Search results for: total fertility rate (TFR)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15935

Search results for: total fertility rate (TFR)

2105 Inhibitory Action of Fatty Acid Salts against Cladosporium cladosporioides and Dermatophagoides farinae

Authors: Yui Okuno, Mariko Era, Takayoshi Kawahara, Takahide Kanyama, Hiroshi Morita

Abstract:

Introduction: Fungus and mite are known as allergens that cause an allergic disease for example asthma bronchiale and allergic rhinitis. Cladosporium cladosporioides is one of the most often detected fungi in the indoor environment and causes pollution and deterioration. Dermatophagoides farinae is major mite allergens indoors. Therefore, the creation of antifungal agents with high safety and the antifungal effect is required. Fatty acid salts are known that have antibacterial activities. This report describes the effects of fatty acid salts against Cladosporium cladosporioides NBRC 30314 and Dermatophagoides farinae. Methods: Potassium salts of 9 fatty acids (C4:0, C6:0, C8:0, C10:0, C12:0, C14:0, C18:1, C18:2, C18:3) were prepared by mixing the fatty acid with the appropriate amount of KOH solution to a concentration of 175 mM and pH 10.5. The antifungal method, the spore suspension (3.0×104 spores/mL) was mixed with a sample of fatty acid potassium (final concentration of 175 mM). Samples were counted at 0, 10, 60, 180 min by plating (100 µL) on PDA. Fungal colonies were counted after incubation for 3 days at 30 °C. The MIC (minimum inhibitory concentration) against the fungi was determined by the two-fold dilution method. Each fatty acid salts were inoculated separately with 400 µL of C. cladosporioides at 3.0 × 104 spores/mL. The mixtures were incubated at the respective temperature for each organism for 10 min. The tubes were then contacted with the fungi incubated at 30 °C for 7 days and examined for growth of spores on PDA. The acaricidal method, twenty D. farinae adult females were used and each adult was covered completely with 2 µL fatty acid potassium for 1 min. The adults were then dried with filter paper. The filter paper was folded and fixed by two clips and kept at 25 °C and 64 % RH. Mortalities were determained 48 h after treatment under the microscope. D. farina was considered to be dead if appendages did not move when prodded with a pin. Results and Conclusions: The results show that C8K, C10K, C12K, C14K was effective to decrease survival rate (4 log unit) of the fatty acids potassium incubated time for 10 min against C. cladosporioides. C18:3K was effective to decrease 4 log unit of the fatty acids potassium incubated time for 60 min. Especially, C12K was the highest antifungal activity and the MIC of C12K was 0.7 mM. On the other hand, the fatty acids potassium showed no acaricidal effects against D. farinae. The activity of D. farinae was not adversely affected after 48 hours. These results indicate that C12K has high antifungal activity against C. cladosporioides and suggest the fatty acid potassium will be used as an antifungal agent.

Keywords: fatty acid salts, antifungal effects, acaricidal effects, Cladosporium cladosporioides, Dermatophagoides farinae

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2104 Diverse High-Performing Teams: An Interview Study on the Balance of Demands and Resources

Authors: Alana E. Jansen

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With such a large proportion of organisations relying on the use of team-based structures, it is surprising that so few teams would be classified as high-performance teams. While the impact of team composition on performance has been researched frequently, there have been conflicting findings as to the effects, particularly when examined alongside other team factors. To broaden the theoretical perspectives on this topic and potentially explain some of the inconsistencies in research findings left open by other various models of team effectiveness and high-performing teams, the present study aims to use the Job-Demands-Resources model, typically applied to burnout and engagement, as a framework to examine how team composition factors (particularly diversity in team member characteristics) can facilitate or hamper team effectiveness. This study used a virtual interview design where participants were asked to both rate and describe their experiences, in one high-performing and one low-performing team, over several factors relating to demands, resources, team composition, and team effectiveness. A semi-structured interview protocol was developed, which combined the use of the Likert style and exploratory questions. A semi-targeted sampling approach was used to invite participants ranging in age, gender, and ethnic appearance (common surface-level diversity characteristics) and those from different specialties, roles, educational and industry backgrounds (deep-level diversity characteristics). While the final stages of data analyses are still underway, thematic analysis using a grounded theory approach was conducted concurrently with data collection to identify the point of thematic saturation, resulting in 35 interviews being completed. Analyses examine differences in perceptions of demands and resources as they relate to perceived team diversity. Preliminary results suggest that high-performing and low-performing teams differ in perceptions of the type and range of both demands and resources. The current research is likely to offer contributions to both theory and practice. The preliminary findings suggest there is a range of demands and resources which vary between high and low-performing teams, factors which may play an important role in team effectiveness research going forward. Findings may assist in explaining some of the more complex interactions between factors experienced in the team environment, making further progress towards understanding the intricacies of why only some teams achieve high-performance status.

Keywords: diversity, high-performing teams, job demands and resources, team effectiveness

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2103 Production, Characterisation and Assessment of Biomixture Fuels for Compression Ignition Engine Application

Authors: K. Masera, A. K. Hossain

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Hardly any neat biodiesel satisfies the European EN14214 standard for compression ignition engine application. To satisfy the EN14214 standard, various additives are doped into biodiesel; however, biodiesel additives might cause other problems such as increase in the particular emission and increased specific fuel consumption. In addition, the additives could be expensive. Considering the increasing level of greenhouse gas GHG emissions and fossil fuel depletion, it is forecasted that the use of biodiesel will be higher in the near future. Hence, the negative aspects of the biodiesel additives will likely to gain much more importance and need to be replaced with better solutions. This study aims to satisfy the European standard EN14214 by blending the biodiesels derived from sustainable feedstocks. Waste Cooking Oil (WCO) and Animal Fat Oil (AFO) are two sustainable feedstocks in the EU (including the UK) for producing biodiesels. In the first stage of the study, these oils were transesterified separately and neat biodiesels (W100 & A100) were produced. Secondly, the biodiesels were blended together in various ratios: 80% WCO biodiesel and 20% AFO biodiesel (W80A20), 60% WCO biodiesel and 40% AFO biodiesel (W60A40), 50% WCO biodiesel and 50% AFO biodiesel (W50A50), 30% WCO biodiesel and 70% AFO biodiesel (W30A70), 10% WCO biodiesel and 90% AFO biodiesel (W10A90). The prepared samples were analysed using Thermo Scientific Trace 1300 Gas Chromatograph and ISQ LT Mass Spectrometer (GC-MS). The GS-MS analysis gave Fatty Acid Methyl Ester (FAME) breakdowns of the fuel samples. It was found that total saturation degree of the samples was linearly increasing (from 15% for W100 to 54% for A100) as the percentage of the AFO biodiesel was increased. Furthermore, it was found that WCO biodiesel was mainly (82%) composed of polyunsaturated FAMEs. Cetane numbers, iodine numbers, calorific values, lower heating values and the densities (at 15 oC) of the samples were estimated by using the mass percentages data of the FAMEs. Besides, kinematic viscosities (at 40 °C and 20 °C), densities (at 15 °C), heating values and flash point temperatures of the biomixture samples were measured in the lab. It was found that estimated and measured characterisation results were comparable. The current study concluded that biomixture fuel samples W60A40 and W50A50 were perfectly satisfying the European EN 14214 norms without any need of additives. Investigation on engine performance, exhaust emission and combustion characteristics will be conducted to assess the full feasibility of the proposed biomixture fuels.

