Search results for: behavioral-physical and visual methods
Commenced in January 2007
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Edition: International
Paper Count: 16868

Search results for: behavioral-physical and visual methods

5318 Acupoint Injection of High Concentration of Glucose Attenuates Mice Chronic Pain and Depression Comorbidity

Authors: Chanya Inprasit, Yi-Wen Lin

Abstract:

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

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

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5317 A Comprehensive Study and Evaluation on Image Fashion Features Extraction

Authors: Yuanchao Sang, Zhihao Gong, Longsheng Chen, Long Chen

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Clothing fashion represents a human’s aesthetic appreciation towards everyday outfits and appetite for fashion, and it reflects the development of status in society, humanity, and economics. However, modelling fashion by machine is extremely challenging because fashion is too abstract to be efficiently described by machines. Even human beings can hardly reach a consensus about fashion. In this paper, we are dedicated to answering a fundamental fashion-related problem: what image feature best describes clothing fashion? To address this issue, we have designed and evaluated various image features, ranging from traditional low-level hand-crafted features to mid-level style awareness features to various current popular deep neural network-based features, which have shown state-of-the-art performance in various vision tasks. In summary, we tested the following 9 feature representations: color, texture, shape, style, convolutional neural networks (CNNs), CNNs with distance metric learning (CNNs&DML), AutoEncoder, CNNs with multiple layer combination (CNNs&MLC) and CNNs with dynamic feature clustering (CNNs&DFC). Finally, we validated the performance of these features on two publicly available datasets. Quantitative and qualitative experimental results on both intra-domain and inter-domain fashion clothing image retrieval showed that deep learning based feature representations far outweigh traditional hand-crafted feature representation. Additionally, among all deep learning based methods, CNNs with explicit feature clustering performs best, which shows feature clustering is essential for discriminative fashion feature representation.

Keywords: convolutional neural network, feature representation, image processing, machine modelling

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5316 Association of Vascular Endothelial Growth Factor Gene +405 C>G and -460 T>C Polymorphism with Type 2 Diabetic Foot Ulcer Patient in Cipto Mangunkusumo National Hospital Jakarta

Authors: Dedy Pratama, Akhmadu Muradi, Hilman Ibrahim, Raden Suhartono, Alexander Jayadi Utama, Patrianef Darwis, S. Dwi Anita, Luluk Yunaini, Kemas Dahlan

Abstract:

Introduction: Vascular endothelial growth factor (VEGF) gene shows association with various angiogenesis conditions including Diabetic Foot Ulcer (DFU) disease. In this study, we performed this study to examine VEGF gene polymorphism associated with DFU. Methods: Case-control study of polymorphism of VEGF gene +405 C>G and -460 T>C, of diabetes mellitus (DM) type 2 with Diabetic Foot Ulcer (DFU) in Cipto Mangunkusumo National Hospital (RSCM) Jakarta from June to December 2016. Results: There were 203 patients, 102 patients with DFU and 101 patients without DFU. Forty-nine point 8 percent of total samples is male and 50,2% female with mean age 56,06 years. Distribution of the wild-type genotype VEGF +405 C>G wild type CC was found in 6,9% of respondents, the number of mutant heterozygote CG was 69,5% and mutant homozygote GG was 19,7%. Cumulatively, there were 6,9% wild-type and 85,2% mutant and 3,9% of total blood samples could not be detected on PCR-RFLP. Distribution of VEGF allele +405 C>G C alleles were 43% and G alleles were 57%. Distribution of genotype from VEGF gene -460 T>C is wild type TT 42,9%, mutant heterozygote TC 37,9% and mutant homozygote CC 13,3%. Cumulatively, there were 42,9% wild-type and 51% mutant type. Distribution of VEGF -460 T>C were 62% T allele and 38% C allele. Conclusion: In this study we found the distribution of alleles from VEGF +405 C>G is C 43% and G 57% and from VEGF -460 T>C; T 62% and C 38%. We propose that G allele in VEGF +405 C>G can act as a protective allele and on the other hands T allele in VEGF -460 T>C could be acted as a risk factor for DFU in diabetic patients.

Keywords: diabetic foot ulcer, diabetes mellitus, polymorphism, VEGF

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5315 Oxidosqualene Cyclase: A Novel Inhibitor

Authors: Devadrita Dey Sarkar

Abstract:

Oxidosqualene cyclase is a membrane bound enzyme in which helps in the formation of steroid scaffold in higher organisms. In a highly selective cyclization reaction oxidosqualene cyclase forms LANOSTEROL with seven chiral centres starting from the linear substrate 2,3-oxidosqualene. In humans OSC in cholesterol biosynthesis it represents a target for the discovery of novel anticholesteraemic drugs that could complement the widely used statins. The enzyme oxidosqualene: lanosterol cyclase (OSC) represents a novel target for the treatment of hypercholesterolemia. OSC catalyzes the cyclization of the linear 2,3-monoepoxysqualene to lanosterol, the initial four-ringed sterol intermediate in the cholesterol biosynthetic pathway. OSC also catalyzes the formation of 24(S), 25-epoxycholesterol, a ligand activator of the liver X receptor. Inhibition of OSC reduces cholesterol biosynthesis and selectively enhances 24(S),25-epoxycholesterol synthesis. Through this dual mechanism, OSC inhibition decreases plasma levels of low-density lipoprotein (LDL)-cholesterol and prevents cholesterol deposition within macrophages. The recent crystallization of OSC identifies the mechanism of action for this complex enzyme, setting the stage for the design of OSC inhibitors with improved pharmacological properties for cholesterol lowering and treatment of atherosclerosis. While studying and designing the inhibitor of oxidosqulene cyclase, I worked on the pdb id of 1w6k which was the most worked on pdb id and I used several methods, techniques and softwares to identify and validate the top most molecules which could be acting as an inhibitor for oxidosqualene cyclase. Thus, by partial blockage of this enzyme, both an inhibition of lanosterol and subsequently cholesterol formation as well as a concomitant effect on HMG-CoA reductase can be achieved. Both effects complement each other and lead to an effective control of cholesterol biosynthesis. It is therefore concluded that 2,3-oxidosqualene cyclase plays a crucial role in the regulation of intracellular cholesterol homeostasis. 2,3-Oxidosqualene cyclase inhibitors offer an attractive approach for novel lipid-lowering agents.

