Search results for: prolonged resuscitation

Authors: Asamaporn Puetpaiboon, Sunisa Chatmongkolchart, Nalinee Kovitwanawong, Osaree Akaraborworn

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Traumatic patients with massive bleeding require intensive resuscitation. The actual cost of anesthesia per case has never been clarified, so our study aimed to quantify the direct cost, and cost-to-charge ratio of anesthetic care in traumatic patients with intraoperative massive bleeding. This study was a prospective, observational, cost analysis study, conducted in Prince of Songkla University hospital, Thailand, with traumatic patients, of any mechanisms being recruited. Massive bleeding was defined as estimated blood loss of at least one blood volume in 24 hours, or a half of blood volume in 3 hours. The cost components were identified by the micro-costing method, and valued by the bottom-up approach. The direct cost was divided into 4 categories: the labor cost, the capital cost, the material cost and the cost of drugs. From September 2017 to August 2018, 10 patients with multiple injuries were included. Seven patients had motorcycle accidents, two patients fell from a height and another one was in a minibus accident. Two patients died on the operating table, and another two died within 48 hours. The median Sequential Organ Failure Assessment (SOFA) score was 8. The median intraoperative blood loss was 3,500 ml. The median direct cost, per case, was 250 United States Dollars (2017 exchange rate), and the cost-to-charge ratio was 0.53. In summary, the direct cost was nearly half of the hospital charge, for these traumatic patients with massive bleeding. However, our study did not analyze the indirect cost.

Keywords: cost, cost-to-charge ratio, micro-costing, trauma

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Authors: Ammar Asma, Bouafia Nabiha, Ben Cheikh Asma, Ezzi Olfa, Mahjoub Mohamed, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Ventilator-associated pneumonia (VAP) is currently recognized as one of the most relevant causes of morbidity and mortality among intensive care unit (ICU) patients worldwide. Identifying modifiable risk factors for VAP could be helpful for future controlled interventional studies aiming at improving prevention of VAP. The purposes of this study were to determine the incidence and risk factors for VAP in in a Tunisian medical ICU. Materials / Methods: A retrospective case-control study design based on the prospective database collected over a 14-month period from September 15th, 2015 through November 15th, 2016 in an 8-bed medical ICU. Patients under ventilation for over 48 h were included. The number of cases was estimated by Epi-info Software with the power of statistical test equal to 90 %. Each case patient was successfully matched to two controls according to the length of mechanical ventilation (MV) before VAP for cases and the total length of MV in controls. VAP in the ICU was defined according to American Thoracic Society; Infectious Diseases Society of America guidelines. Early onset or late-onset VAP were defined whether the infectious process occurred within or after 96 h of ICU admission. Patients’ risk factors, causes of admission, comorbidities and respiratory specimens collected were reviewed. Univariate and multivariate analyses were performed to determine variables associated with VAP with a p-value < 0.05. Results: During the period study, a total of 169 patients under mechanical ventilation were considered, 34 patients (20.11%) developed at least one episode of VAP in the ICU. The incidence rate for VAP was 14.88/1000 ventilation days. Among these cases, 9 (26.5 %) were early-onset VAP and 25 (73.5 %) were late-onset VAP. It was a certain diagnosis in 66.7% of cases. Tracheal aspiration was positive in 80% of cases. Multi-drug resistant Acinerobacter baumanii was the most common species detected in cases; 67.64% (n=23). The rate of mortality out of cases was 88.23% (n= 30). In univariate analysis, the patients with VAP were statistically more likely to suffer from cardiovascular diseases (p=0.035) and prolonged duration of sedation (p=0.009) and tracheostomy (p=0.001), they also had a higher number of re-intubation (p=0.017) and a longer total time of intubation (p=0.012). Multivariate analysis showed that cardiovascular diseases (OR= 4.44; 95% IC= [1.3 - 14]; p=0.016), tracheostomy (OR= 4.2; 95% IC= [1.16 -15.12]; p= 0.028) and prolonged duration of sedation (OR=1.21; 95% IC= [1.07, 1.36]; p=0.002) were independent risk factors for the development of VAP. Conclusion: VAP constitutes a therapeutic challenge in an ICU setting, therefore; strategies that effectively prevent VAP are needed. An infection control-training program intended to all professional heath care in this unit insisting on bundles and elaboration of procedures are planned to reduce effectively incidence rate of VAP.

