364 (35.4%) had received 1-dose and 650 (63.2%) had received 2-dose varicella vaccine, for 98.6% school-wide vaccination coverage with ≥ 1 dose before the outbreak. A total of 20 cases were identified for an overall attack rate of 1.9%. The index case was in a 2-dose vaccinated student who was not isolated. The majority of cases were breakthrough (19/20, 95%) with attack rates of 7.1% (1/14), 1.6% (6/364) and 2.0% (13/650) among unvaccinated, 1-dose, and 2-dose students, respectively. Most cases had < 50 lesions (18/20, 90%). No difference was found between 1-dose and 2-dose breakthrough cases in disease severity or sociodemographic factors. Conclusion: Moderate 2-dose varicella vaccine coverage was insufficient to prevent a varicella outbreak. Two-dose breakthrough varicella is still contagious. High 2-dose varicella vaccine coverage and timely isolation of ill persons might be needed for varicella outbreak control in the 2-dose era.

Keywords: varicella, outbreak, breakthrough varicella, vaccination

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557 Quality of Life and Willingness to Take Treatment and the Importance of the Disease in the Lives of Patients with Eating Disorders

Authors: Marzena Trojanczyk, Mariusz Jaworski, Ewa Dmoch Gajzlerska

Abstract:

Purpose: The purpose of this paper is to assess the relationship between the level of quality of life and willingness to take treatment in patients with eating disorders as anorexia, bulimia and compulsive bingeing. Material and methods: The subjects consisted of 99 women with eating disorders: anorexia, n = 33; bulimia, n = 35; compulsive overeating, n = 31 and 35 women in the control group. The study used an original questionnaire to assess the overall quality of life, as well as selected areas of the physical, mental, social and spiritual satisfaction. The subjects were also asked about the level of motivation for treatment, and the importance of the disease in the lives of patients. Statistical analyses were performed using the statistical program SPSS 18.0. Results: Women with eating disorders in particular groups did not differ with respect to each other in the aspect of overall quality of life, satisfaction with the development of the spiritual, social functioning and mental health. The severity level of the disease in the lives of patients showed a negative correlation with social functioning in women with anorexia nervosa. In the case of patients with compulsive bingeing a positive relationship between the level of importance of the disease and the satisfaction of spiritual development is reported. Conclusions: Concerning the inferior quality of life, there is no relationship between a willingness to take treatment and the importance of the disease in the lives of patients with anorexia, bulimia and compulsive bingeing.

Keywords: anorexia, bulimia, compulsive overeating, quality of life

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556 Efficacy of Eutectic Mixture of Local Anaesthetics and Diclofenac Spray in Attenuating Intravenous Cannulation Pain- Paeallel Randomized Trial

Authors: Anju Rani, Geeta, Sudha Rani, Choudhary, Puhal

Abstract:

Method- A total of 300 patients were studied, with 100 patients in each group. Patients aged 16-60 years, ASA grade I and II undergoing elective general surgical, urology and orthopedic procedures were included in the study. The patients were randomly allocated to any of the three groups by Using Sealed envelopes. 1. Group A: EMLA (eutectic mixture of 2.5% lidocaine with 2.5% prilocaine) - Patients receiving eutectic Lidocaine/ Prilocaine cream (2gm/10cm2) of Prilox cream), for 60- 70 min under occlusive dressing. 2. Group B - Patients receiving topical diclofenac 4 % spray gel for 60- 70 min, covering an absorption area of 50 cm2 3. Group C: control – Direct cannulation was done without any intervention. Results - Group B showed significantly least number of patients complaining pain on IV cannulation in comparison to group A and group C. The Mean VAS scores were found to be maximum in GROUP C: control-8.76 ± 4.14, then in GROUP A: EMLA- 2.54 ± 4.21.and least in GROUP B: Diclofenac 4% spray-1.13 ± 3.05. Erythema, induration and edema were significantly reported to be higher for the control group. Also group A patients reported adverse skin reactions more than patients in group B. Conclusion - It can be concluded that diclofenac spray 4 % and EMLA cream are effective in reducing the incidence and severity of venous cannulation pain as compared to the control group. However, a higher incidence of skin blanching, erythema, and oedema associated with EMLA cream and a lower incidence of these adverse effects favours the use of diclofenac spray 4%. They are promising agents for the treatment of venous cannulation pain.

