Search results for: dietary diversity practice and associated facrors among hypertension patients at tirunesh beijing hospital
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Search results for: dietary diversity practice and associated facrors among hypertension patients at tirunesh beijing hospital

2145 Self-Regulated Learning: A Required Skill for Web 2.0 Internet-Based Learning

Authors: Pieter Conradie, M. Marina Moller

Abstract:

Web 2.0 Internet-based technologies have intruded all aspects of human life. Presently, this phenomenon is especially evident in the educational context, with increased disruptive Web 2.0 technology infusions dramatically changing educational practice. The most prominent of these Web 2.0 intrusions can be identified as Massive Open Online Courses (Coursera, EdX), video and photo sharing sites (Youtube, Flickr, Instagram), and Web 2.0 online tools utilize to create Personal Learning Environments (PLEs) (Symbaloo (aggregator), Delicious (social bookmarking), PBWorks (collaboration), Google+ (social networks), Wordspress (blogs), Wikispaces (wiki)). These Web 2.0 technologies have supported the realignment from a teacher-based pedagogy (didactic presentation) to a learner-based pedagogy (problem-based learning, project-based learning, blended learning), allowing greater learner autonomy. No longer is the educator the source of knowledge. Instead the educator has become the facilitator and mediator of the learner, involved in developing learner competencies to support life-long learning (continuous learning) in the 21st century. In this study, the self-regulated learning skills of thirty first-year university learners were explored by utilizing the Online Self-regulated Learning Questionnaire. Implementing an action research method, an intervention was affected towards improving the self-regulation skill set of the participants. Statistical significant results were obtained with increased self-regulated learning proficiency, positively impacting learner performance. Goal setting, time management, environment structuring, help seeking, task (learning) strategies and self-evaluation skills were confirmed as determinants of improved learner success.

Keywords: andragogy, online self-regulated learning questionnaire, self-regulated learning, web 2.0

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2144 An Integrated Label Propagation Network for Structural Condition Assessment

Authors: Qingsong Xiong, Cheng Yuan, Qingzhao Kong, Haibei Xiong

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Deep-learning-driven approaches based on vibration responses have attracted larger attention in rapid structural condition assessment while obtaining sufficient measured training data with corresponding labels is relevantly costly and even inaccessible in practical engineering. This study proposes an integrated label propagation network for structural condition assessment, which is able to diffuse the labels from continuously-generating measurements by intact structure to those of missing labels of damage scenarios. The integrated network is embedded with damage-sensitive features extraction by deep autoencoder and pseudo-labels propagation by optimized fuzzy clustering, the architecture and mechanism which are elaborated. With a sophisticated network design and specified strategies for improving performance, the present network achieves to extends the superiority of self-supervised representation learning, unsupervised fuzzy clustering and supervised classification algorithms into an integration aiming at assessing damage conditions. Both numerical simulations and full-scale laboratory shaking table tests of a two-story building structure were conducted to validate its capability of detecting post-earthquake damage. The identifying accuracy of a present network was 0.95 in numerical validations and an average 0.86 in laboratory case studies, respectively. It should be noted that the whole training procedure of all involved models in the network stringently doesn’t rely upon any labeled data of damage scenarios but only several samples of intact structure, which indicates a significant superiority in model adaptability and feasible applicability in practice.

Keywords: autoencoder, condition assessment, fuzzy clustering, label propagation

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2143 Bridging the Gap: Living Machine in Educational Nature Preserve Center

Authors: Zakeia Benmoussa

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Pressure on freshwater systems comes from removing too much water to grow crops; contamination from economic activities, land use practices, and human waste. The paper will be focusing on how water management can influence the design, implementation, and impacts of the ecological principles of biomimicry as sustainable methods in recycling wastewater. At Texas State, United States of America, in particular the lower area of the Trinity River refuge, there is a true example of the diversity to be found in that area, whether when exploring the lands or the waterways. However, as the Trinity River supplies water to the state’s residents, the lower part of the river at Liberty County presents several problem of wastewater discharge in the river. Therefore, conservation efforts are particularly important in the Trinity River basin. Clearly, alternative ways must be considered in order to conserve water to meet future demands. As a result, there should be another system provided rather than the conventional water treatment. Mimicking ecosystem's technologies out of context is not enough, but if we incorporate plants into building architecture, in addition to their beauty, they can filter waste, absorb excess water, and purify air. By providing an architectural proposal center, a living system can be explored through several methods that influence natural resources on the micro-scale in order to impact sustainability on the macro-scale. The center consists of an ecological program of Plant and Water Biomimicry study which becomes a living organism that purifies the river water in a natural way through architecture. Consequently, a rich beautiful nature could be used as an educational destination, observation and adventure, as well as providing unpolluted fresh water to the major cities of Texas. As a result, these facts raise a couple of questions: Why is conservation so rarely practiced by those who must extract a living from the land? Are we sufficiently enlightened to realize that we must now challenge that dogma? Do architects respond to the environment and reflect on it in the correct way through their public projects? The method adopted in this paper consists of general research into careful study of the system of the living machine, in how to integrate it at architectural level, and finally, the consolidation of the all the conclusions formed into design proposal. To summarise, this paper attempts to provide a sustainable alternative perspective in bridging physical and mental interaction with biodiversity to enhance nature by using architecture.

Keywords: Biodiversity, Design with Nature, Sustainable architecture, Waste water treatment.

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2142 Virulence Phenotypes among Multi Drug Resistant Uropathogenic E. Coli and Klebsiella SPP

Authors: V. V. Lakshmi, Y. V. S. Annapurna

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Urinary tract infection (UTI) is one of the most common infectious diseases seen in the community. Susceptible individuals experience multiple episodes, and progress to acute pyelonephritis or uro-sepsis or develop asymptomatic bacteriuria (ABU). Ability to cause extraintestinal infections depends on several virulence factors required for survival at extraintestinal sites. Presence of virulence phenotypes enhances the pathogenicity of these otherwise commensal organisms and thus augments its ability to cause extraintestinal infections, the most frequent in urinary tract infections(UTI). The present study focuses on detection of the virulence characters exhibited by the uropathogenic organism and most common factors exhibited in the local pathogens. A total of 700 isolates of E.coli and Klebsiella spp were included in the study.These were isolated from patients from local hospitals reported to be suffering with UTI over a period of three years. Isolation and identification was done based on Gram character and IMVIC reactions. Antibiotic sensitivity profile was carried out by disc diffusion method and multi drug resistant strains with MAR index of 0.7 were further selected. Virulence features examined included their ability to produce exopolysaccharides, protease- gelatinase production, hemolysin production, haemagglutination and hydrophobicity test. Exopolysaccharide production was most predominant virulence feature among the isolates when checked by congo red method. The biofilms production examined by microtitre plates using ELISA reader confirmed that this is the major factor contributing to virulencity of the pathogens followed by hemolysin production.

