Search results for: vibration aging
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1452

Search results for: vibration aging

282 Effect of Exercise Training on Body Composition and Metabolic Profile in Older Adults during Cancer Treatment

Authors: Adeline Fontvieille, Hugo Parent-Roberge, Marie-France Langlois, Tamas Fulop, Michel Pavic, Eleonor Riesco

Abstract:

Introduction: Total lean body mass is reduced during cancer treatment. This loss is called cancer cachexia and is accompanied by a progressive loss of fat mass. In older adults, these body composition changes can have a larger impact on metabolic health, physical autonomy, and cancer survival. Although currently untreatable, exercise training could reduce these effects. Hence, the objective of this pilot study is to investigate if 12 weeks of exercise training during cancer treatment can mitigate the loss of muscle mass and fat mass in older adults. Methods: A total of 40 older adults (65-80 years) with an ongoing treatment for a curable cancer are currently recruited and randomised in two groups: 1) Combined training (EX, n=20) and 2) Control group (CON, n=20). All variables are measured before and after 12 weeks of intervention: Anthropometry (weight, height, body mass index), body composition (total fat mass, visceral adipose tissue, total and appendicular muscle mass; DXA), metabolic profile (HDL-C and LDL-C, triglycerides, glucose and insulin levels). Results: Preliminary analyses revealed no impact of exercise training on appendicular muscle mass (p=0,31) and fat mass (p=0,31). Furthermore, total body weight, waist circumference, HDL-cholesterol, LDL-cholesterol, glucose and insulin levels remained unchanged (all p ≥ 0.79) after 12 weeks of training. However, statistical analyses revealed that triglyceride levels slightly increased (p=0.03), irrespective of the group. Conclusion: Preliminary analyses did not reveal any impact of aerobic and resistance exercise training on body composition in oncogeriatric patients. Furthermore, exercise training seems not efficient to prevent the cancer treatment-related triglyceride levels increase.

Keywords: muscle mass, fat mass, metabolic profile, combined training, aging, cancer

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281 Evaluation of Certain Medicinal Plants for in vitro Anti-Oxidant and Anti-Glycation Activities

Authors: K. Shailaja

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The advanced glycation end products (AGEs) formed between the reducing sugar and protein as a result of Oxidative stress and non-enzymatic glycosylation play an important role in pathogenesis of diabetes and aging complication. Glycation results in the production of free radicals. The oxidation process is believed to play an important role in AGEs formation. Thus agents with antioxidative property and antiglycation activity may retard the process of AGEs formation. Selected medicinal plants for the present study include Catharanthus roseus, Bougainvillea spectabilis (pink flowers), Cinnamomum tamala, Cinnamomum zeylanica, Abutilon indicum, Asparagus racemosus, and Sapindus emarginatus. The crude ethanolic extracts of the selected medicinal plants at varying concentrations ranging from 1-100 mg/ml were evaluated for in vitro antioxidant and protein glycation activities by FRAP and glucose-BSA assay respectively. Among all the plants tested, Bougainvillea spectabilis, Catharanthus roseus and Abutilon indicum showed strong antioxidant activity The antioxidant activity was expressed as mg of Gallic acid/ gm sample which was found to be 4.3 mg, 1.3mg, and 1.3mg respectively for Bougainvillea spectabilis, Catharanthus roseus and Abutilon indicum. The results of inhibition of the initial glycation product i.e., fructosamine was found to be 35% for Asparagus racemosus, Cinnamomum tamala and Abutilon indicum followed by the other plant extracts. The results indicate that these plants are potential sources of natural antioxidants which have free radical scavenging activity and might be used not only for reducing oxidative stress in diabetes but also open a new research avenues in the field of Natural Products.

Keywords: in vitro antioxidant activity, anti-glycation activity, ethanol extracts, polyphenols, Catharanthus roseus, Cinnamomum tamala

Procedia PDF Downloads 423
280 Comparison of the Proprioception Sense and Standing Balance in Patients with Osteoarthritis Before and After Total Knee Arthroplasty Surgery

Authors: S. Daneshi, G. Shahcheraghi, F. Ghaffarinejad

Abstract:

Back ground: Osteoarthritis (OA) is the most common form of arthritis, affecting millions of people around the world during the aging process. Knee joint proprioception sense decrease with OA and Total Knee Arthroplasty (TKA) surgery may affect them. We investigated two parameters of proprioception sense (the joint position sense and kinesthesia) and standing balance in affected limbs before and after TKA, in patient with Knee OA. Methods and Materials: In this Analytic study, 10 patients who were candidate for TKA during two months in Dena Hospital of Shiraz, selected for further analysis. All of cases were female in range of 55-70 years old. Participants assessed before and two weeks after TKA using three instruments: electrogoniometer and continuous passive motion (CPM) to assess Knee joint position sense and kinesthesia in 20 and 45 degrees; and chronometer to assess duration of standing balance on affected leg with open and closed eyes. Results: To examine differences between before and after of TKA scorings Willcoxon Signed Rank and Mann-Whitney was performed which indicated no significant differences between knee joint position sense and kinesthesia in 20 and 45 degrees (P>0.05) and no significant differences between Standing Balance in a patient with knee OA before and after TKA (P>0.05). Conclusion: The study indicates that, OA can affect proprioception sense and standing balance but TKA doesn’t have any effect on these parameters. Intra articular structures such as cruciate ligaments and mines are responsible for proprioception sense in normal knee joint. Since in severe knee OA the number of mechanoreceptors in these intra articular structures decrease and their function reduce more than normal knee joint, so the anterior cruciate ligaments (ACL) become defected, thus after TKA surgery which this ligament is removed no significant change was found in proprioception sense. As a result of involving proprioception sense, muscles strength and the function of vestibular system in balance, standing balance did not show significant difference before and after TKA.

