Search results for: multiple conditions diagnosis

Authors: Mari Murakami, Hiromi Kawasaki, Saori Fujimoto, Yoko Ueno

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Background: In Japan, one of the goals of midwifery education is the development of one’s ability to comprehensively support the child-rearing generation in collaboration with professionals from other disciplines. However, in order to prevent the spread of Covid-19, it has become extremely difficult to provide face-to-face support for mothers and children. Early on in the pandemic, we sought help from three parenting midwives as an alternative and attempted an online visit. Since midwives who are raising children respond to the training as both mothers who are care recipients and midwives as care providers. Therefore, we attempted to verify the usefulness of midwives experiencing training as mothers by clarifying the effects on those midwives who are raising children and who have experienced online visit training by students. Methods: The online visitations were conducted in June 2020. The collaborators were three midwives who were devoted to childcare. During the online visit training, we used the feedback records of their questions given by the collaborators (with their permission) to the students. The verbatim record was created from the records. Qualitative descriptive analysis was used, and subcategories and categories were extracted. This study was approved by the Ethical Committee for Epidemiology of Hiroshima University. Results: The average age of the three midwives was 36.3 years, with an average of 12.3 years of experience after graduation. They were each raising multiple children (ranging between a minimum of 2 and a maximum of 4 children). Their youngest infants were 6.7 months old on average for all. Five categories that emerged were: contributing to the development of midwifery students as a senior; the joy of accepting the efforts of a mother while raising children; recalling the humility of beginners through the integrity of midwifery students; learning opportunities about the benefits of online visits; and suggesting further challenges for online visits. Conclusion: The online visit training was an opportunity for midwives who are raising their own children to reinforce an honest and humble approach based on the attitude of the students, for self-improvement, and to reflect on the practice of midwifery from another person’s viewpoint. It was also noted that the midwives contributed to the education of midwifery students. Furthermore, they also agreed with the use of online visitations and considered the advantages and disadvantages of its use from the perspective of mothers and midwives. Online visits were seen to empower midwives on childcare leave, as their child-rearing was accepted and admired. Online visits by students were considered to be an opportunity to not only provide a sense of fulfillment as a recipient of care but also to think concretely about career advancement, during childcare leave, regarding the ideal way for midwifery training and teaching.

Keywords: child-rearing midwife, COVID-19 pandemic, online visit practice, qualitive descriptive study

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Authors: Xiaoyu Li, Wenchuan Ding, Yujia Yia

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As the nanoscale zinc oxide particles (nano-ZnO) accumulate in the landfill, nano-ZnO will enter the landfill leachate and come into contact with the heavy metal ions in leachate, which will change their transport process in the landfill and, furthermore, affect each other's environmental fate and toxicity. In this study, we explored the transport of co-existing nano-ZnO, Cu(II) and Cr(VI) ions by column experiments under different stages of landfill leachate conditions (flow rate, pH, ionic strength, humic acid). The results show that Cu(II) inhibits the transport of nano-ZnO in the quartz sand column by increasing the surface potential of nano-ZnO, and nano-ZnO increases the retention of Cu(II) in the quartz sand column by adsorbing Cu(II) ions. Cr(VI) promotes the transport of nano-ZnO in the quartz sand column by neutralizing the surface potential of the nano-ZnO which reduces electrostatic attraction between nZnO and quartz sand, but the nano-ZnO has no effect on the transport of Cr(VI). The nature of landfill leachates such as flow rate, pH, ionic strength (IS) and humic acid (HA) has a certain effect on the transport of coexisting nano-ZnO and heavy metal ions. For leachate containing Cu(II) and Cr(VI) ions, at the initial stage of landfilling, the pH of leachate is acidic, ionic strength value is high, the humic acid concentration is low, and the transportability of nano-ZnO is weak. As the landfill age increased, the pH value in the leachate gradually increases, when the ions are raised to alkaline, these ions are trending to precipitated or adsorbed to the solid wastes in landfill, which resulting in low IS value of leachate. At the same time, more refractory organic matter gradually increases such as HA, which provides repulsive steric effects, so the nano-ZnO is more likely to migrate. Overall, the Cr(VI) can promote the transport of nano-ZnO more than Cu(II).

Keywords: heavy metal ions, landfill leachate, nano-ZnO, transport

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Authors: Wahyu Eko Diyanto, Amalia Dyah Arumsari, Ulfatu Layinatinnahdiyah Arrosyadi

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Tofu industry is one of the local food industry which is can being competitive industry in the ASEAN Economic Community (AEC). However, a lot of tofu entrepreneurs just thinking how to produce good quality product without considering the impact of environmental conditions from the production process. Production of tofu per day requires a number of 15 kg with liquid waste generated is 652.5 liters. That liquid waste is discharged directly into waterways, whereas tofu liquid waste contains organic compounds that quickly unraveled, so it can pollute waterways. In addition, tofu liquid waste is high in Biological Oxygen Demand (BOD), Chemical Oxygen Demand (COD), Total Suspended Solid (TSS), nitrogen and phosphorus. This research is aim to create a method of handling liquid waste effectively and efficiently by using water lettuce. The method is done by observation and experiment by using phytoremediation method in the tofu liquid waste using water lettuce and adding aeration to reduce the concentration of contaminants. The results of the research analyzed the waste quality standard parameters based on SNI (National Standardization Agency of Indonesia). The efficiency concentration and parameters average of tofu liquid waste are obtained pH 3,42% (from 4,0 to be 3,3), COD 76,13% (from 3579 ppm to be 854 ppm), BOD 55 % (from 11600 ppm to be 5242 ppm), TSS 93,6% (from 3174 ppm to be 203 ppm), turbidity is 64,8% (from 977 NTU to be 1013 NTU), and temperature 36oC (from 45oC to be 40oC). The efficiency of these parameters indicates a safe value for the effluent to be channeled in waterways. Water lettuce and tofu liquid waste phytoremediation result will be used as biogas as renewable energy.

