Search results for: natural resources management

Authors: Zainab Elazab, Azhar Aziz

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Background: Spontaneous Splenic artery pseudoaneurysm rupture is a rare condition which is potentially life threatening, if not detected and managed early. We report a case of abdominal pain with intraperitoneal free fluid, which turned out to be spontaneous rupture of a splenic artery pseudoaneurysm, and was treated with arterial embolization. Case presentation: A 28-year old, previously healthy male presented to the ED with a history of sudden onset upper abdominal pain and fainting attack. The patient denied any history of trauma or prior similar attacks. On examination, the patient had tachycardia and a low-normal BP (HR 110, BP 106/66) but his other vital signs were normal (Temp. 37.2, RR 18 and SpO2 100%). His abdomen was initially soft with mild tenderness in the upper region. Blood tests showed leukocytosis of 12.3 X109/L, Hb of 12.6 g/dl and lactic acid of 5.9 mmol/L. Ultrasound showed trace of free fluid in the perihepatic and perisplenic areas, and a splenic hypoechoic lesion. The patient remained stable; however, his abdomen became increasingly tender with guarding. We made a provisional diagnosis of a perforated viscus and the patient was started on IV fluids and IV antibiotics. An erect abdominal x-ray did not show any free air under the diaphragm so a CT abdomen was requested. Meanwhile, bedside ultrasound was repeated which showed increased amount of free fluid, suggesting intra-abdominal bleeding as the most probable etiology for the condition. His CT abdomen revealed a splenic injury with multiple lacerations, a focal intrasplenic enhancing area on venous phase scan (suggesting a pseudoaneurysm with associated splenic intraparenchymal, sub capsular and perisplenic hematomas). Free fluid in the subhepatic and intraperitoneal regions along the small bowel was also detected. Angiogram was done which confirmed a diagnosis of pseudoaneurysm of intrasplenic arterial branch, and angio-embolization was done to control the bleeding. The patient was later discharged in good condition with a surgery follow-up. Conclusion: Splenic artery pseudoaneurysm rupture is a rare cause of abdominal pain which should be considered in any case of abdominal pain with intraperitoneal bleeding. Early management is crucial as it carries a high mortality. Bedside ultrasound is a useful tool to help for early diagnosis of such cases.

Keywords: abdominal pain, pseudo aneurysm, rupture, splenic artery

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Authors: Xiaoyuan Chen

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Background: This study aimed to characterize the epidemiological and clinical features of five rare subtypes of hepatocellular carcinoma (HCC) and to create a competing risk nomogram for predicting cancer-specific survival. Methods: This study used the Surveillance, Epidemiology, and End Results database to analyze the clinicopathological data of 50,218 patients with classic HCC and five rare subtypes (ICD-O-3 Histology Code=8170/3-8175/3) between 2004 and 2018. The annual percent change (APC) was calculated using Joinpoint regression, and a nomogram was developed based on multivariable competing risk survival analyses. The prognostic performance of the nomogram was evaluated using the Akaike information criterion, Bayesian information criterion, C-index, calibration curve, and area under the receiver operating characteristic curve. Decision curve analysis was used to assess the clinical value of the models. Results: The incidence of scirrhous carcinoma showed a decreasing trend (APC=-6.8%, P=0.025), while the morbidity of other rare subtypes remained stable from 2004 to 2018. The incidence-based mortality plateau in all subtypes during the period. Clear cell carcinoma was the most common subtype (n=551, 1.1%), followed by fibrolamellar (n=241, 0.5%), scirrhous (n=82, 0.2%), spindle cell (n=61, 0.1%), and pleomorphic (n=17, ~0%) carcinomas. Patients with fibrolamellar carcinoma were younger and more likely to have non-cirrhotic liver and better prognoses. Scirrhous carcinoma shared almost the same macro clinical characteristics and outcomes as classic HCC. Clear cell carcinoma tended to occur in the Asia-Pacific elderly male population, and more than half of them were large HCC (Size>5cm). Sarcomatoid (including spindle cell and pleomorphic) carcinoma was associated with larger tumor size, poorer differentiation, and more dismal prognoses. The pathological subtype, T stage, M stage, surgery, alpha-fetoprotein, and cancer history were identified as independent predictors in patients with rare subtypes. The nomogram showed good calibration, discrimination, and net benefits in clinical practice. Conclusion: The rare subtypes of HCC had distinct clinicopathological features and biological behaviors compared with classic HCC. Our findings could provide a valuable reference for clinicians. The constructed nomogram could accurately predict prognoses, which is beneficial for individualized management.

Keywords: hepatocellular carcinoma, pathological subtype, fibrolamellar carcinoma, scirrhous carcinoma, clear cell carcinoma, spindle cell carcinoma, pleomorphic carcinoma

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Authors: Neisha Shepherd

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In Australia, an independent children's lawyer is appointed to represent a child in parenting disputes in the Federal Circuit and Family Court of Australia, where there are complex issues such as child protection, family violence, high conflict, relocation, and parental alienation. The appointment of an Independent Children's Lawyer is to give effect in the family law proceedings of the United Nations Convention on the Rights of the Child, in particular Article 3.1, 12.1, and 12.2. There is a strong focus on alternative dispute resolution in the Australian Family Law jurisdiction in matters that are before the Court that has formed part of the case management pathways. An Independent Children's Lawyer's role is even more crucial in assisting families in resolving the most complex parenting disputes through mediation as they are required to act impartial and be independent of the Court and the parties. A child has the right to establish a professional relationship with the Independent Children's Lawyer. This relationship is usually established over a period of time, and the child is afforded the opportunity to talk about their views and wishes and participate in decisions that affect them. In considering the views and wishes of the child, the Independent Children's lawyer takes into account the different emotional, cognitive, and intellectual developmental levels, family structures, family dynamics, sibling relationships, religious and cultural backgrounds; and that children are vulnerable to external pressures when caught in disputes involving their parents. With the increase of child-inclusive mediations being used to resolve family disputes in the best interests of a child, an Independent Children's Lawyer can have a critical role in this process with the specialised skills that they have working with children in the family law jurisdiction. This paper will discuss how inclusive child mediation with the assistance of an Independent Children's Lawyer can assist in the resolution of some of the most complex parenting disputes by examining through case studies: the effectiveness and challenges of such an approach; strategies to work with child clients, adolescents, and sibling groups; ways to provide feedback regarding a child's views and wishes and express a child's understanding, actual experiences and perspective to parties in a mediation and whether it is appropriate to do so; strategies and examples to assist in developing parenting plans or orders that are in the best interest of a child that is workable and achievable; how to deal with cases that involve serious child protection and family violence and strategies to ensure that child safety is paramount; the importance of feedback to the child client. Finally this paper will explore some of the challenges for Independent Children's Lawyers in relation to child-inclusive mediations where matters do not resolve.

Keywords: child inclusive mediation, independent children's lawyer, family violence, child protection

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Authors: Gikunda Aloise, Mjema Saida, Barasa Herbert, Wanyungu John, Kimani Maureen

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Background: Community Health Workforce (CHW) is health care providers at the community level (Level 1) and serves as a bridge between the community and the formal healthcare system. This human resource has enormous potential to extend healthcare services and ensures that the vulnerable, marginalized, and hard-to-reach populations have access to quality healthcare services at the community and primary health facility levels. However, these cadres are neither recognized, remunerated, nor in most instances, registered in a master list. Management and supervision of CHWs is not easy if their individual demographics, training capacity and incentives is not well documented through a centralized registry. Description: In February 2022, Amref supported the Kenya Ministry of Health in developing a community health workforce database called Community Health Workers Master List Registry (CHWML), which is hosted in Kenya Health Information System (KHIS) tracker. CHW registration exercise was through a sensitization meeting conducted by the County Community Health Focal Person for the Sub-County Community Health Focal Person and Community Health Assistants who uploaded information on individual demographics, training undertaken and incentives received by CHVs. Care was taken to ensure compliance with Kenyan laws on the availability and use of personal data as prescribed by the Data Protection Act, 2019 (DPA). Results and lessons learnt: By June 2022, 80,825 CHWs had been registered in the system; 78,174 (96%) CHVs and 2,636 (4%) CHAs. 25,235 (31%) are male, 55,505 (68%) are female & 85 (1%) are transgender. 39,979. (49%) had secondary education and 2500 (3%) had no formal education. Only 27 641 (34%) received a monthly stipend. 68,436 CHVs (85%) had undergone basic training. However, there is a need to validate the data to align with the current situation in the counties. Conclusions/Next steps: The use of CHWML will unlock opportunities for building more resilient and sustainable health systems and inform financial planning, resource allocation, capacity development, and quality service delivery. The MOH will update the CHWML guidelines in adherence to the data protection act which will inform standard procedures for maintaining, updating the registry and integrate Community Health Workforce registry with the HRH system.