Keywords: knee joint, proprioception sense, standing balance, rehabilitation sciences

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279 Combined Treatment of Aged Rats with Donepezil and the Gingko Extract EGb 761® Enhances Learning and Memory Superiorly to Monotherapy

Authors: Linda Blümel, Bettina Bert, Jan Brosda, Heidrun Fink, Melanie Hamann

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Age-related cognitive decline can eventually lead to dementia, the most common mental illness in elderly people and an immense challenge for patients, their families and caregivers. Cholinesterase inhibitors constitute the most commonly used antidementia prescription medication. The standardized Ginkgo biloba leaf extract EGb 761® is approved for treating age-associated cognitive impairment and has been shown to improve the quality of life in patients suffering from mild dementia. A clinical trial with 96 Alzheimer´s disease patients indicated that the combined treatment with donepezil and EGb 761® had fewer side effects than donepezil alone. In an animal model of cognitive aging, we compared the effect of combined treatment with EGb 761® or donepezil monotherapy and vehicle. We compared the effect of chronic treatment (15 days of pretreatment) with donepezil (1.5 mg/kg p. o.), EGb 761® (100 mg/kg p. o.), or the combination of the two drugs, or vehicle in 18 – 20 month old male OFA rats. Learning and memory performance were assessed by Morris water maze testing, motor behavior in an open field paradigm. In addition to chronic treatment, the substances were administered orally 30 minutes before testing. Compared to the first day and to the control group, only the combination group showed a significant reduction in latency to reach the hidden platform on the second day of testing. Moreover, from the second day of testing onwards, the donepezil, the EGb 761® and the combination group required less time to reach the hidden platform compared to the first day. The control group did not reach the same latency reduction until day three. There were no effects on motor behavior. These results suggest a superiority of the combined treatment of donepezil with EGb 761® compared to monotherapy.

Keywords: age-related cognitive decline, dementia, ginkgo biloba leaf extract EGb 761®, learning and memory, old rats

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278 Structural Design for Effective Load Balancing of the Iron Frame in Manhole Lid

Authors: Byung Il You, Ryun Oh, Gyo Woo Lee

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Manhole refers to facilities that are accessible to the people cleaning and inspection of sewer, and its covering is called manhole lid. Manhole lid is typically made of a cast iron material. Due to the heavy weight of the cast iron manhole lids their installation and maintenance are not easy, and an electrical shock and corrosion aging of them can cause critical problems. The manhole body and the lid manufacturing using the fiber-reinforced composite material can reduce the weight considerably compared to the cast iron manhole. But only the fiber reinforcing is hard to maintain the heavy load, and the method of the iron frame with double injection molding of the composite material has been proposed widely. In this study reflecting the situation of this market, the structural design of the iron frame for the composite manhole lid was carried out. Structural analysis with the computer simulation for the effectively distributed load on the iron frame was conducted. In addition, we want to assess manufacturing costs through the comparing of weights and number of welding spots of the frames. Despite the cross-sectional area is up to 38% compared with the basic solid form the maximum von Mises stress is increased at least about 7 times locally near the rim and the maximum strain in the central part of the lid is about 5.5 times. The number of welding points related to the manufacturing cost was increased gradually with the more complicated shape. Also, the higher the height of the arch in the center of the lid the better result might be obtained. But considering the economic aspect of the composite fabrication we determined the same thickness as the frame for the height of the arch at the center of the lid. Additionally in consideration of the number of the welding points we selected the hexagonal as the optimal shape. Acknowledgment: These are results of a study on the 'Leaders Industry-university Cooperation' Project, supported by the Ministry of Education (MOE).

Keywords: manhole lid, iron frame, structural design, computer simulation

Procedia PDF Downloads 270
277 A Systematic Review on Lifelong Learning Programs for Community-Dwelling Older Adults

Authors: Xi Vivien Wu, Emily Neo Kim Ang, Yi Jung Tung, Wenru Wang

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Background and Objective: The increase in life expectancy and emphasis on self-reliance for the older adults are global phenomena. As such, lifelong learning in the community is considered a viable means of promoting successful and active aging. This systematic review aims to examine various lifelong learning programs for community-dwelling older adults and to synthesize the contents and outcomes of these lifelong learning programs. Methods: A systematic search was conducted in July to December 2016. Two reviewers were engaged in the process to ensure creditability of the selection process. Narrative description and analysis were applied with the support of a tabulation of key data including study design, interventions, and outcomes. Results: Eleven articles, which consisted of five randomized controlled trials and six quasi-experimental studies, were included in this review. Interventions included e-health literacy programs with the aid of computers and the Internet (n=4), computer and Internet training (n=3), physical fitness programs (n=2), music program (n=1), and intergenerational program (n=1). All studies used objective measurement tools to evaluate the outcomes of the study. Conclusion: The systematic review indicated lifelong learning programs resulted in positive outcomes in terms of physical health, mental health, social behavior, social support, self-efficacy and confidence in computer usage, and increased e-health literacy efficacy. However, the lifelong learning programs face challenges such as funding shortages, program cuts, and increasing costs. A comprehensive lifelong learning program could be developed to enhance the well-being of the older adults at a more holistic level. Empirical research can be done to explore the effectiveness of this comprehensive lifelong learning program.

Keywords: community-dwelling older adults, e-health literacy program, lifelong learning program, the wellbeing of the older adults

Procedia PDF Downloads 159
276 Modified 'Perturb and Observe' with 'Incremental Conductance' Algorithm for Maximum Power Point Tracking

Authors: H. Fuad Usman, M. Rafay Khan Sial, Shahzaib Hamid

Abstract:

The trend of renewable energy resources has been amplified due to global warming and other environmental related complications in the 21st century. Recent research has very much emphasized on the generation of electrical power through renewable resources like solar, wind, hydro, geothermal, etc. The use of the photovoltaic cell has become very public as it is very useful for the domestic and commercial purpose overall the world. Although a single cell gives the low voltage output but connecting a number of cells in a series formed a complete module of the photovoltaic cells, it is becoming a financial investment as the use of it fetching popular. This also reduced the prices of the photovoltaic cell which gives the customers a confident of using this source for their electrical use. Photovoltaic cell gives the MPPT at single specific point of operation at a given temperature and level of solar intensity received at a given surface whereas the focal point changes over a large range depending upon the manufacturing factor, temperature conditions, intensity for insolation, instantaneous conditions for shading and aging factor for the photovoltaic cells. Two improved algorithms have been proposed in this article for the MPPT. The widely used algorithms are the ‘Incremental Conductance’ and ‘Perturb and Observe’ algorithms. To extract the maximum power from the source to the load, the duty cycle of the convertor will be effectively controlled. After assessing the previous techniques, this paper presents the improved and reformed idea of harvesting maximum power point from the photovoltaic cells. A thoroughly go through of the previous ideas has been observed before constructing the improvement in the traditional technique of MPP. Each technique has its own importance and boundaries at various weather conditions. An improved technique of implementing the use of both ‘Perturb and Observe’ and ‘Incremental Conductance’ is introduced.

