Search results for: median arcuate ligament syndrome

Authors: Taku Numao, Kazu Amimoto, Tomoko Shimada, Kyohei Ichikawa

Abstract:

Background: Unilateral spatial neglect (USN) is a common syndrome following damage to one hemisphere of the brain (usually the right side), in which a patient fails to report or respond to stimulation from the contralesional side. These symptoms are not due to primary sensory or motor deficits, but instead, reflect an inability to process input from that side of their environment. Prism adaptation (PA) is a therapeutic treatment for USN, wherein a patient’s visual field is artificially shifted laterally, resulting in a sensory-motor adaptation. However, patients with USN also tend to perceive a left-leaning subjective vertical in the frontal plane. The traditional PA cannot be used to correct a tilt in the subjective vertical, because a prism can only polarize, not twist, the surroundings. However, this can be accomplished using a head mounted display (HMD) and a web-camera. Therefore, this study investigated whether an HMD system could be used to correct the spatial perception of USN patients in the frontal as well as the horizontal plane. We recruited healthy subjects in order to collect data for the refinement of USN patient therapy. Methods: Eight healthy subjects sat on a chair wearing a HMD (Oculus rift DK2), with a web-camera (Ovrvision) displaying a 10 degree leftward rotation and a 10 degree counter-clockwise rotation along the frontal plane. Subjects attempted to point a finger at one of four targets, assigned randomly, a total of 48 times. Before and after the intervention, each subject’s body-centre judgment (BCJ) was tested by asking them to point a finger at a touch panel straight in front of their xiphisternum, 10 times sight unseen. Results: Intervention caused the location pointed to during the BCJ to shift 35 ± 17 mm (Ave ± SD) leftward in the horizontal plane, and 46 ± 29 mm downward in the frontal plane. The results in both planes were significant by paired-t-test (p<.01). Conclusions: The results in the horizontal plane are consistent with those observed following PA. Furthermore, the HMD and web-camera were able to elicit 3D effects, including in both the horizontal and frontal planes. Future work will focus on applying this method to patients with and without USN, and investigating whether subject posture is also affected by the HMD system.

Keywords: head mounted display, posture, prism adaptation, unilateral spatial neglect

Procedia PDF Downloads 269

Authors: Esam Roshdy, Saleh AlRashdi, Turki Alharbi, Rawan Eskandarani, Zurina Cabilo

Abstract:

Introduction/ background: Consultation in the Emergency Department constitute a major part of the work flow every day. Any delay in the consultation process have a major impact on the length of stay and patient disposition and thus affect the total waiting time of patients in the ED. King Fahad medical City in Riyadh City, Saudi Arabia is considered a major Tertiary hospital where there is high flow of patients of different categories visiting the ED. The importance of decreasing consultation time and decision for final disposition of patients was recognized and interpreted in this project to find ways to improve the patient flow in the department and thus the total patient disposition and outcome. Aim / Objectives: 1. To monitor the time of consultation for patients in the Emergency department and its impact on the length of stay of patients in the ED. 2. To detect and assess the problems that lead to long consultation times in the ED, and reach a targeted time of 2 hours for final disposition of patients, according to recognized international and our institutional consultation policy, to reach the final goal of decreasing total length of stay and thus improve the patient flow in the ED. Methods: Data was collected retrospectively for a 92 charts of consultations done in the ED over 2 month’s period. The data was analyzed to get the median of Total Consultation Time. A survey was conducted among all ED staff to determine the level of knowledge about the total consultation time and the compliance to the institutional policy target of 2 hours. A second Data sample of 168 chart was collected after awareness campaign and education of all ED staff about the importance of reaching the target consultation time and compliance to the institutional policy. Results: We have found that there is room for improvement in our overall consultation time. This was found to be more frequent with certain specialties. Our surveys have showed that many ED staff are not familiar or not compliant with our consultation policy which was not clear for everyone. Post-intervention data have showed that awareness of the importance to decrease the total consultation time and compliance alone to the targeted goal have had a huge impact on overall improvement and decreasing the time of final decision and disposition of the patient and the overall patient length of stay in the ED. Conclusion: Working on improving Consultation time in the Emergency Department is a major factor in improving overall length of stay and patient flow. This improvement helps in the overall patient disposition and satisfaction. Plan: As a continuation of our project we are planning to focus on the conflict of admission cases where more than one specialty is involved in the care of patients. We are planning to collect data on the time it takes to resolve and reach final disposition of those patients, and its impact on the length of stay and our department flow and the overall patient outcome and satisfaction.

Keywords: consultation time, impact, length of stay, in the ED

Procedia PDF Downloads 280

Authors: Rebecca Keyte, Helen Egan, Michail Mantzios

Abstract:

It is well acknowledged that ongoing adherence is a major concern within CF. However recently literature has indicated that non-adherence should not be viewed just in terms of medical regimens. There are other damaging behaviours that some chronically ill patients engage in which can be viewed as a form of non-adherence, such as risky behaviours. Risky behaviours are a major concern within CF, as they can have adverse health effects on patients regardless of patients adherence to medical regimens. The risky behaviours this research is predominantly focusing on are smoking, excessive alcohol consumption, illicit drug use and risky sexual behaviour. This research investigates patient’s beliefs about their CF and the impact their CF has upon their life, exploring rationales for why some patients engage in risky behaviours. This research utilises qualitative semi-structured interviews taking an interpretive perspective. Twenty-four adult participants have been recruited (16 male, age range 19–66 yrs) from two UK regional CF centres, with a median FEV1 61.77% predicted. Participants were recruited via clinician guidance, with 13 participants identified by clinicians as partaking in risky behaviours. However, during the interviews 17 participants were identified as partaking in risky behaviours, illustrating that not all patients offer full disclosure of engagement in such behaviours to their clinicians. Preliminary findings illustrate a variety of reasons as to why some CF patients engage in risky behaviours, with many participants stating that one challenge in terms of living with CF is accepting their illness. Disclosure of illness was also an issue, the desire to be seen as ‘normal’ was important to many. It is often possible for CF patients to hide their illness as they do not always appear to be unwell. However, literature indicates a desire for normalcy can be accompanied with the engagement of normalised risky behaviours, enabling patients to retaliate against their illness identity. There was also evidence of a life-orientated perspective amongst participants, with some reporting that their desire for fun and enjoyment was the reason for why they were engaging in risky behaviours. Some participants did not acknowledge the impact their risky behaviours could have upon their CF, and others rationalised their continuation with the behaviours by suggesting that they were in fact beneficial to their health. There was an apparent lack of knowledge around the implications of risky behaviours, with participants indicating that they had not been informed of such potential consequences by their clinicians. Given the adverse health effects of risky behaviours within CF, more effective health promotion measures are needed to both reduce and more importantly prevent these behaviours. Due to the initiation of risky behaviours within the CF population commonly occurring during adolescence, the researcher now proposes to conduct semi-structured interviews with paediatric patients to investigate their awareness and beliefs towards risky behaviours. Overall, this research will highlight reasons why some CF patients engage in risky behaviours, in order to inform interventions aimed to prevent the initiation in risky behaviours by increasing patient awareness.

