Search results for: major adverse cardiac events
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10340

Search results for: major adverse cardiac events

9290 Follower Upward Influence Tactics: A Review of Quantitative Studies

Authors: Najla Alshenaifi, Nicholas Clarke

Abstract:

Interest in how followers may influence their leaders in order to achieve their goals can be traced to studies in the late 1970s. The last major review of the literature was published over a decade ago in 2002. It would seem timely then to take stock of the literature and consider what we have learned since then. In so doing, our aim is to derive an empirically-based framework for understanding the effects of upward influence tactics to underpin future research in the field. Many factors are identified as having a major effect on upward influence processes including goals of influence, culture, gender, leadership style and the outcome of influence. A key conclusion from our review is that although upward influence tactics can result in positive outcomes for followers, the results from many studies are more often than inconclusive.

Keywords: upward influence tactics, influence tactics, influence strategies, followership

Procedia PDF Downloads 365
9289 A Corporate Social Responsibility View on Bribery Control in Business Relationships

Authors: Irfan Ameer

Abstract:

Bribery control in developing countries is the biggest challenge for multinational enterprises (MNEs). Bribery practices are socially embedded and institutionalized, and therefore may achieve collective legitimacy in the society. MNEs often have better and strict norms, codes and standards about such corrupt practices. Bribery in B2B sales relationships has been researched but studies focusing on the role of firm in controlling bribery are scarce. The main objective of this paper is to explore MNEs strategies to control bribery in an environment where bribery is institutionalized. This qualitative study uses narrative approach and focuses on key events, actors and their role in controlling bribery in B2B sales relationships. The context of this study is pharmaceutical industry of Pakistan and data is collected through 23 episodic interviews supported by secondary data. The Corporate social responsibility (CSR) literature e.g. CSR three domain model and CSR pyramid is used to make sense of MNEs strategies to control bribery in developing countries. Results show that MNEs’ bribery control strategies are rather emerging based on the role of some key stakeholders and events which shape bribery strategies. Five key bribery control strategies were found through which MNEs can control both demand and supply side of bribery: bribery related codes development; bribery related codes implementation; focusing on competitive advantage; find mutually beneficial ethical solution; and collaboration with ethical stakeholders. The results also highlight the problems associated with each strategy. Study is unique in a sense that it focuses on stakeholders having unethical interests and provides guidelines to MNEs in controlling bribery practices in B2B sales relationships.

Keywords: bribery, developing countries, CSR, narrative research, B2B sales, MNEs

Procedia PDF Downloads 356
9288 Fake Accounts Detection in Twitter Based on Minimum Weighted Feature Set

Authors: Ahmed ElAzab, Amira M. Idrees, Mahmoud A. Mahmoud, Hesham Hefny

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Social networking sites such as Twitter and Facebook attracts over 500 million users across the world, for those users, their social life, even their practical life, has become interrelated. Their interaction with social networking has affected their life forever. Accordingly, social networking sites have become among the main channels that are responsible for vast dissemination of different kinds of information during real time events. This popularity in Social networking has led to different problems including the possibility of exposing incorrect information to their users through fake accounts which results to the spread of malicious content during life events. This situation can result to a huge damage in the real world to the society in general including citizens, business entities, and others. In this paper, we present a classification method for detecting fake accounts on Twitter. The study determines the minimized set of the main factors that influence the detection of the fake accounts on Twitter, then the determined factors have been applied using different classification techniques, a comparison of the results for these techniques has been performed and the most accurate algorithm is selected according to the accuracy of the results. The study has been compared with different recent research in the same area, this comparison has proved the accuracy of the proposed study. We claim that this study can be continuously applied on Twitter social network to automatically detect the fake accounts, moreover, the study can be applied on different Social network sites such as Facebook with minor changes according to the nature of the social network which are discussed in this paper.

Keywords: fake accounts detection, classification algorithms, twitter accounts analysis, features based techniques

Procedia PDF Downloads 386
9287 Two-Sided Information Dissemination in Takeovers: Disclosure and Media

Authors: Eda Orhun

Abstract:

Purpose: This paper analyzes a target firm’s decision to voluntarily disclose information during a takeover event and the effect of such disclosures on the outcome of the takeover. Such voluntary disclosures especially in the form of earnings forecasts made around takeover events may affect shareholders’ decisions about the target firm’s value and in return takeover result. This study aims to shed light on this question. Design/methodology/approach: The paper tries to understand the role of voluntary disclosures by target firms during a takeover event in the likelihood of takeover success both theoretically and empirically. A game-theoretical model is set up to analyze the voluntary disclosure decision of a target firm to inform the shareholders about its real worth. The empirical implication of model is tested by employing binary outcome models where the disclosure variable is obtained by identifying the target firms in the sample that provide positive news by issuing increasing management earnings forecasts. Findings: The model predicts that a voluntary disclosure of positive information by the target decreases the likelihood that the takeover succeeds. The empirical analysis confirms this prediction by showing that positive earnings forecasts by target firms during takeover events increase the probability of takeover failure. Overall, it is shown that information dissemination through voluntary disclosures by target firms is an important factor affecting takeover outcomes. Originality/Value: This study is the first to the author's knowledge that studies the impact of voluntary disclosures by the target firm during a takeover event on the likelihood of takeover success. The results contribute to information economics, corporate finance and M&As literatures.

Keywords: takeovers, target firm, voluntary disclosures, earnings forecasts, takeover success

Procedia PDF Downloads 300
9286 Factors Affecting Visual Environment in Mine Lighting

Authors: N. Lakshmipathy, Ch. S. N. Murthy, M. Aruna

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The design of lighting systems for surface mines is not an easy task because of the unique environment and work procedures encountered in the mines. The primary objective of this paper is to identify the major problems encountered in mine lighting application and to provide guidance in the solution of these problems. In the surface mining reflectance of surrounding surfaces is one of the important factors, which improve the vision, in the night hours. But due to typical working nature in the mines it is very difficult to fulfill these requirements, and also the orientation of the light at work site is a challenging task. Due to this reason machine operator and other workers in a mine need to be able to orient themselves in a difficult visual environment. The haul roads always keep on changing to tune with the mining activity. Other critical area such as dumpyards, stackyards etc. also change their phase with time, and it is difficult to illuminate such areas. Mining is a hazardous occupation, with workers exposed to adverse conditions; apart from the need for hard physical labor, there is exposure to stress and environmental pollutants like dust, noise, heat, vibration, poor illumination, radiation, etc. Visibility is restricted when operating load haul dumper and Heavy Earth Moving Machinery (HEMM) vehicles resulting in a number of serious accidents. one of the leading causes of these accidents is the inability of the equipment operator to see clearly people, objects or hazards around the machine. Results indicate blind spots are caused primarily by posts, the back of the operator's cab, and by lights and light brackets. The careful designed and implemented, lighting systems provide mine workers improved visibility and contribute to improved safety, productivity and morale. Properly designed lighting systems can improve visibility and safety during working in the opencast mines.