Keywords: Escherichia coli, Klebsiella spp, Uropathogens, virulence features

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2141 Experimental Investigation on Geosynthetic-Reinforced Soil Sections via California Bearing Ratio Test

Authors: S. Abdi Goudazri, R. Ziaie Moayed, A. Nazeri

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Loose soils normally are of weak bearing capacity due to their structural nature. Being exposed to heavy traffic loads, they would fail in most cases. To tackle the aforementioned issue, geotechnical engineers have come up with different approaches; one of which is making use of geosynthetic-reinforced soil-aggregate systems. As these polymeric reinforcements have highlighted economic and environmentally-friendly features, they have become widespread in practice during the last decades. The present research investigates the efficiency of four different types of these reinforcements in increasing the bearing capacity of two-layered soil sections using a series California Bearing Ratio (CBR) test. The studied sections are comprised of a 10 cm-thick layer of no. 161 Firouzkooh sand (weak subgrade) and a 10 cm-thick layer of compacted aggregate materials (base course) classified as SP and GW according to the United Soil Classification System (USCS), respectively. The aggregate layer was compacted to the relative density (Dr) of 95% at the optimum water content (Wopt) of 6.5%. The applied reinforcements were including two kinds of geocomposites (type A and B), a geotextile, and a geogrid that were embedded at the interface of the lower and the upper layers of the soil-aggregate system. As the standard CBR mold was not appropriate in height for this study, the mold used for soaked CBR tests were utilized. To make a comparison between the results of stress-settlement behavior in the studied specimens, CBR values pertinent to the penetrations of 2.5 mm and 5 mm were considered. The obtained results demonstrated 21% and 24.5% increments in the amount of CBR value in the presence of geocomposite type A and geogrid, respectively. On the other hand, the effect of both geotextile and geocomposite type B on CBR values was generally insignificant in this research.

Keywords: geosynthetics, geogrid, geotextile, CBR test, increasing bearing capacity

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2140 Multilevel of Factors Affected Optimal Adherence to Antiretroviral Therapy and Viral Suppression amongst HIV-Infected Prisoners in South Ethiopia: A Prospective Cohort Study

Authors: Terefe Fuge, George Tsourtos , Emma Miller

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Objectives: Maintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of adherence and viral suppression, as well as its associated factors in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors to this amongst prisoners in South Ethiopia. Methods: A prospective cohort study was conducted between June 1, 2019 and July 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration-related characteristics was collected using a structured questionnaire. Adherence was determined based on participants’ self-report and pharmacy refill records, and plasma viral load measurements which were undertaken within the study period were prospectively extracted to determine viral suppression. Various univariate and multivariate regression models were used to analyse data. Results: Self-reported dose adherence was approximately similar between ILWHA and non-incarcerated PLWHA (81% and 83% respectively), but ILWHA had a significantly higher medication possession ratio (MPR) (89% vs 75%). The prevalence of viral failure (VF) was slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31-35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions: This study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to doses and so to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors was found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

Keywords: Adherence , Antiretroviral therapy, Incarceration, South Ethiopia, Viral suppression

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2139 A Study on the Effects of a Mindfulness Training on Managers: The Case of the Malian Company for the Development of Textile

Authors: Aboubacar Garba Konte, Wei Jun, Li Xiaohui

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Nowadays companies are facing increasing pressure. The market environment changes more frequently than ever. Therefore, managers have to develop their agility, their performance and their capacity for innovation. Most companies look for managerial innovations to develop in their employees qualities such as motivation, commitment, creativity, autonomy or even the ability to adapt to change and manage intensive pressure. On a more collective level, companies are looking for teams that are able to organize, communicate and develop a form of collective intelligence based on cooperation and solidarity. Among the many managerial innovations that are currently developing, mindfulness (or mindfulness) is drawing the attention of a growing number of companies (Google, Apple, Sony, ING ...), These companies have implemented programs based on mindfulness. Although the concept of mindfulness and its effects have been the subject of in-depth research in the psychological field, research on mindfulness in the field of management is still in its infancy and it is necessary to evaluate its contribution to organizations. The purpose of this research is to evaluate the effects of a mindfulness training among the managers of a Malian textile company (CMDT). We conducted a case study on their experience and their managerial practices. In addition, we discuss the innovative nature of mindfulness in terms of managerial practice The results show significant positive effects on two major skills identified by managers that raise significant difficulties in their daily lives: their ability to supervise a team of employees with all that this implies in terms of interpersonal skills and their ability to organize and prioritize their activities. In addition, the research methodology sheds light on the innovative nature of mindfulness in a favorable organizational environment.

Keywords: mindfulness, manager, managerial innovation, relational skills, organization and prioritization

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2138 Application of Principal Component Analysis and Ordered Logit Model in Diabetic Kidney Disease Progression in People with Type 2 Diabetes

Authors: Mequanent Wale Mekonen, Edoardo Otranto, Angela Alibrandi

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Diabetic kidney disease is one of the main microvascular complications caused by diabetes. Several clinical and biochemical variables are reported to be associated with diabetic kidney disease in people with type 2 diabetes. However, their interrelations could distort the effect estimation of these variables for the disease's progression. The objective of the study is to determine how the biochemical and clinical variables in people with type 2 diabetes are interrelated with each other and their effects on kidney disease progression through advanced statistical methods. First, principal component analysis was used to explore how the biochemical and clinical variables intercorrelate with each other, which helped us reduce a set of correlated biochemical variables to a smaller number of uncorrelated variables. Then, ordered logit regression models (cumulative, stage, and adjacent) were employed to assess the effect of biochemical and clinical variables on the order-level response variable (progression of kidney function) by considering the proportionality assumption for more robust effect estimation. This retrospective cross-sectional study retrieved data from a type 2 diabetic cohort in a polyclinic hospital at the University of Messina, Italy. The principal component analysis yielded three uncorrelated components. These are principal component 1, with negative loading of glycosylated haemoglobin, glycemia, and creatinine; principal component 2, with negative loading of total cholesterol and low-density lipoprotein; and principal component 3, with negative loading of high-density lipoprotein and a positive load of triglycerides. The ordered logit models (cumulative, stage, and adjacent) showed that the first component (glycosylated haemoglobin, glycemia, and creatinine) had a significant effect on the progression of kidney disease. For instance, the cumulative odds model indicated that the first principal component (linear combination of glycosylated haemoglobin, glycemia, and creatinine) had a strong and significant effect on the progression of kidney disease, with an effect or odds ratio of 0.423 (P value = 0.000). However, this effect was inconsistent across levels of kidney disease because the first principal component did not meet the proportionality assumption. To address the proportionality problem and provide robust effect estimates, alternative ordered logit models, such as the partial cumulative odds model, the partial adjacent category model, and the partial continuation ratio model, were used. These models suggested that clinical variables such as age, sex, body mass index, medication (metformin), and biochemical variables such as glycosylated haemoglobin, glycemia, and creatinine have a significant effect on the progression of kidney disease.