Keywords: diclofenac spray, EMLA, intravenous, pain

Procedia PDF Downloads 135
555 Erectile Dysfunction among Bangladeshi Men with Diabetes

Authors: Shahjada Selim

Abstract:

Background: Erectile dysfunction (ED) is an important impediment to quality of life of men. ED is approximate, three times more common in diabetic than non-diabetic men, and diabetic men develop ED earlier than age-matched non-diabetic subjects. Glycemic control and other factors may contribute in developing and or deteriorating ED. Aim: The aim of the study was to determine the prevalence of ED and its risk factors in type 2 diabetic (T2DM) men in Bangladesh. Methods: During 2013-2014, 3980 diabetic men aged 30-69 years were interviewed at the out-patient departments of seven diabetic centers in Dhaka by using the validated Bengali version of the questionnaire of the International index of erectile function (IIEF) for evaluation of baseline erectile function (EF). The indexes indicate a very high correlation between the items and the questionnaire is consistently reliable. Data were analyzed with Chi-squared (χ²) test using SPSS software. P ≤ 0.05 was considered significant. Results: Out of 3790, ED was found in 2046 (53.98%) of T2DM men. The prevalence of ED was increased with age from 10.5% in men aged 30-39 years to 33.6% in those aged over 60 years (P < 0.001). In comparison with patients with reported diabetes lasting ≤ 5 years (26.4%), the prevalence of ED was less than in those with diabetes of 6-11 years (35.3%) and of 12-30 years (42.5%, P <0.001). ED increased significantly in those who had poor glycemic control. The prevalence of ED in patients with good, fair and poor glycemic control was 22.8%, 42.5% and 47.9% respectively (P = 0.004). Treatment modalities (medical nutrition therapy, oral agents, insulin, and insulin plus oral agents) had significant association with ED and its severity (P < 0.001). Conclusion: Prevalence of ED is very high among T2DM men in Bangladesh and can be reduced the burden by improving glycemic status. Glycemic control, duration of diabetes, treatment modalities, increasing age are associated with ED.

Keywords: erectile dysfunction, diabetes, men, Bangladesh

Procedia PDF Downloads 249
554 Predictor Factors in Predictive Model of Soccer Talent Identification among Male Players Aged 14 to 17 Years

Authors: Muhamad Hafiz Ismail, Ahmad H., Nelfianty M. R.

Abstract:

The longitudinal study is conducted to identify predictive factors of soccer talent among male players aged 14 to 17 years. Convenience sampling involving elite respondents (n=20) and sub-elite respondents (n=20) male soccer players. Descriptive statistics were reported as frequencies and percentages. The inferential statistical analysis is used to report the status of reliability, independent samples t-test, paired samples t-test, and multiple regression analysis. Generally, there are differences in mean of height, muscular strength, muscular endurance, cardiovascular endurance, task orientation, cognitive anxiety, self-confidence, juggling skills, short pass skills, long pass skills, dribbling skills, and shooting skills for 20 elite players and sub-elite players. Accordingly, there was a significant difference between pre and post-test for thirteen variables of height, weight, fat percentage, muscle strength, muscle endurance, cardiovascular endurance, flexibility, BMI, task orientation, juggling skills, short pass skills, a long pass skills, and dribbling skills. Based on the first predictive factors (physical), second predictive factors (fitness), third predictive factors (psychological), and fourth predictive factors (skills in playing football) pledged to the soccer talent; four multiple regression models were produced. The first predictive factor (physical) contributed 53.5 percent, supported by height and percentage of fat in soccer talents. The second predictive factor (fitness) contributed 63.2 percent and the third predictive factors (psychology) contributed 66.4 percent of soccer talent. The fourth predictive factors (skills) contributed 59.0 percent of soccer talent. The four multiple regression models could be used as a guide for talent scouting for soccer players of the future.