Keywords: cystic fibrosis, health beliefs, preliminary findings, risky health behaviours

Procedia PDF Downloads 281

Authors: Mohammad Ali Al Qatawneh, Bespalchuk Pavel Ivanovich

Abstract:

Computer navigation has been introduced in total knee arthroplasty to improve the accuracy of the procedure. Computer navigation improves the accuracy of bone resection in the coronal and sagittal planes. It was also noted that it normalizes the rotational alignment of the femoral component and fully assesses and balances the deformation of soft tissues in the coronal plane. The work is devoted to the advantages of using computer navigation technology in total knee arthroplasty in 62 patients (11 men and 51 women) suffering from gonarthrosis, aged 51 to 83 years, operated using a computer navigation system, followed up to 3 years from the moment of surgery. During the examination, the deformity variant was determined, and radiometric parameters of the knee joints were measured using the Knee Society Score (KSS), Functional Knee Society Score (FKSS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scales. Also, functional stress tests were performed to assess the stability of the knee joint in the frontal plane and functional indicators of the range of motion. After surgery, improvement was observed in all scales; firstly, the WOMAC values decreased by 5.90 times, and the median value to 11 points (p < 0.001), secondly KSS increased by 3.91 times and reached 86 points (p < 0.001), and the third one is that FKSS data increased by 2.08 times and reached 94 points (p < 0.001). After TKA, the axis deviation of the lower limbs of more than 3 degrees was observed in 4 patients at 6.5% and frontal instability of the knee joint just in 2 cases at 3.2%., The lower incidence of sagittal instability of the knee joint after the operation was 9.6%. The range of motion increased by 1.25 times; the volume of movement averaged 125 degrees (p < 0.001). Computer navigation increases the accuracy of the spatial orientation of the endoprosthesis components in all planes, reduces the variability of the axis of the lower limbs within ± 3 °, allows you to achieve the best results of surgical interventions, and can be used to solve most basic tasks, allowing you to achieve excellent and good outcomes of operations in 100% of cases according to the WOMAC scale. With diaphyseal deformities of the femur and/or tibia, as well as with obstruction of their medullary canal, the use of computer navigation is the method of choice. The use of computer navigation prevents the occurrence of flexion contracture and hyperextension of the knee joint during the distal sawing of the femur. Using the navigation system achieves high-precision implantation for the endoprosthesis; in addition, it achieves an adequate balance of the ligaments, which contributes to the stability of the joint, reduces pain, and allows for the achievement of a good functional result of the treatment.

Keywords: knee joint, arthroplasty, computer navigation, advantages

Procedia PDF Downloads 76

Authors: Lucie Matricon, Anne Roubaud, Geert Haarlemmer, Christophe Geantet

Abstract:

Introduction: This case discusses the management of two floor of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. Case Report: A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Discussion: Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk, and second primary cancer development.

Keywords: microalgae, biofuels, hydrothermal liquefaction, biomass

Procedia PDF Downloads 121

Authors: Siddharth Jain, Abhenil Mittal, Surendra Kumar Sharma

Abstract:

Background: With its recent emergence and re-emergence, dengue has become a major international public health concern, imposing significant financial burden especially in developing countries. Despite aggressive control measures in place, India experienced one of its largest outbreaks in 2015 with Delhi being most severely affected. There is a lack of reliable predictors of disease severity and mortality in dengue. The present study was carried out to identify these predictors during the 2015 outbreak. Methods: This prospective observational study conducted at an apex tertiary care center in Delhi, India included confirmed adult dengue patients admitted between August-November 2015. Patient demographics, clinical details, and laboratory findings were recorded in a predesigned proforma. Appropriate statistical tests were used to summarize and compare the clinical and laboratory characteristics and derive predictors of mortality and severe disease, while developing a clinical risk score for mortality. Serotype analysis was also done for 75 representative samples to identify the dominant serotypes. Results: Data of 369 patients were analyzed (mean age 30.9 years; 67% males). Of these, 198 (54%) patients had dengue fever, 125 (34%) had dengue hemorrhagic fever (DHF Grade 1,2)and 46 (12%) developed dengue shock syndrome (DSS). Twenty two (6%) patients died. Late presentation to the hospital (≥5 days after onset) and dyspnoea at rest were identified as independent predictors of severe disease. Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. A clinical risk score was developed (12*age + 14*sensorium + 10*dyspnoea) which, if ≥ 22, predicted mortality with a high sensitivity (81.8%) and specificity (79.2%). The predominant serotypes in Delhi (2015) were DENV-2 and DENV-4. Conclusion: Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. Platelet counts did not determine the outcome in dengue patients. Timely referral/access to health care is important. Development and use of validated predictors of disease severity and simple clinical risk scores, which can be applied in all healthcare settings, can help minimize mortality and morbidity, especially in resource limited settings.

Keywords: dengue, mortality, predictors, severity

Procedia PDF Downloads 296

Authors: Mwenya Mubanga, Sula Mazimba

Abstract:

Background: In Zambia, much of the focus on nutrition and health has been on reducing micronutrient deficiencies, wasting and underweight malnutrition and not on the rising global projections of trends in obesity and type 2 diabetes. The aim of this review was to identify and collate studies on the prevalence of obesity, diabetes and diabetes-related cardiovascular disease conducted in Zambia, to summarize their findings and to identify areas that need further research. Methods: The Medical Literature Analysis and Retrieval System (MEDLINE) database was searched for peer-reviewed articles on the prevalence of, and factors associated with obesity, type 2 diabetes, and diabetes-related cardiovascular disease amongst Zambian residents using a combination of search terms. The period of search was from 1 January 2000 to 31 December 2016. We expanded the search terms to include all possible synonyms and spellings obtained in the search strategy. Additionally, we performed a manual search for other articles and references of peer-reviewed articles. Results: In Zambia, the current prevalence of Obesity and Type 2 diabetes is estimated at 13%-16% and 2.0 – 3.0% respectively. Risk factors such as the adoption of western dietary habits, the social stigmatization associated with rapid weight loss due to Tuberculosis and/ or the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and rapid urbanization have all been blamed for fueling the increased risk of obesity and type 2 diabetes. However, unlike traditional Western populations, those with no formal education were less likely to be obese than those who attained secondary or tertiary level education. Approximately 30% of those surveyed were unaware of their diabetes diagnosis and more than 60% were not on treatment despite a known diabetic status. Socio-demographic factors such as older age, female sex, urban dwelling, lack of tobacco use and marital status were associated with an increased risk of obesity, impaired glucose tolerance and type 2 diabetes. We were unable to identify studies that specifically looked at diabetes-related cardiovascular disease. Conclusion: Although the prevalence of Obesity and Type 2 diabetes in Zambia appears low, more representative studies focusing on parts of the country outside of the main industrial zone need to be conducted. There also needs to be research on diabetes-related cardiovascular disease. National surveillance, monitoring and evaluation on all non-communicable diseases need to be prioritized and policies that address underweight, obesity and type 2 diabetes developed.

Keywords: type 2 diabetes, Zambia, obesity, cardiovascular disease

Procedia PDF Downloads 232

Authors: Sylvain Perrin, Thomas Saillour

Abstract:

The Grande-Motte port and seafront development project on the French Mediterranean coastline entailed evaluating wave impact loads (pressures and forces) on the new beach seawall and comparing the resulting scour potential at the base of the existing and new seawall. A physical model was built at ARTELIA’s hydraulics laboratory in Grenoble (France) to provide insight into the evolution of scouring overtime at the front of the wall, quasi-static and impulsive wave force intensity and distribution on the wall, and water and sand overtopping discharges over the wall. The beach was constituted of fine sand and approximately 50 m wide above mean sea level (MSL). Seabed slopes were in the range of 0.5% offshore to 1.5% closer to the beach. A smooth concrete structure will replace the existing concrete seawall with an elevated curved crown wall. Prior the start of breaking (at -7 m MSL contour), storm-driven maximum spectral significant wave heights of 2.8 m and 3.2 m were estimated for the benchmark historical storm event dated of 1997 and the 50-year return period storms respectively, resulting in 1 m high waves at the beach. For the wave load assessment, a tensor scale measured wave forces and moments and five piezo / piezo-resistive pressure sensors were placed on the wall. Light-weight sediment physical model and pressure and force measurements were performed with scale 1:18. The polyvinyl chloride light-weight particles used to model the prototype silty sand had a density of approximately 1 400 kg/m3 and a median diameter (d50) of 0.3 mm. Quantitative assessments of the seabed evolution were made using a measuring rod and also a laser scan survey. Testing demonstrated the occurrence of numerous impulsive wave impacts on the reflector (22%), induced not by direct wave breaking but mostly by wave run-up slamming on the top curved part of the wall. Wave forces of up to 264 kilonewtons and impulsive pressure spikes of up to 127 kilonewtons were measured. Maximum scour of -0.9 m was measured for the new seawall versus -0.6 m for the existing seawall, which is imputable to increased wave reflection (coefficient was 25.7 - 30.4% vs 23.4 - 28.6%). This paper presents a methodology for the setup and operation of a physical model in order to assess the hydrodynamic and morphodynamic processes at a beach seawall during storms events. It discusses the pros and cons of such methodology versus others, notably regarding structures peculiarities and model effects.