Keywords: contrast, efficacy, illuminance, illumination, light, luminaire, luminance, reflectance, visibility

Procedia PDF Downloads 343
9285 Vulnerability of People to Climate Change: Influence of Methods and Computation Approaches on Assessment Outcomes

Authors: Adandé Belarmain Fandohan

Abstract:

Climate change has become a major concern globally, particularly in rural communities that have to find rapid coping solutions. Several vulnerability assessment approaches have been developed in the last decades. This comes along with a higher risk for different methods to result in different conclusions, thereby making comparisons difficult and decision-making non-consistent across areas. The effect of methods and computational approaches on estimates of people’s vulnerability was assessed using data collected from the Gambia. Twenty-four indicators reflecting vulnerability components: (exposure, sensitivity, and adaptive capacity) were selected for this purpose. Data were collected through household surveys and key informant interviews. One hundred and fifteen respondents were surveyed across six communities and two administrative districts. Results were compared over three computational approaches: the maximum value transformation normalization, the z-score transformation normalization, and simple averaging. Regardless of the approaches used, communities that have high exposure to climate change and extreme events were the most vulnerable. Furthermore, the vulnerability was strongly related to the socio-economic characteristics of farmers. The survey evidenced variability in vulnerability among communities and administrative districts. Comparing output across approaches, overall, people in the study area were found to be highly vulnerable using the simple average and maximum value transformation, whereas they were only moderately vulnerable using the z-score transformation approach. It is suggested that assessment approach-induced discrepancies be accounted for in international debates to harmonize/standardize assessment approaches to the end of making outputs comparable across regions. This will also likely increase the relevance of decision-making for adaptation policies.

Keywords: maximum value transformation, simple averaging, vulnerability assessment, West Africa, z-score transformation

Procedia PDF Downloads 86
9284 Natural Law in the Mu’Tazilite Theology

Authors: Samaneh Khalili

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Natural law theory, in moral philosophy, refers to a system of unchanging values held to be mutual to all humans and can be discovered through reason. The natural law theory is commonly associated with western Philosophers. In contrast, discussions on notions of natural law in Islamic intellectual history were relatively rare. This paper aims to show that the moral theory developed by the Mu'tazilite thinkers can be classified in the ideas of natural law. In doing so, this study will demonstrate that the objective and unchanging values, according to Mu'tazilite theologians, provide the guidelines for assessing the Islamic law rules in the field of human coexistence. The focus of the paper lies on ʿAbd al-Ğabbār, who was the most influential thinker in the late epoch of the Muʿtazila. Although ʿAbd al-Ǧabbār did not leave a text with a systematic discussion of natural law, his teaching of nature, human reason, and the moral values of actions are all scattered throughout his work -'al-Muġnī fī abwāb at-tawḥīd wa-l-'adl'. It is necessary to focus on ʿAbd al-Ǧabbār's theories on reason, nature, and ethics since natural law revolves around the basic concepts of nature, reason, and moral value. While analyzing the concept of the Nature, it will attempt to answer how he explains the world's physical structure and God's relationship to natural events. Moreover, from ʿAbd al-Ǧabbār's point of view, is nature a self-determined system that follows its inner principle in every kind of change, or is nature guided by an external power? Does causality govern natural events? About the concept of reason, an attempt is made to examine how human reason, according to ʿAbd al-Ǧabbār, conceives moral attributes. Finally, the Autor will discuss the concepts of objective values and the place of rights and duties derived from Islamic law in ʿAbd al-Ǧabbār's thought.

Keywords: Islamic law, Mu'tazilite theology, natural law in Islamic theology, objective and unchanging values.

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9283 Rupture Termination of the 1950 C. E. Earthquake and Recurrent Interval of Great Earthquake in North Eastern Himalaya, India

Authors: Rao Singh Priyanka, Jayangondaperumal R.

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The Himalayan active fault has the potential to generate great earthquakes in the future, posing a biggest existential threat to humans in the Himalayan and adjacent region. Quantitative evaluation of accumulated and released interseismic strain is crucial to assess the magnitude and spatio-temporal variability of future great earthquakes along the Himalayan arc. To mitigate the destruction and hazards associated with such earthquakes, it is important to understand their recurrence cycle. The eastern Himalayan and Indo-Burman plate boundary systems offers an oblique convergence across two orthogonal plate boundaries, resulting in a zone of distributed deformation both within and away from the plate boundary and clockwise rotation of fault-bounded blocks. This seismically active region has poorly documented historical archive of the past large earthquakes. Thus, paleoseismologicalstudies confirm the surface rupture evidences of the great continental earthquakes (Mw ≥ 8) along the Himalayan Frontal Thrust (HFT), which along with the Geodetic studies, collectively provide the crucial information to understand and assess the seismic potential. These investigations reveal the rupture of 3/4th of the HFT during great events since medieval time but with debatable opinions for the timing of events due to unclear evidences, ignorance of transverse segment boundaries, and lack of detail studies. Recent paleoseismological investigations in the eastern Himalaya and Mishmi ranges confirms the primary surface ruptures of the 1950 C.E. great earthquake (M>8). However, a seismic gap exists between the 1714 C.E. and 1950 C.E. Assam earthquakes that did not slip since 1697 C.E. event. Unlike the latest large blind 2015 Gorkha earthquake (Mw 7.8), the 1950 C.E. event is not triggered by a large event of 1947 C.E. that occurred near the western edge of the great upper Assam event. Moreover, the western segment of the eastern Himalayadid not witness any surface breaking earthquake along the HFT for over the past 300 yr. The frontal fault excavations reveal that during the 1950 earthquake, ~3.1-m-high scarp along the HFT was formed due to the co-seismic slip of 5.5 ± 0.7 m at Pasighat in the Eastern Himalaya and a 10-m-high-scarp at a Kamlang Nagar along the Mishmi Thrust in the Eastern Himalayan Syntaxis is an outcome of a dip-slip displacement of 24.6 ± 4.6 m along a 25 ± 5°E dipping fault. This event has ruptured along the two orthogonal fault systems in the form of oblique thrust fault mechanism. Approx. 130 km west of Pasighat site, the Himebasti village has witnessed two earthquakes, the historical 1697 Sadiya earthquake, and the 1950 event, with a cumulative dip-slip displacement of 15.32 ± 4.69 m. At Niglok site, Arunachal Pradesh, a cumulative slip of ~12.82 m during at least three events since pre 19585 B.P. has produced ~6.2-m high scarp while the youngest scarp of ~2.4-m height has been produced during 1697 C.E. The site preserves two deformational events along the eastern HFT, providing an idea of last serial ruptures at an interval of ~850 yearswhile the successive surface rupturing earthquakes lacks in the Mishmi Range to estimate the recurrence cycle.