Keywords: aeration, phytoremediation, water letuce, tofu liquid waste

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Authors: Steven G. Sclan

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Background: Since December 2019, the world has been afflicted by the spread of the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2), which is responsible for the condition referred to as Covid-19. The illness has had a cataclysmic impact on the political, social, economic, and overall well-being of the population of the entire globe. While Covid-19 has had a substantial universal fatality impact, it may have an even greater effect on the socioeconomic, medical well-being, and healthcare planning for remaining societies. Significance: As these numbers illustrate, many more persons survive the infection than die from it, and many of those patients have noted ongoing, persistent symptoms after successfully enduring the acute phase of the illness. Recognition and understanding of these symptoms are crucial for developing and arranging efficacious models of care for all patients (whether or not having been hospitalized) surviving acute covid illness and plagued by post-acute symptoms. Furthermore, regarding Covid infection in children (< 18 y/o), although it may be that Covid “+” children are not major vectors of infective transmission, it now appears that many more children than initially thought are carrying the virus without accompanying obvious symptomatic expression. It seems reasonable to wonder whether viral effects occur in children – those children who are Covid “+” and now asymptomatic – and if, over time, they might also experience similar symptoms. An even more significant question is whether Covid “+” asymptomatic children might manifest increased multiple health problems as they grow – i.e., developmental complications (e.g., physical/medical, metabolic, neurobehavioral, etc.) – in comparison to children who had been consistently Covid “ - ” during the pandemic. Topics Addressed and Theoretical Importance: This review is important because of the description of both quantitative and qualitative methods for clinical and biomedical research. Topics reviewed will consider the importance of well-designed, comprehensive (i.e., quantitative and qualitative methods) longitudinal studies of Post Covid-19 symptoms in both adults and children. Also reviewed will be general characteristics of longitudinal studies and a presentation of a model for a proposed study. Also discussed will be the benefit of longitudinal studies for the development of efficacious interventions and for the establishment of cogent, practical, and efficacious community healthcare service planning for post-acute covid patients. Conclusion: Results of multi-dimensional, longitudinal studies will have important theoretical implications. These studies will help to improve our understanding of the pathophysiology of long COVID and will aid in the identification of potential targets for treatment. Such studies can also provide valuable insights into the long-term impact of COVID-19 on public health and socioeconomics.

Keywords: COVID-19, post-COVID-19, long COVID, longitudinal research, quantitative research, qualitative research

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Authors: Qingying Liu, S. Liu, L. Hao, B. Zhang, J. D. Yan

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HVDC technology is becoming increasingly popular due to its simplicity in topology and less power loss over long distance of power transmission, in comparison with HVAC technology. However, the dielectric behavior of insulators in the long term under HVDC stress is completely different from that under HVAC stress as a result of charge accumulation in a constant electric field. Insulators used in practical systems are never perfect in their structural conditions. Over time shallow cracks may develop on their surface. The presence of defects can lead to drastic change in their dielectric behaviour and thus increase the probability of surface flashover. In this contribution, experimental investigations have been carried out on the charge accumulation phenomenon on the surface of a rod insulator made of epoxy that is placed between two disk shaped electrodes at different voltage levels and in different gases (SF6, CO2 and N2). Many results obtained, such as, the two-dimensional electrostatic potential distribution along the insulator surface after the removal of the power source following a pre-defined period of application. The probe has been carefully calibrated before each test. Results show that surface charge distribution near the two disk shaped electrodes is not uniform in the circumferential direction, possibly due to the imperfect electrical connections between the embeded conductor in the insulator and the disk shaped electrodes. The axial length of this non-uniform region is experimentally determined, which provides useful information for shielding design. A charge transport model is also used to explain the formation of the long term electrostatic potential distribution under a constant applied voltage.

Keywords: HVDC, power systems, dielectric behavior, insulation, charge accumulation

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Authors: Jefri Draup, Antoine Ambard, Chi-Toan Nguyen

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Zirconium alloys exhibit solid-state phase transformations under thermal loading. These can lead to a significant evolution of the microstructure and associated mechanical properties of materials used in nuclear fuel cladding structures. Therefore, the ability to capture effects of phase transformation on the material constitutive behavior is of interest during conditions of severe transient thermal loading. Whilst typical Avrami, or Johnson-Mehl-Avrami-Kolmogorov (JMAK), type models for phase transformations have been shown to have a good correlation with the behavior of Zircaloy-4 under constant heating rates, the effects of variable and fast heating rates are not fully explored. The present study utilises the results of in-situ high energy synchrotron X-ray diffraction (SXRD) measurements in order to validate the phase transformation models for Zircaloy-4 under fast variable heating rates. These models are used to assess the performance of fuel cladding structures under loss of coolant accident (LOCA) scenarios. The results indicate that simple Avrami type models can provide a reasonable indication of the phase distribution in experimental test specimens under variable fast thermal loading. However, the accuracy of these models deteriorates under the faster heating regimes, i.e., 100Cs⁻¹. The studies highlight areas for improvement of simple Avrami type models, such as the inclusion of temperature rate dependence of the JMAK n-exponent.

Keywords: accident, fuel, modelling, zirconium

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Authors: Silvia Boschetti, Jakub Binter, Robin Kopecký, Lenka PříPlatová, Jaroslav Flegr

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A strict dichotomy was present between religion and science, but recently, cognitive science focusses on the impact of supernatural beliefs on cognitive processes such as pattern recognition. It has been hypothesized that cognitive and perceptual processes have been under evolutionary pressures that ensured amplified perception of patterns, especially when in stressful and harsh conditions. The pattern detection in religious and non-religious individuals after induction of negative, anxious mood shall constitute a cornerstone of the general role of anxiety, cognitive bias, leading towards or against the by-product hypothesis, one of the main theories on the evolutionary studies of religion. The apophenia (tendencies to perceive connection and meaning on unrelated events) and perception of visual patterns (or pateidolia) are of utmost interest. To capture the impact of culture and upbringing, a comparative study of two European countries, the Czech Republic (low organized religion participation, high esoteric belief) and Italy (high organized religion participation, low esoteric belief), are currently in the data collection phase. Outcomes will be presented at the conference. A battery of standardized questionnaires followed by pattern recognition tasks (the patterns involve color, shape, and are of artificial and natural origin) using an experimental method involving the conditioning of (controlled, laboratory-induced) stress is taking place. We hypothesize to find a difference between organized religious belief and personal (esoteric) belief that will be alike in both of the cultural environments.

Keywords: culture, esoteric belief, pattern perception, religiosity

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Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Luca Preis

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A primary healthcare facility in developing countries should be a multifunctional space able to respond to different requirements: Flexibility, modularity, aggregation and reversibility. These basic features could be better satisfied if applied to an architectural artifact that complies with the typological, figurative and constructive aspects of the context in which it is located. Therefore, the purpose of this paper is to identify a procedure that can define the figurative aspects of the architectural structure of the health prototype for the marginal areas of developing countries through a critical approach. The application context is the rural areas of the Northeast of Bahia in Brazil. The prototype should be located in the rural district of Quingoma, in the municipality of Lauro de Freitas, a particular place where there is still a cultural fusion of black and indigenous populations. Based on the historical analysis of settlement strategies and architectural structures in spaces of public interest or collective use, this paper aims to provide a procedure able to identify the categories and rules underlying typological and figurative aspects, in order to detect significant and generalizable elements, as well as materials and constructive techniques typically adopted in the rural areas of Brazil. The object of this work is therefore not only the recovery of certain constructive approaches but also the development of a procedure that integrates the requirements of the primary healthcare prototype with its surrounding economic, social, cultural, settlement and figurative conditions.

