Search results for: secondary healing
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3568

Search results for: secondary healing

3448 Challenging the Traditional Practice of Continuous Abscess Cavity Packing – A Single Center, Single Blind Randomized Controlled Trial

Authors: Lakmali Anthony, Bushra Oathman, Anshini Jain, Raaj Chandra

Abstract:

Introduction: Abscesses are traditionally treated by incision and drainage with the packing of the residual abscess cavity until healing. This method requires regular visits from community nurses for continuous wound packing upon discharge from the hospital and causes considerable patient discomfort. Whether abscess cavity packing offers any advantage over non-packing has not yet been adequately studied to the best of our knowledge. This study aims to determine if there are differences in clinical outcomes of time to healing, fistula formation and recurrence of abscess between abscess cavity packing vs. non-packing groups. Methods: This study was a single-center, single-blind, randomized controlled trial where patients were randomized into packing and non-packing arms. All patients over 18 years presenting to Eastern Health with an abscess requiring incision and drainage in the theatre were invited to participate. Those with underlying conditions that cause recurrent abscesses were excluded. Data were collected from December 2018 to April 2020. Results: There were 63 patients who had abscesses treated with incision and drainage that were enrolled in the study, 52 of which were suitable for analysis. Demographic characteristics were similar in both groups. The packing group had a significantly longer time to heal compared to the non-packing group. Rates of fistula formation and recurrence of abscess were low and there were no statistically significant differences between groups. The packing group had more patients with delayed healing (defined as >60 days) and required more follow-up visits compared to the non-packing group. Conclusion: This pilot study indicates that abscesses can not only be managed safely with incision and drainage alone without the need for continuous abscess cavity packing but also that non-packing may offer clinical benefits to patients with earlier healing of abscesses compared to continuous cavity packing.

Keywords: abscess packing, subcutaneous, perianal, pilonidal

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3447 Drainage Management In A Cascade Hydroponic System: Combination Of Cucumber And Melon Crops

Authors: Nikolaos Katsoulas, Ioannis Naounoulis, Sofia Faliagka

Abstract:

Cascade hydroponic systems have the potential to minimize environmental impact and improve resource efficiency by recycling the nutrient solution drained from a hydroponic (primary-donor) crop to irrigate another (secondary-receiver), less sensitive to salinity crop. However, it remains unclear if the drained solution from the primary crop can fully meet the nutritional requirements of a secondary crop and whether the productivity of the secondary crop is affected. To address this question, a prototype cascade hydroponic system was designed and tested using a cucumber crop as the donor crop and a melon as secondary crop. The performance of the system in terms of productivity and water and nutrient use efficiency was evaluated by measuring plant growth, fresh and dry matter production, nutrients content, and photosynthesis rate in the secondary crop. The amount of water and nutrients used for the primary and secondary crops was also recorded. This work was carried out under the ECONUTRI project that has received funding from the European Union’s Horizon 2020 research and innovation programme under the Horizon Europe Grant agreement: 101081858.

Keywords: hydroponics, salinity, water use efficiencu, nutrients use efficiency

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3446 Compensation Analysis on Secondary Public Hospitals of Pudong New Area in Shanghai

Authors: Wei Fang, Jian Jun Gu, Di Xue

Abstract:

Objective: To analyze the employee compensation status of secondary public hospitals of Pudong New Area in Shanghai in order to provide information for compensation reform of public hospitals in Shanghai and as well as in China. Methods: We surveyed all 15 secondary public hospitals of Pudong New Area in Shanghai to collect hospital annual compensation data for their employees and to investigate their suggestions for compensation reform in public hospitals in China. We also collected related annual compensation data of employees in Shanghai and of physicians in the USA from Shanghai statistical Yearbook 2013 and from Bureau of Labor Statistics, U.S. Department of Labor. Results: The average annual compensation for the employees in secondary public hospitals of Pudong New Area in Shanghai in 2012 was 2.65 times of that for overall employees in Shanghai. The physician’s compensation in these public hospitals was relatively lower than that in the USA. Conclusion: The physicians’ compensation in the secondary public hospitals of Pudong New Area in Shanghai should be increased rationally and new compensation reform in public hospitals in Shanghai should be carefully designed.

Keywords: human resource, compensation, public hospital, Shanghai

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3445 Developing a Systemic Monoclonal Antibody Therapy for the Treatment of Large Burn Injuries

Authors: Alireza Hassanshahi, Xanthe Strudwick, Zlatko Kopecki, Allison J Cowin

Abstract:

Studies have shown that Flightless (Flii) is elevated in human wounds, including burns, and reducing the level of Flii is a promising approach for improving wound repair and reducing scar formation. The most effective approach has been to neutralise Flii activity using localized, intradermal application of function blocking monoclonal antibodies. However, large surface area burns are difficult to treat by intradermal injection of therapeutics, so the aim of this study was to investigate if a systemic injection of a monoclonal antibody against Flii could improve healing in mice following burn injury. Flii neutralizing antibodies (FnAbs) were labelled with Alxa-Fluor-680 for biodistribution studies and the healing effects of systemically administered FnAbs to mice with burn injuries. A partial thickness, 7% (70mm2) total body surface area scald burn injury was created on the dorsal surface of mice (n=10/group), and 100µL of Alexa-Flour-680-labeled FnAbs were injected into the intraperitoneal cavity (IP) at time of injury. The burns were imaged on days 0, 1, 2, 3, 4, and 7 using IVIS Lumina S5 Imaging System, and healing was assessed macroscopically, histologically, and using immunohistochemistry. Fluorescent radiance efficiency measurements showed that IP injected Alexa-Fluor-680-FnAbs localized at the site of burn injury from day 1, remaining there for the whole 7-day study. The burns treated with FnAbs showed a reduction in macroscopic wound area and an increased rate of epithelialization compared to controls. Immunohistochemistry for NIMP-R14 showed a reduction in the inflammatory infiltrate, while CD31/VEGF staining showed improved angiogenesis post-systemic FnAb treatment. These results suggest that systemically administered FnAbs are active within the burn site and can improve healing outcomes. The clinical application of systemically injected Flii monoclonal antibodies could therefore be a potential approach for promoting the healing of large surface area burns immediately after injury.