Keywords: beach, impacts, scour, seawall, waves

Procedia PDF Downloads 143

Authors: Bharat Rawat, Shekhar Rajbhandari, Yadav Bhatta, Jay Prakash Jaiswal, Shivaji Bikram Silwal, Rajiv Shrestha, Shova Sunuwar

Abstract:

Introduction: The honey produced by the bees fed on Rhobdodendron species containing grayanotoxin is known as mad honey. Grayanotoxin is found in honey obtained from the nectar of Rhododendron species growing on the mountains of the Black Sea region of Turkey and also in Japan, Nepal, Brazil, parts of North America, and Europe. Although the incidence of grayanotoxin poisoning is rare, there is concern that the number of cases per year will rise with the increasing demand for organic products. Mad honey intoxication might present with mild symptoms of cardiovascular, gastrointestinal and neurological systems or might also present with a life-threatening form with AV block and cardiovascular collapse. In this article, we describe the summary of five cases, which came to our hospital with mad honey related cardiac complications. Findings: In last one year, five cases presented in the emergency department with sudden onset of Loss of consciousness, dizziness, shortness of breath. They felt difficulty after the consumption of 1-3 teaspoonful of wild honey. The honey was brought from most of the rural parts of Nepal like khotang. Some of them also came with vomiting, dizziness, and loose stool. On examination, most of them had severe bradycardia and low blood pressure. No abnormalities were detected on systemic examinations. In one patient, ECG and cardiac enzymes showed features of the acute coronary syndrome, but his treadmill test done few days later was normal. All patients were managed with inj. Atropine, I/V normal saline, and other supportive measures and discharged in a stable condition within one or two days. Conclusions: Rhododendrons is the national flower of Nepal. The specific species of rhododendron found in Nepal which contains the toxin is not known. Bees feeding on these rhododendrons are known to transfer the grayanotoxin to the honey they produce. Most symptoms are mild and resolve themselves without medical intervention. Signs and symptoms of grayanotoxin poisoning rarely last more than 24 hours and are usually not fatal. Some signs of mad honey poisoning include Bradycardia, Cardiac arrhythmia, Hypotension, Nausea and Vomiting. They respond to close monitoring and appropriate supportive treatment. Normally, patients recover completely with no residual damage to the heart or its conduction system.

Keywords: rhobdodendron, honey, grayanotoxin, bradycardia

Procedia PDF Downloads 338

Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher

Abstract:

The Dandy-Walker malformation (DWM) represents a clinical syndrome manifesting as a combination of posterior fossa cyst, hypoplasia of the cerebellar vermis, and obstructive hydrocephalus. Anatomic hallmarks include hypoplasia of the cerebellar vermis, enlargement of the posterior fossa, and cystic dilatation of the fourth ventricle. Current treatments of DWM, including shunting of the cerebral spinal fluid ventricular system and endoscopic third ventriculostomy (ETV), are frequently clinically insufficient, require additional surgical interventions, and carry risks of infections and neurological deficits. Bionaut Labs develops an alternative way to treat Dandy-Walker Malformation (DWM) associated with non-communicating hydrocephalus. We utilize our discreet microsurgical Bionaut™ particles that are controlled externally and remotely to perform safe, accurate, effective fenestration of the Dandy-Walker cyst, specifically in the posterior fossa of the brain, to directly normalize intracranial pressure. Bionaut™ allows for complex non-linear trajectories not feasible by any conventional surgical techniques. The microsurgical particle safely reaches targets in the lower occipital section of the brain. Bionaut™ offers a minimally invasive surgical alternative to highly involved posterior craniotomy or shunts via direct fenestration of the fourth ventricular cyst at the locus defined by the individual anatomy. Our approach offers significant advantages over the current standards of care in patients exhibiting anatomical challenge(s) as a manifestation of DWM, and therefore, is intended to replace conventional therapeutic strategies. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.

Keywords: Bionaut™, cerebral spinal fluid, CSF, cyst, Dandy-Walker, fenestration, hydrocephalus, micro-robot

Procedia PDF Downloads 205

Authors: Danilo A. F. Fontes, Magaly A. M.Lyra, Maria L. C. Moura, Leslie R. M. Ferraz, Salvana P. M. Costa, Amanda C. Q. M. Vieira, Larissa A. Rolim, Giovanna C. R. M. Schver, Ping I. Lee, Severino Alves-Júnior, José L. Soares-Sobrinho, Pedro J. Rolim-Neto

Abstract:

Efavirenz (EFV) is a first-choice drug in antiretroviral therapy with high efficacy in the treatment of infection by Human Immunodeficiency Virus, which causes Acquired Immune Deficiency Syndrome (AIDS). EFV has low solubility in water resulting in a decrease in the dissolution rate and, consequently, in its bioavailability. Among the technological alternatives to increase solubility, the Lamellar Double Hydroxides (LDH) have been applied in the development of systems with poorly water-soluble drugs. The use of analytical techniques such as X-Ray Diffraction (XRD), Infrared Spectroscopy (IR) and Differential Scanning Calorimetry (DSC) allowed the elucidation of drug interaction with the lamellar compounds. The objective of this work was to characterize and develop the binary systems with EFV and LDH in order to increase the solubility of the drug. The LDH-CaAl was synthesized by the method of co-precipitation from salt solutions of calcium nitrate and aluminum nitrate in basic medium. The systems EFV-LDH and their physical mixtures (PM) were obtained at different concentrations (5-60% of EFV) using the solvent technique described by Takahashi & Yamaguchi (1991). The characterization of the systems and the PM’s was performed by XRD techniques, IR, DSC and dissolution test under non-sink conditions. The results showed improvements in the solubility of EFV when associated with LDH, due to a possible change in its crystal structure and formation of an amorphous material. From the DSC results, one could see that the endothermic peak at 173°C, temperature that correspond to the melting process of EFZ in the crystal form, was present in the PM results. For the EFZ-LDH systems (with 5, 10 and 30% of drug loading), this peak was not observed. XRD profiles of the PM showed well-defined peaks for EFV. Analyzing the XRD patterns of the systems, it was found that the XRD profiles of all the systems showed complete attenuation of the characteristic peaks of the crystalline form of EFZ. The IR technique showed that, in the results of the PM, there was the appearance of one band and overlap of other bands, while the IR results of the systems with 5, 10 and 30% drug loading showed the disappearance of bands and a few others with reduced intensity. The dissolution test under non-sink conditions showed that systems with 5, 10 and 30% drug loading promoted a great increase in the solubility of EFV, but the system with 10% of drug loading was the only one that could keep substantial amount of drug in solution at different pHs.