Keywords: diabetic kidney disease, ordered logit model, principal component analysis, type 2 diabetes

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2137 In silico and in vitro Investigation of the Role of Acinetobacter baumannii in the Pathogenesis of Multiple Sclerosis

Authors: Kieren Luellman, Makenzi Rockwell, Eduardo Callegari, Nichole Haag, Chun Wu

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Multiple sclerosis (MS) is an autoimmune disorder that damages the myelin sheath of neurons in the central nervous system. The presence of Acinetobacter bacteria and anti-Acinetobacter antibodies in MS patients has led to the hypothesis that the bacteria may contribute to MS pathogenesis. In this study, the protein sequences of Acinetobacter baumannii were compared to five peptides from three mammalian myelin proteins, i.e., Proteolipid Protein (PLP): PLP 139-151, PLP 178-191, Myelin Basic Protein (MBP): MBP 84-104 and Myelin Oligodendrocyte Glycoprotein (MOG): MOG 35-55 and MOG 92-106 respectively, known to induce experimental autoimmune encephalomyelitis (EAE), a condition similar to MS. We found 11 hits (i.e., with five or more amino acid sequence similarity) in Acinetobacter baumannii, which are identical or similar to PLP139-151, 32 hits to PLP178-191, 35 to MBP 84-104, 41 hits to MOG 35-55 and 26 hits to MOG92-106. In addition, Western blotting was used to assess possible interaction between the bacterial proteins and human anti-MBP, anti-MOG, and anti-PLP antibodies produced in rabbits, corresponding to MBP 84-104, MOG 35-55, and PLP 139-151, respectively. We found that both human Polyclonal anti-MOG antibody and anti-PLP antibody recognized a protein or more proteins of the same molecular mass of around 25 kDa. in Acinetobacter baumannii. The results suggested that this/these protein(s) might potentially serve as antigen(s) to induce anti-MOG antibody and anti-PLP antibody production in mammalian B cells. The proteomic study identified 433 hits, among which the sequence of Acinetobacter baumannii protein 491 subunit A matches a previously published enzyme Acinetobacter 3-Oxoadipate CoA-Transferase, in which a fragment of its peptide was observed to recognize MS patient serum via ELISA method. Our findings might pave the road to understanding one of the pathogenesis mechanisms of MS.

Keywords: multiple sclerosis, pathogenesis, Acinetobacter baumannii, antibody recognition

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2136 Practical Ways to Acquire the Arabic Language through Electronic Means

Authors: Hondozi Jahja

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There is an obvious need to learn Arabic language and teach it to other speakers through the new curricula. The idea is to bridge the gap between theory and practice. To that end, we have sought to offer some means of help to master the Arabic language, in addition to our efforts to apply these means, enriching the culture of the student and develop his vocabulary. There is no doubt that taking care of the practical aspect of the grammar was our constant goal, and this particular aspect is what builds the student’s positive values and refine his taste and develop his language. In addressing these issues, we have adopted a school-based approach based primarily on the active and positive participation of the student. The theoretical linguistic issues - in our opinion - are not a primary goal, but the goal is to be used them by students through speaking and applying them. Among the objectives of this research is to establish the basic language skills of the students using new means that help the student to acquire these skills and apply them in various subjects of interest in his progress and development. Unfortunately, some of our students consider the grammar as ‘difficult’, ‘complex’ and ‘heavy’ in itself. This is one of the obstacles that stand in the way of their desired results. As a consequence, they end up talking – mumbling - about the difficulties they face in applying those rules. Therefore, some of our students finish their university studies and are unable to express what they feel using language correctly. For this purpose, we have sought in this research to follow a new integrated approach, which is to study the grammar of the language through modern means of the consolidation of the principle of functional language, and that the rule implies to control tongues and linguistic expressions properly. This research is a result of a practical experience as a teacher of Arabic language for non-native speakers at the ‘Hassan Pristina’ University, located in Pristina, the capital of Kosovo and at the Qatar Training Center since its establishment in 2012.

Keywords: arabic, applied methods, acquire, learning

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2135 Evaluation Means in English and Russian Academic Discourse: Through Comparative Analysis towards Translation

Authors: Albina Vodyanitskaya

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Given the culture- and language-specific nature of evaluation, this phenomenon is widely studied around the linguistic world and may be regarded as a challenge for translators. Evaluation penetrates all the levels of a scientific text, influences its composition and the reader’s attitude towards the information presented. One of the most challenging and rarely studied phenomena is the individual style of the scientific writer, which is mostly reflected in the use of evaluative language means. The evaluative and expressive potential of a scientific text is becoming more and more welcoming area for researchers, which stems in the shift towards anthropocentric paradigm in linguistics. Other reasons include: the cognitive and psycholinguistic processes that accompany knowledge acquisition, a genre-determined nature of a scientific text, the increasing public concern about the quality of scientific papers and some such. One more important issue, is the fact that linguists all over the world still argue about the definition of evaluation and its functions in the text. The author analyzes various approaches towards the study of evaluation and scientific texts. A comparative analysis of English and Russian dissertations and other scientific papers with regard to evaluative language means reveals major differences and similarities between English and Russian scientific style. Though standardized and genre-specific, English scientific texts contain more figurative and expressive evaluative means than the Russian ones, which should be taken into account while translating scientific papers. The processes that evaluation undergoes while being expressed by means of a target language are also analyzed. The author offers a target-language-dependent strategy for the translation of evaluation in English and Russian scientific texts. The findings may contribute to the theory and practice of translation and can increase scientific writers’ awareness of inter-language and intercultural differences in evaluative language means.

Keywords: academic discourse, evaluation, scientific text, scientific writing, translation

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2134 Aerobic Capacity Outcomes after an Aerobic Exercise Program with an Upper Body Ergometer in Diabetic Amputees

Authors: Cecilia Estela Jiménez Pérez Campos

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Introduction: Amputation comes from a series of complications in diabetic persons; at that point, of the illness evolution they have a deplored aerobic capacity. Adding to that, cardiac rehabs programs are almost base in several activities in a standing position. The cardiac rehabilitation programs have to improve for them, based on scientific advice. Objective: Evaluation of aerobic capacity of diabetic amputee after an aerobic exercise program, with upper limb ergometer. Methodology: The design is longitudinal, prospective, comparative and no randomized. We include all diabetic pelvic limb amputees, who assist to the cardiac rehabilitation. We made 2 groups: an experimental and a control group. The patients did the exercise testing, with the author’s design protocol. The experimental group completed 24 exercise sessions (3 sessions/week), with an intensity determined with the training heart rate. At the end of 8 weeks period, the subjects did a second exercise test. Results: Both groups were a homogeneous sample in age (experimental n=15) 57.6+12.5 years old and (control n=8) 52.5+8.0 years old, sex, occupation, education and economic features. (square chi) (p=0.28). The initial aerobic capacity was similar in both groups. And the aerobic capacity accomplishes after the program was statistically greater in the experimental group than in the control one. The final media VO2peak (mlO2/kg/min) was experimental (17.1+3.8), control (10.5+3.8), p=0.001. (t student). Conclusions: The aerobic capacity improved after an arm ergometer exercise program and the quality of life improve too, in diabetic amputees. So this program is fundamental in diabetic amputee’s rehabilitation management.