Keywords: community health registry, community health volunteers (CHVs), community health workers masters list (CHWML), data protection act

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Authors: Nélio Veiga, Paula Ferreira, Tiago Correia, Maria J. Correia, Carlos Pereira, Odete Amaral, Ilídio J. Correia

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Introduction: The application of fissure sealants is considered to be an important primary prevention method used in dental medicine. However, the formation of microleakage gaps between tooth enamel and the fissure sealant applied is one of the most common reasons of dental caries development in teeth with fissure sealants. The association between various dental biomaterials may limit the major disadvantages and limitations of biomaterials functioning in a complementary manner. The present study consists in the incorporation of a cariostatic agent – silver diamine fluoride (SDF) – in a resin-based fissure sealant followed by the study of release kinetics by spectrophotometry analysis of the association between both biomaterials and assessment of the inhibitory effect on the growth of the reference bacterial strain Streptococcus mutans (S. mutans) in an in vitro study. Materials and Methods: An experimental in vitro study was designed consisting in the entrapment of SDF (Cariestop^® 12% and 30%) into a commercially available fissure sealant (Fissurit^®), by photopolymerization and photocrosslinking. The same sealant, without SDF was used as a negative control. The effect of the sealants on the growth of S. mutans was determined by the presence of bacterial inhibitory halos in the cultures at the end of the incubation period. In order to confirm the absence of bacteria in the surface of the materials, Scanning Electron Microscopy (SEM) characterization was performed. Also, to analyze the release profile of SDF along time, spectrophotometry technique was applied. Results: The obtained results indicate that the association of SDF to a resin-based fissure sealant may be able to increase the inhibition of S. mutans growth. However, no SDF release was noticed during the in vitro release studies and no statistical significant difference was verified when comparing the inhibitory halo sizes obtained for test and control group.  Conclusions: In this study, the entrapment of SDF in the resin-based fissure sealant did not potentiate the antibacterial effect of the fissure sealant or avoid the immediate development of dental caries. The development of more laboratorial research and, afterwards, long-term clinical data are necessary in order to verify if this association between these biomaterials is effective and can be considered for being used in oral health management. Also, other methodologies for associating cariostatic agents and sealant should be addressed.

Keywords: biomaterial, fissure sealant, primary prevention, silver diamine fluoride

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Authors: Rose Vanessa Bandeira Reidel, Bernardo Melai, Pier Luigi Cioni, Luisa Pistelli

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Ziziphus jujuba Miller is a common species of the Ziziphus genus (Rhamnaceae family) native to the tropics and subtropics known for its edible fruits, fresh consumed or used in healthy food, as flavoring and sweetener. Many phytochemicals and biological activities are described for this species. In this work, the aroma profiles emitted in vivo by whole fresh organs (leaf, bud flower, flower, green and red fruits) were analyzed separately by mean of solid phase micro-extraction (SPME) coupled with gas chromatography mass spectrometry (GC-MS). The emitted volatiles from different plant parts were analysed using Supelco SPME device coated with polydimethylsiloxane (PDMS, 100µm). Fresh plant material was introduced separately into a glass conical flask and allowed to equilibrate for 20 min. After the equilibration time, the fibre was exposed to the headspace for 15 min at room temperature, the fibre was re-inserted into the needle and transferred to the injector of the CG and CG-MS system, where the fibre was desorbed. All the data were submitted to multivariate statistical analysis, evidencing many differences amongst the selected plant parts and their developmental stages. A total of 144 compounds were identified corresponding to 94.6-99.4% of the whole aroma profile of jujube samples. Sesquiterpene hydrocarbons were the main chemical class of compounds in leaves also present in similar percentage in flowers and bud flowers where (E, E)-α-farnesene was the main constituent in all cited plant parts. This behavior can be due to a protection mechanism against pathogens and herbivores as well as resistance to abiotic factors. The aroma of green fruits was characterized by high amount of perillene while the red fruits release a volatile blend mainly constituted by different monoterpenes. The terpenoid emission of flesh fruits has important function in the interaction with animals including attraction of seed dispersers and it is related to a good quality of fruits. This study provides for the first time the chemical composition of the volatile emission from different Ziziphus jujuba organs. The SPME analyses of the collected samples showed different patterns of emission and can contribute to understand their ecological interactions and fruit production management.

Keywords: Rhamnaceae, aroma profile, jujube organs, HS-SPME, GC-MS

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Authors: Dipak Subedi, Anil Giri, Christine Whitt, Tia McDonald

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This study aims to understand the impact of the pandemic on the overall economic well-being of the agricultural sector of the United States. The two key metrics used to examine the economic well-being are the bankruptcy rate of the U.S. farm operations and the operating profit margin. One of the primary reasons for farm operations (in the U.S.) to file for bankruptcy is continuous negative profit or a significant decrease in profit. The pandemic caused significant supply and demand shocks in the domestic market. Furthermore, the ongoing trade disruptions, especially with China, also impacted the prices of agricultural commodities. The significantly reduced demand for ethanol and closure of meat processing plants affected both livestock and crop producers. This study uses data from courts to examine the bankruptcy rate over time of U.S. farm operations. Preliminary results suggest there wasn’t an increase in farm operations filing for bankruptcy in 2020. This was most likely because of record high Government payments to producers in 2020. The Federal Government made direct payments of more than $45 billion in 2020. One commonly used economic metric to measure farm profitability is the operating profit margin (OPM). Operating profit margin measures profitability as a share of the total value of production and government payments. The Economic Research Service of the United States Department of Agriculture defines a farm operation to be in a) a high-risk zone if the OPM is less than 10 percent and b) a low-risk zone if the OPM is higher than 25 percent. For this study, OPM was calculated for small, medium, and large-scale farm operations using the data from the Agriculture Resource Management Survey (OPM). Results show that except for small family farms, the share of farms in high-risk zone decreased in 2020 compared to the most recent non-pandemic year, 2019. This was most likely due to higher commodity prices at the end of 2020 and record-high government payments. Further investigation suggests a lower share of smaller farm operations receiving lower average government payments resulting in a large share (over 70 percent) being in the critical zone. This study should be of interest to multiple stakeholders, including policymakers across the globe, as it shows the resilience of the U.S. agricultural system as well as (some) impact of government payments.