Keywords: anticholesteraemic, crystallization, statins, homeostasis

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5314 Cardiorespiratory Fitness and the Cardiometabolic Profile in Inactive Obese Postmenopausal Women: A MONET Study

Authors: Ahmed Ghachem, Johann Colomba, Denis Prud'homme, Martin Brochu

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Background: Inactive obese postmenopausal women, are at greater risk for metabolic complications. On the other hand, high levels of cardiorespiratory fitness (CRF) are associated with a lower risk of metabolic complications. Objective: To compare inactive obese postmenopausal women displaying ‘lower’ vs ‘higher’ levels of CRF for body composition, metabolic profile, inflammatory profile and measures of energy expenditure. Methods: 132 women (age: 57.6 ± 4.8 yrs; BMI: 32.3 ± 4.6 kg/m2; Peak VO2: 17.81 ± 3.02 ml O2•kg-1•min-1) were studied. They were first divided into tertiles based on their CRF. Then, women in the first (< 16.51 ml O2•min-1•kg-1) and second tertiles (16.51 to 19.22 ml O2•min-1•kg-1) were combined (N= 88), and compared with those in the third tertile (> 19.22 ml O2•min-1•kg-1) (N= 44). Variables of interest were: Peak VO2 (stationary bike), body composition (DXA), body fat distribution (CT scan), glucose homeostasis (fasting state and euglycemic/ hyperinsulinemic clamp), fasting lipids, resting blood pressure, inflammatory profile and energy expenditure (DLW). Results: Both CRF groups (lower= 16.0 ± 2.0 ml O2•kg-1•min-1 vs higher= 21.2 ± 1.7 ml O2•kg-1•min-1; p < 0.001) were similar for age. Significant differences were observed between groups for body composition; with lower values for body weight, BMI, fat mass and visceral fat in women with higher CRF (p between 0.001 and 0.005). Also, women with higher CRF had lower values for fasting insulin (13.4 ± 4.5 vs 15.6 ± 6.6 μU/ml; p = 0.03) and CRP levels (2.31 ± 1.97 vs 3.83 ± 3.24 mg/liter; p = 0.001); and higher values for glucose disposal (6.71 ± 1.78 vs 5.92 ± 1.67 mg/kg/min; p = 0.01). However, these differences were no longer significant after controlling for visceral adipose tissue accumulations. Finally, no significant difference was observed between groups for the other variables of interest. Conclusion: Our results suggest that, among inactive overweight/obese postmenopausal women, those with higher CRF levels have a better metabolic profile; which is caused by lower visceral fat accumulations.

Keywords: cardiorespiratory fitness, metabolic profile, menopause, obesity

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5313 Towards Designing of a Potential New HIV-1 Protease Inhibitor Using Quantitative Structure-Activity Relationship Study in Combination with Molecular Docking and Molecular Dynamics Simulations

Authors: Mouna Baassi, Mohamed Moussaoui, Hatim Soufi, Sanchaita RajkhowaI, Ashwani Sharma, Subrata Sinha, Said Belaaouad

Abstract:

Human Immunodeficiency Virus type 1 protease (HIV-1 PR) is one of the most challenging targets of antiretroviral therapy used in the treatment of AIDS-infected people. The performance of protease inhibitors (PIs) is limited by the development of protease mutations that can promote resistance to the treatment. The current study was carried out using statistics and bioinformatics tools. A series of thirty-three compounds with known enzymatic inhibitory activities against HIV-1 protease was used in this paper to build a mathematical model relating the structure to the biological activity. These compounds were designed by software; their descriptors were computed using various tools, such as Gaussian, Chem3D, ChemSketch and MarvinSketch. Computational methods generated the best model based on its statistical parameters. The model’s applicability domain (AD) was elaborated. Furthermore, one compound has been proposed as efficient against HIV-1 protease with comparable biological activity to the existing ones; this drug candidate was evaluated using ADMET properties and Lipinski’s rule. Molecular Docking performed on Wild Type and Mutant Type HIV-1 proteases allowed the investigation of the interaction types displayed between the proteases and the ligands, Darunavir (DRV) and the new drug (ND). Molecular dynamics simulation was also used in order to investigate the complexes’ stability, allowing a comparative study of the performance of both ligands (DRV & ND). Our study suggested that the new molecule showed comparable results to that of Darunavir and may be used for further experimental studies. Our study may also be used as a pipeline to search and design new potential inhibitors of HIV-1 proteases.

Keywords: QSAR, ADMET properties, molecular docking, molecular dynamics simulation.

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5312 Comparison of Radiation Dosage and Image Quality: Digital Breast Tomosynthesis vs. Full-Field Digital Mammography

Authors: Okhee Woo

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Purpose: With increasing concern of individual radiation exposure doses, studies analyzing radiation dosage in breast imaging modalities are required. Aim of this study is to compare radiation dosage and image quality between digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM). Methods and Materials: 303 patients (mean age 52.1 years) who studied DBT and FFDM were retrospectively reviewed. Radiation dosage data were obtained by radiation dosage scoring and monitoring program: Radimetrics (Bayer HealthCare, Whippany, NJ). Entrance dose and mean glandular doses in each breast were obtained in both imaging modalities. To compare the image quality of DBT with two-dimensional synthesized mammogram (2DSM) and FFDM, 5-point scoring of lesion clarity was assessed and the better modality between the two was selected. Interobserver performance was compared with kappa values and diagnostic accuracy was compared using McNemar test. The parameters of radiation dosages (entrance dose, mean glandular dose) and image quality were compared between two modalities by using paired t-test and Wilcoxon rank sum test. Results: For entrance dose and mean glandular doses for each breasts, DBT had lower values compared with FFDM (p-value < 0.0001). Diagnostic accuracy did not have statistical difference, but lesion clarity score was higher in DBT with 2DSM and DBT was chosen as a better modality compared with FFDM. Conclusion: DBT showed lower radiation entrance dose and also lower mean glandular doses to both breasts compared with FFDM. Also, DBT with 2DSM had better image quality than FFDM with similar diagnostic accuracy, suggesting that DBT may have a potential to be performed as an alternative to FFDM.

