Search results for: starvation death

Authors: Guo Yu, Haoming Ma, Peiru Zhou

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BACKGROUND: In addition to hyperglycemia, hypoglycemia, and glycemic variability, a decrease in the time in the targeted blood glucose range (TIR) may be associated with an increased risk of death for critically ill patients. However, the relationship between the TIR and mortality may be influenced by the presence of diabetes and glycemic variability. METHODS: A total of 998 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The TIR is defined as the percentage of time spent in the target blood glucose range of 3.9–10.0 mmol/L within 24 hours. The relationship between TIR and in-hospital in diabetic and non-diabetic patients was analyzed. The effect of glycemic variability was also analyzed. RESULTS: The binary logistic regression model showed that there was a significant association between the TIR as a continuous variable and the in-hospital death of severely ill non-diabetic patients (OR=0.991, P=0.015). As a classification variable, TIR≥70% was significantly associated with in-hospital death (OR=0.581, P=0.003). Specifically, TIR≥70% was a protective factor for the in-hospital death of severely ill non-diabetic patients. The TIR of severely ill diabetic patients was not significantly associated with in-hospital death; however, glycemic variability was significantly and independently associated with in-hospital death (OR=1.042, P=0.027). Binary logistic regression analysis of comprehensive indices showed that for non-diabetic patients, the C3 index (low TIR & high CV) was a risk factor for increased mortality (OR=1.642, P<0.001). In addition, for diabetic patients, the C3 index was an independent risk factor for death (OR=1.994, P=0.008), and the C4 index (low TIR & low CV) was independently associated with increased survival. CONCLUSIONS: The TIR of non-diabetic patients during ICU hospitalization was associated with in-hospital death even after adjusting for disease severity and glycemic variability. There was no significant association between the TIR and mortality of diabetic patients. However, for both diabetic and non-diabetic critically ill patients, the combined effect of high TIR and low CV was significantly associated with ICU mortality. Diabetic patients seem to have higher blood glucose fluctuations and can tolerate a large TIR range. Both diabetic and non-diabetic critically ill patients should maintain blood glucose levels within the target range to reduce mortality.

Keywords: severe disease, diabetes, blood glucose control, time in targeted blood glucose range, glycemic variability, mortality

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Authors: Renukha Devi Anandan

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Charles Forsman’s The End of The Fxxxing World, I Am Not Okay With This, and Slasher invariably deals with existential themes. They reflect the perplexed situation of the characters torn between the search for existence and the constraints of human conditions that impede them from such realization, ensuing a dilemma deeply-rooted in absurdity and alienation. These characters are social misfits who fail to fashion their existence and develop harmoniously. Therefore, the present paper adopts an Existential approach to examine the vignettes of alienation and absurdity vis-à-vis the characters’ speech, actions, and thoughts. Furthermore, this paper explores the role of death either as a self-destructive behavior or the eternal freedom of man in graphic novels. Findings portrayed how the characters’ absurd existence surrounded by the void, would eventually develop into death. Finally, the study revealed that Forsman’s distinctive serial illustration not only unveiled the predicaments of the characters through their hard-boiled smokescreens in the 21st-century social paradigm but also established graphic novels as part and parcel of a literary genre.

Keywords: existentialism, absurdity, alienation, death, self-destruction, eternal freedom

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Authors: Rasha F. Sharaf

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Treatment of dental caries in young children is considered a great challenge for all dentists, especially with uncooperative children. Recently non-invasive techniques have been highlighted as they alleviate the need for local anesthesia and other painful procedures during management of carious teeth and, at the same time, increase the success rate of the treatment done. Silver Diamine Fluoride (SDF) is one of the most effective cariostatic materials that arrest the progression of carious lesions and aid in remineralizing the demineralized tooth structure. Both fluoride and silver ions proved to have an antibacterial action and aid in the precipitation of an insoluble layer that prevents further decay. At the same time, Moringa proved to have an effective antibacterial action against different types of bacteria, therefore, it can be used as a non-invasive technique for the management of caries in children. One of the important theories for the control of caries is by depriving the cariogenic bacteria from nutrients causing their starvation and death, which can be achieved by applying stainless steel crown on primary molars with carious lesions which are not involving the pulp, and this technique is known as Hall technique. The success rate of the Hall technique can be increased by arresting the carious lesion using either SDF or Moringa and gaining the benefit of their antibacterial action. Multiple clinical cases with 1 year follow up will be presented, comparing different treatment options, and using various materials and techniques for non-invasive and non-painful management of carious primary teeth.