Keywords: U.S. farm sector, COVID-19, operating profit margin, farm bankruptcy, ag finance, government payments to the farm sector

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Authors: Angelis P. Barlampas

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Objective: The confusion of terms is a common practice in many situations of the everyday life. But, in some circumstances, such as in medicine, the precise meaning of a word curries a critical role for the health of the patient. Fahr disease and Fahr syndrome are often falsely used interchangeably, but they are two different conditions with different physical histories of different etiology and different medical management. A case of the seldom Fahr disease is presented, and a comparison with the more common Fahr syndrome follows. Materials and method: A 72 years old patient came to the emergency department, complaining of some kind of non specific medal disturbances, like anxiety, difficulty of concentrating, and tremor. The problems had a long course, but he had the impression of getting worse lately, so he decided to check them. Past history and laboratory tests were unremarkable. Then, a computed tomography examination was ordered. Results: The CT exam showed bilateral, hyperattenuating areas of heavy, dense calcium type deposits in basal ganglia, striatum, pallidum, thalami, the dentate nucleus, and the cerebral white matter of frontal, parietal and iniac lobes, as well as small areas of the pons. Taking into account the absence of any known preexisting illness and the fact that the emergency laboratory tests were without findings, a hypothesis of the rare Fahr disease was supposed. The suspicion was confirmed with further, more specific tests, which showed the lack of any other conditions which could probably share the same radiological image. Differentiating between Fahr disease and Fahr syndrome. Fahr disease: Primarily autosomal dominant Symmetrical and bilateral intracranial calcifications The patient is healthy until the middle age Absence of biochemical abnormalities. Family history consistent with autosomal dominant Fahr syndrome :Earlier between 30 to 40 years old. Symmetrical and bilateral intracranial calcifications Endocrinopathies: Idiopathic hypoparathyroidism, secondary hypoparathyroidism, hyperparathyroidism, pseudohypoparathyroidism ,pseudopseudohypoparathyroidism, e.t.c The disease appears at any age There are abnormal laboratory or imaging findings. Conclusion: Fahr disease and Fahr syndrome are not the same illness, although this is not well known to the inexperienced doctors. As clinical radiologists, we have to inform our colleagues that a radiological image, along with the patient's history, probably implies a rare condition and not something more usual and prompt the investigation to the right route. In our case, a genetic test could be done earlier and reveal the problem, and thus avoiding unnecessary and specific tests which cost in time and are uncomfortable to the patient.

Keywords: fahr disease, fahr syndrome, CT, brain calcifications

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Authors: S. Rodosik, J. P. Poirot-Crouvezier, Y. Bultel

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With the expansion of the hydrogen economy, Proton Exchange Membrane Fuel Cell (PEMFC) systems are often presented as promising energy converters suitable for transport applications. However, reaching a durability of 5000 h recommended by the U.S. Department of Energy and decreasing system cost are still major hurdles to their development. In order to increase the system efficiency and simplify the system without affecting the fuel cell lifetime, an architecture called alternative fuel feeding has been developed. It consists in a fuel cell stack divided into two parts, alternatively fed, implemented on a 5-kW system for real scale testing. The operation strategy can be considered close to Dead End Anode (DEA) with specific modifications to avoid water and nitrogen accumulation in the cells. The two half-stacks are connected in series to enable each stack to be alternatively fed. Water and nitrogen accumulated can be shifted from one half-stack to the other one according to the alternative feeding frequency. Thanks to the homogenization of water vapor along the stack, water management was improved. The operating conditions obtained at system scale are close to recirculation without the need of a pump or an ejector. In a first part, a performance comparison with the DEA strategy has been performed. At high temperature and low pressure (80°C, 1.2 bar), performance of alternative fuel feeding was higher, and the system efficiency increased. In a second part, in order to highlight the benefits of the architecture on the fuel cell lifetime, two durability tests, lasting up to 1000h, have been conducted. A test on the 5-kW system has been compared to a reference test performed on a test bench with a shorter stack, conducted with well-controlled operating parameters and flow-through hydrogen strategy. The durability test is based upon the Fuel Cell Dynamic Load Cycle (FC-DLC) protocol but adapted to the system limitations: without OCV steps and a maximum current density of 0.4 A/cm². In situ local measurements with a segmented S++® plate performed all along the tests, showed a more homogeneous distribution of the current density with alternative fuel feeding than in flow-through strategy. Tests performed in this work enabled the understanding of this architecture advantages and drawbacks. Alternative fuel feeding architecture appeared to be a promising solution to ensure the humidification function at the anode side with a simplified fuel cell system.

Keywords: automotive conditions, durability, fuel cell system, proton exchange membrane fuel cell, stack architecture

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Authors: Raquel Pérez Estébanez

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This research proposal seeks to delve into the intricate relationship between performance indicators and sustainability metrics within the realm of corporate entities. As businesses grapple with the imperative of sustainable practices, understanding how traditional performance metrics intersect with sustainability indicators becomes paramount. This study endeavours to unravel the dynamics of this relationship, aiming to illuminate ways in which these two sets of metrics can be harmoniously integrated to offer a comprehensive evaluation of a company's success while considering its environmental and societal impact. The integration of performance measures and sustainability metrics has become a focal point in contemporary business literature as companies strive to balance economic success with environmental and social responsibility. Performance indicators traditionally focus on financial metrics such as return on assets, return on equity and profitability. Sustainability metrics, on the other hand, encompass environmental, social, and governance (ESG) factors. The challenge lies in aligning these diverse metrics for a comprehensive assessment. Researches indicates a growing trend among corporations to incorporate sustainability metrics into their performance evaluations. However, challenges persist, with companies often struggling to integrate non-financial indicators seamlessly. The works of GRI (Global Reporting Initiative) and SASB (Sustainability Accounting Standards Board) propose frameworks for harmonizing financial and sustainability reporting. These frameworks emphasize the need for companies to disclose material sustainability information alongside traditional financial metrics. Several studies suggest that integrating sustainability metrics positively influences decision-making. Companies considering sustainability factors in decision-making exhibit improved long-term performance and risk management. Other researches highlights the increasing importance of sustainability metrics in shaping stakeholder perceptions. Investors, in particular, are placing greater emphasis on companies' environmental and social performance when making investment decisions. Industry-specific studies underscore the need for customized approaches to integration due to sector-specific challenges and opportunities. This suggests that a one-size-fits-all solution may not be applicable across diverse industries. While progress is evident, challenges persist, necessitating further research to refine integration frameworks, address industry-specific nuances, and assess the long-term impact on organizational performance and societal contributions.

Keywords: ESG, ROE, ROA, performance measures

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Authors: J. D. García Espinel, Paula Pérez Sánchez, Carlos Egea Ruiz, Carlos Lardín Mifsut, Andrés López-Aranguren Oliver

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This paper shortly describes three main actuations over a Waste Water Treatment Plant (WWTP) for reducing its energy consumption: Optimization of the biological reactor in the aeration stage by including new control algorithms and introducing new efficient equipment, the installation of an innovative hybrid system with zero Grid injection (formed by 100kW of PV energy and 5 kW of mini-wind energy generation) and an intelligent management system for load consumption and energy generation control in the most optimum way. This project called RENEWAT, involved in the European Commission call LIFE 2013, has the main objective of reducing the energy consumptions through different actions on the processes which take place in a WWTP and introducing renewable energies on these treatment plants, with the purpose of promoting the usage of treated waste water for irrigation and decreasing the C02 gas emissions. WWTP is always required before waste water can be reused for irrigation or discharged in water bodies. However, the energetic demand of the treatment process is high enough for making the price of treated water to exceed the one for drinkable water. This makes any policy very difficult to encourage the re-use of treated water, with a great impact on the water cycle, particularly in those areas suffering hydric stress or deficiency. The cost of treating waste water involves another climate-change related burden: the energy necessary for the process is obtained mainly from the electric network, which is, in most of the cases in Europe, energy obtained from the burning of fossil fuels. The innovative part of this project is based on the implementation, adaptation and integration of solutions for this problem, together with a new concept of the integration of energy input and operative energy demand. Moreover, there is an important qualitative jump between the technologies used and the alleged technologies to use in the project which give it an innovative character, due to the fact that there are no similar previous experiences of a WWTP including an intelligent discrimination of energy sources, integrating renewable ones (PV and Wind) and the grid.