Keywords: biodiesel, blending, characterisation, CI engine

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2102 Effects of a Head Mounted Display Adaptation on Reaching Behaviour: Implications for a Therapeutic Approach in Unilateral Neglect

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

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

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

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2101 The Relationship Between Weight Gain, Cyclicality of Diabetologic Education and the Experienced Stress: A Study Involving Pregnant Women

Authors: Agnieszka Rolinska, Marta Makara-Studzinska

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Introduction: In recent years, there has been an intensive development of research into the physiological relationships between the experienced stress and obesity. Moreover, strong chronic stress leads to the disorganization of a person’s activeness on various levels of functioning, including the behavioral and cognitive sphere (also in one’s diet). Aim: The present work addresses the following research questions: Is there a relationship between an increase in stress related to the disease and the need for the cyclicality of diabetologic education in gestational diabetes? Are there any differences in terms of the experienced stress during the last three months of pregnancy in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Are there any differences in terms of stress coping styles in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Method: The study involved pregnant women with gestational diabetes (treated with diet, without insulin therapy) and in normal pregnancy – 206 women in total. The following psychometric tools were employed: Perceived Stress Scale (PSS; Cohen, Kamarck, Mermelstein), Coping Inventory for Stressful Situations (CISS; Endler, Parker) and authors’ own questionnaire. Gestational diabetes mellitus was diagnosed on the basis of the results of fasting oral glucose tolerance test (75 g OGTT). Body weight measurements were confirmed in a diagnostic interview, taking into account medical data. Regularities in weight gains in pregnancy were determined according to the recommendations of the Polish Gynecological Society and American norms determined by the Institute of Medicine (IOM). Conclusions: An increase in stress related to the disease varies in patients with differing requirements for the cyclical nature of diabetologic education (i.e. education which is systematically repeated). There are no differences in terms of recently experienced stress and stress coping styles between women with gestational diabetes and those in normal pregnancy. There is a relationship between weight gains in pregnancy and the stress experienced in life as well as stress coping styles – both in pregnancy complicated by diabetes and in physiological pregnancy. In the discussion of the obtained results, the authors refer to scientific reports from English-language magazines of international range.

Keywords: diabetologic education, gestational diabetes, stress, weight gain in pregnancy

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2100 Prescription of Maintenance Fluids in the Emergency Department

Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall

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The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.

Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma

Procedia PDF Downloads 322
2099 Assessment of Genetic Variability of Potato Genotypes for Proline Under Salt Stress Conditions

Authors: Elchin Hajiyev, Afet Memmedova Dadash, Sabina Hajiyeva, Aynur Karimova, Ramiz Aliyev

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Although potatoes have a wide distribution range, the yield potential of varieties varies greatly depending on the region. Our country is made up of agricultural regions with very different environmental characteristics.In this case, we cannot expect the introduced varieties to show the same adaptation to the different conditions of our country. For this reason, in our country, varieties with high general adaptability should be used, rather than varieties with special adaptability in certain areas. Soil salinization has become a global problem.Increased salinity has a serious impact on food security by reducing plant productivity. Plants have protective mechanisms of adaptation to salt stress, such as the synthesis of physiologically active substances, resistance to antioxidant stress and oxidation of membrane lipids. One of these substances is free proline. Our study revealed genetic variation in proline accumulation among samples exposed to stress factors.Changes in proline content under stress conditions were studied in 50 samples. There was wide variation across all treatments.The amount of proline varied between 7.2–37.7 μM/g under salinity conditions.The lowest rate was in the SF33 genotype (1.5 times more than the control (2.5 μM/g)).The highest level of proline under the influence of salt stress was in the SF45 genotype (7.25 times higher than the control (32.5 μM/g)). Our studies have found that the protective system reacts differently to the influence of stress factors. According to the results obtained on the amount of proline, adaptation mechanisms must be more actively activated to maintain metabolism and ensure viability in sensitive forms under the influence of stress factors. At high doses of the salt stressor, a tenfold increase in proline compared to the control indicates significant damage to the plant organism as a result of stress.To prevent damage to the body, the antioxidant system needs to quickly mobilize and work at full capacity in adverse conditions. An increase in the dose of the stress factor salt in our study caused a greater increase in the amount of free proline in plant tissues. Considering the functions of proline as an osmoprotector and antioxidant, it was found that increasing its amount is aimed at protecting the plant from the acute effects of stressors.

Keywords: genetic variability, potato, genotypes, proline, stress

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2098 Biodegradation of Phenazine-1-Carboxylic Acid by Rhodanobacter sp. PCA2 Proceeds via Decarboxylation and Cleavage of Nitrogen-Containing Ring

Authors: Miaomiao Zhang, Sabrina Beckmann, Haluk Ertan, Rocky Chau, Mike Manefield

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Phenazines are a large class of nitrogen-containing aromatic heterocyclic compounds, which are almost exclusively produced by bacteria from diverse genera including Pseudomonas and Streptomyces. Phenazine-1-carboxylic acid (PCA) as one of 'core' phenazines are converted from chorismic acid before modified to other phenazine derivatives in different cells. Phenazines have attracted enormous interests because of their multiple roles on biocontrol, bacterial interaction, biofilm formation and fitness of their producers. However, in spite of ecological importance, degradation as a part of phenazines’ fate only have extremely limited attention now. Here, to isolate PCA-degrading bacteria, 200 mg L-1 PCA was supplied as sole carbon, nitrogen and energy source in minimal mineral medium. Quantitative PCR and Reverse-transcript PCR were employed to study abundance and activity of functional gene MFORT 16269 in PCA degradation, respectively. Intermediates and products of PCA degradation were identified with LC-MS/MS. After enrichment and isolation, a PCA-degrading strain was selected from soil and was designated as Rhodanobacter sp. PCA2 based on full 16S rRNA sequencing. As determined by HPLC, strain PCA2 consumed 200 mg L-1 (836 µM) PCA at a rate of 17.4 µM h-1, accompanying with significant cells yield from 1.92 × 105 to 3.11 × 106 cells per mL. Strain PCA2 was capable of degrading other phenazines as well, including phenazine (4.27 µM h-1), pyocyanin (2.72 µM h-1), neutral red (1.30 µM h-1) and 1-hydroxyphenazine (0.55 µM h-1). Moreover, during the incubation, transcript copies of MFORT 16269 gene increased significantly from 2.13 × 106 to 8.82 × 107 copies mL-1, which was 2.77 times faster than that of the corresponding gene copy number (2.20 × 106 to 3.32 × 107 copies mL-1), indicating that MFORT 16269 gene was activated and played roles on PCA degradation. As analyzed by LC-MS/MS, decarboxylation from the ring structure was determined as the first step of PCA degradation, followed by cleavage of nitrogen-containing ring by dioxygenase which catalyzed phenazine to nitrosobenzene. Subsequently, phenylhydroxylamine was detected after incubation for two days and was then transferred to aniline and catechol. Additionally, genomic and proteomic analyses were also carried out for strain PCA2. Overall, the findings presented here showed that a newly isolated strain Rhodanobacter sp. PCA2 was capable of degrading phenazines through decarboxylation and cleavage of nitrogen-containing ring, during which MFORT 16269 gene was activated and played important roles.