Keywords: SDF, hall technique, carious primary teeth, moringa extract

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Authors: Po-Ching Chou, Wen-Chen Liang, I. Chen Chen, Jong-Hau Hsu, Yuh-Jyh Jong

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Background：Cardiopulmonary complications seem to cause high morbidity and mortality in patients with neuromuscular diseases (NMD) but so far there is no domestic data reported in Taiwan. We, therefore attempted to analyze the factors to cause the death in NMD patients from our cohort. Methods：From 1998 to 2013, we retrospectively collected the information of the NMD patients treated and followed up in Kaohsiung Medical University Hospital. Forty-two patients with NMD who expired during these fifteen years were enrolled. The medical records of these patients were reviewed and the causes of death and the associated affecting factors were analyzed. Results：Eighteen patients with NMD (mean age=13.3, SD=12.4) with complete medical record and detailed information were finally included in this study, including spinal muscular atrophy (SMA) (n=9, 7/9: type 1), Duchenne muscular dystrophy (n=6), congenital muscular dystrophy (n=1), carnitine acyl-carnitine translocase (CACT) deficiency (n=1) and spinal muscular atrophy with respiratory distress (SMARD)(n=1). The place of death was in ICU (n=11, 61%), emergency room (n=3, 16.6%) or home (n=4, 22.2%). For SMA type 1 patients, most of them (71.4%, 5/7) died in emergency room or home and the other two expired during an ICU admission. The causes of death included acute respiratory failure due to pneumonia (n=13, 72.2 %), ventilator failure or dislocation (n=2, 11.1%), suffocation/choking (n=2, 11.1%), and heart failure with hypertrophic cardiomyopathy (n=1, 5.55%). Among the 15 patients died of respiratory failure or choking, 73.3% of the patients (n=11) received no ventilator care at home. 80% of the patients (n=12) received no cough assist at home. The patient died of cardiomyopathy received no medications for heart failure until the last admission. Conclusion: Respiratory failure and choking are the leading causes of death in NMD patients. Appropriate respiratory support and airway clearance play the critical role to reduce the mortality.

Keywords: neuromuscular disease, cause of death, tertiary care hospital, medical sciences

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Authors: Debatosh Das, Moxian Chen, Jianhua Zhang, Caroline Gutjahr

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Arbuscular mycorrhiza (AM) is a mutualistic symbiosis between plant roots and Glomeromycotina fungi, which is activated under low but inhibited by high phosphate. The effect of phosphate on AM development has been observed for many years, but mechanisms regulating it under contrasting phosphate levels remain unknown. Based on previous observations that promoters of several AM functional genes contain PHR binding motifs, we hypothesized that PHR2, a master regulator of phosphate starvation response in rice, was recruited to regulate AM symbiosis development. We observed a drastic reduction in root colonization and significant AM transcriptome modulation in phr2. PHR2 targets genes required for root colonization and AM signaling. The role of PHR2 in improving root colonization, mycorrhizal phosphate uptake, and growth response was confirmed in field soil. In conclusion, rice PHR2, which is considered a master regulator of phosphate starvation responses, acts as a positive regulator of AM symbiosis between Glomeromycotina fungi and rice roots. PHR2 directly targets the transcription of plant strigolactone and AM genes involved in the establishment of this symbiosis. Our work facilitates an understanding of ways to enhance AMF propagule populations introduced in field soils (as a biofertilizer) in order to restore the natural plant-AMF networks disrupted by modern agricultural practices. We show that PHR2 is required for AM-mediated improvement of rice yield in low phosphate paddy field soil. Thus, our work contributes knowledge for rational application of AM in sustainable agriculture. Our data provide important insights into the regulation of AM by the plant phosphate status, which has a broad significance in agriculture and terrestrial ecosystems.

Keywords: biofertilizer, phosphate, mycorrhiza, rice, sustainable, symbiosis

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Authors: Zhou Shangcheng, Yi Sicen

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Objective: To understand the mortality patterns of Zhangwan District in 2010 and provide the basis for the development of scientific and rational health policy. Methods: Data are collected from the Sixth Census of Zhangwan District and disease surveillance system. The statistical analysis include death difference between age, gender, region and time and the related factors. Methods developed for the Global Burden of Disease (GBD) Study by the World Bank and World Health Organization (WHO) were adapted and applied to Zhangwan District population health data. DALY rate per 1,000 was calculated for varied causes of death. SPSS 16 is used by statistic analysis. Results: From the data of death population of Zhangwan District we know the crude mortality rate was 6.03 ‰. There are significant differences of mortality rate in male and female population which was respectively 7.37 ‰ and 4.68 ‰. 0 age group population life expectancy in Zhangwan District in 2010 was 78.40 years old(Male 75.93, Female 81.03). The five leading causes of YLL in descending order were: cardiovascular diseases(42.63DALY/1000), malignant neoplasm (23.73DALY/1000), unintentional injuries (5.84DALY/1000), Respiratory diseases(5.43 DALY/1000), Respiratory infections (2.44DALY/1000). In addition, there are strong relation between the marital status , educational level and mortality in some to a certain extend. Conclusion Zhangwan District, as city level, is at lower mortality levels. The mortality of the total population of Zhangwan District has a downward trend and life expectancy is rising.

Keywords: sixth census, Zhangwan district, death level differences, influencing factors, cause of death

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Authors: O. S. Adeyemi, C. G. Whiteley

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The present study determined the toxic potential of metal nanoparticles in cell culture system. Silver and gold nanoparticles were synthesized and characterized following established "green" protocols. The synthesized nanoparticles, in varying concentrations ranging from 0.1–100 µM were evaluated for toxicity in metastatic MDA-MB-231 cells. The nanoparticles promoted a generation of reactive oxygen species and reduced cell viability to less than 50% in the demonstration of cellular toxicity. The nanoparticles; gold and the silver-gold mixture had IC50 values of 56.65 and 18.44 µM respectively. The IC50 concentration for silver nanoparticles could not be determined. Furthermore, the probe of the cell death using flow cytometry and confocal microscopy revealed the partial involvement of apoptosis as well as necrosis. Our results revealed cellular toxicity caused by the nanoparticles but the mechanism remains yet undefined.