Keywords: Efavirenz, Lamellar Double Hydroxides, Pharmaceutical Techonology, Solubility

Procedia PDF Downloads 565

Authors: Mishell E. Cabrera, Bryan G. Valencia, Anderson I. Guamán

Abstract:

Human dependence on plastic products has led to global pollution, with plastic particles ranging in size from 0.001 to 5 millimeters, which are called microplastics (hereafter, MPs). The abundance of microplastics is used as an indicator of pollution. However, reports of pollution (abundance of MPs) in river sediments do not consider that the accumulation of sediments and MPs depends on the energy of the river. That is, the abundance of microplastics will be underestimated if the sediments analyzed come from places where the river flows with a lot of energy, and the abundance will be overestimated if the sediment analyzed comes from places where the river flows with less energy. This bias can generate an error greater than 300% of the MPs value reported for the same river and should increase when comparisons are made between 2 rivers with different characteristics. Sections where the river flows with higher energy allow sands to be deposited and limit the accumulation of MPs, while sections, where the same river has lower energy, allow fine sediments such as clays and silts to be deposited and should facilitate the accumulation of MPs particles. That is, the abundance of MPs in the same river is underrepresented when the sediment analyzed is sand, and the abundance of MPs is overrepresented if the sediment analyzed is silt or clay. The present investigation establishes a protocol aimed at incorporating sample granulometry to calibrate MPs quantification and eliminate over- or under-representation bias (hereafter granulometric bias). A total of 30 samples were collected by taking five samples within six work zones. The slope of the sampling points was less than 8 degrees, referred to as low slope areas, according to the Van Zuidam slope classification. During sampling, blanks were used to estimate possible contamination by MPs during sampling. Samples were dried at 60 degrees Celsius for three days. A flotation technique was employed to isolate the MPs using sodium metatungstate with a density of 2 gm/l. For organic matter digestion, 30% hydrogen peroxide and Fenton were used at a ratio of 6:1 for 24 hours. The samples were stained with rose bengal at a concentration of 200 mg/L and were subsequently dried in an oven at 60 degrees Celsius for 1 hour to be identified and photographed in a stereomicroscope with the following conditions: Eyepiece magnification: 10x, Zoom magnification (zoom knob): 4x, Objective lens magnification: 0.35x for analysis in ImageJ. A total of 630 fibers of MPs were identified, mainly red, black, blue, and transparent colors, with an overall average length of 474,310 µm and an overall median length of 368,474 µm. The particle size of the 30 samples was calculated using 100 g per sample using sieves with the following apertures: 2 mm, 1 mm, 500 µm, 250 µm, 125 µm and 0.63 µm. This sieving allowed a visual evaluation and a more precise quantification of the microplastics present. At the same time, the weight of sediment in each fraction was calculated, revealing an evident magnitude: as the presence of sediment in the < 63 µm fraction increases, a significant increase in the number of MPs particles is observed.

Keywords: microplastics, pollution, sediments, Tena River

Procedia PDF Downloads 63

Authors: Fuad Hamsyah

Abstract:

Since last two decades, major disasters have happened in the Philippines and Indonesia as two countries that are located in the pacific ring of fire territory. While in Southeast Asian countries, the process of psychosocial support provision is facing various constraints such as limited number of mental health professionals and the limited knowledge about the provision of psychosocial support for disaster survivors. Yet after the tsunami disaster in 2004, many Asian countries begin to develop policies about the provision of psychosocial interventions as an effort for future disasters preparedness. In addition, mental health professionals have to consider the local cultural values and beliefs in order to provide people with effective psychosocial support since cultural values and beliefs play a significant role in the diversity of psychological distress that forms symptoms formation, and people’s way to seek for psychological assistance. This study is a critical literature review on 130 relevant selected documents and literatures. IASC MHPSS guideline is used as the research framework in doing critical analysis. The purpose of this study is to conduct a critical analysis on the mental health and psychosocial support provision in the Philippines and Indonesia with three main objectives: 1) To describe strengths, weaknesses, and challenges in the process of psychosocial supports given by public and private organizations in emergency settings of disaster in the Philippines and Indonesia, 2) To compare psychosocial support practices between the Philippines and Indonesia, and to identify the good practices among these countries, 3) To learn how cultural values influence the implementation of psychosocial supports in emergency settings of disaster. This research indicated that almost every function from IASC MHPSS guidelines has been implemented effectively in the Philippines and Indonesia, yet not in every detail of IASC MHPSS guidelines. Several similarities and differences are indicated in this study also based on the IASC MHPSS guidelines as the analysis framework. Further, both countries have some good practices that can be useful as an example of a comprehensive psychosocial support implementation. Apart from the IASC MHPSS guideline, cultural values and beliefs in the Philippines such as kanya-kanya syndrome, pakikipakapwa, utang na loob, bahala na, pagkaya are indicated as several cultural values that have strong influences towards people’s attitude and behavior in disaster situations. While in Indonesia, several cultural values such as sabar and nrimo become two important attitudes to cope disaster situations.

Keywords: disaster, Indonesia, psychosocial support, Philippines

Procedia PDF Downloads 381

Authors: Tracey Lion-Cachet

Abstract:

Eating disorders typically manifest in adolescence and are notoriously difficult to treat. There are two notable reasons for this. Firstly, research consistently demonstrates that early intervention is a critical mediator of prognosis, with early intervention leading to a better prognosis. However, because eating disorders do not originate as full-syndrome diagnoses but rather as prodromal cases, they often go undetected; by the time symptoms meet diagnostic criteria, they have become recalcitrant. Another interrelated issue is motivation to change. Research demonstrates that in the early stages of an eating disorder, adolescents are highly resistant to change, and motivation increases only once symptoms have shifted from egosyntonic to egodystonic in nature. The purpose of this project was to design a prevention model based on the social psychology paradigm of Entertainment-Education, which embeds messages within the genre of film as a means of affecting change. The resulting project was a narrative screenplay targeting teenagers/young adults from diverse backgrounds. The goals of the project were to create a film script that, if ultimately made into a film, could serve to: 1) interrupt symptom progression and improve prognosis through early intervention; 2) incorporate techniques from third-wave cognitive behavioral treatment models, acceptance and commitment therapy (ACT) and rational recovery (RR), with a focus on the effects of mindfulness as a means of informing recovery; 3) target issues to do with motivation to change by shifting the perception of eating disorders from culturally specific psychiatric illnesses to habit-based brain wiring issues. Nine licensed clinicians were asked to evaluate two excerpts taken from the final script. They subsequently provided feedback on a Likert-scale, which assessed whether the script had achieved its goals. Overall, evaluators agreed that the project’s etiological and intervention models have the potential to inspire change and serve as an effective means of prevention and treatment of eating disorders. However, one-third of the evaluators did not find the content developmentally appropriate. This is a notable limitation to the study and will need to be addressed in the larger script before the final project can potentially be targeted to a teenage and young adult audience.

Keywords: adolescents, eating disorders, pediatrics, entertainment-education, mindfulness-based intervention, prevention

Procedia PDF Downloads 68

Authors: Leila Sadeghi

Abstract:

Gender equality is a critical concern in the workplace, particularly in Iran, where legal and social barriers contribute to significant disparities. This abstract presents a case study of Dahi Bondad Co., a company based in Tehran, Iran that recognized the urgency of addressing the gender gap within its organization. Through a comprehensive investigation, the company identified issues related to biased recruitment, pay disparities, promotion biases, internal barriers, and everyday boundaries. This abstract highlights the strategies implemented by Dahi Bondad Co. to combat these challenges and foster gender equality. The company revised its recruitment policies, eliminated gender-specific language in job advertisements, and implemented blind resume screening to ensure equal opportunities for all applicants. Comprehensive pay equity analyses were conducted, leading to salary adjustments based on qualifications and experience to rectify pay disparities. Clear and transparent promotion criteria were established, and training programs were provided to decision-makers to raise awareness about unconscious biases. Additionally, mentorship and coaching programs were introduced to support female employees in overcoming self-limiting beliefs and imposter syndrome. At the same time, practical workshops and gamification techniques were employed to boost confidence and encourage women to step out of their comfort zones. The company also recognized the importance of dress codes and allowed optional hijab-wearing, respecting local traditions while promoting individual freedom. As a result of these strategies, Dahi Bondad Co. successfully fostered a more equitable and empowering work environment, leading to increased job satisfaction for both male and female employees within a short timeframe. This case study serves as an example of practical approaches that human resource managers can adopt to address gender inequality in the workplace, providing valuable insights for organizations seeking to promote gender equality in similar contexts.