Keywords: radiation dose, DBT, digital mammography, image quality

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5311 Beyond Diagnosis: Innovative Instructional Methods for Children with Multiple Disabilities

Authors: Patricia Kopetz

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Too often our youngest children with disabilities receive diagnostic labels and accompanying treatment plans based upon perceptions that the children are of limited aptitude and/or ambition. However, children of varied-ability levels who are diagnosed with ‘multiple disabilities,’ can participate and excel in school-based instruction that aligns with their desires, interests, and fortitude – criteria components not foretold by scores on standardized assessments. The paper represents theoretical work in Special Education Innovative Instruction, and includes presenting research materials, some developed by the author herself. The majority of students with disabilities are now served in general education settings in the United States, embracing inclusive practices in our schools. ‘There is now a stronger call for special education to step up and improve efficiency, implement evidence-based practices, and provide greater accountability on key performance indicators that support successful academic and post-school outcomes for students with disabilities.’ For example, in the United States, the Office of Special Education Programs (OSEP) is focusing on results-driven indicators to improve outcomes for students with disabilities. School personnel are appreciating the implications of research-driven approaches for students diagnosed with multiple disabilities, and aim to align their practices toward such focus. The paper presented will provide updates on current theoretical principles and perspectives, and explore advancements in latest, evidence-based and results-driven instructional practices that can motivate children with multiple disabilities to advance their skills and engage in learning activities that as nonconventional, innovative, and proven successful.

Keywords: childhood special education, educational technology , innovative instruction, multiple disabilities

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5310 Nursing Documentation of Patients' Information at Selected Primary Health Care Facilities in Limpopo Province, South Africa: Implications for Professional Practice

Authors: Maria Sonto Maputle, Rhulani C. Shihundla, Rachel T. Lebese

Abstract:

Background: Patients’ information must be complete and accurately documented in order to foster quality and continuity of care. The multidisciplinary health care members use patients’ documentation to communicate about health status, preventive health services, treatment, planning and delivery of care. The purpose of this study was to determine the practice of nursing documentation of patients’ information at selected Primary Health Care (PHC) facilities in Vhembe District, Limpopo Province, South Africa. Methods: The research approach adopted was qualitative while exploratory and descriptive design was used. The study was conducted at selected PHC facilities. Population included twelve professional nurses. Non-probability purposive sampling method was used to sample professional nurses who were willing to participate in the study. The criteria included participants’ whose daily work and activities, involved creating, keeping and updating nursing documentation of patients’ information. Qualitative data collection was through unstructured in-depth interviews until no new information emerged. Data were analysed through open–coding of, Tesch’s eight steps method. Results: Following data analysis, it was found that professional nurses’ had knowledge deficit related to insufficient training on updates and rendering multiple services daily had negative impact on accurate documentation of patients’ information. Conclusion: The study recommended standardization of registers, books and forms used at PHC facilities, and reorganization of PHC services into open day system.

Keywords: documentation, knowledge, patient care, patient’s information, training

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5309 The Bespoke ‘Hybrid Virtual Fracture Clinic’ during the COVID-19 Pandemic: A Paradigm Shift?

Authors: Anirudh Sharma

Abstract:

Introduction: The Covid-19 pandemic necessitated a change in the manner outpatient fracture clinics are conducted due to the need to reduce footfall in hospital. While studies regarding virtual fracture clinics have shown these to be useful and effective, they focus exclusively on remote consultations. However, our service was bespoke to the patient – either a face-to-face or telephone consultation depending on patient need – a ‘hybrid virtual clinic (HVC).’ We report patient satisfaction and outcomes with this novel service. Methods: Patients booked onto our fracture clinics during the first 2 weeks of national lockdown were retrospectively contacted to assess the mode of consultations (virtual, face-to-face, or hybrid), patient experience, and outcome. Patient experience was assessed using the net promoter (NPS), customer effort (CES) and customer satisfaction scores (CSS), and their likelihood of using the HVC in the absence of a pandemic. Patient outcomes were assessed using the components of the EQ5D score. Results: Of 269 possible patients, 140 patients responded to the questionnaire. Of these, 66.4% had ‘hybrid’ consultations, 27.1% had only virtual consultations, and 6.4% had only face-to-face consultations. The mean overall NPS, CES, and CSS (on a scale of 1-10) were 7.27, 7.25, and 7.37, respectively. The mean likelihood of patients using the HVC in the absence of a pandemic was 6.5/10. Patients who had ‘hybrid’ consultations showed better effort scores and greater overall satisfaction than those with virtual consultations only and also reported superior EQ5D outcomes (mean 79.27 vs. 72.7). Patients who did not require surgery reported increased satisfaction (mean 7.51 vs. 7.08) and were more likely to use the HVC in the absence of a pandemic. Conclusion: Our study indicates that a bespoke HVC has good overall patient satisfaction and outcomes and is a better format of fracture clinic service than virtual consultations alone. It may be the preferred mode for fracture clinics in similar situations in the future. Further analysis needs to be conducted in order to explore the impact on resources and clinician experience of HVC in order to appreciate this new paradigm shift.

Keywords: hybrid virtual clinic, coronavirus, COVID-19, fracture clinic, remote consultation

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5308 Research on Community-Based Engineering Learning and Undergraduate Students’ Creativity in China: The Moderate Effect of Engineering Identity

Authors: Liang Wang, Wei Zhang

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There have been some existing researches on design-based engineering learning (DBEL) and project-based or problem-based engineering learning (PBEL). Those findings have greatly promoted the reform of engineering education in China. However, the engineering with a big E means that more and more engineering activities are designed and operated by communities of practice (CoPs), namely community-based engineering learning. However, whether community-based engineering learning can promote students' innovation has not been verified in published articles. This study fills this gap by investigating the relationship between community-based learning approach and students’ creativity, using engineering identity as an intermediary variable. The goal of this study is to discover the core features of community-based engineering learning, and make the features more beneficial for students’ creativity. The study created and adapted open survey items from previously published studies and a scale on learning community, students’ creativity and engineering identity. Firstly, qualitative content analysis methods by MAXQDA were used to analyze 32 open-ended questionnaires. Then the authors collected data (n=322) from undergraduate students in engineering competition teams and engineering laboratories in Zhejiang University, and structural equation modelling (SEM) was used to understand the relationship between different factors. The study finds: (a) community-based engineering learning has four main elements like real-task context, self-inquiry learning, deeply-consulted cooperation and circularly-iterated design, (b) community-based engineering learning can significantly enhance the engineering undergraduate students’ creativity, and (c) engineering identity partially moderated the relationship between community-based engineering learning and undergraduate students' creativity. The findings further illustrate the value of community-based engineering learning for undergraduate students. In the future research, the authors should further clarify the core mechanism of community-based engineering learning, and pay attention to the cultivation of undergraduate students’ engineer identity in learning community.