Keywords: aeration system, biological reactor, CO2 emissions, energy efficiency, hybrid systems, LIFE 2013 call, process optimization, renewable energy sources, wasted water treatment plants

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Authors: Ali K. M. Al-Nasrawi, Uday A. Al-Hamdany, Sarah M. Hamylton, Brian G. Jones, Yasir M. Alyazichi

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Surface elevation dynamics have always responded to disturbance regimes. Creating Digital Elevation Models (DEMs) to detect surface dynamics has led to the development of several methods, devices and data clouds. DEMs can provide accurate and quick results with cost efficiency, in comparison to the inherited geomatics survey techniques. Nowadays, remote sensing datasets have become a primary source to create DEMs, including LiDAR point clouds with GIS analytic tools. However, these data need to be tested for error detection and correction. This paper evaluates various DEMs from different data sources over time for Apple Orchard Island, a coastal site in southeastern Australia, in order to detect surface dynamics. Subsequently, 30 chosen locations were examined in the field to test the error of the DEMs surface detection using high resolution global positioning systems (GPSs). Results show significant surface elevation changes on Apple Orchard Island. Accretion occurred on most of the island while surface elevation loss due to erosion is limited to the northern and southern parts. Concurrently, the projected differential correction and validation method aimed to identify errors in the dataset. The resultant DEMs demonstrated a small error ratio (≤ 3%) from the gathered datasets when compared with the fieldwork survey using RTK-GPS. As modern modelling approaches need to become more effective and accurate, applying several tools to create different DEMs on a multi-temporal scale would allow easy predictions in time-cost-frames with more comprehensive coverage and greater accuracy. With a DEM technique for the eco-geomorphic context, such insights about the ecosystem dynamic detection, at such a coastal intertidal system, would be valuable to assess the accuracy of the predicted eco-geomorphic risk for the conservation management sustainability. Demonstrating this framework to evaluate the historical and current anthropogenic and environmental stressors on coastal surface elevation dynamism could be profitably applied worldwide.

Keywords: DEMs, eco-geomorphic-dynamic processes, geospatial Information Science, remote sensing, surface elevation changes,

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Authors: Aime P. Lampad-Dela Pena, Rhodora V. Azanza, Cesar L. Villanoy, Ephrime B. Metillo, Aletta T. Yniguez

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Phytoplankton community changes in relation to environmental parameters were compared between and within, the three interconnected basins. Phytoplankton samples were collected from thirteen stations of Baler Bay and Casiguran Sound, Aurora last May 2013 by filtering 10 L buckets of surface water and 5 L Niskin samples at 20 meters and at 30 to 40 meters depths through a 20um sieve. Duplicate samples per station were preserved, counted, and identified up to genus level, in order to determine the horizontal and vertical spatial variation of different phytoplankton functional groups during the summer ebb and flood flow. Baler Bay, Outer and Inner Casiguran Sound had a total of 89 genera from four phytoplankton groups: Diatom (62), Dinoflagellate (25), Silicoflagellate (1) and Cyanobacteria (1). Non-toxic diatom Chaetoceros spp. bloom (averaged 2.0 x 105 to 2.73 x 106 cells L⁻¹) co-existed with Bacteriastrum spp. at surface waters in Inner and Outer Casiguran. Pseudonitzschia spp. (1.73 x 106 cells L⁻¹) bloomed at bottom waters of the innermost embayment near Casiguran mangrove estuary. Cyanobacteria Trichodesmium spp. significantly increased during ebb tide at the mid-water layers (20 meters depth) in the three basins (ranged from 6, 900 to 15, 125 filaments L⁻¹), forming another bloom. Gonyaulax spp. - dominated dinoflagellate did not significantly change with depth across the three basins. Overall, diatoms and dinoflagellates community assemblages significantly changed between sites (p < 0.001) while diatoms and cyanobacteria varied within Casiguran outer and inner sites (p < 0.001) only. Tidal fluctuations significantly affected dinoflagellates and diatom groups (p < 0.001) in inner and baler sites. Chlorophyll significantly varied between (KW, p < 0.001) and within each basins (KW, p < 0.05), no tidal influence, with the highest value at inner Casiguran and at deeper waters indicating deep chlorophyll maxima. Aurora’s distinct shelf morphology favoring counterclockwise circulation pattern, advective transport, and continuous stratification of the water column could basically affect the phytoplankton assemblages and water quality of Baler Bay and Casiguran inner and outer basins. Observed spatial phytoplankton community changes with multi-species diatom and cyanobacteria bloom at different water layers of the three inter-connected embayments would be vital for any environmental management initiatives in Aurora.

Keywords: aurora fronting Philippines Rise, intermonsoon, multi-species diatom bloom, spatial variability

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Authors: Ram Sharan Mehta, Sanjeev Sharma

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Introduction: Haemodialysis (HD) is a mechanical process of removing waste products from the blood and replacing essential substances in patients with renal failure. First artificial kidney developed in Netherlands in 1943 AD First successful treatment of CRF reported in 1960AD, life-saving treatment begins for CRF in 1972 AD. In 1973 AD Medicare took over financial responsibility for many clients and after that method become popular. BP Koirala institute of health science is the only center outside the Kathmandu, where HD service is available. In BPKIHS PD started in Jan.1998, HD started in August 2002 till September 2003 about 278 patients received HD. Day by day the number of HD patients is increasing in BPKIHS as with institutional growth. No such type of study was conducted in past hence there is lack of valid & reliable baseline data. Hence, the investigators were interested to conduct the study on " Profile of the Renal Failure patients under Haemodialysis at B.P. Koirala Institute of Health Sciences Nepal". Objectives: The objectives of the study were: to find out the Socio-demographic characteristics of the patients, to explore the knowledge of the patients regarding disease process and Haemodialysis and to identify the problems encountered by the patients. Methods: It is a hospital-based exploratory study. The population of the study was the clients under HD and the sampling method was purposive. Fifty-four patients undergone HD during the period of 17 July 2012 to 16 July 2013 of complete one year were included in the study. Structured interview schedule was used for collect data after obtaining validity and reliability. Results: Total 54 subjects had undergone for HD, having age range of 5-75 years and majority of them were male (74%) and Hindu (93 %). Thirty-one percent illiterate, 28% had agriculture their occupation, 80% of them were from very poor community, and about 30% subjects were unaware about the disease they suffering. Majority of subjects reported that they had no complications during dialysis (61%), where as 20% reported nausea and vomiting, 9% Hypotension, 4% headache and 2%chest pain during dialysis. Conclusions: CRF leading to HD is a long battle for patients, required to make major and continuous adjustment, both physiologically and psychologically. The study suggests that non-compliance with HD regimen were common. The socio-demographic and knowledge profile will help in the management and early prevention of disease and evaluate aspects that will influence care and patients can select mode of treatment themselves properly.

Keywords: profile, haemodialysis, Nepal, patients, treatment

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Authors: Pin Yu Chen, Puay Chuan Lee, Yu Jen Loo, Ju Xia Zhang, Deborah Teo, Jack Wei Chieh Tan, Biauw Chi Ong

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Background: Synchronous communication, such as telephone calls, remains the standard communication method between nurses and other healthcare professionals in Singapore public hospitals despite advances in asynchronous technological platforms, such as instant messaging. Although miscommunication is one of the most common causes of lapses in patient care, there is a scarcity of research characterizing baseline inter-professional healthcare communications in a hospital setting due to logistic difficulties. Objective: This study aims to characterize the frequency and patterns of communication behaviours among healthcare professionals. Methods: The one-week observational study was conducted on Monday through Sunday at the nursing station of a cardiovascular medicine and cardiothoracic surgery inpatient ward at the National Heart Centre Singapore. Subjects were shadowed by two physicians for sixteen hours or consecutive morning and afternoon nursing shifts. Communications were logged and characterized by type, duration, caller, and recipient. Results: A total of 1,023 communication events involving the attempted use of the common telephones at the nursing station were logged over a period of one week, corresponding to a frequency of one event every 5.45 minutes (SD 6.98, range 0-56 minutes). Nurses initiated the highest proportion of outbound calls (38.7%) via the nursing station common phone. A total of 179 face-to-face communications (17.5%), 362 inbound calls (35.39%), 481 outbound calls (47.02%), and 1 emergency alert (0.10%) were captured. Average response time for task-oriented communications was 159 minutes (SD 387.6, range 86-231). Approximately 1 in 3 communications captured aimed to clarify patient-related information. The total duration of time spent on synchronous communication events over one week, calculated from total inbound and outbound calls, was estimated to be a total of 7 hours. Conclusion: The results of our study showed that there is a significant amount of time spent on inter-professional healthcare communications via synchronous channels. Integration of patient-related information and use of asynchronous communication channels may help to reduce the redundancy of communications and clarifications. Future studies should explore the use of asynchronous mobile platforms to address the inefficiencies observed in healthcare communications.