Keywords: soccer talent identification, fitness and physical test, soccer skills test, psychological test

Procedia PDF Downloads 136
553 Esthetic Rehabilitation of White and Brown Spot Lesions with Ceramic Veneers: A Clinical Report

Authors: Rania E. Ramadan

Abstract:

Dental esthetics is subjective, can be reported by the dentist and not noticed by the patient. However, if there is any imperfection seen by both the dentist and the patient, it is considered as an unesthetic like white and/or brown spot lesions. Many patients nowadays have been concerned about dental esthetics. Esthetic rehabilitation of anterior teeth and even maxillary premolars aid a lot in patients’ satisfaction of their smile consequently, gaining positive psychological impact for the patients. Many cases need esthetic rehabilitation such as diastema closure, spaced teeth and masking discolored teeth. Dental fluorosis and enamel hypo calcification can be presented as white and/or brown spot lesions. There are many treatment options for the management of these spotted teeth. Treatment options range from bleaching, microabrasion, direct composite restorations, porcelain veneers, and complete coverage crowns. The selection of certain options depends on many factors: the patient’s age, socioeconomic status and the severity of the lesion. In this clinical report, a 22-year-old male patient has been presented to the Department of Prosthodontics in Alexandria University, Egypt. His chief complaint was, “I was unpleased by white and brown spots in my teeth and I want to close the space between the two maxillary central.” Upon medical history, clinical examination, diagnostic photographs, and digital smile design by Exocad software, lithium disilicate veneers were chosen as the treatment of choice in maxillary anterior and first premolars.

Keywords: flourosis, ceramic veneers, case report, diastema closure

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552 Decision-Making Under Uncertainty in Obsessive-Compulsive Disorder

Authors: Helen Pushkarskaya, David Tolin, Lital Ruderman, Ariel Kirshenbaum, J. MacLaren Kelly, Christopher Pittenger, Ifat Levy

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Obsessive-Compulsive Disorder (OCD) produces profound morbidity. Difficulties with decision making and intolerance of uncertainty are prominent clinical features of OCD. The nature and etiology of these deficits are poorly understood. We used a well-validated choice task, grounded in behavioral economic theory, to investigate differences in valuation and value-based choice during decision making under uncertainty in 20 unmedicated participants with OCD and 20 matched healthy controls. Participants’ choices were used to assess individual decision-making characteristics. Compared to controls, individuals with OCD were less consistent in their choices and less able to identify options that were unambiguously preferable. These differences correlated with symptom severity. OCD participants did not differ from controls in how they valued uncertain options when outcome probabilities were known (risk) but were more likely than controls to avoid uncertain options when these probabilities were imprecisely specified (ambiguity). These results suggest that the underlying neural mechanisms of valuation and value-based choices during decision-making are abnormal in OCD. Individuals with OCD show elevated intolerance of uncertainty, but only when outcome probabilities are themselves uncertain. Future research focused on the neural valuation network, which is implicated in value-based computations, may provide new neurocognitive insights into the pathophysiology of OCD. Deficits in decision-making processes may represent a target for therapeutic intervention.

Keywords: obsessive compulsive disorder, decision-making, uncertainty intolerance, risk aversion, ambiguity aversion, valuation

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551 A Medical Vulnerability Scoring System Incorporating Health and Data Sensitivity Metrics