Keywords: duty cycle, MPPT (Maximum Power Point Tracking), perturb and observe (P&O), photovoltaic module

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275 Effect of Oxidative Stress on Glutathione Reductase Activity of Escherichia coli Clinical Isolates from Patients with Urinary Tract Infection

Authors: Fariha Akhter Chowdhury, Sabrina Mahboob, Anamika Saha, Afrin Jahan, Mohammad Nurul Islam

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Urinary tract infection (UTI) is frequently experienced by the female population where the prevalence increases with aging. Escherichia coli, one of the most common UTI causing organisms, retains glutathione defense mechanism that aids the organism to withstand the harsh physiological environment of urinary tract, host oxidative immune response and even to affect antibiotic-mediated cell death and the emergence of resistance. In this study, we aimed to investigate the glutathione reductase activity of uropathogenic E. coli (UPEC) by observing the reduced glutathione (GSH) level alteration under stressful condition. Urine samples of 58 patients with UTI were collected. Upon isolation and identification, 88% of the samples presented E. coli as UTI causing organism among which randomly selected isolates (n=9), obtained from urine samples of female patients, were considered for this study. E. coli isolates were grown under normal and stressful conditions where H₂O₂ was used as the stress-inducing agent. GSH level estimation of the isolates in both conditions was carried out based on the colorimetric measurement of 5,5'-dithio-bis (2-nitrobenzoic acid) (DTNB) and GSH reaction product using microplate reader assay. The GSH level of isolated E. coli sampled from adult patients decreased under stress compared to normal condition (p = 0.011). On the other hand, GSH production increased markedly in samples that were collected from elderly subjects (p = 0.024). A significant partial correlation between age and change of GSH level was found as well (p = 0.007). This study may help to reveal ways for better understanding of E. coli pathogenesis of UTI prevalence in elderly patients.

Keywords: Escherichia coli, glutathione reductase activity, oxidative stress, reduced glutathione (GSH), urinary tract infection (UTI)

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274 Health Promoting Behaviors among Thai Older Adults: Trend and Association with Health Status

Authors: Alongkorn Pekalee, Rossarin Gray

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Various determinants associated with older health include socio-demographic factors and health-promoting behaviors but lack in scholars recommended what factors associated with health status in specific sub-groups of older adults. The current study aims to explore the health-promoting behaviors and to examine and compare the associations of these factors with self-rated health status among three older age cohorts in Thai traditional context. Methods: This study is based on the Survey of Older Persons in Thailand (SOPT), in 2017, conducted by the National Statistical Office (NSO) of Thailand. Participants were classified into three groups by using the Thai contextual recommendation: youngest-old cohort (60-69), old-old cohort (70-79) and oldest old cohort (80 or older). Health promoting behaviors are the behaviors which associated with the health status of older adults include alcohol consumption, smoking, diet, and physical activity. Health status was defined as a subjective measurement by using self-rated health, a simple measure of general health. The socio-demographic factors, health-promoting behaviors, and health status were explained and summarized by descriptive statistics. The binary logistic regression was performed to analyze the data and evaluate the associations between independent and dependent variables. Results: Increase of age contributes to a higher proportion of health-promoting behaviors. All variables were associated with self-reported health status as good health among three older age cohorts statistically significant (p-value = 0.000). However, the influence of income sufficiency on health status is more notable, especially in older adults who aged 60-69 and 70-79. The influence of dietary and physical activity on health status became greater as age increased. Conclusion: the results suggest that income sufficiency should be noted in a plan to promote healthy aging, and co-residence should be more concerned especially in the oldest old cohort. Moreover, the interventions or policies to promote older health behaviors like diet and physical activity should be emphasized in the oldest old cohort more than others.

Keywords: health-promoting behaviors, older adults, self- rated health, Thailand

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273 Influence of Dynamic Loads in the Structural Integrity of Underground Rooms

Authors: M. Inmaculada Alvarez-Fernández, Celestino González-Nicieza, M. Belén Prendes-Gero, Fernando López-Gayarre

Abstract:

Among many factors affecting the stability of mining excavations, rock-bursts and tremors play a special role. These dynamic loads occur practically always and have different sources of generation. The most important of them is the commonly used mining technique, which disintegrates a certain area of the rock mass not only in the area of the planned mining, but also creates waves that significantly exceed this area affecting the structural elements. In this work it is analysed the consequences of dynamic loads over the structural elements in an underground room and pillar mine to avoid roof instabilities. With this end, dynamic loads were evaluated through in situ and laboratory tests and simulated with numerical modelling. Initially, the geotechnical characterization of all materials was carried out by mean of large-scale tests. Then, drill holes were done on the roof of the mine and were monitored to determine possible discontinuities in it. Three seismic stations and a triaxial accelerometer were employed to measure the vibrations from blasting tests, establish the dynamic behaviour of roof and pillars and develop the transmission laws. At last, computer simulations by FLAC3D software were done to check the effect of vibrations on the stability of the roofs. The study shows that in-situ tests have a greater reliability than laboratory samples because of eliminating the effect of heterogeneities, that the pillars work decreasing the amplitude of the vibration around them, and that the tensile strength of a beam and depending on its span is overcome with waves in phase and delayed. The obtained transmission law allows designing a blasting which guarantees safety and prevents the risk of future failures.

Keywords: dynamic modelling, long term instability risks, room and pillar, seismic collapse

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272 Trends of Cancer Patients Who Underwent Curative/radical Radiotherapy at Radiotherapy Center, Tikur Anbessa Specialized Hospital

Authors: Emeshaw Damtew Zebene, Edom Seife, Hagos Tesfay, Gurja Belay

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Background: cancer incidence and mortality has grown rapidly throughout the world. Aging of the population, urbanization, physical inactivity, economic growth followed by smoking and drinking contributed a lot for the increased incidence of cancer all over the globe. Objective: the aim of this study was to assess a one-year trend of cancer patients who underwent curative/radical radiotherapy at radiotherapy center, Tikur Anbessa specialized hospital, Ethiopia. Methodology: We performed a prospective descriptive study of cancer patients treated with LINAC at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia, from April 2021- March 2022. A standardized questionnaire was used to collect sociodemographic and clinical characteristics of the patients. Descriptive statistics and chi-square results were generated using SPSS version 24. The level of significance was obtained at 0.05. Results: Sixty-four (64) curative/radical patients-44 females and 20 males were analyzed. Majority, 27(42.2%), of the patients age range from 45 to 64, and 45(70%) of them were urban residents where a group of higher gynecologic cancer was observed.78% of the patients were with locally advanced cancer, and 54(84.4%) of them had no awareness about cancer. Generally, head & neck cancer were found the most prevalent cancer 20(31.3%), and the leading cause of cancer among women was cervical cancer 17(38.6%), where about half 7(15.9%) of them were HIV positive. Conclusion: Our finding revealed that most of curative/radical patients presented at a locally advanced stage of the disease. Hence, maintaining the already available teletherapy machines and installing additional radiotherapy centers may help in treating the patients at the early stage of the disease. Since almost all of our study participants did not have information about cancer, awareness raising mechanisms should be done. Additionally, understanding differences in cancer incidence between urban and rural is important. Key words: Cancer, Curative/radical, Radiotherapy, Tikur Anbessa Specialized Hospital