Keywords: paleoseismology, surface rupture, recurrence interval, Eastern Himalaya

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9282 The Effects of Cardiovascular Risk on Age-Related Cognitive Decline in Healthy Older Adults

Authors: A. Badran, M. Hollocks, H. Markus

Abstract:

Background: Common risk factors for cardiovascular disease are associated with age-related cognitive decline. There has been much interest in treating modifiable cardiovascular risk factors in the hope of reducing cognitive decline. However, there is currently no validated neuropsychological test to assess the subclinical cognitive effects of vascular risk. The Brief Memory and Executive Test (BMET) is a clinical screening tool, which was originally designed to be sensitive and specific to Vascular Cognitive Impairment (VCI), an impairment characterised by decline in frontally-mediated cognitive functions (e.g. Executive Function and Processing Speed). Objective: To cross-sectionally assess the validity of the BMET as a measure of the subclinical effects of vascular risk on cognition, in an otherwise healthy elderly cohort. Methods: Data from 346 participants (57 ± 10 years) without major neurological or psychiatric disorders were included in this study, gathered as part of a previous multicentre validation study for the BMET. Framingham Vascular Age was used as a surrogate measure of vascular risk, incorporating several established risk factors. Principal Components Analysis of the subtests was used to produce common constructs: an index for Memory and another for Executive Function/Processing Speed. Univariate General Linear models were used to relate Vascular Age to performance on Executive Function/Processing Speed and Memory subtests of the BMET, adjusting for Age, Premorbid Intelligence and Ethnicity. Results: Adverse vascular risk was associated with poorer performance on both the Memory and Executive Function/Processing Speed indices, adjusted for Age, Premorbid Intelligence and Ethnicity (p=0.011 and p<0.001, respectively). Conclusions: Performance on the BMET reflects the subclinical effects of vascular risk on cognition, in age-related cognitive decline. Vascular risk is associated with decline in both Executive Function/Processing Speed and Memory groups of subtests. Future studies are needed to explore whether treating vascular risk factors can effectively reduce age-related cognitive decline.

Keywords: age-related cognitive decline, vascular cognitive impairment, subclinical cerebrovascular disease, cognitive aging

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9281 An Analysis of the Wheat Export Performance of Ukraine in Europe

Authors: Kiran Bala Das

Abstract:

This paper examines the Ukraine wheat export condition after Russian-Ukrainian military confrontation. The political conflict in Ukraine and the recent military intervention of Russia in Crimea is raising concern full effect of the events there is still uncertain, but some hints can be seen in the wheat market by analyzing the trend and pattern of Ukraine wheat export. Crimea is extremely important as it is where most of Ukraine grain exported by ship from its ports of the black sea. Ukraine is again seeking to establish itself a significant exporter of agricultural product with its rich black soil, it is chornozem the top soil layer that makes the country soil so fertile and become one of the major exporter of wheat in the world, its generous supplier of wheat make Ukraine 'Bread basket of Europe'. Ukraine possesses 30% of the world’s richest black soil; its agricultural industry has huge potential especially in grains. European Union (EU) is a significant trading partner of Ukraine but geopolitical tension adversely affects the wheat trade from black sea, which threatens Europe breadbasket. This study also highlights an index of export intensity to analyze the intensity of existing trade for the period 2011-2014 between Ukraine and EU countries. The result show export has intensified over the years, but this year low trade intensity. The overall consequence is hard to determine but if the situation deteriorates and Ukraine cutoff export, international wheat price will hike and grain prices (wheat) also come under the current circumstances and the recent development indicates how the grain market get affected and Agri future now in danger in Ukraine, and its forecast that Ukraine harvest low wheat crop this year and projected decline in export of wheat.

Keywords: breadbasket of Europe, export intensity index, growth rate, wheat export

Procedia PDF Downloads 333
9280 A Piebald Cladistic Portray of Mitochondrial DNA Control Region Haplogroups in Khyber Pakhtunkhwa, Pakistan

Authors: Shahzad Bhatti, M. Aslamkhan, Sana Abbas, Marcella Attimonelli, Hikmet Hakan Aydin, Erica Martinha Silva de Souza,

Abstract:

Despite being situated at the crossroad of Asia, Pakistan has gained crucial importance because of its pivotal role in subsequent migratory events. To highlight the genetic footprints and to contribute an enigmatic picture of the relative population expansion pattern among four major Pashtun tribes in Khyber Pakhtunkhwa viz., Bangash, Khattak, Mahsuds and Orakzai, the complete mitochondrial control region of 100 Pashtun were analyzed. All Pashtun tribes studied here revealed high genetic diversity; that was comparable to the other Central Asian, Southeast Asian and European populations. The configuration of genetic variation and heterogeneity further unveiled through Multidimensional Scaling, Principal Component Analysis, and phylogenetic analysis. The results revealed that the Pashtun is a composite mosaic of West Eurasian ancestry of numerous geographic origin. They received substantial gene flow during different invasions and have a high element of the Western provenance. The most common haplogroups reported in this study are: South Asian haplogroup M (28%) and R (8%); whereas, West Asians haplogroups are present, albeit in high frequencies (67%) and widespread over all; HV (15%), U (17%), H (9%), J (8%), K (8%), W (4%), N (3%) and T (3%). Herein we linked the unexplored genetic connection between Ashkenazi Jews and Pashtun. The presence of specific haplotypes J1b (4%) and K1a1b1a (5%) point to a genetic connection of Jewish conglomeration with Khattak tribe. This was a result of an ancient genetic influx in the early Neolithic period that led to the formation of a diverse genetic substratum in present day Pashtun.