Keywords: case control study, intensive care unit, risk factors, ventilator associated pneumonia

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Authors: N. N. Pilau, M. S. Abubakar, A. Danmaigoro, P. C. Mshelia, Y. Sani

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A severely debilitated 4months old Caucasian male dog presented dehydration, emaciation, vomiting, icteric ocular and oral mucous membranes, generalized lymphadenopathy, hematuria, anorexia and prolonged recumbency. Clinical workup was done in established protocols for diagnosis based on history, clinical signs and selected laboratory tests. Treatment course were administered over 48hours during which the patient died of overwhelming hepatopathy, nephropathy and pneumonia. Postmortem findings supported by ante mortem laboratory test results tentatively diagnosed leptospirosis, a disease endemic and presenting potentially fatal epidemics and zoonoses in some countries amongst the developing regions of the world. This disease is reviewed and a call for attention on the public health significance of the disease is hereby presented through this case report.

Keywords: canine, endemic, leptospirosis, prevalence

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Authors: Raheel Shakoor Siddiqui, Sanjay Narayana Murthy, Manikandar Srinivas Cheruvu, Kash Akhtar

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Major trauma is a dynamic public health epidemic that is continuously evolving. Major trauma care services rely on multi-disciplinary team input involving highly trained pre and in-hospital critical care teams. Pre-hospital critical care teams (PHCCTs), major trauma centres (MTCs), trauma units, and rehabilitation facilities all form an efficient and organised trauma system. England comprises 27 MTCs funded by the National Health Service (NHS). Major trauma care entails enhanced resuscitation protocols coupled with the expertise of dedicated trauma teams and rapid radiological imaging to improve trauma outcomes. Literature reports a change in the demographic of major trauma as elderly patients (silver trauma) with injuries sustained from a fall of 2 metres or less commonly present to services. Evidence of an increasing population age with multiple comorbidities necessitates treatment within the first hour of injury (golden hour) to improve trauma survival outcomes. Staffing and funding pressures within the NHS have subsequently led to a shortfall of available physician-led PHCCTs. Thus, there is a strong emphasis on targeted research and funding to appropriately deploy resources to deprived areas. This review article will discuss the current English trauma system whilst critically appraising present challenges, identifying insufficiencies, and recommending aims for an improved future trauma system in England.

Keywords: trauma, orthopaedics, major trauma, trauma system, trauma network

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Authors: Seul Ki Min, Gwang Heum Yoon, Jung Hyun Joo, Hwa Sung Shin

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Cellular membrane distortion is known as a factor to change intracellular signaling. However, progress of relevant studies is difficult because there are no facilities that can control membrane distortion finely. In this study, we developed microfluidic device which can inflict mechanical stress on cell membrane of Chlamydomonas reinhardtii using regular height of the channels. And cellular physiological changes were analyzed from cells cultured in the device. Excessive calcium ion influx through into cytoplasm was induced from mechanical stress. The results revealed that compressed cells had up-regulated Mat3 mRNA which regulates cell size and cell cycle from a prolonged G1 phase. Additionally, TAG used for the production of biodiesel was raised rapidly from 4 h after compression. Taken together, membrane distortion can be considered as an attractive inducer for biofuel production.

Keywords: mechanical stress, membrane distortion, Chlamydomonas reinhardtii, deflagellation, cell cycle, lipid metabolism

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Authors: Dalila Chaid, Bennameur Fedilli, Mohammed Amine Bellelou

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The study focuses on the experience of lower-limb amputees, who face both physical and psychological challenges due to their disability. Chronic neuropathic pain and various types of limb pain are common in these patients. They often require orthopaedic interventions for issues such as dressings, infection, ulceration, and bone-related problems. Research Aim: The aim of this study is to determine the most suitable anaesthetic technique for lower-limb amputees, which can provide them with the greatest comfort and prolonged analgesia. The study also aims to demonstrate the effectiveness and cost-effectiveness of ultrasound-guided local regional anaesthesia (LRA) in this patient population. Methodology: The study is an observational analytical study conducted over a period of eight years, from 2010 to 2018. It includes a total of 955 cases of revisions performed on lower limb stumps. The parameters analyzed in this study include the effectiveness of the block and the use of sedation, the duration of the block, the post-operative visual analog scale (VAS) scores, and patient comfort. Findings: The study findings highlight the benefits of ultrasound-guided LRA in providing comfort by optimizing post-operative analgesia, which can contribute to psychological and bodily repair in lower-limb amputees. Additionally, the study emphasizes the use of alpha2 agonist adjuvants with sedative and analgesic properties, long-acting local anaesthetics, and larger volumes for better outcomes. Theoretical Importance: This study contributes to the existing knowledge by emphasizing the importance of choosing an appropriate anaesthetic technique for lower-limb amputees. It highlights the potential of ultrasound-guided LRA and the use of specific adjuvants and local anaesthetics in improving post-operative analgesia and overall patient outcomes. Data Collection and Analysis Procedures: Data for this study were collected through the analysis of medical records and relevant documentation related to the 955 cases included in the study. The effectiveness of the anaesthetic technique, duration of the block, post-operative pain scores, and patient comfort were analyzed using statistical methods. Question Addressed: The study addresses the question of which anaesthetic technique would be most suitable for lower-limb amputees to provide them with optimal comfort and prolonged analgesia. Conclusion: The study concludes that ultrasound-guided LRA, along with the use of alpha2 agonist adjuvants, long-acting local anaesthetics, and larger volumes, can be an effective approach in providing comfort and improving post-operative analgesia for lower-limb amputees. This technique can potentially contribute to the psychological and bodily repair of these patients. The findings of this study have implications for clinical practice in the management of lower-limb amputees, highlighting the importance of personalized anaesthetic approaches for better outcomes.