Keywords: biodistribution, burn, flightless, systemic, fnAbs

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3444 Formulation and in Vitro Characterization of Bioactives Loaded Polymeric Nanoparticle Incorporated into Multiphase Hydrogel System for the Treatment of Infected Burn Wound

Authors: Rajni Kant Panik, Deependra Singh, Manju Singh

Abstract:

Despite significant advances in the treatment of severe burn injury, infection and sepsis persist as frequent causes of morbidity and mortality for burn victims due to extensive compromise of the skin and contiguous tissue that serve as a protective barrier against microbial invasion. In the setting of a burn wound infection, Staphylococcus aureus is the most commonly isolated pathogens from bloodstream infections in burn care hospitals. We aimed to develop a biocompatible system of Poly vinyl alcohol (PVA)-sodium alginate hydrogel carrying multiple drugs- catalase and mupirocin in controlled manner for effective and complete burn wound healing. PLGA nanoparticles of Catalase and mupirocin were prepared by homogenization method and optimized system was incorporated in PVA-sodium alginate slurry. PVA-sodium alginate hydrogels were prepared by freeze thaw method. The prepared dispersion was casted into films to prepare multiphase hydrogel system and characterized by in vitro and in vivo studies. The study clearly showed the beneficial effect of antioxidant enzyme and antibiotic in the treatment of infected burn wound, as evidenced by the reduced incidence of wound infection and the shortening of healing time.

Keywords: burn wound, catalase, mupirocin, wound healing

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3443 Breaking the Silence and Rewriting the Script

Authors: Carlette Groome

Abstract:

This paper examined the role of drama in the lives of four women. The researcher concluded that drama can be an avenue of healing and could be an effective means of social work intervention in the communities as well as female empowerment. The participants in the study were able to, through the dramatic process; re-write their life’s scripts by resolving paradoxes and conflicts related to the themes unearthed. The research conducted examined the role of drama in the lives of four women living in volatile communities in Jamaica, who were each exposed to violence in one, or multiple, forms. The women were trained by Sistren Theatre Collective in the use of drama for education (edutainment), and were actresses in Sistren's street theatre drama group. Using their own personal and collective experiences, they used drama to raise social consciousness at the community level, about violence and other issues affecting women. The study employed a narrative case study approach and was grounded in a constructivist paradigm. This paradigm was coupled with a basic interpretive qualitative method and the concept of the reflective practitioner provided the foundation for the analysis. Through individual conversations with the women, themes of abuse, resilience, self- esteem, and empowerment arose sharply. The women explored drama and understood it to be instrumental in healing different aspects of their lives. Also, through the dramatic process; they were able to re-write their life’s scripts by resolving paradoxes and conflicts related to the themes unearthed.

Keywords: women, drama, healing, community

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3442 Scoliosis Effect towards of Incidence of the Secondary Osteoarthritis on the Knee in Athletes at the National Sports Cibubur Hospital on July 2013-April 2014

Authors: Basuki Supartono, Nunuk Nugrohowati, Ryan Gamma Andiraldi

Abstract:

Osteoarthritis of the knee can occur due to scoliosis. The purpose of this study is to determine the effect of scoliosis cause secondary osteoarthritis on the knee. This research use an analytic cross-sectional design. The total sample of 92 athletes scoliosis taken by simple random sampling technique. The data obtained were analyzing with Chi-square test, Fisher and Prevalence Ratio. The results of analysis show that there are influences on the incidence of scoliosis secondary osteoarthritis on the knee in athletes at the National Sports Hospital. Based on the criteria in the Cobbs angle had the results (p = 0.022 (p <0.05)), moderate Cobbs angle degree were 7.5 times more at risk of causing secondary osteoarthritis on the knee than a mild degree. While the shape of the curve scoliosis is getting results (p = 0.038 (p <0.05)), the shape of the S curve scoliosis 3.2 times more at risk of causing secondary osteoarthritis on the knee than the curve C. It can be concluded that there is significant influence between the Cobbs angle, shape of the curve scoliosis on the incidence of secondary osteoarthritis on the knee in National Sports Cibubur Hospital on July 2013- April 2014

Keywords: Cobbs angle, curve shape scoliosis, secondary osteoarthritis on the knee, analytic cross-sectional design

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3441 The Interplay between Autophagy and Macrophages' Polarization in Wound Healing: A Genetic Regulatory Network Analysis

Authors: Mayada Mazher, Ahmed Moustafa, Ahmed Abdellatif

Abstract:

Background: Autophagy is a eukaryotic, highly conserved catabolic process implicated in many pathophysiologies such as wound healing. Autophagy-associated genes serve as a scaffolding platform for signal transduction of macrophage polarization during the inflammatory phase of wound healing and tissue repair process. In the current study, we report a model for the interplay between autophagy-associated genes and macrophages polarization associated genes. Methods: In silico analysis was performed on 249 autophagy-related genes retrieved from the public autophagy database and gene expression data retrieved from Gene Expression Omnibus (GEO); GSE81922 and GSE69607 microarray data macrophages polarization 199 DEGS. An integrated protein-protein interaction network was constructed for autophagy and macrophage gene sets. The gene sets were then used for GO terms pathway enrichment analysis. Common transcription factors for autophagy and macrophages' polarization were identified. Finally, microRNAs enriched in both autophagy and macrophages were predicated. Results: In silico prediction of common transcription factors in DEGs macrophages and autophagy gene sets revealed a new role for the transcription factors, HOMEZ, GABPA, ELK1 and REL, that commonly regulate macrophages associated genes: IL6,IL1M, IL1B, NOS1, SOC3 and autophagy-related genes: Atg12, Rictor, Rb1cc1, Gaparab1, Atg16l1. Conclusions: Autophagy and macrophages' polarization are interdependent cellular processes, and both autophagy-related proteins and macrophages' polarization related proteins coordinate in tissue remodelling via transcription factors and microRNAs regulatory network. The current work highlights a potential new role for transcription factors HOMEZ, GABPA, ELK1 and REL in wound healing.

