Search results for: fatigue risk index calculator
Commenced in January 2007
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Edition: International
Paper Count: 9482

Search results for: fatigue risk index calculator

1262 Spatial Heterogeneity of Urban Land Use in the Yangtze River Economic Belt Based on DMSP/OLS Data

Authors: Liang Zhou, Qinke Sun

Abstract:

Taking the Yangtze River Economic Belt as an example, using long-term nighttime lighting data from DMSP/OLS from 1992 to 2012, support vector machine classification (SVM) was used to quantitatively extract urban built-up areas of economic belts, and spatial analysis of expansion intensity index, standard deviation ellipse, etc. was introduced. The model conducts detailed and in-depth discussions on the strength, direction, and type of the expansion of the middle and lower reaches of the economic belt and the key node cities. The results show that: (1) From 1992 to 2012, the built-up areas of the major cities in the Yangtze River Valley showed a rapid expansion trend. The built-up area expanded by 60,392 km², and the average annual expansion rate was 31%, that is, from 9615 km² in 1992 to 70007 km² in 2012. The spatial gradient analysis of the watershed shows that the expansion of urban built-up areas in the middle and lower reaches of the river basin takes Shanghai as the leading force, and the 'bottom-up' model shows an expanding pattern of 'upstream-downstream-middle-range' declines. The average annual rate of expansion is 36% and 35%, respectively. 17% of which the midstream expansion rate is about 50% of the upstream and downstream. (2) The analysis of expansion intensity shows that the urban expansion intensity in the Yangtze River Basin has generally shown an upward trend, the downstream region has continued to rise, and the upper and middle reaches have experienced different amplitude fluctuations. To further analyze the strength of urban expansion at key nodes, Chengdu, Chongqing, and Wuhan in the upper and middle reaches maintain a high degree of consistency with the intensity of regional expansion. Node cities with Shanghai as the core downstream continue to maintain a high level of expansion. (3) The standard deviation ellipse analysis shows that the overall center of gravity of the Yangtze River basin city is located in Anqing City, Anhui Province, and it showed a phenomenon of reciprocating movement from 1992 to 2012. The nighttime standard deviation ellipse distribution range increased from 61.96 km² to 76.52 km². The growth of the major axis of the ellipse was significantly larger than that of the minor axis. It had obvious east-west axiality, in which the nighttime lights in the downstream area occupied in the entire luminosity scale urban system leading position.

Keywords: urban space, support vector machine, spatial characteristics, night lights, Yangtze River Economic Belt

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1261 The Effect of Mindfulness Meditation on Pain, Sleep Quality, and Self-Esteem in Patients Receiving Hemodialysis in Jordan

Authors: Hossam N. Alhawatmeh, Areen I. Albustanji

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Hemodialysis negatively affects physical and psychological health. Pain, poor sleep quality, and low self-esteem are highly prevalent among patients with end-stage renal disease (ESRD) who receive hemodialysis, significantly increasing mortality and morbidity of those patients. Mind-body interventions (MBI), such as mindfulness meditation, have been recently gaining popularity that improved pain, sleep quality, and self-esteem in different populations. However, to our best knowledge, its effects on these health problems in patients receiving hemodialysis have not been studied in Jordan. Thus, the purpose of the study was to examine the effect of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESR receiving hemodialysis in Jordan. An experimental repeated-measures, randomized, parallel control design was conducted on (n =60) end-stage renal disease patients undergoing hemodialysis between March and June 2023 in the dialysis center at a public hospital in Jordan. Participants were randomly assigned to the experimental (n =30) and control groups (n =30) using a simple random assignment method. The experimental group practiced mindfulness meditation for 30 minutes three times per week for five weeks during their hemodialysis treatments. The control group's patients continued to receive hemodialysis treatment as usual for five weeks during hemodialysis sessions. The study variables for both groups were measured at baseline (Time 0), two weeks after intervention (Time 1), and at the end of intervention (Time 3). The numerical rating scale (NRS), the Rosenberg Self-Esteem Scale (RSES-M), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure pain, self-esteem, and sleep quality, respectively. SPSS version 25 was used to analyze the study data. The sample was described by frequency, mean, and standard deviation as an appropriate. The repeated measures analysis of variance (ANOVA) tests were run to test the study hypotheses. The results of repeated measures ANOVA (within-subject) revealed that mindfulness meditation significantly decrease pain by the end of the intervention in the experimental group. Additionally, mindfulness meditation improved sleep quality and self-esteem in the experimental group, and these improvements occurred significantly after two weeks of the intervention and at the end of the intervention. The results of repeated measures ANOVA (within and between-subject) revealed that the experimental group, compared to the control group, experienced lower levels of pain and higher levels of sleep quality and self-esteem over time. In conclusion, the results provided substantial evidence supporting the positive impacts of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESRD undergoing hemodialysis. These results highlight the potential of mindfulness meditation as an adjunctive therapy in the comprehensive care of this patient population. Incorporating mindfulness meditation into the treatment plan for patients receiving hemodialysis may contribute to improved well-being and overall quality of life.

Keywords: hemodialysis, pain, sleep quality, self-esteem, mindfulness

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1260 Psychosocial Experience of Parents of Children with Conduct Disorder in Thulamela, South Africa

Authors: Constance Singo, Choja Oduaran

Abstract:

Child mental disorders are strongly associated with different forms of challenges, including behavioural problems. The burden of care for children with a mental disorder is high and put primary caregivers, parents in particular, at risk of poor mental wellbeing. Understanding the experience of parents of children with mental disorders is crucial to developing a relevant intervention to assist them to attain optimal mental wellbeing. The aim of this study was to explore the experiences of parents of children with conduct disorder by focussing on the psychological and social stress experience of the parents in raising and caring for their children with conduct disorder. A qualitative research approach, using in-depth interview was utilized in this study. Purposive and snowballing sampling techniques were used to select 9 parents of children with conduct disorder in Thulamela Municipality, Limpopo Province of South Africa. Participants comprising of 2 males and 7 females aged between 30 years and 49 years were interviewed individually at scheduled appointment in-home setting. Interviews were conducted in both English and Setswana language. Data collected in Setswana language were translated to English by 'expert in language translation'. Ethical approval was obtained from appropriate authority before data collection. Thematic analysis was conducted to analyse the collected data. The findings identified anger, fear, depressive symptoms, denial, and suicidal ideation as predominant psychological experiences of the parents. Furthermore, deteriorated interpersonal relationships with family and community members, financial stress, and stigma emerged as social problems being the experience of the parents. It was concluded that parents of children with conduct disorder are highly traumatized by the challenges of caring for their children. We recommend professional engagement in terms of counselling service to support the parents. There is also a need for massive enlightenment programmes for members of the community in order to support the parents of children with child mental disorders.

Keywords: conduct disorder, parents, psychosocial experiences, South Africa

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1259 Covid-19 Pandemic: Another Lesson Learned by a Military Hospital

Authors: Mariana Floria, Elena-Diana Năfureanu, Diana-Mihaela Gălăţanu, Anca-Ecaterina Grumeza, Cristina Gorea-Bocîncă, Diana-Elena Iov, Aurelian-Corneliu Moraru, Dragoș-Marian Popescu

Abstract:

SARS-CoV-2 is the most deadly and devastating virus of the last one hundred years, being more highly contagious than EBOLA, HIV, Swine Influenza, Severe Acute Respiratory Syndrome, or Middle Eastern Respiratory Syndrome. After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. The aim of this study was to analyze the costs for hospital stay in patients with predominantly moderate forms of COVID-19 in a support military hospital located in Nord-East of Romania. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes (DRG payment), in a Covid-19 support military hospital were analyzed. From August 2020 through June 2021, 241 patientswere hospitalized. Our national protocol for the treatment of Covid-19 infection was applied. The main COVID-19 manifestations were: 69% respiratory (18% with severe pneumonia, 2.9% with pulmonary embolism, diagnosed by angio-computed tomography), 3.3% cardiac, 28% digestive, and 33% psychiatric (most common anxiety) manifestations. According to COVID-19 severity, most of the patients had moderate (104 patients – 43%) and severe (50 patients - 21%) forms. Seven patients with severe form died because of multiple comorbidities, and 30 patients were transferred in hospitals with COVID-19 intensive care units.Only two patients have had procalcitonin>10 ng/mL (high probability of severe sepsis or septic shock), and 1 patient had moderate risk for septic shock (0.5 - 2 ng/mL). The average estimated costs were about 3000€/patient, without significantly differences depending on disease severity. Equipment costs were 2 times higher than for drugs and 4 times than for laboratory tests. In a Covid-19 support military hospital that took care for predominantly moderate forms of COVID-19, the costs for equipment were much higher than that for treatment. Therefore, new criteria for hospitalization of these forms of COVID-19 deserve to be analyzed to avoid useless costs.