Keywords: gender equality, human resource strategies, legal barrier, social barrier, successful result, successful strategies, workplace in Iran

Procedia PDF Downloads 62

Authors: Camila Lemos Pinto, Juliana Alves Carneiro, Patrícia Borges Botelho, João Felipe Mota

Abstract:

Sarcopenia, a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, currently affects over 50 million people and increases the risk of adverse outcomes such as physical disability, poor quality of life and death. The aim of this study was to examine the efficacy of creatine supplementation associated with resistance training on muscle mass in the elderly. A 12-week, double blind, randomized, parallel group, placebo controlled trial was conducted. Participants were randomly allocated into one of the following groups: placebo with resistance training (PL+RT, n=14) and creatine supplementation with resistance training (CR + RT, n=13). The subjects from CR+RT group received 5 g/day of creatine monohydrate and the subjects from the PL+RT group were given the same dose of maltodextrin. Participants were instructed to ingest the supplement on non-training days immediately after lunch and on training days immediately after resistance training sessions dissolved in a beverage comprising 100 g of maltodextrin lemon flavored. Participants of both groups undertook a supervised exercise training program for 12 weeks (3 times per week). The subjects were assessed at baseline and after 12 weeks. The primary outcome was muscle mass, assessed by dual energy X-ray absorptiometry (DXA). The secondary outcome included diagnose participants with one of the three stages of sarcopenia (presarcopenia, sarcopenia and severe sarcopenia) by skeletal muscle mass index (SMI), handgrip strength and gait speed. CR+RT group had a significant increase in SMI and muscle (p<0.0001), a significant decrease in android and gynoid fat (p = 0.028 and p=0.035, respectively) and a tendency of decreasing in body fat (p=0.053) after the intervention. PL+RT only had a significant increase in SMI (p=0.007). The main finding of this clinical trial indicated that creatine supplementation combined with resistance training was capable of increasing muscle mass in our elderly cohort (p=0.02). In addition, the number of subjects diagnosed with one of the three stages of sarcopenia at baseline decreased in the creatine supplemented group in comparison with the placebo group (CR+RT, n=-3; PL+RT, n=0). In summary, 12 weeks of creatine supplementation associated with resistance training resulted in increases in muscle mass. This is the first research with elderly of both sexes that show the same increase in muscle mass with a minor quantity of creatine supplementation in a short period. Future long-term research should investigate the effects of these interventions in sarcopenic elderly.

Keywords: creatine, dietetic supplement, elderly, resistance training

Procedia PDF Downloads 465

Authors: Jennifer Gallup, Joel Bocanegra, Greg Callan, Abigail Vaughn

Abstract:

Students with disabilities (SWD) engaged in a distance summer program delivered over multiple virtual mediums that used gaming principles to teach and practice self-regulated learning (SRL) through the process of exploring possible jobs. Gaming quests were developed to explore jobs and teach transition skills. Students completed specially designed quests that taught and reinforced SRL and problem-solving through individual, group, and teacher-led experiences. SRL skills learned were reinforced through guided job explorations over the context of MinecraftEDU, zoom with experts in the career, collaborations with a team over Marco Polo, and Zoom. The quests were developed and laid out on an accessible web page, with active learning opportunities and feedback conducted within multiple virtual mediums including MinecraftEDU. Gaming mediums actively engage players in role-playing, problem-solving, critical thinking, and collaboration. Gaming has been used as a medium for education since the inception of formal education. Games, and specifically board games, are pre-historic, meaning we had board games before we had written language. Today, games are widely used in education, often as a reinforcer for behavior or for rewards for work completion. Games are not often used as a direct method of instruction and assessment; however, the inclusion of games as an assessment tool and as a form of instruction increases student engagement and participation. Games naturally include collaboration, problem-solving, and communication. Therefore, our summer program was developed using gaming principles and MinecraftEDU. This manuscript describes a virtual learning summer program called Virtual Academy New and Exciting Transitions (VAN) that was redesigned from a face-to-face setting to a completely online setting with a focus on SWD aged 14-21. The focus of VAN was to address transition planning needs such as problem-solving skills, self-regulation, interviewing, job exploration, and communication for transition-aged youth diagnosed with various disabilities (e.g., learning disabilities, attention-deficit hyperactivity disorder, intellectual disability, down syndrome, autism spectrum disorder).

Keywords: autism, disabilities, transition, summer program, gaming, simulations

Procedia PDF Downloads 66

Authors: M. Warburton

Abstract:

Background: Case study examining hydrotherapy for a person with DSI. A 46 year-old lady completely deaf and blind post congenital rubella syndrome. Touch becomes the primary information gathering sense to optimise function in life. Communication is achieved via tactile finger spelling and signals onto her hand and skin. Hydrotherapy may provide a suitable mobility environment and somato-sensory input to people, and especially DSI persons. Buoyancy, warmth, hydrostatic pressure, viscosity and turbulence are elements of hydrotherapy that may offer a DSI person somato-sensory input to stimulate the mechanoreceptors, thermoreceptors and proprioceptors and offer a unique hydro-therapeutic environment. Purpose: The purpose of this case study was to establish what measurable benefits could be achieved from hydrotherapy with a DSI person. Methods: Hydrotherapy was provided for 8-weeks, 2 x week, 35-minute session duration. Pool temperature 32.5 degrees centigrade. Pool length 25-metres. Each session consisted of mobility encouragement and supervision, and activities to stimulate the somato-sensory system utilising aquatic properties of buoyancy, turbulence, viscosity, warmth and hydrostatic pressure. Somato-sensory activities focused on stimulating touch and tactile exploration including objects of various shape, size, weight, contour, texture, elasticity, pliability, softness and hardness. Outcomes were measured by the Goal Attainment Scale (GAS) and included mobility distance, attendance, and timed tactile responsiveness to varying objects. Results: Mobility distance and attendance exceeded baseline expectations. Timed tactile responsiveness to varying objects also changed positively from baseline. Average scale scores were 1.00 with an overall GAS t-score of 63.69. Conclusions: Hydrotherapy can be a quantifiable physio-therapeutic option for persons with DSI. It provides a relatively safe environment for mobility and allows the somato-sensory system to be fully engaged - important for the DSI population. Implications: Hydrotherapy can be a measurable therapeutic option for a DSI person. Physiotherapists should consider hydrotherapy for DSI people. Hydrotherapy can offer unique physical properties for the DSI population not available on land.

Keywords: chronic, disability, disease, rehabilitation

Procedia PDF Downloads 336

Authors: E. H. Szeto, E. Ammendola, J. V. Tabares, A. Starkey, J. Hay, J. G. McClung, C. J. Bryan

Abstract:

Introduction: Suicide is a leading cause of death globally, which accounts for more deaths annually than war, acquired immunodeficiency syndrome, homicides, and car accidents, while an estimated 140 million individuals have significant suicide ideation (SI) each year in the United States. Typical risk factors such as hopelessness, depression, and psychiatric disorders can predict suicide ideation but cannot distinguish between those who ideate from those who attempt suicide (SA). The Fluid Vulnerability Theory of suicide posits that a person’s activation of the suicidal mode is predicated on one’s predisposition, triggers, baseline/acute risk, and protective factors. The current study compares self-conscious cognitive-affective states (including guilt, shame, anger towards the self, and suicidal beliefs) among patients based on the endorsement of recent SI (i.e., past two weeks; acute risk) and lifetime SA (i.e., baseline risk). Method: A total of 2,722 individuals in an outpatient primary care setting were included in this cross-sectional, observational study; data for 2,584 were valid and retained for analysis. The Differential Emotions Scale measuring guilt, shame, and self-anger and the Suicide Cognitions Scale measuring suicide cognitions were administered. Results: A total of 2,222 individuals reported no recent SI or lifetime SA (Group 1), 161 reported recent SI only (Group 2), 145 reported lifetime SA only (Group 3), 56 reported both recent SI and lifetime SA (Group 4). The Kruskal-Wallis test showed that guilt, shame, self-anger, and suicide cognitions were the highest for Group 4 (both recent SI and lifetime SA), followed by Group 2 (recent SI-only), then Group 3 (lifetime SA-only), and lastly, Group 1 (no recent SI or lifetime SA). Conclusion: The results on recent SI-only versus lifetime SA-only contribute to the literature on the Fluid Vulnerability Theory of suicide by capturing SI and SA in two different time periods, which signify the acute risks and chronic baseline risks of the suicidal mode, respectively. It is also shown that: (a) people with a lifetime SA reported more severe symptoms than those without, (b) people with recent SI reported more severe symptoms than those without, and (c) people with both recent SI and lifetime SA were the most severely distressed. Future studies may replicate the findings here with other pertinent risk factors such as thwarted belongingness, perceived burdensomeness, and acquired capability, the last of which is consistently linked to attempting among ideators.

