Search results for: clinical quality and safety
Commenced in January 2007
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Paper Count: 14840

Search results for: clinical quality and safety

3230 Physics Recitations for College Physics Courses Using Breakout Rooms during COVID Pandemic

Authors: Pratheesh Jakkala

Abstract:

This paper addresses the use of breakout sessions to conduct successful weekly physics recitations for College Physics I and II at a large University in remote teaching method during COVID-19 pandemic. All breakout sessions are synchronous, conducted live, and handled by teaching assistants. A two-prong approach is used to maintain the integrity of recitations. Three different conference platforms WebEx, Zoom, and Canvas conferences, were tested, and BigBlue button using Canvas was adopted. The results and experiences of all three learning platforms are presented in this paper. Recitation questions were assigned on WebAssign learning platform and a standard five-question template developed by the instructor was used for group discussions and active peer-peer engagement. Breakout sessions feature of BigBlueButton in Canvas conferences was successfully implemented. Each breakout session consists of a team of 4 students. An online whiteboard, chat window options were used for live teamwork. Student peer-peer interactions, Teaching Assistants’ interaction with students were video and audio recorded. A total of 72 students in College Physics II and 55 students in College Physics I was enrolled. 82% of students agreed that method under study is better than previous methods. The study addressed the quality of student teamwork, student attitude towards problem-solving, and student performance in the exams.

Keywords: recitations, breakout rooms, online learning platforms, COVID pandemic

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3229 Study on the Key Stakeholders' Perception and Establishment of Sustainability Goals in the Green Building Projects: The Case of Malaysia

Authors: Nor Kalsum M. Isa, Mohd Yazid M. Yunos, Anuar Alias, Mazdi Marzuki, Kamarul Ismail, Mohd H. Ibrahim

Abstract:

Green building is an emerging concept with the ultimate target to achieve sustainable development by integrating sustainability goals and principles into project development. Basically, a green building is a building that is designed, constructed and operated to boost environmental, economic, health and productivity performance over conventional buildings. The buildings have been proven to be successful in contributing towards sustainability and project success. The purpose of this study was to determine the benefits of sustainability application in building projects, looking towards project success from the perspective of Malaysian key project stakeholders. The study also aimed to explore the establishment of sustainability goals in the green building projects in Malaysia. The Triple Bottom Line (TBL) Concept of Sustainability was used as the foundation theoretical framework. Surveys, interviews and multiple case study methods were employed. A sample of 188 Malaysian building project stakeholders was selected for questionnaire surveys, and 15 stakeholders from three award-winning green building projects in Malaysia were involved in the interviews. The study found that the majority of the respondents were less aware that the sustainability integration in the building project can significantly affect cost reduction, schedule effectiveness and stakeholders’ satisfaction with the performance of buildings as at the same level as the quality performance. Of the four sustainability goals, the environmental aspect was given more priority than others in the development of the green building projects.

Keywords: green building, sustainability, project stakeholders, Malaysia

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3228 Intensive Care Unit Patient Self-Determination When Facing Cardiovascular Surgery for the First Time

Authors: Hsiao-Lin Fang

Abstract:

The Patient Self-Determination Act is based on the belief that each life is unique. The act regards each patient as an autonomous entity and explicitly protects the patient’s rights to know and make decisions and choices while ensuring that the patient’s wish for a peaceful end is granted. Even when the patient is unconscious and unable to express himself/herself, the patient’s self-determination and its exercise are still protected under the law. The act also ensures that healthcare professionals (HCPs) have a specific set of rules to follow and complete legal protection when their patients are unable to express themselves clearly. This report is about a 55-year-old female patient who weighed 110 kg and was diagnosed with acute type A aortic dissection. The case was that the patient suddenly felt backache and nausea during sleep before daybreak and was therefore transferred to this hospital from the original one. After the doctor explained the patient’s conditions, it was concluded that surgery was necessary. However, the patient’s family was immediately against the surgery after having heard its possible complications. Nevertheless, the patient was still willing to receive the surgery. Being at odds with her family, the patient decided to sign the surgery agreement herself and agreed to receive the two surgical procedures: (1) ascending aorta replacement and (2) innominate artery debranching. After the surgery, the patient did not regain consciousness and therefore received computed tomography scanning of the brain, which revealed false lumen involving proximal left common carotid artery, left subclavian artery and innominate artery, and severe compression of the true lumen with total/subtotal occlusion in the left common carotid artery. On the following day, the doctor discussed two further surgical procedures: (1) endografting for descending aorta and (2) endografting for left common carotid artery and subclavian artery with the family. However, as the patient’s postoperative recovery of consciousness only reached the level of stupor and her family had no intention of subsequent healthcare for the patient, the family made the joint decision three days later to have the endotracheal tube removed from the patient and let her die a natural death. Suggestion: An advance directive (AD) can be created beforehand. Once the patient is in a special clinical state (e.g., terminal illness, permanent vegetative state, etc.), the AD can determine whether to sustain the patient’s life through ‘medical intervention’ or to respect the patient’s rights to choose a peaceful end and receive palliative care. Through the expression of self-determination, it is possible to respect the patient’s medical practice autonomy and protect the patient’s dignity and right to a peaceful end, thereby respecting and supporting the patient’s decision. This also allows the three sides: the patient, the family and the medical team to understand the patient’s true wish in the process of advance care planning (ACP) and thereby promote harmony in the HCP-patient relationship.

Keywords: intensive care unit patient, cardiovascular surgery, self-determination, advance directive

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3227 Weapon-Being: Weaponized Design and Object-Oriented Ontology in Hypermodern Times

Authors: John Dimopoulos

Abstract:

This proposal attempts a refabrication of Heidegger’s classic thing-being and object-being analysis in order to provide better ontological tools for understanding contemporary culture, technology, and society. In his work, Heidegger sought to understand and comment on the problem of technology in an era of rampant innovation and increased perils for society and the planet. Today we seem to be at another crossroads in this course, coming after postmodernity, during which dreams and dangers of modernity augmented with critical speculations of the post-war era take shape. The new era which we are now living in, referred to as hypermodernity by researchers in various fields such as architecture and cultural theory, is defined by the horizontal implementation of digital technologies, cybernetic networks, and mixed reality. Technology today is rapidly approaching a turning point, namely the point of no return for humanity’s supervision over its creations. The techno-scientific civilization of the 21st century creates a series of problems, progressively more difficult and complex to solve and impossible to ignore, climate change, data safety, cyber depression, and digital stress being some of the most prevalent. Humans often have no other option than to address technology-induced problems with even more technology, as in the case of neuron networks, machine learning, and AI, thus widening the gap between creating technological artifacts and understanding their broad impact and possible future development. As all technical disciplines and particularly design, become enmeshed in a matrix of digital hyper-objects, a conceptual toolbox that allows us to handle the new reality becomes more and more necessary. Weaponized design, prevalent in many fields, such as social and traditional media, urban planning, industrial design, advertising, and the internet in general, hints towards an increase in conflicts. These conflicts between tech companies, stakeholders, and users with implications in politics, work, education, and production as apparent in the cases of Amazon workers’ strikes, Donald Trump’s 2016 campaign, Facebook and Microsoft data scandals, and more are often non-transparent to the wide public’s eye, thus consolidating new elites and technocratic classes and making the public scene less and less democratic. The new category proposed, weapon-being, is outlined in respect to the basic function of reducing complexity, subtracting materials, actants, and parameters, not strictly in favor of a humanistic re-orientation but in a more inclusive ontology of objects and subjects. Utilizing insights of Object-Oriented Ontology (OOO) and its schematization of technological objects, an outline for a radical ontology of technology is approached.

