Search results for: primary health care facilities
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14943

Search results for: primary health care facilities

6573 Zooplankton Health Status Monitoring in Bir Mcherga Dam (Tunisia)

Authors: Sabria Barka, Imen Gdara, Zouhour Ouanès, Samia Mouelhi, Monia El Bour, Amel Hamza-Chaffai

Abstract:

Because dams are large semi-closed reservoirs of pollutants originating from numerous anthropogenic activities, they represent a threat to aquatic life and they should be monitored. The present work aims to use freshwater zooplankton (Copepods and Cladocerans) in order to evaluate the environmental health status of Bir M'cherga dam in Tunisia. Animals were collected in situ monthly between October and August. Genotoxicity (micronucleus test), neurotoxicity (acetylcholinesterase, AChE) and oxidative stress (catalase, CAT and malondialdehyde, MDA) biomarkers were analyzed in zooplankton. High frequencies of micronucleus were observed in zooplankton cells during summer. AChE activities were inhibited during early winter and summer. CAT and MDA biomarker levels showed high seasonal variability, suggesting that animals are permanently exposed to multiple oxidative stress. The results of this study suggest that the Bir Mcherga dam is subject to continuous multi-origin stress, probably amplified by abiotic parameters. It is then recommended to urgently monitor freshwater environments in Tunisia, especially those used for irrigation and consumption.

Keywords: Biomonitoring, Bir Mcherga Dam, cladocerans, copepods, freshwater zooplankton, genotoxicity, neurotoxicity, oxidative stress, Tunisia

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6572 Isolation and Elimination of Latent and Productive Herpes Simplex Virus from the Sacral and Trigeminal Ganglions

Authors: Bernard L. Middleton, Susan P. Cosgrove

Abstract:

There is an immediate need for alternative anti-herpetic treatment options effective for both primary infections and reoccurring reactivations of herpes simplex virus types 1 (HSV-1) and 2 (HSV-2). Alternatives currently approved for the purposes of clinical administration includes antivirals and a reduced set of nucleoside analogues. The present article tests a treatment based on a systemic understanding of how the herpes virus affects cell inhibition and breakdown and targets different phases of the viral cycle, including the entry stage, reproductive cross mutation, and cell-to-cell infection. The treatment consisted of five immunotherapeutic core compounds (5CC), which were hypothesized to be capable of neutralizing human monoclonal antibodies. The tested 5CC were noted as being functional in the application of eliminating the DNA synthesis of herpes viral interferon (IFN) - induced cellular antiviral response. They were here found to neutralize antiviral reproduction by blocking cell-to-cell infection. The activity of the 5CC was tested on RC-37 in vitro using an assay plaque reduction and in vivo against HSV-1 and HSV-2. The 50% inhibitory concentration (IC50) of 5CC was 0.0009% for HSV-1 plaque formation and 0.0008% for HSV-2 plaque formation. Further tests were performed to evaluate the susceptibility of HSV-1 and HSV-2 to anti-herpetic drugs in Vero cells after virus entry. There were high-level markers of the 5CC virucidal activity in the viral suspension of HSV-1 and HSV-2. These concentrations of the 5CC are nontoxic and reduced plaque formation by 98.2% for HSV-1 and 93.0% for HSV-2. Virus HSV-1 and HSV-2 titers were reduced significantly by 5CC to the point of being negative, ranging 0.01–0.09 in 72%. The results concluded the 5CC as being an effective treatment option for the herpes simplex virus.

Keywords: synergy pharmaceuticals, herpes treatment, herpes cure, synergy pharmaceuticals treatment

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6571 The Effect of an Infill on the Bearing Capacity and Stiffness of Infilled Frames

Authors: Goran Baloevic, Jure Radnic, Nikola Grgic

Abstract:

The application of frames with masonry or panel infill is common in the engineering practice. In these cases, a frame is often considered to be a primary structure, while an infill is considered to be a secondary structure. In past calculations, the infill was rarely included in the design of frame structures in terms of their bearing capacity and safety. Recent calculations of such structures necessarily include the effect of infill since it contributes to stiffness and bearing capacity of overall system, especially under horizontal loads. In certain cases, if the infill is not included in the seismic design of frame structures, the result can be lower design safety. However, since the different configuration of the infill through the building’s height can be made, it is possible that contribution of such infill to the overall bearing capacity can be lower and seismic forces on the building can be increased due to greater stiffness of the structure. So far, many experimental and numerical researches on the behavior of infilled frames under horizontal static forces and earthquake have been performed. In this paper, several masonry-infilled concrete and steel frames under horizontal static forces and earthquake are analysed. The experimental results by shake-table and numerical results are compared in terms of the bearing capacity of bare and infilled frames. Herein, the stiffness of frames and infill were varied, with different position of the infill and different types of openings. Cases with positive and negative effects of the infill to the bearing capacity of the frames were considered. Finally, main conclusions and recommendations for practical application and design of masonry-infilled concrete and steel frames are given.

Keywords: bearing capacity, infilled frame, numerical model, shake table

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6570 Effect of Built in Polarization on Thermal Properties of InGaN/GaN Heterostructures

Authors: Bijay Kumar Sahoo

Abstract:

An important feature of InₓGa₁-ₓN/GaN heterostructures is strong built-in polarization (BIP) electric field at the hetero-interface due to spontaneous (sp) and piezoelectric (pz) polarizations. The intensity of this electric field reaches several MV/cm. This field has profound impact on optical, electrical and thermal properties. In this work, the effect of BIP field on thermal conductivity of InₓGa₁-ₓN/GaN heterostructure has been investigated theoretically. The interaction between the elastic strain and built in electric field induces additional electric polarization. This additional polarization contributes to the elastic constant of InₓGa₁-ₓN alloy. This in turn modifies material parameters of InₓGa₁-ₓN. The BIP mechanism enhances elastic constant, phonon velocity and Debye temperature and their bowing constants in InₓGa₁-ₓN alloy. These enhanced thermal parameters increase phonon mean free path which boost thermal conduction process. The thermal conductivity (k) of InxGa1-xN alloy has been estimated for x=0, 0.1, 0.3 and 0.9. Computation finds that irrespective of In content, the room temperature k of InₓGa₁-ₓN/GaN heterostructure is enhanced by BIP mechanism. Our analysis shows that at a certain temperature both k with and without BIP show crossover. Below this temperature k with BIP field is lower than k without BIP; however, above this temperature k with BIP field is significantly contributed by BIP mechanism leading to k with BIP field become higher than k without BIP field. The crossover temperature is primary pyroelectric transition temperature. The pyroelectric transition temperature of InₓGa₁-ₓN alloy has been predicted for different x. This signature of pyroelectric nature suggests that thermal conductivity can reveal pyroelectricity in InₓGa₁-ₓN alloy. The composition dependent room temperature k for x=0.1 and 0.3 are in line with prior experimental studies. The result can be used to minimize the self-heating effect in InₓGa₁-ₓN/GaN heterostructures.

Keywords: built-in polarization, phonon relaxation time, thermal properties of InₓGa₁-ₓN /GaN heterostructure, self-heating

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6569 Healthy Beverages Made from Grape Juice: Antioxidant, Energetic, and Isotonic Components

Authors: Yasmina Bendaali, Cristian Vaquero, Carlos Escott, Carmen González, Antonio Morata

Abstract:

Consumer tendencies to healthy eating habits and request for organic beverages led to the production of new drinks from fruit juices as a source of nutrients and bioactive compounds. Grape juice is a rich source of sugars, organic acids, and phenolic compounds, which define its beneficial effect on health and the attractive sensory profile for consumers' choices (color, taste, flavor). Thus, grape juice was used as a source of sugars, avoiding the addition of sweeteners by diluting it with mineral water to obtain the sugar concentration recommended for isotonic drinks (6% to 8%) to provide energy during physical activities. In addition, phenolic compounds of grape juice are associated with many human health benefits, mainly antioxidant activity, which helps to prevent different diseases associated with oxidative stress, including cancers and cardiovascular and neurodegenerative diseases. Furthermore, physical exercise has been shown to increase the production of free radicals and other reactive oxygen species. Thus, athletes need to improve their antioxidant defense systems to prevent oxidative damage. Different studies have demonstrated the positive effect of grape juice consumption during physical activities, which improves antioxidant activity and performance, protects against oxidative damage, and reduces inflammation. Thus, the use of grape juice to develop isotonic drinks can provide isotonic drinks with antioxidant and biological activities in addition to their principal role of rehydration and replacement of minerals and carbohydrates during physical exercises. Moreover, attractive sensory characteristics, mainly color, which is provided by anthocyanin content, have a great contribution to making the drinks more natural and help to dispense the use of synthetic dyes in addition to the health benefits which will be a novel product in the field of healthy beverages responding on the demand of consumers for new, innovative, and healthy products.

Keywords: grape juice, isotonic, antioxidants, anthocyanins, natural, sport

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6568 Development of Energy Benchmarks Using Mandatory Energy and Emissions Reporting Data: Ontario Post-Secondary Residences

Authors: C. Xavier Mendieta, J. J McArthur

Abstract:

Governments are playing an increasingly active role in reducing carbon emissions, and a key strategy has been the introduction of mandatory energy disclosure policies. These policies have resulted in a significant amount of publicly available data, providing researchers with a unique opportunity to develop location-specific energy and carbon emission benchmarks from this data set, which can then be used to develop building archetypes and used to inform urban energy models. This study presents the development of such a benchmark using the public reporting data. The data from Ontario’s Ministry of Energy for Post-Secondary Educational Institutions are being used to develop a series of building archetype dynamic building loads and energy benchmarks to fill a gap in the currently available building database. This paper presents the development of a benchmark for college and university residences within ASHRAE climate zone 6 areas in Ontario using the mandatory disclosure energy and greenhouse gas emissions data. The methodology presented includes data cleaning, statistical analysis, and benchmark development, and lessons learned from this investigation are presented and discussed to inform the development of future energy benchmarks from this larger data set. The key findings from this initial benchmarking study are: (1) the importance of careful data screening and outlier identification to develop a valid dataset; (2) the key features used to develop a model of the data are building age, size, and occupancy schedules and these can be used to estimate energy consumption; and (3) policy changes affecting the primary energy generation significantly affected greenhouse gas emissions, and consideration of these factors was critical to evaluate the validity of the reported data.

Keywords: building archetypes, data analysis, energy benchmarks, GHG emissions

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6567 Designing Electric Vehicle Charging Infrastructure to Benefit Historically-Marginalized Residents

Authors: Polly Parkinson, Emma Mecham, Fawn Groves, Amy Wilson-Lopez, Ivonne Santiago

Abstract:

In the rush to meet electric vehicle (EV) adoption goals that address environmental and health concerns, engineering planners and community policy experts cannot separate the socioeconomic and equity factors from transportation needs. Two gaps are identified in existing research: concrete proposals that address affordable micromobility options and provide for needs of community members without cars, and community-engaged research that elevates the concerns and solutions brought forward by historically-marginalized community members. This data analysis from a recent case study in a vulnerable community indicates that because transportation decisions are inextricably linked to health, work, and housing, EV adoption must also address multifaceted human needs. Communities focused on building more electric vehicle charging stations must find ways for lower-income households to also benefit. This research engaged residents in the planning process and resulted in a template for charging stations to advance mobility justice with a range of options that purposefully benefit the whole community.