Keywords: Covid-19, costs, hospital stay, military hospital

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1258 Design and Development of a Safety Equipment and Accessory for Bicycle Users

Authors: Francine Siy, Stephen Buñi

Abstract:

Safety plays a significant role in everyone’s life on a day-to-day basis. We wish ourselves and our loved ones their safety as we all venture out on our daily commute. The road is undeniably dangerous and unpredictable, with abundant traffic collisions and pedestrians experiencing various injuries. For bicycle users, the risk of accidents is even more exacerbated, and injuries may be severe. Even when cyclists try their best to be safe and protected, the possibility of encountering danger is always there. Despite being equipped with protective gear, safety is never guaranteed. Cyclists often settle for helmets and standard reflector vests to establish a presence on the road. There are different types of vests available, depending on the profession. However, traditional reflector vests, mostly seen on construction workers and traffic enforcers, were not designed for riders and their protection from injuries. With insufficient protection for riders, they need access to ergonomically designed equipment and accessories that suit the riders and cater to their needs. This research aimed to offer a protective vest with safety features for riders that is comfortable, effective, durable, and intuitive. This sheds light and addresses the safety of the biker population, which continuously grows through the years. The product was designed and developed by gathering data and using the cognitive mapping method to ensure that all qualitative and quantitative data were considered in this study to improve other existing products that do not have the proper design considerations. It is known that available equipment for cyclists is often sold separately or lacks the safety features for cyclists traversing open roads. Each safety feature like the headlights, reflectors, signal or rear lights, zipper pouch, body camera attachment, and wireless remote control all play a particular role in helping cyclists embark on their daily commute. These features aid in illumination, visibility, easy maneuvering, convenience, and security, allowing cyclists to go for a safer ride that is of use throughout the day. The product is designed and produced effectively and inexpensively without sacrificing the quality and purpose of its usage.

Keywords: bicycle accessory, protective gear, safety, transport, visibility

Procedia PDF Downloads 80
1257 Effect of Climate Variability on Children Health Outcomes in Rural Uganda

Authors: Emily Injete Amondo, Alisher Mirzabaev, Emmanuel Rukundo

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Children in rural farming households are often vulnerable to a multitude of risks, including health risks associated with climate change and variability. Cognizant of this, this study empirically traced the relationship between climate variability and nutritional health outcomes in rural children while identifying the cause-and-effect transmission mechanisms. We combined four waves of the rich Uganda National Panel Survey (UNPS), part of the World Bank Living Standards Measurement Studies (LSMS) for the period 2009-2014, with long-term and high-frequency rainfall and temperature datasets. Self-reported drought and flood shock variables were further used in separate regressions for triangulation purposes and robustness checks. Panel fixed effects regressions were applied in the empirical analysis, accounting for a variety of causal identification issues. The results showed significant negative outcomes for children’s anthropometric measurements due to the impacts of moderate and extreme droughts, extreme wet spells, and heatwaves. On the contrary, moderate wet spells were positively linked with nutritional measures. Agricultural production and child diarrhea were the main transmission channels, with heatwaves, droughts, and high rainfall variability negatively affecting crop output. The probability of diarrhea was positively related to increases in temperature and dry spells. Results further revealed that children in households who engaged in ex-ante or anticipatory risk-reducing strategies such as savings had better health outcomes as opposed to those engaged in ex-post coping such as involuntary change of diet. These results highlight the importance of adaptation in smoothing the harmful effects of climate variability on the health of rural households and children in Uganda.

Keywords: extreme weather events, undernutrition, diarrhea, agricultural production, gridded weather data

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1256 Roads and Agriculture: Impacts of Connectivity in Peru

Authors: Julio Aguirre, Yohnny Campana, Elmer Guerrero, Daniel De La Torre Ugarte

Abstract:

A well-developed transportation network is a necessary condition for a country to derive full benefits from good trade and macroeconomic policies. Road infrastructure plays a key role in the economic development of rural areas of developing countries; where agriculture is the main economic activity. The ability to move agricultural production from the place of production to the market, and then to the place of consumption, greatly influence the economic value of farming activities, and of the resources involved in the production process, i.e., labor and land. Consequently, investment in transportation networks contributes to enhance or overcome the natural advantages or disadvantages that topography and location have imposed over the agricultural sector. This is of particular importance when dealing with countries, like Peru, with a great topographic diversity. The objective of this research is to estimate the impacts of road infrastructure on the performance of the agricultural sector. Specific variables of interest are changes in travel time, shifts of production for self-consumption to production for the market, changes in farmers income, and impacts on the diversification of the agricultural sector. In the study, a cross-section model with instrumental variables is the central methodological instrument. The data is obtained from agricultural and transport geo-referenced databases, and the instrumental variable specification utilized is based on the Kruskal algorithm. The results show that the expansion of road connectivity reduced farmers' travel time by an average of 3.1 hours and the proportion of output sold in the market increases by up to 40 percentage points. The increase in connectivity has an unexpected increase in the districts index of diversification of agricultural production. The results are robust to the inclusion of year and region fixed-effects, and to control for geography (i.e., slope and altitude), population variables, and mining activity. Other results are also very eloquent. For example, a clear positive impact can be seen in access to local markets, but this does not necessarily correlate with an increase in the production of the sector. This can be explained by the fact that agricultural development not only requires provision of roads but additional complementary infrastructure and investments intended to provide the necessary conditions so that producers can offer quality products (improved management practices, timely maintenance of irrigation infrastructure, transparent management of water rights, among other factors). Therefore, complementary public goods are needed to enhance the effects of roads on the welfare of the population, beyond enabling them to increase their access to markets.

Keywords: agriculture devolepment, market access, road connectivity, regional development

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1255 Mathematics Bridging Theory and Applications for a Data-Driven World

Authors: Zahid Ullah, Atlas Khan

Abstract:

In today's data-driven world, the role of mathematics in bridging the gap between theory and applications is becoming increasingly vital. This abstract highlights the significance of mathematics as a powerful tool for analyzing, interpreting, and extracting meaningful insights from vast amounts of data. By integrating mathematical principles with real-world applications, researchers can unlock the full potential of data-driven decision-making processes. This abstract delves into the various ways mathematics acts as a bridge connecting theoretical frameworks to practical applications. It explores the utilization of mathematical models, algorithms, and statistical techniques to uncover hidden patterns, trends, and correlations within complex datasets. Furthermore, it investigates the role of mathematics in enhancing predictive modeling, optimization, and risk assessment methodologies for improved decision-making in diverse fields such as finance, healthcare, engineering, and social sciences. The abstract also emphasizes the need for interdisciplinary collaboration between mathematicians, statisticians, computer scientists, and domain experts to tackle the challenges posed by the data-driven landscape. By fostering synergies between these disciplines, novel approaches can be developed to address complex problems and make data-driven insights accessible and actionable. Moreover, this abstract underscores the importance of robust mathematical foundations for ensuring the reliability and validity of data analysis. Rigorous mathematical frameworks not only provide a solid basis for understanding and interpreting results but also contribute to the development of innovative methodologies and techniques. In summary, this abstract advocates for the pivotal role of mathematics in bridging theory and applications in a data-driven world. By harnessing mathematical principles, researchers can unlock the transformative potential of data analysis, paving the way for evidence-based decision-making, optimized processes, and innovative solutions to the challenges of our rapidly evolving society.