Keywords: design, hypermodernity, object-oriented ontology, weapon-being

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3226 Improved Classification Procedure for Imbalanced and Overlapped Situations

Authors: Hankyu Lee, Seoung Bum Kim

Abstract:

The issue with imbalance and overlapping in the class distribution becomes important in various applications of data mining. The imbalanced dataset is a special case in classification problems in which the number of observations of one class (i.e., major class) heavily exceeds the number of observations of the other class (i.e., minor class). Overlapped dataset is the case where many observations are shared together between the two classes. Imbalanced and overlapped data can be frequently found in many real examples including fraud and abuse patients in healthcare, quality prediction in manufacturing, text classification, oil spill detection, remote sensing, and so on. The class imbalance and overlap problem is the challenging issue because this situation degrades the performance of most of the standard classification algorithms. In this study, we propose a classification procedure that can effectively handle imbalanced and overlapped datasets by splitting data space into three parts: nonoverlapping, light overlapping, and severe overlapping and applying the classification algorithm in each part. These three parts were determined based on the Hausdorff distance and the margin of the modified support vector machine. An experiments study was conducted to examine the properties of the proposed method and compared it with other classification algorithms. The results showed that the proposed method outperformed the competitors under various imbalanced and overlapped situations. Moreover, the applicability of the proposed method was demonstrated through the experiment with real data.

Keywords: classification, imbalanced data with class overlap, split data space, support vector machine

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3225 Feasibility Studies on the Removal of Fluoride from Aqueous Solution by Adsorption Using Agro-Based Waste Materials

Authors: G. Anusha, J. Raja Murugadoss

Abstract:

In recent years, the problem of water contaminant is drastically increasing due to the disposal of industrial wastewater containing iron, fluoride, mercury, lead, cadmium, phosphorus, silver etc. into water bodies. The non-biodegradable heavy metals could accumulate in the human system through food chain and cause various dreadful diseases and permanent disabilities and in worst cases it leads to casual losses. Further, the presence of the excess quantity of such heavy metals viz. Lead, Cadmium, Chromium, Nickel, Zinc, Copper, Iron etc. seriously affect the natural quality of potable water and necessitates the treatment process for removal. Though there are dozens of standard procedures available for the removal of heavy metals, their cost keeps the industrialists away from adopting such technologies. In the present work, an attempt has been made to remove such contaminants particularly fluoride and to study the efficiency of the removal of fluoride by adsorption using a new agro-based materials namely Limonia acidissima and Emblica officinalis which is commonly referred as wood apple and gooseberry respectively. Accordingly a set of experiments has been conducted using batch and column processes, with the help of activated carbon prepared from the shell of wood apple and seeds of gooseberries. Experiments reveal that the adsorption capacity of the shell of wood apple is significant to yield promising solutions.

Keywords: adsorption, fluoride, agro-based waste materials, Limonia acidissima, Emblica officinalis

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3224 Ferulic Acid-Grafted Chitosan: Thermal Stability and Feasibility as an Antioxidant for Active Biodegradable Packaging Film

Authors: Sarekha Woranuch, Rangrong Yoksan

Abstract:

Active packaging has been developed based on the incorporation of certain additives, in particular antimicrobial and antioxidant agents, into packaging systems to maintain or extend product quality and shelf-life. Ferulic acid is one of the most effective natural phenolic antioxidants, which has been used in food, pharmaceutical and active packaging film applications. However, most phenolic compounds are sensitive to oxygen, light and heat; its activities are thus lost during product formulation and processing. Grafting ferulic acid onto polymer is an alternative to reduce its loss under thermal processes. Therefore, the objectives of the present research were to study the thermal stability of ferulic acid after grafting onto chitosan, and to investigate the possibility of using ferulic acid-grafted chitosan (FA-g-CTS) as an antioxidant for active biodegradable packaging film. FA-g-CTS was incorporated into biodegradable film via a two-step process, i.e. compounding extrusion at temperature up to 150 °C followed by blown film extrusion at temperature up to 175 °C. Although incorporating FA-g-CTS with a content of 0.02–0.16% (w/w) caused decreased water vapor barrier property and reduced extensibility, the films showed improved oxygen barrier property and antioxidant activity. Radical scavenging activity and reducing power of the film containing FA-g-CTS with a content of 0.04% (w/w) were higher than that of the naked film about 254% and 94%, respectively. Tensile strength and rigidity of the films were not significantly affected by adding FA-g-CTS with a content of 0.02–0.08% (w/w). The results indicated that FA-g-CTS could be potentially used as an antioxidant for active packaging film.

Keywords: active packaging film, antioxidant activity, chitosan, ferulic acid

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3223 Kinetic Modeling of Colour and Textural Properties of Stored Rohu (Labeo rohita) Fish

Authors: Pramod K. Prabhakar, Prem P. Srivastav

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Rohu (Labeo rohita) is an Indian major carp and highly relished freshwater food for its unique flavor, texture, and culinary properties. It is highly perishable and, spoilage occurs as a result of series of complicated biochemical changes brought about by enzymes which are the function of time and storage temperature also. The influence of storage temperature (5, 0, and -5 °C) on colour and texture of fish were studied during 14 days storage period in order to analyze kinetics of colour and textural changes. The rate of total colour change was most noticeable at the highest storage temperature (5°C), and these changes were well described by the first order reaction. Texture is an important variable of quality of the fish and is increasing concern to aquaculture industries. Textural parameters such as hardness, toughness and stiffness were evaluated on a texture analyzer for the different day of stored fish. The significant reduction (P ≤ 0.05) in hardness was observed after 2nd, 4th and 8th day for the fish stored at 5, 0, and -5 °C respectively. The textural changes of fish during storage followed a first order kinetic model and fitted well with this model (R2 > 0.95). However, the textural data with respect to time was also fitted to modified Maxwell model and found to be good fit with R2 value ranges from 0.96 to 0.98. Temperature dependence of colour and texture change was adequately modelled with the Arrhenius type equation. This fitted model may be used for the determination of shelf life of Rohu Rohu (Labeo rohita) Fish.