Authors: Nadir A. Carreon, Christa Sonderer, Aakarsh Rao, Roman Lysecky

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With the advent of complex software and increased connectivity, the security of life-critical medical devices is becoming an increasing concern, particularly with their direct impact on human safety. Security is essential, but it is impossible to develop completely secure and impenetrable systems at design time. Therefore, it is important to assess the potential impact on the security and safety of exploiting a vulnerability in such critical medical systems. The common vulnerability scoring system (CVSS) calculates the severity of exploitable vulnerabilities. However, for medical devices it does not consider the unique challenges of impacts to human health and privacy. Thus, the scoring of a medical device on which human life depends (e.g., pacemakers, insulin pumps) can score very low, while a system on which human life does not depend (e.g., hospital archiving systems) might score very high. In this paper, we propose a medical vulnerability scoring system (MVSS) that extends CVSS to address the health and privacy concerns of medical devices. We propose incorporating two new parameters, namely health impact, and sensitivity impact. Sensitivity refers to the type of information that can be stolen from the device, and health represents the impact on the safety of the patient if the vulnerability is exploited (e.g., potential harm, life-threatening). We evaluate fifteen different known vulnerabilities in medical devices and compare MVSS against two state-of-the-art medical device-oriented vulnerability scoring systems and the foundational CVSS.

Keywords: common vulnerability system, medical devices, medical device security, vulnerabilities

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550 A Scenario-Based Experiment Comparing Managerial and Front-Line Employee Apologies in Terms of Customers' Perceived Justice, Satisfaction, and Commitment

Authors: Ioana Dallinger, Vincent P. Magnini

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Due to the many moving parts and high human component, mistakes and failures sometimes occur during transactions in service environments. Because a certain portion of such failures is unavoidable, many service providers constantly look for guidance regarding optimal ways by which they should manage failures and recoveries. Through the use of a scenario-based experiment, the findings of this study run counter to the empowerment approach (i.e. that frontline employees should be empowered to resolve failure situations on their own doing). Specifically, this study finds that customers’ perceptions of distributive, procedural, and interactional justice are significantly higher [p-values < .05] when a manager delivers an apology as opposed to the frontline provider. Moreover, customers’ satisfaction with the recovery and commitment to the firm are also significantly stronger [p-values < .05] when a manager apologizes. Interestingly, this study also empirically tests the effects of combined apologies of both the manager and employee and finds that the combined approach yields better results for customers’ interactional justice perceptions and for their satisfaction with recovery, but not for their distributive or procedural justice perceptions or consequent commitment to the firm. This study can serve a springboard for further research. For example, perceptions and attitudes regarding employee empowerment vary based upon country culture. Furthermore, there are likely a number of factors that can moderate the cause and effect relationship between a failure recovery and customers’ post-recovery perceptions [e.g. the severity of the failure].

Keywords: apology, empowerment, service failure recovery, service recovery

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549 An Investigation of the Association between Pathological Personality Dimensions and Emotion Dysregulation among Virtual Network Users: The Mediating Role of Cyberchondria Behaviors

Authors: Mehdi Destani, Asghar Heydari

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Objective: The present study aimed to investigate the association between pathological personality dimensions and emotion dysregulation through the mediating role of Cyberchondria behaviors among users of virtual networks. Materials and methods: A descriptive–correlational research method was used in this study, and the statistical population consisted of all people active on social network sites in 2020. The sample size was 300 people who were selected through Convenience Sampling. Data collection was carried out in a survey method using online questionnaires, including the "Difficulties in Emotion Regulation Scale" (DERS), Personality Inventory for DSM-5 Brief Form (PID-5-BF), and Cyberchondria Severity Scale Brief Form (CSS-12). Data analysis was conducted using Pearson's Correlation Coefficient and Structural Equation Modeling (SEM). Findings: Findings suggested that pathological personality dimensions and Cyberchondria behaviors have a positive and significant association with emotion dysregulation (p<0.001). The presented model had a good fit with the data. The variable “pathological personality dimensions” with an overall effect (p<0.001, β=0.658), a direct effect (p<0.001, β=0.528), and an indirect mediating effect through Cyberchondria Behaviors (p<.001), β=0.130), accounted for emotion dysregulation among virtual network users. Conclusion: The research findings showed a necessity to pay attention to the pathological personality dimensions as a determining variable and Cyberchondria behaviors as a mediator in the vulnerability of users of social network sites to emotion dysregulation.