Keywords: neuropathic pain, ultrasound-guided peripheral nerve block, DN4 quiz, EMG

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Authors: Esther Baldwin

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It is well settled that the use of solitary confinement can cause psychological and physical harm to detainees. For juveniles, who are more susceptible to irreparable harm due to their underdeveloped psyches, the risks are exacerbated. Despite these risks, across the United States juvenile detainees are regularly held in isolation for prolonged periods of time. This essay will examine the broad impact of solitary confinement on juvenile detainees while giving particular focus to the story of Kalief Browder, a juvenile awaiting trial on Rikers Island in New York for a period of three years, nearly two years of which were spent in solitary confinement. Although sadly, his story is not uncommon, Kalief’s story offers a unique perspective in that it provides first-hand insight on the effects of solitary confinement on juveniles. It is our hope that by sharing his story, we will demand better detention practices and policies for juveniles under correctional control in the United States.

Keywords: criminal justice system, juveniles, Kalief browder, solitary confinement

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Authors: Mona Afifi, Yara Al Qahtani, Afnan Al Dosari, Amnah Hamdi

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Background: First aid is the care provided outside the hospital. It is important in saving lives. Delay in helping the victims may result in serious complication or even death. Many people die in Saudi Arabia because they don’t get proper first aid interventions. According to Traffic Safety council in KSA (2012), in the year of 2011 there was 7153 deaths from car accident in KAS. Subjects and method: Quasi-experimental research design was utilized to assess the effect of a structured 45-minute educational session on 82 undergraduate nursing students’ knowledge about first aid. Two tools were developed for the purpose of the current study. First tool containing the sociodemographic data including age, gender, level, and previous participation in a first aid course, and 55 statements specific to different situations that requires first aid. Concept and Knowledge of First Aid has 9 questions, cardiopulmonary resuscitation has 12 questions, Bleeding and Shock have 7 questions, Road Traffic Accidents has 5 questions, Fracture and Trauma have 4 questions, wound has 5 questions, sunstroke has 4 questions, bits and stings has 4 questions and burn has 5 questions. The second tool was to evaluate the campaign session. Result: The overall knowledge score showed significant difference between the pre and post awareness session (59.58 and 93.00 respectively, p=.000). Mean score shows significant difference in pre-tests between third and fourth year nursing students indicating that knowledge of fourth year students is higher compared to third year students with the mean knowledge scores of 69.56 and 60.88 respectively (p=0.006). Conclusion: Results of the current study indicate that the level of the knowledge in the post test session was higher than in the pre session. Also results showed that the fourth year student`s knowledge in pre-test was better compared to previous year.

Keywords: first aid, awareness campaign, undergraduate nursing students, knowledge

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Authors: Xiaopeng Shang, Xin YU, Jun CHANG

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Calcium barium sulphoaluminate (CBSA), derived from calcium sulphoaluminate(CSA), has excellent cementitious properties. In this study, the sintering system of CBSA with a theoretical stoichiometric Ca3BaAl6SO16 was investigated. Rietveld refinement was performed using TOPAS 4.2 software to quantitatively calculate the content of CBSA and the actual ionic site occupancy of Ba2+. The results indicate that the contents of Ca4-xBaxAl6SO16 increases with increasing sintering temperature in the 1200℃-1400℃ ranges. When sintered at 1400℃ for 180min, the content of CBSA reaches 88.4%. However, CBSA begins to decompose at 1440℃ and the content of which decreases. The replacement rate of Ba2+ was also enlarged by increasing sintering temperature and prolonged sintering time. Sintering at 1400℃ for 180min is considered as the optimum when replacement rate of Ba2+ and the content of CBSA were taken into account. Ca3.2Ba0.8Al6SO16 with a content of 88.4% was synthesized.