Keywords: mtDNA haplogroups, control region, Pakistan, KPK, ethnicity

Procedia PDF Downloads 467
9279 Configuring Systems to Be Viable in a Crisis: The Role of Intuitive Decision-Making

Authors: Ayham Fattoum, Simos Chari, Duncan Shaw

Abstract:

Volatile, uncertain, complex, and ambiguous (VUCA) conditions threaten systems viability with emerging and novel events requiring immediate and localized responses. Such responsiveness is only possible through devolved freedom and emancipated decision-making. The Viable System Model (VSM) recognizes the need and suggests maximizing autonomy to localize decision-making and minimize residual complexity. However, exercising delegated autonomy in VUCA requires confidence and knowledge to use intuition and guidance to maintain systemic coherence. This paper explores the role of intuition as an enabler of emancipated decision-making and autonomy under VUCA. Intuition allows decision-makers to use their knowledge and experience to respond rapidly to novel events. This paper offers three contributions to VSM. First, it designs a system model that illustrates the role of intuitive decision-making in managing complexity and maintaining viability. Second, it takes a black-box approach to theory development in VSM to model the role of autonomy and intuition. Third, the study uses a multi-stage discovery-oriented approach (DOA) to develop theory, with each stage combining literature, data analysis, and model/theory development and identifying further questions for the subsequent stage. We synthesize literature (e.g., VSM, complexity management) with seven months of field-based insights (interviews, workshops, and observation of a live disaster exercise) to develop a framework of intuitive complexity management framework and VSM models. The results have practical implications for enhancing the resilience of organizations and communities.

Keywords: Intuition, complexity management, decision-making, viable system model

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9278 Epigenetic and Archeology: A Quest to Re-Read Humanity

Authors: Salma A. Mahmoud

Abstract:

Epigenetic, or alteration in gene expression influenced by extragenetic factors, has emerged as one of the most promising areas that will address some of the gaps in our current knowledge in understanding patterns of human variation. In the last decade, the research investigating epigenetic mechanisms in many fields has flourished and witnessed significant progress. It paved the way for a new era of integrated research especially between anthropology/archeology and life sciences. Skeletal remains are considered the most significant source of information for studying human variations across history, and by utilizing these valuable remains, we can interpret the past events, cultures and populations. In addition to archeological, historical and anthropological importance, studying bones has great implications in other fields such as medicine and science. Bones also can hold within them the secrets of the future as they can act as predictive tools for health, society characteristics and dietary requirements. Bones in their basic forms are composed of cells (osteocytes) that are affected by both genetic and environmental factors, which can only explain a small part of their variability. The primary objective of this project is to examine the epigenetic landscape/signature within bones of archeological remains as a novel marker that could reveal new ways to conceptualize chronological events, gender differences, social status and ecological variations. We attempted here to address discrepancies in common variants such as methylome as well as novel epigenetic regulators such as chromatin remodelers, which to our best knowledge have not yet been investigated by anthropologists/ paleoepigenetists using plethora of techniques (biological, computational, and statistical). Moreover, extracting epigenetic information from bones will highlight the importance of osseous material as a vector to study human beings in several contexts (social, cultural and environmental), and strengthen their essential role as model systems that can be used to investigate and construct various cultural, political and economic events. We also address all steps required to plan and conduct an epigenetic analysis from bone materials (modern and ancient) as well as discussing the key challenges facing researchers aiming to investigate this field. In conclusion, this project will serve as a primer for bioarcheologists/anthropologists and human biologists interested in incorporating epigenetic data into their research programs. Understanding the roles of epigenetic mechanisms in bone structure and function will be very helpful for a better comprehension of their biology and highlighting their essentiality as interdisciplinary vectors and a key material in archeological research.

Keywords: epigenetics, archeology, bones, chromatin, methylome

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9277 Kawasaki Disease in a Two Months Kuwaiti Girl: A Case Report ‎and Literature Review.‎

Authors: Hanan Bin Nakhi, Asaad M. Albadrawi, Maged Al Shahat, ‎Entesar Mandani

Abstract:

Background:‎ Kawasaki disease (KD) is one of the most common vasculitis of childhood. ‎It is considered the leading cause of acquired heart disease in children. The ‎peak age of occurrence is 6 to 24 months, with 80% of affected children being ‎less than 5 years old. There are only a few reports of KD in infants younger ‎than 6 months. Infants had a higher incidence of atypical KD and of coronary ‎artery complications. This case report from Kuwait will reinforce considering ‎atypical KD in case of sepsis like condition with negative cultures and ‎unresponding to systemic antibiotics. Early diagnosis allows early treatment ‎with intravenous immune globulin (IVIG) and so decreases the incidence of ‎cardiac aneurysm.‎ Case Report:‎ A 2 month old female infant, product of full term normal delivery to ‎consanguineous parents, presented with fever and poor feeding. She was ‎admitted and treated as urinary tract infection as her urine routine revealed ‎pyurea. The baby continued to have persistent fever and hypoactivity inspite ‎of using intravenous antibiotics. Latter, she developed non purulent ‎conjunctivitis, skin mottling, oedema of the face / lower limb and was treated ‎in intensive care unit as a case of septic shock. In spite of her partial general ‎improvement, she continued to look unwell, hypoactive and had persistent ‎fever. Septic work up, metabolic, and immunologic screen were negative. KD ‎was suspected when the baby developed polymorphic erythematous rash and ‎noticed to have peeling of skin at perianal area and periangular area of the ‎fingers of the hand and feet. IVIG was given in dose of 2 gm/kg/day in single ‎dose and aspirin 100 mg/kg/day in four divided doses. The girl showed marked ‎clinical improvement. The fever subsided dramatically and the level acute ‎phase reactant markedly decreased but the platelets count increased to ‎‎1600000/mm3. Echo cardiography showed mild dilatation of mid right ‎coronary artery. Aspirin was continued in a dose of 5 mg/kg/d till repeating ‎cardiac echo. ‎Conclusion:‎ A high index of suspicion of KD must be maintained in young infants with ‎prolonged unexplained fever. Accepted criteria should be less restrictive to ‎allow early diagnosis of a typical KD in infants less than 6 months of age. ‎Timely appropriate treatment with IVIG is essential to avoid severe coronary ‎sequels.‎

Keywords: Kawasaki disease, atypical Kawasaki disease, infantile Kawasaki disease, hypo activity‎ ‎

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9276 The Development of an Anaesthetic Crisis Manual for Acute Critical Events: A Pilot Study

Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

Abstract:

Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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9275 Chemical Variability in the Essential Oils from the Leaves and Buds of Syzygium Species

Authors: Rabia Waseem, Low Kah Hin, Najihah Mohamed Hashim

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The variability in the chemical components of the Syzygium species essential oils has been evaluated. The leaves of Syzygium species have been collected from Perak, Malaysia. The essential oils extracted by using the conventional Hydro-distillation extraction procedure and analyzed by using Gas chromatography System attached with Mass Spectrometry (GCMS). Twenty-seven constituents were found in Syzygium species in which the major constituents include: α-Pinene (3.94%), α-Thujene (2.16%), α-Terpineol (2.95%), g-Elemene (2.89%) and D-Limonene (14.59%). The aim of this study was the comparison between the evaluated data and existing literature to fortify the major variability through statistical analysis.

