Search results for: lower abdominal surgery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6766

Search results for: lower abdominal surgery

5716 Stress Evaluation at Lower Extremity during Walking with Unstable Shoe

Authors: Sangbaek Park, Seungju Lee, Soo-Won Chae

Abstract:

Unstable shoes are known to strengthen lower extremity muscles and improve gait ability and to change the user’s gait pattern. The change in gait pattern affects human body enormously because the walking is repetitive and steady locomotion in daily life. It is possible to estimate the joint motion including joint moment, force and inertia effect using kinematic and kinetic analysis. However, the change of internal stress at the articular cartilage has not been possible to estimate. The purpose of this research is to evaluate the internal stress of human body during gait with unstable shoes. In this study, FE analysis was combined with motion capture experiment to obtain the boundary condition and loading condition during walking. Motion capture experiments were performed with a participant during walking with normal shoes and with unstable shoes. Inverse kinematics and inverse kinetic analysis was performed with OpenSim. The joint angle and muscle forces were estimated as results of inverse kinematics and kinetics analysis. A detailed finite element (FE) lower extremity model was constructed. The joint coordinate system was added to the FE model and the joint coordinate system was coincided with OpenSim model’s coordinate system. Finally, the joint angles at each phase of gait were used to transform the FE model’s posture according to actual posture from motion capture. The FE model was transformed into the postures of three major phases (1st peak of ground reaction force, mid stance and 2nd peak of ground reaction force). The direction and magnitude of muscle force were estimated by OpenSim and were applied to the FE model’s attachment point of each muscle. Then FE analysis was performed to compare the stress at knee cartilage during gait with normal shoes and unstable shoes.

Keywords: finite element analysis, gait analysis, human model, motion capture

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5715 Experimental Investigation of Folding of Rubber-Filled Circular Tubes on Energy Absorption Capacity

Authors: MohammadSadegh SaeediFakher, Jafar Rouzegar, Hassan Assaee

Abstract:

In this research, mechanical behavior and energy absorption capacity of empty and rubber-filled brazen circular tubes under quasi-static axial loading are investigated, experimentally. The brazen tubes were cut out of commercially available brazen circular tubes with the same length and diameter. Some of the specimens were filled with rubbers with three different shores and also, an empty tube was prepared. The specimens were axially compressed between two rigid plates in a quasi-static process using a Zwick testing machine. Load-displacement diagrams and energy absorption of the tested tubes were extracted from experimental data. The results show that filling the brazen tubes with rubber causes those to absorb more energy and the energy absorption of specimens are increased by increasing the shore of rubbers. In comparison to the empty tube, the first fold for the rubber-filled tubes occurs at lower load and it can be concluded that the rubber-filled tubes are better energy absorbers than the empty tubes. Also, in contrast with the empty tubes, the tubes that were filled with lower rubber shore deform asymmetrically.

Keywords: axial compression, quasi-static loading, folding, energy absorbers, rubber-filled tubes

Procedia PDF Downloads 426
5714 Preliminary Short-Term Results of a Population of Patients Treated with Mitraclip Therapy: One Center Experience

Authors: Rossana Taravella, Gilberto M. Cellura, Giuseppe Cirrincione, Salvatore Asciutto, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Novo

Abstract:

Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effectiveness endpoint. Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study)II trial, the percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age 74±11years, 43 men (69%)] with MR of at least grade3+. Most of the patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+ (primary effectiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients, with a large freedom from death, surgery or recurrent MR in a great portion of patients.

Keywords: MitraClip, mitral regurgitation, heart valves, catheter-based therapy

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5713 Designing Information Systems in Education as Prerequisite for Successful Management Results

Authors: Vladimir Simovic, Matija Varga, Tonco Marusic

Abstract:

This research paper shows matrix technology models and examples of information systems in education (in the Republic of Croatia and in the Germany) in support of business, education (when learning and teaching) and e-learning. Here we researched and described the aims and objectives of the main process in education and technology, with main matrix classes of data. In this paper, we have example of matrix technology with detailed description of processes related to specific data classes in the processes of education and an example module that is support for the process: ‘Filling in the directory and the diary of work’ and ‘evaluation’. Also, on the lower level of the processes, we researched and described all activities which take place within the lower process in education. We researched and described the characteristics and functioning of modules: ‘Fill the directory and the diary of work’ and ‘evaluation’. For the analysis of the affinity between the aforementioned processes and/or sub-process we used our application model created in Visual Basic, which was based on the algorithm for analyzing the affinity between the observed processes and/or sub-processes.

Keywords: designing, education management, information systems, matrix technology, process affinity

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5712 Effects of Harmful Alcohol Consumption and Gender on Academic and Personal-Emotional Adjustment in First Year University Students in Spain

Authors: M. F. Páramo, F. Cadaveira, M. S. Rodríguez

Abstract:

The first year at university is a critical period for personal-emotional and academic adjustment in emerging adults. Moreover, some studies show that alcohol consumption increases in young adults on transition to university. The main purpose of this study was to analyze the impact of hazardous alcohol consumption and gender on adjustment to university, understood as a multidimensional construct involving an array of demands. A sample of 300 first year students in Spain completed the Student Adaptation to College Questionnaire (SACQ) and the Alcohol Use Disorders Identification Test (AUDIT). Examination of the data by analysis of variance revealed that adjustment to university was lower in the students undertaking hazardous alcohol consumption than in the other students. Surprisingly, the personal-emotional adjustment of students with hazardous alcohol consumption was not lower than in the other students. Analysis of the gender effect revealed that levels of personal-emotional adjustment were higher in males than in females. This is our first study examining the influence of alcohol consumption on university adjustment. Future research should examine this relationship more closely, with the aim of designing public health strategies focused on limiting abusive consumption of alcohol in university students.