Keywords: suicide, guilt, shame, self-anger, suicide cognitions, suicide ideation, suicide attempt

Procedia PDF Downloads 152

Authors: Mustafa M. Donma, Ayşen Haksayar, Bahadır Batar, Buse Tepe, Birol Topçu, Orkide Donma

Abstract:

Childhood obesity is an ever-increasing health problem. The Association of obesity with severe chronic diseases such as diabetes and cardiovascular diseases makes the problem life-threatening. Aside from psychological, societal and metabolic factors, genetic polymorphisms have gained importance concerning etiology in recent years. The aim of this study was to evaluate the relationship between rs10455872 gene polymorphism in the Lipoprotein (a) locus and the development of childhood obesity. This was a prospective study carried out according to the Helsinki Declarations. The study protocol was approved by the Institutional Ethics Committee. This study was supported by Tekirdag Namik Kemal University Rectorate, Scientific Research Projects Coordination Unit. Project No: NKUBAP.02.TU.20.278. A total of 180 children (103 obese (OB) and 77 healthy), aged 6-18 years, without any acute or chronic disease, participated in the study. Two different groups were created: OB and healthy control. Each group was divided into two further groups depending on the nature of the polymorphism. Anthropometric measurements were taken during the detailed physical examination. Laboratory tests and TANITA measurements were performed. For the statistical evaluations, SPSS version 28.0 was used. A P-value smaller than 0.05 was the statistical significance degree. The distribution of lipoprotein (a) rs10455872 gene polymorphism did not differ between OB and healthy children. Children with AG genotype in both OB and control groups had lower body mass index (BMI), diagnostic obesity notation model assessment index (DONMA II), body fat ratio (BFR), C-reactive protein (CRP), and metabolic syndrome index (MetS index) values compared to children with normal AA genotype. In the OB group, serum iron, vitamin B12, hemoglobin, MCV, and MCH values were found to be higher in the AG genotype group than those of children with the normal AA genotype. A significant correlation was found between the MetS index and BFR among OB children with normal homozygous genotype. MetS index increased as BFR increased in this group. However, such a correlation was not observed in the OB group with heterozygous AG genotype. To the best of our knowledge, the association of lipoprotein (a) rs10455872 gene polymorphism with the etiology of childhood obesity has not been studied yet. Therefore, this study was the first report suggesting polymorphism with AG genotype as a good risk factor for obesity.

Keywords: child, gene polymorphism, lipoprotein (a), obesity, rs10455872

Procedia PDF Downloads 62

Authors: Shimeles Terefe Mengistue, Ascensión Del Olmo, Paola Marziani, Mirjana Pović, María Angeles Martínez-Carballo, Jaime Perea, Isabel M. Árquez

Abstract:

Quasars have historically been classified into two distinct classes, radio-loud (RL) and radio-quiet (RQ), taking into account the presence and absence of relativistic radio jets, respectively. The absence of spectra with a high S/N ratio led to the impression that all quasars (QSOs) are spectroscopically similar. Although different attempts were made to unify these two classes, there is a long-standing open debate involving the possibility of a real physical dichotomy between RL and RQ quasars. In this work, we present new high S/N spectra of 11 extremely powerful jetted quasars with radio-to-optical flux density ratio > 1000 that concomitantly cover the low-ionization emission of Mgii𝜆2800 and Hbeta𝛽 as well as the Feii blends in the redshift range 0.35 < z < 1, observed at Calar Alto Observatory (Spain). This work aims to quantify broad emission line differences between RL and RQ quasars by using the four-dimensional eigenvector 1 (4DE1) parameter space and its main sequence (MS) and to check the effect of powerful radio ejection on the low ionization broad emission lines. Emission lines are analysed by making two complementary approaches, a multicomponent non-linear fitting to account for the individual components of the broad emission lines and by analysing the full profile of the lines through parameters such as total widths, centroid velocities at different fractional intensities, asymmetry, and kurtosis indices. It is found that broad emission lines show large reward asymmetry both in Hbeta𝛽 and Mgii2800A. The location of our RL sources in a UV plane looks similar to the optical one, with weak Feii UV emission and broad Mgii2800A. We supplement the 11 sources with large samples from previous work to gain some general inferences. The result shows, compared to RQ, our extreme RL quasars show larger median Hbeta full width at half maximum (FWHM), weaker Feii emission, larger 𝑀BH, lower 𝐿bol/𝐿Edd, and a restricted space occupation in the optical and UV MS planes. The differences are more elusive when the comparison is carried out by restricting the RQ population to the region of the MS occupied by RL quasars, albeit an unbiased comparison matching 𝑀BH and 𝐿bol/𝐿Edd suggests that the most powerful RL quasars show the highest redward asymmetries in Hbeta.

Keywords: galaxies, active, line, profiles, quasars, emission lines, supermassive black holes

Procedia PDF Downloads 50

Authors: Ying-Jung Hsieh, Angela S. Huang, Chu-Ming Chiu, Yu-Min Chou, Chin-Hui Yang

Abstract:

Background and Objectives: Hepatitis A is primarily acquired by the fecal-oral route through person-to-person contact or ingestion of contaminated food or water. During 2010 to 2014, an average of 83 cases of locally-acquired disease was reported to Taiwan’s notifiable disease system. Taiwan Centers for Disease Control (TCDC) identified an outbreak of acute hepatitis A which began in June 2015. Of the 126 cases reported in 2015, 103 (82%) cases were reported during June–December and 95 cases (92%) of them were male. The average age of all male cases was 31 years (median, 29 years; range, 15–76 years). Among the 95 male cases, 49 (52%) were also infected with HIV, and all reported to have had sex with other men. To control this outbreak, TCDC launched a free hepatitis A vaccination program in January 2016 for close contacts of confirmed hepatitis A cases, including family members, sexual partners, and household contacts. Effect of the vaccination program was evaluated. Methods: All cases of hepatitis A reported to the National Notifiable Disease Surveillance System were included. A case of hepatitis A was defined as a locally-acquired disease in a person who had acute clinical symptoms include fever, malaise, loss of appetite, nausea or abdominal discomfort compatible with hepatitis, and tested positive for anti-HAV IgM during June 2015 to June 2016 in Taiwan. The rate of case accumulation was calculated using a simple regression model. Results: During January–June 2016, there were 466 cases of hepatitis A reported; of the 243 (52%) who were also infected with HIV, 232 (95%) had a history of having sex with men. Of the 346 cases that were followed up, 259 (75%) provided information on contacts but only 14 (5%) of them provided the name of their sexual partners. Among the 602 contacts reported, 349 (58%) were family members, 14 (2%) were sexual partners, and 239 (40%) were other household contacts. Among the 602 contacts eligible for free hepatitis A vaccination, 440 (73%) received the vaccine. There were 87 (25%) cases that refused to disclose their close contacts. The average case accumulation rate during January–June 2016 was 21.7 cases per month, which was 6.8 times compared to the average case accumulation rate during June–December 2015 of 3.2 cases per month. Conclusions: Despite vaccination program aimed to provide free hepatitis A vaccine to close contacts of hepatitis A patients, the outbreak continued and even gained momentum in transmission. Refusal by hepatitis A patients to provide names of their close contacts and rejection of contacts to take the hepatitis A vaccine may have contributed to the poor effect of the program. Targeted vaccination efforts of all MSM may be needed to control the outbreak among this population in the short term. In the long term, universal vaccination program is needed to prevent the infection of hepatitis A.