Keywords: decarboxylation, MFORT16269 gene, phenazine-1-carboxylic acid degradation, Rhodanobacter sp. PCA2

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2097 Congenital Malformations in Neonate Dogs in the Sao Paulo State University Veterinary Hospital, Botucatu, Sao Paulo, Brazil

Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

Congenital malformations are organ defects due to genetic or teratogenic causes, which can lead to high mortality in dog litters. This study assessed and described the congenital malformations in newborn dogs. The study included litters attend in the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil. One hundred seventy-eight litters and 803 newborns were evaluated. The occurrence of litters with malformations was 24.7%, and of newborns was 6.7%. Twenty-seven different malformations were registered: anasarca, anal atresia, cleft lip, cleft palate, duplicated right ribcage, equinovarus, exencephaly, gastroschisis, hydrocephaly, lissencephaly, macroglossia, microphthalmia, mitral valve dysplasia, omphalocele, eyelid agenesis, persistent urachus, polydactyly, pulmonary hypoplasia, pulmonary valve stenosis, rectovaginal fistula, agenesis of abdominal muscles, rib hypoplasia, scoliosis, segmental aplasia of the intestines, tricuspid valve dysplasia, unilateral kidney agenesis, and vaginal atresia. 68.7% of newborns died as a result of malformations. The pure breeds with the highest chances of manifesting malformations in contrast with mixed breeds were French Bulldog, Pug, English Bulldog, Rottweiler, German Spitz, Pinscher, Pitbull, Yorkshire Terrier, and Shih-Tzu. Significant values (P<0.05) occurred in races French Bulldogs and Pugs. The causes of congenital disabilities are possibly related to hereditary genetic factors considering that the highest incidence of malformations was observed among purebreds. There as one case of exposure to a teratogenic agent, but no other mothers were exposed to such agents during pregnancy. Two cases of consanguineal breeding between siblings were reported. The mortality rate was high. Genetic breeding programs for reproduction, avoiding consanguineous mating, care in choosing parents, and avoiding maternal exposure to teratogenic agents are of utmost importance in reducing dog malformations and consequent mortality.

Keywords: congenital defects, teratogenesis, canine neonatology, newborn puppy

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2096 Effect of Human Resources Accounting on Financial Performance of Banks in Nigeria

Authors: Oti Ibiam, Alexanda O. Kalu

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Human Resource Accounting is the process of identifying and measuring data about human resources and communicating this information to interested parties in order to meaningful investment decisions. In recent time, firms focus has shifted to human resource accounting so as to ensure efficiency and effectiveness in their operations. This study focused on the effect of human resource accounting on the financial performance of Banks in Nigerian. The problem that led to the study revolves around the current trend whereby Nigeria banks do not efficiently account for the input of human resource in their annual statement, thereby instead of capitalizing human resources in their statement of financial position; they expend it in their income statement thereby reducing their profit after tax. The broad objective of this study is to determine the extent to which human resource accounting affects the financial performance and value of Nigerian Banks. This study is therefore considered significant because, there are still universally, grey areas to be sorted out on the subject matter of human resources accounting. In the bid to achieve the study objectives, the researcher gathered data from sixteen commercial banks. Data were collected from both primary and secondary sources using an ex-post facto research design. The data collected were then tabulated and analyzed using the multiple regression analysis. The result of hypothesis one revealed that there is a significant relationship between Capitalized Human Resource Cost and post capitalization Profit before tax of banks in Nigeria. The finding of hypothesis two revealed that the association between Capitalized Human Resource Cost and post capitalization Net worth of banks in Nigeria is significant. The finding in Hypothesis three reveals that there is a significant difference between pre and post capitalization profit before tax of banks in Nigeria. The study concludes that human resources accounting positively influenced financial performance of banks in Nigeria within the period under study. It is recommended that standards should be set for human resources identification and measurement in the banking sector and also the management of commercial banks in Nigeria should have a proper appreciation of human resource accounting. This will enable managers to take right decision regarding investment in human resource. Also, the study recommends that policies on enhancing the post capitalization profit before tax of banks in Nigeria should pay great attention to capitalized human resources cost, net worth and total asset as the variables significantly influenced post capitalization profit before tax of the studied banks in Nigeria. The limitation of the study centers on the limited number of years and companies that was adopted for the study.

Keywords: capitalization, human resources cost, profit before tax, net worth

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2095 An Evaluation of Medical Waste in Health Facilities through Data Envelopment Analysis (DEA) Method: Turkey-Amasya Public Hospitals Union Model

Authors: Murat Iskender Aktaş, Sadi Ergin, Rasime Acar Aktaş

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In the light of fast-paced changes and developments in the health sector, the Ministry of Health started a new structuring with decree law numbered 663 within the scope of the Project of Transformation in Health. Accordingly, hospitals should ensure patient satisfaction through more efficient, more effective use of resources and sustainable finance by placing patients in the centre and should operate to increase efficiency to its maximum level while doing these. Within this study, in order to find out how efficient the hospitals were in terms of medical waste management between the years 2011-2014, the data from six hospitals of Amasya Public Hospitals Union were evaluated separately through Data Envelopment Analysis (DEA) method. First of all, input variables were determined. Input variables were the number of patients admitted to polyclinics, the number of inpatients in clinics, the number of patients who were operated and the number of patients who applied to the laboratory. Output variable was the cost of medical wastes in Turkish liras. Each hospital’s total medical waste level before and after public hospitals union; the amounts of average medical waste per patient admitted to polyclinics, per inpatient in clinics, per patient admitted to laboratory and per operated patient were compared within each group. In addition, average medical waste levels and costs were compared for Turkey in general and Europe in general. Paired samples t-test was used to find out whether the changes (increase-decrease) after public hospitals union were statistically significant. The health facilities that were unsuccessful in terms of medical waste management before and after public hospital union and the factors that caused this failure were determined. Based on the results, for each health facility that was ineffective in terms of medical waste management, the level of improvement required for each input was determined. The results of the study showed that there was an improvement in medical waste management applications after the health facilities became a member of public hospitals union; their medical waste levels were lower than the average of Turkey and Europe while the averages of cost of disposal were the highest.

Keywords: medical waste management, cost of medical waste, public hospitals, data envelopment analysis

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2094 Dietary Patterns and Adherence to the Mediterranean Diet among Breast Cancer Female Patients in Lebanon: A Cross-Sectional Study

Authors: Yasmine Aridi, Lara Nasreddine, Maya Khalil, Arafat Tfayli, Anas Mugharbel, Farah Naja

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Breast cancer is the most commonly diagnosed cancer site among women worldwide and the second most common cause of cancer mortality. Breast cancer rates differ vastly between geographical areas, countries, and within the same country. In Lebanon, the proportion of breast cancer to all other sites of tumor is 38.2%; these rates are still lower than those observed worldwide, but remain the highest among Arab countries. Studies and evidence based reviews show a strong association between breast cancer development and prognosis and dietary habits, specifically the Mediterranean diet (MD). As such, the aim of this study is to examine dietary patterns and adherence to the MD among a sample of 182 breast cancer female patients in Beirut, Lebanon. Subjects were recruited from two major hospitals; a private medical center and a public hospital. All subjects were administered two questionnaires: socio- demographics and Mediterranean diet adherence. Five Mediterranean scores were calculated: MS, MSDPS, PMDI, PREDIMED and DDS. The mean age of the participants was 53.78 years. The overall adherence to the Mediterranean diet (MD) was low since the sample means of 3 out of the 5 calculated scores were less than the scores’ medians. Given that 4 out of the 5 Mediterranean scores significantly varied between the recruitment sites, women in the private medical center were found to adhere more to the MD. Our results also show that the majority of the sample population’s intakes are exceeding the recommendations for total and saturated fat, while meeting the requirements for fiber, EPA, DHA and Linolenic Acid. Participants in the private medical center were consuming significantly more calories, carbohydrates, fiber, sugar, Lycopene, Calcium, Iron and Folate and less fat. After conducting multivariate linear regression analyses, the following significant results were observed: positive associations between MD (CPMDI, PREDIMED) and monthly income & current state of health, while negative associations between MD (MSDPS, PREDIMED) and age & employment status. Our findings indicated a low overall adherence to the MD and identified factors associated with it; which suggests a need to address dietary habits among BC patients in Lebanon, specifically encouraging them to adhere to their traditional Mediterranean diet.