Keywords: cell death, nanomedicine, nanotoxicology, toxicity

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Authors: Kate L. Yusi

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This paper is an attempt to theoretically reframe the act of self-immolation beyond violence/non-violence discourse, to differentiate it from other paradigmatic examples of necropolitical activism like suicide bombing, in order to highlight its particular ontopolitical statement in relation to life and death and to re-energize its deactivating power. In this paper, the writer seeks to focus on self-immolation by Tibetan monks and other activists against Chinese imperialism, its continuing ethnic cleansing of the Tibetan people, forced assimilation, and territorial occupation. Here, the main driving force is this question: what does self-immolation mean to a people who are forced to live in deathspace? In other words, if one is reduced to nothingness that their deaths (as is their lives) become insignificant, in what ways does the reclamation of death/dying become a “way out” of this state-imposed enclave of death? To answer these questions, the writer engages with and put in conversation the works of Achille Mbembe, Elias Cannetti, and Giorgio Agamben.

Keywords: necropolitics, self immolation, tibetan people, chinese imperialism

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Authors: Ruotian Wang

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Since the birth of the Buddha himself more than 2000 years ago, Buddhism has continued to lead many people’s lives. Scholars and Buddhists have contributed to give detailed explanations to all kinds of issues within the structure of Buddhist philosophy to make Buddhism more complete. Different schools have developed, therefore leading to a lot of different branches within Buddhism. Although they all follow what the Buddha himself taught, they still have various explanations to even fundamental issues. As one of the fundamental problems regarding our lives, death is widely discussed in Buddhism. The controversy regarding death is its seemly incompatibility with the idea of non-self and impermanence, which is what I will discuss in this essay. The idea of rebirth is the basic structure of birth and death, which suggests a connection between this life and the next. Therefore, according to common logic, we should tell that there is something that connects each life, an agent that receives the process of rebirth, which is normally known as a soul. In Buddhism, non-self is also an important concept which speaks to the illusion of a self or soul. The idea of rebirth and non-self seems contradicted. Many different schools of Buddhism attempt to resolve such conflicts, but there are logical flaws within the arguments they made. Thus, I raise a better solution: Different from the annihilationist view, non-self in Buddhism speaks only to the illusion of a self in each moment. There is a self that exists as a sum of all our karmas which we can achieve after Nirvana. However, the nature of such a self is still emptiness. There are no agents needed as one rebirth since the whole cycle of rebirth is the self. Then, the contradiction between rebirth and non-self can be resolved.

Keywords: Buddhism, impermanence, non-self, reincarnation

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Authors: W. Phokhwang-Just, A. Saraketrin, P. Thongpet, J. Udomkitpipat, J. Kaewsakulthong

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The more people get older and live longer, the more health problems they may have. This cross-sectional study aims to study a correlation between death anxiety, quality of life, and self-esteem as well as factors affecting these variables in the elderly living in Surat Thani Province, Thailand. Of 382 elderly people, who were proportionally sampled from 19 districts in Surat Thani Province, 256 (67%) already returned the questionnaires. The Thai version of Templer’s Death Anxiety, Quality of Life (WHO-BREF), and of Rosenberg’s Self-Esteem Questionnaires were employed. The result showed that the samples had a mean age of 72 years old, 53% were female, 62% were married, 61% graduated with primary-school, and 61% had at least one chronic disease Approximately, 19% of them had 3 diseases. The quality of life (QOL), self-esteem (SE), and death anxiety (DA) of samples were in moderate (n= 91, mean = 86.89, SD = 15.47), high (n = 138, mean = 29.33, SD=4.77), and low level (n= 85, mean = 6.23, SD= 3.65), respectively. The QOL was not significantly different between male and female as well as among different marital status. The female elderly had more DA and less SE than male (t= 2.095, df = 83; t =-3.258, df =135, respectively, p < 0.05). The female elderly, who were separated or widow, had a higher level of DA than did the married elderly (LSD: p < 0.05). The married elderly had a higher level of SE than did the separated, widowed (Tukey HSD, LSD: p < 0.05), or single elderly (LSD: p < 0.05). The more diseases the elderly got, the lower level of QOL they had (r = -0.335, p < 0.05). The QOL was significantly correlated with SE (r =0.434, p < 0.05), but not significantly related to DA (r = -0.200, p = 0.069). The lower level of SE the elderly had, the higher level of DA they become (r = -2.71, p < 0.05). In order to promote the QOL, the SE of the elderly should be enhanced. Consequently, the DA can be minimized. Healthcare providers should provide care that promotes QOL, SE, and reduces DA of the elderly, especially those, who are female, single, and separated or widowed as well as those, who have more diseases than the others