Keywords: autophagy related proteins, integrated network analysis, macrophages polarization M1 and M2, tissue remodelling

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3440 Violence and Unintentional Injuries among Secondary School Students in Jordan

Authors: Malakeh Zuhdi Malak, Mahmoud Taher Kalaldeh

Abstract:

In Jordan, no available data exists regarding violence and unintentional injuries among secondary school students aged 15-19 years. The purpose of this study was to assess the violence and unintentional injuries among those students, and to compare these two behaviors between male and female students. A descriptive cross-sectional design was carried out on randomly selected eight comprehensive secondary schools (four schools for females and four schools for males) from the public school educational directorate located in Amman. A modified Arabic version of the General School Health Survey questionnaire was used to measure violence and unintentional injuries. A sample of 750 secondary school students was studied. The findings showed that 26.8 % of students had been physically attacked. Overall, 43.3 % of students had been involved in a physical fight and 20.1% of them had been bullied. Overall, 45.3% of students were seriously injured. There was a difference between male and female students regarding to physical attack, physical fight, and serious injuries. In conclusion, it is necessary to develop effective training program in life skills for students that functions to reduce risk-taking behaviors that often leading to violence and unintentional injuries.

Keywords: secondary school students, violence, unintentional injuries, bullying

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3439 Effect of Plasma Radiation on Keratinocyte Cells Involved in the Wound Healing Process

Authors: B. Fazekas, I. Korolov, K. Kutasi

Abstract:

Plasma medicine, which involves the use of gas discharge plasmas for medical applications is a rapidly growing research field. The use of non-thermal atmospheric pressure plasmas in dermatology to assist tissue regeneration by improving the healing of infected and/or chronic wounds is a promising application. It is believed that plasma can activate cells, which are involved in the wound closure. Non-thermal atmospheric plasmas are rich in chemically active species (such as O and N-atoms, O2(a) molecules) and radiative species such as the NO, N2+ and N2 excited molecules, which dominantly radiate in the 200-500 nm spectral range. In order to understand the effect of plasma species, both of chemically active and radiative species on wound healing process, the interaction of physical plasma with the human skin cells is necessary. In order to clarify the effect of plasma radiation on the wound healing process we treated keratinocyte cells – that are one of the main cell types in human skin epidermis – covered with a layer of phosphate-buffered saline (PBS) with a low power atmospheric pressure plasma. For the generation of such plasma we have applied a plasma needle. Here, the plasma is ignited at the tip of the needle in flowing helium gas in contact with the ambient air. To study the effect of plasma radiation we used a plasma needle configuration, where the plasma species – chemically active radicals and charged species – could not reach the treated cells, but only the radiation. For the comparison purposes, we also irradiated the cells using a UV-B light source (FS20 lamp) with a 20 and 40 mJ cm-2 dose of 312 nm. After treatment the viability and the proliferation of the cells have been examined. The proliferation of cells has been studied with a real time monitoring system called Xcelligence. The results have indicated, that the 20 mJ cm-2 dose did not affect cell viability, whereas the 40 mJ cm-2 dose resulted a decrease in cell viability. The results have shown that the plasma radiation have no quantifiable effect on the cell proliferation as compared to the non-treated cells.

Keywords: UV radiation, non-equilibrium gas discharges (non-thermal plasmas), plasma emission, keratinocyte cells

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3438 A Metallography Study of Secondary A226 Aluminium Alloy Used in Automotive Industries

Authors: Lenka Hurtalová, Eva Tillová, Mária Chalupová, Juraj Belan, Milan Uhríčik

Abstract:

The secondary alloy A226 is used for many automotive casting produced by mould casting and high pressure die-casting. This alloy has excellent castability, good mechanical properties and cost-effectiveness. Production of primary aluminium alloys belong to heavy source fouling of life environs. The European Union calls for the emission reduction and reduction in energy consumption, therefore, increase production of recycled (secondary) aluminium cast alloys. The contribution is deal with influence of recycling on the quality of the casting made from A226 in automotive industry. The properties of the casting made from secondary aluminium alloys were compared with the required properties of primary aluminium alloys. The effect of recycling on microstructure was observed using combination different analytical techniques (light microscopy upon black-white etching, scanning electron microscopy-SEM upon deep etching and energy dispersive X-ray analysis-EDX). These techniques were used for the identification of the various structure parameters, which was used to compare secondary alloy microstructure with primary alloy microstructure.

Keywords: A226 secondary aluminium alloy, deep etching, mechanical properties, recycling foundry aluminium alloy

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3437 Prediction of All-Beta Protein Secondary Structure Using Garnier-Osguthorpe-Robson Method

Authors: K. Tejasri, K. Suvarna Vani, S. Prathyusha, S. Ramya

Abstract:

Proteins are chained sequences of amino acids which are brought together by the peptide bonds. Many varying formations of the chains are possible due to multiple combinations of amino acids and rotation in numerous positions along the chain. Protein structure prediction is one of the crucial goals worked towards by the members of bioinformatics and theoretical chemistry backgrounds. Among the four different structure levels in proteins, we emphasize mainly the secondary level structure. Generally, the secondary protein basically comprises alpha-helix and beta-sheets. Multi-class classification problem of data with disparity is truly a challenge to overcome and has to be addressed for the beta strands. Imbalanced data distribution constitutes a couple of the classes of data having very limited training samples collated with other classes. The secondary structure data is extracted from the protein primary sequence, and the beta-strands are predicted using suitable machine learning algorithms.