Keywords: aerobic fitness, metabolic equivalent (MET), oxygen output, upper limb ergometer

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2133 Cellulolytic and Xylanolytic Enzymes from Mycelial Fungi

Authors: T. Sadunishvili, L. Kutateladze, T. Urushadze, R. Khvedelidze, N. Zakariashvili, M. Jobava, G. Kvesitadze

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Multiple repeated soil-climatic zones in Georgia determines the diversity of microorganisms. Hundreds of microscopic fungi of different genera have been isolated from different ecological niches, including some extreme environments. Biosynthetic ability of microscopic fungi has been studied. Trichoderma ressei, representative of the Ascomycetes secrete cellulolytic and xylanolytic enzymes that act in synergy to hydrolyze polysaccharide polymers to glucose, xylose and arabinose, which can be fermented to biofuels. The other mesophilic strains producing cellulases are Allesheria terrestris, Chaetomium thermophile, Fusarium oxysporium, Piptoporus betulinus, Penicillium echinulatum, P. purpurogenum, Aspergillus niger, A. wentii, A. versicolor, A. fumigatus etc. In the majority of the cases the cellulases produced by strains of genus Aspergillus usually have high β-glucosidase activity and average endoglucanases levels (with some exceptions), whereas strains representing Trichoderma have high endo enzyme and low β-glucosidase, and hence has limited efficiency in cellulose hydrolysis. Six producers of stable cellulases and xylanases from mesophilic and thermophilic fungi have been selected. By optimization of submerged cultivation conditions, high activities of cellulases and xylanases were obtained. For enzymes purification, their sedimentation by organic solvents such as ethyl alcohol, acetone, isopropanol and by ammonium sulphate in different ratios have been carried out. Best results were obtained with precipitation by ethyl alcohol (1:3.5) and ammonium sulphate. The yields of enzyme according to cellulase activities were 80-85% in both cases. Cellulase activity of enzyme preparation obtained from the strain Trichoderma viride X 33 is 126 U/g, from the strain Penicillium canescence D 85–185U/g and from the strain Sporotrichum pulverulentum T 5-0 110 U/g. Cellulase activity of enzyme preparation obtained from the strain Aspergillus sp. Av10 is 120 U/g, xylanase activity of enzyme preparation obtained from the strain Aspergillus niger A 7-5–1155U/g and from the strain Aspergillus niger Aj 38-1250 U/g. Optimum pH and temperature of operation and thermostability, of the enzyme preparations, were established. The efficiency of hydrolyses of different agricultural residues by the microscopic fungi cellulases has been studied. The glucose yield from the residues as a result of enzymatic hydrolysis is highly determined by the ratio of enzyme to substrate, pH, temperature, and duration of the process. Hydrolysis efficiency was significantly increased as a result of different pretreatment of the residues by different methods. Acknowledgement: The Study was supported by the ISTC project G-2117, funded by Korea.

Keywords: cellulase, xylanase, microscopic fungi, enzymatic hydrolysis

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2132 A Study in Optimization of FSI(Floor Space Index) in Kerala

Authors: Anjali Suresh

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Kerala is well known for its unique settlement pattern; comprising the most part, a continuous spread of habitation. The notable urbanization trend in Kerala is urban spread rather than concentration which points out the increasing urbanization of peripheral areas of existing urban centers. This has thrown a challenge for the authorities to cater the needs of the urban population like to provide affordable housing and infrastructure facilities to sustain their livelihood; which is a matter of concern that needs policy attention in fixing the optimum FSI value. Based on recent reports (Post Disaster Need Analysis –PDNA) from the UN, addressing the unsafe situation of the carpet FAR/FSI practice in the state showcasing the varying geological & climatic conditions should also be the matter of concern. The FSI (Floor space index- the ratio of the built-up space on a plot to the area of the plot) value is certainly one of the key regulation factors in checking the land utilization for the varying occupancies desired for the overall development of a state with limitation in land availability when compared to its neighbors. The pattern of urbanization, physical conditions, topography, etc., varies within the state and can change remarkably over time which identifies that the practicing FSI norms in Kerala does not fulfils the intended function. Thus the FSI regulation is expected to change dynamically from location to location. So for determining the optimum value of FSI /FAR of a region in the state of Kerala, the government agencies should consider the optimum land utilization for the growing urbanization. On the other hand, shall keep in check the overutilization of the same in par with environmental and geographic nature. Therefore the study identifies parameters that should be considered for assigning FSI within the Kerala context, and through expert surveys; opinions arrive at a methodology for assigning an optimum FSI value of a region in the state of Kerala.

Keywords: floor space index, urbanization, density, civic pressure, optimization

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2131 The Prevalence of Cardiovascular Diseases in World-Class Triathletes: An Internet-Based Study from 2006 to 2019

Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

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Background: The prevalence of cardiovascular diseases (CVD) in different triathlon sports disciplines has not been determined. Purpose: The present study aimed to determine the prevalence of CVD in world-class triathletes according to their sex, sports disciplines (aquathlon, duathlon, triathlon…), and formats (short/medium, long, and ultra-long distance). Methods: Male and female elite athletes from eleven triathlon sport disciplines, ranked in the internationally yearly top 10 between 2006 and 2019, were included. The athlete’s name was associated in a Google search with selected key terms related to heart disease and/or cardiac abnormalities. The prevalence and the hazard function of the variation were calculated, and the differences were then compared. Results: From 1329 athletes (male 639, female 690), 13 cases of CVD (0.98%, 95% CI: [0.45-1.51]) were identified, and the mean age of their occurrence was 29±6 years. Although no sex differences were found in each sport discipline/format (p > 0.05), severe outcomes (sudden cardiac arrest/death and those who had to stop their sports practice) were only observed in males. Short-distance triathlon (5.08%, 95% CI: [1.12-9.05]) was more affected than other disciplines in short/medium, long, and ultra-long formats. The prevalence of CVD in athletes who participated in multi-type of sports disciplines (4.14%, 95% CI: [1.14-7.15]) was higher than in those who participated in one type (0.52%, 95% CI: [0.10-0.93]) (p = 0.0004). Conclusion: Athletes in short-distance triathlon were more affected than other disciplines in short/medium, long and ultra-long formats. Athletes who participate in short/medium distances and those who participate in multi-type of sports disciplines should be closely monitored regardless of sex.

