Search results for: maternal outcome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2417

Search results for: maternal outcome

767 Neuropsychological Disabilities in Executive Functions and Visuospatial Skills of Juvenile Offenders in a Half-Open Program in Santiago De Chile

Authors: Gabriel Sepulveda Navarro

Abstract:

Traditional interventions for young offenders are necessary but not sufficient to tackle the multiple causes of juvenile crime. For instance, interventions offered to young offenders often are verbally mediated and dialogue based, requiring important metacognitive abilities as well as abstract thinking, assuming average performance in a wide variety of skills. It seems necessary to assess a broader set of abilities and functions in order to increase the efficiency of interventions while addressing offending. In order to clarify these assumptions, Stroop Test, as well as Rey-Osterrieth Complex Figure Test were applied to juvenile offenders tried and sentenced for violent crimes in Santiago de Chile. A random sample was drawn from La Cisterna Half-Open Program, consisting of 50 young males between 18 and 24 years old, residing in different districts of Santiago de Chile. The analysis of results suggests a disproportionately elevated incidence of impairments in executive functions and visuospatial skills. As an outcome, over 40% of the sample shows a significant low performance in both assessments, exceeding four times the same prevalence rates among young people in the general population. While executive functions entail working memory (being able to keep information and use it in some way), cognitive flexibility (to think about something in more than one way) and inhibitory control (being able to self-control, ignore distractions and delay immediate gratification), visuospatial skills permit to orientate and organize a planned conduct. All of these abilities are fundamental to the skill of avoiding violent behaviour and abiding by social rules. Understanding the relevance of neurodevelopmental impairments in the onset of violent and criminal behaviour, as well as recidivism, eventually may guide the deployment of a more comprehensive assessment and treatment for juvenile offenders.

Keywords: executive functions, half-open program, juvenile offenders, neurodisabilities, visuospatial skills

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766 A Five–Year Review Study of Epidemiology of Ocular and Adnexal Injuries Requiring Surgical Intervention in a Middle Eastern Area: Al Ain, UAE

Authors: Tahra AlMahmoud, Sameeha Mohamed Al Hadhrami, Mohamed Elhanan, Hanan Naser Alshamsi, Fikri Abu-Zidan

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Background: To the best of the author(s)’ knowledge there are no epidemiological studies for traumatic eye injuries in UAE, neither data on groups at risk or mechanisms for ocular trauma. Purpose: To report the epidemiology of eye injuries that required hospital admission and surgery at a referral center at the eastern part of Abu Dhabi. Method: Retrospective charts review of all patients who had suffered an eye injury that required surgical intervention between 2012 and 2017 at Al Ain Hospital. Demographic data, place of occurrence, the cause of injury, visual acuity (VA) before and after treatment, number of admission days and follow up were extracted. Data were tabulated and presented as number (%), mean (SD), or median (range) as appropriate. Wilcoxon signed rank test was used for VA outcome. Results: One hundred forty-one patients were identified, 96 eyes with open-globe and 48 other types of injuries. The mean age of the patients was 26±15.5 years, and 89% were male. Majority of injuries occurred at the workplace (50.4%) followed by home (31.2%). Trauma with a sharp object (24.1%), blunt object (16.3%), nail (11.3%), and hammer on metal (7.8%) were the most common etiologies of injury. Corneas injuries (48.2%) was the most frequent cause for visual acuity limitation followed by lens/cataract (23.4%). Among the traumatized eyes, 30 eyes (21.3%) retained intraocular foreign body, Mean admission days was 3.16± 2.81days (1-16) and a number of follow up visit was 3.17± 4.11times (0-26). Conclusion: Ocular trauma requiring surgical intervention is an area of concern in particular for occupations involving work with metals. This work may give insight into the value and necessity of implementing preventive measures.

Keywords: epidemiology, Middle Eastern area, occupational injury, ocular traumas

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765 The Quality of Economic Growth Regency and Cities in West Java Province: Inclusive Economic Growth

Authors: Fryanto Anugrah Rhamdhani Rhamdhani, Hana Riana Permatasari

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The aim of this study analyzes the inclusive of economic growth and analyzes the inclusive of economic growth determinant in regency and city (West Java Province). The background this study Economic Growth can do not afford to reduce poverty, Disparity and expand The Workforce. Referring Central Bureau Of Statistic West Java Province report in 2015 recorded only 5 regions able reduce poverty, 3 regions able reduce Gini Ratio and 7 regions able Workforce Absorption, meanwhile, 11 regions was improved Economic Growth. The Inclusive of Economic Growth definition based on various literature means the quality Economic Growth able reduce Poverty, Gini Ratio, and Workforce absorption. This study adopted the measurement Inclusive Economic of Growth Klassen and analyzes factor in Term Reducing Poverty, Gini Ratio, and the workforce Absorption. Data used panels data composite time series and cross-section including 25 regency and cities regions from Central Bureau Of Statistic West Java Province during 2014-2015. As a result, the measurement inclusive economic of growth Klassen 2014-2015 from 25 regency and cities shows all region does not inclusive reducing Poverty, only 2 regions able reduce Gini Ratio and 3 regions able increase Workforce absorption. Different from the result the measurement Inclusive Economic of Growth for workforce absorption, several regions shows a negative coefficient indicates Economic Growth decline Workforce absorption. The outcome of this study analyzes factor of Inclusive economic of Growth, so that give recommendations for government achieve inclusive economic of growth toward Sustainable Economic. Can be Concluded above low-quality Economic Growth, that due to all region does not inclusive Economic of Growth.