Keywords: proteins, secondary structure elements, beta-sheets, beta-strands, alpha-helices, machine learning algorithms

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3436 Analysis of the Secondary Stationary Flow Around an Oscillating Circular Cylinder

Authors: Artem Nuriev, Olga Zaitseva

Abstract:

This paper is devoted to the study of a viscous incompressible flow around a circular cylinder performing harmonic oscillations, especially the steady streaming phenomenon. The research methodology is based on the asymptotic explanation method combined with the computational bifurcation analysis. Present studies allow to identify several regimes of the secondary streaming with different flow structures. The results of the research are in good agreement with experimental and numerical simulation data.

Keywords: oscillating cylinder, secondary streaming, flow regimes, asymptotic and bifurcation analysis

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3435 On Consolidated Predictive Model of the Natural History of Breast Cancer Considering Primary Tumor and Secondary Distant Metastases Growth in Patients with Lymph Nodes Metastases

Authors: Ella Tyuryumina, Alexey Neznanov

Abstract:

This paper is devoted to mathematical modelling of the progression and stages of breast cancer. We propose Consolidated mathematical growth model of primary tumor and secondary distant metastases growth in patients with lymph nodes metastases (CoM-III) as a new research tool. We are interested in: 1) modelling the whole natural history of primary tumor and secondary distant metastases growth in patients with lymph nodes metastases; 2) developing adequate and precise CoM-III which reflects relations between primary tumor and secondary distant metastases; 3) analyzing the CoM-III scope of application; 4) implementing the model as a software tool. Firstly, the CoM-III includes exponential tumor growth model as a system of determinate nonlinear and linear equations. Secondly, mathematical model corresponds to TNM classification. It allows to calculate different growth periods of primary tumor and secondary distant metastases growth in patients with lymph nodes metastases: 1) ‘non-visible period’ for primary tumor; 2) ‘non-visible period’ for secondary distant metastases growth in patients with lymph nodes metastases; 3) ‘visible period’ for secondary distant metastases growth in patients with lymph nodes metastases. The new predictive tool: 1) is a solid foundation to develop future studies of breast cancer models; 2) does not require any expensive diagnostic tests; 3) is the first predictor which makes forecast using only current patient data, the others are based on the additional statistical data. Thus, the CoM-III model and predictive software: a) detect different growth periods of primary tumor and secondary distant metastases growth in patients with lymph nodes metastases; b) make forecast of the period of the distant metastases appearance in patients with lymph nodes metastases; c) have higher average prediction accuracy than the other tools; d) can improve forecasts on survival of breast cancer and facilitate optimization of diagnostic tests. The following are calculated by CoM-III: the number of doublings for ‘non-visible’ and ‘visible’ growth period of secondary distant metastases; tumor volume doubling time (days) for ‘non-visible’ and ‘visible’ growth period of secondary distant metastases. The CoM-III enables, for the first time, to predict the whole natural history of primary tumor and secondary distant metastases growth on each stage (pT1, pT2, pT3, pT4) relying only on primary tumor sizes. Summarizing: a) CoM-III describes correctly primary tumor and secondary distant metastases growth of IA, IIA, IIB, IIIB (T1-4N1-3M0) stages in patients with lymph nodes metastases (N1-3); b) facilitates the understanding of the appearance period and inception of secondary distant metastases.

Keywords: breast cancer, exponential growth model, mathematical model, primary tumor, secondary metastases, survival

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3434 Effect of Operative Stabilization on Rib Fracture Healing in Porcine Experimental Model: A Pilot Study

Authors: Maria Stepankova, Lucie Vistejnova, Pavel Klein, Tereza Blassova, Marketa Slajerova, Radek Sedlacek, Martin Bartos, Jaroslav Chlupac

Abstract:

Background: Clinical outcome benefits of the segment rib fracture surgical therapy are well known and follow from better stabilization of the chest wall. Despite this, some authors still incline to conservative therapy and point out to possible rib fracture healing failure in connection with the bone vascular supply disturbance caused by metal plate implantation. This suggestion met neither experimental nor clinical verification and remains the object of discussion. In our pilot study we investigated the titanium plate fixation effect on the rib fracture healing in porcine model and its histological, biomechanical and radiological aspects. Materials and Method: Two porcine models (experimental group) underwent the operative chest wall stabilization with a titanium plate implantation after osteotomy. Two other porcine models (control group) were treated conservatively after osteotomy. Three weeks after surgery, all animals were sacrificed, treated ribs were explanted and the histological analysis, µCT imaging and biomechanical testing of the calluses tissue were performed. Results: In µCT imaging, experimental group showed a higher cortical bone volume compared to the control group. Histological analysis using the non-decalcified bone tissue blocks demonstrated more maturated callus with higher newly-formed osseous tissue ratio in experimental group in comparison to controls. In contrast, no significant differences in bone blood vessels supply in both groups were observed. This finding suggests that the bone blood supply in experimental group was not impaired. Biomechanical analysis using 3-point bending test demonstrated significantly higher bending stiffness and the maximum force in experimental group. Conclusion: Based on our observation, it could be concluded, that the titanium plate fixation of the rib fractures leads to faster bone callus maturation whereas does not cause the vascular supply impairment after 3 weeks and thus has a beneficial effect on the rib fracture healing.