Keywords: chemotaxonomy, cluster analysis, essential oil, medicinal plants, statistical analysis

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9274 Acute Myocardial Infarction Associated with Ingestion of Herbal Mixtures Containing Acetylcholinesterase Inhibitors: A Case Study

Authors: M. Hakami, A. Jammaly, I. Attafi, M. Oraiby, M. Jeraiby

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We reviewed an unusual case of a 65-year-old male taking an herbal mixture containing compounds with anticholinesterase activity for a long period of time, presented with acute my myocardial infarction and multiple organ dysfunction syndrome followed by death. Clinically, there are findings correlated with anticholinesterase activity, such as bilateral miosis, diaphoresis, vomiting and fasciculation without a history of any toxic ingestion or exposure. Gas chromatography–mass spectrometry screening studies identified the presence of thymol, anethole in the herbal extract and butylated hydroxytoluene in the blood sample. Hence, with this case report, we intend to highlight the necessity of evaluating the long-term use of the herbal mixture.

Keywords: cholinesterase inhibitors, thymole, anethole, butylatedhydroxytoluene, cardiac toxicity, myocardial infarction

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9273 Sweepline Algorithm for Voronoi Diagram of Polygonal Sites

Authors: Dmitry A. Koptelov, Leonid M. Mestetskiy

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Voronoi Diagram (VD) of finite set of disjoint simple polygons, called sites, is a partition of plane into loci (for each site at the locus) – regions, consisting of points that are closer to a given site than to all other. Set of polygons is a universal model for many applications in engineering, geoinformatics, design, computer vision, and graphics. VD of polygons construction usually done with a reduction to task of constructing VD of segments, for which there are effective O(n log n) algorithms for n segments. Preprocessing – constructing segments from polygons’ sides, and postprocessing – polygon’s loci construction by merging the loci of the sides of each polygon are also included in reduction. This approach doesn’t take into account two specific properties of the resulting segment sites. Firstly, all this segments are connected in pairs in the vertices of the polygons. Secondly, on the one side of each segment lies the interior of the polygon. The polygon is obviously included in its locus. Using this properties in the algorithm for VD construction is a resource to reduce computations. The article proposes an algorithm for the direct construction of VD of polygonal sites. Algorithm is based on sweepline paradigm, allowing to effectively take into account these properties. The solution is performed based on reduction. Preprocessing is the constructing of set of sites from vertices and edges of polygons. Each site has an orientation such that the interior of the polygon lies to the left of it. Proposed algorithm constructs VD for set of oriented sites with sweepline paradigm. Postprocessing is a selecting of edges of this VD formed by the centers of empty circles touching different polygons. Improving the efficiency of the proposed sweepline algorithm in comparison with the general Fortune algorithm is achieved due to the following fundamental solutions: 1. Algorithm constructs only such VD edges, which are on the outside of polygons. Concept of oriented sites allowed to avoid construction of VD edges located inside the polygons. 2. The list of events in sweepline algorithm has a special property: the majority of events are connected with “medium” polygon vertices, where one incident polygon side lies behind the sweepline and the other in front of it. The proposed algorithm processes such events in constant time and not in logarithmic time, as in the general Fortune algorithm. The proposed algorithm is fully implemented and tested on a large number of examples. The high reliability and efficiency of the algorithm is also confirmed by computational experiments with complex sets of several thousand polygons. It should be noted that, despite the considerable time that has passed since the publication of Fortune's algorithm in 1986, a full-scale implementation of this algorithm for an arbitrary set of segment sites has not been made. The proposed algorithm fills this gap for an important special case - a set of sites formed by polygons.

Keywords: voronoi diagram, sweepline, polygon sites, fortunes' algorithm, segment sites

Procedia PDF Downloads 162
9272 M-Number of Aortic Cannulas Applied During Hypothermic Cardiopulmonary Bypass

Authors: Won-Gon Kim

Abstract:

A standardized system to describe the pressure-flow characteristics of a given cannula has recently been proposed and has been termed ‘the M-number’. Using three different sizes of aortic cannulas in 50 pediatric cardiac patients on hypothermic cardiopulmonary bypass, we analyzed the correlation between experimentally and clinically derived M-numbers, and found this was positive. Clinical M-numbers were typically 0.35 to 0.55 greater than experimental M-numbers, and correlated inversely with a patient's temperature change; this was most probably due to increased blood viscosity, arising from hypothermia. This inverse relationship was more marked in higher M-number cannulas. The clinical data obtained in this study suggest that experimentally derived M-numbers correlate strongly with clinical performance of the cannula, and that the influence of temperature is significant.

Keywords: cardiopulmonary bypass, M-number, aortic cannula, pressure-flow characteristics

Procedia PDF Downloads 228
9271 Poststreptococcal Reactive Arthritis in Children: A Serial Case

Authors: A. Lubis, S. S. Pasulu, Z. Hikmah, A. Endaryanto, A. Harsono

Abstract:

Infection by group A streptococci (GAS) can trigger an autoantibody that cause a poststreptococcal reactive arthritis (PSRA). Four patients with PSRA aged 10 years to 14 years old with the main complaint of joint pain for five days to 10 days after suffering a fever and sore throat. The joint pain was persistent, additive, and non migratory. All patients revealed an increase in erythrocyte sedimentation rate (ESR) and anti-streptolysin O (ASLO), but the chest x-ray, electrocardiography, and echocardiography were normal. Bone imaging showed no destruction on the affected joint. Jones Criteria were not fulfilled in all patients. Erythromycin and ibuprofen were given in all patients and an improvement was shown. Erythromycin was continued for one year and routine controls were conducted for cardiac evaluation. The prognosis of all the patients was good.