Keywords: cancer, curative/radical, radiotherapy, tkur anbessa specialized hospital

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271 Enhancing Cognitive and Emotional Well-Being in an 85-Year-Old American-Dominican Veteran through Neuropsychological Intervention and Cognitive Stimulation

Authors: Natividad Natalia Angeles Manuel

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In the Dominican Republic, American-Dominican veterans face unique challenges due to their dual identities and wartime experiences. This case study examines an 85-year-old veteran with memory impairments and emotional distress linked to military service. A neuropsychological assessment using standardized tools evaluated cognitive domains and functional abilities. Significant deficits in memory, orientation, semantic memory, and executive functions, alongside symptoms of Post-Traumatic Stress Disorder and depression, were identified. A six-month cognitive stimulation program included tailored interventions to enhance memory, attention, and executive skills through weekly sessions and group activities. Medical and physical therapy support aimed to improve overall cognitive, functional, and emotional outcomes. Follow-up evaluations showed improvements in memory retention, attention, task proficiency, and reduced depressive symptoms, highlighting the program's effectiveness in promoting emotional well-being and quality of life. Despite ongoing memory challenges and military-related nightmares, the veteran responded positively to interventions, demonstrating resilience and motivation. This study emphasizes the importance of personalized neuropsychological interventions for American-Dominican veterans in the Dominican Republic. Through assessment tools and focused cognitive stimulation strategies, healthcare providers can successfully alleviate cognitive and emotional challenges stemming from traumatic experiences in elderly veterans. Overall, integrated neuropsychological assessment and stimulation programs are shown to enhance cognitive resilience and emotional well-being, thus contributing to an enhanced quality of life for aging American-Dominican veterans.

Keywords: neuropsychology, cognitive stimulation, American-Dominican veterans, Dominican Republic, PTSD, memory deficits

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270 Functional Vision of Older People with Cognitive Impairment Living in Galician Nursing Homes

Authors: C. Vázquez, L. M. Gigirey, C. P. del Oro, S. Seoane

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Poor vision is common among older people, and several studies show connections between visual impairment and cognitive function. 15 older adult live in Galician Government nursing homes, and cognitive decline is one of the main reasons of admission. Objectives: (1) To evaluate functional far and near vision of older people with cognitive impairment. (2) To determine connections between visual and cognitive state of “our” residents. Methodology: A total of 364 older adults (aged 65 years or more) underwent a visual and cognitive screening. We tested presenting visual acuity (binocular visual acuity with habitual correction if warn) for distance and near vision (E-Snellen, usual working distance for near vision). Binocular presenting visual acuity less than 0.3 was used as cut point for diagnosis of visual impairment. Exclusion criteria included immobilized residents unable to reach the USC Dual Sensory Loss Unit for visual screening. To screen cognition we employed the mini-mental examination test (Spanish version). Analysis of categorical variables was performed using chi-square tests. We utilized Pearson and Spearman correlation tests and the variance analysis to determine differences between groups of interest (SPSS 19.0 version). Results: the percentage of residents with cognitive decline reaches 32.2% Prevalence of visual impairment for distance and near vision increases among those subjects with cognitive impairment respect those with normal cognition. Shift correlation exists between distance visual acuity and mini-mental test (age and sex controlled), and moderate association was found in case of near vision (p<0.01). Conclusion: First results shows that people with cognitive impairment have poor functional distance and near vision than those with normal cognition. Next step will be to analyse the individual contribution of distance and near vision loss on cognition.

Keywords: visual impairment, cognition, aging, nursing homes

Procedia PDF Downloads 423
269 Bridge Damage Detection and Stiffness Reduction Using Vibration Data: Experimental Investigation on a Small Scale Steel Bridge

Authors: Mirco Tarozzi, Giacomo Pignagnoli, Andrea Benedetti

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The design of planning maintenance of civil structures often requires the evaluation of their level of safety in order to be able to choose which structure, and in which measure, it needs a structural retrofit. This work deals with the evaluation of the stiffness reduction of a scaled steel deck due to the presence of localized damages. The dynamic tests performed on it have shown the variability of its main frequencies linked to the gradual reduction of its rigidity. This deck consists in a steel grillage of four secondary beams and three main beams linked to a concrete slab. This steel deck is 6 m long and 3 m wide and it rests on two abutments made of concrete. By processing the signals of the accelerations due to a random excitation of the deck, the main natural frequencies of this bridge have been extracted. In order to assign more reliable parameters to the numerical model of the deck, some load tests have been performed and the mechanical property of the materials and the supports have been obtained. The two external beams have been cut at one third of their length and the structural strength has been restored by the design of a bolted plate. The gradual loss of the bolts and the plates removal have made the simulation of localized damage possible. In order to define the relationship between frequency variation and loss in stiffness, the identification of its natural frequencies has been performed, before and after the occurrence of the damage, corresponding to each step. The study of the relationship between stiffness losses and frequency shifts has been reported in this paper: the square of the frequency variation due to the presence of the damage is proportional to the ratio between the rigidities. This relationship can be used to quantify the loss in stiffness of a real scale bridge in an efficient way.

Keywords: damage detection, dynamic test, frequency shifts, operational modal analysis, steel bridge

Procedia PDF Downloads 157
268 Enhancing Quality of Life for the Elderly and Their Caregivers: Exploring Low-Cost Therapeutic Strategy and Innovation

Authors: Paulina Pergoł-Metko, Tomasz Kryczka

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The aging of societies is a global phenomenon with significant social, economic, and medical implications. Numerous methods for promoting the health of the elderly, improving cognitive functions, and enhancing quality of life are discussed in the literature. The most employed method for activating the elderly is physical activity, which often includes not only standard exercise programs but also activities such as dance, tai chi, and yoga. However, the introduction of physical activity can be limited by the disabilities that frequently accompany individuals aged 65 and older. Other activation methods mentioned in the literature include animal-assisted therapy, plant therapy (hortitherapy), and the increasingly popular music therapy. All these therapeutic approaches typically require the involvement of an occupational therapist, which can be a financial burden for many nursing homes. One therapeutic method recommended for the elderly that does not require significant financial investment is reminiscence therapy, which involves recalling personal experiences and memories. Reminiscence therapy has been shown to increase self-esteem and reduce symptoms of depression by allowing seniors to revisit happy moments in their lives. A pilot study was conducted in Warsaw, Poland with a group of 30 nursing home residents as part of the Queen Silvia Nursing Award competition. Over the course of three months, medical students engaged in systematic correspondence with retired doctors residing in the nursing home. The results of this pilot study suggest that correspondence-based activation can be an effective and low-cost form of therapy. To fully assess and validate the benefits of this approach, further research should be conducted on a larger group of participants, using standardized scales to measure various psychological parameters.