Keywords: bone vascular supply, chest wall stabilization, fracture healing, histological analysis, titanium plate implantation

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3433 Evaluation of κ -Carrageenan Hydrogel Efficiency in Wound-Healing

Authors: Ali Ayatic, Emad Mozaffari, Bahareh Tanhaei, Maryam Khajenoori, Saeedeh Movaghar Khoshkho, Ali Ayati

Abstract:

The abuse of antibiotics, such as tetracycline (TC), is a great global threat to people and the use of topical antibiotics is a promising tact that can help to solve this problem. Antibiotic therapy is often appropriate and necessary for acute wound infections, while topical tetracycline can be highly efficient in improving the wound healing process in diabetics. Due to the advantages of drug-loaded hydrogels as wound dressing, such as ease of handling, high moisture resistance, excellent biocompatibility, and the ability to activate immune cells to speed wound healing, it was found as an ideal wound treatment. In this work, the tetracycline-loaded hydrogels combining agar (AG) and κ-carrageenan (k-CAR) as polymer materials were prepared, in which span60 surfactant was introduced inside as a drug carrier. The Field Emission Scanning Electron Microscopes (FESEM) and Fourier-transform infrared spectroscopy (FTIR) techniques were employed to provide detailed information on the morphology, composition, and structure of fabricated drug-loaded hydrogels and their mechanical properties, and hydrogel permeability to water vapor was investigated as well. Two types of gram-negative and gram-positive bacteria were used to explore the antibacterial properties of prepared tetracycline-contained hydrogels. Their swelling and drug release behavior was studied using the changing factors such as the ratio of polysaccharides (MAG/MCAR), the span60 surfactant concentration, potassium chloride (KCl) concentration and different release media (deionized water (DW), phosphate-buffered saline (PBS), and simulated wound fluid (SWF)) at different times. Finally, the kinetic behavior of hydrogel swelling was studied. Also, the experimental data of TC release to DW, PBS, and SWF using various mathematical models such as Higuchi, Korsmeyer-Peppas, zero-order, and first-order in the linear and nonlinear modes were evaluated.

Keywords: drug release, hydrogel, tetracycline, wound healing

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3432 Children of Syria: Using Drawings for Diagnosing and Treating Trauma

Authors: Fatten F. Elkomy

Abstract:

The Syrian refugees are the largest refugee population since World War II. Mostly, children, these individuals were exposed to intense traumatic events in their homeland, throughout their journey, and during settlement in foreign lands. Art is a universal language to express feelings and tough human experiences. It is also a medium for healing and promoting creativity and resilience. Literature review was conducted to examine the use of art to facilitate psychiatric interviews, diagnosis, and therapy with traumatized children. Results show a severe impact of childhood trauma on the increased risk for abuse, neglect, and psychiatric disorders. Clinicians must recognize, evaluated and provide help for these children. In conclusion, drawings are used to tell a story, reflect deep emotions, and create a meaningful self-recognition and determination. Participants will understand art therapy using the expressive therapies continuum framework to evaluate drawings and to promote healing for refugee children.

Keywords: art therapy, children drawings, Syrian refugees, trauma in childhood

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3431 Batch Biodrying of Pulp and Paper Secondary Sludge: Influence of Initial Moisture Content on the Process

Authors: César Huiliñir, Danilo Villanueva, Pedro Iván Alvarez, Francisco Cubillos

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Biodrying aims at removing water from biowastes and has been mostly studied for municipal solid wastes (MSW), while few studies have dealt with secondary sludge from the paper and pulp industry. The goal of this study was to investigate the effect of initial moisture content (MC) on the batch biodrying of pulp and paper secondary sludge, using rice husks as bulking agents. Three initial MCs were studied (54, 65, and 74% w.b.) in closed batch laboratory-scale reactors under adiabatic conditions and with a constant air-flow rate (0.65 l min-1 kg-1 wet solid). The initial MC of the mixture of secondary sludge and rice husks showed a significant effect on the biodrying process. Using initial moisture content between 54-65% w.b., the solid moisture content was reduce up to 37 % w.b. in ten days, getting calorific values between 8000-9000 kJ kg-1. It was concluded that a decreasing of initial MC improves the drying rate and decreases the solid volatile consumption, therefore, the optimization of biodrying should consider this parameter.

Keywords: biodrying, secondary sludge, initial moisture content, pulp and paper industry, rice husk

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3430 CICAP: Promising Wound Healing Gel from Bee Products and Medicinal Plants

Authors: Laïd Boukraâ

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Complementary and Alternative Medicine is an inclusive term that describes treatments, therapies, and modalities that are not accepted as components of mainstream education or practice, but that are performed on patients by some practitioners. While these treatments and therapies often form part of post-graduate education, study and writing, they are generally viewed as alternatives or complementary to more universally accepted treatments. Ancient civilizations used bee products and medicinal plants, but modern civilization and ‘education’ have seriously lessened our natural instinctive ability and capability. Despite the fact that the modern Western establishment appears to like to relegate apitherapy and aromatherapy to the status of 'folklore' or 'old wives' tales', they contain a vast spread of pharmacologically-active ingredients and each one has its own unique combination and properties. They are classified in modern herbal medicine according to their spheres of action. Bee products and medicinal plants are well-known natural product for their healing properties and their increasing popularity recently as they are widely used in wound healing. Honey not only has antibacterial properties which can help as an antibacterial agent but also has chemical properties which may further help in the wound healing process. A formulation with honey as its main component was produced into a honey gel. This new formulation has enhanced texture and is more user friendly for usage as well. This new formulation would be better than other formulas as it is hundred percent consisting of natural products and has been made into a better formulation. In vitro assay, animal model study and clinical trials have shown the effectiveness of LEADERMAX for the treatment of diabetic foot, burns, leg ulcer and bed sores. This one hundred percent natural product could be the best alternative to conventional products for wound and burn management. The advantages of the formulation are: 100% natural, affordable, easy to use, strong power of absorption, dry surface on the wound making a film, will not stick to the wound bed; helps relieve wound pain, inflammation, edema and bruising while improving comfort.