Keywords: mathematics, bridging theory and applications, data-driven world, mathematical models

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1254 Development of Method for Detecting Low Concentration of Organophosphate Pesticides in Vegetables Using near Infrared Spectroscopy

Authors: Atchara Sankom, Warapa Mahakarnchanakul, Ronnarit Rittiron, Tanaboon Sajjaanantakul, Thammasak Thongket

Abstract:

Vegetables are frequently contaminated with pesticides residues resulting in the most food safety concern among agricultural products. The objective of this work was to develop a method to detect the organophosphate (OP) pesticides residues in vegetables using Near Infrared (NIR) spectroscopy technique. Low concentration (ppm) of OP pesticides in vegetables were investigated. The experiment was divided into 2 sections. In the first section, Chinese kale spiked with different concentrations of chlorpyrifos pesticide residues (0.5-100 ppm) was chosen as the sample model to demonstrate the appropriate conditions of sample preparation, both for a solution or solid sample. The spiked samples were extracted with acetone. The sample extracts were applied as solution samples, while the solid samples were prepared by the dry-extract system for infrared (DESIR) technique. The DESIR technique was performed by embedding the solution sample on filter paper (GF/A) and then drying. The NIR spectra were measured with the transflectance mode over wavenumber regions of 12,500-4000 cm⁻¹. The QuEChERS method followed by gas chromatography-mass spectrometry (GC-MS) was performed as the standard method. The results from the first section showed that the DESIR technique with NIR spectroscopy demonstrated good accurate calibration result with R² of 0.93 and RMSEP of 8.23 ppm. However, in the case of solution samples, the prediction regarding the NIR-PLSR (partial least squares regression) equation showed poor performance (R² = 0.16 and RMSEP = 23.70 ppm). In the second section, the DESIR technique coupled with NIR spectroscopy was applied to the detection of OP pesticides in vegetables. Vegetables (Chinese kale, cabbage and hot chili) were spiked with OP pesticides (chlorpyrifos ethion and profenofos) at different concentrations ranging from 0.5 to 100 ppm. Solid samples were prepared (based on the DESIR technique), then samples were scanned by NIR spectrophotometer at ambient temperature (25+2°C). The NIR spectra were measured as in the first section. The NIR- PLSR showed the best calibration equation for detecting low concentrations of chlorpyrifos residues in vegetables (Chinese kale, cabbage and hot chili) according to the prediction set of R2 and RMSEP of 0.85-0.93 and 8.23-11.20 ppm, respectively. For ethion residues, the best calibration equation of NIR-PLSR showed good indexes of R² and RMSEP of 0.88-0.94 and 7.68-11.20 ppm, respectively. As well as the results for profenofos pesticide, the NIR-PLSR also showed the best calibration equation for detecting the profenofos residues in vegetables according to the good index of R² and RMSEP of 0.88-0.97 and 5.25-11.00 ppm, respectively. Moreover, the calibration equation developed in this work could rapidly predict the concentrations of OP pesticides residues (0.5-100 ppm) in vegetables, and there was no significant difference between NIR-predicted values and actual values (data from GC-MS) at a confidence interval of 95%. In this work, the proposed method using NIR spectroscopy involving the DESIR technique has proved to be an efficient method for the screening detection of OP pesticides residues at low concentrations, and thus increases the food safety potential of vegetables for domestic and export markets.

Keywords: NIR spectroscopy, organophosphate pesticide, vegetable, food safety

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1253 Wearable System for Prolonged Cooling and Dehumidifying of PPE in Hot Environments

Authors: Lun Lou, Jintu Fan

Abstract:

While personal protective equipment (PPE) prevents the healthcare personnel from exposing to harmful surroundings, it creates a barrier to the dissipation of body heat and perspiration, leading to severe heat stress during prolonged exposure, especially in hot environments. It has been found that most of the existed personal cooling strategies have limitations in achieving effective cooling performance with long duration and lightweight. This work aimed to develop a lightweight (<1.0 kg) and less expensive wearable air cooling and dehumidifying system (WCDS) that can be applied underneath the protective clothing and provide 50W mean cooling power for more than 5 hours at 35°C environmental temperature without compromising the protection of PPE. For the WCDS, blowers will be used to activate an internal air circulation inside the clothing microclimate, which doesn't interfere with the protection of PPE. An air cooling and dehumidifying chamber (ACMR) with a specific design will be developed to reduce the air temperature and humidity inside the protective clothing. Then the cooled and dried air will be supplied to upper chest and back areas through a branching tubing system for personal cooling. A detachable ice cooling unit will be applied from the outside of the PPE to extract heat from the clothing microclimate. This combination allows for convenient replacement of the cooling unit to refresh the cooling effect, which can realize a continuous cooling function without taking off the PPE or adding too much weight. A preliminary thermal manikin test showed that the WCDS was able to reduce the microclimate temperature inside the PPE averagely by about 8°C for 60 minutes when the environmental temperature was 28.0 °C and 33.5 °C, respectively. Replacing the ice cooling unit every hour can maintain this cooling effect, while the longest operation duration is determined by the battery of the blowers, which can last for about 6 hours. This unique design is especially helpful for the PPE users, such as health care workers in infectious and hot environments when continuous cooling and dehumidifying are needed, but the change of protective clothing may increase the risk of infection. The new WCDS will not only improve the thermal comfort of PPE users but can also extend their safe working duration.

Keywords: personal thermal management, heat stress, ppe, health care workers, wearable device

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1252 Lean Production to Increase Reproducibility and Work Safety in the Laser Beam Melting Process Chain

Authors: C. Bay, A. Mahr, H. Groneberg, F. Döpper

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Additive Manufacturing processes are becoming increasingly established in the industry for the economic production of complex prototypes and functional components. Laser beam melting (LBM), the most frequently used Additive Manufacturing technology for metal parts, has been gaining in industrial importance for several years. The LBM process chain – from material storage to machine set-up and component post-processing – requires many manual operations. These steps often depend on the manufactured component and are therefore not standardized. These operations are often not performed in a standardized manner, but depend on the experience of the machine operator, e.g., levelling of the build plate and adjusting the first powder layer in the LBM machine. This lack of standardization limits the reproducibility of the component quality. When processing metal powders with inhalable and alveolar particle fractions, the machine operator is at high risk due to the high reactivity and the toxic (e.g., carcinogenic) effect of the various metal powders. Faulty execution of the operation or unintentional omission of safety-relevant steps can impair the health of the machine operator. In this paper, all the steps of the LBM process chain are first analysed in terms of their influence on the two aforementioned challenges: reproducibility and work safety. Standardization to avoid errors increases the reproducibility of component quality as well as the adherence to and correct execution of safety-relevant operations. The corresponding lean method 5S will therefore be applied, in order to develop approaches in the form of recommended actions that standardize the work processes. These approaches will then be evaluated in terms of ease of implementation and their potential for improving reproducibility and work safety. The analysis and evaluation showed that sorting tools and spare parts as well as standardizing the workflow are likely to increase reproducibility. Organizing the operational steps and production environment decreases the hazards of material handling and consequently improves work safety.