Keywords: cyberchondria, emotion dysregulation, pathological personality dimensions, social networks

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548 Allium Cepa Extract Provides Neuroprotection Against Ischemia Reperfusion Induced Cognitive Dysfunction and Brain Damage in Mice

Authors: Jaspal Rana, Alkem Laboratories, Baddi, Himachal Pradesh, India Chitkara University, Punjab, India

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Oxidative stress has been identified as an underlying cause of ischemia-reperfusion (IR) related cognitive dysfunction and brain damage. Therefore, antioxidant based therapies to treat IR injury are being investigated. Allium cepa L. (onion) is used as culinary medicine and is documented to have marked antioxidant effects. Hence, the present study was designed to evaluate the effect of A. cepa outer scale extract (ACE) against IR induced cognition and biochemical deficit in mice. ACE was prepared by maceration with 70% methanol and fractionated into ethylacetate and aqueous fractions. Bilateral common carotid artery occlusion for 10 min followed by 24 h reperfusion was used to induce cerebral IR injury. Following IR injury, ACE (100 and 200 mg/kg) was administered orally to animals for 7 days once daily. Behavioral outcomes (memory and sensorimotor functions) were evaluated using Morris water maze and neurological severity score. Cerebral infarct size, brain thiobarbituric acid reactive species, reduced glutathione, and superoxide dismutase activity was also determined. Treatment with ACE significantly ameliorated IR mediated deterioration of memory and sensorimotor functions and rise in brain oxidative stress in animals. The results of the present investigation revealed that ACE improved functional outcomes after cerebral IR injury, which may be attributed to its antioxidant properties.

Keywords: stroke, neuroprotection, ischemia reperfusion, herbal drugs

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547 TLR4 Gene Polymorphism and Biochemical Markers as a Tool to Identify Risk of Osteoporosis in Women from Karachi

Authors: Rozeena Baig, R. Rehana Rehman, Rifat Ahmed

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Background: Osteoporosis, characterized by low bone mineral density, poses a global health concern. Diagnosis increases the likelihood of developing osteoporosis, a multifactorial disorder marked by low bone mass, elevating the risk of fractures in the lumbar spine, femoral neck, hip, vertebras, and distal forearm, particularly in postmenopausal women due to bone loss influenced by various pathophysiological factors. Objectives: The aim is to investigate the association of serum cytokine, bone turnover marker, bone mineral density and TLR4 gene polymorphism in pre and post-menopausal women and to find if any of these can be the potential predictor of osteoporosis in postmenopausal women. Material and methods: The study participants consisted of Group A (n=91) healthy pre-menopausal women and Group B (n=102) healthy postmenopausal women having ≥ 5 years’ history of menopause. ELISA was performed for cytokine (TNFα) and bone turnover markers (carboxytelopeptides), respectively. Bone Mineral Density (BMD)was measured through a dual X-ray absorptiometry (DEXA) scan. Toll-like Receptors 4 (TLR4) gene polymorphisms (A896G; Asp299Gly) and (C1196T; Thr399Ile) were investigated by PCR and Sanger sequencing. Results: Statistical analysis reveals a positive correlation of age and BMI with T scores in the premenopausal group, whereas in post-menopausal group found a significant negative correlation between age and T-score at hip (r = - 0.352**), spine (r = - .306**), and femoral neck (r = - 0.344**) and a significant negative correlation of BMI with TNF-α (- 0.316**). No association and significant differences were observed for TLR4 genotype and allele frequencies among studied groups However, both SNPs exhibited significant association with each other. Conclusions: This study concludes that BMI, BMD and TNF-α are the potential predictors of osteoporosis in post-menopausal women. However, CTX and TLR4 gene polymorphism did not appear as potential predictors of bone loss in this study and apparently cannot help in predicting bone loss in post-menopausal women.