Keywords: community-based engineering learning, students' creativity, engineering identity, moderate effect

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5307 Synthesis of Electrospun Polydimethylsiloxane (PDMS)/Polyvinylidene Fluoriure (PVDF) Nanofibrous Membranes for CO₂ Capture

Authors: Wen-Wen Wang, Qian Ye, Yi-Feng Lin

Abstract:

Carbon dioxide emissions are expected to increase continuously, resulting in climate change and global warming. As a result, CO₂ capture has attracted a large amount of research attention. Among the various CO₂ capture methods, membrane technology has proven to be highly efficient in capturing CO₂, because it can be scaled up, low energy consumptions and small area requirements for use by the gas separation. Various nanofibrous membranes were successfully prepared by a simple electrospinning process. The membrane contactor combined with chemical absorption and membrane process in the post-combustion CO₂ capture is used in this study. In a membrane contactor system, the highly porous and water-repellent nanofibrous membranes were used as a gas-liquid interface in a membrane contactor system for CO₂ absorption. In this work, we successfully prepared the polyvinylidene fluoride (PVDF) porous membranes with an electrospinning process. Afterwards, the as-prepared water-repellent PVDF porous membranes were used for the CO₂ capture application. However, the pristine PVDF nanofibrous membranes were wetted by the amine absorbents, resulting in the decrease in the CO₂ absorption flux, the hydrophobic polydimethylsiloxane (PDMS) materials were added into the PVDF nanofibrous membranes to improve the solvent resistance of the membranes. To increase the hydrophobic properties and CO₂ absorption flux, more hydrophobic surfaces of the PDMS/PVDF nanofibrous membranes are obtained by the grafting of fluoroalkylsilane (FAS) on the membranes surface. Furthermore, the highest CO₂ absorption flux of the PDMS/PVDF nanofibrous membranes is reached after the FAS modification with four times. The PDMS/PVDF nanofibrous membranes with 60 wt% PDMS addition can be a long and continuous operation of the CO₂ absorption and regeneration experiments. It demonstrates the as-prepared PDMS/PVDF nanofibrous membranes could potentially be used for large-scale CO₂ absorption during the post-combustion process in power plants.

Keywords: CO₂ capture, electrospinning process, membrane contactor, nanofibrous membranes, PDMS/PVDF

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5306 Neural Network-based Risk Detection for Dyslexia and Dysgraphia in Sinhala Language Speaking Children

Authors: Budhvin T. Withana, Sulochana Rupasinghe

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The problem of Dyslexia and Dysgraphia, two learning disabilities that affect reading and writing abilities, respectively, is a major concern for the educational system. Due to the complexity and uniqueness of the Sinhala language, these conditions are especially difficult for children who speak it. The traditional risk detection methods for Dyslexia and Dysgraphia frequently rely on subjective assessments, making it difficult to cover a wide range of risk detection and time-consuming. As a result, diagnoses may be delayed and opportunities for early intervention may be lost. The project was approached by developing a hybrid model that utilized various deep learning techniques for detecting risk of Dyslexia and Dysgraphia. Specifically, Resnet50, VGG16 and YOLOv8 were integrated to detect the handwriting issues, and their outputs were fed into an MLP model along with several other input data. The hyperparameters of the MLP model were fine-tuned using Grid Search CV, which allowed for the optimal values to be identified for the model. This approach proved to be effective in accurately predicting the risk of Dyslexia and Dysgraphia, providing a valuable tool for early detection and intervention of these conditions. The Resnet50 model achieved an accuracy of 0.9804 on the training data and 0.9653 on the validation data. The VGG16 model achieved an accuracy of 0.9991 on the training data and 0.9891 on the validation data. The MLP model achieved an impressive training accuracy of 0.99918 and a testing accuracy of 0.99223, with a loss of 0.01371. These results demonstrate that the proposed hybrid model achieved a high level of accuracy in predicting the risk of Dyslexia and Dysgraphia.

Keywords: neural networks, risk detection system, Dyslexia, Dysgraphia, deep learning, learning disabilities, data science

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5305 The Suitability of Agile Practices in Healthcare Industry with Regard to Healthcare Regulations

Authors: Mahmood Alsaadi, Alexei Lisitsa

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Nowadays, medical devices rely completely on software whether as whole software or as embedded software, therefore, the organization that develops medical device software can benefit from adopting agile practices. Using agile practices in healthcare software development industries would bring benefits such as producing a product of a high-quality with low cost and in short period. However, medical device software development companies faced challenges in adopting agile practices. These due to the gaps that exist between agile practices and the requirements of healthcare regulations such as documentation, traceability, and formality. This research paper will conduct a study to investigate the adoption rate of agile practice in medical device software development, and they will extract and outline the requirements of healthcare regulations such as Food and Drug Administration (FDA), Health Insurance Portability and Accountability Act (HIPAA), and Medical Device Directive (MDD) that affect directly or indirectly on software development life cycle. Moreover, this research paper will evaluate the suitability of using agile practices in healthcare industries by analyzing the most popular agile practices such as eXtream Programming (XP), Scrum, and Feature-Driven Development (FDD) from healthcare industry point of view and in comparison with the requirements of healthcare regulations. Finally, the authors propose an agile mixture model that consists of different practices from different agile methods. As result, the adoption rate of agile practices in healthcare industries still low and agile practices should enhance with regard to requirements of the healthcare regulations in order to be used in healthcare software development organizations. Therefore, the proposed agile mixture model may assist in minimizing the gaps existing between healthcare regulations and agile practices and increase the adoption rate in the healthcare industry. As this research paper part of the ongoing project, an evaluation of agile mixture model will be conducted in the near future.