Keywords: healthcare communication, healthcare management, nursing, qualitative observational study

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Authors: Catherine Begin, Jeanne Berthod, Manon Truchon

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In Quebec, there are more than 8,000 community organizations throughout the province, representing more than 72,000 jobs. Working in a community setting involves several particularities (e.g., contact with the suffering of users, feelings of powerlessness, institutional pressure, unstable funding, etc.), which can put workers at risk of fatigue, burnout, and psychological distress. A 2007 study shows that 52% of community workers surveyed have a high psychological distress index. The Ricochet project, founded in 2019, is an initiative aimed at providing various care and services to community workers in the Quebec City region, with a global health approach. Within this program, mindful self-compassion training (MSC) is offered at a low cost. MSC is one of the effective strategies proposed in the literature to help prevent and reduce burnout. Self-compassion is the recognition that suffering, failure, and inadequacies are inherent in the human experience and that everyone, including oneself, deserves compassion. MSC training targets several behavioral, cognitive, and emotional learnings (e.g., motivating oneself with caring, better managing difficult emotions, promoting resilience, etc.). A mixed-method evaluation was conducted with the participants in order to explore the effects of the training on community workers in the Quebec City region. The participants were community workers (management or caregiver). 15 participants completed satisfaction and perceived impact surveys, and 30 participated in structured interviews. Quantitative results showed that participants were generally completely satisfied or satisfied with the training (94%) and perceived that the training allowed them to develop new strategies for dealing with stress (87%). Participants perceived effects on their mood (93%), their contact with others (80%), and their stress level (67%). Some of the barriers raised were scheduling constraints, length of training, and guilt about taking time for oneself. The qualitative results show that individuals experienced long-term benefits, as they were able to apply the tools they received during the training in their daily lives. Some barriers were noted, such as difficulty in getting away from work or problems with the employer, which prevented enrollment. Overall, the results of this evaluation support the use of MSC (mindful self-compassion) training among community workers. Future research could support this evaluation by using a rigorous design and developing innovative ways to overcome the barriers raised.

Keywords: mindful self-compassion, community workers, work stres, burnout, wellbeing at work

Procedia PDF Downloads 100

Authors: Marco Ferretti, Marcello Risitano, Maria Cristina Pietronudo, Lina Ozturk

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A green port is the result of a sustainable long-term strategy adopted by an entire port infrastructure, therefore by the set of actors involved in port activities. The strategy aims to realise the development of sustainable port infrastructure focused on the reduction of negative environmental impacts without jeopardising economic growth. Green technology represents the core tool to implement sustainable solutions, however, they are not a magic bullet. Ports have always been integrated in the local territory affecting the environment in which they operate, therefore, the sustainable strategy should fit with the entire local systems. Therefore, adopting a sustainable strategy means to know how to involve and engage a wide stakeholders’ network (industries, production, markets, citizens, and public authority). The existing research on the topic has not well integrated this perspective with those of sustainability. Research on green ports have mixed the sustainability aspects with those on the maritime industry, neglecting dynamics that lead to the development of the green port phenomenon. We propose an analysis of green ports adopting the lens of ecosystem studies in the field of management. The ecosystem approach provides a way to model relations that enable green solutions and green practices in a port ecosystem. However, due to the local dimension of a port and the port trend on innovation, i.e., sustainable innovation, we draw to a specific concept of ecosystem, those on local innovation systems. More precisely, we explore if a green port is a local innovation system engaged in developing sustainable innovation with a large impact on the territory or merely an innovation adopter. To address this issue, we adopt a comparative case study selecting two innovative ports in Europe: Rotterdam and Genova. The case study is a research method focused on understanding the dynamics in a specific situation and can be used to provide a description of real circumstances. Preliminary results show two different approaches in supporting sustainable innovation: one represented by Rotterdam, a pioneer in competitiveness and sustainability, and the second one represented by Genoa, an example of technology adopter. The paper intends to provide a better understanding of how sustainable innovations are developed and in which manner a network of port and local stakeholder support this process. Furthermore, it proposes a taxonomy of green ports as developers and adopters of sustainable innovation, suggesting also best practices to model relationships that enable the port ecosystem in applying a sustainable strategy.

Keywords: green port, innovation, sustainability, local innovation systems

Procedia PDF Downloads 97

Authors: Ahlyum Mun, Ji-Young Moon, Moon-Seok Yoon, Dong-Jin Baek, Doo-Seok Seo, Oun-Kyong Moon

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There is a growing public concern over the standards of farm animal welfare, with higher standards of food safety. In addition, the recent low incidence of Avian Influenza in laying hens among certificated farms is receiving attention. In this study, we introduce animal welfare systems covering the rearing, transport and slaughter of farm animals in South Korea. The concepts of animal welfare farm certification are based on ensuring the five freedoms of animal. The animal welfare is also achieved by observing the condition of environment including shelter and resting area, feeding and water and the care for the animal health. The certification of farm animal welfare is handled by the Animal Protection & Welfare Division of Animal and Plant Quarantine Agency (APQA). Following the full amendment of Animal Protection Law in 2011, animal welfare farm certification program has been implemented since 2012. The certification system has expanded to cover laying hen, swine, broiler, beef cattle and dairy cow, goat and duck farms. Livestock farmers who want to be certified must apply for certification at the APQA. Upon receipt of the application, the APQA notifies the applicant of the detailed schedule of the on-site examination after reviewing the document and conducts the on-site inspection according to the evaluation criteria of the welfare standard. If the on-site audit results meet the certification criteria, APQA issues a certificate. The production process of certified farms is inspected at least once a year for follow-up management. As of 2017, a total of 145 farms have been certified (95 laying hen farms, 12 swine farms, 30 broiler farms and 8 dairy cow farms). In addition, animal welfare transportation vehicles and slaughterhouses have been designated since 2013 and currently 6 slaughterhouses have been certified. Animal Protection Law has been amended so that animal welfare certification marks can be affixed only to livestock products produced by animal welfare farms, transported through animal welfare vehicles and slaughtered at animal welfare slaughterhouses. The whole process including rearing–transportation- slaughtering completes the farm animal welfare system. APQA established its second 5-year animal welfare plan (2014-2019) that includes setting a minimum standard of animal welfare applicable to all livestock farms, transportation vehicles and slaughterhouses. In accordance with this plan, we will promote the farm animal welfare policy in order to truly advance the Korean livestock industry.

Keywords: animal welfare, farm animal, certification system, South Korea

Procedia PDF Downloads 376

Authors: Minu Bharati, Priyanka Rai, Satarupa Dutta, Dhiraj Saha

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Culex quinquefasciatus Say, is a mosquito of immense public health concern due to its role in transmission of filariasis, which is an endemic disease in 20 states and union territories of India, putting about 600 million people at the risk of infection. The main strategies to control filaria in India include anti-larval measures in urban areas, Indoor Residual Spray (IRS) in rural areas and mass diethylcarbamazine citrate (DEC) administration. Larval destruction measures and IRS are done with the use of insecticides. In this study, Susceptibility/ Resistance to insecticides were assessed in Culex quinquefasciatus mosquitoes collected from eight densely populated areas of Siliguri subdivision, which has a high rate of filarial infection. To unveil the insecticide susceptibility status of Culex quinquefasciatus, bioassays were performed on field-caught mosquitoes against two major groups of insecticides, i.e. Synthetic Pyrethroids (SPs): 0.05% deltamethrin and 0.05% lambda-cyhalothrin and Organophosphates (OPs): 5% malathion and temephos using World Health Organisation (WHO) discriminating doses. The knockdown rates and knockdown times (KDT50) were also noted against deltamethrin, lambda-cyhalothrin and malathion. Also, activities of major detoxifying enzymes, i.e. α-carboxylesterases, β-carboxylesterases and cytochrome P450 (CYP450) monooxygenases were determined to find the involvement of biochemical mechanisms in resistance phenomenon (if any). The results obtained showed that, majority of the mosquito populations were moderately to severely resistant against both the SPs and one OP, i.e. temephos. Whereas, most of the populations showed 100% susceptibility to malathion. The knockdown rates and KDT50 in response to above-mentioned insecticides showed significant variation among different populations. Variability in activities of carboxylesterases and CYP450 monooxygenases were also observed with hints of their involvement in contribution towards insecticide resistance in some of the tested populations. It may be concluded that, Culex quinquefasciatus has started developing resistance against deltamethrin, lambda-cyhalothrin and temephos in Siliguri subdivision. Malathion seems to hold the greatest potentiality for control of these mosquitoes in this area as revealed through this study. Adoption of Integrated mosquito management (IMM) strategy should be the prime objective of the concerned authorities to delimit the insecticide resistance phenomenon and filariasis infections.