Keywords: osteoporosis, post-menopausal, pre-menopausal woemn, genetics mutaiont, TLR4 genepolymorphsum

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546 Influence of Online Sports Events on Betting among Nigerian Youth

Authors: Babajide Olufemi Diyaolu

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The opportunity provided by advances in technology as regards sports betting is so numerous that even at one's comfort, with the use of a phone, Nigerian youth are found engaging in all kinds of betting. Today it is more difficult to differentiate a true fan as there are quite a number of them that became fans as a result of betting on live games. This study investigated the influence of online sports events on betting among Nigerian youth. A descriptive survey research design was used, and the population consists of all Nigerian youth that engages in betting and live within the southwest zone of Nigeria. A simple random sampling technique was used to pick three states from the southwest zone of Nigeria. Two thousand five hundred respondents comprising males and female were sampled from the three states. A structured questionnaire on online sports event contribution to sports betting (OSECSB) was used. The Instrument consists of three sections. Section A seeks information on the demographic data of the respondents. Section B seeks information on online sports events, while section C is used to extract information on sports betting. The modified instrument, which consists of 14 items, has a reliability coefficient of 0.74. The hypothesis was tested at 0.05 significance level. The completed questionnaire was collated, coded, and analyzed using descriptive statistics of frequency counts, percentage and pie chart, and inferential statistics of multiple regressions. The findings of this study revealed that online sports betting is a significant predictor of an increase in sports betting among Nigerian youth. The media and television, as well as globalization and the internet coupled with social media and various online platforms, have all contributed to the immense increase in sports betting. The increase in the advertisement of the betting platform during live matches, especially football, is becoming more alarming. In most organized international events, the media attention, as well as sponsorship right, are now been given to one or two betting platforms. There is a need for all stakeholders to put in place school-based intervention programs to reorientate our youth about the consequences of addiction to betting. Such programs must include meta-analyses and emotional control towards sports betting.

Keywords: betting platform, Nigerian fans, Nigerian youth, sports betting

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545 Prognosis of Interstitial Lung Disease (ILD) Based on Baseline Pulmonary Function Test (PFT) Results in Omani Adult Patients Diagnosed with ILD In Sultan Qaboos University Hospital

Authors: Manal Al Bahri, Saif Al Mubahisi, Shamsa Al Shahaimi, Asma Al Qasabi, Jamal Al Aghbari

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Introduction: ILD is a common disease worldwide and in Oman. No previous Omani study was published regarding ILD prognosis based on baseline PFT results and other factors. This study aims to determine the severity of ILD by the baseline PFT, correlate between baseline PFT and outcome, and study other factors that influence disease mortality. Method: It is a retrospective cohort study; data was collected from January 2011 to December 2021 from electronic patient records (EPR). Means, Standard Deviations, frequencies, and Chi-square tests were used to examine the different variables in the study. Results: The total population of the study was 146 patients; 87 (59.6%) were females, and 59 (40.4%) were males. The median age was 59 years. Age at diagnosis, CVA, rheumatological disease, and baseline FVC were found to be statistically significant predictors of mortality .59.6% of the patients are diagnosed with IPF. Most of our study patients had mild disease based on baseline FVC. Death was higher with the more severe disease based on FVC. In mild disease (FVC >70%), 26.9% of the patients died. In moderate disease (FVC 50-69%),55.7% of the patients died, and in the severe group (FVC <50 %), 55.1% died. This was statistically significant with a P value of 0. 001. There is no statistically significant difference in the overall survival distribution between the different groups of DLCO. Conclusion: In our study, we found that ILD is more common among females, but death is more common among males. Based on baseline PFT, we can predict mortality by FVC level, as moderate to severe limitation is associated with a lower survival rate. DLCO was not a statistically significant parameter associated with mortality.

Keywords: PFT, ILD, FVC, DLCO, mortality

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544 Spontaneous Pneumothorax in Mixed Poisoning Presented as Daisley Barton Syndrome

Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam

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Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.