Keywords: alcohol consumption, first year university students, gender, SACQ

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5711 (De)Criminalising Sex Toys in Thailand: A Law and Economics Approach

Authors: Piyanee Khumpao

Abstract:

Under the Thai Penal Code and Customs Act, sex toys are criminalized and completely prohibited through the legal interpretation as obscene objects by law enforcement, despite there is no explicit legal sanction against them. The purpose of preventing people from accessing sex toys is to preserve public morals. However, sex toys are still available, exposed, and sold publicly in main cities throughout Thailand. They are easily observed by people of any age. This paper argues that sexuality is human nature and human right. Human deserves sexual pleasure as long as getting sexual pleasure does not inflict any harm on others. Using sex toys in private (individually and/or as a couple with mutual consent) does not constitute any harm nor degrade public moral. Therefore, the complete ban of sex toys shall be lifted and decriminalized. Nevertheless, the economic analysis illustrates that criminalization and prohibition of sex toys would lead to its black market – higher price and lower quantity. Although it is socially desirable to have fewer sex toys in the market, there will usually be high demand for them because sexual pleasure is natural and, hence, people have a lower price elasticity of demand for such things, including pornography. Thus, its deterrent effect is not very effective. Moreover, sex toys vendors still always exist because higher price incentivizes them to act illegally and may gain benefits from selling low-quality sex toys. Consequently, consumers do not have a choice to select high-quality sex toys at a reasonable price. Then, they are forced to purchase low quality sex toys at a higher price. They also may suffer from health issues as well as other harms from its dangerous/toxic substances since lower quality products are manufactured poorly to save costs. A law and economics approach supports the decriminalization of sex toys in Thailand. Other measures to control its availability shall be adopted to protect the vulnerable, such as children. Options are i) zoning or regulation on-premises selling sex toys as in Singapore, Japan, and China, ii) regulations of sex toys as medical apparatus like in the state of Alabama, and iii) the prevention of sex toys exposure in the real (physical) appearance (i.e., allowing virtual exposure of sex toys) like in India.

Keywords: human nature, law and economics approach, sex toys, sexual pleasure

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5710 Olive Stone Valorization to Its Application on the Ceramic Industry

Authors: M. Martín-Morales, D. Eliche-Quesada, L. Pérez-Villarejo, M. Zamorano

Abstract:

Olive oil is a product of particular importance within the Mediterranean and Spanish agricultural food system, and more specifically in Andalusia, owing to be the world's main production area. Olive oil processing generates olive stones which are dried and cleaned to remove pulp and olive stones fines to produce biofuel characterized to have high energy efficiency in combustion processes. Olive stones fine fraction is not too much appreciated as biofuel, so it is important the study of alternative solutions to be valorized. Some researchers have studied recycling different waste to produce ceramic bricks. The main objective of this study is to investigate the effects of olive stones addition on the properties of fired clay bricks for building construction. Olive stones were substituted by volume (7.5%, 15%, and 25%) to brick raw material in three different sizes (lower than 1 mm, lower than 2 mm and between 1 and 2 mm). In order to obtain comparable results, a series without olive stones was also prepared. The prepared mixtures were compacted in laboratory type extrusion under a pressure of 2.5MPa for rectangular shaped (30 mm x 60 mm x 10 mm). Dried and fired industrial conditions were applied to obtain laboratory brick samples. Mass loss after sintering, bulk density, porosity, water absorption and compressive strength of fired samples were investigated and compared with a sample manufactured without biomass. Results obtained have shown that olive stone addition decreased mechanical properties due to the increase in water absorption, although values tested satisfied the requirements in EN 772-1 about methods of test for masonry units (Part 1: Determination of compressive strength). Finally, important advantages related to the properties of bricks as well as their environmental effects could be obtained with the use of biomass studied to produce ceramic bricks. The increasing of the percentage of olive stones incorporated decreased bulk density and then increased the porosity of bricks. On the one hand, this lower density supposes a weight reduction of bricks to be transported, handled as well as the lightening of building; on the other hand, biomass in clay contributes to auto thermal combustion which involves lower fuel consumption during firing step. Consequently, the production of porous clay bricks using olive stones could reduce atmospheric emissions and improve their life cycle assessment, producing eco-friendly clay bricks.

Keywords: clay bricks, olive stones, sustainability, valorization

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5709 In Search of Zero Beta Assets: Evidence from the Sukuk Market

Authors: Andrea Paltrinieri, Alberto Dreassi, Stefano Miani, Alex Sclip

Abstract:

The financial crises caused a collapse in prices of most asset classes, raising the attention on alternative investments such as Sukuk, a smaller, fast growing but often misunderstood market. We study diversification benefits of Sukuk, their correlation with other asset classes and the effects of their inclusion in investment portfolios of institutional and retail investors, through a comprehensive comparison of their risk/return profiles during and after the financial crisis. We find a beneficial performance adjusted for the specific volatility together with a lower correlation especially during the financial crisis. The distribution of Sukuk returns is positively skewed and leptokurtic, with a risk/return profile similarly to high yield bonds. Overall, our results suggest that Sukuk present diversification opportunities, a significant volatility-adjusted performance and lower correlations especially during the financial crisis. Our findings are relevant for a number of institutional investors. Long term investors, such as life insurers would benefit from Sukuk’s protective features during financial crisis yet keeping return and growth opportunities, whereas banks would gain due to their role of placers, advisors, market makers or underwriters.

Keywords: sukuk, zero beta asset, asset allocation, sukuk market

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5708 Influence of Chelators, Zn Sulphate and Silicic Acid on Productivity and Meat Quality of Fattening Pigs

Authors: A. Raceviciute-Stupeliene, V. Sasyte, V. Viliene, V. Slausgalvis, J. Al-Saifi, R. Gruzauskas

Abstract:

The objective of this study was to investigate the influence of special additives such as chelators, zinc sulphate and silicic acid on productivity parameters, carcass characteristics and meat quality of fattening pigs. The test started with 40 days old fattening pigs (mongrel (mother) and Yorkshire (father)) and lasted up to 156 days of age. During the fattening period, 32 pigs were divided into 2 groups (control and experimental) with 4 replicates (total of 8 pens).  The pigs were fed for 16 weeks’ ad libitum with a standard wheat-barley-soybean meal compound (Control group) supplemented with chelators, zinc sulphate and silicic acid (dosage 2 kg/t of feed, Experimental group). Meat traits in live pigs were measured by ultrasonic equipment Piglog 105. The results obtained throughout the experimental period suggest that supplementation of chelators, zinc sulphate and silicic acid tend to positively affect average daily gain and feed conversion ratio of pigs for fattening (p < 0.05). Pigs’ evaluation with Piglog 105 showed that thickness of fat in the first and second point was by 4% and 3% respectively higher in comparison to the control group (p < 0.05). Carcass weight, yield, and length, also thickness of fat showed no significant difference among the groups. The water holding capacity of meat in Experimental group was lower by 5.28%, and tenderness – lower by 12% compared with that of the pigs in the Control group (p < 0.05). Regarding pigs’ meat chemical composition of the experimental group, a statistically significant difference comparing with the data of the control group was not determined. Cholesterol concentration in muscles of pigs fed diets supplemented with chelators, zinc sulphate and silicic acid was lower by 7.93 mg/100 g of muscle in comparison to that of the control group. These results suggest that supplementation of chelators, zinc sulphate and silicic acid in the feed for fattening pigs had significant effect on pigs growing performance and meat quality.