Keywords: Culex quinquefasciatus, detoxifying enzymes, insecticide resistance, knockdown rate

Procedia PDF Downloads 233

Authors: O. C. Abbah, O. Obidoa, J. Omale

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Prostate tumor is fast becoming a leading cause of morbidity and mortality in human male adults, with 50 percent of men aged 50 years and above having histological evidence of the benign tumor. The study was set out to undertake phytochemical screening and proximate analysis of the pulp of A. muricata fruit - soursop; to determine the acute toxicity of the fruit pulp extract and its effect on male albino Wistar rats with concurrent induction of experimental benign prostate hyperplasia (BPH). Eighteen rats (average weight of 100g) were used for the lethality studies and were orally administered graded doses of aqueous extracts of the fruit pulp up to 5000 mg/kg body weight. Twenty five rats weighing 150-200g were divided into five groups of five rats each for the tumor studies. The groups included four controls – Hormone control, HC, which took Testosterone, T; and Estradiol, E2 – only, in olive oil as vehicle; Vehicle control, VC; Soursop control, SC, which received the extract only; VS, Vehicle and Soursop – and the Test group, TG (500mg/kg b.w.). All rats were dosed orally. Tumor was induced with exogenous Testosterone propionate: Estradiol valerate at 300µg: 80µg/kg b.w. (respectively) in olive oil, administered subcutaneously in the inguinal region of the rats on alternate days for 21 days. Administration of the fruit pulp at graded doses up to 5000mg/kg resulted in no lethality even after 72 hours. Results from tumor studies revealed that the administration of the fruit extracts significantly (p < 0.05) reduced the relative prostate weight of the TG compared with the HC, with values of 006±0.001 and 0.010±0.003 respectively. Treatment with vehicle, soursop and vehicle with soursop caused no significant (p>0.05) change in prostate size, with their respective relative prostate weights being 0.002±0.001, 0.004±0.002 and 0.002±0.001 compared with TG. Also, treatment with A. muricata fruit extract significantly decreased (p < 0.05) serum prostate specific antigen, PSA, in TG compared with HC, with values 0.055±0.017 and 0.194±0.068 ng/ml respectively. Furthermore, A. muricata administration displayed Testosterone boosting, Estradiol lowering and consequently testosterone-estradiol ratio increasing potential at the end of the 21 days. The preventive property of soursop against experimental BPH was corroborated by histological evidence in this study. The study concludes that A. muricata fruit holds a great potential for benign prostate tumor prevention and, possibly, management.

Keywords: annona muricata, benign prostate tumor, hormone, preventive potential, soursop

Procedia PDF Downloads 287

Authors: Germans Natuhwera, Peter Ellis, Acuda Wilson, Anne Merriman, Martha Rabwoni

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Objective: The aim of the study was to diagnose the socio-economic burden and impact of a diagnosis of cervical cancer (CC) in rural women in the context of low-resourced country Uganda, using a phenomenological enquiry. Methods: This was a multi-site phenomenological inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in southwestern, Little Hospice Hoima in Western, and Hospice Africa Uganda Kampala in central Uganda. A purposive sample of women with a histologically confirmed diagnosis of CC was recruited. Data was collected using open-ended audio-recorded interviews conducted in the native languages of participants. Interviews were transcribed verbatim in English, and Braun and Clarke’s (2019) framework of thematic analysis was used. Results: 13 women with a mean age of 49.2 and age range 29-71 participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A fuller reading of transcripts produced four major themes clustered under; (1) socioeconomic characteristics of women, (2) impact of CC on women’s relationships, (3) disrupted and impaired activities of daily living (ADLs), and (4) economic disruptions. Conclusions: A diagnosis of CC introduces significant socio-economic disruptions in a woman’s and her family’s life. CC causes disability, impairs the woman and her family’s productivity hence exacerbating levels of poverty in the home. High and expensive out-of-pocket expenditure on treatment, investigations, and transport costs further compound the socio-economic burden. Decentralizing cancer care services to regional centers, scaling up screening services, subsidizing costs of cancer care services, or making cervical cancer care treatment free of charge, strengthening monitoring mechanisms in public facilities to curb the vice of healthcare workers soliciting bribes from patients, increased mass awareness campaigns about cancer, training more healthcare professionals in cancer investigation and management, and palliative care, and introducing an introductory course on gynecologic cancers into all health training institutions are recommended.

Keywords: activities of daily living, cervical cancer, out-of-pocket, expenditure, phenomenology, socioeconomic

Procedia PDF Downloads 186

Authors: Alice Nwanyioma Ohuoba, Rose Erdoo Kukwa, Ukpabi Joseph Ukpabi

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Cassava root (Manihot esculenta) is one of the important carbohydrates containing crops in Nigeria. It is a staple food, mostly in the southern part of the country, and a source of income to farmers and processors. Cassava gari processing methods result to residue fiber (solid waste) from the sieving operation, these residue fibers ( solid wastes) can be dried and milled into flour and used to prepare cakes, cookies, crackers and chin-chin instead of being thrown away mostly on farmland or near the residential area. Flour for baking or frying may contain carbohydrates and protein (wheat flour) or rich in only carbohydrates (cassava flour). Cake, cookies, crackers, and chin-chin were prepared using the residue flour obtained from the residue fiber of cassava variety NR87184 roots, processed into gari. This study is aimed at evaluating the proximate composition, mineral content and sensory attributes of these selected snacks produced. The proximate composition results obtained showed that crackers had the lowest value in moisture (2.3390%) and fat (1.7130%), but highest in carbohydrates (85.2310%). Amongst the food products, cakes recorded the highest value in protein (8.0910%). Crude fibre values ranges from 2.5265% (cookies) to 3.4165% (crackers). The result of the mineral contents showed cookies ranking the highest in Phosphorus (65.8535 ppm) and Iron (0.1150 mg/L), Calcium (1.3800mg/L) and Potassium (7.2850 mg/L) contents, while chin-chin and crackers were lowest in Sodium ( 2.7000 mg/L). The food products were also subjected to sensory attributes evaluation by thirty member panelists using 9-hedonic scale which ranged from 1 ( dislike extremely) to 9 (like extremely). The means score obtained shows all the food products having above 7.00 (above “like moderately”). This study has shown that food products that may be functional or nutraceuticals could be prepared from the residue flour. There is a call for the use of gluten-free flour in baking due to ciliac disease and other allergic causes by gluten. Therefore local carbohydrates food crops like cassava residue flour that are gluten-free, could be the solution. In addition, this could aid cassava gari processing waste management thereby reducing post-harvest losses of cassava root.