Keywords: community engagement, electric vehicle charging, environmental justice, participatory research, transportation equity

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6566 The Use of the Mediated Learning Experience in Response of Special Needs Education

Authors: Maria Luisa Boninelli

Abstract:

This study wants to explore the effects of a mediated intervention program in a primary school. The participants where 120 students aged 8-9, half of them Italian and half immigrants of first or second generation. The activities consisted on the cognitive enhancement of the participants through Feuerstein’s Instrumental Enrichment, (IE) and on an activity centred on body awareness and mediated learning experience. Given that there are limited studied on learners in remedial schools, the current study intented to hypothesized that participants exposed to mediation would yiel a significant improvement in cognitive functioning. Hypothesis One proposed that, following the intervention, improved Q1vata scores of the participants would occur in each of the groups. Hypothesis two postulated that participants within the Mediated Learning Experience would perform significantly better than those group of control. For the intervention a group of 60 participants constituted a group of Mediation sample and were exposed to Mediated Learning Experience through Enrichment Programm. Similiary the other 60 were control group. Both the groups have students with special needs and were exposed to the same learning goals. A pre-experimental research design, in particular a one-group pretest-posttest approach was adopted. All the participants in this study underwent pretest and post test phases whereby they completed measures according to the standard instructions. During the pretest phase, all the participants were simultaneously exposed to Q1vata test for logical and linguistic evaluation skill. During the mediation intervention, significant improvement was demonstrated with the group of mediation. This supports Feuerstein's Theory that initial poor performance was a result of a lack of mediated learning experience rather than inherent difference or deficiencies. Furthermore the use of an appropriate mediated learning enabled the participants to function adequately.

Keywords: cognitive structural modifiability, learning to learn, mediated learning experience, Reuven Feuerstein, special needs

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6565 L-Carnitine vs Extracorporeal Elimination for Acute Valproic Acid Intoxication: A Systemic Review

Authors: Byung Keun Yang, Jae Eun Ku, Young Seon Joo, Je Sung You, Sung Phil Chung, Hahn Shick Lee

Abstract:

The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication. PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs. 11 days) in case of delayed extracorporeal therapy. Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.

Keywords: carnitine, overdose, poisoning, renal dialysis, valproic acid

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6564 Efficacy and Safety of Probiotic Treatment in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis

Authors: Samir Malhotra, Rajan K. Khandotra, Rakesh K. Dhiman, Neelam Chadha

Abstract:

There is paucity of data about safety and efficacy of probiotic treatment on patient outcomes in cirrhosis. Specifically, it is important to know whether probiotics can improve mortality, hepatic encephalopathy (HE), number of hospitalizations, ammonia levels, quality of life, and adverse events. Probiotics may improve outcomes in patients with acute or chronic HE. However, it is also important to know whether probiotics can prevent development of HE, even in situations where patients do not have acute HE at the time of administration. It is also important to know if probiotics are useful as primary prophylaxis of HE. We aimed to conduct an updated systematic review and meta-analysis to evaluate the safety and efficacy of probiotics in patients with cirrhosis. We searched PubMed, Cochrane library, Embase, Scopus, SCI, Google Scholar, conference proceedings, and references of included studies till June 2017 to identify randomised clinical trials comparing probiotics with other treatments in cirrhotics. Data was analyzed using MedCalc. Probiotics had no effect on mortality but significantly reduced HE (14 trials, 1073 patients, OR 0.371; 95% CI 0.282 to 0.489). There was not enough data to conduct a meta-analysis on outcomes like hospitalizations and quality of life. The effect on plasma ammonia levels was not significant (SMD -0.429; 95%CI -1.034 – 0.177). There was no difference in adverse events. To conclude, although the included studies had a high risk of bias, the available evidence does suggest a beneficial effect on HE. Larger studies with longer periods of follow-up are needed to determine if probiotics can reduce all-cause mortality.

Keywords: cirrhosis, hepatic encephalopathy, meta-analysis, probiotic

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6563 Antepartum and Postpartum Pulmonary Cryptococcosis: A Case Report and Systematic Review

Authors: Ghadeer M Alkusayer, Adelicia Yu, Pamela Orr

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Study objective: To report a case of postpartum pulmonary cryptococcal infection (CCI) in an otherwise healthy 35-year-old woman. Additionally, the cases of pulmonary cryptococcal infections either in the antepartum or the postpartum period with pregnancy outcomes, were systematically reviwed. Methods: A systematic search of Cochrane Library, MEDLINE, and EMBASE was conducted for peer-reviewed studies without date restrictions, published in English and relating to CCI during pregnancy or postpartum period. Conference press, editorials, opinion pieces and letters were excluded. Two authors independently screened citations and full-text articles, extracted data and assessed study quality. Given the heterogeneity of study designs, a narrative synthesis was conducted. Results: The search identified 128 references, of which 22 case reports and series met the inclusion criteria. This is a total of 29 women (including the current case) . The mean age of the women was 28.3 ± 12.3 years. Nine (31.03%) presented and were diagnosed in the postpartum period. Two (6.90%) of the patients were reported as immunocompromised with HIV. Four maternal deaths (13.79%) were found in this case series with one (4.3%) patient with severe neurological deficits. Four (17.4%) infant deaths were reported. Women primary presentation varied with chest pain 13 (44.82%), headache 10 (35.70%), dyspnea 19 (65.51%), or fever 12 (41.38%). Three studies reported placental pathology positive for C. neoformans. Conclusion: This case of pulmonary cryptococcal infection in the postpartum period is an important addition to the literature of this rare infection in pregnancy. The patient is not immunocompromised. The patient was successfully treated with 4 months of Fluconazole 400 mg and continued to breastfeed the healthy baby.