Keywords: additive manufacturing, lean production, reproducibility, work safety

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1251 The Effect of General Data Protection Regulation on South Asian Data Protection Laws

Authors: Sumedha Ganjoo, Santosh Goswami

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The rising reliance on technology places national security at the forefront of 21st-century issues. It complicates the efforts of emerging and developed countries to combat cyber threats and increases the inherent risk factors connected with technology. The inability to preserve data securely might have devastating repercussions on a massive scale. Consequently, it is vital to establish national, regional, and global data protection rules and regulations that penalise individuals who participate in immoral technology usage and exploit the inherent vulnerabilities of technology. This study paper seeks to analyse GDPR-inspired Bills in the South Asian Region and determine their suitability for the development of a worldwide data protection framework, considering that Asian countries are much more diversified than European ones. In light of this context, the objectives of this paper are to identify GDPR-inspired Bills in the South Asian Region, identify their similarities and differences, as well as the obstacles to developing a regional-level data protection mechanism, thereby satisfying the need to develop a global-level mechanism. Due to the qualitative character of this study, the researcher did a comprehensive literature review of prior research papers, journal articles, survey reports, and government publications on the aforementioned topics. Taking into consideration the survey results, the researcher conducted a critical analysis of the significant parameters highlighted in the literature study. Many nations in the South Asian area are in the process of revising their present data protection measures in accordance with GDPR, according to the primary results of this study. Consideration is given to the data protection laws of Thailand, Malaysia, China, and Japan. Significant parallels and differences in comparison to GDPR have been discussed in detail. The conclusion of the research analyses the development of various data protection legislation regimes in South Asia.

Keywords: data privacy, GDPR, Asia, data protection laws

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1250 Reducing the Length of Stay and Mortality in COVID-19 Patients with Diabetes

Authors: Sara Alzahrani, Samia Bokari, Patan Khan, Muneera Alshareef, Rania Safwat, Mohammed Galal, Hamdi Alqadi, Ameerah Alzahrani, Rehab Alboraie

Abstract:

Introduction & Background: Diabetes in COVID-19 patients is individual risk factor and documented in worldwide studies to contribute to disease severity, increased length of stay and higher mortality. Aggressive management of blood sugars and acute diabetic complications reduce the length of stay and mortality. Methods: Randomly selected 200 patients admitted with diabetes and COVID-19 studied. The unified treatment protocol applied for all patients and blood sugars monitored closely and optimized .Data collected on bimonthly basis and analyzed. Patients’ characteristics taken from data extraction tool (Oasis) of hospital. Median values for length of stay and post discharge FBS and RBS were calculated via Microsoft Excel tool. Mortality rates were calculated by percentages. The results monitored in the post discharge clinic was 130 mg/dl and 170 mg/dl respectively. The results compared with the standard international studies. Discussion: Diabetes in COVID-19 patients posed great challenge as increased severity and mortalities reported compared to non-diabetic. Taking a pre-emptive strategy to combat this problem by aggressively manage diabetes help in reducing length of stay and morbidity. The length of stay in studded population was 3 days as compared to 13 days in a major international study. Financial saving come from rapid turnover of beds. The mortality was 2.5 % compared to reported 7.3% in a major study, reflecting the implications of aggressive management of diabetes. Regular follow-up and support by running post-discharge clinic definitely help reducing readmissions and acute complications of uncontrolled diabetes. Conclusion: Aggressive management of diabetes in COVID-19 patients by tailored treatment protocols and dedicated teams will help to decrease the morbidity and mortality.

Keywords: diabetes, covid-19, management, mortality

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1249 Determining the Materiality of an Undisclosed Fact: An Onerous Duty on the Assured

Authors: Adekemi Adebowale

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The duty of disclosure in Nigerian insurance law is in need of reform. The materiality of an undisclosed fact (notwithstanding that it was an honest and innocent non-disclosure) currently entitles insurers to avoid insurance policies, leaving an insured with an uncovered loss. While the test of materiality requires an insured to voluntarily disclose facts that will influence an insurer's decision without proper guidelines from the insurer, the insurer is only expected to prove that the undisclosed fact had influenced its judgment in fixing the premium or determining whether to accept the risk. This problem places an onerous duty on the assured to volunteer to the insurer every material fact even though the insured only has a slight idea about the mind of a hypothetical prudent insurer. This paper explores the modern approach to revisiting the problem of an insured’s pre-contractual obligation to determine material facts in Nigerian insurance law. The aim is to build upon the change in the structure of insurance contract obligations in other common law jurisdictions such as the United Kingdom. The doctrinal and comparative methodology captures the burden imposed on the insured under the existing Nigerian insurance law. It finds that the continued application of the law leaves the insured in the weakest position, and he stands to lose in a contract supposedly created for his benefit. It is apparent that if this problem remains unresolved, the over-all consequence will contribute to a significant decline in the insurance contract, which may affect the Nigerian economy. The paper aims to evaluate the risks of the continuous application of the traditional law, which does not keep with the pace of modern insurance practice. It will ultimately produce a legally compliant reform, along with a significant deviation from the archaic structure that exists in the Nigerian insurance law. This paper forms part of an on-going PhD research on "The insured’s pre-contractual duty of utmost of utmost good faith". The outcome from the research to date finds that the insured bears the burden of the obligation to act in utmost good faith where it concerns disclosure of material facts.

Keywords: disclosure, materiality, Nigeria, United Kingdom, utmost good faith

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1248 Determination of Medians of Biochemical Maternal Serum Markers in Healthy Women Giving Birth to Normal Babies

Authors: Noreen Noreen, Aamir Ijaz, Hamza Akhtar

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Background: Screening plays a major role to detect chromosomal abnormalities, Down syndrome, neural tube defects and other inborn diseases of the newborn. Serum biomarkers in the second trimester are useful in determining risk of most common chromosomal anomalies; these test include Alpha-fetoprotein (AFP), Human chorionic gonadotropin (hCG), Unconjugated Oestriol (UEȝ)and inhibin-A. Quadruple biomarkers are worth test in diagnosing the congenital pathology during pregnancy, these procedures does not form a part of routine health care of pregnant women in Pakistan, so the median value is lacking for population in Pakistan. Objective: To determine median values of biochemical maternal serum markers in local population during second trimester maternal screening. Study settings: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP) Rawalpindi. Methods: Cross-Sectional study for estimation of reference values. Non-probability consecutive sampling, 155 healthy pregnant women, of 30-40 years of age, will be included. As non-parametric statistics will be used, the minimum sample size is 120. Result: Total 155 women were enrolled into this study. The age of all women enrolled ranged from 30 to39 yrs. Among them, 39 per cent of women were less than 34 years. Mean maternal age 33.46±2.35 SD and maternal body weight were 54.98±2.88. Median value of quadruple markers calculated from 15-18th week of gestation that will be used for calculation of MOM for screening of trisomy21 in this gestational age. Median value at 15 week of gestation were observed hCG 36650 mIU/ml, AFP 23.3 IU/ml, UEȝ 3.5 nmol/L, InhibinA 198 ng/L, at 16 week of gestation hCG 29050 mIU/ml, AFP 35.4 IU/ml, UEȝ 4.1 nmol/L, InhibinA 179 ng/L, at 17 week of gestation hCG 28450 mIU/ml, AFP 36.0 IU/ml, UEȝ 6.7 nmol/L, InhibinA 176 ng/L and at 18 week of gestation hCG 25200 mIU/ml, AFP 38.2 IU/ml, UEȝ 8.2 nmol/L, InhibinA 190 ng/L respectively.All the comparisons were significant (p-Value <0.005) with 95% confidence Interval (CI) and level of significance of study set by going through literature and set at 5%. Conclusion: The median values for these four biomarkers in Pakistani pregnant women can be used to calculate MoM.