Keywords: allergy, flour, food-products, gluten-free

Procedia PDF Downloads 136

Authors: Yunjia Yang, Peng Li, Gordon Xu, Timothy Mahony, Bing Zhang, Neena Mitter, Karishma Mody

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Sheep flystrike is one of the most economically important diseases affecting the Australian sheep and wool industry (>356M/annually). Currently, control of Lucillia cuprina relies almost exclusively on chemicals controls and the parasite has developed resistance to nearly all control chemicals used in the past. It is therefore critical to develop an alternative solution for the sustainable control and management of flystrike. RNA interference (RNAi) technologies have been successfully explored in multiple animal industries for developing parasites controls. This research project aims to develop a RNAi based biological control for sheep blowfly. Double-stranded RNA (dsRNA) has already proven successful against viruses, fungi and insects. However, the environmental instability of dsRNA is a major bottleneck for successful RNAi. Bentonite polymer (BenPol) technology can overcome this problem, as it can be tuned for the controlled release of dsRNA in the gut challenging pH environment of the blowfly larvae, prolonging its exposure time to and uptake by target cells. To investigate the potential of BenPol technology for dsRNA delivery, four different BenPol carriers were tested for their dsRNA loading capabilities, and three of them were found to be capable of affording dsRNA stability under multiple temperatures (4°C, 22°C, 40°C, 55°C) in sheep serum. Based on stability results, dsRNA from potential targeted genes was loaded onto BenPol carriers and tested in larvae feeding assays, three genes resulting in knockdowns. Meanwhile, a primary blowfly embryo cell line (BFEC) derived from L. cuprina embryos was successfully established, aim for an effective insect cell model for testing RNAi efficacy for preliminary assessments and screening. The results of this study establish that the dsRNA is stable when loaded on BenPol particles, unlike naked dsRNA rapidly degraded in sheep serum. The stable nanoparticle delivery system offered by BenPol technology can protect and increase the inherent stability of dsRNA molecules at higher temperatures in a complex biological fluid like serum, providing promise for its future use in enhancing animal protection.

Keywords: flystrike, RNA interference, bentonite polymer technology, Lucillia cuprina

Procedia PDF Downloads 72

Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

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Transient ischaemic attacks (TIAs) are warning signs for future strokes. TIA patients are at increased risk of stroke and cardio-vascular events after a first episode. A majority of studies on TIA focused on the occurrence of these ancillary events after a TIA. Long-term mortality after TIA received only limited attention. We undertook this study to determine the long-term hazards of all-cause mortality following a first episode of a TIA using anonymised electronic health records (EHRs). We used a retrospective case-control study using electronic primary health care records from The Health Improvement Network (THIN) database. Patients born prior to or in year 1960, resident in England, with a first diagnosis of TIA between January 1986 and January 2017 were matched to three controls on age, sex and general medical practice. The primary outcome was all-cause mortality. The hazards of all-cause mortality were estimated using a time-varying Weibull-Cox survival model which included both scale and shape effects and a random frailty effect of GP practice. 20,633 cases and 58,634 controls were included. Cases aged 39 to 60 years at the first TIA event had the highest hazard ratio (HR) of mortality compared to matched controls (HR = 3.04, 95% CI (2.91 - 3.18)). The HRs for cases aged 61-70 years, 71-76 years and 77+ years were 1.98 (1.55 - 2.30), 1.79 (1.20 - 2.07) and 1.52 (1.15 - 1.97) compared to matched controls. Aspirin provided long-term survival benefits to cases. Cases aged 39-60 years on aspirin had HR of 0.93 (0.84 - 1.00), 0.90 (0.82 - 0.98) and 0.88 (0.80 - 0.96) at 5 years, 10 years and 15 years, respectively, compared to cases in the same age group who were not on antiplatelets. Similar beneficial effects of aspirin were observed in other age groups. There were no significant survival benefits with other antiplatelet options. No survival benefits of antiplatelet drugs were observed in controls. Our study highlights the excess long-term risk of death of TIA patients and cautions that TIA should not be treated as a benign condition. The study further recommends aspirin as the better option for secondary prevention for TIA patients compared to clopidogrel recommended by NICE guidelines. Management of risk factors and treatment strategies should be important challenges to reduce the burden of disease.

Keywords: dual antiplatelet therapy (DAPT), General Practice, Multiple Imputation, The Health Improvement Network(THIN), hazard ratio (HR), Weibull-Cox model

Procedia PDF Downloads 125

Authors: Najmeh Hamid, Vajiheh Hamedy , Zahra Rostamianasl

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Background: Cancer is one of the medical problems that have been associated with pain. Moreover, the pain is combined with negative emotions such as anxiety, depression and anger. Poor pain management causes negative effects on the quality of life, which results in negative effects that continue a long time after the painful experiences. Objectives: The aim of this research was to compare the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, depression, anger and anxiety in children with cancer. Methods: The research method of this “Randomized Controlled Clinical Trial” was a pre, post-test and follow-up with a control group. In this research, we have examined the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, anxiety, depression and anger in children with cancer in Ahvaz. Two psychological interventions (cognitive behavioral therapy for pain and the computerized version) were compared with the control group. The sample consisted of 60 children aged 8 to 12 years old with different types of cancer at Shafa hospital in Ahwaz. According to the including and excluding criteria such as age, socioeconomic status, clinical diagnostic interview and other criteria, 60 subjects were selected. Then, randomly, 45 subjects were selected. The subjects were randomly divided into three groups of 15 (two experimental and one control group). The research instruments included Spielberger Anxiety Inventory (STAY-2) and International Pain Measurement Scale. The first experimental group received 6 sessions of cognitive-behavioral therapy for 6 weeks, and the second group was subjected to a computerized version of cognitive-behavioral therapy for 6 weeks, but the control group did not receive any interventions. For ethical considerations, a version of computerized cognitive-behavioral therapy was provided to them. After 6 weeks, all three groups were evaluated as post-test and eventually after a one-month follow-up. Results: The findings of this study indicated that both interventions could reduce the negative emotions (pain, anger, anxiety, depression) associated with cancer in children in comparison with a control group (p<0.0001). In addition, there were no significant differences between the two interventions (p<0.01). It means both interventions are useful for reducing the negative effects of pain and enhancing adjustment. Conclusion: we can use CBT in situations in which there is no access to psychologists and psychological services. In addition, it can be a useful alternative to conventional psychological interventions.

Keywords: pain, children, psychological intervention, cancer, anger, anxiety, depression

Procedia PDF Downloads 60

Authors: M. M. Essa, S. Subash, M. Akbar, S. Al-Adawi, A. Al-Asmi, G. J. Guillemein

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Transgenic (tg) mice which contain an amyloid precursor protein (APP) gene mutation, develop extracellular amyloid beta (Aβ) deposition in the brain, and severe memory and behavioral deficits with age. These mice serve as an important animal model for testing the efficacy of novel drug candidates for the treatment and management of symptoms of Alzheimer's disease (AD). Several reports have suggested that oxidative stress is the underlying cause of Aβ neurotoxicity in AD. Date palm fruits contain very high levels of antioxidants and several medicinal properties that may be useful for improving the quality of life in AD patients. In this study, we investigated the effect of dietary supplementation of Omani date palm fruits on the memory, anxiety and learning skills along with inflammation in an AD mouse model containing the double Swedish APP mutation (APPsw/Tg2576). The experimental groups of APP-transgenic mice from the age of 4 months were fed custom-mix diets (pellets) containing 2% and 4% Date palm fruits. We assessed spatial memory and learning ability, psychomotor coordination, and anxiety-related behavior in Tg and wild-type mice at the age of 4-5 months and 18-19 months using the Morris water maze test, rota rod test, elevated plus maze test, and open field test. Further, inflammatory parameters also analyzed. APPsw/Tg2576 mice that were fed a standard chow diet without dates showed significant memory deficits, increased anxiety-related behavior, and severe impairment in spatial learning ability, position discrimination learning ability and motor coordination along with increased inflammation compared to the wild type mice on the same diet, at the age of 18-19 months In contrast, PPsw/Tg2576 mice that were fed a diet containing 2% and 4% dates showed a significant improvements in memory, learning, locomotor function, and anxiety with reduced inflammatory markers compared to APPsw/Tg2576 mice fed the standard chow diet. Our results suggest that dietary supplementation with dates may slow the progression of cognitive and behavioral impairments in AD. The exact mechanism is still unclear and further extensive research needed.