Keywords: first order kinetics, biochemical changes, Maxwell model, colour, texture, Arrhenius type equation

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3222 A Framework to Assess the Maturity of Customer Involvement in the Service Design of Product-Service Systems

Authors: Taghreed Abu-Salim

Abstract:

This paper develops and investigates a framework for the assessment of customer involvement in the service design process of result oriented product-service systems in order to improve the service offering in a business to business (B2B) context. The framework comprises five main criteria and fifteen sub-criteria that contribute to customer involvement in a hierarchy using a maturity grid to highlight the strengths and weaknesses for each criterion. To develop the customer involvement framework, an extensive literature review related to service design, result oriented product-service system (PSS) and customer involvement in service design was carried out. Key factors that significantly influence customer involvement from industry and literature were identified to develop an initial framework. This framework was tested in six companies from four different sectors of industry: district cooling, medical equipment, transportation and oil storage. Validation of the framework was carried out using expert opinions and industrial case studies. A major contribution of the developed framework includes a hierarchy of appropriate criteria for assessing customer involvement in the service design process within results oriented PSS; the definition of four maturity levels which are suitable to describe the whole spectrum of customer involvement in the service design process; and finally, The paper concludes by enabling service providers to: take proactive decisions; screen and evaluate new services; improve perceived service quality; and provide barriers against imitation.

Keywords: customer involvement, maturity grid, new service development, result oriented product-service system, service design

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3221 Micropollutant Carbamazepine: Its Occurrences, Toxicological Effects, and Possible Degradation Methods (Review)

Authors: Azad Khalid, Sifa Dogan

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Because of its persistence in conventional treatment plants and broad prevalence in water bodies, the pharmaceutical chemical carbamazepine (CBZ) has been suggested as an anthropogenic marker to evaluate water quality. This study provides a thorough examination of the origins and occurrences of CBZ in water bodies, as well as the drug's toxicological effects and laws. Given CBZ's well-documented negative consequences on the human body when used medicinally, cautious monitoring in water is advised. CBZ residues in drinking water may enter embryos and newborns via intrauterine exposure or breast-feeding, causing congenital abnormalities and/or neurodevelopmental issues over time. The insufficiency of solo solutions was shown after an in-depth technical study of traditional and sophisticated treatment technologies. Nanofiltration and reverse osmosis membranes are more successful at removing CBZ than traditional activated sludge and membrane bioreactor techniques. Recent research has shown that severe chemical cleaning, which is essential to prevent membrane fouling, may lower long-term removal efficiency. Furthermore, despite the efficacy of activated carbon adsorption and advanced oxidation processes, a few issues such as chemical cost and activated carbon renewal must be carefully examined. Individual technology constraints lead to the benefits of combined and hybrid systems, namely the heterogeneous advanced oxidation process.

Keywords: carbamazepine, occurrence, toxicity, conventical treatment, advanced oxidation process (AOPs)

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3220 Psychological Aspects of Depression among the Romanian Adults

Authors: Zoltan Abram

Abstract:

Background: In the last time it was hardly increased the prevalence of psychical diseases and disorders which reduce work capacity, life quality and life expectancy. Objectives: The aim of our research is to study the psychical health state of the Romanian adults living in the middle part of the country and the role of some economical, psychological and social factors, especially in relationship with depression. Methods: The study is based on a complex anonymous questionnaire, including Beck depressive scale, which was completed by a representative sample among adult population. The applied method was a combination between stratification and more-steps sampling. Results: After our results depression is the most common psychical illness with 9,1% diagnosis, but the tendency to depression, the existence of depressive symptoms is much higher than the treated illness. The percentage of suicide attempt among the studied population was 2,9%. It is analysed how gender, age, professional and social status, living and working conditions and different social factors are influencing the health state. According to Beck score, it was established a significant difference in the favour of female, elderly people, lower educational level, urban population. Conclusions: In our study it is underlined the importance of health promotion and education. It is concluded that improving living standards, modifying in a proper way the lifestyle of the population, we can positively influence the physical and mental health state of the Romanian adult population.

Keywords: Beck scale, depression, psychological aspects, suicide attempt

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3219 Ethical, Legal and Societal Aspects of Unmanned Aircraft in Defence

Authors: Henning Lahmann, Benjamyn I. Scott, Bart Custers

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Suboptimal adoption of AI in defence organisations carries risks for the protection of the freedom, safety, and security of society. Despite the vast opportunities that defence AI-technology presents, there are also a variety of ethical, legal, and societal concerns. To ensure the successful use of AI technology by the military, ethical, legal, and societal aspects (ELSA) need to be considered, and their concerns continuously addressed at all levels. This includes ELSA considerations during the design, manufacturing and maintenance of AI-based systems, as well as its utilisation via appropriate military doctrine and training. This raises the question how defence organisations can remain strategically competitive and at the edge of military innovation, while respecting the values of its citizens. This paper will explain the set-up and share preliminary results of a 4-year research project commissioned by the National Research Council in the Netherlands on the ethical, legal, and societal aspects of AI in defence. The project plans to develop a future-proof, independent, and consultative ecosystem for the responsible use of AI in the defence domain. In order to achieve this, the lab shall devise a context-dependent methodology that focuses on the ‘analysis’, ‘design’ and ‘evaluation’ of ELSA of AI-based applications within the military context, which include inter alia unmanned aircraft. This is bolstered as the Lab also recognises and complements the existing methods in regards to human-machine teaming, explainable algorithms, and value-sensitive design. Such methods will be modified for the military context and applied to pertinent case-studies. These case-studies include, among others, the application of autonomous robots (incl. semi- autonomous) and AI-based methods against cognitive warfare. As the perception of the application of AI in the military context, by both society and defence personnel, is important, the Lab will study how these perceptions evolve and vary in different contexts. Furthermore, the Lab will monitor – as they may influence people’s perception – developments in the global technological, military and societal spheres. Although the emphasis of the research project is on different forms of AI in defence, it focuses on several case studies. One of these case studies is on unmanned aircraft, which will also be the focus of the paper. Hence, ethical, legal, and societal aspects of unmanned aircraft in the defence domain will be discussed in detail, including but not limited to privacy issues. Typical other issues concern security (for people, objects, data or other aircraft), privacy (sensitive data, hindrance, annoyance, data collection, function creep), chilling effects, PlayStation mentality, and PTSD.