Keywords: screening, down syndrome, quadruple test, second trimester, serum biomarkers

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1247 A Therapeutic Approach for Bromhidrosis with Glycopyrrolate 2% Cream: Clinical Study of 20 Patients

Authors: Vasiliki Markantoni, Eftychia Platsidaki, Georgios Chaidemenos, Georgios Kontochristopoulos

Abstract:

Introduction: Bromhidrosis, also known as osmidrosis, is a common distressing condition with a significant negative effect on patient’s quality of life. Its etiology is multifactorial. It usually affects axilla, genital skin, breasts and soles, areas where apocrine glands are mostly distributed. Therapeutic treatments include topical antibacterial agents, antiperspirants and neuromuscular blocker agents-toxins. In this study, we aimed to evaluate the efficacy and possible complications of topical glycopyrrolate, an anticholinergic agent, for treatment of bromhidrosis. Glycopyrrolate, applied topically as a cream, solution or spray at concentrations between 0,5% and 4%, has been successfully used to treat different forms of focal hyperhidrosis. Materials and Methods: Twenty patients, six males and fourteen females, meeting the criteria for bromhidrosis were treated with topical glycopyrrolate for two months. The average age was 36. Eleven patients had bromhidrosis located to the axillae, four to the soles, four to both axillae and soles and one to the genital folds. Glycopyrrolate was applied topically as a cream at concentration 2%, formulated in Fitalite. During the first month, patients were using the cream every night and thereafter twice daily. The degree of malodor was assessed subjectively by patients and scaled averagely as ‘none’, ‘mild’, ‘moderate’, and ‘severe’ with corresponding scores of 0, 1, 2, and 3, respectively. The modified Dermatology Life Quality Index (DLQI) was used to assess the quality of life. The clinical efficacy was graded by the patient scale of excellent, good, fair and poor. In the end, patients were given the power to evaluate whether they were totally satisfied with, partially satisfied or unsatisfied and possible side effects during the treatment were recorded. Results: All patients were satisfied at the end of the treatment. No patient defined the response as no improvement. The subjectively assessed score level of bromhidrosis was remarkably improved after the first month of treatment and improved slightly more after the second month. DLQI score was also improved to all patients. Adverse effects were reported in 2 patients. In the first case, topical irritation was reported. This was classed as mild (erythema and desquamation), appeared during the second month of treatment and was treated with low-potency topical corticosteroids. In the second case, mydriasis was reported, that recovered without specific treatment, as soon as we insisted to the importance of careful hygiene after cream application so as not to contaminate the periocular skin or ocular surface. Conclusions: Dermatologists often encounter patients with bromhidrosis, therefore should be aware of treatment options. To the best of our knowledge, this is the first study to evaluate the use of topical glycopyrrolate as a therapeutic approach for bromhidrosis. Our findings suggest that topical glycopyrrolate has an excellent safety profile and demonstrate encouraging results for the management of this distressful condition.

Keywords: Bromhidrosis, glycopyrrolate, topical treatment, osmidrosis

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1246 Effect of Blood Sugar Levels on Short Term and Working Memory Status in Type 2 Diabetics

Authors: Mythri G., Manjunath ML, Girish Babu M., Shireen Swaliha Quadri

Abstract:

Background: The increase in diabetes among the elderly is of concern because in addition to the wide range of traditional diabetes complications, evidence has been growing that diabetes is associated with increased risk of cognitive decline. Aims and Objectives: To find out if there is any association between blood sugar levels and short-term and working memory status in patients of type 2 diabetes. Materials and Methods: The study was carried out in 200 individuals aged between 40-65 years consisting of 100 diagnosed cases of Type 2 Diabetes Mellitus and 100 non-diabetics from OPD of Mc Gann Hospital, Shivamogga. Rye’s Auditory Verbal Learning Test, Verbal Fluency Test and Visual Reproduction Test, Working Digit Span Test and Validation Span Test were used to assess short-term and working memory. Fasting and Post Prandial blood sugar levels were estimated. Statistical analysis was done using SPSS 21. Results: Memory test scores of type 2 diabetics were significantly reduced (p < 0.001) when compared to the memory scores of age and gender matched non-diabetics. Fasting blood sugar levels were found to have a negative correlation with memory scores for all 5 tests: AVLT (r=-0.837), VFT (r=-0.888), VRT(r=-0.787), WDST (r=-0.795) and VST (r=-0.943). Post- Prandial blood sugar levels were found to have a negative correlation with memory scores for all 5 tests: AVLT (r=-0.922), VFT (r=-0.848), VRT(r=-0.707),WDST (r=-0.729) and VST (r=-0.880) Memory scores in all 5 tests were found to be negatively correlated with the FBS and PPBS levels in diabetic patients (p < 0.001). Conclusion: The decreased memory status in diabetic patients may be due to many factors like hyperglycemia, vascular disease, insulin resistance, amyloid deposition and also some of the factor combine to produce additive effects like, type of diabetes, co-morbidities, age of onset, duration of the disease and type of therapy. These observed effects of blood sugar levels of diabetics on memory status are of potential clinical importance because even mild cognitive impairment could interfere with todays’ activities.

Keywords: diabetes, cognition, diabetes, HRV, respiratory medicine

Procedia PDF Downloads 279
1245 Effective, Affordable, and Accessible Treatment for Pregnancy’s Commonest Complication: Online Synchronous Interpersonal Psychotherapy for Mothers with Postpartum Depression

Authors: Vivian Polak, Lena Verdeli, Wendy Lou, Caroline Lovett

Abstract:

Postnatal depression (PND) is a common complication of childbirth that increases the risk of future depressive episodes in women, postpartum depression in partners, as well as social, emotional, behavioural, language, and cognitive problems in offspring. Although psychotherapy, and in particular Group Interpersonal Psychotherapy (IPT-G), has been proven effective in treating PND, it remains largely inaccessible. However, research has indicated that online synchronous group therapy can be equally as effective as in-person therapy and is a more affordable and accessible modality of treatment. This study aimed to ascertain whether delivering IPT-G virtually when compared to treatment as usual, could more effectively reduce depressive and anxiety symptoms, enhance mother-infant attachment, improve the couple relationship, augment social support, improve overall functioning, and enhance the quality of life for women in rural and northern Ontario who are suffering from PND. By bridging the gap in access to mental health services during the postpartum period, this study seeks to improve the well-being of mothers and their families in rural and northern Ontario, Canada. A randomized controlled trial was conducted to determine whether virtual IPT-G plus treatment as usual would be more effective than treatment as usual alone in treating women with PND in Ontario, Canada. Preliminary results indicate that women who received virtual IPT-G had a clinically and statistically significant decrease in overall depressive symptoms compared to their counterparts who received only the treatment as usual. As such, providing online synchronous IPT-G in the perinatal period not only has the potential to improve women's outcomes in the present but also to decrease future health costs, reduce the burden on the educational and justice systems, and decrease the number of disability life years lost to postnatal depression.

Keywords: family wellbeing, group psychotherapy, interpersonal psychotherapy, postnatal depression, virtual psychotherapy

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1244 Human Activities Damaging the Ecosystem of Isheri Ogun River, South West Nigeria

Authors: N. B. Ikenweiwe, A. A. Alimi, N. A. Bamidele, O. A. Ewumi, K. Fasina, S. O. Otubusin

Abstract:

A study on the physical, chemical and biological parameters of the lower course of Ogun River, Isheri-Olofin was carried out between January and December 2014 in order to determine the effects of the anthropogenic activities of the Kara abattoir and domestic waste depositions on the quality of the water. Water samples were taken twice each month at three selected stations A, B and C (based on characteristic features or activity levels) along the water course. Samples were analysed using standard methods for chemical and biological parameters the same day in the laboratory while physical parameters were determined in-situ with water parameters kit. Generally, results of Transparency, Dissolved Oxygen, Nitrates, TDS and Alkalinity fall below the permissible limits of WHO and FEPA standards for drinking and fish production. Results of phosphates, lead and cadmium were also low but still within the permissible limit. Only Temperature and pH were within limit. Low plankton community, (phytoplankton, zooplankton), which ranges from 3, 5 to 40, 23 were as a result of low levels of DO, transparency and phosphate. The presence of coliform bacteria of public health importance like Escherichia coli, Proteus vulgaris, Aeromonas sp., Shigella sp, Enterobacter aerogenes as well as gram negative bacteria Proteus morganii are mainly indicators of faecal pollution. Fish and other resources obtained from this water stand the risk of being contaminated with these organisms and man is at the receiving end. The results of the physical, chemical and some biological parameters of Isheri, Ogun River, according to this study showed that the live forms of aquatic and fisheries resources there are dwelling under stress as a result of deposition of bones, horns, faecal components, slurry of suspended solids, fat and blood into the water. Government should therefore establish good monitoring system against illegal waste depositions and create education programmes that will enlighten the community on the social, ecological and economic values of the river.