Keywords: bed sore bee products, burns, diabetic foot, medicinal plants, leg ulcer, wounds

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3429 Primary and Secondary Psychopathic Traits: Assessing Differences in Interpersonal Relationships through Friendship, Emotional Contagion, and Social Rewards

Authors: Silene Ten Seldam, Kiara Margarita Lu, Melina Nicole Kyranides

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Psychopathic traits are marked by a lack of empathy and an inability to maintain meaningful relationships. Yet little research has investigated differences in interpersonal relationships between primary and secondary psychopathic traits. Emotional contagion, the tendency to automatically mimic others’ facial expressions and movements, is a type of empathy contributing to relationship quality. Additionally, the motivating and pleasurable aspects of social interaction, social reward is integral to understanding relationships. Therefore, the current research investigated interpersonal relationships through relationship status, the quality of friendships, the susceptibility to positive (happiness, love) and negative (sadness, fear, anger) emotional contagion, and social reward. Recruited online, 389 participants between 18 and 76 years old (M = 33.61; of which 241 were female) completed self-report questionnaires assessing primary and secondary psychopathic traits, friendship, emotional contagion, and social rewards. Hierarchical multiple regression showed relationship status as a protective factor and that individuals with secondary psychopathic traits are less likely to be in a relationship. This study is the first to investigate emotional contagion with primary and secondary psychopathic traits. Emotional contagion for sadness predicted secondary psychopathic traits. Negative social potency (enjoying being cruel and antagonistic to others) predicted both primary and secondary traits. However, admiration and prosocial interactions only predicted primary psychopathic traits. Findings infer differences in maintaining relationships, regulating emotions, empathising with others through emotional contagion, and motivation to socially engage, perhaps due to each dimensions’distinct origins and manifestations.

Keywords: primary psychopathic traits, secondary psychopathic traits, interpersonal relationships, friendship, emotional contagion, social reward

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3428 The Dangers of Attentional Inertia in the Driving Task

Authors: Catherine Thompson, Maryam Jalali, Peter Hills

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The allocation of visual attention is critical when driving and anything that limits attention will have a detrimental impact on safety. Engaging in a secondary task reduces the amount of attention directed to the road because drivers allocate resources towards this task, leaving fewer resources to process driving-relevant information. Yet the dangers associated with a secondary task do not end when the driver returns their attention to the road. Instead, the attentional settings adopted to complete a secondary task may persist to the road, affecting attention, and therefore affecting driver performance. This 'attentional inertia' effect was investigated in the current work. Forty drivers searched for hazards in driving video clips while their eye-movements were recorded. At varying intervals they were instructed to attend to a secondary task displayed on a tablet situated to their left-hand side. The secondary task consisted of three separate computer games that induced horizontal, vertical, and random eye movements. Visual search and hazard detection in the driving clips were compared across the three conditions of the secondary task. Results showed that the layout of information in the secondary task, and therefore the allocation of attention in this task, had an impact on subsequent search in the driving clips. Vertically presented information reduced the wide horizontal spread of search usually associated with accurate driving and had a negative influence on the detection of hazards. The findings show the additional dangers of engaging in a secondary task while driving. The attentional inertia effect has significant implications for semi-autonomous and autonomous vehicles in which drivers have greater opportunity to direct their attention away from the driving task.

Keywords: attention, eye-movements, hazard perception, visual search

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3427 Net Work Meta Analysis to Identify the Most Effective Dressings to Treat Pressure Injury

Authors: Lukman Thalib, Luis Furuya-Kanamori, Rachel Walker, Brigid Gillespie, Suhail Doi

Abstract:

Background and objectives: There are many topical treatments available for Pressure Injury (PI) treatment, yet there is a lack of evidence with regards to the most effective treatment. The objective of this study was to compare the effect of various topical treatments and identify the best treatment choice(s) for PI healing. Methods: Network meta-analysis of published randomized controlled trials that compared the two or more of the following dressing groups: basic, foam, active, hydroactive, and other wound dressings. The outcome complete healing following treatment and the generalised pair-wise modelling framework was used to generate mixed treatment effects against hydroactive wound dressing, currently the standard of treatment for PIs. All treatments were then ranked by their point estimates. Main Results: 40 studies (1,757 participants) comparing 5 dressing groups were included in the analysis. All dressings groups ranked better than basic (i.e. saline gauze or similar inert dressing). The foam (RR 1.18; 95%CI 0.95-1.48) and active wound dressing (RR 1.16; 95%CI 0.92-1.47) ranked better than hydroactive wound dressing in terms of healing of PIs when the latter was used as the reference group. Conclusion & Recommendations: There was considerable uncertainty around the estimates, yet, the use of hydroactive wound dressings appear to perform better than basic dressings. Foam and active wound dressing groups show promise and need further investigation. High-quality research on clinical effectiveness of the topical treatments are warranted to identify if foam and active wound dressings do provide advantages over hydroactive dressings.