Keywords: silicic acid, chelators, meat quality, pigs, zinc sulphate

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5707 Testing the Effectiveness of a Peer Facilitated Body Project Interventions Among Body Dissatisfied Young Women in China: A Randomized Control Trial

Authors: Todd Jackson

Abstract:

In this randomized control trial, we tested the effectiveness of a peer-facilitated version of the Body Project (BP) intervention among body-dissatisfied young women in China. Participants were randomly assigned to a peer-facilitator BP condition (N = 94) versus an educational video minimal intervention control condition (N = 89). Questionnaire measures of two primary outcomes (i.e., disordered eating and body dissatisfaction) and six secondary outcomes (thin-ideal internalization, pressure to be thin, negative affect, body surveillance, body shame, body appreciation and interest in cosmetic surgery) were administered at a pre-treatment baseline, a post-treatment assessment, and at a 12-month follow-up. A series of 2 (Group) x 2 (Time) analyses of variance indicated women in the peer-facilitated BP condition reported significant improvements in primary outcome measures of disordered eating and body dissatisfaction compared to women in the educational video control condition following treatment and at the 12-month follow-up. Furthermore, women in the peer-facilitated BP condition reported significant improvements in measures of body surveillance, body shame and body appreciation) compared to educational video controls that extended to the 12-month follow-up. Finally, although women in the peer-facilitated BP condition showed significant post-treatment improvements in thin-ideal internalization, negative affect, perceived pressure to be thin, and interest in cosmetic surgery compared to video controls, these differences were no longer statistically significant at the 12-month follow-up. In conclusion, findings supported the overall effectiveness of a peer-facilitated group version of the BP as an intervention for reducing disordered eating and several associated risk factors among at-risk young women in China.

Keywords: body project, disordered eating, body dissatisfaction, risk factors, prevention, China

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5706 Prostheticly Oriented Approach for Determination of Fixture Position for Facial Prostheses Retention in Cases with Atypical and Combined Facial Defects

Authors: K. A.Veselova, N. V.Gromova, I. N.Antonova, I. N. Kalakutskii

Abstract:

There are many diseases and incidents that may result facial defects and deformities: cancer, trauma, burns, congenital anomalies, and autoimmune diseases. In some cases, patient may acquire atypically extensive facial defect, including more than one anatomical region or, by contrast, atypically small defect (e.g. partial auricular defect). The anaplastology gives us opportunity to help patient with facial disfigurement in cases when plastic surgery is contraindicated. Using of implant retention for facial prosthesis is strongly recommended because improves both aesthetic and functional results and makes using of the prosthesis more comfortable. Prostheticly oriented fixture position is extremely important for aesthetic and functional long-term result; however, the optimal site for fixture placement is not clear in cases with atypical configuration of facial defect. The objective of this report is to demonstrate challenges in fixture position determination we have faced with and offer the solution. In this report, four cases of implant-supported facial prosthesis are described. Extra-oral implants with four millimeter length were used in all cases. The decision regarding the quantity of surgical stages was based on anamnesis of disease. Facial prostheses were manufactured according to conventional technique. Clinical and technological difficulties and mistakes are described, and prostheticly oriented approach for determination of fixture position is demonstrated. The case with atypically large combined orbital and nasal defect resulting after arteriovenous malformation is described: the correct positioning of artificial eye was impossible due to wrong position of the fixture (with suprastructure) located in medial aspect of supraorbital rim. The suprastructure was unfixed and this fixture wasn`t used for retention in order to achieve appropriate artificial eye placement and better aesthetic result. In other case with small partial auricular defect (only helix and antihelix were absent) caused by squamoized cell carcinoma T1N0M0 surgical template was used to avoid the difficulties. To achieve the prostheticly oriented fixture position in case of extremely small defect the template was made on preliminary cast using vacuum thermoforming method. Two radiopaque markers were incorporated into template in preferable for fixture placement positions taking into account future prosthesis configuration. The template was put on remaining ear and cone-beam CT was performed to insure, that the amount of bone is enough for implant insertion in preferable position. Before the surgery radiopaque markers were extracted and template was holed for guide drill. Fabrication of implant-retained facial prostheses gives us opportunity to improve aesthetics, retention and patients’ quality of life. But every inaccuracy in planning leads to challenges on surgery and prosthetic stages. Moreover, in cases with atypically small or extended facial defects prostheticly oriented approach for determination of fixture position is strongly required. The approach including surgical template fabrication is effective, easy and cheap way to avoid mistakes and unpredictable result.

Keywords: anaplastology, facial prosthesis, implant-retained facial prosthesis., maxillofacil prosthese

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5705 The Effects of Topically-Applied Skin Moisturizer on Striae Gravidarum in East Indian Women

Authors: Dipanshu Sur, Ratnabali Chakravorty

Abstract:

Background: Striae result from rapid expansion of the underlying tissue, e.g. during puberty, pregnancy or rapid weight gain. Prior data indicate that the incidence of stretch marks in Indian women is 77%.The hormonal and genetic factors are associated with their appearance. Recently that has been found skin extensibility, elasticity and rupture were strongly influenced by the water content of dermis and epidermis cells. Objective: The objectives were to assess the effects of topical treatments applied during pregnancy on the later development of stretch marks. Materials and methods: An open, prospective, randomized study was done on 120 pregnant women in whom skin elasticity and hydration as well as striae presence or apparition were measured at baseline and periodically until delivery. Patients were randomly assigned to application in wet skin cream, or in dry skin conditions. Results: The average basal hydration was 42 ±13 IU and the final was 46 ± 6 IU (P = 0.0325; 95% CI: -7.66 to -0.34), which difference was statistically significant. By measuring the moisture in the control region (forearm) a basal reading of 40 ± 9 IU and end of study of 38 ± 6; (p = 0.1547; 95% CI: -0.77 to 4.77) and this difference was considered to be not statistically significant. It was observed that at the end of the study, 55% women without ridges; mild ridges 5%; 36% moderate, and 4%, severe ridges. The proportion of women without grooves was 54% when the cream was applied studied wet skin and 45% when the cream was applied on dry skin. Conclusion: It was shown that cream under study increased hydration and elasticity of abdominal skin consequently in all subjects. This effect is more significant (54%) when the cream is applied to damp skin.