Keywords: damage, ecosystem, human activities, Isheri ogun river

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1243 Resistance Training and Ginger Consumption on Cytokines Levels

Authors: Alireza Barari, Ahmad Abdi

Abstract:

Regular body trainings cause adaption in various system in body. One of the important effect of body training is its effect on immune system. It seems that cytokines usually release after long period exercises or some exercises which cause skeletal muscular damages. If some of the cytokines which cause responses such as inflammation of cells in skeletal muscles, with manipulating of training program, it can be avoided or limited from those exercises which induct cytokines release. Ginger plant is a kind of medicinal plants which is known as a anti inflammation plant. This plant is as most precedence medicinal plants in medicine science especially in inflammation cure. The aim of the present study was the effect of selected resistance training and consumption of ginger extract on IL-1α and TNFα untrained young women. The population includes young women interested in participating in the study with the average of 30±2 years old from Abbas Abad city among which 32 participants were chosen randomly and divided into 4 four groups, resistance training (R), resistance training and ginger consumption(RG), Ginger consumption(G)and Control group(C). The training groups performed circuit resistance training at the intensity of 65-75% one repeat maximum, 3 days a week for 6 weeks. Besides resistance training, subjects were given either ginseng (5 mg/kg per day) or placebo. Prior to and 48 hours after interventions body composition was measured and blood samples were taken in order to assess serum levels of IL-1α and TNFα. Plasma levels of cytokines were measured with commercially available ELISA Kits.IL-1α kit and TNFα kit were used in this research. To demonstrate the effectiveness of the independent variable and the comparison between groups, t-test and ANOVA were used. To determine differences between the groups, the Scheffe test was used that showed significant changes in any of the variables. we observed that circuit resistance training in R and RG groups can significant decreased in weight and body mass index in untrained females (p<0.05). The results showed a significant decreased in the mean level of IL-1α levels before and after the training period in G group (p=0.046) and RG group (p=0.022). Comparison between groups also showed there was significant difference between groups R-RG and RG-C. Intergroup comparison results showed that the mean levels of TNFα before and after the training in group G (p=0.044) and RG (p=0.037), significantly decreased. Comparison between groups also showed there was significant difference between groups R–RG , R-G ,RG-C and G-C. The research shows that circuit resistance training with reducing overload method results in systemic inflammation had significant effect on IL-1α levels and TNFα. Of course, Ginger can counteract the negative effects of resistance training exercise on immune function and stability of the mast cell membrane. Considerable evidence supported the anti-inflammatory properties of ginger for several constituents, especially gingerols, shogaols, paradols, and zingerones, through decreased cytokine gene TNF α and IL-1Α expression and inhibition of cyclooxygenase 1 and 2. These established biological actions suggest that ingested ginger could block the increase in IL-1α.

Keywords: resistance training, ginger, IL-1α , TNFα

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1242 Building Climate Resilience in the Health Sector in Developing Countries: Experience from Tanzania

Authors: Hussein Lujuo Mohamed

Abstract:

Introduction: Public health has always been influenced by climate and weather. Changes in climate and climate variability, particularly changes in weather extremes affect the environment that provides people with clean air, food, water, shelter, and security. Tanzania is not an exception to the threats of climate change. The health sector is mostly affected due to emergence and proliferation of infectious diseases, thereby affecting health of the population and thus impacting achievement of sustainable development goals. Methodology: A desk review on documented issues pertaining to climate change and health in Tanzania was done using Google search engine. Keywords included climate change, link, health, climate initiatives. In cases where information was not available, documents from Ministry of Health, Vice Presidents Office-Environment, Local Government Authority, Ministry of Water, WHO, research, and training institutions were reviewed. Some of the reviewed documents from these institutions include policy brief papers, fieldwork activity reports, training manuals, and guidelines. Results: Six main climate resilience activities were identified in Tanzania. These were development and implementation of climate resilient water safety plans guidelines both for rural and urban water authorities, capacity building of rural and urban water authorities on implementation of climate-resilient water safety plans, and capacity strengthening of local environmental health practitioners on mainstreaming climate change and health into comprehensive council health plans. Others were vulnerability and adaptation assessment for the health sector, mainstreaming climate change in the National Health Policy, and development of risk communication strategy on climate. In addition information, education, and communication materials on climate change and to create awareness were developed aiming to sensitize and create awareness among communities on climate change issues and its effect on public health. Conclusion: Proper implementation of these interventions will help the country become resilient to many impacts of climate change in the health sector and become a good example for other least developed countries.

Keywords: climate, change, Tanzania, health

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1241 An Introduction to the Concept of Environmental Audit: Indian Context

Authors: Pradip Kumar Das

Abstract:

Phenomenal growth of population and industry exploits the environment in varied ways. Consequently, the greenhouse effect and other allied problems are threatening mankind the world over. Protection and up gradation of environment have, therefore, become the prime necessity all of mankind for the sustainable development of environment. People in humbler walks of life including the corporate citizens have become aware of the impacts of environmental pollution. Governments of various nations have entered the picture with laws and regulations to correct and cure the effects of present and past violations of environmental practices and to obstruct future violations of good environmental disciplines. In this perspective, environmental audit directs verification and validation to ensure that the various environmental laws are complied with and adequate care has been taken towards environmental protection and preservation. The discipline of environmental audit has experienced expressive development throughout the world. It examines the positive and negative effects of the activities of an enterprise on environment and provides an in-depth study of the company processes any growth in realizing long-term strategic goals. Environmental audit helps corporations assess its achievement, correct deficiencies and reduce risk to the health and improving safety. Environmental audit being a strong management tool should be administered by industry for its own self-assessment. Developed countries all over the globe have gone ahead in environment quantification; but unfortunately, there is a lack of awareness about pollution and environmental hazards among the common people in India. In the light of this situation, the conceptual analysis of this study is concerned with the rationale of environmental audit on the industry and the society as a whole and highlights the emerging dimensions in the auditing theory and practices. A modest attempt has been made to throw light on the recent development in environmental audit in developing nations like India and the problems associated with the implementation of environmental audit. The conceptual study also reflects that despite different obstacles, environmental audit is becoming an increasing aspect within the corporate sectors in India and lastly, conclusions along with suggestions have been offered to improve the current scenario.

Keywords: environmental audit, environmental hazards, environmental laws, environmental protection, environmental preservation

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1240 Effect of Antioxidant-Rich Nutraceutical on Serum Glucose, Lipid Profile and Oxidative Stress Markers of Salt-Induced Metabolic Syndrome in Rats

Authors: Nura Lawal, Lawal Suleiman Bilbis, Rabiu Aliyu Umar, Anas A. Sabir

Abstract:

Metabolic syndrome (MS) a high-risk condition involving obesity, dyslipidemia, hypertension, and diabetes mellitus is prevalent in Nigeria. The study aims to formulate an antioxidant-rich nutraceutical from locally available foodstuff (onion, garlic, ginger, tomato, lemon, palm oil, watermelon seeds) and investigate their effects on blood pressure, body weight, serum glucose, lipid profile, insulin and oxidative stress markers in salt-induced rats. The rats were placed on 8% salt diet for 6 weeks and then supplementation and treatment with nutraceutical and nifedipine in the presence of salt diet for additional 4 weeks. Feeding rats with salt diet for 6 weeks increased blood pressure and body weight of the salt-loaded rats relative to control. Significant (P < 0.001) increase in serum blood glucose and lipid profile, and the decrease in high-density lipoprotein-cholesterol (HDL-C) was observed in salt-loaded rats as compared with control. Both supplementation and treatment (nifedipine) lowered the blood pressure but the only supplementation lowered the body weight. Supplementation with nutraceutical resulted in significant (P < 0.001) decrease in the serum blood glucose, lipid profile, malonyldialdehyde (MDA), insulin levels, insulin resistance, and increased HDL-C and antioxidant indices. The percentage protection against atherogenesis was 76.5±2.13%. There is strong positive correlation between blood pressure, body weight and serum blood glucose, lipid profile, markers of oxidative stress and strong negative correlation with HDL-C and antioxidant status. The results suggest that the nutraceuticals are useful in reversing most of the component of metabolic syndrome and might be beneficial in the treatment of patients with metabolic syndrome.