Keywords: autonomous weapon systems, unmanned aircraft, human-machine teaming, meaningful human control, value-sensitive design

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3218 Does Women Involvement in Politics Decrease Corruption? A Context Based Approach to the Corruption Rate Index of ASEAN Countries

Authors: Lu Anne A. Godinez, May Claudine I. Gador, Preacious G. Gumolon, Louiechi Von R. Mendoza, Neil Bryan N. Moninio

Abstract:

Gender equality and women empowerment is the third of eight Millennium Development Goals. Understanding corruption’s linkages to gender equality issues and how it impacts women’s empowerment is part of the broader process of advancing women’s rights and understanding the gender dimensions of democratic governance. Taking a long view of political (corruption index) and the social (women empowerment) dimension — a view from 2015 to 2030, a context based forecast was conducted to forecast the ASEAN corruption index in the next 15 years, answering the question: “Does women political involvement decrease corruption rate index of ASEAN countries in the next 15 years?” The study have established that there will be an increase women political involvement in the ASEAN countries in the next 15 years that will cause a drop on corruption rate index. There will be a significant decline on corruption rate index in 2030. This change entails reform not only in the political aspect of progress, but to the social aspect as well. Finally, the political aspect is increasing at a constant rate however a double or triple increase of the social aspect is seen to be the key solution for corruption.

Keywords: women, women political involvement, corruption, gender equity index, economic participation, educational attainment, political empowerment, control of corruption, regulatory quality, rule of law, voice and accountability government effectiveness, political stability and corruption perception index

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3217 A Literature Review on Bladder Management in Individuals with Spinal Cord Injury

Authors: Elif Ates, Naile Bilgili

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Background: One of the most important medical complications that individuals with spinal cord injury (SCI) face are the neurogenic bladder. Objectives: To review methods used for management of neurogenic bladder and their effects. Methods: The study was conducted by searching CINAHL, Ebscohost, MEDLINE, Science Direct, Ovid, ProQuest, Web of Science, and ULAKBİM National Databases for studies published between 2005 and 2015. Key words used during the search included ‘spinal cord injury’, ‘bladder injury’, ‘nursing care’, ‘catheterization’ and ‘intermittent urinary catheter’. After examination of 551 studies, 21 studies which met inclusion criteria were included in the review. Results: Mean age of individuals in all study samples was 42 years. The most commonly used bladder management method was clean intermittent catheterization (CIC). Compliance with CIC was found to be significantly related to spasticity, maximum cystometric capacity, and the person performing catheterization (p < .05). The main reason for changing the existing bladder management method was urinary tract infections (UTI). Individuals who performed CIC by themselves and who voided spontaneously had better life quality. Patient age, occupation status and whether they performed CIC by themselves or not were found to be significantly associated with depression level (p ≤ .05). Conclusion: As the most commonly used method for bladder management, CIC is a reliable and effective method, and reduces the risk of UTI development. Individuals with neurogenic bladder have a higher prevalence of depression symptoms than the normal population.

Keywords: bladder management, catheterization, nursing, spinal cord injury

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3216 Awareness and Perception of Food Safety, Nutrition and Food Security among Omani Women

Authors: Abeer Al Kalbani

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Oman is a sub-tropical country with limited water resources, harsh weather and limited soil fertility, constraining food production. Therefore, it largely depends on international markets to assure supply of food. In the light of these circumstances, food security in Oman is defined as the ability of the country to grant the staple food needs of people (e.g. rice, wheat, lentil, sugar, dates, dairy products, fish and plant or vegetable oils). It also involves exporting local goods with high production rates to exchange them with required food products. This concept of food security includes the availability of food through production and/or importing, stability of the market prices during all circumstances, and the ability of people to meet their needs within their income capabilities. As a result, most of the food security work is focused on availability and access dimensions of the issue. Not much research is focused on the utilization aspect of food security in Oman. Although women play a vital role in food security, there is limited research on women’s role in food security neither in Oman nor in neighboring Gulf countries. Women play an important role not only by carrying the responsibility of feeding their families but also by setting the consumption model for the household. Therefore, the research aims to contribute to the work done on food security in Oman and similar regions of the world by studying the role women play at the utilization level. Methods used in this research include Qualitative unstructured interviews, focus groups, survey questionnaire and an experimental study. Based on the FAO definition of food security, it consists of availability, access, utilization and sustainability. Results from a pilot study conducted for this research on two groups of women in Oman; urban and rural women, showed that women in Oman are responsible for achieving these four pillars at the household level. Moreover, awareness of women increased as their educational level increased. Urban women showed more awareness and openness to adopt healthier and proper food related choices than rural women. Urban women seem also more open than rural women to new ideas and concepts and ways to healthier food. However, both urban and rural women claim that no training and educational programs are available for them and awareness of food security in general remains relatively low in both groups. In the light of these findings, this research attempts to further investigate the social beliefs, practices and attitudes women adopt in relation to food purchase, storage, preparation and consumption as considered as important parts of the food system. It also seeks to examine the effect of educational training programs and media on the level of women awareness on the issue.

Keywords: food security, household food security, utilization, role of women

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3215 Interrelationship between Quadriceps' Activation and Inhibition as a Function of Knee-Joint Angle and Muscle Length: A Torque and Electro and Mechanomyographic Investigation

Authors: Ronald Croce, Timothy Quinn, John Miller

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Incomplete activation, or activation failure, of motor units during maximal voluntary contractions is often referred to as muscle inhibition (MI), and is defined as the inability of the central nervous system to maximally drive a muscle during a voluntary contraction. The purpose of the present study was to assess the interrelationship amongst peak torque (PT), muscle inhibition (MI; incomplete activation of motor units), and voluntary muscle activation (VMA) of the quadriceps’ muscle group as a function of knee angle and muscle length during maximal voluntary isometric contractions (MVICs). Nine young adult males (mean + standard deviation: age: 21.58 + 1.30 years; height: 180.07 + 4.99 cm; weight: 89.07 + 7.55 kg) performed MVICs in random order with the knee at 15, 55, and 95° flexion. MI was assessed using the interpolated twitch technique and was estimated by the amount of additional knee extensor PT evoked by the superimposed twitch during MVICs. Voluntary muscle activation was estimated by root mean square amplitude electromyography (EMGrms) and mechanomyography (MMGrms) of agonist (vastus medialis [VM], vastus lateralis [VL], and rectus femoris [RF]) and antagonist (biceps femoris ([BF]) muscles during MVICs. Data were analyzed using separate repeated measures analysis of variance. Results revealed a strong dependency of quadriceps’ PT (p < 0.001), MI (p < 0.001) and MA (p < 0.01) on knee joint position: PT was smallest at the most shortened muscle position (15°) and greatest at mid-position (55°); MI and MA were smallest at the most shortened muscle position (15°) and greatest at the most lengthened position (95°), with the RF showing the greatest change in MA. It is hypothesized that the ability to more fully activate the quadriceps at short compared to longer muscle lengths (96% contracted at 15°; 91% at 55°; 90% at 95°) might partly compensate for the unfavorable force-length mechanics at the more extended position and consequent declines in VMA (decreases in EMGrms and MMGrms muscle amplitude during MVICs) and force production (PT = 111-Nm at 15°, 217-NM at 55°, 199-Nm at 95°). Biceps femoris EMG and MMG data showed no statistical differences (p = 0.11 and 0.12, respectively) at joint angles tested, although there were greater values at the extended position. Increased BF muscle amplitude at this position could be a mechanism by which anterior shear and tibial rotation induced by high quadriceps’ activity are countered. Measuring and understanding the degree to which one sees MI and VMA in the QF muscle has particular clinical relevance because different knee-joint disorders, such ligament injuries or osteoarthritis, increase levels of MI observed and markedly reduced the capability of full VMA.