Keywords: striae gravidarum, skin moisturizer, skin hydration, skin elasticity

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5704 UEMG-FHR Coupling Analysis in Pregnancies Complicated by Pre-Eclampsia and Small for Gestational Age

Authors: Kun Chen, Yan Wang, Yangyu Zhao, Shufang Li, Lian Chen, Xiaoyue Guo, Jue Zhang, Jing Fang

Abstract:

The coupling strength between uterine electromyography (UEMG) and Fetal heart rate (FHR) signals during peripartum reflects the fetal biophysical activities. Therefore, UEMG-FHR coupling characterization is instructive in assessing placenta function. This study introduced a physiological marker named elevated frequency of UEMG-FHR coupling (E-UFC) and explored its predictive value for pregnancies complicated by pre-eclampsia and small for gestational age (SGA). Placental insufficiency patients (n=12) and healthy volunteers (n=24) were recruited and participated. UEMG and FHR were recorded non-invasively by a trans-abdominal device in women at term with singleton pregnancy (32-37 weeks) from 10:00 pm to 8:00 am. The product of the wavelet coherence and the wavelet cross-spectral power between UEMG and FHR was used to weight these two effects in order to quantify the degree of the UEMG-FHR coupling. E-UFC was exacted from the resultant spectrogram by calculating the mean value of the high-coherence (r > 0.5) frequency band. Results showed the high-coherence between UEMG and FHR was observed in the frequency band (1/512-1/16Hz). In addition, E-UFC in placental insufficiency patients was weaker compared to healthy controls (p < 0.001) at group level. These findings suggested the proposed approach could be used to quantitatively characterize the fetal biophysical activities, which is beneficial for early detection of placental insufficiency and reduces the occurrence of adverse pregnancy.

Keywords: uterine electromyography, fetal heart rate, coupling analysis, wavelet analysis

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5703 In Support of Sustainable Water Resources Development in the Lower Mekong River Basin: Development of Guidelines for Transboundary Environmental Impact Assessment

Authors: Kongmeng Ly

Abstract:

The management of transboundary river basins across developing countries, such as the Lower Mekong River Basin (LMB), is frequently challenging given the development and conservation divergences of the basin countries. Driven by needs to sustain economic performance and reduce poverty, the LMB countries (Cambodia, Lao PDR, Thailand, Viet Nam) are embarking on significant land use changes in the form hydropower dam, to fulfill their energy requirements. This pathway could lead to irreversible changes to the ecosystem of the Mekong River, if not properly managed. Given the uncertain trade-offs of hydropower development and operation, the Lower Mekong River Basin Countries through the technical support of the Mekong River Commission (MRC) Secretariat embarked on decade long the development of Technical Guidelines for Transboundary Environmental Impact Assessment. Through a series of workshops, seminars, national and regional consultations, and pilot studies and further development following the recommendations generated through legal and institutional reviews undertaken over two decades period, the LMB Countries jointly adopted the MRC Technical Guidelines for Transboundary Environmental Impact Assessment (TbEIA Guidelines). These guidelines were developed with particular regard to the experience gained from MRC supported consultations and technical reviews of the Xayaburi Dam Project, Don Sahong Hydropower Project, Pak Beng Hydropower Project, and lessons learned from the Srepok River and Se San River case studies commissioned by the MRC under the generous supports of development partners around the globe. As adopted, the TbEIA Guidelines have been designed as a supporting mechanism to the national EIA legislation, processes and systems in each Member Country. In recognition of the already agreed mechanisms, the TbEIA Guidelines build on and supplement the agreements stipulated in the 1995 Agreement on the Cooperation for the Sustainable Development of the Mekong River Basin and its Procedural Rules, in addressing potential transboundary environmental impacts of development projects and ensuring mutual benefits from the Mekong River and its resources. Since its adoption in 2022, the TbEIA Guidelines have already been voluntary implemented by Lao PDR on its underdevelopment Sekong A Downstream Hydropower Project, located on the Sekong River – a major tributary of the Mekong River. While this implementation is ongoing with results expected in early 2024, the implementation thus far has strengthened cooperation among concerned Member Countries with multiple successful open dialogues organized at national and regional levels. It is hope that lessons learnt from this application would lead to a wider application of the TbEIA Guidelines for future water resources development projects in the LMB.

Keywords: transboundary, EIA, lower mekong river basin, mekong river

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5702 Evaluating Portfolio Performance by Highlighting Network Property and the Sharpe Ratio in the Stock Market

Authors: Zahra Hatami, Hesham Ali, David Volkman

Abstract:

Selecting a portfolio for investing is a crucial decision for individuals and legal entities. In the last two decades, with economic globalization, a stream of financial innovations has rushed to the aid of financial institutions. The importance of selecting stocks for the portfolio is always a challenging task for investors. This study aims to create a financial network to identify optimal portfolios using network centralities metrics. This research presents a community detection technique of superior stocks that can be described as an optimal stock portfolio to be used by investors. By using the advantages of a network and its property in extracted communities, a group of stocks was selected for each of the various time periods. The performance of the optimal portfolios compared to the famous index. Their Sharpe ratio was calculated in a timely manner to evaluate their profit for making decisions. The analysis shows that the selected potential portfolio from stocks with low centrality measurement can outperform the market; however, they have a lower Sharpe ratio than stocks with high centrality scores. In other words, stocks with low centralities could outperform the S&P500 yet have a lower Sharpe ratio than high central stocks.