Keywords: arthritis, group a streptococcus, autoantibody, Jones criteria

Procedia PDF Downloads 213
9270 The Evaluation of the Cognitive Training Program for Older Adults with Mild Cognitive Impairment: Protocol of a Randomized Controlled Study

Authors: Hui-Ling Yang, Kuei-Ru Chou

Abstract:

Background: Studies show that cognitive training can effectively delay cognitive failure. However, there are several gaps in the previous studies of cognitive training in mild cognitive impairment: 1) previous studies enrolled mostly healthy older adults, with few recruiting older adults with cognitive impairment; 2) they also had limited generalizability and lacked long-term follow-up data and measurements of the activities of daily living functional impact. Moreover, only 37% were randomized controlled trials (RCT). 3) Limited cognitive training has been specifically developed for mild cognitive impairment. Objective: This study sought to investigate the changes in cognitive function, activities of daily living and degree of depressive symptoms in older adults with mild cognitive impairment after cognitive training. Methods: This double-blind randomized controlled study has a 2-arm parallel group design. Study subjects are older adults diagnosed with mild cognitive impairment in residential care facilities. 124 subjects will be randomized by the permuted block randomization, into intervention group (Cognitive training, CT), or active control group (Passive information activities, PIA). Therapeutic adherence, sample attrition rate, medication compliance and adverse events will be monitored during the study period, and missing data analyzed using intent-to-treat analysis (ITT). Results: Training sessions of the CT group are 45 minutes/day, 3 days/week, for 12 weeks (36 sessions each). The training of active control group is the same as CT group (45min/day, 3days/week, for 12 weeks, for a total of 36 sessions). The primary outcome is cognitive function, using the Mini-Mental Status Examination (MMSE); the secondary outcome indicators are: 1) activities of daily living, using the Lawton’s Instrumental Activities of Daily Living (IADLs) and 2) degree of depressive symptoms, using the Geriatric Depression Scale-Short form (GDS-SF). Latent growth curve modeling will be used in the repeated measures statistical analysis to estimate the trajectory of improvement by examining the rate and pattern of change in cognitive functions, activities of daily living and degree of depressive symptoms for intervention efficacy over time, and the effects will be evaluated immediate post-test, 3 months, 6 months and one year after the last session. Conclusions: We constructed a rigorous CT program adhering to the Consolidated Standards of Reporting Trials (CONSORT) reporting guidelines. We expect to determine the improvement in cognitive function, activities of daily living and degree of depressive symptoms of older adults with mild cognitive impairment after using the CT.

Keywords: mild cognitive impairment, cognitive training, randomized controlled study

Procedia PDF Downloads 426
9269 Genomic and Evolutionary Diversity of Long Terminal Repeat (LTR) Retrotransposons in Date Palm (Phoenix dactylifera)

Authors: Faisal Nouroz, Mukaramin Mukaramin

Abstract:

Of the transposable elements (TEs), the retrotransposons are the most copious elements identified from many sequenced genomes. They have played a major role in genome evolution, rearrangement, and expansions based on their copy and paste mode of proliferation. They are further divided into LTR and Non-LTR retrotransposons. The purpose of the current study was to identify the LTR REs in sequenced Phoenix dactylifera genome and to study their structural diversity. A total of 150 P. dactylifera BAC sequences with > 60kb sizes were randomly retrieved from National Center for Biotechnology Information (NCBI) database and screened for the presence of LTR retrotransposons. Seven bacterial artificial chromosomes (BAC) sequences showed full-length LTR Retrotransposons with 4 Copia and 3 Gypsy families having variable copy numbers in respective families. Reverse transcriptase (RT) domain was found as the most conserved domain among Copia and Gypsy superfamilies and was used to deduce evolutionary analysis. The amino acid residues among various RT sequences showed variability in their percentages indicating post divergence evolution. Amino acid Leucine was found in highest proportions followed by Lysine, while Methionine and Tryptophan were in lowest percentages. The phylogenetic analysis based on RT domains confirmed that although having most conserved RT regions, several evolutionary events occurred causing nucleotide polymorphisms and hence clustering of Gypsy and Copia superfamilies into their respective lineages. The study will be helpful in identification and annotation of these elements in other species and genera and their distribution patterns on chromosomes by fluorescent in situ hybridization techniques.

Keywords: transposable elements, Phoenix dactylifera, retrotransposons, phylogenetic analysis

Procedia PDF Downloads 117
9268 Regional Rates of Sand Supply to the New South Wales Coast: Southeastern Australia

Authors: Marta Ribo, Ian D. Goodwin, Thomas Mortlock, Phil O’Brien

Abstract:

Coastal behavior is best investigated using a sediment budget approach, based on the identification of sediment sources and sinks. Grain size distribution over the New South Wales (NSW) continental shelf has been widely characterized since the 1970’s. Coarser sediment has generally accumulated on the outer shelf, and/or nearshore zones, with the latter related to the presence of nearshore reef and bedrocks. The central part of the NSW shelf is characterized by the presence of fine sediments distributed parallel to the coastline. This study presents new grain size distribution maps along the NSW continental shelf, built using all available NSW and Commonwealth Government holdings. All available seabed bathymetric data form prior projects, single and multibeam sonar, and aerial LiDAR surveys were integrated into a single bathymetric surface for the NSW continental shelf. Grain size information was extracted from the sediment sample data collected in more than 30 studies. The information extracted from the sediment collections varied between reports. Thus, given the inconsistency of the grain size data, a common grain size classification was her defined using the phi scale. The new sediment distribution maps produced, together with new detailed seabed bathymetric data enabled us to revise the delineation of sediment compartments to more accurately reflect the true nature of sediment movement on the inner shelf and nearshore. Accordingly, nine primary mega coastal compartments were delineated along the NSW coast and shelf. The sediment compartments are bounded by prominent nearshore headlands and reefs, and major river and estuarine inlets that act as sediment sources and/or sinks. The new sediment grain size distribution was used as an input in the morphological modelling to quantify the sediment transport patterns (and indicative rates of transport), used to investigate sand supply rates and processes from the lower shoreface to the NSW coast. The rate of sand supply to the NSW coast from deep water is a major uncertainty in projecting future coastal response to sea-level rise. Offshore transport of sand is generally expected as beaches respond to rising sea levels but an onshore supply from the lower shoreface has the potential to offset some of the impacts of sea-level rise, such as coastline recession. Sediment exchange between the lower shoreface and sub-aerial beach has been modelled across the south, central, mid-north and far-north coast of NSW. Our model approach is that high-energy storm events are the primary agents of sand transport in deep water, while non-storm conditions are responsible for re-distributing sand within the beach and surf zone.