Keywords: electromyography, interpolated twitch technique, mechanomyography, muscle activation, muscle inhibition

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3214 Sociological Research as a Tool of Social Assessment of the Territory in Urban Planning: In a Case of Kazakhstan

Authors: Alexey Abilov

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Sociological research in the form of a questionnaire survey of the population in the last decade has become an essential part of a comprehensive assessment of the territory in the practice of urban planning in Kazakhstan. This method was successfully used for developing master plans of settlements, urban agglomerations, and projects of detailed planning of individual sections of the urban environment. Also, it greatly contributes to the objectification of design solutions, since in addition to the traditional expert multifactorial assessment of urban development territories by professional designers, they provide an opportunity to consider existing urban development problems at the local level from the inside, through the eyes of the living population. A comparison of two areas of assessment of the territory -expert and social- allows us to give a more balanced final assessment, which can serve as a strong basis for making correct design decisions. The author of the article shows this by the example of the social assessment of the territory of the Almaty urban agglomeration in the form of a questionnaire survey of the population conducted in order to assess the quality of the living environment of the population, preferences in place and forms of recreation, as well as to delimitation the boundaries of the agglomeration. At the same time, the author's methodology of qualitative and quantitative assessment of the territory divided into polling stations is used, based on a comparison of the percentage of respondents' responses to various questionnaire questions with the total number of respondents.

Keywords: social assessment of territory, comprehensive assessment, urban agglomeration, correct design decisions

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3213 Biosorption of Manganese Mine Effluents Using Crude Chitin from Philippine Bivalves

Authors: Randy Molejona Jr., Elaine Nicole Saquin

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The area around the Ajuy river in Iloilo, Philippines, is currently being mined for manganese ore, and river water samples exceed the maximum manganese contaminant level set by US-EPA. At the same time, the surplus of local bivalve waste is another environmental concern. Synthetic chemical treatment compromises water quality, leaving toxic residues. Therefore, an alternative treatment process is biosorption or using the physical and chemical properties of biomass to adsorb heavy metals in contaminated water. The study aims to extract crude chitin from shell wastes of Bractechlamys vexillum, Perna viridis, and Placuna placenta and determine its adsorption capacity on manganese in simulated and actual mine water. Crude chitin was obtained by pulverization, deproteinization, demineralization, and decolorization of shells. Biosorption by flocculation followed 5 g: 50 mL chitin-to-water ratio. Filtrates were analyzed using MP-AES after 24 hours. In both actual and simulated mine water, respectively, B. vexillum yielded the highest adsorption percentage of 91.43% and 99.58%, comparable to P. placenta of 91.43% and 99.37%, while significantly different to P. viridis of -57.14% and 31.53%, (p < 0.05). FT-IR validated the presence of chitin in shells based on carbonyl-containing functional groups at peaks 1530-1560 cm⁻¹ and 1660-1680 cm⁻¹. SEM micrographs showed the amorphous and non-homogenous structure of chitin. Thus, crude chitin from B. vexillum and P. placenta can be bio-sorbents for water treatment of manganese-impacted effluents, and promote appropriate waste management of local bivalves.

Keywords: biosorption, chitin, FT-IR, mine effluents, SEM

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3212 Investigation of FOXM1 Gene Expression in Breast Cancer and Its Relationship with Mir-216B-5P Expression Level

Authors: Ramin Mehdiabadi, Neda Menbari, Mohammad Nazir Menbari

Abstract:

As a pressing public health concern, breast cancer stands as the predominant oncological diagnosis and principal cause of cancer-related mortality among women globally, accounting for 11.7% of new cancer incidences and 6.9% of cancer-related deaths. The annual figures indicate that approximately 230,480 women are diagnosed with breast cancer in the United States alone, with 39,520 succumbing to the disease. While developed economies have reported a deceleration in both incidence and mortality rates across various forms of cancer, including breast cancer, emerging and low-income economies manifest a contrary escalation, largely attributable to lifestyle-mediated risk factors such as tobacco usage, physical inactivity, and high caloric intake. Breast cancer is distinctly characterized by molecular heterogeneity, manifesting in specific subtypes delineated by biomarkers—Estrogen Receptors (ER), Progesterone Receptors (PR), and Human Epidermal Growth Factor Receptor 2 (HER2). These subtypes, comprising Luminal A, Luminal B, HER2-enriched, triple-negative/basal-like, and normal-like, necessitate nuanced, subtype-specific therapeutic regimens, thereby challenging the applicability of generalized treatment protocols. Within this molecular complexity, the transcription factor Forkhead Box M1 (FoxM1) has garnered attention as a significant driver of cellular proliferation, tumorigenesis, metastatic progression, and treatment resistance in a spectrum of human malignancies, including breast cancer. Concurrently, microRNAs (miRs), specifically miR-216b-5p, have been identified as post-transcriptional gene expression regulators and potential tumor suppressors. The overarching objective of this academic investigation is to explicate the multifaceted interrelationship between FoxM1 and miR-216b-5p across the disparate molecular subtypes of breast cancer. Employing a methodologically rigorous, interdisciplinary research design that incorporates cutting-edge molecular biology techniques, sophisticated bioinformatics analytics, and exhaustive meta-analyses of extant clinical data, this scholarly endeavor aims to unveil novel biomarker-specific therapeutic pathways. By doing so, this research is positioned to make a seminal contribution to the advancement of personalized, efficacious, and minimally toxic treatment paradigms, thus profoundly impacting the global efforts to ameliorate the burden of breast cancer.