Keywords: portfolio management performance, network analysis, centrality measurements, Sharpe ratio

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5701 Investigation on Scattered Dose Rate and Exposure Parameters during Diagnostic Examination Done with an Overcouch X-Ray Tube in Nigerian Teaching Hospital

Authors: Gbenga Martins, Christopher J. Olowookere, Lateef Bamidele, Kehinde O. Olatunji

Abstract:

The aims of this research are to measure the scattered dose rate during an X-ray examination in an X-ray room, compare the scattered dose rate with exposure parameters based on the body region examined, and examine the X-ray examination done with an over couch tube. The research was carried out using Gamma Scout software installation on the computer system (Laptop) to record the radiation counts, pulse rate, and dose rate. The measurement was employed by placing the detector at 900 to the incident X-ray. Proforma was used for the collection of patients’ data such as age, sex, examination type, and initial diagnosis. Data such as focus skin distance (FSD), body mass index (BMI), body thickness of the patients, the beam output (kVp) were collected at Obafemi Awolowo University, Ile-Ife, Western Nigeria. Total number of 136 patients was considered during this research. Dose rate range between 14.21 and 86.78 µSv/h for the plain abdominal region, 85.70 and 2.86 µSv/h for the lumbosacral region,1.3 µSv/yr and 3.6 µSv/yr in the pelvis region, 2.71 µSv/yr and 28.88 µSv/yr for leg region, 3.06 µSv/yr and 29.98 µSv/yr in hand region. The results of this study were compared with those of other studies carried out in other countries. The findings of this study indicated that the number of exposure parameters selected for each diagnostic examination contributed to the dose rate recorded. Therefore, these results call for a quality assurance program (QAP) in diagnostic X-ray units in Nigerian hospitals.

Keywords: X-radiation, exposure parameters, dose rate, pulse rate, number of counts, tube current, tube potential, diagnostic examination, scattered radiation

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5700 Reducing Phytic Acid in Rice Grain by Targeted Mutagenesis of a Phospholipase D Gene

Authors: Muhammad Saad Shoaib Khan, Rasbin Basnet, Qingyao Shu

Abstract:

Phospholipids are one of the major classes of lipid comprising 10% of total grain lipid in rice. Phospholipids are the main phosphorus containing lipid in the rice endosperm, contributing to rice palatability and seed storage property. However, in the rice grain, the majority of phosphorus occur in the form of phytic acid and are highly abundant in the bran. Phytic acid, also known as hexaphosphorylated inositol (IP6), are strong chelating agents which reduces the bioavailability of essential dietary nutrients and are therefore less desirable by rice breeders. We used the CRISPR/Cas9 system to generate mutants of a phospholipase D gene (PLDα1), which is responsible for the degradation of phospholipids into phosphatidic acid (PA). In the mutants, we found a significant reduction in the concentration of phytic acid in the grain as compared to the wild-type. The biochemical analysis of the PLDα1 mutants showed that the decrease in production of phosphatidic acid is due to reduced accumulation of CDP-diacylglycerolderived phosphatidylinositol (PI), ultimately leading to lower accumulation of phytic acid in mutants. These results showed that loss of function of PLD in rice leads to lower production of phytic acid, suggesting the potential application of Ospldα1 in breeding rice with less phytic acid.

Keywords: CRISPR/Cas9, phospholipase D, phytic acid, rice

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5699 Cat Stool as an Additive Aggregate to Garden Bricks

Authors: Mary Joy B. Amoguis, Alonah Jane D. Labtic, Hyna Wary Namoca, Aira Jane V. Original

Abstract:

Animal waste has been rapidly increasing due to the growing animal population and the lack of innovative waste management practices. In a country like the Philippines, animal waste is rampant. This study aims to minimize animal waste by producing garden bricks using cat stool as an additive. The research study analyzes different levels of concentration to determine the most efficient combination in terms of compressive strength and durability of cat stool as an additive to garden bricks. The researcher's first collects the cat stool and incinerates the different concentrations. The first concentration is 25% cat stool and 75% cement mixture. The second concentration is 50% cat stool and 50% cement mixture. And the third concentration is 75% cat stool and 25% cement mixture. The researchers analyze the statistical data using one-way ANOVA, and the statistical analysis revealed a significant difference compared to the controlled variable. The research findings show an inversely proportional relationship: the higher the concentration of cat stool additive, the lower the compressive strength of the bricks, and the lower the concentration of cat stool additive, the higher the compressive strength of the bricks.

Keywords: cat stool, garden bricks, cement, concentrations, animal wastes, compressive strength, durability, one-way ANOVA, additive, incineration, aggregates, stray cats

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5698 Social Justice and Castes Discrimination: Experiences of Scheduled Castes Students in India

Authors: Dhaneswar Bhoi

Abstract:

In Indian History, the Dalits (Scheduled Castes) were exploited with caste, since the Vedic Age (1500 BCE). They were deprived of many rights in the society and their education was also restricted by the upper castes since the introduction of the Law of Manu (1500 BCE). The Dalits were treated as lower castes (Sudras and Ati-Sudra) in the society. Occupation of these caste groups were attached to some low profile and menial occupation. Whereas, the upper caste (Brahamins) declared themselves as the top most caste groups who chose the occupation of priests and had the supreme right to education. During those days occupation was not decided by the caliber of a person rather, it was decided by the upper caste Brahamins and kept on transferring from one generation to another generation. At this juncture of the society, the upper caste people oppressed and suppressed the lower caste people endlessly. To get rid of these social problems the emancipator and the charismatic leader (Prophet for the lower caste communities), Dr. Babasaheb Ambedkar appeard in the scene of Indian unjust society. Restlessly he fought against the caste oppression, social dogmas and tyranny on the basis of caste. Finally, he succeeded to affirm statutory safeguards for the oppressed and depressed or lower caste communities. Today these communities are scheduled as Scheduled Castes to access social justice for their upliftment and development. Through the liberty, equality and fraternity, he established social justice for the first time in the Indian history with the implementation of Indian Constitution on 26th January 1950. Since then the social justice has been accessed through the Constitution and Indian Republics. However, even after sixty five years of the Indian Republic and Constitutional safeguards the Scheduled Castes (SCs) are suffering many problems in the phases of their life. Even if there are special provisions made by the state aimed to meet the challenges of the weaker sections, they are still deprived of access to it, which is true especially for the Dalits or SCs. Many of the people of these communities are still not accessing education and particularly, higher education. Those who are managing to access the education have been facing many challenges in their educational premises as well as in their social life. This paper tries to find out the problem of discrimination in educational and societal level. Secondly, this paper aims to know the relation between the discrimination and access to social justice for the SCs in the educational institution and society. It also enquires the experiences of SCs who faced discrimination in their educational and social life. This study is based on the both quantitative and qualitative methods. Both of which were interpreted through the data triangulation method in mixed methodology approach. In this paper, it is found that the SCs are struggling with injustice in their social and educational spheres. Starting from their primary level to higher education, they were discriminated in curricular, co-curricular and extra-curricular activities.