Keywords: Adherence, Breast cancer, Dietary patterns, Mediterranean diet, Nutrition

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2093 Performance of HVOF Sprayed Ni-20CR and Cr3C2-NiCr Coatings on Fe-Based Superalloy in an Actual Industrial Environment of a Coal Fired Boiler

Authors: Tejinder Singh Sidhu

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Hot corrosion has been recognized as a severe problem in steam-powered electricity generation plants and industrial waste incinerators as it consumes the material at an unpredictably rapid rate. Consequently, the load-carrying ability of the components reduces quickly, eventually leading to catastrophic failure. The inability to either totally prevent hot corrosion or at least detect it at an early stage has resulted in several accidents, leading to loss of life and/or destruction of infrastructures. A number of countermeasures are currently in use or under investigation to combat hot corrosion, such as using inhibitors, controlling the process parameters, designing a suitable industrial alloy, and depositing protective coatings. However, the protection system to be selected for a particular application must be practical, reliable, and economically viable. Due to the continuously rising cost of the materials as well as increased material requirements, the coating techniques have been given much more importance in recent times. Coatings can add value to products up to 10 times the cost of the coating. Among the different coating techniques, thermal spraying has grown into a well-accepted industrial technology for applying overlay coatings onto the surfaces of engineering components to allow them to function under extreme conditions of wear, erosion-corrosion, high-temperature oxidation, and hot corrosion. In this study, the hot corrosion performances of Ni-20Cr and Cr₃C₂-NiCr coatings developed by High Velocity Oxy-Fuel (HVOF) process have been studied. The coatings were developed on a Fe-based superalloy, and experiments were performed in an actual industrial environment of a coal-fired boiler. The cyclic study was carried out around the platen superheater zone where the temperature was around 1000°C. The study was conducted for 10 cycles, and one cycle was consisting of 100 hours of heating followed by 1 hour of cooling at ambient temperature. Both the coatings deposited on Fe-based superalloy imparted better hot corrosion resistance than the uncoated one. The Ni-20Cr coated superalloy performed better than the Cr₃C₂-NiCr coated in the actual working conditions of the coal fired boiler. It is found that the formation of chromium oxide at the boundaries of Ni-rich splats of the coating blocks the inward permeation of oxygen and other corrosive species to the substrate.

Keywords: hot corrosion, coating, HVOF, oxidation

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2092 Effect of Amount of Crude Fiber in Grass or Silage to the Digestibility of Organic Matter in Suckler Cow Feeding Systems

Authors: Scholz Heiko, Kuhne Petra, Heckenberger Gerd

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Problems during the calving period (December to May) often result in a high body condition score (BCS) at this time. At the end of the grazing period (frequently after early weaning), however, an increase of BCS can often be observed under German conditions. In the last eight weeks before calving, the body condition should be reduced or at least not increased. Rations with a higher amount of crude fiber can be used (rations with straw or late mowed grass silage). Fermentative digestion of fiber is slow and incomplete; that’s why the fermentative process in the rumen can be reduced over a long feeding time. Viewed in this context, feed intake of suckler cows (8 weeks before calving) in different rations and fermentation in the rumen should be checked by taking rumen fluid. Eight suckler cows (Charolais) were feeding a Total Mixed Ration (TMR) in the last eight weeks before calving and grass silage after calving. By the addition of straw (30 % [TMR1] vs. 60 % [TMR2] of dry matter) was varied the amount of crude fiber in the TMR (grass silage, straw, mineral) before calving. After calving of the cow's grass, silage [GS] was fed ad libitum, and the last measurement of rumen fluid took place on the pasture [PS]. Rumen fluid, plasma, body weight, and backfat thickness were collected. Rumen fluid pH was assessed using an electronic pH meter. Volatile fatty acids (VFA), sedimentation, methylene-blue and amount of infusorians were measured. From these 4 parameters, an “index of rumen fermentation” [IRF] in the rumen was formed. Fixed effects of treatment (TMR1, TMR2, GS and PS) and a number of lactations (3-7 lactations) were analyzed by ANOVA using SPSS Version 25.0 (significant by p ≤ 5 %). Rumen fluid pH was significant influenced by variants (TMR 1 by 6.6; TMR 2 by 6.9; GS by 6.6 and PS by 6.9) but was not affected by other effects. The IRF showed disturbed fermentation in the rumen by feeding the TMR 1+2 with a high amount of crude fiber (Score: > 10.0 points) and a very good environment for fermentation during grazing the pasture (Score: 6.9 points). Furthermore, significant differences were found for VFA, methylene blue and the number of infusorians. The use of rations with the high amount of crude fiber from weaning to calving may cause deviations from undisturbed fermentation in the rumen and adversely affect the utilization of the feed in the rumen.

Keywords: suckler cow, feeding systems, crude fiber, digestibilty of organic matter

Procedia PDF Downloads 146
2091 An AHP Study on The Migrant and Refugee Employees Occupational Health and Safety Issues in Turkey

Authors: Cengiz Akyildiz, Ismail Ekmekci

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In the past 15 years, many people have sought refuge and emigrated to developed countries due to the civil war in Syria, terrorism and turmoil in Iraq, Iran and Afghanistan, hunger problems in Africa and the purpose of work. Many of these people came to Turkey. By the end of the 2019, in Turkey, regular and irregular migrants, asylum seekers and foreigners under international protection are about 6 million people. The majority of these people are Syrians. Approximately 2 800 000 immigrants and refugees are in the workforce. Migrant workers in our country constitute the largest proportion among all countries in the world according to the local labor force. 2.5 million of these employees, with a high rate of about 90%, work informally and do not have legal records and valid employment contracts as a workforce; They cannot benefit from Occupational Health and Safety (OHS) services. Migrant workers generally receive less wages than local workers, working longer hours and worse conditions; they are often subjected to human rights violations, harassment, human trafficking and violence. Migrant workers face problems such as OHS practices, environmental and occupational exposures, language / cultural barriers, access to health services, and lack of documentation. Therefore, the OHS problems of these employees are becoming an increasingly problematic area. However, there is not enough research, analysis and academic studies in this field. The order of importance should be known for the radical solution of the problems, because of the problems with high severity are also at high risk. In this study, for the first time, a Search Conference was held with the participation of 45 stakeholders to reveal the OHS problems of regular and irregular migrant workers in our country. The problems arising from this workshop were compared with the problems in the literature and the problems in this field were determined and weighted for our country. Later, to determine the significance levels of these problems, AHP study, which is a Multi Criteria Decision Making Method in which 15 experts participated, was conducted and the significance levels of these problems were determined. When the data obtained are evaluated, it has been seen that the OSH risks of migrant workers arise from 58% laws and government policies, 29% from employers, 13% from personal faults of employees. An academic study has been carried out for the first time in this field regarding the OHS problems of migrant workers, and an academic study has been created to guide which of the problems should be prioritized.