Keywords: hepatitis A, HIV, men who have sex with men, vaccination

Procedia PDF Downloads 248

Authors: Mohamad Ammar Ayass, Natalya Griko, Victor Pashkov, Wanying Cao, Kevin Zhu, Jin Zhang, Lina Abi Mosleh

Abstract:

Respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent for coronavirus disease 2019 (COVID-19). Early evidence pointed at the angiotensin-converting enzyme 2 (ACE-2) expressed on the epithelial cells of the lung as the main entry point of SARS-CoV-2 into the cells. The viral entry is mediated by the binding of the Receptor Binding Domain (RBD) of the spike protein that is expressed on the surface of the virus to the ACE-2 receptor. As the number of SARS-CoV-2 variants continues to increase, mutations arising in the RBD of SARS-CoV-2 may lead to the ineffectiveness of RBD targeted neutralizing antibodies. To address this limitation, the objective of this study is to develop a combination of aptamers that target different regions of the RBD, preventing the binding of the spike protein to ACE-2 receptor and subsequent viral entry and replication. A safe and innovative biomedical tool was developed to inhibit viral infection and reduce the harms of COVID-19. In the present study, DNA aptamers were developed against a recombinant trimer S protein using the Systematic Evolution of Ligands by Exponential enrichment (SELEX). Negative selection was introduced at round number 7 to select for aptamers that bind specifically to the RBD domain. A series of 9 aptamers (ADI2010, ADI2011, ADI201L, ADI203L, ADI205L, ADIR68, ADIR74, ADIR80, ADIR83) were selected and characterized with high binding affinity and specificity to the RBD of the spike protein. Aptamers (ADI25, ADI2009, ADI203L) were able to bind and pull down endogenous spike protein expressed on the surface of SARS-CoV-2 virus in COVID-19 positive patient samples and determined by liquid chromatography- tandem mass spectrometry analysis (LC-MS/MS). LC-MS/MS data confirmed that aptamers can bind to the RBD of the spike protein. Furthermore, results indicated that the combination of the 9 best aptamers inhibited the binding of the purified trimer spike protein to the ACE-2 receptor found on the surface of Vero E6 cells. In the same experiment, the combined aptamers displayed a better neutralizing effect than antibodies. The data suggests that the selected aptamers could be used in therapy to neutralize the effect of the SARS-CoV-2 virus by inhibiting the interaction between the RBD and ACE-2 receptor, preventing viral entry into target cells and therefore blocking viral replication.

Keywords: aptamer, ACE-2 receptor, binding inhibitor, COVID-19, spike protein, SARS-CoV-2, treatment

Procedia PDF Downloads 178

Authors: Bronwyn Griffin, Caroline Acton, Tona Gillen, Roy Kimble

Abstract:

Background: Bicycle riding is a common recreational activity enjoyed by many children throughout Australia that has been associated with the usual caveat of benefits related to exercise and recreation. Given Australia was the first country in the world to introduce cyclist helmet laws in 1991, very few publications have reviewed paediatric cycling injuries (fatal or non-fatal) since. Objectives: To identify trends in children (0-16 years) who required admission for greater than 24 hours following a bicycle-related injury (fatal and non-fatal) in Queensland. Further, to discuss changes that have occurred in paediatric cycling injury trends in Queensland since a prominent local study/publication in 1995. This paper aims to establish evidence to inform interventions promoting safer riding to parents, children and communities. Methods: Data on paediatric (0-16 years) cycling injuries in Queensland resulting in hospital admission more than 24 hours across three tertiary paediatric hospitals in Brisbane between November 2008-June 2015 was compiled by the Paediatric Trauma Data Registry for non-fatal injuries. The Child Death Review Team at the Queensland Families and Childhood Commission provided data on fatalities in children <17years from (June 2004 –June 2015). Comparing trends to a local study published in 1995 Results: Between 2008-2015 there were 197 patients admitted for greater than 24 hours following a cycling injury. The median age was 11 years, with males more frequently involved (n=139, 87%) compared to females. Mean length of stay was three days, with 47 (28%) children admitted to PICU, location of injury was most often the street (n=63, 37%). Between 2004 –2015 there were 15 fatalities (Incidence rate 0.25/100,000); all were male, 14/15 occurred on the street, with eight stated to have not been wearing a helmet, 11/15 children came from the least advantaged socio-economic group (SEIFA) compared to a local publication in 1995, finding of 94 fatalities between (1981-1992). Conclusions: There has been a notable decrease in incidence of fatalities between the two time periods with incidence rates dropping from 1.75-0.25/100,000. More statistics need to be run to ascertain if this is a true reduction or perhaps a decrease in children riding bicycles. Injuries that occur on the street that come in contact with a car remain of serious concern. The purpose of this paper is not to discourage bicycle riding among child and adolescent populations, rather, inform parents and the wider community about the risks associated with cycling in order to reduce injuries associated with this sport, whilst promoting safe cycling.

Keywords: paediatric, cycling, trauma, prevention, emergency

Procedia PDF Downloads 237

Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

Abstract:

Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

Procedia PDF Downloads 287

Authors: Otgonjargal Damdinbaljir

Abstract:

Background: Infant feeding practices have a major role in determining the nutritional status of children and are associated with household socioeconomic and demographic factors. In 2010, Mongolia used WHO 2008 edition of Indicators for assessing infant and young child feeding practices for the first time. Objective: To evaluate the feeding status of infants and young children under 2 years old in Mongolia. Materials and Methods: The study was conducted by cluster random sampling. The data on breastfeeding and complementary food supplement of the 350 infants and young children aged 0-23 months in 21 provinces of the 4 economic regions of the country and capital Ulaanbaatar city were collected through questionnaires. The feeding status was analyzed according to the WHO 2008 edition of Indicators for assessing infant and young child feeding practices. Analysis of data: Survey data was analysed using the PASW statistics 18.0 and EPI INFO 2000 software. For calculation of overall measures for the entire survey sample, analyses were stratified by region. Age-specific feeding patterns were described using frequencies, proportions and survival analysis. Logistic regression was done with feeding practice as dependent and socio demographic factors as independent variables. Simple proportions were calculated for each IYCF indicator. The differences in the feeding practices between sexes and age-groups, if any, were noted using chi-square test. Ethics: The Ethics Committee under the auspices of the Ministry of Health approved the study. Results: A total of 350 children aged 0-23 months were investigated. The rate of ever breastfeeding of children aged 0-23 months reached up to 98.2%, while the percentage of early initiation of breastfeeding was only 85.5%. The rates of exclusive breastfeeding under 6 months, continued breastfeeding for 1 year, and continued breastfeeding for 2 years were 71.3%, 74% and 54.6%, respectively. The median time of giving complementary food was the 6th month and the weaning time was the 9th month. The rate of complementary food supplemented from 6th-8th month in time was 80.3%. The rates of minimum dietary diversity, minimum meal frequency, and consumption of iron-rich or iron-fortified foods among children aged 6-23 months were 52.1%, 80.8% (663/813) and 30.1%, respectively. Conclusions: The main problems revealed from the study were inadequate category and frequency of complementary food, and the low rate of consumption of iron-rich or iron-fortified foods were the main issues to be concerned on infant feeding in Mongolia. Our findings have highlighted the need to encourage mothers to enrich their traditional wheat- based complementary foods add more animal source foods and vegetables.

Keywords: complementary feeding, early initiation of breastfeeding, exclusive breastfeeding, minimum meal frequency

Procedia PDF Downloads 464

Authors: Jaroslav Kraus

Abstract:

Spatial information about demographic processes are a standard part of outputs in the Czech Republic. That was also the case of Population and Housing Census which was held on 2011. This is a starting point for a follow up study devoted to two basic types of households: single person households and households of one completed family. Single person households and one family households create more than 80 percent of all households, but the share and spatial structure is in long-term changing. The increase of single households is results of long-term fertility decrease and divorce increase, but also possibility of separate living. There are regions in the Czech Republic with traditional demographic behavior, and regions like capital Prague and some others with changing pattern. Population census is based - according to international standards - on the concept of currently living population. Three types of geospatial approaches will be used for analysis: (i) firstly measures of geographic distribution, (ii) secondly mapping clusters to identify the locations of statistically significant hot spots, cold spots, spatial outliers, and similar features and (iii) finally analyzing pattern approach as a starting point for more in-depth analyses (geospatial regression) in the future will be also applied. For analysis of this type of data, number of households by types should be distinct objects. All events in a meaningful delimited study region (e.g. municipalities) will be included in an analysis. Commonly produced measures of central tendency and spread will include: identification of the location of the center of the point set (by NUTS3 level); identification of the median center and standard distance, weighted standard distance and standard deviational ellipses will be also used. Identifying that clustering exists in census households datasets does not provide a detailed picture of the nature and pattern of clustering but will be helpful to apply simple hot-spot (and cold spot) identification techniques to such datasets. Once the spatial structure of households will be determined, any particular measure of autocorrelation can be constructed by defining a way of measuring the difference between location attribute values. The most widely used measure is Moran’s I that will be applied to municipal units where numerical ratio is calculated. Local statistics arise naturally out of any of the methods for measuring spatial autocorrelation and will be applied to development of localized variants of almost any standard summary statistic. Local Moran’s I will give an indication of household data homogeneity and diversity on a municipal level.