Keywords: calcium barium sulphoaluminate, sintering system, Ba2+ replacement rate, Rietveld refinement

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Authors: Behcet Al, Mehmet Murat Oktay, Suat Zengin, Mustafa Sabak, Cuma Yildirim

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Objective: Th Recognition of arrest patients and application of basic life support (BLS) by bystanders in the field and the activation of emergency serves were evaluated in present study. Methodology: The present study was carried out by Emergency Department of Medicine Faculty of Gaziantep University at 33 of Emergency Health center in Gaziantep between December 2012- April 2014 prospectively. Of 539 arrested patients, 171 patients were included in study. Results: 118 (69%) male, and 53 31(%) female with a totlay of 171 patients were included in this study. Of patients, 32.2% had syncope and 24% had shorth breathing just befor being arrested. The majority of arrest cases had occured at home (61.4%) and rural area (11.7%) respectively. Of asking help, %48.5 were constructed by family members. Of announcement, only 15.2% occured within first minute of arrest. The BLS ratio that was applied by bystanders was 22.2%. Of bystanders, 47.4% had a course experience of BLS. The emergency serve had reached to the field with a mean of 8.43 min. Of cases, 55% (n=94) were evaluated as exitus firstly bu emergency staff. The most noticed rythim was asystol (73.1%). BLS and advanced life support (ALS) were applied to 98.8% and 60% respectively at the field. 10.5% (n=18) of cases were defibrilated, and 45 (26.3%) were intubated endotrecealy. The majority (48.5%) of staff who applied BLS and ALS at the fied were emergency medicine technicians. CPR was performed to 86.5% (n=148) cases in ambulance while they were transported. The mean arrival time to mergency department was 9.13 min. When the patients arrived to ED 15.2% needed defirlitation. 91.2% (n =156) of patients resulted in exitus in ED. 15 (8.8%) patients were discharged (9 with recovery, six patients with damage). Conclusion: The ratio of inntervention for arrest patients by bystanders is still low. To optain a high percentage of survival, BLS training should be widened among the puplic especiallyamong the caregivers.

Keywords: arrest patients, cardiopulmonary resuscitation, bystanders, chest compressions, prehospital

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Authors: Mohd Said Nurumal, Sarah Sheikh Abdul Karim

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Information regarding out of hospital cardiac arrest incidence include outcome in Malaysia is limited and fragmented. This study aims to identify incidence and adherence to protocol of out of hospital cardiac arrest and also to explore the issues faced by the pre-hospital personnel in regards managing cardiac arrest victim in Kuala Lumpur, Malaysia. A mixed method approach combining the qualitative and quantitative study design was used. The 285 pre-hospital care data sheet of out of hospital cardiac arrest during the year of 2011 were examined by using checklists for identify the incidence and adherence to protocol. Nine semi-structured interviews and two focus group discussions were performed. For the incidence based on the overall out of hospital cardiac arrest cases that occurred in 2011 (n=285), the survival rates were 16.8%. For adherence to protocol, only 89 (41.8%) of the cases adhered to the given protocol and 124 did not adhere to such protocol. The qualitative information provided insight about the issues related to out of hospital cardiac arrest in every aspect. All the relevant qualitative data were merged into few categories relating issues that could affect the management of out of hospital cardiac arrest performed by pre-hospital care team. One of the essential elements in the out of hospital cardiac arrest handling by pre-hospital care is to ensure increase of survival rates and excellent outcomes by adhering to given protocols based on international standard benchmarks. Measures are needed to strengthen the quick activation of the pre-hospital care service, prompt bystander cardiopulmonary resuscitation, early defibrillation and timely advanced cardiac life support and also to tackle all the issues highlighted in qualitative results.

Keywords: pre-hospital care, out of hospital cardiac arrest, incidence, protocol, mixed method research

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Authors: Taekyun Kim, Jongho Park, Jinwoong Choi, Sun-Kyu Park

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Recently, the abnormal climate phenomenon has enlarged due to the global warming. As a result, temperature variation is increasing and the term is being prolonged, frequency of high and low temperature is increasing by heat wave and severe cold. Especially for reinforced concrete structure, the corrosion of reinforcement has occurred by concrete crack due to temperature change and the durability of the structure that has decreased by concrete crack. Accordingly, the textile reinforced concrete (TRC) which does not corrode due to using textile is getting the interest and the investigation of TRC is proceeding. The study of TRC structure behavior has proceeded, but the characteristic study of the concrete used in TRC is insufficient. Therefore, characteristic of the concrete by changing mixing ratio is studied in this paper. As a result, mixing ratio with different water-binder ratio has influenced to the strength of concrete. Also, as the water-binder ratio has decreased, strength of concrete has increased.

Keywords: concrete, mixing ratio, textile, TRC

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

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Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

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Authors: Daniel Azizyan, Marina Vardanyan, Astghik Dallakyan

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The objective of this literature review is to bring valuable and much-needed insight into Virtual Reality Exposure Therapy (VRET) for the treatment of Post-Traumatic Stress Disorder (PTSD) among military personnel. As the issues regarding war veterans who suffer from PTSD become more and more widespread, the task of finding possible solutions that would provide alternative approaches to existing methods being used today becomes more relevant than ever. By analyzing the previous applications of VRET, this literature review covers the state of the research done currently on the topic, reviews the known information while identifying the main problems, and aims to use missed opportunities and find potential solutions. It provides the answers to the most relevant questions concerning VRET and leads to important conclusions in the hope of making the technology more practical, widespread, and effective.