Keywords: metabolic syndrome, hypertension, diabetes mallitus, obesity

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1239 Comparative Study on Efficacy and Clinical Outcomes in Minimally Invasive Surgery Transforaminal Interbody Fusion vs Minimally Invasive Surgery Lateral Interbody Fusion

Authors: Sundaresan Soundararajan, George Ezekiel Silvananthan, Chor Ngee Tan

Abstract:

Introduction: Transforaminal Interbody Fusion (TLIF) has been adopted for many decades now, however, XLIF, still in relative infancy, has grown to be accepted as a new Minimally Invasive Surgery (MIS) option. There is a paucity of reports directly comparing lateral approach surgery to other MIS options such as TLIF in the treatment of lumbar degenerative disc diseases. Aims/Objectives: The objective of this study was to compare the efficacy and clinical outcomes between Minimally Invasive Transforaminal Interbody Fusion (TLIF) and Minimally Invasive Lateral Interbody Fusion (XLIF) in the treatment of patients with degenerative disc disease of the lumbar spine. Methods: A single center, retrospective cohort study involving a total of 38 patients undergoing surgical intervention between 2010 and 2013 for degenerative disc disease of lumbar spine at single L4/L5 level. 18 patients were treated with MIS TLIF, and 20 patients were treated with XLIF. Results: The XLIF group showed shorter duration of surgery compared to the TLIF group (176 mins vs. 208.3 mins, P = 0.03). Length of hospital stay was also significantly shorter in XLIF group (5.9 days vs. 9 days, p = 0.03). Intraoperative blood loss was favouring XLIF as 85% patients had blood loss less than 100cc compared to 58% in the TLIF group (P = 0.03). Radiologically, disc height was significantly improved post operatively in the XLIF group compared to the TLIF group (0.56mm vs. 0.39mm, P = 0.01). Foraminal height increment was also higher in the XLIF group (0.58mm vs. 0.45mm , P = 0.06). Clinically, back pain and leg pain improved in 85% of patients in the XLIF group and 78% in the TLIF group. Post op hip flexion weakness was more common in the XLIF group (40%) than in the TLIF group (0%). However, this weakness resolved within 6 months post operatively. There was one case of dural tear and surgical site infection in the TLIF group respectively and none in the XLIF group. Visual Analog Scale (VAS) score 6 months post operatively showed comparable reduction in both groups. TLIF group had Owsterty Disability Index (ODI) improvement on 67% while XLIF group showed improvement of 70% of its patients. Conclusions: Lateral approach surgery shows comparable clinical outcomes in resolution of back pain and radiculopathy to conventional MIS techniques such as TLIF. With significantly shorter duration of surgical time, minimal blood loss and shorter hospital stay, XLIF seems to be a reasonable MIS option compared to other MIS techniques in treating degenerative lumbar disc diseases.

Keywords: extreme lateral interbody fusion, lateral approach, minimally invasive, XLIF

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1238 Global-Scale Evaluation of Two Satellite-Based Passive Microwave Soil Moisture Data Sets (SMOS and AMSR-E) with Respect to Modelled Estimates

Authors: A. Alyaaria, b, J. P. Wignerona, A. Ducharneb, Y. Kerrc, P. de Rosnayd, R. de Jeue, A. Govinda, A. Al Bitarc, C. Albergeld, J. Sabaterd, C. Moisya, P. Richaumec, A. Mialonc

Abstract:

Global Level-3 surface soil moisture (SSM) maps from the passive microwave soil moisture and Ocean Salinity satellite (SMOSL3) have been released. To further improve the Level-3 retrieval algorithm, evaluation of the accuracy of the spatio-temporal variability of the SMOS Level 3 products (referred to here as SMOSL3) is necessary. In this study, a comparative analysis of SMOSL3 with a SSM product derived from the observations of the Advanced Microwave Scanning Radiometer (AMSR-E) computed by implementing the Land Parameter Retrieval Model (LPRM) algorithm, referred to here as AMSRM, is presented. The comparison of both products (SMSL3 and AMSRM) were made against SSM products produced by a numerical weather prediction system (SM-DAS-2) at ECMWF (European Centre for Medium-Range Weather Forecasts) for the 03/2010-09/2011 period at global scale. The latter product was considered here a 'reference' product for the inter-comparison of the SMOSL3 and AMSRM products. Three statistical criteria were used for the evaluation, the correlation coefficient (R), the root-mean-squared difference (RMSD), and the bias. Global maps of these criteria were computed, taking into account vegetation information in terms of biome types and Leaf Area Index (LAI). We found that both the SMOSL3 and AMSRM products captured well the spatio-temporal variability of the SM-DAS-2 SSM products in most of the biomes. In general, the AMSRM products overestimated (i.e., wet bias) while the SMOSL3 products underestimated (i.e., dry bias) SSM in comparison to the SM-DAS-2 SSM products. In term of correlation values, the SMOSL3 products were found to better capture the SSM temporal dynamics in highly vegetated biomes ('Tropical humid', 'Temperate Humid', etc.) while best results for AMSRM were obtained over arid and semi-arid biomes ('Desert temperate', 'Desert tropical', etc.). When removing the seasonal cycles in the SSM time variations to compute anomaly values, better correlation with the SM-DAS-2 SSM anomalies were obtained with SMOSL3 than with AMSRM, in most of the biomes with the exception of desert regions. Eventually, we showed that the accuracy of the remotely sensed SSM products is strongly related to LAI. Both the SMOSL3 and AMSRM (slightly better) SSM products correlate well with the SM-DAS2 products over regions with sparse vegetation for values of LAI < 1 (these regions represent almost 50% of the pixels considered in this global study). In regions where LAI>1, SMOSL3 outperformed AMSRM with respect to SM-DAS-2: SMOSL3 had almost consistent performances up to LAI = 6, whereas AMSRM performance deteriorated rapidly with increasing values of LAI.

Keywords: remote sensing, microwave, soil moisture, AMSR-E, SMOS

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1237 Outcomes of the Gastrocnemius Flap Performed by Orthopaedic Surgeons in Salvage Revision Knee Arthroplasty: A Retrospective Study at a Tertiary Orthopaedic Centre

Authors: Amirul Adlan, Robert McCulloch, Scott Evans, Michael Parry, Jonathan Stevenson, Lee Jeys

Abstract:

Background and Objectives: The gastrocnemius myofascial flap is used to manage soft-tissue defects over the anterior aspect of the knee in the context of a patient presenting with a sinus and periprosthetic joint infection (PJI) or extensor mechanism failure. The aim of this study was twofold: firstly, to evaluate the outcomes of gastrocnemius flaps performed by appropriately trained orthopaedic surgeons in the context of PJI and, secondly, to evaluate the infection-free survival of this patient group. Methods: We retrospectively reviewed 30 patients who underwent gastrocnemius flap reconstruction during staged revision total knee arthroplasty for prosthetic joint infection (PJI). All flaps were performed by an orthopaedic surgeon with orthoplastics training. Patients had a mean age of 68.9 years (range 50–84) and were followed up for a mean of 50.4 months (range 2–128 months). A total of 29 patients (97 %) were categorized into Musculoskeletal Infection Society (MSIS) local extremity grade 3 (greater than two compromising factors), and 52 % of PJIs were polymicrobial. The primary outcome measure was flap failure, and the secondary outcome measure was a recurrent infection. Results: Flap survival was 100% with no failures or early returns to theatre for flap problems such as necrosis or haematoma. Overall infection-free survival during the study period was 48% (13 of 27 infected cases). Using limb salvage as the outcome, 77% (23 of 30 patients) retained the limb. Infection recurrence occurred in 48% (10 patients) in the type B3 cohort and 67% (4 patients) in the type C3 cohort (p = 0.65). Conclusion: The surgical technique for a gastrocnemius myofascial flap is reliable and reproducible when performed by appropriately trained orthopaedic surgeons, even in high-risk groups. However, the risks of recurrent infection and amputation remain high within our series due to poor host and extremity factors.