Keywords: death anxiety, quality of life, self-esteem, elderly

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Authors: M. Yaqoob, C. S. O’Neill, S. Faraj, C. L. O’Neill

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This paper presents the preliminary findings from a study exploring nurse’s contributions to end of life decisions and to the care of dying patients in ICU units in the Kingdom of Bahrain. The process of dying is complex as medical clinicians are frequently unable to say with certainty when death will occur. It is generally accepted that end of life care begins when it is possible to know that death is imminent. Nurses do not make medical treatment decisions when caring for a dying patient. There are, however, many other types of decisions made when a patient is approaching the end of life and nurses are either formally or informally part of these decision making processes. This study explored nurses care practices at the end of life, in two ICU units in large hospitals in the Kingdom of Bahrain. The research design was a grounded theory approach. Ten nurses participated, six of whom were Bahraini nationals and four were Indian. A core category death avoidance talk was supported by three major subcategories, degrees of involvement in decision making; signalling and creating an awareness of death; care shifting from dying patients to family. Despite nurses asserting that they carried out the orders of doctors and had no role in decision making processes at end of life this study showed that there were degrees of nurse involvement. Doctors frequently discussed the patient’s clinical condition with nurses and also sought information regarding the family. Information about the family was of particular relevance if the doctor was considering a DNR order, which the nurses equated with dying. Families were not always informed when a DNR decision was made. When families were not informed the nurses engaged in sophisticated rituals signalling and creating awareness to family members that the death of their loved one was near. This process also involved a subtle shifting of care from the dying patient to the family. This seminar paper will focus particularly on how nurses signal and create an awareness of death in an ICU setting. The findings suggest that despite the avoidance of death talk in the ICU nurses indirectly convey and create an awareness that death is near to family members.

Keywords: decision making, dying patients, end of life, intensive care unit

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Authors: Paolo Scolari

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Nietzschean thought flows like a current throughout Marcel’s philosophy. Marcel is in constant dialogue with him. He wants to give homage to him, making him one of the most eminent representatives of existential thought. His enthusiasm is triggered by Nietzsche’s phrase: ‘God is dead,’ the fil rouge that ties all of the Nietzschean references scattered through marcelian texts. The death of God is the theme which emphasises both the greatness and simultaneously the tragedy of Nietzsche. Marcel wants to substitute the idea ‘God is dead’ with its original meaning: a tragic existential characteristic that imitators of Nietzsche seemed to have blurred. An interpretation that Marcel achieves aiming at double target. On the one hand he removes the heavy metaphysical suit from Nietzsche’s aphorisms on the death of God, that his interpreters have made them wear – Heidegger especially. On the other hand, he removes a stratus of trivialisation which takes the aphorisms out of context and transforms them into advertising slogans – here Sartre becomes the target. In the lecture: Nietzsche: l'homme devant la mort de dieu, Marcel hurls himself against the metaphysical Heidegger interpretation of the death of God. A hermeneutical proposal definitely original, but also a bit too abstract. An interpretation without bite, that does not grasp the tragic existential weight of the original Nietzschean idea. ‘We are probably on the wrong road,’ announces, ‘when at all costs, like Heidegger, we want to make a metaphysic out of Nietzsche.’ Marcel also criticizes Sartre. He lands in Geneva and reacts to the journalists, by saying: ‘Gentlemen, God is dead’. Marcel only needs this impromptu exclamation to understand how Sartre misinterprets the meaning of the death of God. Sartre mistakes and loses the existential sense of this idea in favour of the sensational and trivialisation of it. Marcel then wipes the slate clean from these two limited interpretations of the declaration of the death of God. This is much more than a metaphysical quarrel and not at all comparable to any advertising slogan. Behind the cry ‘God is dead’ there is the existence of an anguished man who experiences in his solitude the actual death of God. A man who has killed God with his own hands, haunted by the chill that from now on he will have to live in a completely different way. The death of God, however, is not the end. Marcel spots a new beginning at the point in which nihilism is overcome and the Übermensch is born. Dialoguing with Nietzsche he notices to being in the presence of a great spirit that has contributed to the renewal of a spiritual horizon. He descends to the most profound depths of his thought, aware that the way out is really far below, in the remotest areas of existence. The ambivalence of Nietzsche does not scare him. Rather such a thought, characterised by contradiction, will simultaneously be infinitely dangerous and infinitely healthy.

Keywords: Nietzsche's Death of God, Gabriel Marcel, Heidegger, Sartre

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Authors: Maira Farooq Maneka

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Death has increasingly caused humans to investigate its reality and what lies after it, if something at all, with personal conviction and concern. Till date it remains a matter of speculation. We do not encounter arguments other than ‘faith’ from major world religions when justifying claims about life after death (LAD) as it is an unseen phenomenon. This paper attempts to analyse the Islamic idea of resurrection (after death) and its justification that is distinct from faith but instead contemplative in nature. To do this a legal lens was adopted which allowed the categorisation of selected Quranic arguments under the heading of direct evidence, indirect evidence and intuitive reasoning. Results: Four kinds of direct evidences are discussed under the themes of sleep, droughts, predictions and Quranic challenge. The section of indirect evidences narrows its scope only to two, out of many, broad possible signs that pointed towards the reality of resurrection. These include the signs found in nature such as sun and water as well as signs one finds within the human body such as the creation and function of human fingertips. Finally the last section tries to amalgamate Quran’s appeal to human rationality that facilitates the reader in accepting the possibility of resurrection and hence a final Day of Judgement. These include the notion of accountability, pleasure, pain and human agency.