Keywords: social justice, discrimination, caste, scheduled castes, education

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5697 Motor Vehicle Accidents During Pregnancy: Analysis of Maternal and Fetal Outcome at a University Hospital

Authors: Manjunath Attibele, Alsawafi Manal, Al Dughaishi Tamima

Abstract:

Introduction: The purpose of this study was to describe the clinical characteristics and types of mechanisms of injuries caused by Motor vehicle accidents (MVA) during pregnancy. To analyze the patterns of accidents during pregnancy and its adverse consequences on both maternal and fetal outcome. Methods: This was a retrospective cohort study on pregnant patients who met with MVAs The study period was from January 1, 2010, to December 31, 2019. All relevant data were retrieved from electronic patients’ records from the hospital information system and from the antenatal ward admission register Results: Out of 168 women who had motor vehicle accidents during the study period, of which, 39 (23.2%) women during pregnancy. Twenty-one (53.8%) women were over 30 years old. Thirty-five (89.7%) women were Omanis, and 27 (69.2%) were in their third trimester. Twenty-three (59%) of accidents happened at night, and 31 (79.5%) of them happened on a weekday. Twenty-two (56.4%) of women were driving themselves, and 24 (61.5%) of them were not using any seatbelt. Accident related abdominal & back pain was seen in 23(59%) women. Regarding the outcome of pregnancy, 23 (74.2%) had a normal vaginal delivery. The mean accident to delivery interval was 7 weeks. Thirty (96.7%) of involved newborns were relatively healthy. One woman (3.2%) had a ruptured uterusleading to fetal death (3.2%). Conclusion: This study showed that the incidence of motor vehicle accidents during pregnancy is around 23.2% . Majority had trauma-associated pain. One serious injury to a woman causing a ruptured uterus which lead to fetal death. Majority of involved newborns were relatively healthy. No reported maternal death.

Keywords: motor vehicle accidents, pregnancy, maternal outcome, fetal outcome

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5696 Characterization of the Intestinal Microbiota: A Signature in Fecal Samples from Patients with Irritable Bowel Syndrome

Authors: Mina Hojat Ansari, Kamran Bagheri Lankarani, Mohammad Reza Fattahi, Ali Reza Safarpour

Abstract:

Irritable bowel syndrome (IBS) is a common bowel disorder which is usually diagnosed through the abdominal pain, fecal irregularities and bloating. Alteration in the intestinal microbial composition is implicating to inflammatory and functional bowel disorders which is recently also noted as an IBS feature. Owing to the potential importance of microbiota implication in both efficiencies of the treatment and prevention of the diseases, we examined the association between the intestinal microbiota and different bowel patterns in a cohort of subjects with IBS and healthy controls. Fresh fecal samples were collected from a total of 50 subjects, 30 of whom met the Rome IV criteria for IBS and 20 Healthy control. Total DNA was extracted and library preparation was conducted following the standard protocol for small whole genome sequencing. The pooled libraries sequenced on an Illumina Nextseq platform with a 2 × 150 paired-end read length and obtained sequences were analyzed using several bioinformatics programs. The majority of sequences obtained in the current study assigned to bacteria. However, our finding highlighted the significant microbial taxa variation among the studied groups. The result, therefore, suggests a significant association of the microbiota with symptoms and bowel characteristics in patients with IBS. These alterations in fecal microbiota could be exploited as a biomarker for IBS or its subtypes and suggest the modification of the microbiota might be integrated into prevention and treatment strategies for IBS.

Keywords: irritable bowel syndrome, intestinal microbiota, small whole genome sequencing, fecal samples, Illumina

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5695 Effect of Foot Posture and Fatigue on Static Balance and Electromyographic Activity of Selected Lower Limb Muscles in School Children Aged 12 to 14 Years

Authors: Riza Adriyani, Tommy Apriantono, Suprijanto

Abstract:

Objective: Several studies have revealed that flatfoot posture has some effect on altered lower limb muscle function, in comparison to normal foot posture. There were still limited studies to examine the effect of fatigue on flatfoot posture in children. Therefore, this study was aimed to find out jumping fatiguing effect on static balance and to compare lower limb muscle function between flatfoot and normal foot in school children. Methods: Thirty junior high school children aged 12 to 14 years took part in this study. Of these all children, 15 had the normal foot (8 males and 7 females) and 15 had flatfoot (6 males and 9 females). Foot posture was classified based on an arch index of the footprint by a foot scanner which calculated the data using AUTOCAD 2013 software. Surface electromyography (EMG) activity was recorded from tibialis anterior, gastrocnemius medialis, and peroneus longus muscles while those participants were standing on one leg barefoot with opened eyes. All participants completed the entire protocol (pre-fatigue data collection, fatigue protocol, and post fatigue data collection) in a single session. Static balance and electromyographic data were collected before and after a functional fatigue protocol. Results: School children with normal foot had arch index 0.25±0.01 whereas those with flatfoot had 0.36±0.01. In fact, there were no significant differences for anthropometric characteristics between children with flatfoot and normal foot. This statistical analysis showed that fatigue could influence static balance in flatfoot school children (p < 0.05), but not in normal foot school children. Based on electromyographic data, the statistical analysis showed that there were significant differences (p < 0.05) of the decreased median frequency on tibialis anterior in flatfoot compared to normal foot school children after fatigue. However, there were no significant differences on the median frequency of gastrocnemius medialis and peroneus longus between both groups. After fatigue, median frequency timing was significantly different (p < 0.05) on tibialis anterior in flatfoot compared to normal foot children and tended to appear earlier on tibialis anterior, gastrocnemius medialis and peroneus longus (at 7s, 8s, 9s) in flatfoot compared to normal foot (at 15s, 11s , 12s). Conclusion: Fatigue influenced static balance and tended to appear earlier on selected lower limb muscles while performing static balance in flatfoot school children. After fatigue, tremor (median frequency decreased) showed more significant differences on tibialis anterior in flatfoot rather than in normal foot school children.