Keywords: environmental conditions, migrant workers, OHS issues, workplace conditions

Procedia PDF Downloads 151
2090 The Role of Artificial Intelligence in Creating Personalized Health Content for Elderly People: A Systematic Review Study

Authors: Mahnaz Khalafehnilsaz, Rozina Rahnama

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Introduction: The elderly population is growing rapidly, and with this growth comes an increased demand for healthcare services. Artificial intelligence (AI) has the potential to revolutionize the delivery of healthcare services to the elderly population. In this study, the various ways in which AI is used to create health content for elderly people and its transformative impact on the healthcare industry will be explored. Method: A systematic review of the literature was conducted to identify studies that have investigated the role of AI in creating health content specifically for elderly people. Several databases, including PubMed, Scopus, and Web of Science, were searched for relevant articles published between 2000 and 2022. The search strategy employed a combination of keywords related to AI, personalized health content, and the elderly. Studies that utilized AI to create health content for elderly individuals were included, while those that did not meet the inclusion criteria were excluded. A total of 20 articles that met the inclusion criteria were identified. Finding: The findings of this review highlight the diverse applications of AI in creating health content for elderly people. One significant application is the use of natural language processing (NLP), which involves the creation of chatbots and virtual assistants capable of providing personalized health information and advice to elderly patients. AI is also utilized in the field of medical imaging, where algorithms analyze medical images such as X-rays, CT scans, and MRIs to detect diseases and abnormalities. Additionally, AI enables the development of personalized health content for elderly patients by analyzing large amounts of patient data to identify patterns and trends that can inform healthcare providers in developing tailored treatment plans. Conclusion: AI is transforming the healthcare industry by providing a wide range of applications that can improve patient outcomes and reduce healthcare costs. From creating chatbots and virtual assistants to analyzing medical images and developing personalized treatment plans, AI is revolutionizing the way healthcare is delivered to elderly patients. Continued investment in this field is essential to ensure that elderly patients receive the best possible care.

Keywords: artificial intelligence, health content, older adult, healthcare

Procedia PDF Downloads 69
2089 Seasonal Variations, Environmental Parameters, and Standing Crop Assessment of Benthic Foraminifera in Western Bahrain, Arabian Gulf

Authors: Muhammad Arslan, Michael A. Kaminski, Bassam S. Tawabini, Fabrizio Frontalini

Abstract:

We conducted a survey of living benthic foraminifera in a relatively unpolluted site of Bahrain in the Arabian Gulf, with the aim of determining the seasonal variability in their populations, as well as various environmental parameters that affect their distribution. The maximum standing crop was observed during winter, with highest population of rotaliids, followed by a peak in miliolids. The highest population is attributed to an increasing number juveniles observed along the depth transect. A strong correlation between sediment grain size and the foraminiferal population indicates that juveniles were most abundant on coarser sandy substrate and less abundant on fine substrate. In spring, the total living population decreased, and lowest values are observed in the summer. The population started to increase again in the autumn with highest juveniles/adult ratios. Moreover, results of relative abundance and species consistency show that Ammonia is found to be consistent from the shallowest to the deepest station, whereas miliolids start appearing in the deeper stations. The average numbers of Peneroplis and Elphidium also increases along the depth transect. Environmental characterization reveals that although the site is subjected to eutrophication caused by nitrates and sulfates, pollution caused by hydrocarbons and heavy metals is not significant. The assessment of 63 heavy metals showed that none of the metals had concentrations that exceed internationally accepted norms [the devised level of Effect Range-Low], with the exception of strontium. The lack of a significant environmental effect of heavy metals is confirmed by a Foraminiferal Deformities Index value of less than 2%. Likewise, no hydrocarbon contamination was detected in the water or sediment samples. Lastly, observations of cytoplasmic streaming and pseudopodial activity in Petri dishes suggest that the foraminiferal population is not stressed. We conclude that the site in Bahrain is not yet adversely affected by human development, and therefore can provide baseline information for future comparison and assessment of foraminiferal assemblages in contaminated zones of the Arabian Gulf.

Keywords: Arabian Gulf, benthic foraminifera, standing crop, Western Bahrain

Procedia PDF Downloads 643
2088 A Critical Examination of the Iranian National Legal Regulation of the Ecosystem of Lake Urmia

Authors: Siavash Ostovar

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The Iranian national Law on the Ramsar Convention (officially known as the Convention of International Wetlands and Aquatic Birds' Habitat Wetlands) was approved by the Senate and became a law in 1974 after the ratification of the National Council. There are other national laws with the aim of preservation of environment in the country. However, Lake Urmia which is declared a wetland of international importance by the Ramsar Convention in 1971 and designated a UNESCO Biosphere Reserve in 1976 is now at the brink of total disappearance due mainly to the climate change, water mismanagement, dam construction, and agricultural deficiencies. Lake Urmia is located in the north western corner of Iran. It is the third largest salt water lake in the world and the largest lake in the Middle East. Locally, it is designated as a National Park. It is, indeed, a unique lake both nationally and internationally. This study investigated how effective the national legal regulation of the ecosystem of Lake Urmia is in Iran. To do so, the Iranian national laws as Enforcement of Ramsar Convention in the country including three nationally established laws of (i) Five sets of laws for the programme of economic, social and cultural development of Islamic Republic of Iran, (ii) The Iranian Penal Code, (iii) law of conservation, restoration and management of the country were investigated. Using black letter law methods, it was revealed that (i) regarding the national five sets of laws; the benchmark to force the implementation of the legislations and policies is not set clearly. In other words, there is no clear guarantee to enforce these legislations and policies at the time of deviation and violation; (ii) regarding the Penal Code, there is lack of determining the environmental crimes, determining appropriate penalties for the environmental crimes, implementing those penalties appropriately, monitoring and training programmes precisely; (iii) regarding the law of conservation, restoration and management, implementation of this regulation is adjourned to preparation, announcement and approval of several categories of enactments and guidelines. In fact, this study used a national environmental catastrophe caused by drying up of Lake Urmia as an excuse to direct the attention to the weaknesses of the existing national rules and regulations. Finally, as we all depend on the natural world for our survival, this study recommended further research on every environmental issue including the Lake Urmia.

Keywords: conservation, environmental law, Lake Urmia, national laws, Ramsar Convention, water management, wetlands

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2087 Medical Student's Responses to Emotional Content in Doctor-Patient Communication: To Explore Differences in Communication Training of Medical Students and Its Impact on Doctor-Patient Communication

Authors: Stephanie Yun Yu Law

Abstract:

Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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2086 Review of the Safety of Discharge on the First Postoperative Day Following Carotid Surgery: A Retrospective Analysis

Authors: John Yahng, Hansraj Riteesh Bookun

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Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

Procedia PDF Downloads 166
2085 Preparation and CO2 Permeation Properties of Carbonate-Ceramic Dual-Phase Membranes