Keywords: adoption of agile, agile gaps, agile mixture model, agile practices, healthcare regulations

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5304 Mental Disorders and Physical Illness in Geriatric Population

Authors: Vinay Kumar, M. Kishor, Sathyanarayana Rao Ts

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Background: Growth of elderly people in the general population in recent years is termed as ‘greying of the world’ where there is a shift from high mortality & fertility to low mortality and fertility, resulting in an increased proportion of older people as seen in India. Improved health care promises longevity but socio-economic factors like poverty, joint families and poor services pose a psychological threat. Epidemiological data regarding the prevalence of mental disorders in geriatric population with physical illness is required for proper health planning. Methods: Sixty consecutive elderly patients aged 60 years or above of both sexes, reporting with physical illness to general outpatient registration counter of JSS Medical College and Hospital, Mysore, India, were considered for the Study. With informed consent, they were screened with General Health Questionnaire (GHQ-12) and were further evaluated for diagnosing mental disorders according to WHO International Classification of Diseases (ICD-10) criteria. Results: Mental disorders were detected in 48.3%, predominantly depressive disorders, nicotine dependence, generalized anxiety disorder, alcohol dependence and least was dementia. Most common physical illness was cardiovascular disease followed by metabolic, respiratory and other diseases. Depressive disorders, substance dependence and dementia were more associated with cardiovascular disease compared to metabolic disease and respiratory diseases were more associated with nicotine dependence. Conclusions: Depression and Substance use disorders among elderly population is of concern, which needs to be further studied with larger population. Psychiatric morbidity will adversely have an impact on physical illness which needs proper assessment and management. This will enhance our understanding and prioritize our planning for future.

Keywords: Geriatric, mental disorders, physical illness, psychiatry

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5303 Understanding John H. Johnson and Ebony Magazine Financial Responsiveness to Rise of Black Power in the U.S, 1966

Authors: Sid Ahmed Ziane

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This paper argues for Johnson's financial responsiveness to the rise of Black Power and its advocate, 'Stokely Carmichael' in 1966. John H. Johnson was a Black businessman and the owner of Ebony magazine, one of the widely read Black magazines in the U.S. His magazine, however, was designed only to promoting Black fashion, aesthetic, marketing, and consumerism. In mid-1966, the mainstream of the Civil Rights movement was heading into two distinct camps when some of its advocates, led by Stokely Carmichael, began to question the slow pace of the Civil Rights and sought to pursue a more radical approach to bring about upheaval to the Black community. Their new approach, however, propelled the national media into paying close attention to their activities, their new methods, and their radical orientations. In fact, the major White-oriented media discredited Carmichael and distorted his public image via sensational stories and race-mongering reports. However, the Black owned outlets such as The Liberator advocated his agendas, whereas other magazines such as The Crisis rejected them. Based on such oral sources and Ebony’s online issues, this paper adds and argues that Johnson had also responded to the rise of Black Power and Carmichael. This reaction had, in fact, aimed at scooping and selling Carmichael and his new orientation as well as advertising him in his magazine to attract the readers who showed a strong tendency to hear and read about the heyday and even the ferment of Black Power. This paper is part of an ongoing project which aims at framing our understanding of how the Black print media and the modern Black liberation struggle were correlated and could shape each other by appraising their agendas, milestones, and their pivotal figures.

Keywords: Black power, Ebony magazine, John Johson, Stokely Carmichael

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5302 Understanding Chromosome Movement in Starfish Oocytes

Authors: Bryony Davies

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Many cell and tissue culture practices ignore the effects of gravity on cell biology, and little is known about how cell components may move in response to gravitational forces. Starfish oocytes provide an excellent model for interrogating the movement of cell components due to their unusually large size, ease of handling, and high transparency. Chromosomes from starfish oocytes can be visualised by microinjection of the histone-H2B-mCherry plasmid into the oocytes. The movement of the chromosomes can then be tracked by live-cell fluorescence microscopy. The results from experiments using these methods suggest that there is a replicable downward movement of centrally located chromosomes at a median velocity of 0.39 μm/min. Chromosomes nearer the nuclear boundary showed more restricted movement. Chromosome density and shape could also be altered by microinjection of restriction enzymes, primarily Alu1, before imaging. This was found to alter the speed of chromosome movement, with chromosomes from Alu1-injected nuclei showing a median downward velocity of 0.60 μm/min. Overall, these results suggest that there is a non-negligible movement of chromosomes in response to gravitational forces and that this movement can be altered by enzyme activity. Future directions based on these results could interrogate if this observed downward movement extends to other cell components and to other cell types. Additionally, it may be important to understand whether gravitational orientation and vertical positioning of cell components alter cell behaviour. The findings here may have implications for current cell culture practices, which do not replicate cell orientations or external forces experienced in vivo. It is possible that a failure to account for gravitational forces in 2D cell culture alters experimental results and the accuracy of conclusions drawn from them. Understanding possible behavioural changes in cells due to the effects of gravity would therefore be beneficial.

Keywords: starfish, oocytes, live-cell imaging, microinjection, chromosome dynamics

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5301 The Effect of Vitamin D Supplementation on Prostate Cancer: A Systematic Review and Meta-Analysis of Clinical Trials

Authors: Simin Shahvazi, Sepideh Soltani, Seyed Mehdi Ahmadi, Russell J. De Souza, Amin Salehi-Abargouei

Abstract:

Background and Objectives: Vitamin D has received attention for its potential to disrupt cancer processes such as attenuating cell proliferation and exacerbating differentiation and apoptosis. However, whether there exists a role for vitamin D in the treatment of prostate cancer specifically remains controversial. We systematically review the literature to assess whether supplementation with vitamin D influences PSA response and overall survival in patients with prostate cancer. Methods: We searched PubMed, Scopus, ISI Web of Science and Google scholar from inception through up to 10 September 2017 for both before-and-after and randomized trials that evaluated the effect of vitamin D supplementation on the prostate specific antigen (PSA) response rate in participants with prostate cancer. The DerSimonian and Laird, inverse-weighted random-effects model was used to pool effect estimates from the studies. Heterogeneity and potential publication bias were evaluated. Subgroup analyses were also performed. Results: Twenty-two studies (16 before-after and 6 randomized controlled trials) were found and included in meta-analysis. The analysis on controlled clinical trials revealed that PSA change from baseline [weighted mean difference (WMD) = -1.66 ng/ml, 95%CI: -0.69, 0.36, P= 0.543)], PSA response (RR=1.18, 95%CI: 0.97, 1.45, P=0.104) and mortality rate (risk ratio (RR) = 1.05, 95% CI: 0.81-1.36; P=0.713) was not significantly different between vitamin D supplementation and placebo groups. Single arm trials revealed that vitamin D supplementation had had a modest effect on PSA response rate: 19% of those enrolled had at least a 50% reduction in PSA by the end of treatment (95% CI: 7% to 31%; p=0.002). Conclusion: We found that vitamin D modestly increases the PSA response rate in single arm studies. No effect on serum PSA levels, PSA response and mortality was seen in randomized controlled clinical trials. It does not seem patients with prostate cancer benefit from vitamin D supplementation.