Keywords: elderly, reminiscence therapy, nursing, gerontology

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267 A Game-Based Methodology to Discriminate Executive Function – a Pilot Study With Institutionalized Elderly People

Authors: Marlene Rosa, Susana Lopes

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There are few studies that explore the potential of board games as a performance measure, despite it can be an interesting strategy in the context of frailty populations. In fact, board games are immersive strategies than can inhibit the pressure of being evaluated. This study aimed to test the ability of gamed-base strategies to assess executive function in elderly population. Sixteen old participants were included: 10 with affected executive functions (G1 – 85.30±6.00 yrs old; 10 male); 6 with executive functions with non-clinical important modifications (G2 - 76.30±5.19 yrs old; 6 male). Executive tests were assessed using the Frontal Assessment Battery (FAB), which is a quick-applicable cognitive screening test (score<12 means impairment). The board game used in this study was the TATI Hand Game, specifically for training rhythmic coordination of the upper limbs with multiple cognitive stimuli. This game features 1 table grid, 1 set of Single Game cards (to play with one hand); Double Game cards (to play simultaneously with two hands); 1 dice to plan Single Game mode; cards to plan the Double Game mode; 1 bell; 2 cups. Each participant played 3 single game cards, and the following data were collected: (i) variability in time during board game challenges (SD); (ii) number of errors; (iii) execution speed (sec). G1 demonstrated: high variability in execution time during board game challenges (G1 – 13.0s vs G2- 0.5s); a higher number of errors (1.40 vs 0.67); higher execution velocity (607.80s vs 281.83s). These results demonstrated the potential of implementing board games as a functional assessment strategy in geriatric care. Future studies might include larger samples and statistical methodologies to find cut-off values for impairment in executive functions during performance in TATI game.

Keywords: board game, aging, executive function, evaluation

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266 Methodologies for Stability Assessment of Existing and Newly Designed Reinforced Concrete Bridges

Authors: Marija Vitanovа, Igor Gjorgjiev, Viktor Hristovski, Vlado Micov

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Evaluation of stability is very important in the process of definition of optimal structural measures for maintenance of bridge structures and their strengthening. To define optimal measures for their repair and strengthening, it is necessary to evaluate their static and seismic stability. Presented in this paper are methodologies for evaluation of the seismic stability of existing reinforced concrete bridges designed without consideration of seismic effects and checking of structural justification of newly designed bridge structures. All bridges are located in the territory of the Republic of North Macedonia. A total of 26 existing bridges of different structural systems have been analyzed. Visual inspection has been carried out for all bridges, along with the definition of three main damage categories according to which structures have been categorized in respect to the need for their repair and strengthening. Investigations involving testing the quality of the built-in materials have been carried out, and dynamic tests pointing to the dynamic characteristics of the structures have been conducted by use of non-destructive methods of ambient vibration measurements. The conclusions drawn from the performed measurements and tests have been used for the development of accurate mathematical models that have been analyzed for static and dynamic loads. Based on the geometrical characteristics of the cross-sections and the physical characteristics of the built-in materials, interaction diagrams have been constructed. These diagrams along with the obtained section quantities under seismic effects, have been used to obtain the bearing capacity of the cross-sections. The results obtained from the conducted analyses point to the need for the repair of certain structural parts of the bridge structures. They indicate that the stability of the superstructure elements is not critical during a seismic effect, unlike the elements of the sub-structure, whose strengthening is necessary.

Keywords: existing bridges, newly designed bridges, reinforced concrete bridges, stability assessment

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265 Sensory Evaluation and Microbiological Properties of Gouda Cheese Affected by Bunium persicum (Boiss.) Essential Oil

Authors: N. Noori, P. Taherkhani, A. Akhondzadeh Basti, H. Gandomi, M. Alimohammadi

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Research on natural antimicrobial agents, especially of plant origin, highly noticed in recent years and evaluation of antimicrobial effects of native plants such as Bunium persicum Boiss. is especially important. In the present study, sensory characteristics and microbiological properties of Gouda cheese affected by different concentrations of Bunium persicum Boiss. essential oil were investigated. Extraction of the essential oil was performed by hydro distillation. The oil was analyzed by GC using flame ionization (FID) and GC/ MS for detection. The antimicrobial effects were determined against various microbial groups (aerobic mesophilic bacteria, enterococci, mesophilic lactobacilli, enterobacteriaceae, lactococcus and yeasts). Microbial groups were counted during ripening period using plate count on specific culture media. Organoleptic evaluation including teture, flavor, odor, color and total acceptability were determined at the end of aging. According to results, the essential oil yield was 4/1 % ( W/ W). Twenty- six compounds were identified in the oil that concluded 99.7 % of the total oil. The major components of Bunium persicum Boiss. essential oil were γ- terpinene- 7- al (26.9 %) and cuminaldehyde (23.3 %). Generally, the increase of Black Cumin essential oil concentration led to reduction in microbial counts in different groups. The maximum antimicrobial effect was seen in yeast that reduced by 2 log compared to the control group at EO concentration of 4µl/ ml at day 90.The minimum reduction was observed in enterobacteriaceae that showed only 0.75 log decreese compared to the control at the same concentration of EO. Addition of EO improved organoleptic properties of Gouda cheese especially in the case of flavor and odor characteristic. However, no significant differences were observed in texture and color between treatment and control groups. Bunium persicum Boiss. essential oil could be used as preservative material and flavoring agent in some kinds of food such as cheese and also could be provided consumers health.