Keywords: architectural typology, developing countries, local construction techniques, primary health care.

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Authors: Funmilayo Lanrewaju Amao, Amos Olusegun Amao, Odetoye Adeola Sunday, Joseph Joshua Olu

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There is a high magnitude of housing inadequacy in urban centers in Nigeria. This is manifested in quantitative and qualitative terms. Severe overcrowding and insanitary physical environment characterize the housing in the urban centers. The culminating effect of this is the growth of slum areas. This paper takes a critical look at inter-allia history and anatomy, general characteristic, present condition, root causes, official responses and reactions, possible solution and advocacy housing in central city slum of Ibadan. It also examines slum development and consequent deviant behaviors in the inner-city neighborhoods of Ibadan, the capital city of Oyo State, Nigeria. Residing there are many underemployed and unemployed individuals, these are miscreants who are generally socially frustrated. The activities of this group of people are a cause of concern. Deleterious and anti-social behaviors such as prostitution and house burglary are commonplace in the neighborhoods. The paper examines building conditions in the neighborhoods and the nexus with the deviant behavior of the inhabitants. The paper affirms that there is monumental deficiency in housing quality, while the design and the arrangement of the buildings into spatial units significantly influence the behavior of the residents. The paper suggests a two-prong approach in dealing with the situation. This involves urban renewal and slum upgrading programmes on the one hand, and an improvement in the socio-economic circumstances of the inhabitants, especially an increase in employment opportunity on the other.

Keywords: slum, behavior, housing, poverty, environmental degeneration

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Authors: Veselin Nanev, Margarita Gabrashanska, Neli Tsocheva-Gaytandzieva

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Ascaridiasis in chicks is one of the major causes for the reduction in body weights, higher mortality, and reduction in egg production, worse meat quantity, pathological lesions, blood losses, and secondary infections. It is responsible for economic losses to the poultry. Despite being economically important parasite, little work has been carried out on the role of antioxidants in the pathogenesis of ascaridiasis. Zinc is a trace elements with multiple functions and one of them is its antioxidant ability. The aim of this study was to investigate the combined effect of organic zinc compound (2Gly.ZnCl22H20) and Ascaridia galli infection on the antioxidant status of broiler chicks. The activity of antioxidant enzymes superoxide dismutase, glutathione peroxidase, the level of lipid peroxidation, expressed by malonyl dialdexyde and plasma zinc in chicks experimentally infected with Ascaridia galli was investigated. Parasite burden was studied as well. The study was performed on 80 broiler chicks, Cobb 500 hybrids. They were divided into four groups – 1st group – control (non-treated and non-infected, 2nd group – infected with embryonated eggs of A. galli and without treatment, 3rd group- only treated with 2Gly.ZnCl22H20 compound and gr. 4 - infected and supplemented with Zn-compound. The chicks in gr. 2 and 4 were infected orally with 450 embryonated eggs of A.galli on day 14 post infection. The chicks from gr. 3 and 4 received 40 mg Zn compound /kg of feed after the 1st week of age during 10 days. All chicks were similarly fed, managed and killed at 60 day p.i. Helminthological, biochemical and statistical methods were applied. Reduced plasma Zn content was observed in the infected chicks compared to controls. Zinc supplementation did not restored the lower Zn content. Cu, Zn-SOD was decreased significantly in the infected chicks compared to controls. The GPx – activity was significantly increased in the infected chicks than the controls. Increased GPx activity together with decreased Cu/ZnSOD activity revealed unbalanced antioxidant defense capacity. The increased MDA level in chicks and changes in the activity of the enzymes showed a development of oxidative stress during the infection with A.galli. Zn compound supplementation has been shown to influence the activity of both antioxidant enzymes (SOD, GPx) and reduced MDA in the infected chicks. Organic zinc supplementation improved the antioxidant defense and protect hosts from oxidant destruction, but without any effect on the parasite burden. The number of helminths was similar in both groups. Zn supplementation did not changed the number of parasites. Administration of oral 2Gly.ZnCl22H20 compound has been shown to be useful in chicks infected with A. galli by its improvement of their antioxidant potential.

Keywords: Ascaridia galli, antioxidants, broiler chicks, zinc supplementation

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Authors: Tamar Arieli

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Cross-border cooperation has long been hailed as a means for stabilizing and normalizing relations between former enemies. Cooperation in problem-solving and realizing of local interests in post-conflict environments can indeed serve as a basis for developing dialogue and meaningful relations between neighbors across borders. Hence the potential for formerly sealed borders to serve as a basis for generating local and national perceptions of interdependence and as a buffer against the resume of conflict. Central questions which arise for policy-makers and third parties are how to facilitate cross-border cooperation and which areas of cooperation best serve to normalize post-conflict border regions. The Israel-Jordan border functions as a post-conflict border, in that it is a peaceful border since the 1994 Israel-Jordan peace treaty yet cross-border relations are defined but the highly securitized nature of the border region and the ongoing Arab-Israel regional conflict. This case study is based on long term qualitative research carried out in the border regions of both Israel and Jordan, which mapped and analyzed cross-border in a wide range of activities – social interactions sponsored by peace-facilitating NGOs, government sponsored agricultural cooperation, municipal initiated emergency planning in cross-border continuous urban settings, private cross-border business ventures and various environmental cooperative initiatives. These cooperative initiatives are evaluated through multiple interviews carried out with initiators and partners in cross-border cooperation as well as analysis of documentation, funding and media. These cooperative interactions are compared based on levels of cross-border local and official awareness and involvement as well as sustainability over time. This research identifies environmental cooperation as the most sustainable area of cross- border cooperation and as most conducive to generating perceptions of regional interdependence. This is a variation to the ‘New Middle East’ vision of business-based cooperation leading to conflict amelioration and regional stability. Environmental cooperation serving the public good rather than personal profit enjoys social legitimization even in the face of widespread anti-normalization sentiments common in the post-conflict environment. This insight is examined in light of philosophical and social aspects of the natural environment and its social perceptions. This research has theoretical implications for better understanding dynamics of cooperation and conflict, as well as practical ramifications for practitioners in border region policy and management.