Keywords: military PTSD, post-traumatic stress disorder, prolonged exposure, virtual reality exposure therapy, VRE

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Authors: Yousuf M. Al Suleimani, Robin Hiley

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The endogenous phospholipid lysophosphatidylinositol (LPI) was recently identified as a novel ligand for the G protein-coupled receptor 55 (GPR55) and an inducer of intracellular Ca2+ [Ca2+]i release. This study attempts to characterize Ca2+ signals provoked by LPI in HEK293 cells engineered to stably express human GPR55 and to test cannabinoid ligand activity at GPR55. The study shows that treatment with LPI stimulates a sustained, oscillatory Ca2+ release. The response is characterized by an initial rapid rise, which is mediated by the Gαq-PLC-IP3 pathway, and this is followed by prolonged oscillations that require RhoA activation. Ca2+ oscillations are initiated by intracellular mechanisms and extracellular Ca2+ is only required to replenish Ca2+ lost from the cytoplasm. Analysis of cannabinoid ligand activity at GPR55 revealed no clear effect of the endocannabinoid anandamide, however, rimonabant and the CB1 receptor antagonist AM251 evoked GPR55-mediated [Ca2+]i. Thus, LPI is likely to be a key plasma membrane mediator of signaling events and changes in gene expression through GPR55 activation.

Keywords: lysophosphatidylinositol, calcium, GPR55, cannabinoid

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Authors: Mrunal Phatak, Suvarna Raut

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Introduction: Thyroid hormone is important for the normal function of the auditory system. Hearing impairment can occur insidiously in subclinical hypothyroidism. The present study was undertaken with the aims of evaluating audiological tests like tuning fork tests, pure tone audiometry, brainstem evoked auditory potentials (BAEPs), and auditory reaction time (ART) in hypothyroid women and in age and sex matched controls so as to evaluate the effect of thyroid hormone on hearing. The objective of the study was to investigate hearing status by the audiological profile in hypothyroidism (group 1) and healthy controls ( group 2) to compare the audiological profile between these groups and find the correlation of levels of TSH, T3, and T4 with the above parameters. Material and methods: A total sample size of 124 women in the age group of 30 to 50 years was recruited and divided into the Cases group comprising of 62 newly diagnosed hypothyroid women and the Control group having 62 women with normal thyroid profile. Otoscopic examination, tuning fork tests, Pure tone audiometry tests (PTA). Brain Stem Auditory Evoked Potential (BAEP) and Auditory Reaction Time (ART) were done in both ears, i.e. total 248 ears of all subjects. Results: By BAEPs, hearing impairment was detected in total 64 ears (51.61%). A significant increase was seen in Wave V latency, IPL I-V, and IPL III-V, and the decrease was seen in the amplitude of Wave I and V in both the ears in cases. Positive correlation of Wave V latency of Right and Left ears is seen with TSH levels (p < 0.001) and a negative correlation with T3 (>0.05) and with T4 (p < 0.01). Negative correlation of wave V amplitude of Right and Left ears is seen with TSH levels (p < 0.001), and a significant positive correlation is seen with T3 and T4. Pure tone audiometry parameters showed hearing impairment of conductive (31.29%), sensorineural (36.29%), as well as the mixed type (15.32%). Hearing loss was mild in 65.32% of ears and moderate in 17.74% of ears. Pure tone averages (PTA) were significantly increased in cases than in controls in both the ears. Significant positive correlation of PTA of Right and Left ears is seen with TSH levels (p<0.05). Negative correlation with T3 and T4 is seen. A significant increase in HF ART and LF ART is seen in cases as compared to controls. Positive correlation of ART of high frequency and low frequency is seen with TSH levels and a negative correlation with T3 and T4 (p > 0.05). Conclusion: The abnormal BAEPs in hypothyroid women suggest an impaired central auditory pathway. BAEP abnormalities are indicative of a nonspecific injury in the bulbo-ponto-mesencephalic centres. The results of auditory investigations suggest a causal relationship between hypothyroidism and hearing loss. The site of lesion in the auditory pathway is probably at several levels, namely, in the middle ear and at cochlear and retrocochlear sites. Prolonged ART also suggests the impairment in central processing mechanisms. The results of the present study conclude that the probable reason for hearing impairment in hypothyroidism may be delayed impulse conduction in acoustic nerve up to the level of the midbrain (IPL I-V, III-V), particularly inferior colliculus (wave V). There is also impairment in central processing mechanisms, as shown by prolonged ART.