Keywords: Bunium persicum Boiss. essential oil, Microbiological properties, sensory evaluation, gouda cheese

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264 Brain Atrophy in Alzheimer's Patients

Authors: Tansa Nisan Gunerhan

Abstract:

Dementia comes in different forms, including Alzheimer's disease. The most common dementia diagnosis among elderly individuals is Alzheimer's disease. On average, for patients with Alzheimer’s, life expectancy is around 4-8 years after the diagnosis; however, expectancy can go as high as twenty years or more, depending on the shrinkage of the brain. Normally, along with aging, the brain shrinks at some level but doesn’t lose a vast amount of neurons. However, Alzheimer's patients' neurons are destroyed rapidly; hence problems with loss of memory, communication, and other metabolic activities begin. The toxic changes in the brain affect the stability of the neurons. Beta-amyloid and tau are two proteins that are believed to play a role in the development of Alzheimer's disease through their toxic changes. Beta-amyloid is a protein that is produced in the brain and is normally broken down and removed from the body. However, in people with Alzheimer's disease, the production of beta-amyloid increases, and it begins to accumulate in the brain. These plaques are thought to disrupt communication between nerve cells and may contribute to the death of brain cells. Tau is a protein that helps to stabilize microtubules, which are essential for the transportation of nutrients and other substances within brain cells. In people with Alzheimer's disease, tau becomes abnormal and begins to accumulate inside brain cells, forming neurofibrillary tangles. These tangles disrupt the normal functioning of brain cells and may contribute to their death, forming amyloid plaques which are deposits of a protein called amyloid-beta that build up between nerve cells in the brain. The accumulation of amyloid plaques and neurofibrillary tangles in the brain is thought to contribute to the shrinkage of brain tissue. As the brain shrinks, the size of the brain may decrease, leading to a reduction in brain volume. Brain atrophy in Alzheimer's disease is often accompanied by changes in the structure and function of brain cells and the connections between them, leading to a decline in brain function. These toxic changes that accumulate can cause symptoms such as memory loss, difficulty with thinking and problem-solving, and changes in behavior and personality.

Keywords: Alzheimer, amyloid-beta, brain atrophy, neuron, shrinkage

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263 Frequency Selective Filters for Estimating the Equivalent Circuit Parameters of Li-Ion Battery

Authors: Arpita Mondal, Aurobinda Routray, Sreeraj Puravankara, Rajashree Biswas

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The most difficult part of designing a battery management system (BMS) is battery modeling. A good battery model can capture the dynamics which helps in energy management, by accurate model-based state estimation algorithms. So far the most suitable and fruitful model is the equivalent circuit model (ECM). However, in real-time applications, the model parameters are time-varying, changes with current, temperature, state of charge (SOC), and aging of the battery and this make a great impact on the performance of the model. Therefore, to increase the equivalent circuit model performance, the parameter estimation has been carried out in the frequency domain. The battery is a very complex system, which is associated with various chemical reactions and heat generation. Therefore, it’s very difficult to select the optimal model structure. As we know, if the model order is increased, the model accuracy will be improved automatically. However, the higher order model will face the tendency of over-parameterization and unfavorable prediction capability, while the model complexity will increase enormously. In the time domain, it becomes difficult to solve higher order differential equations as the model order increases. This problem can be resolved by frequency domain analysis, where the overall computational problems due to ill-conditioning reduce. In the frequency domain, several dominating frequencies can be found in the input as well as output data. The selective frequency domain estimation has been carried out, first by estimating the frequencies of the input and output by subspace decomposition, then by choosing the specific bands from the most dominating to the least, while carrying out the least-square, recursive least square and Kalman Filter based parameter estimation. In this paper, a second order battery model consisting of three resistors, two capacitors, and one SOC controlled voltage source has been chosen. For model identification and validation hybrid pulse power characterization (HPPC) tests have been carried out on a 2.6 Ah LiFePO₄ battery.

Keywords: equivalent circuit model, frequency estimation, parameter estimation, subspace decomposition

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262 Lightweight Ceramics from Clay and Ground Corncobs

Authors: N.Quaranta, M. Caligaris, R. Varoli, A. Cristobal, M. Unsen, H. López

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Corncobs are agricultural wastes and they can be used as fuel or as raw material in different industrial processes like cement manufacture, contaminant adsorption, chemical compound synthesis, etc. The aim of this work is to characterize this waste and analyze the feasibility of its use as a pore-forming material in the manufacture of lightweight ceramics for the civil construction industry. The characterization of raw materials is carried out by using various techniques: electron diffraction analysis X-ray, differential and gravimetric thermal analyses, FTIR spectroscopy, ecotoxicity evaluation, among others. The ground corncobs, particle size less than 2 mm, are mixed with clay up to 30% in volume and shaped by uniaxial pressure of 25 MPa, with 6% humidity, in moulds of 70mm x 40mm x 18mm. Then the green bodies are heat treated at 950°C for two hours following the treatment curves used in ceramic industry. The ceramic probes are characterized by several techniques: density, porosity and water absorption, permanent volumetric variation, loss on ignition, microscopies analysis, and mechanical properties. DTA-TGA analysis of corncobs shows in the range 20°-250°C a small loss in TGA curve and exothermic peaks at 250°-500°C. FTIR spectrum of the corncobs sample shows the characteristic pattern of this kind of organic matter with stretching vibration bands of adsorbed water, methyl groups, C–O and C–C bonds, and the complex form of the cellulose and hemicellulose glycosidic bonds. The obtained ceramic bodies present external good characteristics without loose edges and adequate properties for the market requirements. The porosity values of the sintered pieces are higher than those of the reference sample without waste addition. The results generally indicate that it is possible to use corncobs as porosity former in ceramic bodies without modifying the usual sintering temperatures employed in the industry.

Keywords: ceramic industry, biomass, recycling, hemicellulose glycosidic bonds

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261 Investigating the Molecular Behavior of H₂O in Caso 4 -2h₂o Two-Dimensional Nanoscale System

Authors: Manal Alhazmi, Artem Mishchenko

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A molecular fluids' behavior and interaction with other materials at the nanoscale is a complex process. Nanoscale fluids behave so differently than macroscale fluids and interact with other materials in unique ways. It is, therefore, feasible to understand the molecular behavior of H₂O in such two-dimensional nanoscale systems by studying (CaSO4-2H2O), commonly known as gypsum. In the present study, spectroscopic measurements on a 2D structure of exfoliated gypsum crystals are carried out by Raman and IR spectroscopy. An array of gypsum flakes with thicknesses ranging from 8nm to 100nm were observed and analyzed for their Raman and IR spectrum. Water molecules stretching modes spectra lines were also measured and observed in nanoscale gypsum flakes and compared with those of bulk crystals. CaSO4-2H2O crystals have Raman and infrared bands at 3341 cm-1 resulting from the weak hydrogen bonds between the water molecules. This internal vibration of water molecules, together with external vibrations with other atoms, are responsible for these bands. There is a shift of about 70 cm-1 In the peak position of thin flakes with respect to the bulk crystal, which is a result of the different atomic arrangement from bulk to thin flake on the nano scale. An additional peak was observed in Raman spectra around 2910-3137 cm⁻¹ in thin flakes but is missing in bulk crystal. This additional peak is attributed to a combined mode of water internal (stretching mode at 3394cm⁻¹) and external vibrations. In addition to Raman and infra- red analysis of gypsum 2D structure, electrical measurements were conducted to reveal the water molecules transport behavior in such systems. Electrical capacitance of the fabricated device is measured and found to be (0.0686 *10-12) F, and the calculated dielectric constant (ε) is (12.26).