Keywords: pneumothorax, suicide, dithionate, OPC, herbicide

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543 Comparison of Virtual and Face to Face Training Program in Reducing Pain and Quality of Life of Female Students with Dysmenorrhea

Authors: Nilofar Mohammadi Ahvazi, Somayeh Ansari, Mohammad Hossein Haghighizadeh, Zahra Abbaspoor

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Introduction: Dysmenorrhea is one of the common causes of decreased efficiency at work, education and decreased quality of life of women. The aim of this study was to compare virtual and face-to-face training programs in reducing pain and improving the quality of life of female students with primary dysmenorrhea in Ahvaz. Methods: In this quasi-experimental study, 112 female students living in the dormitories of Ahvaz University of Medical Sciences with moderate to severe primary dysmenorrhea were divided into two face-to-face and virtual groups using blocks of size 4. The educational intervention was carried out in two groups at a specific hour before the start of the first menstrual cycle. Data were collected with the help of a quality-of-life questionnaire (Sf-36), visual analog scale (VAS), and McGill questionnaire and were analyzed using descriptive and analytical tests with the help of SPSS version 25 software. Findings: The average age of the research subjects was 25.93±2.00, and the average duration of dysmenorrhea in each period was 2.49 days. There was no statistically significant difference in the quality of life of the students before the intervention, but after the educational intervention, a statistically significant difference was found between the two groups in terms of the quality of life and its dimensions (p<0.001). They were the same before the intervention, But after the intervention, the difference became significant (p<0.001). Conclusion: The virtual training method, like face-to-face training, can improve the quality of life and reduce the severity of primary dysmenorrhea pain in students. Therefore, depending on the conditions, both educational methods can be used.

Keywords: primary dysmenorrhea, face-to-face training, virtual, training

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542 Characteristics of Serum Exosomes after Burn Injury and Dermal Fibroblast Regulation by Exosomes in Vitro

Authors: Jie Ding, Yingying Pan, Shammy Raj, Lindy Schaffrick, Jolene Wong, Antoinette Nguyen, Sharada Manchikanti, Larry Unsworth, Peter Kwan, Edward E. Tredget

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Background: Exosomes (EXOs) have been considered a new target that is thought to be involved in and treat wound healing. More research is needed to fully understand the EXO characteristics and mechanisms of EXO-mediated wound healing, especially wound healing after burn injury. Methods: Total EXOs were isolated from 85 serum samples of 29 burn patients and 13 healthy individuals. We characterized the EXOs for morphology and density, serum concentration, protein level, marker expression, size distribution, and cytokine content. After confirmation of EXO uptake by dermal fibroblasts, we also explored functional regulation of primary human normal skin and hypertrophic scar fibroblast cell lines by the EXOs in vitro, including cell proliferation and apoptosis. Results: EXOs dynamically changed their morphology, density, size, and cytokine level during wound healing in burn patients, which were correlated with burn severity and the stages of wound healing. EXOs from both burn patients and healthy individuals stimulated dermal fibroblast proliferation and apoptosis. Conclusion: EXO features may be important signals that influence wound healing after burn injury; however, to understand the mechanisms by which EXOs regulated the fibroblasts in healing wounds, further studies will be required in the future.

Keywords: exosome, burn, wound healing, hypertrophic scarring, cytokines

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541 Correlation between Creatinine Level with Erectile Dysfunction among Diabetics in Temerloh Health Clinic