Keywords: borders, cooperation, post-conflict, security

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Authors: Malgorzata Walkowiak, Magdalena Witczak, Wojciech Cichy

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Biomass is an important renewable energy source in Poland. As a biofuel, it has many advantages like renewable in noticeable time and relatively high energy potential. But disadvantages of biomass like high moisture content and hygroscopic nature causes that gaining, transport, storage and preparation for combustion become troublesome and uneconomic. Thermal modification of biomass can improve hydrophobic properties, increase its calorific value and natural resistance. This form of thermal processing is known as torrefaction. The aim of the study was to investigate the effect of the pre-heat treatment of wood and plant lignocellulosic raw materials on the properties of solid biofuels. The preliminary studies included pine, beech and willow wood and other lignocellulosic raw materials: mustard, hemp, grass stems, tobacco stalks, sunflower husks, Miscanthus straw, rape straw, cereal straw, Virginia Mallow straw, rapeseed meal. Torrefaction was carried out using variable temperatures and time of the process, depending on the material used. It was specified the weight loss and the ash content and calorific value was determined. It was found that the thermal treatment of the tested lignocellulosic raw materials is able to provide solid biofuel with improved properties. In the woody materials, the increase of the lower heating value was in the range of 0,3 MJ/kg (pine and beech) to 1,1 MJ/kg (willow), in non-woody materials – from 0,5 MJ/kg (tobacco stalks, Miscanthus) to 3,5 MJ/kg (rapeseed meal). The obtained results indicate for further research needs, particularly in terms of conditions of the torrefaction process.

Keywords: biomass, lignocellulosic materials, solid biofuels, torrefaction

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Authors: Gursimran Jandu, Melissa Nelson, Mia Ingram, Hana Jalal

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There is a significant overlap between autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD), with up to 90% of young people diagnosed with ASD having this co-morbidity. Distinguishing between the symptoms of the two leads to issues with accurate treatment, yet this is paramount in benefiting the young person. There are two distinct methods of treatment, psychological or pharmacological, with clinicians tending to choose one or the other, potentially due to the lack of research available. This report reviews the efficacy of psychological and pharmacological treatments for young people diagnosed with ASD and co-morbid OCD. A literature review was performed on papers from the last fifteen years including ‘ASD’, ‘OCD’ and individuals under the age of 18. Eleven papers were selected as relevant. The report looks at the comparison between more traditional methods, such as selective-serotonin-reuptake-inhibitors (SSRI) and Cognitive behaviour therapy (CBT), and newer therapies, such as modified or intensive ASD focused psychotherapies, and the use of other medication classes. On reviewing the data, it was identified that there was a distinct lack of information on this important topic. The most widely used treatment was medication such as Fluoxetine, an SSRI, which rarely showed improvement in symptoms or outcomes. This is in contrast to modified forms of CBT which often reduces symptoms or even results in OCD remission. With increased research into non-traditional management of these co-morbid conditions, it is clear there is scope that modified CBT may become the future treatment of choice for OCD in young people with ASD.

Keywords: autism spectrum disorder, intensive or adapted cognitive behavioural therapy, obsessive compulsive disorder, pharmacological management

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Authors: Majid Samiee Zenoozian

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The Persian Gulf is a bordering sea with an normal depth of 35 m and a supreme depth of 100 m near its narrow appearance. Its lengthen bathymetric axis divorces two main geological shires — the steady Arabian Foreland and the unbalanced Iranian Fold Belt — which are imitated in the conflicting shore and bathymetric morphologies of Arabia and Iran. The sediments were experimented with from 72 offshore positions through an oceanographic cruise in the winter of 2018. Throughout the observation era, several storms and river discharge actions happened, as well as the major flood on record since 1982. Suspended-sediment focus at all three sites varied in reaction to both wave resuspension and advection of river-derived sediments. We used hydrological models to evaluation and associate the wave height and inundation distance required to carriage the rocks inland. Our results establish that no known or possible storm happening on the Makran coast is accomplished of detaching and transporting the boulders. The fluid mud consequently is conveyed seaward due to gravitational forcing. The measured sediment focus and velocity profiles on the shelf provide a strong indication to provision this assumption. The sediment model is joined with a 3D hydrodynamic module in the Environmental Fluid Dynamics Code (EFDC) model that offers data on estuarine rotation and salinity transport under normal temperature conditions. 3-D sediment transport from model simulations specify dynamic sediment resuspension and transport near zones of highly industrious oyster beds.

Keywords: sediment transport, storm, coast, fluid dynamics

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Authors: L. Achab, F. Iachachene

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In microvessels, red blood cells (RBCs) exhibit a tendency to migrate towards the vessel center, establishing a core-annular flow pattern. The core region, marked by a high concentration of RBCs, is governed by significantly non-Newtonian viscosity. Conversely, the annular layer, composed of cell-free plasma, is characterized by Newtonian low viscosity. This property enables the plasma layer to act as a lubricant for the vessel walls, efficiently reducing resistance to the movement of blood cells. In this study, we investigate the factors influencing blood flow in microvessels and the thickness of the annular plasma layer using a non-miscible fluids approach in a 2D axisymmetric geometry. The governing equations of an incompressible unsteady flow are solved numerically through the Volume of Fluid (VOF) method to track the interface between the two immiscible fluids. To model blood viscosity in the core region, we adopt the Quemada constitutive law which is accurately captures the shear-thinning blood rheology over a wide range of shear rates. Our results are then compared to an established theoretical approach under identical flow conditions, particularly concerning the radial velocity profile and the thickness of the annular plasma layer. The simulation findings for low Reynolds numbers, demonstrate a notable agreement with the theoretical solution, emphasizing the pivotal role of blood’s rheological properties in the core region in determining the thickness of the annular plasma layer.

Keywords: core-annular flows, microvessels, Quemada model, plasma layer thickness, volume of fluid method

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Authors: Mrinalini Ranjan, Sudheesh Chethil

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Epilepsy is a common neurological disorder characterised by the recurrence of seizures. Electroencephalogram (EEG) signals are complex biomedical signals which exhibit nonlinear and nonstationary behavior. We use two methods 1) Detrended Fluctuation Analysis (DFA) and 2) Recurrence Plots (RP) to capture this complex behavior of EEG signals. DFA considers fluctuation from local linear trends. Scale invariance of these signals is well captured in the multifractal characterisation using detrended fluctuation analysis (DFA). Analysis of long-range correlations is vital for understanding the dynamics of EEG signals. Correlation properties in the EEG signal are quantified by the calculation of a scaling exponent. We report the existence of two scaling behaviours in the epileptic EEG signals which quantify short and long-range correlations. To illustrate this, we perform DFA on extant ictal (seizure) and interictal (seizure free) datasets of different patients in different channels. We compute the short term and long scaling exponents and report a decrease in short range scaling exponent during seizure as compared to pre-seizure and a subsequent increase during post-seizure period, while the long-term scaling exponent shows an increase during seizure activity. Our calculation of long-term scaling exponent yields a value between 0.5 and 1, thus pointing to power law behaviour of long-range temporal correlations (LRTC). We perform this analysis for multiple channels and report similar behaviour. We find an increase in the long-term scaling exponent during seizure in all channels, which we attribute to an increase in persistent LRTC during seizure. The magnitude of the scaling exponent and its distribution in different channels can help in better identification of areas in brain most affected during seizure activity. The nature of epileptic seizures varies from patient-to-patient. To illustrate this, we report an increase in long-term scaling exponent for some patients which is also complemented by the recurrence plots (RP). RP is a graph that shows the time index of recurrence of a dynamical state. We perform Recurrence Quantitative analysis (RQA) and calculate RQA parameters like diagonal length, entropy, recurrence, determinism, etc. for ictal and interictal datasets. We find that the RQA parameters increase during seizure activity, indicating a transition. We observe that RQA parameters are higher during seizure period as compared to post seizure values, whereas for some patients post seizure values exceeded those during seizure. We attribute this to varying nature of seizure in different patients indicating a different route or mechanism during the transition. Our results can help in better understanding of the characterisation of epileptic EEG signals from a nonlinear analysis.