Keywords: cardiovascular diseases, sudden cardiac death, triathlon sport disciplines, world-class athletes

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2130 Maryland Restoration of Anterior Tooth Loss as a Minimal Invasive Dentistry: An Alternative Treatment

Authors: B. Oral, C. Bal, M. S. Kar, A. Akgürbüz

Abstract:

Loss of maxillary central incisors occurs in many patients, and the treatment of young adults with this problem is a challenge for both prosthodontists and orthodontists. Common treatment alternatives are distalization of adjacent teeth and fabrication of a conventional 3-unit fixed partial denture, a single implant supported crown restoration or a resin-bonded fixed partial denture. This case report describes the indication of a resin-bonded fixed partial denture, preparation of the abutment teeth and the prosthetic procedures. The technique described here represents a conservative, esthetically pleasing and rapid solution for the missing maxillary central incisor when implant placement and/or guided bone regeneration techniques are not feasible because of financial, social or time restrictions. In this case a 16 year-old female patient who lost her maxillary left central incisor six years ago in a bicycle accident applied to our clinic with a major complaint of her unaesthetic appearance associated with the loss of her maxillary left central incisor. Although there was an indication for orthodontic treatment because of the limited space at the traumatized area, the patient did not accept to receive any orthodontic procedure. That is why an implant supported restoration could not be an option for the narrow area. Therefore maryland bridge as a minimal invasive dental therapy was preferred as a retention appliance so the patient's aesthetic appearance was restored.

Keywords: Maryland bridge, single tooth restoration, aesthetics, maxillary central incisors

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2129 Gellan Gum/Gamma-Polyglutamic Acid and Glycerol Composited Membrane for Guiding Bone Regeneration

Authors: Chi-Chang Lin, Jiun-Yan Chiu

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Periodontal disease, oral cancer relating trauma is the prominent factor devastating bone tissue that is crucial to reestablishing in clinical. As we know, common symptom, osteoporosis, and infection limiting the ability of the bone tissue to recover cause difficulty before implantation therapy. Regeneration of bone tissue is the fundamental therapy before surgical processes. To promote the growth of bone tissue, many commercial products still have sophisticated problems that need to overcome. Regrettably, there is no available material which is apparently preferable for releasing and controlling of loading dosage, or mitigating inflammation. In our study, a hydrogel-based composite membrane has been prepared by using Gellan gum (GG), gamma-polyglutamic acid (γ-PGA) and glycerol with simple sol-gel method. GG is a natural material that is massively adopted in cartilage. Unfortunately, the strength of pure GG film is a manifest weakness especially under simulating body fluidic conditions. We utilize another biocompatible material, γ-PGA as cross-linker which can form tri-dimension structure that enhancing the strength. Our result indicated the strength of pure GG membrane can be obviously improved by cross-linked with γ-PGA (0.5, 0.6, 0.7, 0.8, 0.9, 1.0 w/v%). Besides, blending with glycerol (0, 1.0, 2.0, 3.0 w/v%) can significantly improve membrane toughness that corresponds to practical use. The innovative composited hydrogel made of GG, γ-PGA, and glycerol is attested with neat results including elongation and biocompatibility that take the advantage of extension covering major trauma. Recommendations are made for treatment to build up the foundation of bone tissue that would help patients to escape from the suffering and shorten the amount of time in recovery.

Keywords: bone tissue, gellan gum, regeneration, toughness

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2128 The Relationship between the Competence Perception of Student and Graduate Nurses and Their Autonomy and Critical Thinking Disposition

Authors: Zülfiye Bıkmaz, Aytolan Yıldırım

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This study was planned as a descriptive regressive study in order to determine the relationship between the competency levels of working nurses, the levels of competency expected by nursing students, the critical thinking disposition of nurses, their perceived autonomy levels, and certain socio demographic characteristics. It is also a methodological study with regard to the intercultural adaptation of the Nursing Competence Scale (NCS) in both working and student samples. The sample of the study group of nurses at a university hospital for at least 6 months working properly and consists of 443 people filled out questionnaires. The student group, consisting of 543 individuals from the 4 public university nursing 3rd and 4th grade students. Data collection tools consisted of a questionnaire prepared in order to define the socio demographic, economic, and personal characteristics of the participants, the ‘Nursing Competency Scale’, the ‘Autonomy Subscale of the Sociotropy – Autonomy Scale’, and the ‘California Critical Thinking Disposition Inventory’. In data evaluation, descriptive statistics, nonparametric tests, Rasch analysis and correlation and regression tests were used. The language validity of the ‘NCS’ was performed by translation and back translation, and the context validity of the scale was performed with expert views. The scale, which was formed into its final structure, was applied in a pilot application from a group consisting of graduate and student nurses. The time constancy of the test was obtained by analysis testing retesting method. In order to reduce the time problems with the two half reliability method was used. The Cronbach Alfa coefficient of the scale was found to be 0.980 for the nurse group and 0.986 for the student group. Statistically meaningful relationships between competence and critical thinking and variables such as age, gender, marital status, family structure, having had critical thinking training, education level, class of the students, service worked in, employment style and position, and employment duration were found. Statistically meaningful relationships between autonomy and certain variables of the student group such as year, employment status, decision making style regarding self, total duration of employment, employment style, and education status were found. As a result, it was determined that the NCS which was adapted interculturally was a valid and reliable measurement tool and was found to be associated with autonomy and critical thinking.

Keywords: nurse, nursing student, competence, autonomy, critical thinking, Rasch analysis

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2127 Abstract- Mandible Fractures- A Simple Adjunct to Inform Consent

Authors: Emma Carr, Bilal Aslam-Pervez, David Laraway

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Litigation against surgeons and hospitals continues to increase in Western countries. While verbal consent is all that is required legally, it has for a long time been considered that written consent offers proof of discussion and interaction between the surgeon and the patient. Inadequate consenting of patients continues in the United Kingdom leaving surgeons and Health Trusts open to litigation. We present a standardised consent form which improves patient autonomy and engagement. The General Medical Council recommends that all material risks relevant to the patient are discussed and recorded prior to undergoing surgery, regardless of how likely they are to occur. Current literature was reviewed to evaluate complications associated with surgical management of mandible fractures. Analysis of risks on 52 consent forms were analysed within the Glasgow OMFS department, leading to a procedure-specific form being designed and implemented. This audit showed that the documentation of risks on consent forms was extremely variable- with uncommon risks not being recorded. Interestingly, not a single consent form was found which highlighted all the risks associated with mandible fractures. Our re-audit data confirms 100% of risks being discussed when a procedure specific form is utilised. Our hope, is to introduce further forms for inclusion on the BAOMS website and peripheral distribution. The forms are quick and easy to print and leave more time for consultation with the patient. Whilst we are under no illusion that the forms may not decrease the incidence of intended litigation, we feel confident that they will decrease the chances of it being successful.