Keywords: Islam, life after death, Quran, resurrection

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Authors: Mohd Asrul Affedi, Nyi Nyi Naing

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Overdispersion is present in count data, and basically when a phenomenon happened, a Negative Binomial (NB) is commonly used to replace a standard Poisson model. Analysis of count data event, such as mortality cases basically Poisson regression model is appropriate. Hence, the model is not appropriate when existing a zero values. The zero-inflated negative binomial model is appropriate. In this article, we modelled the mortality cases as a dependent variable by age categorical. The objective of this study to determine existing overdispersion in mortality data of AIDS co-infection patients in Kelantan.

Keywords: negative binomial death rate, overdispersion, zero-inflation negative binomial death rate, AIDS

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Authors: Mercy D. Chirwa, Juliet Nyasulu, Lebisti Modiba, Makombo Ganga-Limando

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Maternal death review is an initiative that provides a deeper understanding of the causes and circumstances sorounding of maternal deaths in Malawi and globally. Midwives are frontline members of the healthcare team and have stories about what pregnant women go through as such they are better placed to contribute to these reviews. Despite midwives’ participation as members of the facility-based maternal death review team, maternal deaths continues to occur. A lot has been documented around processes involved in maternal review, however, not much has been written around challenges experienced by midwives in maternal death review. This study explored the challenges faced by midwives in the implementation of maternal death reviews in the context of the healthcare system in Malawi. Methodology: This was a qualitative exploratory study design. Focus group discussions and individual face-to-face interviews were used to collect data in the study. A total of 40 midwives, who met the inclusion criteria, participated in the study. Data was analysed manually using a thematic content procedure. Findings: The four major challenges identified were: knowledge and skill gaps; lack of leadership and accountability; lack of institutional political will and inconsistency in conducting FBMDR, impeding midwives’ effective contribution to the implementation of maternal death review. The practical solutions and recommendations that emerged were: need-based knowledge and skills updates, supportive leadership, effective and efficient interdisciplinary work ethics, and sustained availability of material and human resources. Conclusion: Midwives have the highest potential to contribute to the reduction of maternal deaths. Practice development strategies are required to improve their practice in all the areas they are challenged with.

Keywords: facility-based maternal death review, maternal deaths, midwife, midwife challenges

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Authors: Kais Siala, Mohamed Kharrat, Mohamed Abid

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Exposure therapies encourage patients to gradually begin facing their painful memories of the trauma in order to reduce fear and anxiety. In this context, virtual reality techniques are widely used for treatment of different kinds of phobia. The particular case of fear of death phobia (thanataphobia) is addressed in this paper. For this purpose, we propose to make a simulation of Near Death Experience (NDE) using augmented reality techniques. We propose in particular to simulate the Out-of-Body experience (OBE) which is the first step of a Near-Death-Experience (NDE). In this paper, we present technical aspects of this simulation as well as short-term impact in terms of physiological measures. The non-linear Poincéré plot is used to describe the difference in Heart Rate Variability between In-Body and Out-Of-Body conditions.

Keywords: Out-of-Body simulation, physiological measure, augmented reality, phobia psychotherapy, HRV, Poincaré plot

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Authors: A. A. Agbor, Jean Joel R. Bigna, Serges Clotaire Billong, Mathurin Cyrille Tejiokem, Gabriel L. Ekali, Claudia S. Plottel, Jean Jacques N. Noubiap, Hortence Abessolo, Roselyne Toby, Sinata Koulla-Shiro

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Background: Contributors to fatal outcomes in patients undergoing tuberculosis (TB) treatment in the setting of HIV co-infection are poorly characterized, especially in sub-Saharan Africa. Our study’s aim was to assess factors associated with death in TB/HIV co-infected patients during the first 6 months their TB treatment. Methods: We conducted a tertiary-care hospital-based retrospective cohort study from January 2006 to December 2013 at the Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify hospitalized co-infected TB/HIV patients aged 15 years and older. Death was defined as any death occurring during TB treatment, as per the World Health Organization’s recommendations. Logistic regression analysis identified factors associated with death. Magnitudes of associations were expressed by adjusted odds ratio (aOR) with 95% confidence interval. A p value < 0.05 was considered statistically significant. Results: The 337 patients enrolled had a mean age of 39.3 (+/- 10.3) years and more (54.3%) were women. TB treatment outcomes included: treatment success in 60.8% (n=205), death in 29.4% (n=99), not evaluated in 5.3% (n=18), loss to follow-up in 5.3% (n=14), and failure in 0.3% (n=1) . After exclusion of patients lost to follow-up and not evaluated, death in TB/HIV co-infected patients during TB treatment was associated with: a TB diagnosis made before national implementation of guidelines regarding initiation of antiretroviral therapy (aOR = 2.50 [1.31-4.78]; p = 0.006), the presence of other AIDS-defining infections (aOR = 2.73 [1.27-5.86]; p = 0.010), non-AIDS comorbidities (aOR = 3.35 [1.37-8.21]; p = 0.008), not receiving co-trimoxazole prophylaxis (aOR = 3.61 [1.71-7.63]; p = 0.001), not receiving antiretroviral therapy (aOR = 2.45 [1.18-5.08]; p = 0.016), and CD4 cell counts < 50 cells/mm3 (aOR = 16.43 [1.05-258.04]; p = 0.047). Conclusions: The success rate of anti-tuberculosis treatment among hospitalized TB/HIV co-infected patients in our setting is low. Mortality in the first 6 months of treatment was high and strongly associated with specific clinical factors including states of greater immunosuppression, highlighting the urgent need for targeted interventions, including provision of anti-retroviral therapy and co-trimoxazole prophylaxis in order to enhance patient outcomes.