Keywords: gypsum, infra-red spectroscopy, raman spectroscopy, H₂O behavior

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260 Spatial Differentiation of Elderly Care Facilities in Mountainous Cities: A Case Study of Chongqing

Authors: Xuan Zhao, Wen Jiang

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In this study, a web crawler was used to collect POI sample data from 38 districts and counties of Chongqing in 2022, and ArcGIS was combined to coordinate and projection conversion and realize data visualization. Nuclear density analysis and spatial correlation analysis were used to explore the spatial distribution characteristics of elderly care facilities in Chongqing, and K mean cluster analysis was carried out with GeoDa to study the spatial concentration degree of elderly care resources in 38 districts and counties. Finally, the driving force of spatial differentiation of elderly care facilities in various districts and counties of Chongqing is studied by using the method of geographic detector. The results show that: (1) in terms of spatial distribution structure, the distribution of elderly care facilities in Chongqing is unbalanced, showing a distribution pattern of ‘large dispersion and small agglomeration’ and the asymmetric pattern of ‘west dense and east sparse, north dense and south sparse’ is prominent. (2) In terms of the spatial matching between elderly care resources and the elderly population, there is a weak coordination between the input of elderly care resources and the distribution of the elderly population at the county level in Chongqing. (3) The analysis of the results of the geographical detector shows that the single factor influence is mainly the number of elderly population, public financial revenue and district and county GDP. The high single factor influence is mainly caused by the elderly population, public financial income, and district and county GDP. The influence of each influence factor on the spatial distribution of elderly care facilities is not simply superimposed but has a nonlinear enhancement effect or double factor enhancement. It is necessary to strengthen the synergistic effect of two factors and promote the synergistic effect of multiple factors.

Keywords: aging, elderly care facilities, spatial differentiation, geographical detector, driving force analysis, Mountain city

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259 Self-Reported Health Status and Its Consistency: Evidence from India

Authors: Dona Ghosh, Zakir Husain

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In India, the increase in share of aged has generated many social and economic issues, of which health concerns is a major challenge that society must confront in coming years. Self-reported health (SRH) is a popular health measure in this regard but has been questioned in recent years due to its heavy dependence on the socioeconomic status. So, the validity of SRH, as a measure of health status during old age, is needed to be verified. This paper emphasizes on the self-reported health and related inconsistent responses among elderly in India. The objective of the study is bifurcated into two parts: firstly, to identify the socioeconomic determinants of subjective health status and its change over time; and secondly, to analyse the role of the socioeconomic components in providing inconsistent responses regarding the health status of elderly. Inconsistency in response can rise in two ways: positive response bias (if an individual has a health problem but reports his/her health as good) and negative response bias (if bad health is reported even if there is no health problem). However, in the present study, we focus only on the negative response bias of elderly individuals. To measure the inconsistencies in responses, self-reported health is compared with two types of physical health conditions – existence of chronicle ailment and physical immobility. Using NSS dataset of 60th and 71st rounds, the study found that subjective health has worsened over time in both rural and urban areas. Findings suggest that inconsistency in responses, related to chronic ailment, vary across social classes, living environments, geographical regions, age groups and education levels. On the contrary, variation in inconsistent responses regarding physical mobility is quite rare and difficult to explain by socioeconomic characteristics because most of the indicators are found to be insignificant in this regard. The findings indicate that in case of chronicle ailment, inconsistency between objective and subjective health status largely depends on socioeconomic conditions but the importance of such factors disappears for physical immobility.

Keywords: India, aging, self-reported health, inconsistent responses

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258 Characterization of Lahar Sands for Reclamation Projects in the Manila Bay, Philippines

Authors: Julian Sandoval, Philipp Schober

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Lahar sand (lahars) is a material that originates from volcanic debris flows. During and after a volcano eruption, the lahars can move at speeds up to 22 meters per hour or more, so they can easily cover extensive areas and destroy any structure in their path. Mount Pinatubo eruption (1991) brought lahars to its vicinities, and its use has been a matter of research ever since. Lahars are often disposed of for land reclamation projects in the Manila Bay, Philippines. After reclamation, some deep loss deposits may still present and they are prone to liquefaction. To mitigate the risk of liquefaction of such deposits, Vibro compaction has been proposed and used as a ground improvement technique. Cone penetration testing (CPT) campaigns are usually initiated to monitor the effectiveness of the ground improvement works by vibro compaction. The CPT cone resistance is used to analyses the in-situ relative density of the reclaimed sand before and after compaction. Available correlations between the CPT cone resistance and the relative density are only valid for non-crushable sands. Due to the partially crushable nature of lahars, the CPT data requires to be adjusted to allow for a correct interpretation of the CPT data. The objective of this paper is to characterize the chemical and mechanical properties of the lahar sands used for an ongoing project in the Port of Manila, which comprises reclamation activities using lahars from the east of Mount Pinatubo, it investigates their effect in the proposed correction factor. Additionally, numerous CPTs were carried out in a test trial and during the execution of the project. Based on this data, the influence of the grid spacing, compaction steps and the holding time on the compaction results are analyzed. Moreover, the so-called “aging effect” of the lahars is studied by comparing the results of the CPT testing campaign at different times after the vibro compaction activities. A considerable increase in the tip resistance of the CPT was observed over time.

Keywords: vibro compaction, CPT, lahar sands, correction factor, chemical composition

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257 Numerical Simulation of Aeroelastic Influence Exerted by Kinematic and Geometrical Parameters on Oscillations' Frequencies and Phase Shift Angles in a Simulated Compressor of Gas Transmittal Unit

Authors: Liliia N. Butymova, Vladimir Y. Modorsky, Nikolai A. Shevelev

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Prediction of vibration processes in gas transmittal units (GTU) is an urgent problem. Despite numerous scientific publications on the problem of vibrations in general, there are not enough works concerning FSI-modeling interaction processes between several deformable blades in gas-dynamic flow. Since it is very difficult to solve the problem in full scope, with all factors considered, a unidirectional dynamic coupled 1FSI model is suggested for use at the first stage, which would include, from symmetry considerations, two blades, which might be considered as the first stage of solving more general bidirectional problem. ANSYS CFX programmed multi-processor was chosen as a numerical computation tool. The problem was solved on PNRPU high-capacity computer complex. At the first stage of the study, blades were believed oscillating with the same frequency, although oscillation phases could be equal and could be different. At that non-stationary gas-dynamic forces distribution over the blades surfaces is calculated in run of simulation experiment. Oscillations in the “gas — structure” dynamic system are assumed to increase if the resultant of these gas-dynamic forces is in-phase with blade oscillation, and phase shift (φ=0). Provided these oscillation occur with phase shift, then oscillations might increase or decrease, depending on the phase shift value. The most important results are as follows: the angle of phase shift in inter-blade oscillation and the gas-dynamic force depends on the flow velocity, the specific inter-blade gap, and the shaft rotation speed; a phase shift in oscillation of adjacent blades does not always correspond to phase shift of gas-dynamic forces affecting the blades. Thus, it was discovered, that asynchronous oscillation of blades might cause either attenuation or intensification of oscillation. It was revealed that clocking effect might depend not only on the mutual circumferential displacement of blade rows and the gap between the blades, but also on the blade dynamic deformation nature.