Keywords: mortality, prostatic neoplasms, PSA response, vitamin D

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5300 The First Fungal Identification from Mini-BAL of Critical COVID-19 Patients

Authors: Fatemeh Fallah, Ensieh Lotfali, Leila Azimi, Hannan Khodaei, Maryam Rajabnejad, Nafiseh Abdollahi, Hossein Tayebi, Saham Ansari, Saeedeh Yaghoubi, Abdollah Karimi

Abstract:

Background: Coronavirus disease 2019 (COVID-19) has become a worldwide issue due to its high prevalence and rapid transmission. Fungal infections have been detected in COVID-19 patients, leading to increased morbidity and mortality. Objectives: This study aimed to isolate Aspergillus fumigatus and Mucor spp. on mini-bronchoalveolar lavage samples obtained from children with COVID-19 hospitalized in an Iranian children’s hospital. Methods: A cross-sectional descriptive study was performed on mini-bronchoalveolar lavage samples from children confirmed positive for COVID-19 admitted to ICU with a ventilator from April 2021 to February 2022. Demographic characteristics were recorded, and fungal DNA was extracted from mini-BAL samples taken from children. Nested PCR was made with two primers for Aspergillus fumigatus and Mucor spp. Results: Out of 100 children with COVID-19, all samples were negative for Aspergillus fumigatus; however, 12 cases were positive for BAL PCR for Mucor spp. Among the 12 patients, fever, shortness of breath, cough, and decreased level of consciousness were reported in 8.3% (n: 1), 16.6% (n: 2), 25% (n: 3), and 25% (n: 3), respectively. Most cases (41.7%; n: 5) suffered from heart disease, followed by underlying malignancy (33.4%; n: 4). All positive BAL PCR for Mucor spp. cases had significantly higher chest CT scan scores and spent more time under a ventilator. Conclusions: The identification of COVID-19 with Mucor spp. was observed among 12% (n: 12) of children hospitalized in a COVID-19 ICU. When dealing with pediatric COVID-19 patients, clinicians should consider the differential diagnosis of fungal co-infections and have a low threshold to begin treatment. Moreover, it is highly advisable to take prophylactic measures, such as properly using corticosteroids and shortening the intubation time.

Keywords: aspergillosis, COVID-19 identification, mucormycosis, paediatrics

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5299 Food Bolus Obstruction: A Rural Hospital’s Experience

Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

Abstract:

Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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5298 Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda

Authors: Humphrey Atwijukiire, Gladys Nakidde, Anne Tweheyo Otwine, Jane Kabami

Abstract:

Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda Introduction: Disclosure of HIV status is key in HIV management. Despite many studies on serostatus disclosure, there is a gap in experiences regarding HIV status disclosure among discordant couples. This study explored the lived experiences of serostatus disclosure among discordant couples in Mbarara City, South Western Uganda. Methods: We conducted 12 in-depth interviews using translated interview guide, and audio recorders. Participants were purposively enrolled in the study. The study was conducted at three public health facilities in Mbarara City. Data was analyzed using thematic content analysis. Approval for this research was obtained from Mbarara University Research Ethics Committee and administrative clearance from city clerk of Mbarara City. Results: The mean age of participants was 38 years. An equal number of males (six) and females participated. Most of them had at least secondary level education, only three had primary education. Experienced benefits of HIV serostatus disclosure included: social support and care; decisions regarding health, fertility, and child bearing; sharing information on HIV prevention and protection; positive living; and, ease of HIV disclosure. The challenges included: misunderstandings in the families. Conclusion: Socially, psychologically and financially PLWHIV have benefited from their negative partners. Health wise, they have been supported, and cared for, but some have faced challenges, such as family misunderstandings. Couple HIV counseling and testing by a trained health worker is beneficial in HIV care and could mitigate the challenges related HIV serostatus disclosure.

Keywords: discordant couples, disclosure, experiences, HIV

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5297 The Nutritional Status and the Kidney Function in Older Patients

Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

Abstract:

Background: Obesity, particularly abdominal type, lead to accelerated progress of atherosclerosis and thus affects the functioning of various human organs. Non-HDL cholesterol includes residual risk of the cardiovascular diseases which persists in patients after achieved recommended level of LDL cholesterol. The maintenance of normal body mass index plays a particularly important role in both the prevention and treatment of chronic diseases. Materials and Methods: The study covered 96 patients (55 females, 42 males, age 66,9 +/-10,2 years). The nutritional status was determined with the Waist to Height Ratio (WHtR) and the Waist to Hip Ratio (WHR). A function of the kidney was evaluated by calculating the estimated glomerular filtration rate (eGFR) using the MDRD formula. Non-high-density lipoprotein cholesterol (non-HDL) is simply the difference between the total cholesterol concentration and the HDL cholesterol concentration. Results: The higher was level of non-HDL cholesterol, the lower eGFR had studied subjects (p<0.001). Significant correlation was found between higher WHtR and lower the eGFR (p=0.002). Also underweight (30% of patient) led to obtaining lower values of eGFR in subjects over 65 years old. The poorer nutrition the lower was glomerular filtration rate. Conclusions: Nutritional statuses of patients have a significant impact on the level of kidney function. Not only accumulated excess fat in the abdominal area, but also its deficiency affects the deterioration in renal filtration. Higher level of non-HDL not only raises the residual risk of the heart disease but also influences on kidney by worsening eGFR. Proper diet in connection with physical activity should lead to achieving good nutrition in these patients and protect their kidney function.

Keywords: nutrition, non-HDL cholesterol, glomerular filtration rate, lifestyle

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5296 Assessment of Air Pollution in Kindergartens due to Indoor Radon Concentrations

Authors: Jana Djounova

Abstract:

The World Health Organization proposes an average annual reference level of 100 Bq/m³ to minimize health risks due to radon exposure in buildings. However, if this cannot be achieved under the country's specific conditions, the chosen reference level should not exceed 300 Bq/m³. The World Health Organization recognized the relationship between indoor radon exposure and lung cancer, even at low doses. Radon in buildings is one of the most important indoor air pollutants, with harmful effects on the health of the population and especially children. This study presents the assessment of indoor radon concentration as air pollution and analyzes the exposure to radon of children and workers. Assessment of air pollution and exposure to indoor radon concentrations under the National Science Fund of Bulgaria, in the framework of grant No КП-06-Н23/1/07.12.2018 in kindergartens in two districts of Bulgaria (Razgrad and Silistra). Kindergartens were considered for the following reasons: 1these buildings are generally at the ground and/or the first floor, where radon concentration is generally higher than at upper floors; 2these buildings are attended by children, a population generally considered more sensitive to ionizing radiation, although little data is available for radon exposure. The measurements of indoor radon concentrations were performed with passive methods (CR-39 track detectors) for the period from February to May 2015. One hundred fifty-six state kindergartens on the territories of two districts in Bulgaria have been studied. The variations of radon in the children's premises vary from 9 to 1087 Bq/m³. The established arithmetic mean value of radon levels in the kindergartens in Silistra is 139 Bq/m³ and in Razgrad 152 Bq/m³, respectively. The percentage of kindergarteners, where the radon in premises exceeds the Bulgarian reference level of 300 Bq/m³, was 19%. The exposure of children and workers in those kindergartens is high, so remediation measures of air pollution had been recommended. The difference in radon concentration in kindergartens in two districts was statistically analyzed to assess the influence of geography and geology and the difference

Keywords: air pollution, radon, kindergartens, detectors

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5295 Comparison of E-learning and Face-to-Face Learning Models Through the Early Design Stage in Architectural Design Education

Authors: Gülay Dalgıç, Gildis Tachir

Abstract:

Architectural design studios are ambiencein where architecture design is realized as a palpable product in architectural education. In the design studios that the architect candidate will use in the design processthe information, the methods of approaching the design problem, the solution proposals, etc., are set uptogetherwith the studio coordinators. The architectural design process, on the other hand, is complex and uncertain.Candidate architects work in a process that starts with abstre and ill-defined problems. This process starts with the generation of alternative solutions with the help of representation tools, continues with the selection of the appropriate/satisfactory solution from these alternatives, and then ends with the creation of an acceptable design/result product. In the studio ambience, many designs and thought relationships are evaluated, the most important step is the early design phase. In the early design phase, the first steps of converting the information are taken, and converted information is used in the constitution of the first design decisions. This phase, which positively affects the progress of the design process and constitution of the final product, is complex and fuzzy than the other phases of the design process. In this context, the aim of the study is to investigate the effects of face-to-face learning model and e-learning model on the early design phase. In the study, the early design phase was defined by literature research. The data of the defined early design phase criteria were obtained with the feedback graphics created for the architect candidates who performed e-learning in the first year of architectural education and continued their education with the face-to-face learning model. The findings of the data were analyzed with the common graphics program. It is thought that this research will contribute to the establishment of a contemporary architectural design education model by reflecting the evaluation of the data and results on architectural education.

Keywords: education modeling, architecture education, design education, design process

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5294 The Effects of Acute Physical Activity on Measures of Inhibition in Pre-School Children

Authors: Antonia Stergiou

Abstract:

Background: Due to the developmental trajectory of executive function in preschool age, the majority of existing studies investigating the association between acute physical activity and cognitive control have focused on adolescents and adult population. Aim- The aim of this study was to investigate the possible effects of physical activity on the inhibitory control of pre-school children. Methods: This is a prospectively designed study that was conducted in a primary school in Bristol in June 2015. The total number of subjects was n=61 and 20 trials of a modified Eriksen Flanker Task were completed before and after a 30-minutes session of moderate exercise (including both 5 minutes of warm up and cool down). For each test a pre- and post-test assessment took place that included both congruent and incongruent trials. The congruent trials were considered as the control condition and the incongruent trials as those that measure inhibitory control (experimental condition). At the end of the assessment, the participants were instructed to choose the face that described their current feelings between three options (happy, neutral, sad). Results: There was a trend for increased accuracy following moderate exercise, but there was statistical significance (p > .05). However, there was statistically significant improvement in the reaction time following the same type of exercise (p = .005). Face board assessment revealed positive emotions after 30 minutes of moderate exercise. Conclusions: The current study supports findings from previous studies related to the benefits of physical activity on the children’s inhibitory control and provides evidence of those benefits in even younger ages. Further research should take place considering each child individually. Implementation of those findings could result in an improved curriculum in schools with additional time spent on physical education courses.

Keywords: cognitive control, inhibition, physical activity, pre-school children

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5293 On Physico-Chemical Status of Agbabu Water, Oluwa River, Odigbo Local Government Area, Ondo State, Nigeria

Authors: Olaniyan Rotimi Francis

Abstract:

Agbabu Water, Oluwa River is used for artisanal fishing, ferrying and domestic activities in Odigbo Local Government Area (OLGA), Ondo State. The river receives bitumen spills and domestic and agricultural wastes, which could adversely impact on the water quality and resident biota. In spite of anthropogenic activities, there is a dearth of information on the limnology and biota of the river. Extensive bitumen spills, as well as uncontrolled discharge of domestic wastes have pollution implications as they alter prevailing conditions and destroy the habitats of aquatic organisms. The aim of this study was to investigate the physic-chemical parameters of Agbabu Water in order to provide baseline information for effective management. Monthly water samples were collected on the surface of Agbabu water, Oluwa River, for a period of 6 months (June,2024 to November,2024). All physic-chemicals were collected and analyzed according to APHA (2005) standard methods. Results showed that temperature ranged between 26.0-32.0oC, transparency (1.0-8.0 m), alkalinity (14.0-25.0 mg/l), electrical conductivity (18-105 µS/cm), dissolved oxygen (1.2-3.8 mg/l), sulphate (0.0 -4.0mg/l) and total dissolved solids (18-36). The parameters at the downstream (station A) accounted for the bulk of the highest values; there were, however, no significant differences between the stations at P<0.05. The results obtained from the physic-chemical parameters agree with the limits set by both national and international bodies for drinking and fish growth. It was recommended that urgent checks and monitoring by relevant agencies, government representatives, public health practitioners, and community leaders are required.