Keywords: TB/HIV co-infection, death, treatment outcomes, factors

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Authors: Shirin Jalili, Hadi Shirzad, Samaneh Nabavi, Somayeh Khanjani

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Forensic entomology is the science of study and analysis of insects evidences to aid in criminal investigation. Being aware of the distribution, biology, ecology and behavior of insects, which are founded at crime scene can provide information about when, where and how the crime has been committed. It has many application in criminal investigations. Its main use is estimation of the minimum time after death in suspicious death. The close association between insects and corpses and the use of insects in criminal investigations is the subject of forensic entomology. Because insects attack to the decomposing corpse and spawning on it from the initial stages. Forensic scientists can estimate the postmortem index by studying the insects population and the developing larval stages.In addition, toxicological and molecular studies of these insects can reveal the cause of death or even the identity of a victim. It also be used to detect drugs and poisons, and determination of incident location. Gathering robust entomological evidences is made possible for experts by recent Techniques. They can provide vital information about death, corpse movement or burial, submersion interval, time of decapitation, identification of specific sites of trauma, post-mortem artefacts on the body, use of drugs, linking a suspect to the scene of a crime, sexual molestations and the identification of suspects.

Keywords: Forensic entomology, post mortem interval, insects, larvae

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Authors: Kurt S. Candilas

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This study is a critical analysis of the work of Robert Frost, 'Nothing Gold Can Stay'. It subjects the literary piece into a qualitative analysis using the critical theory of mimesis. In effect, this study is proposed to find out and shed light on the mimetic feature of the poem’s textuality. Generally, it aims to analyze the poem’s deeper meaning in the context of the reality of life from birth to death. For the most part, this critical analysis discerns, investigates, and highlights the features which present the imitation of life in detail and from a deeper view. Based on the result of analysis, it shows that Frost has portrayed the cycle of life from birth to midst life as about proving oneself to others as far as achievements and accomplishments are concerned; secondly, at some point of one’s life, successes and achievements are just one’s perfect signature of living. As Frost discloses his poem, his message of the reality of life from birth to death is clear enough, that nothing is going to last forever.

Keywords: Nothing Gold Can Stay, mimesis, birth, death

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Authors: G. V. Sai Soumya, Kalpesh Solanki, Sumit K. Choudhary

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Necropsy is another term used for an autopsy, which is known as death examination in the case of animals. It is a complete standardized procedure involving dissection, observation, interpretation, and documentation. Government Bodies like National Tiger Conservation Authority (NTCA) have given standard operating procedures for commencing the necropsies. Necropsies are rarely performed as compared to autopsies performed on human bodies. There are no databases which maintain the count of autopsies in wildlife, but the research in this area has shown a very small number of necropsies. Long back, wildlife forensics came into existence but is coming into light nowadays as there is an increase in wildlife crime cases, including the smuggling of trophies, pooching, and many more. Physical examination in cases of animals is not sufficient to yield fruitful information, and thus postmortem examination plays an important role. Postmortem examination helps in the determination of time since death, cause of death, manner of death, factors affecting the case under investigation, and thus decreases the amount of time required in solving cases. Increasing the rate of necropsies will help forensic veterinary pathologists to build standardized provision and confidence within them, which will ultimately yield a higher success rate in solving wildlife crime cases.

Keywords: necropsy, wildlife crime, postmortem examination, forensic application

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Authors: Priyanka Sharma, Rajeshwar Nath Srivastava

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Hydrogen has a high level of efficacy in suppressing tumour growth. The role of hydrogen in cancer treatment is unclear. This groundbreaking research will focus on the most effective therapeutic approach for osteosarcoma. Recent data reveals that hydrogen, a naturally occurring gaseous chemical, can protect cells from death. However, little is known about the signalling pathways that regulate cardiac cell death and individual apoptosis signalling by H2 and its downstream targets. According to certain research, the anti-tumor effect of H2 released by magnesium-based biomaterials is mediated by the P53-mediated lysosome-mitochondria apoptosis signalling pathway, bolstering the biomaterial's therapeutic potential as a localised anti-tumor treatment. The role of the H2 molecule in the signalling of apoptotic, autophagic, necroptotic, and pyroptotic cell death in Osteosarcoma is discussed in this paper. Potential Hydrogen-based therapy techniques will broaden the treatment horizon for Osteosarcoma.