Keywords: breast cancer, fox m1, microRNAs, mir-216b-5p, gene expression

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3211 Determination of Acid Volatile Sulfides–Simultaneously Extracted Metal Relationship and Toxicity in Contaminated Sediment Layer in Mid-Black Sea Coasts

Authors: Arife Simsek, Gulfem Bakan

Abstract:

Sediment refers to the accumulation of varying amounts of sediment material in natural waters and the formation of bottom sludge. Sediments are the most important sources of pollutants as well as important future sources and carriers of pollutants. The accumulation of pollutants in sediments can cause serious environmental problems for the surrounding areas. Heavy metals (such as Cr, Cd, Al, Pb, Cu, Al, Zn) disrupt the water quality, affect the useful use of sediment, affect the ecosystem and have a toxic effect on the life of the sediment layer. This effect, which accumulates in the aquatic organisms, can enter the human body with the food chain and affect health seriously. Potential metal toxicity can be determined by comparing acid volatile sulfides (AVS) – simultaneously extracted metal (SEM) ratio in anoxic sediments to determine the effect of metals. Determination of the concentration of SEM and AVS is useful in screening sediments for potential toxicity due to the high metal concentration. In the case of SEM/AVS < 0 (anoxic sediment); in terms of AVS biomass production, its toxicity can be controlled. No toxic effects may be observed when SEM / AVS < 0. SEM / AVS > 0 (in the case of oxic sediment); metals with sensitive fraction such as Cu, As, Ag, Zn are stored. In this study, AVS and SEM measurements of sediment samples collected from five different points in the district of Tekkeköy in Samsun province were performed. The SEM - AVS ratio was greater than 0 in all samples. Therefore, it is necessary to test the toxicity against the risks that may occur in the ecosystem.

Keywords: AVS-SEM, Black Sea, heavy metal, sediment, toxicity

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3210 South African Municipal Service Delivery Failure and Public Value Theory

Authors: Andrew Enaifoghe

Abstract:

Municipalities are the most fundamental units of governance, and they are responsible for providing basic services and supporting growth in the areas they rule. South African local government is primarily understood in terms of service delivery, and the South African constitution provides municipalities with the responsibility of mobilizing economic resources, to better the lives of all people. Essential public services are the primary pillars of enhanced quality of life, and appropriate supplies of safe water and sanitation are required for life, well-being, and human dignity. Therefore, having access to basic services is directly tied to social inclusion and social capital, and towns' inability to offer services can have a negative influence on social and economic growth. The problem of service delivery is seen as one of the biggest challenges facing South African municipalities today. This study attempts to assess South African municipal service delivery. Focusing on the main causes of service delivery challenges, the study also looks at the impact of these challenges to identify ways to minimize such challenges by introducing legal instruments such as municipal budgeting and annual reports. A qualitative design was adopted, and data were collected using a desktop technique and analyzed based on content. While public engagement in municipal affairs is required by law, considerable work has to be done to ensure successful participation. Finally, municipalities were deemed to need to do more to improve human capacity to offer services.

Keywords: municipalities, service delivery, corruption, monitoring, South Africa

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3209 iPSC-derived MSC Mediated Immunosuppression during Mouse Airway Transplantation

Authors: Mohammad Afzal Khan, Fatimah Alanazi, Hala Abdalrahman Ahmed, Talal Shamma, Kilian Kelly, Mohammed A. Hammad, Abdullah O. Alawad, Abdullah Mohammed Assiri, Dieter Clemens Broering

Abstract:

Lung transplantation is a life-saving surgical replacement of diseased lungs in patients with end-stage respiratory malfunctions. Despite the remarkable short-term recovery, long-term lung survival continues to face several significant challenges, including chronic rejection and severe toxic side-effects due to global immunosuppression. Stem cell-based immunotherapy has been recognized as a crucial immunoregulatory regimen in various preclinical and clinical studies. Despite initial therapeutic outcomes, conventional stem cells face key limitations. The Cymerus™ manufacturing facilitates the production of a virtually limitless supply of consistent human induced pluripotent stem cell (iPSC)-derived mesenchymal stem cells, which could play a key role in selective immunosuppression and graft repair during rejection. Here, we demonstrated the impact of iPSC-derived human MSCs on the development of immune-tolerance and long-term graft survival in mouse orthotopic airway allografts. BALB/c→C57BL/6 allografts were reconstituted with iPSC-derived MSCs (2 million/transplant/ at d0), and allografts were examined for regulatory T cells (Tregs), oxygenation, microvascular blood flow, airway epithelium and collagen deposition during rejection. We demonstrated that iPSC-derived MSC treatment leads to significant increase in tissue expression of hTSG-6 protein, followed by an upregulation of mouse Tregs and IL-5, IL-10, IL-15 cytokines, which augments graft microvascular blood flow and oxygenation, and thereby maintained a healthy airway epithelium and prevented the subepithelial deposition of collagen at d90 post-transplantation. Collectively, these data confirmed that iPSC-derived MSC-mediated immunosuppression has potential to establish immune-tolerance and rescue allograft from sustained hypoxic/ischemic phase and subsequently limits long-term airway epithelial injury and collagen progression, which therapeutically warrant a study of Cymerus iPSC-derived MSCs as a potential management option for immunosuppression in transplant recipients.

Keywords: stem cell therapy, immunotolerance, regulatory T cells, hypoxia and ischemia, microvasculature

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3208 Modeling and Behavior of Structural Walls

Authors: Salima Djehaichia, Rachid Lassoued

Abstract:

Reinforced concrete structural walls are very efficient elements for protecting buildings against excessive early damage and against collapse under earthquake actions. It is therefore of interest to develop a numerical model which simulates the typical behavior of these units, this paper presents and describes different modeling techniques that have been used by researchers and their advantages and limitations mentioned. The earthquake of Boumerdes in 2003 has demonstrated the fragility of structures and total neglect of sismique design rules in the realization of old buildings. Significant damage and destruction of buildings caused by this earthquake are not due to the choice of type of material, but the design and the study does not congruent with seismic code requirements and bad quality of materials. For idealizing the failure of rules, a parametric study focuses on: low rate of reinforcements, type of reinforcement, resistance moderate of concrete. As an application the modeling strategy based on finite elements combined with a discretization of wall more solicited by successive thin layers. The estimated performance level achieved during a seismic action is obtained from capacity curves under incrementally increasing loads. Using a pushover analysis, a characteristic non linear force-displacement relationship can be determined. The results of numeric model are confronted with those of Algerian Para seismic Rules (RPA) in force have allowed the determination of profits in terms of displacement, shearing action, ductility.