Keywords: New South Wales coast, off-shore transport, sand supply, sediment distribution maps

Procedia PDF Downloads 216
9267 Cell Adhesion, Morphology and Cytokine Expression of Synoviocytes Can Be Altered on Different Nano-Topographic Oxidized Silicon Nanosponges

Authors: Hung-Chih Hsu, Pey-Jium Chang, Ching-Hsein Chen, Jer-Liang Andrew Yeh

Abstract:

Osteoarthritis (OA) is a common disorder in rehabilitation clinic. The main characteristics include joint pain, localized tenderness and enlargement, joint effusion, cartilage destruction, loss of adhesion of perichondrium, synovium hyperplasia. Synoviocytes inflammation might be a cause of local tenderness and effusion. Inflammation cytokines might also play an important role in joint pain, cartilage destruction, decrease adhesion of perichondrium to the bone. Treatments of osteoarthritis include non-steroid anti-inflammation drugs (NSAID), glucosamine supplementation, hyaluronic acid, arthroscopic debridement, and total joint replacement. Total joint replacement is commonly used in patients with severe OA who failed respond to pharmacological treatment. However, some patients received surgery had serious adverse events, including instability of the implants due to insufficient adhesion to the adjacent bony tissue or synovial inflammation. We tried to develop ideal nano-topographic oxidized silicon nanosponges by using with various chemicals to produce thickness difference in nanometers in order to study more about the cell-environment interactions in vitro like the alterations of cell adhesion, morphology, extracellular matrix secretions in the pathogenesis of osteoarthritis. Cytokines studies like growth factor, reactive oxygen species, reactive inflammatory materials (Like nitrous oxide and prostaglandin E2), extracellular matrix (ECM) degradation enzymes, and synthesis of collagen will also be observed and discussed. Extracellular and intracellular expression transforming growth factor beta (TGF-β) will be studied by reverse transcription-polymerase chain reaction (RT-PCR). The degradation of ECM will be observed by the bioactivity ratio of matrix metalloproteinase (MMP) and tissue inhibitors of metalloproteinase by ELISA (Enzyme-linked immunosorbent assay). When rabbit synoviocytes were cultured on these nano-topographic structures, they demonstrate better cell adhesion rate, decreased expression of MMP-2,9 and PGE2, and increased expression of TGF-β when cultured in nano-topographic oxidized silicon nanosponges than in the planar oxidized silicon ones. These results show cell behavior, cytokine production can be influenced by physical characteristics from different nano-topographic structures. Our study demonstrates the possibility of manipulating cell behavior in these nano-topographic biomaterials.

Keywords: osteoarthritis, synoviocyte, oxidized silicon surfaces, reactive oxygen species

Procedia PDF Downloads 368
9266 Powering Pacemakers from Heart Pressure Variation with Piezoelectric Energy Harvesters

Authors: A. Mathieu, B. Aubry, E. Chhim, M. Jobe, M. Arnaud

Abstract:

Present project consists in a study and a development of piezoelectric devices for supplying power to new generation pacemakers. They are miniaturized leadless implants without battery placed directly in right ventricle. Amongst different acceptable energy sources in cardiac environment, we choose the solution of a device based on conversion of the energy produced by pressure variation inside the heart into electrical energy. The proposed energy harvesters can meet the power requirements of pacemakers, and can be a good solution to solve the problem of regular surgical operation. With further development, proposed device should provide enough energy to allow pacemakers autonomy, and could be good candidate for next pacemaker generation.

Keywords: energy harvester, heart, leadless pacemaker, piezoelectric cells, pressure variation

Procedia PDF Downloads 432
9265 Modulation of Fish Allergenicity towards the Production of a Low Allergen Farmed Fish

Authors: Denise Schrama, Claudia Raposo, Pedro Rodrigues

Abstract:

Background: Food allergies are conducted by a hypersensitive response of the immune system. These allergies are a global concern for the public health. Consumption of fish is increasing worldwide as it is a healthy meat with high nutritional value. Unfortunately, fish can cause adverse immune-mediate reactions, affecting part of the population with higher incidence in children. β-parvalbumin, a small, highly conserved stable, calcium or magnesium binding muscle protein is the main fish allergen. In fish-allergic patients, cross-reactivity between different fish species exist due to recognition of highly identical protein regions. Enolases, aldolases, or fish gelatin are other identified fish allergens in some fish species. With no available cure for fish allergies, clinical management is only based on an avoidance diet aiming at the total exclusion of offending food. Methods: Mediterranean fish (S. aurata and D. labrax) were fed specifically designed diets, enriched in components that target the expression or inactivation of parvalbumin (creatine and EDTA, respectively). After 90 days fish were sampled and biological tissues were excised. Proteomics was used to access fish allergens characterization and expression in muscle while IgE assays to confirm the lower allergenic potential are conducted in patients with history of fish allergies. Fish welfare and quality of flesh were established with biochemical, texture and sensorial analysis. Results: Fish welfare shows no major impact between diets. In case of creatine supplementation in D. labrax proteomic analysis show a slight decrease in parvalbumin expression. No accumulation of this compound was found in muscle. For EDTA supplementation in S. aurata IgE assay show a slight decrease in allergenicity when using sera of fish allergic patients. Conclusion: Supplementation with these two compounds seems to change slightly the allergenicity of the two mean Mediterranean species.

Keywords: fish allergies, fish nutrition, proteomics, aquaculture

Procedia PDF Downloads 132
9264 Geothermal Energy Potential Estimates of Niger Delta Basin from Recent Studies

Authors: Olumide J. Adedapo

Abstract:

In this work, geothermal energy resource maps of the Niger Delta Basin were constructed using borehole thermal log data from over 300 deep wells. Three major geothermal anomalies were delineated and quantitatively interpreted in both onshore and offshore parts of the Niger Delta. The geothermal maps present the distribution of geothermal energy stored in the sedimentary rock mass in two ways: the accessible resources in depth interval 0-4000 m and static geothermal energy resources stored in the complete sedimentary infill of the basin (from the ground surface to the basement). The first map shows two major onshore anomalies, one in the north (with maximum energy values, 800 GJ/m2), another in the east to northeastern part (maximum energy values of 1250–1500 GJ/m2). Another two major anomalies occur offshore, one in the south with values of 750-1000 GJ/m2, occurring at about 100 km seawards and the other, in the southwest offshore with values 750-1250 GJ/m2, still at about 100 km from the shore. A second map of the Niger Delta shows a small anomaly in the northern part with the maximum value of 1500 GJ/m2 and a major anomaly occurring in the eastern part of the basin, onshore, with values of 2000-3500 GJ/m2. Offshore in the south and southwest anomalies in the total sedimentary rock mass occur with highest values up to 4000GJ/m2, with the southwestern anomaly extending west to the shore. It is much of interest to note the seaward–westward extension of these anomalies both in size, configuration, and magnitude for the geothermal energy in the total sedimentary thickness to the underlying basement. These anomalous fields show the most favourable locations and areas for further work on geothermal energy resources.