Keywords: census, geo-demography, households, the Czech Republic

Procedia PDF Downloads 89

Authors: Rashid Azeem

Abstract:

Introduction: Eosinophilia, which can be categorized as mild, moderate, and severe form on the basis of increasing eosinophil counts, might be responsible for a wide range of cardiac manifestations, varying from a simple myocarditis to a severe state like endomyocardial fibrosis. Eosinophils are involved in the pathogenesis of a variety of cardiovascular disorder like Loffler endocarditis, eosinophilic granulomatosis with polyangitis (EGPH), and hyper eosinophilic (HES). Among them HES carries and incidence rate b/w 48% and 75% and is the main causes of cardiac motility and mobility due to eosinophilia involvement. Aims and objectives: The aim of this study is to determine the frequency of eosinophilia in cardiac patients and to ascertain the evidence of endomyocardial diseases in eosinophilic patients in a cardiology institution Material and Methods: This cross sectional analytical study was conducted in hematology Department of Peshawar institute of Cardiology after approval from hospital ethical and research committee. All 70 patients were subjected to detailed history and clinical examination. Investigation like CBC, Chest X-ray, ECG, Echo, Angiography findings were used to monitor patient’s clinical status. Data is analyzed using SPSS version 25 and MS Excel. Results: Out of 70 patients in our study, a total of 66 patients(94 %) shows evidence of cardiac manifestations. In our study, we have observed a number of abnormal ECG patterns in cardiac patients presenting with eosinophilia, like T wave changes, loss of R wave, sinus bradycardia with LVH strain, and ST wave abnormality. abnormal echocardiographic findings were observed in our patients, like valvular abnormalities (in 45.7%), RWMA abnormalities (in 2.8%), isolated ventricular dysfunction (in 21.4%), and in 10% patients, normal echocardiography. We further noted abnormal coronary angiography findings in cardiac patients with eosinophilia ranging from single vessel to multi vessel occlusions. Conclusions: Eosinophils are involved in the pathogenesis of a variety of cardiovascular disorders which can be detected by various diagnostic means, and the severity of the disease increases with time and with increasing eosinophil count ranging from simple myocarditis to a fatal condition like endomyocardial fibrosis. Thus, increased eosinophilic count as a laboratory parameter in cardiac patients may be a sign of endomyocardial damage which will further help cardiologist to intervene more aggressively then routine approach to a cardiac patient.

Keywords: eosinophilia, endomyocardial fibrosis, cardiac, hypereosinophilic syndrome

Procedia PDF Downloads 54

Authors: Saeed Rezaeian, M. Rezaee Boroon

Abstract:

Nitrogen accumulates in soils during the process of fertilizer addition to promote the plant growth. When the organic matter decomposes, the form of available nitrogen produced is in the form of nitrate, which is highly mobile. The most significant health effect of nitrate ingestion is methemoglobinemia in infants under six months of age (blue baby syndrome). The mobile nutrients, like nitrate nitrogen, are not stored in the soil as the available forms for the long periods and in large amounts. It depends on the needs for the crops such as vegetables. On the other hand, the vegetables will compete actively for nitrate nitrogen as a mobile nutrient and water. The mobile nutrients must be shared. The fewer the plants, the larger this share is for each plant. Also, this nitrate nitrogen is poisonous for the people who use these vegetables. Nitrate is converted to nitrite by the existing bacteria in the stomach and the Gastro-Intestinal (GI) tract. When nitrite is entered into the blood cells, it converts the hemoglobin to methemoglobin, which causes the anoxemia and cyanosis. The increasing use of pesticides and chemical fertilizers, especially the fertilizers with nitrates compounds, which have been common for the increased production of agricultural crops, has caused the nitrate pollution in the (soil, water, and environment). They have caused a lot of damage to humans and animals. In this research, the nitrate accumulation in different kind of vegetables such as; green pepper, tomatoes, egg plants, watermelon, cucumber, and red pepper were observed in the suburbs of Mashhad, Neisabour, and Sabzevar cities. In some of these cities, the information forms of agronomical practices collected were such as; different vegetable crops fertilizer recommendations, varieties, pesticides, irrigation schedules, etc., which were filled out by some of our colleagues in the research areas mentioned above. Analysis of the samples was sent to the soil and water laboratory in our department in Mashhad. The final results from the chemical analysis of samples showed that the mean levels of nitrates from the samples of the fruit crops in the mentioned cities above were all lower than the critical levels. These fruit crop samples were in the order of: 35.91, 8.47, 24.81, 6.03, 46.43, 2.06 mg/kg dry matter, for the following crops such as; tomato, cucumber, eggplant, watermelon, green pepper, and red pepper. Even though, this study was conducted with limited samples and by considering the mean levels, the use of these crops from the nutritional point of view will not cause the poisoning of humans.

Keywords: environmental pollution, human health, nitrate accumulations, nitrate fertilizers

Procedia PDF Downloads 239

Authors: Walid Al-Qerem, Ruba Zumot

Abstract:

Background: The rise of obesity among children and adolescents remains a primary challenge for healthcare providers globally and in the Middle East. The aim of the present study is to determine the prevalence of obesity among 5-20 years old Jordanians based on CDC criteria. Method: A total of 5722 Jordanians (37% males; 63% females) aged 5-20 years data were retrieved from the Jordanian Ministry of Health electronic database (Hakeem). As per the CDC selection criteria, the chosen data pertains exclusively to healthy Jordanian children and adolescents who are medically sound, not suffering from health conditions, and not undergoing any treatments that could hinder normal growth patterns, such as severe infection, chronic kidney disease (CKD), Down’s syndrome, attention deficit hyperactivity disorder, cancer, heart disease, lung disease, cystic fibrosis, Crohn’s disease, type 1 diabetes, hormonal disturbances, any stress-related conditions, hormonal therapy such as corticosteroids, Growth hormones (GHS) or gonadotropin-releasing hormone agonists, insulin, and amphetamines or any other stimulants. In addition, participants with missing or invalid data values for anthropometric measurements were excluded from the study. Weight for age and body mass index for age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The Z-score for each record was computed based on CDC equations. As per CDC classifications, BMI for age percentiles, values ≥85th and < 95th are classified as overweight, and value at ≥ 95th is classified as obesity. Results: The average age of the evaluated sample was 12.33 ±4.39 years (10.79 ±3.39 for males and 13.23 ± 4.66 for females). The mean weight for males and females were 33.16±14.17 Kg and 133.54±17.17 cm for males, 43.86 ±18.82 Kg, and 142.19±18.35 for females, while for BMI the mean was for boys and girls 17.81±3.88 and 20.52±5.03 respectively. The results indicated that based on CDC criteria, 8.9% of males were classified as children/adolescents with overweight, and 9.7% were classified as children/adolescents with obesity, while in females, 17.8% were classified as children/adolescents with overweight and 10.2% were classified as children/adolescents with obesity. Discussion: The high prevalence of obesity reported in the present study emphasizes the importance of applying different strategies to prevent childhood obesity, including encouraging physical activity, promoting healthier food options, and behavioral changes. Conclusion: The results presented in this study indicated the high prevalence of overweight/obesity among Jordanian adolescents and children, which must be tagged by healthcare planners and providers.

Keywords: CDC, obesity, childhood, Jordan

Procedia PDF Downloads 44