Keywords: deafness, pure tone audiometry, brain stem auditory evoked potential, hyopothyroidism

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Authors: Jadwiga Fila, Mateusz Jezowski, Pawel Poszytek

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The outbreak of the global COVID-19 pandemic started the times of crisis full of uncertainty, especially in the field of transnational cooperation projects based on the international mobility of their participants. This is notably the case of Erasmus+ Program for higher education, which is the flagship European initiative boosting cooperation between educational institutions, businesses, and other actors, enabling students and staff mobility, as well as strategic partnerships between different parties. The aim of this abstract is to study whether competences 4.0 are able to empower Erasmus+ project leaders in sustaining their international cooperation in times of global crisis, widespread online learning, and common project disruption or cancellation. The concept of competences 4.0 emerged from the notion of the industry 4.0, and it relates to skills that are fundamental for the current labor market. For the aim of the study presented in this abstract, four main 4.0 competences were distinguished: digital, managerial, social, and cognitive competence. The hypothesis for the study stipulated that the above-mentioned highly-developed competences may act as a protective shield against the pandemic challenges in terms of projects’ sustainability and continuation. The objective of the research was to assess to what extent individual competences are useful in managing projects in times of crisis. For this purpose, the study was conducted, involving, among others, 141 Polish higher education project leaders who were running their cooperation projects during the peak of the COVID-19 pandemic (Mar-Nov 2020). The research explored the self-perception of the above-mentioned competences among Erasmus+ project leaders and the contextual data regarding the sustainability of the projects. The quantitative character of data permitted validation of scales (Cronbach’s Alfa measure), and the use of factor analysis made it possible to create a distinctive variable for each competence and its dimensions. Finally, logistic regression was used to examine the association of competences and other factors on project status. The study shows that the project leaders’ competence profile attributed the highest score to digital competence (4.36 on the 1-5 scale). Slightly lower values were obtained for cognitive competence (3.96) and managerial competence (3.82). The lowest score was accorded to one specific dimension of social competence: adaptability and ability to manage stress (1.74), which proves that the pandemic was a real challenge which had to be faced by project coordinators. For higher education projects, 10% were suspended or prolonged because of the COVID-19 pandemic, whereas 90% were undisrupted (continued or already successfully finished). The quantitative analysis showed a positive relationship between the leaders’ levels of competences and the projects status. In the case of all competences, the scores were higher for project leaders who finished projects successfully than for leaders who suspended or prolonged their projects. The research demonstrated that, in the demanding times of the COVID-19 pandemic, competences 4.0, to a certain extent, do play a significant role in the successful management of Erasmus+ projects. The implementation and sustainability of international educational projects, despite mobility and sanitary obstacles, depended, among other factors, on the level of leaders’ competences.

Keywords: Competences 4.0, COVID-19 pandemic, Erasmus+ Program, international education, project sustainability

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Authors: Sharmila Sakravarthy

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Prison administration in India, even though an important limb of the criminal justice system are worse off in terms of overcrowding, prolonged detention of under-trial prisoners, and a host of other problems. Considering the statistics of the prison population, over a thousand three hundred prisons across the country were overcrowded, even to the extent of more than six hundred percent. A total of eighteen thousand eight hundred and fifty-eight female prisoners were in India, out of which thirteen thousand hundred and sixty-five were under trials and five thousand and sixty-three convicts. A total of around one thousand seven hundred thirty-five children are residing in prisons along with their mothers. District prisons are more overcrowded than the other prisons, and their practices are at odd with human rights standards. This article examines a range of issues in prisons throughout India including pretrial detention, overcrowding, resources and governance, women and children in prison and rehabilitation. A substantial amount of space is devoted to the reforms that are occurring across the nation, and recommendations are made with regard to what further reforms are necessary.

Keywords: human rights, overcrowding, prisons, rehabilitation

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Authors: Sunil Kamboj, Suman Bala, Vipin Saini

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Niosomes were formulated with an aim of enhancing the oral bioavailability of losartan potassium and formulated in different molar ratios of surfactant, cholesterol and dicetyl phosphate. The formulated niosomes were found in range of 54.98 µm to 107.85 µm in size. Formulations with 1:1 ratio of surfactant and cholesterol have shown maximum entrapment efficiencies. Niosomes with sorbitan monostearate showed maximum drug release and zero order release kinetics, at the end of 24 hours. The in vivo study has shown the significant enhancement in oral bioavailability of losartan potassium in rats, after a dose of 10 mg/kg. The average relative bioavailability in relation with pure drug solution was found 2.56, indicates more than two fold increase in oral bioavailability. A significant increment in MRT reflects the release retarding ability of the vesicles. In conclusion, niosomes could be a promising delivery of losartan potassium with improved oral bioavailability and prolonged release profiles.