Keywords: detrended fluctuation, epilepsy, long range correlations, recurrence plots

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Authors: Yalcin Kaya, Fatma Arslan, Ahmet Selim Kaya

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This study aimed to determine the undesirable hypertrophic anomalies in the body of females and to investigate how they can be affected by the exercise program according to the applied 8 week individual conditions. The research was carried out on 35 women who did not have any regular previous sports practice and had an approximate age of 30 ± 5.0 at the gymnasium because of their asymmetric structure and weight gain of the body. Measurements of width, depth, and periphery were taken from the participants' body, and the exercise protocol was applied for 8 weeks according to the individual measurements in accordance with the obtained measurements. After 8 weeks, the same measurements were applied again. Measurements were made by using ruler and paper tape. The findings were evaluated and differences were analyzed by paired sample t test. According to the findings obtained, ulnae distal proiecturas width averages were 44.77 ± 3.65 and 43.52 ± 3.47 pre- and post-exercise respectively. Bithorachanteric width averages were 29.3 ± 3.12 before exercise and 26.67 ± 3.27 after exercise. Average abdominal widths were observed as 18.64 ± 4.14 (before exercise) and 18.01 ± 6.27 (after exercise). The distances between the malleolus were measured as 16.98 ± 1.62 (before exercise) and 16.70 ± 1.64 (after exercise). The results were statistically significant (p < 0.05). The mean of pre-exercise Externus abdominis circumference was 93.97 ± 8.91, and the mean of post-exercise mean was 90.82 ± 8.24. The results are statistically significant (p < 0.05). In conclusion, findings of the study show that inactivity, daily uncontrolled activities or erroneous postural postures, malnutrition cause some anomalies in the human body. However, with consciously standardized and regular exercises, these abnormalities are reduced by an eight-week exercise protocol in parallel with the expulsion of excess kilos and can be removed when working much longer and fitter, it is proposed to be healthier and more beautiful in appearance.

Keywords: women, body, circumference-width and depth measurements, hypertrophy, exercise

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Authors: Lila Boulekbache-Makhlouf, Fatiha Brahmi

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This study was carried out with the aim of enriching fresh cheese with the food by-products, which are the leaves of shallots and the peels of potatoes. Firstly, the conditions for extracting the total polyphenols using ultrasound are optimized. Then, the contents of total polyphenols PPT , flavonoids and antioxidant activity were evaluated for the extracts obtained by adopting the optimal parameter. On the other hand, we have carried out some physicochemical, microbiological and sensory analyzes of the cheese produced. The maximum total polyphenols value of 70.44 mg GAE gallic acid equivalent / g of dry matter DM of shallot leaves was reached with 40% (v/v) ethanol, an extraction time of 90 min and a temperature of 10 °C. While, the maximum TPP total polyphenols content of potato peels of 45.03 ± 4.16 mg gallic acid equivalent / g of dry matter DM was obtained using an ethanol /water mixture (40%, v/v), a time of 30 min and a temperature of 60 °C and the flavonoid contents were 13.99 and 7.52 QE quercetin equivalent/g dry matter DM, respectively. From the antioxidant tests, we deduced that the potato peels present a higher antioxidant power with the concentration of extracts causing a 50% inhibition IC50s of 125.42 ± 2.78 μg/mL for 2,2-diphényl 1-picrylhydrazyle DPPH, of 87.21 ± 7.72 μg/mL for phosphomolybdate and 200.77 ± 13.38 μg/mL for iron chelation, compared with the results obtained for shallot leaves which were 204.29 ± 0.09, 45.85 ± 3,46 and 1004.10 ± 145.73 μg/mL, respectively. The results of the physicochemical analyzes have shown that the formulated cheese was compliant with standards. Microbiological analyzes show that the hygienic quality of the cheese produced was satisfactory. According to the sensory analysis, the experts liked the cheese enriched with the powder and pieces of the leaves of the shallots.

Keywords: shallots leaves, potato peels, ultrasound extraction, phenolics, cheese

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Authors: Chris Houliez

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This study addresses the complex dynamics of the modern retail environment, focusing on how the ubiquitous nature of mobile communication technologies has reshaped the shopper experience and tested the limits of the conventional "servicescape" concept commonly used to describe retail experiences. The objective is to redefine the conceptualization of retail space by introducing an approach to space that aligns with a retail context where physical and digital interactions are increasingly intertwined. To offer a more shopper-centric understanding of the retail experience, this study draws from phenomenology, particularly Henri Lefebvre’s work on the production of space. The presented protocol differs from traditional methodologies by not making assumptions about what constitutes a retail space. Instead, it adopts a perspective based on Lefebvre’s seminal work, which posits that space is not a three-dimensional container commonly referred to as “servicescape” but is actively produced through shoppers’ spatial practices. This approach allows for an in-depth exploration of the retail experience by capturing the everyday spatial practices of shoppers without preconceived notions of what constitutes a retail space. The designed protocol was tested with eight participants during 209 hours of day-long field trips, immersing the researcher into the shopper's lived experience by combining multiple data collection methods, including participant observation, videography, photography, and both pre-fieldwork and post-fieldwork interviews. By giving equal importance to both locations and connections, this study unpacked various spatial practices that contribute to the production of retail space. These findings highlight the relative inadequacy of some traditional retail space conceptualizations, which often fail to capture the fluid nature of contemporary shopping experiences. The study's emphasis on the customization process, through which shoppers optimize their retail experience by producing a “fully lived retail space,” offers a more comprehensive understanding of consumer shopping behavior in the digital age. In conclusion, this research presents a significant shift in the conceptualization of retail space. By employing a phenomenological approach rooted in Lefebvre’s theory, the study provides a more efficient framework to understand the retail experience in the age of mobile communication technologies. Although this research is limited by its small sample size and the demographic profile of participants, it offers valuable insights into the spatial practices of modern shoppers and their implications for retail researchers and retailers alike.