Keywords: consent, litigation, mandible fracture, surgery

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2126 Oestrous Synchronization: A Technical Note for Nepalese Goat Farmers

Authors: Pravin Mishra, Ajeet K. Jha, Pankaj K. Jha

Abstract:

This technical note is aimed at providing a brief information on goat breeds, its breeding seasonality and different methods of oestrous synchronization for Nepalese goat farmers. It was observed that, these goats are seasonal breeder and showed oestrous during mainly two season; December- February and March-May. This leads to an irregular supply of goat to market and a wide variations in market price. Oestrus synchronization is only an alternative reproductive tool to overcome this scarcity by enhancing production and productivity. This technique enables goat producers breed their animals within a short pre-determined period and permits breeding round the year. The principle of oestrus synchronisation is based on controlling of the luteal phase of the oestrous cycle. There are two basic mechanisms; one by shortening the luteal life (premature luteolysis) using prostaglandins or its analogues and the other by prolonging the luteal life (simulating the activity of natural progesterone produced by the corpus luteum) using exogenous progesterone source. The former is easy to apply and only effective during breeding season, whereas the latter is advantageous when the reproductive status of the goat flock is unknown. The common hormonal products easily available in Nepal includes; prostaglandins or its analogues (Oviprost® Dinoprost® Lutalyse® and Estrumate®), exogenous progesterone (Fluorogestone acetate® and Controlled Internal Drug Release®, CIDR) devices). However, before practicing the oestrous synchronization protocol, it needs to be validated for oestrous response rate, time to onset of oestrous, duration of oestrous and pregnancy rates at farmer’s field. In conclusion, application of oestrus synchronisation practice enhanced goat production and surplus the goat meat demand in Nepal.

Keywords: goat, Nepal, oestrous, synchronization

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2125 Adjusting Electricity Demand Data to Account for the Impact of Loadshedding in Forecasting Models

Authors: Migael van Zyl, Stefanie Visser, Awelani Phaswana

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The electricity landscape in South Africa is characterized by frequent occurrences of loadshedding, a measure implemented by Eskom to manage electricity generation shortages by curtailing demand. Loadshedding, classified into stages ranging from 1 to 8 based on severity, involves the systematic rotation of power cuts across municipalities according to predefined schedules. However, this practice introduces distortions in recorded electricity demand, posing challenges to accurate forecasting essential for budgeting, network planning, and generation scheduling. Addressing this challenge requires the development of a methodology to quantify the impact of loadshedding and integrate it back into metered electricity demand data. Fortunately, comprehensive records of loadshedding impacts are maintained in a database, enabling the alignment of Loadshedding effects with hourly demand data. This adjustment ensures that forecasts accurately reflect true demand patterns, independent of loadshedding's influence, thereby enhancing the reliability of electricity supply management in South Africa. This paper presents a methodology for determining the hourly impact of load scheduling and subsequently adjusting historical demand data to account for it. Furthermore, two forecasting models are developed: one utilizing the original dataset and the other using the adjusted data. A comparative analysis is conducted to evaluate forecast accuracy improvements resulting from the adjustment process. By implementing this methodology, stakeholders can make more informed decisions regarding electricity infrastructure investments, resource allocation, and operational planning, contributing to the overall stability and efficiency of South Africa's electricity supply system.

Keywords: electricity demand forecasting, load shedding, demand side management, data science

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2124 Prenatal Diagnosis of Beta Thalassemia Intermedia in Vietnamese Family: Case Report

Authors: Ha T. T. Ly, Truc B. Truc, Hai N. Truong, Mai P. T. Nguyen, Ngoc D. Ngo, Khanh V. Tran, Hai T. Le

Abstract:

Beta thalassemia is one of the most common inherited blood disorders, which is characterized by decreased or absent in beta globin expression. Patients with Beta thalassemia whose anemia is not so severe as to necessitate transfusions are said to have thalassemia intermedia. Objective: The goal of this study is prenatal diagnosis for pregnancy woman with Beta thalassemia intermedia and her husband with Beta thalassemia carrier at high risk of Beta thalassemia major in Northern of Vietnam. Material and method: The family has a 6 years-old compound heterozygous thalassemia major for CD71/72(+A) and Hbb:c. -78A>G/nt-28(A>G) male child. The father was heterozygous for CD71/72(+A) mutation which is Beta plus type and the mother was compound heterozygosity of two different variants, namely, Hbb: c. -78A>G/nt-28(A>G) and CD26(A-G) HbE. Prenatal Beta thalassemia mutation detection in fetal DNA was carried out using multiplex Amplification-refractory mutation system ARMS-PCR and confirmed by direct Sanger-sequencing Hbb gene. Prenatal diagnoses were perfomed by amniotic fluid sampling from pregnant woman in the 16-18th week of pregnancy after the genotypes of parents of the probands were identified. Result: When amniotic fluid sample was analyzed for Beta globin gene (Hbb), we found that the genotype is heterozygous for CD71/72(+A) and CD26(A-G) HbE. This genotype is different from the 1st child of this family. Conclusion: Prenatal diagnosis helps the parents to know the genotype and the thalassemia status of the fetus, so they can have early decision on their pregnancy. Genetic diagnosis provided a useful method in diagnosis for familial members in pedigree, genetic counseling and prenatal diagnosis.

Keywords: beta thalassemia intermedia, Hbb gene, pedigree, prenatal diagnosis

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2123 Effectiveness of Management Transfer Programs for Managing Irrigation Resources in Developing Countries: A Case Study of Farmer- and Agency-Managed Schemes from Nepal

Authors: Tirtha Raj Dhakal, Brian Davidson, Bob Farquharson

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Irrigation management transfer has been taken as the important policy instrument for effective irrigation resource management in many developing countries. The change in governance of the irrigation schemes for its day-to-day operation and maintenance has been centered in recent Nepalese irrigation policies also. However, both farmer- and agency-managed irrigation schemes in Nepal are performing well below than expected. This study tries to link the present concerns of poor performance of both forms of schemes with the institutions for its operation and management. Two types of surveys, management and farm surveys; were conducted as a case study in the command area of Narayani Lift Irrigation Project (agency-managed) and Khageri Irrigation System (farmer-managed) of Chitwan District. The farm survey from head, middle and tail regions of both schemes revealed that unequal water distribution exists in these regions in both schemes with greater percentage of farmers experiencing this situation in agency managed scheme. In both schemes, the cost recovery rate was very low, even below five percent in Lift System indicating poor operation and maintenance of the schemes. Also, the institution on practice in both schemes is unable to create any incentives for farmers’ willingness to pay as well as for its economical use in the farm. Thus, outcomes from the study showed that only the management transfer programs may not achieve the goal of efficient irrigation resource management. This may suggest water professionals to rethink about the irrigation policies for refining institutional framework irrespective of the governance of schemes for improved cost recovery and better water distribution throughout the irrigation schemes.