Keywords: non-ionic surfactant vesicles, losartan potassium, oral bioavailability, controlled release

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Authors: R. Gadea, J. M. Monzó, F. J. Puertas, M. Castro, A. Tebar, P. J. Fito, R. J. Colom

Abstract:

There exists a wide array of ailments impacting the structural soundness of the esophageal walls, predominantly linked to digestive issues. Presently, the techniques employed for identifying esophageal tract complications are excessively invasive and discomforting, subjecting patients to prolonged discomfort in order to achieve an accurate diagnosis. This study proposes the creation of a sensor with profound measuring capabilities designed to detect fluids coursing through the esophageal tract. The multi-sensor detection system relies on radiofrequency photospectrometry. During experimentation, individuals representing diverse demographics in terms of gender and age were utilized, positioning the sensors amidst the trachea and diaphragm and assessing measurements in vacuum conditions, water, orange juice, and saline solutions. The findings garnered enabled the identification of various liquid mediums within the esophagus, segregating them based on their ionic composition.

Keywords: radiofrequency spectrophotometry, medical device, gastroesophageal disease, photonics

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Authors: Kunle Oparinde, Rachel Matteau-Matsha, Felix Awung

Abstract:

In recent times, the issue of gender-based violence against women in South Africa is prevalent in headlines due to the high rate of attacks directed towards women. Ranging from teenagers to adults, women are continuously targeted indiscriminately in what is seemingly becoming a prolonged cycle in the country. To this end, human rights activists, organisations, and political leaders have managed to somewhat verbally condemn the atrocious acts. Further, interested people in South Africa, through walks and protests, have continued to speak against the swinging violence against women in the country. The thrust in this study is to explore and analyse how discourse (language) has been employed as a resounding voice against gender violence in the country. Through a purposive sampling of materials employed during walks and protests, collected from online sources, we examine how language is being used to combat and confront the issue of gender violence viz-a-viz how it continues to serve as a crucial tool in repelling gender violence.

Keywords: gender, violence, language, discourse, resistance

Procedia PDF Downloads 111

Authors: Mohd Abdullah

Abstract:

This review describes some of the effects of repetitive strain/stress injury (RSI) on the human body especially among computer professionals today that spend extended hours of prolonged sitting in front of a computer day in and day out. The review briefly introduces the main factors that contribute to an increase of RSI among such computer professionals. The review briefly discusses how the human spinal column and knees are mainly affected by the onset of RSI resulting in poor posture. The root and secondary causes and effects of RSI are reviewed. The importance and value of the various breathing techniques are reviewed in an attempt to alleviate some of the effects of RSI. The review concludes with a small sample of suggested office stretches and poses geared towards at reducing RSI follows in this review. Readers will learn about the effects of RSI, as well as ways to cope with it. A better understanding of coping strategies may lead to well-being and a healthier overall lifestyle. Ultimately, the investment of time to connect with oneself with the poses and the power of the breath would promote a well-being that is overall healthier thus resulting in a better ability to cope/manage life stresses.

Keywords: health, wellness, repetitive, chairs

Procedia PDF Downloads 78

Authors: Madiha Tariq, Hena Rabbani

Abstract:

Recently, cavity-optomechanics becomes an extensive research field that has manipulated the mechanical effects of light for coupling of the optical field with other physical objects specifically with regards to dynamical localization. We investigate the dynamical localization (both in momentum and position space) for a vibrational mirror in a Fabry-Pérot cavity driven by a single mode optical field and a transverse probe field. The weak probe field phenomenon results in classical chaos in phase space and spatio temporal dynamics in position |ψ(x)²| and momentum space |ψ(p)²| versus time show quantum localization in both momentum and position space. Also, we discuss the parametric dependencies of dynamical localization for a designated set of parameters to be experimentally feasible. Our work opens an avenue to manipulate the other optical phenomena and applicability of proposed work can be prolonged to turn-able laser sources in the future.

Keywords: dynamical localization, cavity optomechanics, Hamiltonian chaos, probe field

Procedia PDF Downloads 128

Authors: Mengmeng Xiao

Abstract:

The study examines the proactive promotion of feminist agendas by states experiencing prolonged one-party dominance, with a specific focus on Japan. Through a case study approach, it explores why leaders of the dominant party, the Liberal Democratic Party (LDP), actively endorse women-friendly initiatives. The findings reveal three primary motivations: 1) the adoption of women-friendly policies for legitimation, 2) the establishment or funding of women’s organizations for co-optation, and 3) the enhancement of women’s economic and employment rights for state-building purposes. These findings bridge theories across the democracy/autocracy spectrum, emphasizing the need to restructure the research framework on state feminism beyond the binary categorization of regime types. Additionally, they underscore the significance of acknowledging the discretion exercised by state officials, providing insights into instances where state feminism may fail in certain democratic contexts.