Keywords: shopper behavior, mobile telecommunication technologies, qualitative research, servicescape, servicespace

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Authors: Mohamed M. Ali, Adel Nofal, Amr Kandil, Mahmoud Agour

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High phosphorus gray iron (HPGI) is used to connect the steel stub of an anode rod to a prebaked anode carbon block in the aluminium reduction cells. In this paper, a complete characterization for HPGI was done, includes studying the chemical composition of the HPGI collar, anodic voltage drop, collar temperature over 30 days anode life cycle, microstructure and mechanical properties. During anode life cycle, the carbon content in HPGI was lowed from 3.73 to 3.38%, and different changes in the anodic voltage drop at the stub- collar-anode connection were recorded. The collar temperature increases over the anode life cycle and reaches to 850°C in four weeks after anode changing. Significant changes in the HPGI microstructure were observed after 3 and 30 days from the anode changing. To simulate the actual operating conditions in the steel stub/collar/carbon anode connection, a bench-scale experimental set-up was designed and used for electrical resistance and resistivity respectively. The results showed the current HPGI properties needed to modify or producing new alloys with excellent electrical and mechanical properties. The steel stub and HPGI thermal expansion were measured and studied. Considerable permanent expansion was observed for the HPGI collar after the completion of the heating-cooling cycle.

Keywords: high phosphorus gray iron (HPGI), aluminium reduction cells, anodic voltage drop, microstructure, mechanical and electrical properties

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Authors: Mukul R. Gupta, Rajkumar Gandhi, Rajitha Sachan, Naveen K. Khare

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The field of glycoscience has burgeoned in the last several decades, leading to the identification of many glycosides which could serve critical roles in a wide range of biological processes. This has prompted a resurgence in synthetic interest, with a particular focus on new approaches to construct the selective glycosidic bond. Despite the numerous elegant strategies and methods developed for the formation of glycosidic bonds, stereoselective construction of glycosides remains challenging. Here, we have recently developed the novel Hexafluoroisopropanol (HFIP) catalyzed stereoselective glycosylation methods by using KDN imidate glycosyl donor and a variety of alcohols in excellent yield. This method is broadly applicable to a wide range of substrates and with excellent selectivity of glycoside. Also, herein we are reporting the functionalization of the unbiased side of newly formed glycosides by dual-catalytic transition metal systems (Ru- or Fe-). We are using the innovative Reverse & Catalyst strategy, i.e., a reversible activation reaction by one catalyst with a functionalization reaction by another catalyst, together with enabling functionalization of substrates at their inherently unreactive sites. As well, we are targeting the diSia derivative synthesis by Wittig reaction. This synthetic method is applicable in mild conditions, functional group tolerance of the dual-catalytic systems and also highlights the potential of the multicatalytic approach to address challenging transformations to avoid multistep procedures in carbohydrate synthesis.

Keywords: KDN, stereoselective glycosylation, dual-catalytic functionalization, Wittig reaction

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Authors: Fengmei Yao, Pengcheng Qin, Jiahua Zhang, Min Liu

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Global warming is expected to reduce the risk of low temperature stress in rice grown in temperate regions, but this impact has not been well verified by empirical studies directly on chilling injury in rice. In this study, a case study in Northeast China was presented to investigate whether the frequencies of chilling injury declined as a result of climate change, in comprehensive consideration of the potential effects from autonomous adaptation of rice production in response to climate change, such as shifts in cultivation timing and rice cultivars. It was found that frequency of total chilling injury (either delayed-growth type or sterile-type in a year) decreased but only to a limit extent in the context of climate change, mainly owing to a pronounced decrease in frequency of the delayed-growth chilling injury, while there was no overwhelming decreasing tendency for frequency of the sterile-type chilling injury, rather, it even increased considerably for some regions. If changes in cultivars had not occurred, risks of chilling injury of both types would have been much lower, specifically for the sterile-type chilling injury for avoiding deterioration in chilling sensitivity of rice cultivars. In addition, earlier planting helped lower the risk of chilling injury but still can not overweight the effects of introduction of new cultivars. It was concluded that risks of chilling injury in rice would not necessarily decrease as a result of climate change, considering the accompanying adaptation process may increase the chilling sensitivity of rice production system in a warmer climate conditions, and thus precautions should still be taken.

Keywords: chilling injury, rice, CERES-rice model, climate warming, North east China

Procedia PDF Downloads 334

Authors: Mariana L. de Araújo, Pedro P. M. Menezes

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Research on strategic human resource management (SHRM) has made progress in the last few decades, showing a relationship between policies and practices of human resource management (HRM) and improving organizational results. That's because demonstrating the effectiveness of any HRM or other organizational practice, which means the extent that this can operate as a tool to achieve organizational performance, is a complex and arduous task to execute. Even today, there isn't consensus about "effectiveness," and the tools to measure the effectiveness are disconnected and not convincing. It is not different from the performance management system (PMS) effectiveness. A disproportionate focus on specific criteria adopted and an accumulation of studies that don't relate to the others, which damages the development of the field. Therefore, it aimed to evaluate the effectiveness of the PMS through models, dimensions, criteria, and measures. The objective of this study is to propose a theoretical-integrative model for evaluating PMS based on the literature in the PMS field. So, the PRISMA protocol was applied to carry out a systematic review, resulting in 57 studies. After performing the content analysis, we identified six dimensions: learning, societal impact, reaction, financial results, operational results and transfer, and 22 categories. In this way, a theoretical-integrative model for assessing the effectiveness of PMS was proposed based on the findings of this study, in which it was possible to confirm that the effectiveness construct is somewhat complex when viewing that most of the reviewed studies considered multiple dimensions in their assessment. In addition, we identified that the most immediate and proximal results of PMS are the most adopted by the studies; conversely, the studies adopted less distal outcomes to assess the effectiveness of PMS. Another finding of this research is that the reviewed studies predominantly analyze from the individual or psychological perspective, even when it comes to criteria whose phenomena are at an organizational level. Therefore, this study converges with a trend recently identified when referring to a process of "psychologization" in which GP studies, in general, have demonstrated macro results of the GP system from an individual perspective. Therefore, given the identification of a methodological pattern, the predominant influence of individual and psychological aspects in studies on HRM in administration is highlighted, demonstrated by the reflection on the practically absolute way of measuring the effectiveness of PMS from perceptual and subjective measures. Therefore, based on the recognition of the patterns identified, the model proposed to promote studies on the subject more broadly and profoundly to broaden and deepen the perspective of the field of management's interests so that the evaluation of the effectiveness of PMS can promote inputs on the impact of the PMS system in organizational performance. Finally, the findings encourage reflections on assessing the effectiveness of PMS through the theoretical-integrative model developed so that the field can promote new theoretical and practical perspectives.