Authors: H. Ishii, S. Araki, H. Yamamoto

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In recent years, the carbon dioxide (CO2) separation technology is required in terms of the reduction of emission of global warming gases and the efficient use of fossil fuels. Since the emission amount of CO2 gas occupies the large part of greenhouse effect gases, it is considered that CO2 have the most influence on global warming. Therefore, we need to establish the CO2 separation technologies with high efficiency at low cost. In this study, we focused on the membrane separation compared with conventional separation technique such as distillation or cryogenic separation. In this study, we prepared carbonate-ceramic dual-phase membranes to separate CO2 at high temperature. As porous ceramic substrate, the (Pr0.9La0.1)2(Ni0.74Cu0.21Ga0.05)O4+σ, La0.6Sr0.4Ti0.3 Fe0.7O3 and Ca0.8Sr0.2Ti0.7Fe0.3O3-α (PLNCG, LSTF and CSTF) were examined. PLNCG, LSTF and CSTF have the perovskite structure. The perovskite structure has high stability and shows ion-conducting doped by another metal ion. PLNCG, LSTF and CSTF have perovskite structure and has high stability and high oxygen ion diffusivity. PLNCG, LSTF and CSTF powders were prepared by a solid-phase process using the appropriate carbonates or oxides. To prepare porous substrates, these powders mixed with carbon black (20 wt%) and a few drops of polyvinyl alcohol (5 wt%) aqueous solution. The powder mixture were packed into stainless steel mold (13 mm) and uniaxially pressed into disk shape under a pressure of 20 MPa for 1 minute. PLNCG, LSTF and CSTF disks were calcined in air for 6 h at 1473, 1573 and 1473 K, respectively. The carbonate mixture (Li2CO3/Na2CO3/K2CO3: 42.5/32.5/25 in mole percent ratio) was placed inside a crucible and heated to 793 K. Porous substrates were infiltrated with the molten carbonate mixture at 793 K. Crystalline structures of the fresh membranes and after the infiltration with the molten carbonate mixtures were determined by X-ray diffraction (XRD) measurement. We confirmed the crystal structure of PLNCG and CSTF slightly changed after infiltration with the molten carbonate mixture. CO2 permeation experiments with PLNCG-carbonate, LSTF-carbonate and CSTF-carbonate membranes were carried out at 773-1173 K. The gas mixture of CO2 (20 mol%) and He was introduced at the flow rate of 50 ml/min to one side of membrane. The permeated CO2 was swept by N2 (50 ml/min). We confirmed the effect of ceramic materials and temperature on the CO2 permeation at high temperature.

Keywords: membrane, perovskite structure, dual-phase, carbonate

Procedia PDF Downloads 367
2084 Detection and Identification of Antibiotic Resistant Bacteria Using Infra-Red-Microscopy and Advanced Multivariate Analysis

Authors: Uraib Sharaha, Ahmad Salman, Eladio Rodriguez-Diaz, Elad Shufan, Klaris Riesenberg, Irving J. Bigio, Mahmoud Huleihel

Abstract:

Antimicrobial drugs have an important role in controlling illness associated with infectious diseases in animals and humans. However, the increasing resistance of bacteria to a broad spectrum of commonly used antibiotics has become a global health-care problem. Rapid determination of antimicrobial susceptibility of a clinical isolate is often crucial for the optimal antimicrobial therapy of infected patients and in many cases can save lives. The conventional methods for susceptibility testing like disk diffusion are time-consuming and other method including E-test, genotyping are relatively expensive. Fourier transform infrared (FTIR) microscopy is rapid, safe, and low cost method that was widely and successfully used in different studies for the identification of various biological samples including bacteria. The new modern infrared (IR) spectrometers with high spectral resolution enable measuring unprecedented biochemical information from cells at the molecular level. Moreover, the development of new bioinformatics analyses combined with IR spectroscopy becomes a powerful technique, which enables the detection of structural changes associated with resistivity. The main goal of this study is to evaluate the potential of the FTIR microscopy in tandem with machine learning algorithms for rapid and reliable identification of bacterial susceptibility to antibiotics in time span of few minutes. The bacterial samples, which were identified at the species level by MALDI-TOF and examined for their susceptibility by the routine assay (micro-diffusion discs), are obtained from the bacteriology laboratories in Soroka University Medical Center (SUMC). These samples were examined by FTIR microscopy and analyzed by advanced statistical methods. Our results, based on 550 E.coli samples, were promising and showed that by using infrared spectroscopic technique together with multivariate analysis, it is possible to classify the tested bacteria into sensitive and resistant with success rate higher than 85% for eight different antibiotics. Based on these preliminary results, it is worthwhile to continue developing the FTIR microscopy technique as a rapid and reliable method for identification antibiotic susceptibility.

Keywords: antibiotics, E. coli, FTIR, multivariate analysis, susceptibility

Procedia PDF Downloads 265
2083 Identifying Diabetic Retinopathy Complication by Predictive Techniques in Indian Type 2 Diabetes Mellitus Patients

Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

Abstract:

Predicting the risk of diabetic retinopathy (DR) in Indian type 2 diabetes patients is immensely necessary. India, being the second largest country after China in terms of a number of diabetic patients, to the best of our knowledge not a single risk score for complications has ever been investigated. Diabetic retinopathy is a serious complication and is the topmost reason for visual impairment across countries. Any type or form of DR has been taken as the event of interest, be it mild, back, grade I, II, III, and IV DR. A sample was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of DR. Cox proportional hazard regression is used to design risk scores for the prediction of retinopathy. Model calibration and discrimination are assessed from Hosmer Lemeshow and area under receiver operating characteristic curve (ROC). Overfitting and underfitting of the model are checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Optimal cut off point is chosen by Youden’s index. Five-year probability of DR is predicted by both survival function, and Markov chain two state model and the better technique is concluded. The risk scores developed can be applied by doctors and patients themselves for self evaluation. Furthermore, the five-year probabilities can be applied as well to forecast and maintain the condition of patients. This provides immense benefit in real application of DR prediction in T2DM.

Keywords: Cox proportional hazard regression, diabetic retinopathy, ROC curve, type 2 diabetes mellitus

Procedia PDF Downloads 186
2082 Influential Factors Impacting the Utilization of Pain Assessment Tools among Hospitalized Elderly Patients in Taiwan

Authors: Huei Jiun Chen, Hui Mei Huan

Abstract:

Introduction: Pain is an unpleasant experience for hospitalized patients that impacts both their physical and mental well-being. It is important to select appropriate pain assessment tools to ensure effective pain management. Therefore, it is suggested to use Verbal Rating Scale (VRS) instead for better assessment. The Wong-Baker FACES Pain Rating Scale(WBS) is a widely used pain assessment tool in Taiwan to help individuals communicate the intensity of their pain. However, in clinical practice, even when using various assessment tools to evaluate pain, Numeric Rating Scale-11 (NRS-11) is still commonly utilized to quantify the intensity of pain. The correlation between NRS and other pain assessment tools has not been extensively explored in Taiwan. Additionally, the influence of gender and education level on pain assessment among elderly individuals has not been extensively studied in Taiwan. The aim of this study is to investigate the correlation between pain assessment scales (NRS-11, VRS, WBS) in assessing pain intensity among elderly inpatients. The secondary objective of this study is to examine how gender and education level influence pain assessment among individuals, as well as to explore their preferences regarding pain assessment tools. Method: In this study, a questionnaire survey and purposive sampling were employed to recruit participants from a medical center located in central Taiwan. Participants were requested to assess their pain intensity in the past 24 hours using NRS-11, VRS, and WBS. Additionally, the study investigated their preferences for pain assessment tools. Result: A total of 252 participants were included in this study, with a mean age of 71.1 years (SD=6.2). Of these participants, 135 were male (53.6%), and 44.4% had a primary level or below education. Participants were asked to use NRS-11, VRS, and WBS to assess their current, maximum, and minimum pain intensity experienced in the past 24 hours. The findings indicated a significant correlation (p< .01) among all three pain assessment tools. No significant differences were observed in gender across the three pain assessment scales. For severe pain, there were significant differences in self-rated pain scales among the elderly participants with different education levels (F=3.08, p< .01; X²=17.25, X²=17.21, p< .01), but there were no significant differences observed for mild pain. Regarding preferences for pain assessment tools, 158 participants (62.7%) favored VRS, followed by WBS; gender and education level had no influence on their preferences. Conclusion: Most elderly participants prefer using VRS (Verbal Rating Scale) to self-reported their pain. The reason for this preference may be attributed to the verbal nature of VRS, as it is simple and easy to understand. Furthermore, it could be associated with the level of education among the elderly participants. The pain assessment using VRS demonstrated a significant correlation with NRS-11 and WBS, and gender was not found to have any influence on these assessment. Further research is needed to explore the effect of different education levels on self-reported pain intensity among elderly people in Taiwan.