Keywords: geothermal energy, offshore, Niger delta, basin

Procedia PDF Downloads 194
9263 Human Computer Interaction Using Computer Vision and Speech Processing

Authors: Shreyansh Jain Jeetmal, Shobith P. Chadaga, Shreyas H. Srinivas

Abstract:

Internet of Things (IoT) is seen as the next major step in the ongoing revolution in the Information Age. It is predicted that in the near future billions of embedded devices will be communicating with each other to perform a plethora of tasks with or without human intervention. One of the major ongoing hotbed of research activity in IoT is Human Computer Interaction (HCI). HCI is used to facilitate communication between an intelligent system and a user. An intelligent system typically comprises of a system consisting of various sensors, actuators and embedded controllers which communicate with each other to monitor data collected from the environment. Communication by the user to the system is typically done using voice. One of the major ongoing applications of HCI is in home automation as a personal assistant. The prime objective of our project is to implement a use case of HCI for home automation. Our system is designed to detect and recognize the users and personalize the appliances in the house according to their individual preferences. Our HCI system is also capable of speaking with the user when certain commands are spoken such as searching on the web for information and controlling appliances. Our system can also monitor the environment in the house such as air quality and gas leakages for added safety.

Keywords: human computer interaction, internet of things, computer vision, sensor networks, speech to text, text to speech, android

Procedia PDF Downloads 344
9262 Real World Cancer Pain Incidence and Treatment in Daily Hospital

Authors: Alexandru Grigorescu, Alexandra Protesanu

Abstract:

Background: Approximately 34-67 percent of cancer patients experience an episode of uncontrolled pain during the course of their disease, depending on the stage. The aim is to provide evidence-based data for pain prevalence, diagnosis and treatment recommendations on an integrative model of medical oncology and palliative care for patients with cancer diagnostic in a day hospital. Patients and method: Consultation registers and electronic records of 166 Patients (Pts) were studied from April 2022 to March 2023. Pts with pain syndrome were selected. The pain was objectified by the visual pain scale. To elucidate the causes of the pain, investigations were carried out: bone scintigraphy, CT scan, and PET-CT. The analgesic treatments were represented by weak and strong morphine, radiotherapy, and bisphosphonates. Result: During the mentioned period, 166 oncological patients (74 women and 92 men) were treated in the oncology day hospitalization service. There were 1,500 consultations, 40 of which were only for pain. The neoplastic locations were: gynecological, malignant melanoma, breast, gastric, bronchopulmonary, colorectal, liver, pancreatic, bladder, and kidney. 70 Pts presented pain syndrome. The causes of the pain were represented by bone metastases, compressive tumors, and post-surgical status. Drug treatment: Tramadol 47 Pts, of which 10 switched to a major opioid (Oxycodonum, Morphine sulfate), 20 Pts were treated with Oxycodonum as the first intention. In 5 patients ry to rotated morphine, 20 Pts received palliative radiotherapy, 10 Pts were treated with bisphosphonates. 2 Pts required neurosurgery consultation for an antalgic intervention. 5 Pts had important adverse reactions to morphine. All patients and their families were advised by a medical oncologist and psychologist for a lifestyle change. Conclusions: The prevalence of pain was similar to that described in the literature. In most cases, the pain could be managed in the day hospital. Weak and strong morphine represented the main pain therapy. Palliative radiotherapy was the second most effective therapy. Treatment with bisphosphonates was useful. Surgical interventions were rarely indicated. Discussions with patients and their families regarding the lifestyle change were important.

Keywords: cancer pain, opioids, medical oncology, palliative care

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9261 Dietary Exposure of Heavy Metals through Cereals Commonly Consumed by Dhaka City Residents

Authors: A. Md. Bayejid Hosen, B. M Zakir Hossain Howlader, C. Yearul Kabir

Abstract:

Contamination of soil and agricultural products by heavy metals resulting from rapid industrial development has caused major concern. Dietary exposure to heavy metals has been associated with toxic and adverse health effects. The main threats to human health from heavy metals are associated with exposure to Pb, Cd and Hg. The aim of this study was to monitor the presence of heavy metals in cereals collected from different wholesale markets of Dhaka City. One hundred and sixty cereal samples were collected and analyzed for determination of heavy metals. Heavy metals were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). A total of six heavy metals– lead, chromium, cadmium, mercury, arsenic and antimony were estimated. The average concentrations of heavy metals in cereals fall within the safe limit established by regulatory organizations except for Pb (152.4 μg/100g) and Hg (15.13 μg/100g) which exceeded the safe limits. BARI gom-26 was the highest source of Pb (304.1 μg/100g) whereas Haski-29 rice variety contained the highest amount of Hg (60.85 μg/100g). Though all the cereal varieties contained approximately same amount of Cr the naizer sail varieties contained huge amount of Cr (171.8 μg/100g). Among all the cereal samples miniket rice varieties contained the least amount of heavy metals. The concentration of Cr (63.24 μg/100g), Cd (5.54 μg/100g) and As (3.26 μg/100g) in all cereals were below the safe limits. The daily intake of heavy metals was determined using the total weight of cereals consumed each day multiplied by the concentrations of heavy metals in cereals. The daily intake was compared with provisional maximum tolerable daily intake set by different regulatory organizations. The daily intake of Cd (23.0 μg), Hg (63.0 μg) and as (13.6 μg) through cereals were below the risk level except for Pb (634.0 μg) and Cr (263.1 μg). As the main meal of average Bangladeshi people is boiled rice served with some sorts of vegetables, our findings indicate that the residents of Dhaka City are at risk from Pb and Cr contamination. Potential health risks from exposure to heavy metals in self-planted cereals need more attention.

Keywords: contamination, dietary exposure, heavy metals, human health, ICP-MS

Procedia PDF Downloads 427