Keywords: pulmonary cryptococcus, pregnancy, cryptococci , postpartum

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6562 Experimental Monitoring of the Parameters of the Ionosphere in the Local Area Using the Results of Multifrequency GNSS-Measurements

Authors: Andrey Kupriyanov

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In recent years, much attention has been paid to the problems of ionospheric disturbances and their influence on the signals of global navigation satellite systems (GNSS) around the world. This is due to the increase in solar activity, the expansion of the scope of GNSS, the emergence of new satellite systems, the introduction of new frequencies and many others. The influence of the Earth's ionosphere on the propagation of radio signals is an important factor in many applied fields of science and technology. The paper considers the application of the method of transionospheric sounding using measurements from signals from Global Navigation Satellite Systems to determine the TEC distribution and scintillations of the ionospheric layers. To calculate these parameters, the International Reference Ionosphere (IRI) model of the ionosphere, refined in the local area, is used. The organization of operational monitoring of ionospheric parameters is analyzed using several NovAtel GPStation6 base stations. It allows performing primary processing of GNSS measurement data, calculating TEC and fixing scintillation moments, modeling the ionosphere using the obtained data, storing data and performing ionospheric correction in measurements. As a result of the study, it was proved that the use of the transionospheric sounding method for reconstructing the altitude distribution of electron concentration in different altitude range and would provide operational information about the ionosphere, which is necessary for solving a number of practical problems in the field of many applications. Also, the use of multi-frequency multisystem GNSS equipment and special software will allow achieving the specified accuracy and volume of measurements.

Keywords: global navigation satellite systems (GNSS), GPstation6, international reference ionosphere (IRI), ionosphere, scintillations, total electron content (TEC)

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6561 Empirical Study of Health Behaviors of Employees in Information Technology and Business Process Outsourcing

Authors: Yogesh Pawar

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The purpose of this paper is to investigate the behaviors of information technology (IT) and business process outsourcing (BPO) employees in relation to diet, exercise, sleep, stress, and social habits. This was a qualitative research study, using in-depth,semi-structured interviews. Descriptive data were collected from a two-stage purposive sample of 28 IT-BPO employees from two IT companies and one BPOs in Pune. The majority of interviewees reported having an unhealthy diet and/or sedentary lifestyle. Lack of time due to demanding work schedules was the largest barrier to diet and exercise. Given the qualitative study design and limited sampling frame, results may not be generalizable. However, the qualitative data suggests that Pune’s young IT-BPO employees may be at greater risk of lifestyle-related diseases than the general population. The data also suggests that interventions incorporating social influence may be a promising solution, particularly at international call centers. The results from this study provide qualitative insight on the motives for health behaviors of IT-BPO employees, as well as the barriers and facilitators for leading a healthy lifestyle in this industry. The findings provide the framework for future workplace wellness interventions.

Keywords: exercise, information technology, qualitative research, wellness

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6560 Modeling Atmospheric Correction for Global Navigation Satellite System Signal to Improve Urban Cadastre 3D Positional Accuracy Case of: TANA and ADIS IGS Stations

Authors: Asmamaw Yehun

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The name “TANA” is one of International Geodetic Service (IGS) Global Positioning System (GPS) station which is found in Bahir Dar University in Institute of Land Administration. The station name taken from one of big Lakes in Africa ,Lake Tana. The Institute of Land Administration (ILA) is part of Bahir Dar University, located in the capital of the Amhara National Regional State, Bahir Dar. The institute is the first of its kind in East Africa. The station is installed by cooperation of ILA and Sweden International Development Agency (SIDA) fund support. The Continues Operating Reference Station (CORS) is a network of stations that provide global satellite system navigation data to help three dimensional positioning, meteorology, space, weather, and geophysical applications throughout the globe. TANA station was as CORS since 2013 and sites are independently owned and operated by governments, research and education facilities and others. The data collected by the reference station is downloadable through Internet for post processing purpose by interested parties who carry out GNSS measurements and want to achieve a higher accuracy. We made a first observation on TANA, monitor stations on May 29th 2013. We used Leica 1200 receivers and AX1202GG antennas and made observations from 11:30 until 15:20 for about 3h 50minutes. Processing of data was done in an automatic post processing service CSRS-PPP by Natural Resources Canada (NRCan) . Post processing was done June 27th 2013 so precise ephemeris was used 30 days after observation. We found Latitude (ITRF08): 11 34 08.6573 (dms) / 0.008 (m), Longitude (ITRF08): 37 19 44.7811 (dms) / 0.018 (m) and Ellipsoidal Height (ITRF08): 1850.958 (m) / 0.037 (m). We were compared this result with GAMIT/GLOBK processed data and it was very closed and accurate. TANA station is one of the second IGS station for Ethiopia since 2015 up to now. It provides data for any civilian users, researchers, governmental and nongovernmental users. TANA station is installed with very advanced choke ring antenna and GR25 Leica receiver and also the site is very good for satellite accessibility. In order to test hydrostatic and wet zenith delay for positional data quality, we used GAMIT/GLOBK and we found that TANA station is the most accurate IGS station in East Africa. Due to lower tropospheric zenith and ionospheric delay, TANA and ADIS IGS stations has 2 and 1.9 meters 3D positional accuracy respectively.

Keywords: atmosphere, GNSS, neutral atmosphere, precipitable water vapour

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6559 Approach for Evaluating Wastewater Reuse Options in Agriculture

Authors: Manal Elgallal, Louise Fletcher, Barbara Evans

Abstract:

Water scarcity is a growing concern in many arid and semi-arid countries. The increase of water scarcity threatens economic development and sustainability of human livelihoods as well as environment especially in developing countries. Globally, agriculture is the largest water consumption sector, accounting for approximately 70% of all freshwater extraction. Growing competition between the agricultural and higher economic value in urban and industrial uses of high-quality freshwater supplies, especially in regions where water scarcity major problems, will increase the pressure on this precious resource. In this circumstance, wastewater may provide reliable source of water for agriculture and enable freshwater to be exchanged for more economically valuable purposes. Concern regarding the risks from microbial and toxic components to human health and environment quality is a serious obstacle for wastewater reuse particularly in agriculture. Although powerful approaches and tools for microbial risk assessment and management for safe use of wastewater are now available, few studies have attempted to provide any mechanism to quantitatively assess and manage the environmental risks resulting from reusing wastewater. In seeking pragmatic solutions to sustainable wastewater reuse, there remains a lack of research incorporating both health and environmental risk assessment and management with economic analysis in order to quantitatively combine cost, benefits and risks to rank alternative reuse options. This study seeks to enhance effective reuse of wastewater for irrigation in arid and semi-arid areas, the outcome of the study is an evaluation approach that can be used to assess different reuse strategies and to determine the suitable scale at which treatment alternatives and interventions are possible, feasible and cost effective in order to optimise the trade-offs between risks to protect public health and the environment and preserving the substantial benefits.