Keywords: Net work Meta Analysis, Pressure Injury, Dresssing, Pressure Ulcer

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3426 Agarose Based Multifunctional Nanofibrous Bandages for Wound Healing Applications

Authors: Sachin Latiyan, T. S. Sampath Kumar, Mukesh Doble

Abstract:

Natural polymer based nanofibrous wound dressings have gained increased attention because of their high surface area, bioactivity, biodegradability and resemblance to extracellular matrix. Agarose (a natural polymer) have been used largely for angiogenesis, cartilage formation and wound healing applications. However, electrospinning of agarose is tedious thereby rendering limited studies on fabrication and evaluation of agarose based nanofibrous wound dressings. Thus, present study focuses on the fabrication of agarose (10% w/v)/ polyvinyl alcohol (12% w/v) based multifunctional nanofibrous scaffolds. Zinc citrate (1, 3 and 5% w/w of the polymer) was added as a potential antibacterial agent to combat wound infections. The fabricated scaffolds exhibit ~500% swelling (in phosphate buffer saline) with enhanced mechanical strength which is suitable for most of the wound healing applications. In vitro studies were found to reveal an increased migration and proliferation of L929 mouse fibroblasts with agarose blends w.r.t to the control. The fabricated dressings were found to be effective against both Escherichia coli (Gram-negative) and Staphylococcus aureus (Gram-positive) bacterial strains. Hence, a multifunctional (as provides effective swelling and mechanical support along with antibacterial property), natural product based, eco-friendly scaffold was successfully fabricated to serve as a potential wound dressing material.

Keywords: antibacterial dressings, benign solvent, nanofibrous agarose, biocompatibility, enhanced swelling and mechanical strength, biopolymeric dressings

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3425 Energy Deposited by Secondary Electrons Generated by Swift Proton Beams through Polymethylmethacrylate

Authors: Maurizio Dapor, Isabel Abril, Pablo de Vera, Rafael Garcia-Molina

Abstract:

The ionization yield of ion tracks in polymers and bio-molecular systems reaches a maximum, known as the Bragg peak, close to the end of the ion trajectories. Along the path of the ions through the materials, many electrons are generated, which produce a cascade of further ionizations and, consequently, a shower of secondary electrons. Among these, very low energy secondary electrons can produce damage in the biomolecules by dissociative electron attachment. This work deals with the calculation of the energy distribution of electrons produced by protons in a sample of polymethylmethacrylate (PMMA), a material that is used as a phantom for living tissues in hadron therapy. PMMA is also of relevance for microelectronics in CMOS technologies and as a photoresist mask in electron beam lithography. We present a Monte Carlo code that, starting from a realistic description of the energy distribution of the electrons ejected by protons moving through PMMA, simulates the entire cascade of generated secondary electrons. By following in detail the motion of all these electrons, we find the radial distribution of the energy that they deposit in PMMA for several initial proton energies characteristic of the Bragg peak.

Keywords: Monte Carlo method, secondary electrons, energetic ions, ion-beam cancer therapy, ionization cross section, polymethylmethacrylate, proton beams, secondary electrons, radial energy distribution

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3424 Psychometric Properties of the Secondary School Stressor Questionnaire among Adolescents at Five Secondary Schools

Authors: Muhamad Saiful Bahri Yusoff

Abstract:

This study aimed to evaluate the construct, convergent, and discriminant validity of the Secondary School Stressor Questionnaire (3SQ) as well as to evaluate its internal consistency among adolescents in Malaysian secondary schools. A cross-sectional study was conducted on 700 secondary school students in five secondary schools. Stratified random sampling was used to select schools and participants. The confirmatory factor analysis was performed by AMOS to examine construct, convergent, and discriminant validity. The reliability analysis was performed by SPSS to determine internal consistency. The results showed that the original six-factor model with 44 items failed to achieve acceptable values of the goodness of fit indices, suggesting poor model fit. The new five-factor model of 3SQ with 22 items demonstrated acceptable level of goodness of fit indices to signify a model fit. The overall Cronbach’s alpha value for the new version 3SQ was 0.93, while the five constructs ranged from 0.68 to 0.94. The composite reliability values of each construct ranged between 0.68 and 0.93, indicating satisfactory to high level of convergent validity. Our study did not support the construct validity of the original version of 3SQ. We found the new version 3SQ showed more convincing evidence of validity and reliability to measure stressors of adolescents. Continued research is needed to verify and maximize the psychometric credentials of 3SQ across countries.

Keywords: stressors, adolescents, secondary school students, 3SQ, psychometric properties

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3423 Indigenous Influences on American Osteopathy

Authors: Lewis Mehl-Madrona, Josephine Conte, Barbara Mainguy

Abstract:

We explore the historical connection of Andrew Taylor Still with the aboriginal nations placed in Missouri, notably the Shawnee, Pawnee, Kickapoo, Cherokee, and the Pottowattomy. Still was fluent in Shawnee and himself was part Native American (Lumbee). These nations had well-developed forms of hands-on healing as well as practicing lightning bone setting. They were more sophisticated than their European-derived neighbors in treating fractures and discolocations. We trace Still’s writings as evidence for his connectedness with these people and respect for their traditions. We explore the traditional hands-on therapies of these nations and discover that they are quite similar to osteopathy. We propose that Still was a translator of traditional manual medicine of the nations into the mainstream of American society. While, surely, he made his own personal contributions to manual medicine, he did not invent osteopathy de novo but relied on methods that were well-developed across centuries for his inspiration.

Keywords: indigenous healing, indigenous bodywork, American osteopathy, Andrew Taylor Still, Cherokee, Shawnee

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3422 Experts' Perception of Secondary Education Quality Management Challenges in Ethiopia

Authors: Aklilu Alemu, Tak Cheung Chan

Abstract:

Following the intensification of secondary education in the developing world, the attention of Ethiopia has currently shifted to its quality education and its management. This study is aimed to explore experts’ perceptions of quality management challenges in secondary education in Ethiopia. The researchers employed a case study design recruiting participating supervisors from the Ministry of Education, region, zone, wereda, and cluster by using a purposeful sampling technique. Twenty-six interviewees took part in this study. The researchers employed NVivo 8 versions together with a thematic analysis process to analyze the data. This study revealed that major problems that affected quality management practices in Ethiopia were: lack of qualified experts at all levels; lack of accountability in every echelon; the changing nature of teacher education; the ineffectiveness of teacher-licensing programs; and lack of educational budget and the problem of utilizing this limited budget. The study concluded that the experts at different levels were not genuinely fulfilling their roles and responsibilities. Therefore, the Ministry of Finance and Economic Development, together with the concerned parties, needs to reconsider budget allocation for secondary education.