Keywords: aeroelasticity, ANSYS CFX, oscillation, phase shift, clocking effect, vibrations

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256 Comparison of Tribological and Mechanical Properties of White Metal Produced by Laser Cladding and Conventional Methods

Authors: Jae-Il Jeong, Hoon-Jae Park, Jung-Woo Cho, Yang-Gon Kim, Jin-Young Park, Joo-Young Oh, Si-Geun Choi, Seock-Sam Kim, Young Tae Cho, Chan Gyu Kim, Jong-Hyoung Kim

Abstract:

Bearing component has strongly required to decrease vibration and wear to achieve high durability and life time. In the industry field, bearing durability is improved by surface treatment on the bearing surface by centrifugal casting or gravity casting production method. However, this manufacturing method has caused problems such as long processing time, defect rate, and health harmful effect. To solve this problem, there is a laser cladding deposition treatment, which provides fast processing and food adhesion. Therefore, optimum conditions of white metal laser deposition should be studied to minimize bearing contact axis wear using laser cladding techniques. In this study, we deposit a soft white metal layer on SCM440, which is mainly used for shaft and bolt. On laser deposition process, the laser power and powder feed rate and laser head speed factors are controlled to find out the optimal conditions. We also measure hardness using micro Vickers, analyze FE-SEM (Field Emission Scanning Electron Microscope) and EDS (Energy Dispersive Spectroscopy) to study the mechanical properties and surface characteristics with various parameters change. Furthermore, this paper suggests the optimum condition of laser cladding deposition to apply in industrial fields. This work was supported by the Industrial Innovation Project of the Korea Evaluation Institute of Industrial Technology (KEIT) granted financial resource from the Ministry of Trade, Industry & Energy, Republic of Korea (Research no. 10051653).

Keywords: laser deposition, bearing, white metal, mechanical properties

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255 Ageing Gingiva: A New Hope for Autologous Stem Cell Therapy

Authors: Ankush M. Dewle, Suditi Bhattacharya, Prachi R. Abhang, Savita Datar, Ajay J. Jog, Rupesh K. Srivastava, Geetanjali Tomar

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Objectives: The aim of this study was to investigate the quality of mesenchymal stem cells (MSCs) obtained from ageing gingival tissues, in order to suggest their potential role in autologous stem cell therapy for old individuals. Methods: MSCs were isolated from gingival tissues of young (18-45 years) and old (above 45 years) donors by enzymatic digestion. MSCs were analysed for cfu-f, surface marker expression by flow-cytometry and multilineage differentiation potential. The angiogenic potential was compared in a chick embryo yolk sac membrane model. The aging and differentiation markers including SA-β-galactosidase and p21 respectively were analysed by staining and flow-cytometry analysis. Additionally, osteogenic markers such as glucocorticoid receptor (GR), vitamin D receptor (VDR) were measured by flow-cytometry and RT-qPCR was performed for quantification of osteogenic gene expression. Alizarin Red S and alkaline phosphatase (ALP) activity were also quantitated. Results: Gingival MSCs (GMSCs) from both the age groups were similar in their morphology and displayed cfu-f. They had similar expression of MSC surface markers and p21, comparable rate of proliferation and differentiated to all the four lineages. GMSCs from young donors had a higher adipogenic differentiation potential as compared to the old GMSCs. Moreover, these cells did not display a significant difference in ALP activity probably due to comparable expression of GR, VDR, and osteogenic genes. Conclusions: Ageing of GMSCs occurs at a much slower rate than stem cells from other sources. Thus we suggest GMSCs as an excellent candidate for autologous stem cell therapy in degenerative diseases of elderly individuals. Clinical Significance: GMSCs could help overcome the setbacks in clinical implementation of autologous stem cell therapy for regenerative medicine in all age group of patient.

Keywords: bone regeneration, cell therapy, senescence, stem cell

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254 Morphology and Risk Factors for Blunt Aortic Trauma in Car Accidents: An Autopsy Study

Authors: Ticijana Prijon, Branko Ermenc

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Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall.An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: aorta, blunt trauma, car accidents, morphology, risk factors

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253 Study of Hypertension at Sohag City: Upper Egypt Experience

Authors: Aly Kassem, Eman Sapet, Eman Abdelbaset, Hosam Mahmoud

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Objective: Hypertension is an important public health challenge being one of the most common worldwide disease-affecting human. Our aim is to study the clinical characteristics, therapeutic regimens, treatment compliance, and risk factors in a sector of of hypertensive patients at Sohag City. Subject and Methods: A cross sectional study; conducted in Sohag city; it involved 520 patients; males (45.7 %) and females (54.3 %). Their ages ranged between 35-85 years. BP measurements, BMI, blood glucose, Serum creatinine, urine analysis, serum Lipids, blood picture and ECG were done all the studied patients. Results: Hypertension presented more between non-smokers (72.55%), females (54.3%), educated patients (50.99%) and patients with low SES (54.9%). CAD presented in (51.63%) of patients, while laboratory investigations showed hyperglycaemia in (28.7%), anemia in (18.3%), high serum creatinine level in (8.49%) and proteinuria in (10.45%) of patient. Adequate BP control was achieved in (49.67%); older patients had lower adequacy of BP control in spite of the extensive use of multiple-drug therapy. Most hypertensive patients had more than one coexistent CV risk factor. Aging, being a female (54.3%), DM (32.3%), family history of hypertension (28.7%), family history of CAD (25.4%), and obesity (10%) were the common contributing risk factors. ACE-inhibitors were prescribed in (58.16%), Beta-blockers in (34.64%) of the patients. Monotherapy was prescribed for (41.17%) of the patients. (75.81%) of patients had regular use of their drug regimens. (49.67%) only of patients had their condition under control, the number of drugs was inversely related to BP control. Conclusion: Hypertensive patients in Sohag city had a profile of high CV risks, and poor blood pressure control particularly in the elderly. A multidisciplinary approach for routine clinical check-up, follow-up, physicians and patients training, prescribing simple once-daily regimens and encouraging life style modifications are recommended. Anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance.

Keywords: anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance

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