Keywords: environmental risks, management, life cycle costs, waste water irrigation

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6558 More Precise: Patient-Reported Outcomes after Stroke

Authors: Amber Elyse Corrigan, Alexander Smith, Anna Pennington, Ben Carter, Jonathan Hewitt

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Background and Purpose: Morbidity secondary to stroke is highly heterogeneous, but it is important to both patients and clinicians in post-stroke management and adjustment to life after stroke. The consideration of post-stroke morbidity clinically and from the patient perspective has been poorly measured. The patient-reported outcome measures (PROs) in morbidity assessment help improve this knowledge gap. The primary aim of this study was to consider the association between PRO outcomes and stroke predictors. Methods: A multicenter prospective cohort study assessed 549 stroke patients at 19 hospital sites across England and Wales during 2019. Following a stroke event, demographic, clinical, and PRO measures were collected. Prevalence of morbidity within PRO measures was calculated with associated 95% confidence intervals. Predictors of domain outcome were calculated using a multilevel generalized linear model. Associated P -values and 95% confidence intervals are reported. Results: Data were collected from 549 participants, 317 men (57.7%) and 232 women (42.3%) with ages ranging from 25 to 97 (mean 72.7). PRO morbidity was high post-stroke; 93.2% of the cohort report post-stroke PRO morbidity. Previous stroke, diabetes, and gender are associated with worse patient-reported outcomes across both the physical and cognitive domains. Conclusions: This large-scale multicenter cohort study illustrates the high proportion of morbidity in PRO measures. Further, we demonstrate key predictors of adverse outcomes (Diabetes, previous stroke, and gender) congruence with clinical predictors. The PRO has been demonstrated to be an informative and useful stroke when considering patient-reported outcomes and has wider implications for considerations of PROs in clinical management. Future longitudinal follow-up with PROs is needed to consider association of long-term morbidity.

Keywords: morbidity, patient-reported outcome, PRO, stroke

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6557 3D-printing for Ablation Planning in Patients Undergoing Atrial Fibrillation Ablation: 3D-GALA Trial

Authors: Terentes Printzios Dimitrios, Loanna Gourgouli, Vlachopoulos Charalambos

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

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

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6556 Accounting for Rice Productivity Heterogeneity in Ghana: The Two-Step Stochastic Metafrontier Approach

Authors: Franklin Nantui Mabe, Samuel A. Donkoh, Seidu Al-Hassan

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Rice yields among agro-ecological zones are heterogeneous. Farmers, researchers and policy makers are making frantic efforts to bridge rice yield gaps between agro-ecological zones through the promotion of improved agricultural technologies (IATs). Farmers are also modifying these IATs and blending them with indigenous farming practices (IFPs) to form farmer innovation systems (FISs). Also, different metafrontier models have been used in estimating productivity performances and their drivers. This study used the two-step stochastic metafrontier model to estimate the productivity performances of rice farmers and their determining factors in GSZ, FSTZ and CSZ. The study used both primary and secondary data. Farmers in CSZ are the most technically efficient. Technical inefficiencies of farmers are negatively influenced by age, sex, household size, education years, extension visits, contract farming, access to improved seeds, access to irrigation, high rainfall amount, less lodging of rice, and well-coordinated and synergized adoption of technologies. Albeit farmers in CSZ are doing well in terms of rice yield, they still have the highest potential of increasing rice yield since they had the lowest TGR. It is recommended that government through the ministry of food and agriculture, development partners and individual private companies promote the adoption of IATs as well as educate farmers on how to coordinate and synergize the adoption of the whole package. Contract farming concept and agricultural extension intensification should be vigorously pursued to the latter.

Keywords: efficiency, farmer innovation systems, improved agricultural technologies, two-step stochastic metafrontier approach

Procedia PDF Downloads 257
6555 Simultaneous Bilateral Patella Tendon Rupture: A Systematic Review

Authors: André Rui Coelho Fernandes, Mariana Rufino, Divakar Hamal, Amr Sousa, Emma Fossett, Kamalpreet Cheema

Abstract:

Aim: A single patella tendon rupture is relatively uncommon, but a simultaneous bilateral event is a rare occurrence and has been scarcely reviewed in the literature. This review was carried out to analyse the existing literature on this event, with the aim of proposing a standardised approach to the diagnosis and management of this injury. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent reviewers conducted searches in PubMed, OvidSP for Medline and Embase, as well as Cochrane Library using the same search strategy. From a total of 183 studies, 45 were included, i.e. 90 patellas. Results: 46 patellas had a Type 1 Rupture equating to 51%, with Type 3 being the least common, with only 7 patellas sustaining this injury. The mean Insall-Salvio ratio for each knee was 1.62 (R) and 1.60 (L) Direct Primary Repair was the most common surgical technique compared to Tendon Reconstruction, with End to End and Transosseous techniques split almost equally. Brace immobilisation was preferred over cast, with a mean start to weight-bearing of 3.23 weeks post-op. Conclusions: Bilateral patellar tendon rupture is a rare injury that should be considered in patients with knee extensor mechanism disruption. The key limitation of this study was the low number of patients encompassed by the eligible literature. There is space for a higher level of evidence study, specifically regarding surgical treatment choice and methods, as well as post-operative management, which could potentially improve the outcomes in the management of this injury.