Keywords: performance management, strategic human resource management, effectiveness, organizational performance

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Authors: Hugo Sampaio Libero, Max de Castro Magalhaes

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The perception of sound radiated from a building floor is greatly influenced by the rooms in which it is immersed and by the position of both listener and source. The main question that remains unanswered is related to the influence of the source position on the sound power radiated by a complex wall-floor system in buildings. This research is concerned with the investigation of vibration transmission across walls and floors in buildings. It is primarily based on the determination of vibration reduction index via experimental tests. Knowledge of this parameter may help in predicting noise and vibration propagation in building components. First, the physical mechanisms involving vibration transmission across structural junctions are described. An experimental setup is performed to aid this investigation. The experimental tests have shown that the vibration generation in the walls and floors is directed related to their size and boundary conditions. It is also shown that the vibration source position can affect the overall vibration spectrum significantly. Second, the characteristics of the noise spectra inside the rooms due to an impact source (tapping machine) are also presented. Conclusions are drawn for the general trend of vibration and noise spectrum of the structural components and rooms, respectively. In summary, the aim of this paper is to investigate the vibro-acoustical behavior of building floors and walls under floor impact excitation. The impact excitation was at distinct positions on the slab. The analysis has highlighted the main physical characteristics of the vibration transmission mechanism.

Keywords: vibration transmission, vibration reduction index, impact excitation, experimental tests

Procedia PDF Downloads 93

Authors: Benedicta N. Nkeh-Chungag, Constance R. Sewani-Rusike, Isaac M. Malema, Daniel T. Goon, Oladele V. Adeniyi, Idowu A. Ajayi

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Background: Childhood and adolescent obesity is an important predictor of adult cardiometabolic diseases. Current data on age- and gender-specific cardiometabolic risk factors are lacking in the peri-urban Eastern Cape Province, South Africa. However, such information is important in designing innovative strategies to promote healthy living among children and adolescents. The purpose of this pilot study was to compare and determine the extent of cardiometabolic risk factors between samples of lean and overweight/obese adolescent population in a peri-urban township of South Africa. Methods: In this case-control study, age-matched, non-pregnant and non-lactating female adolescents consisting of equal number of cases (50 overweight/obese) and control (50 lean) participated in the study. Fasting venous blood samples were obtained for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (Trig), highly sensitive C-reactive protein (hsCRP) and blood sugar. Anthropometric measurements included weight, height, waist and hip circumferences. Body mass index was calculated. Blood pressure was measured; and metabolic syndrome was assessed using appropriate diagnostic criteria for children and adolescents. Results: Of the 76 participants with complete data, 12/38 of the overweight/obese and 1/38 of the lean group met the criteria for adolescent metabolic syndrome. All cardiometabolic risk factors were elevated in the overweight/obese group compared with the lean group: low HDL-C (RR = 2.21), elevated TC (RR = 1.23), elevated LDL-C (RR = 1.42), elevated Trig (RR = 1.73), and elevated hsCRP (RR = 1.9). There were significant atherosclerotic indices among the overweight/obese group compared with the lean group: TC/HDL and LDL/HDL (2.99±0.91 vs 2.63±0.48; p=0.016 and 1.73±0.61 vs 1.41±0.46; p= 0.014, respectively). Conclusion: There are multiple cardiometabolic risk factors among the overweight/obese female adolescent group compared with lean adolescent group in the study. Female adolescent who are overweight and obese have higher relative risks of developing cardiometabolic diseases compared with their lean counterparts in the peri-urban Mthatha, South Africa. School health programme focusing on promoting physical exercise, healthy eating and keeping appropriate weight are needed in the country.

Keywords: adolescents, cardiometabolic risk factors, obesity, peri-urban South Africa

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Authors: Chi-Chang Lin, Jiun-Yan Chiu

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Periodontal disease, oral cancer relating trauma is the prominent factor devastating bone tissue that is crucial to reestablishing in clinical. As we know, common symptom, osteoporosis, and infection limiting the ability of the bone tissue to recover cause difficulty before implantation therapy. Regeneration of bone tissue is the fundamental therapy before surgical processes. To promote the growth of bone tissue, many commercial products still have sophisticated problems that need to overcome. Regrettably, there is no available material which is apparently preferable for releasing and controlling of loading dosage, or mitigating inflammation. In our study, a hydrogel-based composite membrane has been prepared by using Gellan gum (GG), gamma-polyglutamic acid (γ-PGA) and glycerol with simple sol-gel method. GG is a natural material that is massively adopted in cartilage. Unfortunately, the strength of pure GG film is a manifest weakness especially under simulating body fluidic conditions. We utilize another biocompatible material, γ-PGA as cross-linker which can form tri-dimension structure that enhancing the strength. Our result indicated the strength of pure GG membrane can be obviously improved by cross-linked with γ-PGA (0.5, 0.6, 0.7, 0.8, 0.9, 1.0 w/v%). Besides, blending with glycerol (0, 1.0, 2.0, 3.0 w/v%) can significantly improve membrane toughness that corresponds to practical use. The innovative composited hydrogel made of GG, γ-PGA, and glycerol is attested with neat results including elongation and biocompatibility that take the advantage of extension covering major trauma. Recommendations are made for treatment to build up the foundation of bone tissue that would help patients to escape from the suffering and shorten the amount of time in recovery.

Keywords: bone tissue, gellan gum, regeneration, toughness

Procedia PDF Downloads 142

Authors: Salah Hadjout, Mohamed Zouidi

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In Algeria, several works carried out in recent years have shown the importance of fusarium head blight in durum wheat. Indeed, this disease is caused by a complex of Fusarium genus pathogens. The research carried out reports that F. culmorum is the main species infecting cereals. These informations motivated our interest in the field evaluation of the behavior of some durum wheat genotypes (parental varieties and lines) with regard to fusarium head blight, mainly caused by four F. culmorum isolates. Our research work focused on following the evolution of symptom development throughout the grain filling, after artificial inoculation of ears by Fusarium isolates in order to establish a first image on the differences in genotype behavior to fusarium haed blight. Field disease assessment criteria are: disease assessment using a grading scale, thousand grain weight measurement and AUDPC. The results obtained revealed that the varieties and lines resulting from crosses had a quite different level of sensitivity to F. culmorum species and no genotype showed complete resistance in our culture conditions. Among the material tested, some lines showed higher resistance than their parents. The results also show a slight behavioral variability also linked to the aggressiveness of the Fusarium species studied in this work. Our results open very important research perspectives on fusarium head blight, in particular the search for toxins produced by Fusarium species.