Keywords: physico-chemical, water, Agbabu, River

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5292 The Relationship among Lifestyles, Accompany Forms, and Children’s Capability to Solve Problems of Modern Families

Authors: Tien-Ling Yeh, Jo-Han Chan

Abstract:

The percentage of dual-earner couples has become higher and higher each year. Family lifestyles in Taiwan have also been changing. This fact reflects the importance of family communication and parent-child relationship. This study aimed to explore the influences of family lifestyles and accompany forms on children’s capability to solve problems. The research process included two phases: (1) literature review, to explore the characteristics of children’s capability to solve problems and methods to measure this capability; and (2) questionnaire analyses, to explore the influences of lifestyles and accompany time and forms of modern families on their children’s capability to solve problems. The questionnaires were issued in October and November, 2016. A total of 300 questionnaires were retrieved, among which 250 were valid. The findings are summarized below: -The linguistic performances of the children from families of the busy and haggling lifestyle or the intermittent childcare lifestyle were rather good. Besides being interested in learning, these children could solve problems or difficulties independently. -The capability to ‘analyze problems’ of children from families with accompanying time during 19:00-19:30 (family dinner time) or 22:00-23:30 (before bedtime) was good. When facing a complex problem, these children could identify the most important factor in the problem. When seeing a problem, they would first look for the cause. If they encountered a bottleneck while solving a problem, they would review the context of the problem and related conditions to come up with another solution. -According to the literature, learning toys with numbers and symbols to learn to read can help develop children’s logic thinking, which is helpful to solve problems. Interestingly, some study suggested that children playing with fluid constructive toys are less likely to give up what they are doing and more likely to identify problems in their daily life. Some of them can even come up with creative and effective solutions.

Keywords: accompany, lifestyle, parent-child, problem-solving

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5291 Influence of Socio-Economic Factors on Crime Perpetuation Among Inmates of Correctional Facilities in South-West Nigeria

Authors: Ebenezer Bayode Agboola

Abstract:

The study investigated the influence of socioeconomic factors on crime perpetuation among inmates of correctional facilities in South West Nigeria. A sample size of two hundred and forty-four inmates was drawn from Ado, Akure and Ilesha correctional facilities. The sample size consisted of both male and female inmates. Individual inmate was drawn through systematic sampling with the use of inmates’ register at the correctional facilities. The study employed a mixed design, which allowed the blend of both quantitative and qualitative methods. For the quantitative method, data was collected through the use of a questionnaire and for the qualitative method; data was collected with the aid of an in-depth interview (ID. Four research questions were raised for the study and analysed descriptively using simple frequency count and percentage. Five research hypotheses were formulated for the study and tested using Analysis of Variance (ANOVA) and Multiple Regressions. Based on the data analysis, findings revealed that there was a significant relationship between family history and perpetuation of crime among inmates. Though no significant relationship was found between employment and the perpetuation of crime, however, the rate of crime perpetuation by individuals was significantly found to be related to peer pressure. Also, the study further found that there was a significant relationship between the use of substances and perpetuation of crime. Lastly, it was found that there was a significant relationship between family history, employment, and peer pressure. The study recommended that Parents should pay adequate attention to their children, especially during the adolescent stage and that the Government should enact relevant laws that will checkmate the rising involvement of young people in cybercrime or internet fraud.

Keywords: crime, socio economic factor, inmates, correctional facilities, Southwest

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5290 Accuracy of Trauma on Scene Triage Screen Tool (Shock Index, Reverse Shock Index Glasgow Coma Scale, and National Early Warning Score) to Predict the Severity of Emergency Department Triage

Authors: Chaiyaporn Yuksen, Tapanawat Chaiwan

Abstract:

Introduction: Emergency medical service (EMS) care for trauma patients must be provided on-scene assessment and essential treatment and have appropriate transporting to the trauma center. The shock index (SI), reverse shock index Glasgow Coma Scale (rSIG), and National Early Warning Score (NEWS) triage tools are easy to use in a prehospital setting. There is no standardized on-scene triage protocol in prehospital care. The primary objective was to determine the accuracy of SI, rSIG, and NEWS to predict the severity of trauma patients in the emergency department (ED). Methods: This was a retrospective cross-sectional and diagnostic research conducted on trauma patients transported by EMS to the ED of Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand, from January 2015 to September 2022. We included the injured patients receiving prehospital care and transport to the ED of Ramathibodi Hospital by the EMS team from January 2015 to September 2022. We compared the on-scene parameter (SI, rSIG, and NEWS) and ED (Emergency Severity Index) with the area under ROC. Results: 218 patients were traumatic patients transported by EMS to the ED. 161 was ESI level 1-2, and 57 was level 3-5. NEWS was a more accurate triage tool to discriminate the severity of trauma patients than rSIG and SI. The area under the ROC was 0.743 (95%CI 0.70-0.79), 0.649 (95%CI 0.59-0.70), and 0.582 (95%CI 0.52-0.65), respectively (P-value <0.001). The cut point of NEWS to discriminate was 6 points. Conclusions: The NEWs was the most accurate triage tool in prehospital seeing in trauma patients.

Keywords: on-scene triage, trauma patient, ED triage, accuracy, NEWS

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5289 The Associations between Ankle and Brachial Systolic Blood Pressures with Obesity Parameters

Authors: Matei Tudor Berceanu, Hema Viswambharan, Kirti Kain, Chew Weng Cheng

Abstract:

Background - Obesity parameters, particularly visceral obesity as measured by the waist-to-height ratio (WHtR), correlate with insulin resistance. The metabolic microvascular changes associated with insulin resistance causes increased peripheral arteriolar resistance primarily to the lower limb vessels. We hypothesize that ankle systolic blood pressures (SBPs) are more significantly associated with visceral obesity than brachial SBPs. Methods - 1098 adults enriched in south Asians or Europeans with diabetes (T2DM) were recruited from a primary care practice in West Yorkshire. Their medical histories, including T2DM and cardiovascular disease (CVD) status, were gathered from an electronic database. The brachial, dorsalis pedis, and posterior tibial SBPs were measured using a Doppler machine. Their body mass index (BMI) and WHtR were calculated after measuring their weight, height, and waist circumference. Linear regressions were performed between the 6 SBPs and both obesity parameters, after adjusting for covariates. Results - Generally, the left posterior tibial SBP (P=4.559*10⁻¹⁵) and right posterior tibial SBP (P=1.114* 10⁻¹³ ) are the pressures most significantly associated with the BMI, as well as in south Asians (P < 0.001) and Europeans (P < 0.001) specifically. In South Asians, although the left (P=0.032) and right brachial SBP (P=0.045) were associated to the WHtR, the left posterior tibial SBP (P=0.023) showed the strongest association. Conclusion - Regardless of ethnicity, ankle SBPs are more significantly associated with generalized obesity than brachial SBPs, suggesting their screening potential for screening for early detection of T2DM and CVD. A combination of ankle SBPs with WHtR is proposed in south Asians.

Keywords: ankle blood pressures, body mass index, insulin resistance, waist-to-height-ratio

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