Keywords: trauma and orthopaedic surgery, bilateral patella, tendon rupture, trauma

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6554 Revisiting Ecotourism Development Strategy of Cuc Phuong National Park in Vietnam: Considering Residents’ Perception and Attitudes

Authors: Bui Duc Sinh

Abstract:

Ecotourism in national parks seemed to be one of the options in the conservation of the natural resources and to improve the living condition of local communities. However, ecotourism development will be useless if it lacks the perception and support of local communities and appropriate ecotourism strategies. The aims of this study were to measure residents’ perception and satisfaction towards ecotourism impacts and their attitudes for ecotourism development in Cuc Phuong National Park; to assess the current ecotourism strategies based on ecotourism criteria and then to provide recommendations on ecotourism development strategies. The primary data were collected through personal observations, in-depth interviews with residents and national park staffs, and from surveys on households in all of the five communes in the Cuc Phuong National Park. The results depicted that local communities were aware of ecotourism impacts and had positive attitudes toward ecotourism development, and were satisfied of ecotourism development. However, higher perception rate was found on specific groups such as the young, the high income and educated, and those with jobs related to ecotourism. The study revealed the issues of concerns about the current ecotourism development strategies in Cuc Phuong National Park. The major hindrances for ecotourism development were lack of local participation and unattractive ecotourism services. It was also suggested that Cuc Phuong National Park should use ecotourism criteria to implement ecotourism activities sustainably and to harmonize the sharing of benefits amongst the stakeholders. The approaches proposed were to: create local employment through reengineering, improve the ecotourism quality, appropriate tourism benefits to the stakeholders, and carry out education and training programs. Furthermore, the results of the study helped tour operators and tourism promoters aware the real concerns, issues on current ecotourism activities in Cuc Phuong National Park.

Keywords: ecotourism, ecotourism impact, local community, national park

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6553 Struggles of Non-Binary People in an Organizational Setting in Iceland

Authors: Kevin Henry

Abstract:

Introduction: This research identifies the main struggles of non-binary people in an organizational setting using the ZMET – method of in-depth interviews. The research was done in Iceland, a country that is repeatedly listed in the top countries for gender equality and found three main categories of non-binary struggles in organizations. These categories can be used to improve organizational non-binary inclusion. Aim: The main questions this paper will answer are: Which unique obstacles are non-binary people facing in their daily organizational life? Which organizational and individual measures help with more inclusion of non-binary people? How can organizational gender equality measures be made more inclusive of non-binary issues? Background: Even though gender equality is a much-researched topic, the struggles of non-binary people are often overlooked in gender equality research. Additionally, non-binary and transgender people are frequently researched together, even though their struggles can be very different. Research focused on non-binary people is, in many cases, done on a more structural or organizational level with quantitative data such as salary or position within an organization. This research focuses on the individual and their struggles with qualitative data to derive measures for non-binary inclusion and equality. Method: An adapted approach of the ZMET-Method (Zaltman Metaphor Elicitation Technique) will be used, during which in-depth interviews are held with individuals, utilizing pictures as a metaphorical starting point to discuss their main thoughts and feelings on being non-binary in an organizational setting. Interviewees prepared five pictures, each representing one key thought or feeling about their organizational life. The interviewer then lets the interviewee describe each picture and asks probing questions to get a deeper understanding of each individual topic. This method helps with a mostly unbiased data collection process by only asking probing questions during the interview and not leading the interviewee in any certain direction. Results: This research has identified three main categories of struggles non-binary people are facing in an organizational setting: internal (personal) struggles, external struggles and structural struggles. Internal struggles refer to struggles that originate from the person themselves (e.g., struggles with their own identity). External struggles refer to struggles from the outside (e.g. harassment from coworkers, exclusion). Structural struggles refer to struggles that are built into the organizational policy or facilities (e.g. restrooms, gendered language). Conclusion: This study shows that there are many struggles for non-binary people in organizations and that even in countries that pride themselves on being progressive and having a high level of gender equality, there is still much to be done for non-binary inclusion. Implications for Organizations: Organizations that strive to improve the inclusion of all genders should pay attention to how their structures are built, how their training is conducted, and how their policies affect people of various genders. Simple changes like making restrooms gender-neutral and using neutral language in company communications are good examples of small structural steps for more inclusion.

Keywords: gender equality, non-binary, organizations, ZMET

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6552 Systematic Review of the Efficacy of Traditional Chinese Medicine in Parkinson Disease

Authors: Catarina Ramos Pereira, Jorge Rodrigues, Natália Oliveira, Jorge Machado, Maria Begoña Criado, Jorge Machado, Henri J. Greten

Abstract:

Background: Parkinson's disease is a multi-system neurodegenerative disorder characterized by motor and non-motor symptoms. To slow disorder progression, different treatment options are now available, but in most cases, these therapeutic strategies also involve the presence of important side effects. This has led many patients to pursue complementary therapies, such as acupuncture, to alleviate PD symptoms. Therefore, an update on the efficacy of this treatment for patients of PD is of great value. This work presents a systematic review of the efficacy of acupuncture treatments in relieving PD symptoms. Methods: EMBASE, Medline, Pubmed, Science Direct, The Cochrane Library, Cochrane Central Register of Controlled Trials (Central), and Scielo databases were systematically searched from January 2011 through July 2021. Randomized controlled trials (RCTs) published in English with all types of acupuncture treatment were included. The selection and analysis of the articles were conducted by two blinding authors through the Rayyan application. Results: 720 potentially relevant articles were identified; 52 RCTs met our inclusion criteria. After the exclusion of 35, we found 17 eligible. The included RCTs reported positive effects for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS score. Conclusions: Additional evidence should be supported by rigorous methodological strategies. Although firm conclusions cannot be drawn, acupuncture treatment, in the framework of an interdisciplinary care team, appears to have positive effects on PD symptoms.