Keywords: gastrocnemius flap, limb salvage, revision arthroplasty, outcomes

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1236 Media Framing and Democratization Under Multi-Party System: A Case Study of the 2023 Malaysian Six-State Elections

Authors: Chew Zhao Hong

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Since the transition of power in 2018, the Malaysian political landscape has experienced substantial shifts and complexities. The decline of the longstanding ruling party, United Malays National Organization (UMNO), following the party rotation, has given rise to splinter parties such as the Indigenous Unity Party (Bersatu), along with the enduring presence of the Pan-Malaysian Islamic Party (PAS) in the northern region of the Malay Peninsula. However, the "Sheraton Move" in 2020 led to the fall of the Pakatan Harapan government and the emergence of Perikatan Nasional, signifying the ascent of a third political force. The 2022 general elections marked Malaysia's entry into a hung parliament, culminating in an intricate negotiation that resulted in a coalition government formed by Pakatan Harapan, Barisan Nasional, and the Sarawak parties alliance (GPS), collectively governing the Malaysian federal administration. During the 2023 state elections, Pakatan Harapan and Barisan Nasional formed an unprecedented alliance, yet the media framing benefited Perikatan Nasional, even securing substantial support from UMNO's traditional constituencies. In the era of converging new media, Malaysia’s democratization faces new challenges: first, political leaders leveraging media to cultivate unfiltered personas risk inducing populism; second, under the influence of agenda-setting and two-step flow theories, media contributes to polarization; lastly, Malaysia's multi-party system is no longer effectively moderate extreme ideologies into the political center. This study examines the role of media framing and its impact on the democratization process within Malaysia's consociational democracy under a multi-party system and analyzes media discourse before and after the 2023 Malaysian state elections to explore how different parties shape public opinion and political discourse, and how political messages may be amplified or distorted in the process.

Keywords: multi-party system, democratization, elections, political polarization, Malaysia, media framing

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1235 The Development of the First Inter-Agency Residential Rehabilitation Service for Gambling Disorder with Complex Clinical Needs

Authors: Dragos Dragomir-Stanciu, Leon Marsh

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Background As a response to the gaps identified in recent research in the provision of residential care to address co-occurring health needs, including mental health problems and complexities Gamble Aware has facilitated the possibility to provide a new service which would extend the NGTS provision of residential rehabilitation for gambling disorder with complex and co-morbid presentation. Gordon Moody, together with Adferiad have been successful in securing the tender for this service and this presentation aims to introduce FOLD, the resulting model of treatment developed for the delivery of the service. Setting As a partnership, we have come together to coproduce a model which allows us to share our clinical and industry knowledge and build on our reputations as trusted treatment providers. The presentation will outline our expertise share in development of a unified approach to recovery-oriented models of care, clinical governance, risk assessment and management and aftercare and continuous recovery. We will also introduce our innovative specialist referral portal which will offer referring partners the ability to include the service user in planning their own recovery journey. Outcomes Our collaboration has resulted in the development of the FOLD model which includes three agile and flexible treatment packages aimed at offering the most enhanced and comprehensive treatment in UK, to date, for those most affected by gambling harm. The paper will offer insight into each treatment package and all recovery model stages involved, as well as into the partnership work with NGST providers, local mental health and social care providers and lived experience organisation that will enable us to offer support to more 100 people a year who would otherwise get “lost in the system”. Conclusion FOLD offers a great opportunity to develop, implement and evaluate a new, much needed, whole-person and whole-system approach to counter gambling related harms.

Keywords: gambling treatment, partnership working, integrated care pathways, NGTS, complex needs

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1234 Conceptualizing Psycho-Social Intervention with Juvenile Offenders as Attachment Therapy: A Practical Approach

Authors: Genziana Lay

Abstract:

A wide majority of older children and adolescents who enter the juvenile court system present with an array of problematic symptoms and behaviors including anxiety, depression, aggressive acting out, detachment, and substance abuse. Attachment theory offers a framework for understanding normative and pathological functioning, which during development is influenced by emotional, social and cognitive elements. There is clear evidence that children and adolescents with the highest risk of developing adaptation problems present an insecure attachment profile. Most offending minors have experienced dysfunctional family relationships as well as social and/or economic deprivation. Their maladaptive attachment develops not only through their relationship with caregivers but with the environment at large. Activation of their faulty attachment system leads them to feel emotionally overwhelmed and engage in destructive behaviors and decision-making. A psycho-social intervention with this population conceptualized as attachment therapy is a multi-faceted, practical approach that has shown excellent results in terms of increased psychological well-being and drastically reduced rates of re-offense/ destructive behavior. Through several; components including psychotherapy, monitoring, volunteering, meditation and socialization, the program focuses on seven dimensions: self-efficacy, responsibility, empathy/reparation, autonomy/security, containment/structure, insight building, and relational health. This paper presents the program and illustrates how the framework of attachment theory practically applied to psycho-social intervention has great therapeutic and social reparation potential. Preliminary evidence drawn from the Sassari Juvenile Court is very promising; this paper will illustrate these results and propose an even more comprehensive, applicable approach to psycho-social reparative intervention that leads to greater psychological health and reduced recidivism in the child and adolescent population.

Keywords: attachment, child, adolescent, crime, juvenile, psychosocial

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1233 Carbonyl Iron Particles Modified with Pyrrole-Based Polymer and Electric and Magnetic Performance of Their Composites

Authors: Miroslav Mrlik, Marketa Ilcikova, Martin Cvek, Josef Osicka, Michal Sedlacik, Vladimir Pavlinek, Jaroslav Mosnacek

Abstract:

Magnetorheological elastomers (MREs) are a unique type of materials consisting of two components, magnetic filler, and elastomeric matrix. Their properties can be tailored upon application of an external magnetic field strength. In this case, the change of the viscoelastic properties (viscoelastic moduli, complex viscosity) are influenced by two crucial factors. The first one is magnetic performance of the particles and the second one is off-state stiffness of the elastomeric matrix. The former factor strongly depends on the intended applications; however general rule is that higher magnetic performance of the particles provides higher MR performance of the MRE. Since magnetic particles possess low stability properties against temperature and acidic environment, several methods how to improve these drawbacks have been developed. In the most cases, the preparation of the core-shell structures was employed as a suitable method for preservation of the magnetic particles against thermal and chemical oxidations. However, if the shell material is not single-layer substance, but polymer material, the magnetic performance is significantly suppressed, due to the in situ polymerization technique, when it is very difficult to control the polymerization rate and the polymer shell is too thick. The second factor is the off-state stiffness of the elastomeric matrix. Since the MR effectivity is calculated as the relative value of the elastic modulus upon magnetic field application divided by elastic modulus in the absence of the external field, also the tuneability of the cross-linking reaction is highly desired. Therefore, this study is focused on the controllable modification of magnetic particles using a novel monomeric system based on 2-(1H-pyrrol-1-yl)ethyl methacrylate. In this case, the short polymer chains of different chain lengths and low polydispersity index will be prepared, and thus tailorable stability properties can be achieved. Since the relatively thin polymer chains will be grafted on the surface of magnetic particles, their magnetic performance will be affected only slightly. Furthermore, also the cross-linking density will be affected, due to the presence of the short polymer chains. From the application point of view, such MREs can be utilized for, magneto-resistors, piezoresistors or pressure sensors especially, when the conducting shell on the magnetic particles will be created. Therefore, the selection of the pyrrole-based monomer is very crucial and controllably thin layer of conducting polymer can be prepared. Finally, such composite particle consisting of magnetic core and conducting shell dispersed in elastomeric matrix can find also the utilization in shielding application of electromagnetic waves.

Keywords: atom transfer radical polymerization, core-shell, particle modification, electromagnetic waves shielding

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