Keywords: state feminism, feminist policies, national machinery, regime types, political parties, Japan

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Authors: Ada Adoga James

Abstract:

This paper discussed the concept of community participation and identified tertiary education problems; strategies and methods communities could be involved to reduce conflict witnessed in our tertiary institutions of learning due to government inability to fund education. The paper pointed out that community participation through the use of Parent Teachers Association (PTA), age grade, traditional leaders, village based associations, religious and political organs could be sensitized to raise financial resources. The paper identified different sources of conflicts, the outcome of which causes prolonged academic activities, destruction of lives and properties and in some cased render school environment completely insecure for serious academic activities. It recommends involvement of community participation in assisting government, proper handling of tertiary institutions in management, and more democratic procedure in conflict resolution like cordial relationship between staff, students and trade unions in decision making process.

Keywords: community, conflict resolution, tertiary education, psychology, psychiatry

Procedia PDF Downloads 431

Authors: Efrain Rodriguez, Sergio Pertuz, Cristhian Riano

Abstract:

Tool-path generation is an essential step in the FFF (Fused Filament Fabrication)-based Additive Manufacturing (AM) process planning. In the manufacture of a mechanical part by using additive processes, high resource consumption and prolonged production times are inherent drawbacks of these processes mainly due to non-optimized tool-path generation. In this work, we propose a heuristic-search intelligent algorithm-based approach for optimized tool-path generation for FFF-based AM. The main benefit of this approach is a significant reduction of travels without material deposition when the AM machine performs moves without any extrusion. The optimization method used reduces the number of travels without extrusion in comparison with commercial software as Slic3r or Cura Engine, which means a reduction of production time.

Keywords: additive manufacturing, tool-path optimization, fused filament fabrication, process planning

Procedia PDF Downloads 420

Authors: Kim Young-Jin, Kim Byung-Kon

Abstract:

Although more efforts to expand the application of BIM (Building Information Modeling) technologies have be pursued in recent years than ever, it’s true that there have been various challenges in doing so, including a lack or absence of relevant institutions, lots of costs required to build BIM-related infrastructure, incompatible processes, etc. This, in turn, has led to a more prolonged delay in the expansion of their application than expected at an early stage. Especially, attempts to save costs for building BIM-related infrastructure and provide various BIM services compatible with domestic processes include studies to link between BIM and cloud computing technologies. Also in this study, the author attempted to develop a cloud BIM service operation model through analyzing the level of BIM applications for the construction sector and deriving relevant service areas, and find how to link BIM services to the cloud operation model, as through archiving BIM data and creating a revenue structure so that the BIM services may grow spontaneously, considering a demand for cloud resources.

Keywords: construction IT, BIM (building information modeling), cloud computing, BIM service based cloud computing

Procedia PDF Downloads 466

Authors: Kamel Agroui, George Collins, Rydha Yaiche

Abstract:

The objective of this study is to better understand the thermal characteristics and molecular behaviour of cured EVA before and after outdoor exposure. Thermal analysis methods as DSC, TSC and DMTA studies were conducted on EVA material. DSC experiments on EVA show a glass transition at about -33.1° C which is characteristic of crystalline phase and an endothermic peak at temperature of 55 °C characteristic of amorphous phase. The magnitude of the integrated temperature DSC peak for EVA is 14.4 J/g. The basic results by TSC technique is that there are two relaxations that are reproducibly observed in cured EVA encapsulant material. At temperature polarization 85°C, a low temperature relaxation occurs at –24.4°C and a high temperature relaxation occurs at +30.4ºC. DMTA results exhibit two tan peaks located at -14.9°C and +66.6°C. After outdoor exposure cured EVA by DSC analysis revealed two endothermic peaks due to post crystallization phenomenon and TSC suggests that prolonged exposure selectively effects the poly(vinyl acetate)-rich phase, with much less impact on the polyethylene-rich phase.

Keywords: EVA, encapsulation process, PV module, thermal analysis, quality control

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Authors: Ozlem Durna Aydin, Gultekin Yildiz

Abstract:

Antibiotics are microbial metabolites with low molecular weight produced by fungi and algae, inhibiting the development of other microorganisms even in low growth. Antibiotics have been used as growth factors in animal feeds for many years. They prohibited; because of increased residue problem and increased resistance to antibiotics in bacteria due to prolonged use. Aromatic plants and extracts have attracted the attention of scientists nowadays due to positive reasons such as confidence of the community to the products those are coming from nature, desire to consume, and no residue problems. Plant extracts are obtained from aromatic plants, and they come forward with antifungal, antibacterial, antiviral, antioxidant and antilipidemic properties. It has been stated that intestinal histomorphology and microbiosis are positively affected by the use of plant extract in feeds. In the present day, aromatic plants and extracts are a remarkable research field with intriguing unknowns in the field of animal nutrition, and they continue to exist in the journal in vitro and in vivo studies.

Keywords: aromatic plant, broilers, extract mechanism of action, intestinal health

Procedia PDF Downloads 136