Keywords: systematic review, Parkinson disease, acupuncture, traditional Chinese medicine

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6551 Learners’ Violent Behaviour and Drug Abuse as Major Causes of Tobephobia in Schools

Authors: Prakash Singh

Abstract:

Many schools throughout the world are facing constant pressure to cope with the violence and drug abuse of learners who show little or no respect for acceptable and desirable social norms. These delinquent learners tend to harbour feelings of being beyond reproach because they strongly believe that it is well within their rights to engage in violent and destructive behaviour. Knives, guns, and other weapons appear to be more readily used by them on the school premises than before. It is known that learners smoke, drink alcohol, and use drugs during school hours, hence, their ability to concentrate, work, and learn, is affected. They become violent and display disruptive behaviour in their classrooms as well as on the school premises, and this atrocious behaviour makes it possible for drug dealers and gangsters to gain access onto the school premises. The primary purpose of this exploratory quantitative study was therefore to establish how tobephobia (TBP), caused by school violence and drug abuse, affects teaching and learning in schools. The findings of this study affirmed that poor discipline resulted in producing poor quality education. Most of the teachers in this study agreed that educating learners who consumed alcohol and other drugs on the school premises resulted in them suffering from TBP. These learners are frequently abusive and disrespectful, and resort to violence to seek attention. As a result, teachers feel extremely demotivated and suffer from high levels of anxiety and stress. The word TBP will surely be regarded as a blessing by many teachers throughout the world because finally, there is a word that will make people sit up and listen to their problems that cause real fear and anxiety in schools.

Keywords: aims and objectives of quality education, debilitating effects of tobephobia, fear of failure associated with education, learners' violent behaviour and drug abuse

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6550 Identification of Environmental Damage Due to Mining Area Bangka Islands in Indonesia

Authors: Aroma Elmina Martha

Abstract:

Environment affects the continuity of life and human well-being and the bodies of other living. Environmental quality is very closely related to the quality of life. Sustainability must be protected from damage due to the use of natural resources, such as tin mining in Bangka island. This research is a descriptive study, which identifies the environmental damage caused by mining land and sea in Bangka district. The approach used is juridical, social and economic. The study uses primary legal materials, secondary, and tertiary, equipped with field research. The analysis technique used is qualitative analysis. The impacts of mining on land among other physical and chemical damage, erosion and widening the depth of the river, a pool of micro-climate, the quality and feasibility, vegetation, wildlife and biodiversity, land values, social and economic. This mining causes damage to the soil structure, and puddles in the former digs which were not backfilled again. The impact of mining on the ocean such as changes in current surge, erosion and abrasion basic coastal waters, shoreline change, marine water quality changes, and changes in marine communities. The findings of the research show that tin mining in the sea also potentially have a significant impact on the life of the reef, populations of marine organisms. However, mining on land needs to consider the impact of the damage, so that the damage can be minimized. In the recovery process needs to be pursued by exploiting the rest of the pile of tin. Thus, mining activities should take into account the distance of beach sediment size, wave height, wave length, wave period, and the acceleration of gravity. The process of the tin washing should be done in a fairly safe area, thus avoiding damage to the coral reefs that will eventually reduce the population of marine life.

Keywords: abration, environmental damage, mining, shoreline

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6549 Facing Global Competition through Participation in Global Innovation Networks: The Case of Mechatronics District in the Veneto Region

Authors: Monica Plechero

Abstract:

Many firms belonging to Italian industrial districts faced a crisis starting from 2000 and upsurging during 2008-2014. To remain competitive in the global market, these firms and their local systems need to renovate their traditional competitive advantages, strengthen their link with global flows of knowledge. This may be particularly relevant in sectors such as the mechatronics, that combine traditional knowledge domain with new knowledge domains (e.g. mechanics, electronics, and informatics). This sector is nowadays one of the key sectors within the so-called ‘smart specialization strategy’ that can lead part of the Italian traditional industry towards new economic developmental opportunities. This paper, by investigating the mechatronics district of the Veneto region, wants to shed new light on how firms of a local system can gain from the globalization of innovation and innovation networks. Methodologically, the paper relies on primary data collected through a survey targeting firms of the local system, as well as on a number of qualitative case studies. The relevant role of medium size companies in the district emerges as evident, as they have wider opportunities to be involved in different processes of globalization of innovation. Indeed, with respect to small companies, the size of medium firms allows them to exploit strategically international markets and globally distributed knowledge. Supporting medium firms’ global innovation strategies, and incentivizing their role as district gatekeepers, may strengthen the competitive capability of the local system and provide new opportunities to positively face global competition.

Keywords: global innovation network, industrial district, internationalization, innovation, mechatronics, Veneto region

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6548 Sustainability of Heritage Management in Aksum: Focus on Heritage Conservation and Interpretation

Authors: Gebrekiros Welegebriel Asfaw

Abstract:

The management of the fragile, unique and irreplaceable cultural heritage from different perspectives is becoming a major challenge as important elements of culture are vanishing throughout the globe. The major purpose of this study is to assess how the cultural heritages of Aksum are managed for their future sustainability from heritage conservation and interpretation perspectives. Descriptive type of research design inculcating both quantitative and qualitative research methods is employed. Primary quantitative data was collected from 189 respondents (19 professionals, 88 tourism service providers and 82 tourists) and interview was conducted with 33 targeted informants from heritage and related professions, security employees, local community, service providers and church representatives by applying probability and non probability sampling methods. Findings of the study reveal that the overall sustainable management status of the cultural heritage of Aksum is below average. It is found that the sustainability of cultural heritage management in Aksum is facing a lot of unfavorable factors like lack of long term planning, incompatible system of heritage administration, limited capacity and number of professionals, scant attention to community based heritage and tourism development, dirtiness and drainage problems, problems with stakeholder involvement and cooperation, lack of organized interpretation and presentation systems and others. So, re-organization of the management system, creating platform for coordination among stakeholders and developing appropriate interpretation system can be good remedies. Introducing community based heritage and tourism development concept is also recommendable for a long term win-win success in Aksum.