Keywords: modeling, old building, pushover analysis, structural walls

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3207 The out of Proportion - Pulmonary Hypertension in Indians with Chronic Lung Disease

Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

Abstract:

Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

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3206 Assessment of Physical Activity Patterns in Patients with Cardiopulmonary Diseases

Authors: Ledi Neçaj

Abstract:

Objectives: The target of this paper is (1) to explain objectively physical activity model throughout three chronic cardiopulmonary conditions, and (2) to study the connection among physical activity dimensions with disease severity, self-reported physical and emotional functioning, and exercise performance. Material and Methods: This is a cross-sectional study of patients in their domestic environment. Patients with cardiopulmonary diseases were: chronic obstructive pulmonary disease (COPD), (n-63), coronary heart failure (n=60), and patients with implantable cardioverter defibrillator (n=60). Main results measures: Seven ambulatory physical activity dimensions (total steps, percentage time active, percentage time ambulating at low, medium, and hard intensity, maximum cadence for 30 non-stop minutes, and peak performance) have been measured with an accelerometer. Results: Subjects with COPD had the lowest amount of ambulatory physical activity compared with topics with coronary heart failure and cardiac dysrhythmias (all 7 interest dimensions, P<.05); total step counts have been: 5319 as opposed to 7464 as opposed to 9570, respectively. Six-minute walk distance becomes correlated (r=.44-.65, P<.01) with all physical activity dimensions inside the COPD pattern, the most powerful correlations being with total steps and peak performance. In topics with cardiac impairment, maximal oxygen intake had the most effective small to slight correlations with five of the physical activity dimensions (r=.22-.40, P<.05). In contrast, correlations among 6-minute walk test distance and physical activity have been higher (r=.48-.61, P<.01) albeit in a smaller pattern of most effective patients with coronary heart failure. For all three samples, self-reported physical and mental health functioning, age, frame mass index, airflow obstruction, and ejection fraction had both exceptionally small and no significant correlations with physical activity. Conclusions: Findings from this study present a profitable benchmark of physical activity patterns in individuals with cardiopulmonary diseases for comparison with future studies. All seven dimensions of ambulatory physical activity have disfavor between subjects with COPD, heart failure, and cardiac dysrhythmias. Depending on the research or clinical goal, the use of one dimension, such as total steps, may be sufficient. Although physical activity had high correlations with performance on a six-minute walk test relative to other variables, accelerometers-based physical activity monitoring provides unique, important information about real-world behavior in patients with cardiopulmonary not already captured with existing measures.

Keywords: ambulatory physical activity, walking, monitoring, COPD, heart failure, implantable defibrillator, exercise performance

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3205 Studies On Triazole Resistant Candida Albicans Expressing ERG11 Gene Among Adult Females In Abakaliki; Nigeria

Authors: Agumah N. B. Orji, M. U., Oru C. M., Ugbo, E. N., Onwuliri E. A Nwakaeze, E. A.,

Abstract:

ERG11 gene has been reported to be one of the genes whose expression is responsible for resistance of Candida to various triazole drugs, which are first line treatment for candidiasis. This study was carried out to determine the prevalence of Triazole (Fluconazole and voriconazole) resistant Candida albicans expressing ERG11 gene from adult females in Abakaliki. Urine and vaginal swab samples were randomly collected from volunteers after obtaining their consent to participate in the study. A total of 565 adult females participated in the study. A total of 340 urine specimens and 288 vaginal swab specimens were collected. Direct wet mount technique, as well as culture in Trichomonas broth, were used to examine the urine and vaginal swab specimens for the presence of motile Trichomonads. The Trichomonas broth used was selective for both T. vaginalis and C. albicans. Broths that yielded budding yeast cells after microscopy were subcultured on to Sabouraud dextrose agar, after which Germ tube test was carried out to confirm the presence of C. albicans. Biochemical tests, including carbohydrate fermentation and urease utilization, were also performed. Antibiogram of C. albicans isolates obtained from this study was carried out using commercially available azole drugs. Fluconazole and voriconazole were selected as Triazole drugs used for this study. Nystatin was used as a tangential control. An MIC test was carried out with E-strips on some of the resistant C. albicans isolates A total of 6 isolates that resisted all the azole drugs were selected and screened for the presence of ERG11 gene using Reverse transcriptase polymerase chain reaction technique. The total prevalence recorded for C. albicans was 13.0%. Frequency was statistically higher in Pregnant (7.96%) than non pregnant (5.09%) volunteers (X2=0.94 at P=0.05). With respect to clinical samples, frequency was higher in vaginal swabs samples (7.96%) than Urine samples (5.09%) (X2=9.05 at P=0.05). Volunteers within the age group 26-30 years recorded the highest prevalence (4.46%), while those within the age group 36-40 years recorded the lowest at 1.27%(X2=4.34 at P=0.05). In pregnant female participants, the highest frequency was recorded with those in their 3rd trimester (4.14%), while lowest incidence was recorded for those in their first trimester (0.80%). Antibiogram results from this study showed that C. albicans isolates obtained from this study resisted Fluconazole (72%) more than Voriconazole (57%). Only one out of the six selected isolates yielded resistance in the MIC test. Results obtained from the RT-PCR showed that there was no expression of ERG11 gene among the fluconazole resistant isolates of C. albicans. Observed resistance may be due to other factors other than expression of ERG11 gene.

Keywords: candida, ERG11, triazole, nigeria

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3204 The Effectiveness of a Six-Week Yoga Intervention on Body Awareness, Warnings of Relapse, and Emotion Regulation among Incarcerated Females

Authors: James D. Beauchemin

Abstract:

Introduction: The incarceration of people with mental illness and substance use disorders is a major public health issue with social, clinical, and economic implications. Yoga participation has been associated with numerous psychological benefits; however, there is a paucity of research examining impacts of yoga with incarcerated populations. The purpose of this study was to evaluate effectiveness of a six-week yoga intervention on several mental health-related variables, including emotion regulation, body awareness, and warnings of substance relapse among incarcerated females. Methods: This study utilized a pre-post, three-arm design, with participants assigned to intervention, therapeutic community, or general population groups. A between-group analysis of covariance (ANCOVA) was conducted across groups to assess intervention effectiveness using the Difficulties in Emotion Regulation Scale (DERS), Scale of Body Connection (SBC), and Warnings of Relapse (AWARE) Questionnaire. Results: ANCOVA results for warnings of relapse (AWARE) revealed significant between-group differences F(2, 80) = 7.15, p = .001; np2 = .152), with significant pairwise comparisons between the intervention group and both the therapeutic community (p = .001) and the general population (p = .005) groups. Similarly, significant differences were found for emotional regulation (DERS) F(2, 83) = 10.521, p = .000; np2 = .278). Pairwise comparisons indicated a significant difference between the intervention and general population (p = .01). Finally, significant differences between the intervention and control groups were found for body awareness (SBC) F(2, 84) = 3.69, p = .029; np2 = .081). Between-group differences were clarified via pairwise comparisons, indicating significant differences between the intervention group and both the therapeutic community (p = .028) and general population groups (p = .020). Implications: Study results suggest that yoga may be an effective addition to integrative mental health and substance use treatment for incarcerated women and contributes to increasing evidence that holistic interventions may be an important component for treatment with this population. Specifically, given the prevalence of mental health and substance use disorders, findings revealed that changes in body awareness and emotion regulation might be particularly beneficial for incarcerated populations with substance use challenges as a result of yoga participation. From a systemic perspective, this proactive approach may have long-term implications for both physical and psychological well-being for the incarcerated population as a whole, thereby decreasing the need for traditional treatment. By integrating a more holistic, salutogenic model that emphasizes prevention, interventions like yoga may work to improve the wellness of this population while providing an alternative or complementary treatment option for those with current symptoms.