Authors: Mohammad Zainie Bin Hassan

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Background: Erectile dysfunction (ED) is a complication commonly seen among men with diabetes which can be assessed based upon International Index of Erectile Function (IIEF-5) questionnaire. Creatinine level is a blood test that indicates kidney functionality. Object: To evaluate the association between ED, determined by the IIEF-5scores and Creatinine level in diabetic men attending Temerloh Health Clinic, Pahang, Malaysia.Hence, to identify raising Creatinine level related with ED or not. Methods: All married diabetic patients will be investigated face to face after consented for answering the IIEF-5 questionnaire. Creatinine level will be taken by using standard method.Patients with no sexual partner, refuse to answer the questionnaire, cancer, stroke, heart disease and language barrier will be excluded.Data obtained from IIEF-5 score and Creatinine level will be analyzed by using Pearson correlation. All statistical value determined by p=0.05. ED will be categorized accordingly to IIEF-5 scores: no ED (22-25), mild (17-21), moderate (12-16), severe (8-11) and very severe (1-7). Results: A total of 450 patients were investigated with 385 patients were included (85.6% respondant rate) and 65 patients were excluded in this study with age range from 29 to 85 years old. 7% had no ED, 28% mild ED, 34% moderate ED, 16% severe ED and 15% had very severe ED. There was a significant negative correlation between Creatinine level and IIEF-5 scores (r=-0.218, p <0.001). This result implicated that poor kidney function which indicated by high Creatinine level associated significantly with erectile dysfunction. 93% had ED with a different range of severity which triggers for appropriate aggressive ED management among diabetics. Conclusion: The high level of Creatinine is associated with erectile dysfunction among diabetics in Temerloh Health Clinic.

Keywords: correlation, creatinine level, erectile dysfunction, ED, diabetes

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540 Automatic Classification of Lung Diseases from CT Images

Authors: Abobaker Mohammed Qasem Farhan, Shangming Yang, Mohammed Al-Nehari

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Pneumonia is a kind of lung disease that creates congestion in the chest. Such pneumonic conditions lead to loss of life of the severity of high congestion. Pneumonic lung disease is caused by viral pneumonia, bacterial pneumonia, or Covidi-19 induced pneumonia. The early prediction and classification of such lung diseases help to reduce the mortality rate. We propose the automatic Computer-Aided Diagnosis (CAD) system in this paper using the deep learning approach. The proposed CAD system takes input from raw computerized tomography (CT) scans of the patient's chest and automatically predicts disease classification. We designed the Hybrid Deep Learning Algorithm (HDLA) to improve accuracy and reduce processing requirements. The raw CT scans have pre-processed first to enhance their quality for further analysis. We then applied a hybrid model that consists of automatic feature extraction and classification. We propose the robust 2D Convolutional Neural Network (CNN) model to extract the automatic features from the pre-processed CT image. This CNN model assures feature learning with extremely effective 1D feature extraction for each input CT image. The outcome of the 2D CNN model is then normalized using the Min-Max technique. The second step of the proposed hybrid model is related to training and classification using different classifiers. The simulation outcomes using the publically available dataset prove the robustness and efficiency of the proposed model compared to state-of-art algorithms.

Keywords: CT scan, Covid-19, deep learning, image processing, lung disease classification

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539 Access to the Forest Ecosystem Services: Understanding the Interaction between Livelihood Capitals and Access

Authors: Abu S. M. G. Kibria, Alison M. Behie, Robert Costanza, Colin Groves, Tracy Farrell

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This study is aimed to understand the level of access and the influence of livelihood capitals in maintaining access and control of ecosystem services (ESS) in the Sundarbans, Bangladesh. Besides the villagers, we consider other stakeholders including the forest department, coast guard, police, merchants, pirates and villagers who ‘controlled’ or ‘maintained’ access to ESS (crab catching, shrimp fry, honey, shrimp, mixed fish, fuel wood) in this region. Villagers used human, physical, natural and social capitals to gain access to ESS. The highest level of access was observed in crab catching and the lowest was found in honey collection, both of which were done when balancing the costs and benefits of accessing one ESS against another. The outcomes of these ongoing access negotiations were determined by livelihood capitals of the households. In addition, it was often found that the certain variables could have a positive effect on one ESS and a negative effect on another. For instance, human, social and natural capitals (eldest daughter’s education and No. of livelihood group membership and) had significant positive effects on honey collection while two components of human and social capitals including ‘eldest son’s education’ and ‘severity of pirate problem’ had exactly the opposite impact. These complex interactions were also observed in access to other ESS. It thus seems that access to ESS is not anything which is provided, but rather it is achieved by using livelihood capitals. Protecting any ecosystem from over exploitation and improve wellbeing can be achieved by properly balancing the livelihood capital-access nexus.

Keywords: provisioning services, access level, livelihood capital, interaction, access gain

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