Keywords: fatigue, foot postures, median frequency, static balance

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5694 Ex Vivo Permeation Comparison Study of Flurbiprofen from Nanoparticles through Human Skin

Authors: Sheimah El Bejjaji, Lara Gorsek, Chandler Quilchez, Joaquim Suñer, Mireia Mallandrich

Abstract:

Flurbiprofen is an anti-inflammatory drug used in several treatments. The purpose of this study was to compare the permeation of two different formulations of flurbiprofen through the human skin. The first formulation was a solution of flurbiprofen dissolved with polyethylene glycol 3350 (PEG 3350). The second formulation was flurbiprofen encapsulated in poly-ɛ-caprolactone (PɛCL) nanoparticles (NPs), stabilized with poloxamer 188, submitted individually for freeze-drying with PEG 3350 as a cryoprotectant and sterilized by gamma-irradiation. Human skin was obtained from the abdominal region of a healthy patient. The experimental protocol was approved by the Bioethics Committee of Barcelona SCIAS Hospital (Spain), and they obtained the written informed consent forms. After being frozen to -20ºC, the skin samples were cut with a dermatome at 400 µm. The ex vivo permeation study was performed in Franz diffusion cells with a diffusion area of 2.54 cm². Skin samples were placed between two compartment sites, the dermal side in contact with the receptor medium and the epidermis side in contact with the donor chamber to which the formulation was applied. The permeation study was conducted for 24 hours at 32 ± 0.5 °C in accordance with sink conditions. The results were analyzed with an unpaired t-test, and the p-values indicate the formulation with nanoparticles had a higher permeability coefficient, flux, partition parameter, diffusion parameter, and lag time. The applicability of this formulation topically can benefit articulations and ligament inflammation as an alternative to oral drugs.

Keywords: anti-inflammatory drug, flurbiprofen, human skin, nanoparticles, skin permeation

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5693 Microstructure Dependent Fatigue Crack Growth in Aluminum Alloy

Authors: M. S. Nandana, K. Udaya Bhat, C. M. Manjunatha

Abstract:

In this study aluminum alloy 7010 was subjected to three different ageing treatments i.e., peak ageing (T6), over-ageing (T7451) and retrogression and re ageing (RRA) to study the influence of precipitate microstructure on the fatigue crack growth rate behavior. The microstructural modification was studied by using transmission electron microscope (TEM) to examine the change in the size and morphology of precipitates in the matrix and on the grain boundaries. The standard compact tension (CT) specimens were fabricated and tested under constant amplitude fatigue crack growth tests to evaluate the influence of heat treatment on the fatigue crack growth rate properties. The tests were performed in a computer-controlled servo-hydraulic test machine applying a load ratio, R = 0.1 at a loading frequency of 10 Hz as per ASTM E647. The fatigue crack growth was measured by adopting compliance technique using a CMOD gauge attached to the CT specimen. The average size of the matrix precipitates were found to be of 16-20 nm in T7451, 5-6 nm in RRA and 2-3 nm in T6 conditions respectively. The grain boundary precipitate which was continuous in T6, was disintegrated in RRA and T7451 condition. The PFZ width was lower in RRA compared to T7451 condition. The crack growth rate was higher in T7451 and lowest in RRA treated alloy. The RRA treated alloy also exhibits an increase in threshold stress intensity factor range (∆Kₜₕ). The ∆Kₜₕ measured was 11.1, 10.3 and 5.7 MPam¹/² in RRA, T6 and T7451 alloys respectively. The fatigue crack growth rate in RRA treated alloy was nearly 2-3 times lower than that in T6 and was one order lower than that observed in T7451 condition. The surface roughness of RRA treated alloy was more pronounced when compared to the other conditions. The reduction in fatigue crack growth rate in RRA alloy was majorly due to the increase in roughness and partially due to increase in spacing between the matrix precipitates. The reduction in crack growth rate and increase in threshold stress intensity range is expected to benefit the damage tolerant capability of aircraft structural components under service loads.

Keywords: damage tolerance, fatigue, heat treatment, PFZ, RRA

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5692 Dynamic Response of Magnetorheological Fluid Tapered Laminated Beams Reinforced with Nano-Particles

Authors: Saman Momeni, Abolghassem Zabihollah, Mehdi Behzad

Abstract:

Non-uniform laminated composite structures are being used in many engineering applications where the structures are subjected to unpredicted vibration. To mitigate the vibration response of these structures, recently, magnetorheological fluid (MR), is added to non-uniform (tapered) thickness laminated composite structures to achieve a new generation of the smart composite as MR tapered beam. However, due to the nature of MR fluid, especially the low stiffness, MR tapered beam exhibit lower stiffness and in turn, lower natural frequencies. To achieve the basic design requirements of the structure without MR fluid, one may need to apply a predefined magnetic energy to the structures, requiring a constant source of energy. In the present work, a passive initial stiffness control of MR tapered beam has been studied. The effects of adding nanoparticles on the dynamic response of MR tapered beam has been investigated. It is observed that adding nanoparticles up to 3% may significantly modify the natural frequencies of the structures and achieve dynamic behavior of the structures before addition of MR fluid. Two Models of tapered structures have been taken into consideration. It is observed that adding only 3% of nanoparticles backs the structures to its initial dynamic behavior.

Keywords: non uniform laminated structures, MR fluid, nanoparticles, vibration, stiffness

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5691 Clinical Outcomes of Toric Implantable Collamer Lens (T-ICL) and Toric Implantable Phakic Contact Lens (IPCL) for Correction of High Myopia with Astigmatism: Comparative Study

Authors: Mohamed Salah El-Din Mahmoud, Heba Radi Atta Allah

Abstract:

Background: Our study assesses the safety profile and efficacy of toric Implantable Collamer Lens (T-ICL) and toric implantable phakic contact lens (IPCL) for the correction of high myopia with astigmatism. Methods: A prospective interventional randomized comparative study included 60 myopic eyes divided into 2 groups, group A including 30 eyes that were implanted with T-ICL, and group B including 30 eyes that were implanted with toric IPCL. The refractive results, visual acuity, corneal endothelial cell count, and intraocular pressure (IOP) were evaluated at baseline and at 1, 6, and 9 months post-surgery. Any complications either during or after surgery were assessed. Results: A significant reduction in both spherical and cylindrical refractive errors with good predictability was reported in both groups compared with preoperative values. Regarding the predictability, In T-ICL group (A), the median spherical and cylindrical errors were significantly improved from (-10 D & -4.5 D) pre-operatively to (-0.25 D & - 0.3 D) at the end of 9 months follow up period. Similarly, in the toric IPCL group (B), the median spherical and cylindrical errors were significantly improved from (-11 D & -4.5 D) pre-operatively to (-0.25 D & - 0.3 D) at the end of 9 months follow up period. A statistically significant improvement of UCDVA at 9 months postoperatively was found in both groups, as median preoperative Log Mar UCDVA was 1.1 and 1.3 in groups A and B respectively, which was significantly improved to 0.2 in both groups at the end of follow-up period. Regarding IOP, no significant difference was found between both groups, either pre-operatively or during the postoperative period. Regarding the endothelial count, no significant differences were found during the pre-operative and postoperative follow-up periods between the two groups. Fortunately, no intra or postoperative complications as cataract, keratitis or lens decentration had occurred. Conclusions: Toric IPCL is a suitable alternative to T-ICL for the management of high myopia with astigmatism, especially in developing countries, as it is cheaper and easier for implantation than T-ICL. However, data over longer follow-up periods are needed to confirm its safety and stability.