Keywords: wellness, solution-focused coaching, college students, prevention

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3203 Can Zirconia Wings of Resin Retained Cantilever Bridges Be Effectively Bonded To Tooth Tissue When Compared With Metal Wings In The Anterior Dentition in vivo? - A Systematic Review.

Authors: Ariyan S. Araghi, Guy C. Jackson, Stephen J. Bonsor

Abstract:

Materials & Methods: A systematic literature search was undertaken using pre-determined inclusion and exclusion criteria. This review followed the Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA) statement. Several databases were used to search for randomised control trials and longitudinal cohort studies, which were published less than thirty years ago. A total of 54 studies met the predefined inclusion criteria. Four studies reviewed the success, survival, and failure characteristics of zirconia framework resin retained bridges, whilst two reviewed non-precious metal resin retained bridges. Results: The analysis of the studies revealed an overall survival rate of 95.9% for zirconia-based restorations compared to 90.7% for non-precious metal frameworks. Non-precious metal resin retained bridges displayed a higher overall failure rate of 11.9% compared to 4.6% for zirconia-based restorations in the analysed papers. The most frequent complications were wing debonding for the non-precious metal wing group, whereas substructure fracture and veneering ceramic fracture were more prevalent for the zirconia arm of the study. Conclusion: Both types of resin retained bridges provide effective medium to long-term survival. Zirconia-based frameworks will provide marginally increased success and survival and greatly improved aesthetics. However, catastrophic failure is more likely with zirconia-based restorations. Non-precious metal is time tested but performs worse than its zirconia counterpart with regards to longevity; it does not exhibit the same framework fractures as zirconia. Cement choice and attention to the adhesive bonding systems used appear to be paramount to restoration longevity with both restoration subtypes. Furthermore, improved longevity can be seen when air particle abrasion is incorporated into the adhesive protocol. Within the limitations of this study, it has been determined that zirconia-based resin retained bridges can be effectively used in anterior cantilever bridges. Clinical Significance: Zirconia-based resin retained bridges have been demonstrating promising results in terms of improved success and survival characteristics, together with improved aesthetics when compared to non-precious metal winged resin retained bridges. Their popularity is increasing in the age of digital dentistry as many restorations are manufactured using such technology. It is essential that clinicians understand the limitations of each material type and principles of adhesion to ensure restoration longevity.

Keywords: resin retained bridge, fixed partial denture, zirconia bridge, adhesive bridge

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3202 Challenges & Barriers for Neuro Rehabilitation in Developing Countries

Authors: Muhammad Naveed Babur, Maria Liaqat

Abstract:

Background & Objective: People with disabilities especially neurological disabilities have many unmet health and rehabilitation needs, face barriers in accessing mainstream health-care services, and consequently have poor health. There are not sufficient epidemiological studies from Pakistan which assess barriers to neurorehabilitation and ways to counter it. Objectives: The objective of the study was to determine the challenges and to evaluate the barriers for neuro-rehabilitation services in developing countries. Methods: This is Exploratory sequential qualitative study based on the Panel discussion forum in International rehabilitation sciences congress and national rehabilitation conference 2017. Panel group discussion has been conducted in February 2017 with a sample size of eight professionals including Rehabilitation medicine Physician, Physical Therapist, Speech Language therapist, Occupational Therapist, Clinical Psychologist and rehabilitation nurse working in multidisciplinary/Interdisciplinary team. A comprehensive audio-videography have been developed, recorded, transcripted and documented. Data was transcribed and thematic analysis along with characteristics was drawn manually. Data verification was done with the help of two separate coders. Results: After extraction of two separate coders following results are emerged. General category themes are disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. Barriers identified at the level are high cost, stigma, lengthy course of recovery. Hospital related barriers are lack of social support and individually tailored goal setting processes. Organizational barriers identified are lack of basic diagnostic facilities, lack of funding and human resources. Recommendations given by panelists were investment in education, capacity building, infrastructure, governance support, strategies to promote communication and realistic goals. Conclusion: It is concluded that neurorehabilitation in developing countries need attention in following categories i.e. disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. This study also revealed barriers at the level of patient, hospital, organization. Recommendations were also given by panelists.

Keywords: disability, neurorehabilitation, telerehabilitation, disability

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3201 Comparison of the Effects of Alprazolam and Zaleplon on Anxiety Levels in Patients Undergoing Abdominal Gynecological Surgery

Authors: Shekoufeh Behdad, Amirhossein Yadegari, Leila Ghodrati, Saman Yadegari

Abstract:

Context: Preoperative anxiety is a common psychological reaction experienced by all patients undergoing surgery. It can have negative effects on the patient's well-being and even impact surgical outcomes. Therefore, finding effective interventions to reduce preoperative anxiety is important in improving patient care. Research Aim: The aim of this study is to compare the effects of oral administration of zaleplon (5 mg) and alprazolam (0.5 mg) on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Methodology: This study is a double-blind, randomized clinical trial conducted after receiving approval from the university's ethics committee and obtaining written informed consent from the patients. The night before the surgery, patients were randomly assigned to receive either 0.5 mg of alprazolam or 5 mg of zaleplon orally. Anxiety levels, measured using a 10-cm visual analog scale, and hemodynamic variables (blood pressure and heart rate) were assessed before drug administration and on the morning of the operation after the patient entered the pre-operation room. Findings: The study found that there were no significant differences in mean anxiety levels or hemodynamic variables before and after administration of either drug in both groups (P value > 0.05). This suggests that both 0.5 mg of alprazolam and 5 mg of zaleplon effectively reduce preoperative anxiety in women undergoing abdominal surgery without serious side effects. Theoretical Importance: This study contributes to the understanding of the effectiveness of alprazolam and zaleplon in reducing preoperative anxiety. It adds to the existing literature on pharmacological interventions for anxiety management, specifically in the context of gynecological abdominal surgery. Data Collection: Data for this study were collected through the assessment of anxiety levels using a visual analog scale and measuring hemodynamic variables, including systolic, diastolic, and mean arterial blood pressures, as well as heart rate. These measurements were taken before drug administration and on the morning of the surgery. Analysis Procedures: Statistical analysis was performed to compare the mean anxiety levels and hemodynamic variables before and after drug administration in the two groups. The significance of the differences was determined using appropriate statistical tests. Questions Addressed: This study aimed to answer the question of whether there are differences in the effects of alprazolam and zaleplon on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Conclusion: The oral administration of both 0.5 mg of alprazolam and 5 mg of zaleplon the night before surgery effectively reduces preoperative anxiety in women undergoing abdominal surgery. These findings have important implications for the management of preoperative anxiety and can contribute to improving the overall surgical experience for patients.

Keywords: zaleplon, alprazolam, premedication, abdominal surgery

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