Keywords: osteosarcoma, metastasis, hhydrogen, therapeutic

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Authors: Rika Susanti, Eryati Darwin, Dedi Afandi, Yanwirasti, Syahruddin Said, Noverika Windasari, Zelly Dia Rofinda

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Introduction: Blunt head trauma is one of the leading causes of death associated with murders and other deaths involved in criminal acts. Creatine kinase (CKBB) levels have been used as a biomarker for blunt head trauma. Therefore, it is now used as an alternative to an autopsy. The aim of this study is to investigate CKBB levels in cerebrospinal fluid (CSF) and post-mortem serum in order to deduce the cause and time of death. Method: This investigation was conducted through post-test–only group design involving deaths caused by blunt head trauma, which was compared to deaths caused by ketamine poisoning. Results: There were eight treatment groups, each consisting of six adult rats (Rattus norvegicus) Sprague-Dawley strain. Examinations were done at 0 hours, 1 hour, 2 hours, and 3 hours post-mortem, which followed by brain tissue observation. Data were then analyzed statistically with a repeated-measures general linear model. Conclusion: There were increases in the level of CKBB in CSF and postmortem serum in both blunt head trauma and ketamine poisoning treatment groups. However, there were no significant differences between these two groups.

Keywords: blunt head trauma, CKBB, the cause of death, estimated time of death

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Authors: Shameka Stanford

Abstract:

This presentation will discuss how cognitive and communication disorders in the areas of executive functioning, receptive and expressive language can impact the problem-solving and decision making of individuals with such impairments. More specifically, this presentation will discuss approaches the legal defense team of capital case lawyers can add to their experience when servicing individuals who have a history of educational decline, special education, and limited intervention and treatment. The objective of the research is to explore and identify the correlations between impaired executive function skills and decision making and competency for individuals facing death penalty charges. To conduct this research, experimental design, randomized sampling, qualitative analysis was employed. This research contributes to the legal and criminal justice system related to how they view, defend, and characterize, and judge individuals with documented cognitive and communication disorders who are eligible for capital case charges. More importantly, this research contributes to the increased ability of death penalty lawyers to successfully defend clients with a history of academic difficulty, special education, and documented disorders that impact educational progress and academic success.

Keywords: cognitive impairments, communication disorders, death penalty, executive function

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Authors: Satoshi Furukawa, Satomu Morita, Katsuji Nishi, Masahito Hitosugi

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We experience the autopsy cases that the deceased was alive in emergency room on arrival. Bleeding is the leading cause of preventable death after injury. This retrospective study aimed to characterize opportunities for performance improvement identified in patients who died from traffic trauma and were considered by the quality improvement of education system. The Japan Advanced Trauma Evaluation and Care (JATEC) education program was introduced in 2002. We focused the abdominal traffic trauma injury. An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 41 post-mortems of road traffic accident between April 1999 and March 2014 subjected to medico-legal autopsy at the department of Forensic Medicine, Shiga University of Medical Science. 16 patients (39.0%) were abdominal trauma injury. The mean period of survival after meet with accident was 13.5 hours, compared abdominal trauma death was 27.4 hours longer. In road traffic accidents, the most injured abdominal organs were liver followed by mesentery. We thought delayed treatment was associated with immediate diagnostic imaging, and so expected to expand trauma management examination.

Keywords: abdominal traffic trauma, preventable death, autopsy, emergency medicine

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Authors: Sibel Çaynak, Nur Elçin Boyacıoğlu

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This study was conducted to evaluate the bereavement experiences of families of elderly individuals who died due to the COVID-19 pandemic. One of the qualitative research methods, the case study method, was used in the study. The sample of the research consisted of 19 people who agreed to participate in the research between April and July 2022. The research data were collected using a Personal Information Form and a Semi-Structured Interview Form, which was created to conduct individual in-depth interviews. As a result of the descriptive analysis, four main themes, the ability to perform religious rituals related to the bereavement experience, feelings and thoughts about death, attitudes of those around after death, and coping strategies in the COVID-19 process. It was determined that individuals had difficulty accepting death, felt inadequate about spirituality due to limited religious rituals, had feelings of despair and guilt, and limitedly utilized social support systems.