Keywords: pain assessment, elderly, gender, education

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2081 The Levels of Neurosteroid 7β-Hydroxy-Epiandrosterone in Men and Pregnant Women

Authors: J. Vitku, L. Kolatorova, T. Chlupacova, J. Heracek, M. Hill, M. Duskova, L. Starka

Abstract:

Background: 7β-hydroxy-epiandrosterone (7β–OH-EpiA) is an endogenous steroid, that has been shown to exert neuroprotective and anti-inflammatory effects in vitro as well as in animal models. However, to the best of our knowledge no information is available about concentration of this androgen metabolite in human population. The aim of the study was to measure and compare levels of 7β–OH-EpiA in men and pregnant women in different biological fluids and evaluate the relationship between 7β–OH-EpiA in men and their sperm quality. Methods: First, a sensitive isotope dilution high performance liquid chromatography-mass spectrometry method for measurement of 7β–OH-EpiA in different biological fluids was developed. Validation of the method met the requirements of FDA guidelines. Afterwards 7β–OH-EpiA in plasma and seminal plasma of 191 men with different degree of infertility (healthy men, lightly infertile men, moderately infertile men, severely infertile men) was analysed. Furthermore, the levels of 7β–OH-EpiA in plasma of 34 pregnant women in 37th week of gestation and corresponding cord plasma that reflects steroid levels in the fetus were measured. Results: Concentrations of 7β–OH-EpiA in seminal plasma were significantly higher in severely infertile men in comparison with healthy men and lightly infertile men. The same trend was observed when blood plasma was evaluated. Furthermore, plasmatic 7β –OH-EpiA negatively correlated with concentration (-0.215; p < 0.01) and total count (-0.15; p < 0.05). Seminal 7β–OH-EpiA was negatively associated with motility (-0.26; p < 0.01), progressively motile sperms (-0.233; p < 0.01) and nonprogressively motile sperms (-0.188; p < 0.05). Plasmatic 7β –OH-EpiA levels in men were generally higher in comparison with pregnant women. Levels 7β–OH-EpiA were under the lower limit of quantification (LLOQ) in majority of samples of pregnant women and cord plasma. Only 4 plasma samples of pregnant women and 7 cord blood plasma samples were above LLOQ and where in range of units of pg/ml. Conclusion: Based on available information, this is the first study measuring 7β–OH-EpiA in human samples. 7β–OH-EpiA is associated with lower sperm quality and certainly it is worth to explore its role in this field thoroughly. Interestingly, levels of 7β–OH-EpiA in pregnant women were extremely low despite the fact that steroid levels including androgens are generally higher during pregnancy. Acknowledgements: This work was supported by the project MH CR 17-30528 A from the Czech Health Research Council, MH CZ - DRO (Institute of Endocrinology - EU, 00023761) and by the MEYS CR (OP RDE, Excellent research - ENDO.CZ).

Keywords: 7β-hydroxy-epiandrosterone, steroid, sperm quality, pregnancy

Procedia PDF Downloads 255
2080 Diabetes and Medical Plant's Treatment: Ethnobotanical Studies Carried out in Morocco

Authors: Jamila Fakchich, Mostafa Jamila Lazaar Elachouri, Lakhder Fakchich, Fatna Ouali, Abd Errazzak Belkacem

Abstract:

Diabetes is a chronic metabolic disease that has a significant impact on the health, quality of life, and life expectancy of patients as well as the health care system. By its nature diabetes, is a multisystem disease with wide-ranging complication that span nearly all region of the body. This epidemic problem, however, is not unique to the industrialized society, but has also hardly struck the developing countries. In Morocco, as developing country, there is an epidemic rise in diabetes, with ensuing concern about the management and control of this disease; it began a chronic burdensome disease of largely middle-aged and elderly people, with a long course and serious complications often resulting in high death-rate, the treatment of diabetes spent vast amount of resources including medicines, diets, physical training. Treatment of this disease is considered problematic due to the lack of effective and safe drugs capable of inducing sustained clinical, biochemical, and histological cure. In Moroccan society, the phytoremedies are some times the only affordable sources of healthcare, particularly for the people in remote areas. In this paper, we present a synthesis work obtained from the ethnobotanical data reported in different specialized journals. A Synthesis of four published ethnobotanical studies that have been carried out in different region of Morocco by different team seekers during the period from 1997 to 2015. Medicinal plants inventoried by different seekers in four Moroccan’s areas have been regrouped and codified, then, Factorial Analysis (FA) and Principal Components Analysis (PCA) are used to analyse the aggregated data from the four studies and plants are classified according to their frequency of use by population. Our work deals with an attempt to gather information on some traditional uses of medicinal plants from different regions of Morocco, also, it was designed to give a set of medicinal plants commonly used by Moroccan people in the treatment of diabetes; In this paper, we intended to provide a basic knowledge about plant species used by Moroccan society for treatment of diabetes. One of the most interesting aspects of this type of works is to assess the relative cultural importance of medicinal plants for specific illnesses and exploring its usefulness in the context of diabetes.

Keywords: Morocco, medicinal plants, ethnobotanical, diabetes, phytoremedies

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2079 How Technology Can Help Teachers in Reflective Practice

Authors: Ambika Perisamy, Asyriawati binte Mohd Hamzah

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The focus of this presentation is to discuss teacher professional development (TPD) through the use of technology. TPD is necessary to prepare teachers for future challenges they will face throughout their careers and to develop new skills and good teaching practices. We will also be discussing current issues in embracing technology in the field of early childhood education and the impact on the professional development of teachers. Participants will also learn to apply teaching and learning practices through the use of technology. One major objective of this presentation is to coherently fuse practical, technology and theoretical content. The process begins by concretizing a set of preconceived ideas which need to be joined with theoretical justifications found in the literature. Technology can make observations fairer and more reliable, easier to implement, and more preferable to teachers and principals. Technology will also help principals to improve classroom observations of teachers and ultimately improve teachers’ continuous professional development. Video technology allows the early childhood teachers to record and keep the recorded video for reflection at any time. This will also provide opportunities for her to share with her principals for professional dialogues and continuous professional development plans. A total of 10 early childhood teachers and 4 principals were involved in these efforts which identified and analyze the gaps in the quality of classroom observations and its co relation to developing teachers as reflective practitioners. The methodology used involves active exploration with video technology recordings, conversations, interviews and authentic teacher child interactions which forms the key thrust in improving teaching and learning practice. A qualitative analysis of photographs, videos, transcripts which illustrates teacher’s reflections and classroom observation checklists before and after the use of video technology were adopted. Arguably, although PD support can be magnanimously strong, if teachers could not connect or create meaning out of the opportunities made available to them, they may remain passive or uninvolved. Therefore, teachers must see the value of applying new ideas such as technology and approaches to practice while creating personal meaning out of professional development. These video recordings are transferable, can be shared and edited through social media, emails and common storage between teachers and principals. To conclude the importance of reflective practice among early childhood teachers and addressing the concerns raised before and after the use of video technology, teachers and principals shared the feasibility, practical and relevance use of video technology.