Keywords: cost recovery, governance, institution, irrigation management transfer, willingness to pay

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2122 Literature Review of the Management of Parry Romberg Syndrome with Fillers

Authors: Sana Ilyas

Abstract:

Parry-Romberg syndrome is a rare condition clinically defined by slowly progressive atrophy of the skin and soft tissues. This usually effects one side of the face, although a few cases have been documented of bilateral presentation. It is more prevalent in females and usually affects the left side of the face. The syndrome can also be accompanied by neurological abnormalities. It usually occurs in the first two decades of life with a variable rate of progression. The aetiology is unknown, and the disease eventually stabilises. The treatment options usually involve surgical management. The least invasive of these options is the management of facial asymmetry, associated with Parry Romberg syndrome, through the use of tissue fillers. This paper will review the existing literature on the management of Parry Romberg syndrome with tissue filler. Aim: The aim of the study is to explore the current published literature for the management of Parry Romberg syndrome with fillers. It is to assess the development that has been made in this method of management, its benefits and limitations, and its effectiveness for the management of Parry Romberg syndrome. Methodology: There was a thorough assessment of the current literature published on this topic. PubMed database was used for search of the published literature on this method of the management. Papers were analysed and compared with one another to assess the success and limitation of the management of Parry Romberg with dermal fillers Results and Conclusion: Case reports of the use of tissue fillers discuss the varying degrees of success with the treatment. However, this procedure has it’s limitation, which are discussed in the paper in detail. However, it is still the least invasive of all the surgical options for the management of Parry Romberg Syndrome, and therefore, it is important to explore this option with patients, as they may be more comfortable with pursuingtreatment that is less invasive and can still improve their facial asymmetry

Keywords: dermal fillers, facial asymmetry, parry romberg syndrome, tissue fillers

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2121 Dynamics of Hepatitis B Infection Prevention Practices among Pregnant Women Attending Antenatal Care in Central Uganda Using the Constructs of Information-Motivation-Behavioral Skills Model: A Case of Lubaga Hospital Kampala

Authors: Ismail Bamidele Afolabi, Abdulmujeeb Babatunde Aremu, Lawal Abdurraheem Maidoki, Nnodimele Onuigbo Atulomah

Abstract:

Background: Hepatitis B virus infection remains a significant global public health challenge with infectivity as well as the potential for transmission more than 50 to 100 times that of HIV. Annually, global HBV-related mortality is linked primarily to cirrhosis and liver carcinoma. The ever-increasing endemicity of HBV among children under-5-years, owing to vertical transmission and its lingering chronicity in developing countries, will hamper the global efforts concertedly endorsed towards eliminating viral hepatitis as a global public health threat by 2030. Objective: This study assessed information motivation behavioral skills model constructs as predictors of HBV infection prevention practices among consenting expectant mothers attending antenatal care in Central Uganda as a focal point of intervention towards breaking materno-foetal transmission of HBV. Methods: A cross-sectional study with a quantitative data collection approach based on the constructs of the IMB model was used to capture data on the study variables among 385 randomly selected pregnant women between September and October 2020. Data derived from the quantitative instrument were transformed into weighted aggregate scores using SPSS version 26. ANOVA and regression analysis were done to ascertain the study hypotheses with a significance level set as (p ≤ 0.05). Results: Relatively 60% of the respondents were aged between 18 and 28. Expectant mothers with secondary education (42.3%) were predominant. Furthermore, an average but inadequate knowledge (X ̅=5.97±6.61; B=0.57; p<.001), incorrect perception (X ̅=17.10±18.31; B=0.97; p=.014), and good behavioral skills (X ̅=12.39±13.37; B=0.56; p<.001) for adopting prevention practices all statistically predicted the unsatisfactory level of prevention practices (X ̅=15.03±16.20) among the study respondents as measured on rating scales of 12, 33, 21 and 30 respectively. Conclusion: Evidence from this study corroborates the imperativeness of IMB constructs in reducing the burden of HBV infection in developing countries. Therefore, the inadequate HBV knowledge and misperception among obstetric populations necessitate personalized health education during antenatal visits and subsequent health campaigns in order to inform better prevention practices and, in turn, reduce the lingering chronicity of HBV infection in developing countries.

Keywords: behavioral skills, HBV infection, knowledge, perception, pregnant women, prevention practices

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2120 Assessment of the Efficacy of Routine Medical Tests in Screening Medical Radiation Staff in Shiraz University of Medical Sciences Educational Centers

Authors: Z. Razi, S. M. J. Mortazavi, N. Shokrpour, Z. Shayan, F. Amiri

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Long-term exposure to low doses of ionizing radiation occurs in radiation health care workplaces. Although doses in health professions are generally very low, there are still matters of concern. The radiation safety program promotes occupational radiation safety through accurate and reliable monitoring of radiation workers in order to effectively manage radiation protection. To achieve this goal, it has become mandatory to implement health examination periodically. As a result, based on the hematological alterations, working populations with a common occupational radiation history are screened. This paper calls into question the effectiveness of blood component analysis as a screening program which is mandatory for medical radiation workers in some countries. This study details the distribution and trends of changes in blood components, including white blood cells (WBCs), red blood cells (RBCs) and platelets as well as received cumulative doses from occupational radiation exposure. This study was conducted among 199 participants and 100 control subjects at the medical imaging departments at the central hospital of Shiraz University of Medical Sciences during the years 2006–2010. Descriptive and analytical statistics, considering the P-value<0.05 as statistically significance was used for data analysis. The results of this study show that there is no significant difference between the radiation workers and controls regarding WBCs and platelet count during 4 years. Also, we have found no statistically significant difference between the two groups with respect to RBCs. Besides, no statistically significant difference was observed with respect to RBCs with regards to gender, which has been analyzed separately because of the lower reference range for normal RBCs levels in women compared to men and. Moreover, the findings confirm that in a separate evaluation between WBCs count and the personnel’s working experience and their annual exposure dose, results showed no linear correlation between the three variables. Since the hematological findings were within the range of control levels, it can be concluded that the radiation dosage (which was not more than 7.58 mSv in this study) had been too small to stimulate any quantifiable change in medical radiation worker’s blood count. Thus, use of more accurate method for screening program based on the working profile of the radiation workers and their accumulated dose is suggested. In addition, complexity of radiation-induced functions and the influence of various factors on blood count alteration should be taken into account.