Keywords: T-ICL, Toric IPCL, IOP, corneal endothelium

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5690 Vitamin A Status and Its Correlation with the Dietary Intake of Young Females of Lahore, Pakistan

Authors: Sarah Fatima, Ahmad A. Malik, Saima Sadaf

Abstract:

This study was conducted in order to assess the dietary record and vitamin A status of young females of Lahore. A total sample of 376 consisted of 16 – 20 years of unmarried college going females. Three main tools were adopted: questionnaire, 3-day food diary and serum retinol test. The anthropometric measurements showed that a total of 32.6% of the sample was underweight (BMI < 18.5) and 54.5% had a healthy weight (BMI 18.5 – 22.9). The average Vitamin A intake of the sample was 257.95 µg/day while the RDA for the selected age group was 700 µg/day. The mean energy intake of the adolescents was 1153.64 kcal/ day, whereas the Estimated Energy Requirement (EER) for this age group was 2368 kcal/day. The mean serum Vitamin A level was 24.81µg/dL. 69.6% of the sample was deficient in serum Vitamin A i.e. serum retinol < 24 µg/dL. 30.4% had serum retinol in normal limit (24 – 84 µg/dL) from which 25.3% lied in lower limit (24 – 44 µg/dL) and only 5.1% had serum retinol in 44 – 64 µg/dL range. A slightly negative correlation (r = - 0.21, 95% confidence interval) was found between dietary intake of Vitamin A and serum Vitamin A It was concluded that the dietary intake of major nutrients and vitamin A is not adequate in the selected group. This is also confirmed by the lower serum retinol levels. Hence, vitamin An intake and status are generally inadequate, and vitamin deficiency is prevalent in the unmarried young females of Lahore.

Keywords: vitamin A, young Females, vitamin deficiency, Lahore

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5689 Effects of Porosity Logs on Pore Connectivity and Volumetric Estimation

Authors: Segun S. Bodunde

Abstract:

In Bona Field, Niger Delta, two reservoirs across three wells were analyzed. The research aimed at determining the statistical dependence of permeability and oil volume in place on porosity logs. Of the three popular porosity logs, two were used; the sonic and density logs. The objectives of the research were to identify the porosity logs that vary more with location and direction, to visualize the depth trend of both logs and to determine the influence of these logs on pore connectivity determination and volumetric analysis. The focus was on density and sonic logs. It was observed that the sonic derived porosities were higher than the density derived porosities (in well two, across the two reservoir sands, sonic porosity averaged 30.8% while density derived porosity averaged 23.65%, and the same trend was observed in other wells.). The sonic logs were further observed to have lower co-efficient of variation when compared to the density logs (in sand A, well 2, sonic derived porosity had a co-efficient of variation of 12.15% compared to 22.52% from the density logs) indicating a lower tendency to vary with location and direction. The bulk density was observed to increase with depth while the transit time reduced with depth. It was also observed that for an 8.87% decrease in porosity, the pore connectivity was observed to decrease by about 38%.

Keywords: pore connectivity, co-efficient of variation, density derived porosity, sonic derived porosity

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5688 Caspase-11 and AIM2 Inflammasome are Involved in Smoking-Induced COPD and Lung Adenocarcinoma

Authors: Chiara Colarusso, Michela Terlizzi, Aldo Pinto, Rosalinda Sorrentino

Abstract:

Cigarette smoking is the main cause and the most common risk factor for both COPD and lung cancer. In our previous studies, we proved that caspase-11 in mice and its human analogue, caspase-4, are involved in lung carcinogenesis and that AIM2 inflammasome might play a pro-cancerous role in lung cancer. Therefore, the aim of this study was to investigate potential crosstalk between COPD and lung cancer, focusing on AIM2 and caspase-11-dependent inflammasome signaling pathway. To mimic COPD, we took advantage of an experimental first-hand smoking mouse model and, to confirm what was observed in mice, we used human samples of lung adenocarcinoma patients stratified according to the smoking and COPD status. We demonstrated that smoke exposure led to emphysema-like features, bronchial tone impairment, and release of IL-1-like cytokines (IL-1α, IL-1β, IL-33, IL-18) in a caspase-1 independent manner in C57Bl/6N. Rather, a dysfunctional caspase-11 in smoke-exposed 129Sv mice was associated to lower bronchial inflammation, collagen deposition, and IL-1-like inflammation. In addition, for the first time, we found that AIM2 inflammasome is involved in lung inflammation in smoking and COPD, in that its expression was higher in smoke-exposed C57Bl/6N compared to 129Sv smoking mice, who instead did not show any alteration of AIM2 in both macrophages and dendritic cells. Moreover, we found that AIM2 expression in the cancerous tissue, albeit higher than non-cancerous tissue, was not statistically different according to the COPD and smoking status. Instead, the higher expression of AIM2 in non-cancerous tissue of smoker COPD patients than smokers who did not have COPD was correlated to a higher hazard ratio of poor survival rate than patients who presented lower levels of AIM2. In conclusion, our data highlight that caspase-11 in mice is associated to smoke-induced lung latent inflammation which could drive the establishment of lung cancer, and that AIM2 inflammasome plays a role at the crosstalk between smoking/COPD and lung adenocarcinoma in that its higher presence is correlated to lower survival rate of smoker COPD adenocarcinoma.

Keywords: COPD, inflammasome, lung cancer, lung inflammation, smoke

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5687 Determinants of Hospital Obstetric Unit Closures in the United States 2002-2013: Loss of Hospital Obstetric Care 2002-2013

Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

Abstract:

Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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