Keywords: fusarium head blight, durum wheat, Fusarium culmorum, field disease assessment criteria, Algeria

Procedia PDF Downloads 100

Authors: Z. Kassab, A. Aboulkas, A. Barakat, M. El Achaby

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The red algae are available enormously around the world and their exploitation for the production of agar product has become as an important industry in recent years. However, this industrial processing of red algae generated a large quantity of solid fibrous wastes, which constitute a source of a serious environmental problem. For this reason, the exploitation of this solid waste would help to i) produce new value-added materials and ii) to improve waste disposal from environment. In fact, this solid waste can be fully utilized for the production of cellulose microfibers and nanocrystals because it consists of large amount of cellulose component. For this purpose, the red algae waste was chemically treated via alkali, bleaching and acid hydrolysis treatments with controlled conditions, in order to obtain pure cellulose microfibers and cellulose nanocrystals. The raw product and the as-extracted cellulosic materials were successively characterized using serval analysis techniques, including elemental analysis, X-ray diffraction, thermogravimetric analysis, infrared spectroscopy and transmission electron microscopy. As an application, the as extracted cellulose nanocrystals were used as nanofillers for the production of polymer-based composite films with improved thermal and tensile properties. In these composite materials, the adhesion properties and the large number of functional groups that are presented in the CNC’s surface and the macromolecular chains of the polymer matrix are exploited to improve the interfacial interactions between the both phases, improving the final properties. Consequently, the high performances of these composite materials can be expected to have potential in packaging material applications.

Keywords: cellulose nanowhiskers, food packaging, polymer composites, red algae waste

Procedia PDF Downloads 228

Authors: Keith T. S. Tung, Frederick K. Ho, Rosa S. Wong, Camilla K. M. Lo, Wilfred H. S. Wong, C. B. Chow, Patrick Ip

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Objectives: Underage drinking is an important public health problem both locally and globally. Conventional prevention/intervention relies on unidirectional knowledge transfer such as mail leaflets or health talks which showed mixed results in changing the target behaviour. Previously, we conducted a school internet-based intervention which was found to be effective in reducing alcohol use among adolescents, yet the underlying mechanisms have not been properly investigated. This study, therefore, examined the mechanisms that explain how the intervention produced a change in alcohol drinking behaviours among Chinese adolescent as observed in our previous clustered randomised controlled trial (RCT) study. Methods: This is a cluster randomised controlled trial with parallel group design. Participating schools were randomised to the Internet intervention or the conventional health education group (control) with a 1:1 allocation ratio. Secondary 1–3 students of the participating schools were enrolled in this study. The Internet intervention was a web-based quiz game competition, in which participating students would answer 1,000 alcohol-related multiple-choice quiz questions. Conventional health education group received a promotional package on equivalent alcohol-related knowledge. The participants’ alcohol-related attitude, knowledge, and perceived behavioural control were self-reported before the intervention (baseline) and one month and three months after the intervention. Results: Our RCT results showed that participants in the Internet group were less likely to drink (risk ratio [RR] 0.79, p < 0.01) as well as in lesser amount (β -0.06, p < 0.05) compared to those in the control group at both post-intervention follow-ups. Within the intervention group, regression analyses showed that high quiz scorer had greater improvement in alcohol-related knowledge (β 0.28, p < 0.01) and attitude (β -0.26, p < 0.01) at 1 month after intervention, which in turn increased their perceived behavioural control against alcohol use (β 0.10 and -0.26, both p < 0.01). Attitude, compared to knowledge, was found to be a stronger contributor to the intervention effect on perceived behavioural control. Conclusions: Our internet-based intervention has demonstrated effectiveness in reducing the risk of underage drinking when compared with conventional health education. Our study results further showed an attitude to be a more important factor than knowledge in changing health-related behaviour. This has an important implication for future prevention/intervention on an underage drinking problem.

Keywords: adolescents, internet-based intervention, randomized controlled trial, underage drinking

Procedia PDF Downloads 164

Authors: Esra Yuce, Isil D. S. Yamaner, Murude Yazan

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Aims and objective: Antiresorptive agents including bisphosphonates and denosumab as strong suppressors of osteoclasts are the most commonly used antiresorptive medications for the treatment of osteoporosis which counteract the negative quantitative alteration of trabecular and cortical bone by inhibition of bone turnover. Oral bisphosphonate therapy for the treatment of osteopenia, osteoporosis or Paget's disease is associated with the low-grade risk of osteonecrosis of the jaw, while higher-grade risk is associated with receiving intravenous bisphosphonates therapy in the treatment of multiple myeloma and bone metastases. On the other hand, there has been a remarkable increase in incidences of antiresorptive related osteonecrosis of the jaw (ARONJ) in oral bisphosphonate users. This clinical presentation will evaluate the healing outcomes via piezoelectric bone surgery under the irrigation of PVP-I solution irrigation in patients received bisphosphonate therapy. Material-Method: The study involved 8 female and 5 male patients that have been treated for ARONJ. Among 13 necrotic sites, 9 were in the mandible and 4 were in the maxilla. All of these 13 patients treated with surgical debridement via piezoelectric bone surgery under irrigation by solution with 3% PVP-I concentration in combination with long-term antibiotic therapy and 5 also underwent removal of mobile segments of bony sequestrum. All removable prosthesis in 8 patients were relined with soft liners during the healing periods in order to eliminate chronic minor traumas. Results: All patients were on oral bisphosphonate therapy for at least 2 years and 5 of which had received intravenous bisphosphonates up to 1 year before therapy with oral bisphosphonates was started. According to the AAOMS staging system, four cases were stage II, eight cases were stage I, and one case was stage III. The majority of lesions were identified at sites of dental prostheses (38%) and dental extractions (62%). All patients diagnosed with ARONJ stage I had used unadjusted removable prostheses. No recurrence of the symptoms was observed during the present follow-up (9–37 months). Conclusion: Despite their confirmed effectiveness, the prevention and treatment of osteonecrosis of the jaw secondary to oral bisphosphonate therapy remain major medical challenges. Treatment with piezoelectric bone surgery with irrigation of povidone-iodine solution was effective for management of bisphosphonate-related osteonecrosis of the jaw. Taking precautions for patients treated with oral bisphosphonates, especially also denture users, may allow for a reduction in the rate of developing osteonecrosis of the maxillofacial region.

Keywords: antiresorptive drug related osteonecrosis, bisphosphonate therapy, piezoelectric bone surgery, povidone iodine

Procedia PDF Downloads 267