Keywords: education quality, Ethiopia, quality challenge, quality management, secondary education

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3421 Optical Coherence Tomography in Differentiation of Acute and Non-Healing Wounds

Authors: Ananya Barui, Provas Banerjee, Jyotirmoy Chatterjee

Abstract:

Application of optical technology in medicine and biology has a long track-record. In this endeavor, OCT is able to attract both engineers and biologists to work together in the field of photonics for establishing a striking non-invasive imaging technology. In contrast to other in vivo imaging modalities like Raman imaging, confocal imaging, two-photon microscopy etc. which can perform in vivo imaging upto 100-200 micron depth due to limitation in numerical aperture or scattering, however, OCT can achieve high-resolution imaging upto few millimeters of tissue structures depending on their refractive index in different anatomical location. This tomographic system depends on interference of two light waves in an interferometer to produce a depth profile of specimen. In wound healing, frequent collection of biopsies for follow-up of repair process could be avoided by such imaging technique. Real time skin OCT (the optical biopsy) has efficacy in deeper and faster illumination of cutaneou tissue to acquire high resolution cross sectional images of their internal micro-structure. Swept Source-OCT (SS-OCT), a novel imaging technique, can generate high-speed depth profile (~ 2 mm) of wound at a sweeping rate of laser with micron level resolution and optimum coherent length of 5-6 mm. Normally multi-layered skin tissue depicts different optical properties along with variation in thickness, refractive index and composition (i.e. keratine layer, water, fat etc.) according to their anatomical location. For instance, stratum corneum, the upper-most and relatively dehydrated layer of epidermis reflects more light and produces more lucid and a sharp demarcation line with rest of the hydrated epidermal region. During wound healing or regeneration, optical properties of cutaneous tissue continuously altered with maturation of wound bed. More mature and less hydrated tissue component reflects more light and becomes visible as a brighter area in comparison to immature region which content higher amount water or fat that depicts as a darker area in OCT image. Non-healing wound possess prolonged inflammation and inhibits nascent proliferative stage. Accumulation of necrotic tissues also prevents the repair of non-healing wounds. Due to high resolution and potentiality to reflect the compositional aspects of tissues in terms of their optical properties, this tomographic method may facilitate in differentiating non-healing and acute wounds in addition to clinical observations. Non-invasive OCT offers better insight regarding specific biological status of tissue in health and pathological conditions, OCT images could be associated with histo-pathological ‘gold standard’. This correlated SS-OCT and microscopic evaluation of the wound edges can provide information regarding progressive healing and maturation of the epithelial components. In the context of searching analogy between two different imaging modalities, their relative performances in imaging of healing bed were estimated for probing an alternative approach. Present study validated utility of SS-OCT in revealing micro-anatomic structure in the healing bed with newer information. Exploring precise correspondence of OCT images features with histo-chemical findings related to epithelial integrity of the regenerated tissue could have great implication. It could establish the ‘optical biopsy’ as a potent non-invasive diagnostic tool for cutaneous pathology.

Keywords: histo-pathology, non invasive imaging, OCT, wound healing

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3420 Innovative Strategies for Improving Writing Skills of Secondary Level Students

Authors: Ihsan Ullah Khan, Asim Kareem, Naveed Saif

Abstract:

This research study examined the application of innovative strategies for improving writing skills of Secondary level students. It also examined the steps taken by Secondary level teachers for the improvement of writing skills of their students. Effective written communication is the problem faced by all the ESL students at secondary level. The objective of the study was to help the secondary level students to overcome this problem. More specifically, this research study aimed to guide the teachers, teaching at secondary level, to bring innovation in their teaching by showing the results of innovative strategies. In order to know about the practices of the teachers, inside the classroom, data was calculated through rating scale questionnaire. After that experimental study was carried out. For the experimental study a 10th grade class was selected. Results were drawn by analyzing the pre and post-tests of the students with the help of independent sample t-test. The results showed that a significant change occurred in the writing skills of the students, belonging to Treatment group. No improvement was observed in the writing skills of the students, belonging to Control group. Thus this research study proved to be a great contribution by guiding the teachers to bring a significant change in the writing skills of the students.

Keywords: writing skills, innovative strategies, teachers, students, treatment group, control group

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3419 Collaborative Managerial Practices of Heads of Educational Institutions: Principals and Students Perspective

Authors: Nasir Ahmed

Abstract:

The study was designed to explore the managerial practices of secondary school principals in collaboration with different school stakeholder’s i.e. Teachers, students and school councils. The population of the study comprised 41 principals of government secondary schools, 249 Secondary school teachers (SSTs), 3360 students of 10th class and 300 members of the school councils of government secondary schools (both boys and girls) in Wazirabad, Pakistan. 50 percentage principals, 40 percentage SSTs, 3 percentage students and 15% members of the school councils were taken as a sample of the study. Data was collected through different four-questionnaire design on a five point rating scale. The questionnaires for teachers, students, and school councils were developed to see their involvement in school management. The questionnaire for the secondary school principals was designed to find out to see their perceptions about the involvement of these stakeholders in school’s management. The results of the students indicated that, the remaining stakeholders were not cooperating with the school management. It was recommended that all the stakeholders be provided equal opportunities to take an active part in the school management. This may be based on a formal mechanism for the collaborative efforts of all the stakeholders.

Keywords: collaboration, management, school stakeholders, school councils, managerial practices

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