Keywords: early childhood education, reflective, improve teaching and learning, technology

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2078 Athlete Coping: Personality Dimensions of Recovery from Injury

Authors: Randall E. Osborne, Seth A. Doty

Abstract:

As participation in organized sports increases, so does the risk of sustaining an athletic injury. These unfortunate injuries result in missed time from practice and, inevitably, the field of competition. Recovery time plays a pivotal role in the overall rehabilitation of the athlete. With time and rehabilitation, an athlete’s physical injury can be properly treated. However, there seem to be few measures assessing psychological recovery from injury. Although an athlete has been cleared to return to play, there may still be lingering doubt about their injury. Overall, there is a vast difference between being physically cleared to play and being psychologically ready to return to play. Certain personality traits might serve as predictors of an individual’s rate of psychological recovery from an injury. The purpose of this research study is to explore the correlations between athletes’ personality and their recovery from an athletic injury, specifically, examining how locus of control has been utilized through other studies and can be beneficial to the current study. Additionally, this section will examine the link between hardiness and coping strategies. In the current study, mental toughness is being tested, but it is important to determine the link between these two concepts. Hardiness and coping strategies are closely related and can play a major role in an athlete’s mental toughness. It is important to examine competitive trait anxiety to illustrate perceived anxiety during athletic competition. The Big 5 and Social Support will also be examined in conjunction with recovery from athletic injury. Athletic injury is a devastating and common occurrence that can happen in any sport. Injured athletes often require resources and treatment to be able to return to the field of play. Athletes become more involved with physical and mental treatment as the length of recovery time increases. It is very reasonable to assume that personality traits would be predictive of athlete recovery from injury. The current study investigated the potential relationship between personality traits and recovery time; more specifically, the personality traits of locus of control, hardiness, social support, competitive trait anxiety, and the “Big 5” personality traits. Results indicated that athletes with a higher internal locus of control tend to report being physically ready to return to play and “ready” to return to play faster than those with an external locus of control. Additionally, Openness to Experience (among the Big 5 personality dimensions) was also related to the speed of return to play.

Keywords: athlete, injury, personality, readiness to play, recovery

Procedia PDF Downloads 148
2077 Predicting Wealth Status of Households Using Ensemble Machine Learning Algorithms

Authors: Habtamu Ayenew Asegie

Abstract:

Wealth, as opposed to income or consumption, implies a more stable and permanent status. Due to natural and human-made difficulties, households' economies will be diminished, and their well-being will fall into trouble. Hence, governments and humanitarian agencies offer considerable resources for poverty and malnutrition reduction efforts. One key factor in the effectiveness of such efforts is the accuracy with which low-income or poor populations can be identified. As a result, this study aims to predict a household’s wealth status using ensemble Machine learning (ML) algorithms. In this study, design science research methodology (DSRM) is employed, and four ML algorithms, Random Forest (RF), Adaptive Boosting (AdaBoost), Light Gradient Boosted Machine (LightGBM), and Extreme Gradient Boosting (XGBoost), have been used to train models. The Ethiopian Demographic and Health Survey (EDHS) dataset is accessed for this purpose from the Central Statistical Agency (CSA)'s database. Various data pre-processing techniques were employed, and the model training has been conducted using the scikit learn Python library functions. Model evaluation is executed using various metrics like Accuracy, Precision, Recall, F1-score, area under curve-the receiver operating characteristics (AUC-ROC), and subjective evaluations of domain experts. An optimal subset of hyper-parameters for the algorithms was selected through the grid search function for the best prediction. The RF model has performed better than the rest of the algorithms by achieving an accuracy of 96.06% and is better suited as a solution model for our purpose. Following RF, LightGBM, XGBoost, and AdaBoost algorithms have an accuracy of 91.53%, 88.44%, and 58.55%, respectively. The findings suggest that some of the features like ‘Age of household head’, ‘Total children ever born’ in a family, ‘Main roof material’ of their house, ‘Region’ they lived in, whether a household uses ‘Electricity’ or not, and ‘Type of toilet facility’ of a household are determinant factors to be a focal point for economic policymakers. The determinant risk factors, extracted rules, and designed artifact achieved 82.28% of the domain expert’s evaluation. Overall, the study shows ML techniques are effective in predicting the wealth status of households.

Keywords: ensemble machine learning, households wealth status, predictive model, wealth status prediction

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2076 The Relationships between AntimüLlerian Hormone, Androgens and Ovarian Reserve in Non-Obese East Indian Women with and without Polycystic Ovary Syndrome

Authors: Dipanshu Sur, Ratnabali Chakravorty, Rimi Pal, Siddhartha Chatterjee, Joyshree Chaterjee, Amal Mallik

Abstract:

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disease in reproductive women with a complex hormonal disturbance that affects the menstrual cycle and leads to metabolic consequences in later life. Hyperandrogenaemia is noticeable features of PCOS and influence the process of folliculogenesis in women. The levels of Antimüllerian Hormone (AMH) reflect the number of pre-antral follicles and thus are a marker of oocyte pool – germinal reserve of the ovary for reproduction. Besides its utilization in IVF (In-vitro fertilization), determination of AMH may serve as an additional marker in the diagnostics of PCOS, where increased AMH levels reflect the severity of the disease. The positive correlation of serum AMH with the number of antral follicles was found also in patients with PCOS. Objective: The objective of this study was to investigate the relationship between AMH androgens and whether AMH contributes to altered folliculogenesis in non-obese women with PCOS. Methods: We designed a prospective study which included a total of 65 IVF individuals. It enrolled 26 cases of PCOS based on 2003 Rotterdam criteria and 39 ovulatory normal- non PCOS, healthy, age-matched controls. AMH levels and ovarian morphology were assessed. The relationships between AMH and androgenaemia in patients with and without PCOS were studied. Results: Mean age of PCOS patients were slightly higher than controls (32±4 and 28±3 years, respectively). AMH generally increased with antral follicle count (AFC) [P=0.001], testosterone, and luteinising hormone, and decreased with age, and serum sex hormone binding globulin (SHBG). No significant relationships were found between circulating AMH levels and BMI between PCOS and non-PCOS patients. The calculation of AMH production per antral follicle (AMH/AF) showed that there was a significant difference in median AMH/AF between PCOS and non-PCOS (P =0.001). Both PCOS and non-PCOS groups showed a very similar increase in AMH with increases in AFC, but the PCOS patients had consistently higher AMH across all AFC levels. Conclusions: These observations indicate that there is a connection between AMH and androgens levels between PCOS and non-PCOS East Indian women. Excessive granulosa cell activity may be implicated in the abnormal follicular dynamic of the syndrome. They are higher in women with PCOS and, on the other hand, very low in women with an ovarian failure.

Keywords: anti-Mullerian hormone, polycystic ovary syndrome, antral follicle count, androgens

Procedia PDF Downloads 212