Keywords: Alzheimer's disease, date palm fruits, Oman, cognitive decline, memory loss, anxiety, inflammation

Procedia PDF Downloads 405

Authors: Faustina Masocha, Vusani Moyo

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For decades, dividend announcements have been presumed to contain important signals about the future prospects of companies. Similarly, the same has been presumed about management earnings announcements. Despite both dividend and earnings announcements being considered informative, a number of researchers questioned their credibility and found both to contain short-term signals. Pertaining to dividend announcements, some authors argued that although they might contain important information that can result in changes in share prices, which consequently results in the accumulation of abnormal returns, their degree of informativeness is less compared to other signaling tools such as earnings announcements. Yet, this claim in favor has been refuted by other researchers who found the effect of earnings to be transitory and of little value to shareholders as indicated by the little abnormal returns earned during the period surrounding earnings announcements. Considering the above, it is apparent that both dividends and earnings have been hypothesized to have a signaling impact. This prompts one to question which between these two signaling tools is more informative. To answer this question, two follow-up questions were asked. The first question sought to determine the event which results in the most effect on share prices, while the second question focused on the event that influenced trading volume the most. To answer the first question and evaluate the effect that each of these events had on share prices, an event study methodology was employed on a sample made up of the top 10 JSE-listed companies for data collected from 2012 to 2019 to determine if shareholders gained abnormal returns (ARs) during announcement dates. The event that resulted in the most persistent and highest amount of ARs was considered to be more informative. Looking at the second follow-up question, an investigation was conducted to determine if either dividends or earnings announcements influenced trading patterns, resulting in abnormal trading volumes (ATV) around announcement time. The event that resulted in the most ATV was considered more informative. Using an estimation period of 20 days and an event window of 21 days, and hypothesis testing, it was found that announcements pertaining to the increase of earnings resulted in the most ARs, Cumulative Abnormal Returns (CARs) and had a lasting effect in comparison to dividend announcements whose effect lasted until day +3. This solidifies some empirical arguments that the signaling effect of dividends has become diminishing. It was also found that when reported earnings declined in comparison to the previous period, there was an increase in trading volume, resulting in ATV. Although dividend announcements did result in abnormal returns, they were lesser than those acquired during earnings announcements which refutes a number of theoretical and empirical arguments that found dividends to be more informative than earnings announcements.

Keywords: dividend signaling, event study methodology, information content of earnings, signaling theory

Procedia PDF Downloads 148

Authors: Natalia Uribe Corrales, María Fernanda Benavides Erazo, Santiago Henao Villegas

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Introduction: Transport is a crucial link in the porcine chain because it is considered a stressful event in the animal, due to it is a new environment, which generates new interactions, together with factors such as speed, noise, temperature changes, vibrations, deprivation of food and water. Therefore, inadequate handling at this stage can lead to bruises, musculoskeletal injuries, fatigue, and mortality, resulting in canal seizures and economic losses. Objective: To characterize the transport and driving practices for the mobilization of standing pigs directed to slaughter plants in the Valle de Aburrá, Antioquia, Colombia in 2017. Methods: A descriptive cross-sectional study was carried out with the transporters arriving at the slaughterhouses approved by National Institute for Food and Medicine Surveillance (INVIMA) during 2017 in the Valle de Aburrá. The process of obtaining the samples was made from probabilistic sampling. Variables such as journey time, mechanical technical certificate, training in animal welfare, driving speed, material, and condition of floors and separators, supervision of animals during the trip, load density and mortality were analyzed. It was approved by the ethics committee for the use and care of animals CICUA of CES University, Act number 14 of 2015. Results: 190 trucks were analyzed, finding that 12.4% did not have updated mechanical technical certificate; the transporters experience in pig’s transportation was an average of 9.4 years (d.e.7.5). The 85.8% reported not having received training in animal welfare. Other results were that the average speed was 63.04km/hr (d.e 13.46) and the 62% had floors in good condition; nevertheless, the 48% had bad conditions on separators. On the other hand, the 88% did not supervise their animals during the journey, although the 62.2% had an adequate loading density, in relation to the average mortality was 0.2 deaths/travel (d.e. 0.5). Conclusions: Trainers should be encouraged on issues such as proper maintenance of vehicles, animal welfare, obligatory review of animals during mobilization and speed of driving, as these poorly managed indicators generate stress in animals, increasing generation of injuries as well as possible accidents; also, it is necessary to continue to improve aspects such as aluminum floors and separators that favor easy cleaning and maintenance, as well as the appropriate handling in the density of load that generates animal welfare.

Keywords: animal welfare, driving practices, pigs, truck infrastructure

Procedia PDF Downloads 189

Authors: Păcurar Diana Istina

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The indissoluble link between aesthetics and semiotics, the harmonization and semiotic understanding of the interactions between the viewer and the object being looked at, are the basis of the practical demonstration of the importance of aesthetic perception within the theater performance. The design of a theater performance includes several structures, some considered from the beginning, art forms (i.e., the text), others being represented by simple, common objects (e.g., scenographic elements), which, if reunited, can trigger a certain aesthetic perception. The audience is delivered, by the team involved in the performance, a series of auditory and visual signs with which they interact. It is necessary to explain some notions about the physiological support of the transformation of different types of stimuli at the level of the cerebral hemispheres. The cortex considered the superior integration center of extransecal and entanged stimuli, permanently processes the information received, but even if it is delivered at a constant rate, the generated response is individualized and is conditioned by a number of factors. Each changing situation represents a new opportunity for the viewer to cope with, developing feelings of different intensities that influence the generation of meanings and, therefore, the management of interactions. In this sense, aesthetic perception depends on the detection of the “correctness” of signs, the forms of which are associated with an aesthetic property. Fairness and aesthetic properties can have positive or negative values. Evaluating the emotions that generate judgment and implicitly aesthetic perception, whether we refer to visual emotions or auditory emotions, involves the integration of three areas of interest: Valence, arousal and context control. In this context, superior human cognitive processes, memory, interpretation, learning, attribution of meanings, etc., help trigger the mechanism of anticipation and, no less important, the identification of error. This ability to locate a short circuit produced in a series of successive events is fundamental in the process of forming an aesthetic perception. Our main purpose in this research is to investigate the possible conditions under which aesthetic perception and its minimum content are generated by all these structures and, in particular, by interactions with forms that are not commonly considered aesthetic forms. In order to demonstrate the quantitative and qualitative importance of the categories of signs used to construct a code for reading a certain message, but also to emphasize the importance of the order of using these indices, we have structured a mathematical analysis that has at its core the analysis of the percentage of signs used in a theater performance.

Keywords: semiology, aesthetics, theatre semiotics, theatre performance, structure, aesthetic perception

Procedia PDF Downloads 67

Authors: Arindam Chaudhuri

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Classification of data has been actively used for most effective and efficient means of conveying knowledge and information to users. The prima face has always been upon techniques for extracting useful knowledge from data such that returns are maximized. With emergence of huge datasets the existing classification techniques often fail to produce desirable results. The challenge lies in analyzing and understanding characteristics of massive data sets by retrieving useful geometric and statistical patterns. We propose a supervised parallel fuzzy rough support vector machine (PFRSVM) for data classification in cloud environment. The classification is performed by PFRSVM using hyperbolic tangent kernel. The fuzzy rough set model takes care of sensitiveness of noisy samples and handles impreciseness in training samples bringing robustness to results. The membership function is function of center and radius of each class in feature space and is represented with kernel. It plays an important role towards sampling the decision surface. The success of PFRSVM is governed by choosing appropriate parameter values. The training samples are either linear or nonlinear separable. The different input points make unique contributions to decision surface. The algorithm is parallelized with a view to reduce training times. The system is built on support vector machine library using Hadoop implementation of MapReduce. The algorithm is tested on large data sets to check its feasibility and convergence. The performance of classifier is also assessed in terms of number of support vectors. The challenges encountered towards implementing big data classification in machine learning frameworks are also discussed. The experiments are done on the cloud environment available at University of Technology and Management, India. The results are illustrated for Gaussian RBF and Bayesian kernels. The effect of variability in prediction and generalization of PFRSVM is examined with respect to values of parameter C. It effectively resolves outliers’ effects, imbalance and overlapping class problems, normalizes to unseen data and relaxes dependency between features and labels. The average classification accuracy for PFRSVM is better than other classifiers for both Gaussian RBF and Bayesian kernels. The experimental results on both synthetic and real data sets clearly demonstrate the superiority of the proposed technique.

Keywords: FRSVM, Hadoop, MapReduce, PFRSVM

Procedia PDF Downloads 472