Keywords: Aksum, conservation, interpretation, Sustainable Cultural Heritage Management

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6547 A City Adapting to the Mobile Government and Hybrid Culture Established by Khitan-Liao (907-1125): Up-Capital (Shangjing) and its Special Tent Zone

Authors: Robin Ruowei Yang

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The Khitan-Liao dynasty (907-1125) was founded by the nomadic Khitan people and showed its peculiarities. This regime not only effectively ruled their own nomads, but also ruled the farming ethnic groups of the Han (漢) and others. It also controlled vast territories that included the northern border domains of China, East Asia, and even Central Asia. Different from the practice of other nomadic people, Khitan-Liao built settlement towns and cities on the Mongolia steppe from beginning of the dynasty, which made the politics, economy and culture of the steppe area develop significantly. In the process of cities’ construction, Khitan-Liao set up five capitals respectively. Except three of them were rebuilt or expanded based on existing cities in agricultural areas, two new capitals were built, namely up-capital (Shangjing) and middle-capital (Zhongjing) in the steppe area. This article takes the up-capital (Shangjing) as an example to investigate a special zone in the capital for settling movable tents which adapted Khitan nomads, especially its nomadic government officials to live in. By using primary Chinese historical records and newly archaeological excavations, this article examines how the special tent zone used by the Khitan rulers, discusses how the Khitan-Liao manifested its hybrid cultural characteristics in urban planning, and its implications in studying the history of Khitan-Liao. The information, discussion and argument presented in this article are also worth considering the influence of urbanization of Khitan-Liao’s urbaization on subsequent dynasties in pre-modern China and Inner Asia.

Keywords: cities on Steppe, special tent zone in cities, Khitan-Liao, hybrid culture

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6546 Reception Class Practitioners' Understandings on the Role of Teaching Assistants, in Particular Supporting Children in Mathematics

Authors: Nursel Bektas

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The purpose of this study is to investigate the roles of teaching assistants (TAs) working in reception classes through practitioners’ perspectives. The study has two major purposes; firstly to explore the general roles of TAs, and secondly to identify their roles in supporting children for mathematics. A small-scale case study approach was adopted for this study. The research was carried out in two reception classes within a primary school in London. The qualitative data were gathered through observations and semi-structured interviews with four reception class practitioners, comprising two teachers and two TAs. The results show that TAs consider their role to be more like a teacher, whereas classroom teachers do not corroborate this and they generally believe that the role of TAs depends on their personal characteristics and skills. In regard to the general role of TAs, the study suggests that reception class TAs are deployed both at the classroom level to provide academic support for children’s learning and development, and at the school level they are deployed as support staff such as Midday Meal Supervisor or assistants. In terms of the pedagogical roles of TAs, it was found that TAs have a strong teaching role in literacy development, with notable autonomy if conducting their own phonics sessions without teacher direction, but a negligible influence in numeracy/ math’s. In addition, the results show that the TA role is perceived to be quite limited in planning and assessment processes. Linked to their limited roles in such processes, all participants agree that all the responsibility regarding the children’s learning and development, planning and assessment lies with the teacher. Therefore, data suggest that TAs’ roles in these areas depend on TAs’ their own initiatives.

Keywords: early years education, reception classes, roles, teaching assistants

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6545 Data Science-Based Key Factor Analysis and Risk Prediction of Diabetic

Authors: Fei Gao, Rodolfo C. Raga Jr.

Abstract:

This research proposal will ascertain the major risk factors for diabetes and to design a predictive model for risk assessment. The project aims to improve diabetes early detection and management by utilizing data science techniques, which may improve patient outcomes and healthcare efficiency. The phase relation values of each attribute were used to analyze and choose the attributes that might influence the examiner's survival probability using Diabetes Health Indicators Dataset from Kaggle’s data as the research data. We compare and evaluate eight machine learning algorithms. Our investigation begins with comprehensive data preprocessing, including feature engineering and dimensionality reduction, aimed at enhancing data quality. The dataset, comprising health indicators and medical data, serves as a foundation for training and testing these algorithms. A rigorous cross-validation process is applied, and we assess their performance using five key metrics like accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC-ROC). After analyzing the data characteristics, investigate their impact on the likelihood of diabetes and develop corresponding risk indicators.

Keywords: diabetes, risk factors, predictive model, risk assessment, data science techniques, early detection, data analysis, Kaggle

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6544 Gender Inequalities in Depression among Palestinian Citizens in Israel

Authors: Nihaya Daoud, Adi Finkelstein

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Depression is a major public health concern and it is estimated to be the second leading cause of morbidity in 2020. One of the most consistent findings in mental health in the Western societies is inequalities in depression between men and women. Studies on differences in depression between Arab men and women are scarce. In this paper, we use data of a countrywide study on the Arab minority in Israel to compare the prevalence of depressive symptoms between men and women and examine factors that contribute to this gender inequality in the context of Arab society. The study was conducted in 2005-2006. It included a sample of Palestinian citizens of Israel, aged 30–70. The final sample included 902 respondents (381 women and 521 men) who were interviewed face-to-face using a structured questionnaire in Arabic, before which they each signed an informed consent form. The study was approved by the Institutional Review Board at Hadassah – Hebrew University Medical Center. Results show that women had significantly higher depressive symptoms (DS) than men. In addition, while Arab women had steady rates of depressive symptoms between the ages of 40-54 and a peak at the age group of 55-59, among Arab men there was a peak almost every 10 years (more results will show in the full presentation). We assume that our findings might be attributed to the specific structural changes in the Arab society in Israel in the last decades.

Keywords: Arab men, Arab women, depression, gender inequality

Procedia PDF Downloads 238