Keywords: COVID-19 pandemic, bereavement, psychiatric nursing, qualitative study

Procedia PDF Downloads 63

Authors: Reeta Devi, Hitender Kumar Tyagi, Dinesh Kumar

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In present scenario, cardiovascular problems are growing challenge for researchers and physiologists. As heart disease have no geographic, gender or socioeconomic specific reasons; detecting cardiac irregularities at early stage followed by quick and correct treatment is very important. Electrocardiogram is the finest tool for continuous monitoring of heart activity. Heart rate variability (HRV) is used to measure naturally occurring oscillations between consecutive cardiac cycles. Analysis of this variability is carried out using time domain, frequency domain and non-linear parameters. This paper presents HRV analysis of the online dataset for normal sinus rhythm (taken as healthy subject) and sudden cardiac death (SCD subject) using all three methods computing values for parameters like standard deviation of node to node intervals (SDNN), square root of mean of the sequences of difference between adjacent RR intervals (RMSSD), mean of R to R intervals (mean RR) in time domain, very low-frequency (VLF), low-frequency (LF), high frequency (HF) and ratio of low to high frequency (LF/HF ratio) in frequency domain and Poincare plot for non linear analysis. To differentiate HRV of healthy subject from subject died with SCD, k –nearest neighbor (k-NN) classifier has been used because of its high accuracy. Results show highly reduced values for all stated parameters for SCD subjects as compared to healthy ones. As the dataset used for SCD patients is recording of their ECG signal one hour prior to their death, it is therefore, verified with an accuracy of 95% that proposed algorithm can identify mortality risk of a patient one hour before its death. The identification of a patient’s mortality risk at such an early stage may prevent him/her meeting sudden death if in-time and right treatment is given by the doctor.

Keywords: early stage prediction, heart rate variability, linear and non-linear analysis, sudden cardiac death

Procedia PDF Downloads 342

Authors: Travis J. Meyer, Jasodra Ramlall, Phyo Thu, Nidhi Gadura

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For centuries humans have used the antimicrobial properties of copper to their advantage. Yet, after all these years the underlying mechanisms of copper mediated cell death in various microbes remain unclear. We had explored the hypothesis that copper mediated increased levels of lipid peroxidation in the membrane fatty acids is responsible for increased killing inEscherichia coli. In this study we show that in both gram positive (Staphylococcus aureus) and gram negative (Pseudomonas aeruginosa) bacteria there is a strong correlation between copper mediated cell death and increased levels of lipid peroxidation. Interestingly, the non-spore forming gram positive bacteria as well as gram negative bacteria show similar patterns of cell death, increased levels of lipid peroxidation, as well as genomic DNA degradation, however there is some difference inloss in membrane integrity upon exposure to copper alloy surface.

Keywords: antimicrobial, copper, gram positive, gram negative

Procedia PDF Downloads 481

Authors: Shu-Hsi Ho

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The problems of aging and number of widowed peers gradually rise in Taiwan. It is worth to concern the related issues for elderly after the death of a spouse. Hence, this study is to examine the impact of spousal death on the surviving spouse’s self-perceived health and mental health for the elderly in Taiwan. A cross section data design and ordered logistic regression models are applied to investigate whether marriage is associated significantly to self-perceived health and mental health for the widowed older Taiwanese. The results indicate that widowed marriage shows significant negative effects on self-perceived health and mental health regardless of widows or widowers. Among them, widows might be more likely to show worse mental health than widowers. The belief confirms that marriage provides effective sources to promote self-perceived health and mental health, particularly for females. In addition, since the social welfare system is not perfect in Taiwan, the findings also suggest that family and social support reveal strongly association with the self-perceived health and mental health for the widows and widowers elderly.

Keywords: logistic regression models, self-perceived health, widow, widower

Procedia PDF Downloads 463

Authors: Morteza Gharibi, Abdolghader Pakniat, Somayeh Bahrampouri

Abstract:

Introduction: Emergency department (E.R.) crowding is a serious widespread problem in hospitals that leads to irregularities, a slower rate of delivery of services to patients, and a long-term stay. In addition, the long-term stay in the E.D. reduces the possibility of providing services with appropriate quality to other patients who are undergoing medical emergencies, which leads to dissatisfaction among patients. This study aimed to determine the relationship between ED-crowding and the mortality rate of the patients referred to the E.D. In a retrospective cohort study, all patients who expired in first 24 hours of admission were enrolled in the study. Crowding index at the moment of admission was calculated using Edwin Score. The data including history and physical examination, time of arrival in the E.D., diagnosis (using ICD 10 code), time of death, cause of death, demographic information was recoded based on triage forms on admission and patients’ medical files. Data analysis was performed by using descriptive statistics and chi square test, ANOVA tests using SPSS ver. 19. The time of arrival in E.D. to death in crowded E.D. conditions, with an average of five hours and 25 minutes, was significantly higher than the average admission Time of arrival in E.D. to death in active and crowded E.D. conditions. More physicians and nurses can be employed during crowded times to reduce staff fatigue and improve their performance during these hours.

Keywords: mortality, emergency, department, crowding

Procedia PDF Downloads 94

Authors: Zahra Afshordi

Abstract:

Instagram, as an everyday life social network, hosts from the ultrasound image of an unborn fetus to the pictures of newly placed gravestones and funerals. It is a platform that allows its users to create a second identity independently from and at the same time in relation to the real space identity. The motives behind this identification are what this article is about. This article studies the motivations of Instagram users mourning for celebrities with a focus on the death of MohammadReza Shajarian. The Shajarian’s death had a wide reflection on Instagram Persian-speaking users. The purpose of this qualitative survey is to comprehend and study the user’s motivations in posting mourning and memorializing content. The methodology of the essay is a hybrid methodology consisting of content analysis and open-ended interviews. The results highlight that users' motives are more than just simple sympathy and include political protest, gaining cultural capital, reaching social status, and escaping from solitude.

Keywords: case study, celebrity, identity, Instagram, mourning, qualitative survey

Procedia PDF Downloads 156