Keywords: blood cell count, mandatory testing, occupational exposure, radiation

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2119 Facilitating Curriculum Access for Pupils with Vision Impairments: An Analysis of the Role of Specialist Teachers in England and Turkey

Authors: Kubra Akbayrak

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In parallel with increasing inclusive practice for pupils with vision impairments, the role of specialist teachers who have specialized in the area of vision impairment has dramatically changed in recent years. This study, therefore, aims to provide a holistic perspective towards the distinctive role of specialist teachers of pupils with vision impairments in different educational settings (including mainstream settings, special school settings, etc.) in Turkey and England. Within the scope of the study, semi-structured interviews have been conducted with 17 specialist teachers in Turkey and 14 specialist teachers in England in order to reveal the perception of specialist teachers regarding their roles in different educational settings as well as their perception towards their pre-service training. As this study is a part of an ongoing PhD research, the qualitative data through semi-structured interviews will be analyzed through using Bronfenbrenner’s ecological systems theory as a theoretical framework in order to provide a holistic view regarding the role of specialist teachers particularly in facilitating curriculum access for pupils with vision impairments in England and Turkey. However, the initial findings broadly illustrate that specialist teachers who work in special school settings have different understanding regarding their roles compared to specialist teachers who work in mainstream settings in relation to promoting independence for pupils with vision impairments. The initial findings also imply that specialist teachers in England and Turkey have different perception about their roles in relation to providing specialist advice and guidance for families of pupils. With the completion of the analysis of the study, it is hoped that the findings will provide an insight into the role of specialist teachers in order to provide implication for programmes which prepare specialist teachers of pupils with vision impairments.

Keywords: curriculum access, pupils with vision impairments, specialist teachers, special education

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2118 The Proportion of and Factors Associated With Thyroid Dysfunction among Individuals Referred To A Tertiary Care Facility in Kabul, Afghanistan

Authors: Mohammad Naeem Lakanwall

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Background:The thyroid gland, located just below the vocal cord on each side of and anterior to the trachea, is one of the main endocrine glands. Its normal weight is 15 to 20 grams in adults. The thyroid secretes two most important hormones, thyroxine and triiodothyronine, usually called T4 and T3, respectively. These hormones greatly increase the metabolic rate of the body. In addition to T3 and T4, the thyroid gland secrets calcitonin as well which is a significant hormone for calcium metabolism. Objective: The aim of this study is to estimate the proportion of and to identify factors associated with thyroid dysfunction among individuals coming to a tertiary care facility in Kabul, Afghanistan. Material and Methods: An analytical cross-sectional study design was conducted from July to Sep 2018. Blood samples were obtained, serum TSH levels were measured, and the patients were divided into three diagnostic categories according to their serum TSH concentrations. 1) Hypothyroidism 2) Hyperthyroidism 3) Normal thyroid Results: A total of 127 individuals were part of the sample for the final analysis. The majority of study participants (77%) were females. A large number of the participants (92%) did not have a family history of thyroid dysfunction and the majority of the female participants, (85%) were not pregnant in the last two years. Furthermore, 98% of participants, were non-smokers. Conclusion: The findings of the current study showed a high prevalence of thyroid dysfunctions in individuals coming to FMIC for thyroid functions tests. The findings also indicated that aging and smoking are the factors associated with thyroid dysfunctions. Further studies are needed to find out the prevalence of and factors associated with thyroid dysfunctions.

Keywords: Afghanistan, Kabul, hypothyroidism, hyperthyroidism, triiodothyronine, thyroxine

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2117 Single-Case Experimental Design: Exploratory Pilot Study on the Feasibility and Effect of Virtual Reality for Pain and Anxiety Management During Care

Authors: Corbel Camille, Le Cerf Flora, Corveleyn Xavier

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Introduction: Aging is a physiological phenomenon accompanied by anatomical and cognitive changes leading to anxiety and pain. This could have significant impacts on quality of life, life expectancy, and the progression of cognitive disorders. Virtual Reality Intervention (VRI) is increasingly recognized as a non-pharmacological approach to alleviate pain and anxiety in children and young adults. However, while recent studies have explored the feasibility of applying VRI in the older population, confirmation through studies is still required to establish its benefits in various contexts. Objective: This pilot study, following a clinical trial methodology international recommendation for VRI in healthcare, aims to evaluate the feasibility and effects of using VRI with a 101-year-old woman residing in a nursing home undergoing weekly painful and anxious wound dressing changes. Methods: Following the international recommendations, this study focused on feasibility and preliminary results. A Single Case Experimental Design protocol consists of two distinct phases: control (Phase A) and personalized VRI (Phase B), each lasting for 6 sessions. Data were collected before, during and after the care, using measures of pain (Algoplus and numerical scale), anxiety (Hospital anxiety scale and numerical scale), VRI experience (semi-structured interview) and physiological measures. Results: The results suggest that the utilization of VRI is both feasible and well-tolerated by the participant. VRI contributed to a decrease in pain and anxiety during care sessions, with a more significant impact on pain compared to anxiety, which showed a gradual and slight decrease. Physiological data, particularly those related to stress, also indicate a reduction in physiological activity during VRI. Conclusion: This pilot study confirms the feasibility and benefits of using virtual reality in managing pain and anxiety in an older adult in a nursing home. In light of these results, it is essential that future studies focus on setting up randomized controlled trials (RCTs). These studies should involve a representative number of older adults to ensure generalizable data. This rigorous, controlled methodology will enable us to assess the effectiveness of virtual reality more accurately in various care settings, measure its impact on clinical parameters such as pain and anxiety, and explore the long-term implications of this intervention.

Keywords: anxiety reduction, nursing home, older adult, pain management, virtual reality

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2116 Acupoint Injection of High Concentration of Glucose Attenuates Mice Chronic Pain and Depression Comorbidity

Authors: Chanya Inprasit, Yi-Wen Lin

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Inflammation causes changes of peripheral and central nervous system properties, affecting both neuronal and non-neuronal cells, resulting in inflammatory pain. Acupoint injection (AI) was developed in the 1950s and has been widely used for relieving pain. It is an acupoint-stimulating technique that utilizes anatomically based meridians derived from Chinese medicine theory. AI has been accepted as an effective treatment and is thought to display superior results when compared to traditional acupuncture methods. However, the mechanism of AI needs to be ratified by more scientific evidence in order to support the theory and its therapeutic development. In this study, we explored the effect of AI on the comorbidity of chronic pain and depression. Mice hindpaw was injected by complete Freund’s adjuvant (CFA) to induce the condition of chronic pain. Measurements of mechanical and thermal hyperalgesia and depression-like behavior were analyzed. The results indicated a positive tendency to AI treatment. The comorbidity of chronic pain and depression was investigated with relation to transient receptor potential V1 (TRPV1) mechanism through the use of TRPV1 gene deletion. The expression of nociceptors such as voltage-gated sodium channels (Navs) or TRPV1, was significantly down-regulated by AI. The expression of inflammation-activated molecules: astrocytic marker glial fibrillary acidic protein (GFAP), the microglial marker Iba-1, S100B, and related kinases, were reversed by AI in both the peripheral and central nervous system. Taken together, these data provided a detailed molecular mechanism of AI-induced analgesia and anti-inflammatory properties. This finding may be utilized for clinical practice to treat chronic pain and depression comorbidity.

Keywords: inflammatory pain, acupoint injection, TRPV1, GFAP, S100B

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