Keywords: inclusive economic growth, Gini ratio, poverty, workforce

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764 Ground Source Ventilation and Solar PV Towards a Zero-Carbon House in Riyadh

Authors: Osamah S. Alanazi, Mohammad G. Kotbi, Mohammed O. AlFadil

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While renewable energy technology is developing in Saudi Arabia, and the ambitious 2030 vision encourages the shift towards more efficient and clean energy usage. The research on the application of geothermal resources in residential use for the Saudi Arabian context will contribute towards a more sustainable environment. This paper is a part of an ongoing master's thesis, which its main goal is to investigate the possibility of achieving a zero-carbon house in Riyadh by applying a ground-coupled system into a current sustainable house that uses a grid-tied solar system. The current house was built and designed by King Saud University for the 2018 middle east solar decathlon competition. However, it failed to reach zero-carbon operation due to the high cooling demand. This study will redesign and validate the house using Revit and Carriers Hourly Analysis 'HAP' software with the use of ordinary least square 'OLS' regression. After that, a ground source ventilation system will be designed using the 'GCV Tool' to reduce cooling loads. After the application of the ground source system, the new electrical loads will be compared with the current house. Finally, a simple economic analysis that includes the cost of applying a ground source system will be reported. The findings of this study will indicate the possibility and feasibility of reaching a zero-carbon house in Riyadh, Saudi Arabia, using a ground-coupled ventilation system. While cooling in the residential sector is the dominant energy consumer in the Gulf region, this work will certainly help in moving towards using renewable sources to meet those demands. This paper will be limited to highlight the literature review, the methodology of the research, and the expected outcome.

Keywords: renewable energy, zero-carbon houses, sustainable buildings, geothermal energy, solar PV, GCV Tool

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763 Evaluation of Classification Algorithms for Diagnosis of Asthma in Iranian Patients

Authors: Taha SamadSoltani, Peyman Rezaei Hachesu, Marjan GhaziSaeedi, Maryam Zolnoori

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Introduction: Data mining defined as a process to find patterns and relationships along data in the database to build predictive models. Application of data mining extended in vast sectors such as the healthcare services. Medical data mining aims to solve real-world problems in the diagnosis and treatment of diseases. This method applies various techniques and algorithms which have different accuracy and precision. The purpose of this study was to apply knowledge discovery and data mining techniques for the diagnosis of asthma based on patient symptoms and history. Method: Data mining includes several steps and decisions should be made by the user which starts by creation of an understanding of the scope and application of previous knowledge in this area and identifying KD process from the point of view of the stakeholders and finished by acting on discovered knowledge using knowledge conducting, integrating knowledge with other systems and knowledge documenting and reporting.in this study a stepwise methodology followed to achieve a logical outcome. Results: Sensitivity, Specifity and Accuracy of KNN, SVM, Naïve bayes, NN, Classification tree and CN2 algorithms and related similar studies was evaluated and ROC curves were plotted to show the performance of the system. Conclusion: The results show that we can accurately diagnose asthma, approximately ninety percent, based on the demographical and clinical data. The study also showed that the methods based on pattern discovery and data mining have a higher sensitivity compared to expert and knowledge-based systems. On the other hand, medical guidelines and evidence-based medicine should be base of diagnostics methods, therefore recommended to machine learning algorithms used in combination with knowledge-based algorithms.

Keywords: asthma, datamining, classification, machine learning

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762 Exploration of Environmental Parameters on the Evolution of Vernacular Building Techniques in East Austria

Authors: Hubert Feiglstorfer

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Due to its location in a transition zone from the Pannonian to the pre-Alpine region, the east of Austria shows a small-scale diversity in the regional development of certain vernacular building techniques. In this article the relationship between natural building material resources, topography and climate will be examined. Besides environmental preconditions, social and economic historical factors have developed different construction techniques within certain regions in the Weinviertel and Burgenland, the two eastern federal states of Austria. But even within these regions, varying building techniques were found, due to the locally different use of raw materials like wood, stone, clay, lime, or organic fibres. Within these small-scale regions, building traditions were adapted over the course of time due to changes in the use of the building material, for example from wood to brick or from wood to earth. The processing of the raw materials varies from region to region, for example as rammed earth, cob, log, or brick construction. Environmental preconditions cross national borders. For that reason, developments in the neighbouring countries, the Czech Republic, Slovakia, Hungary and Slovenia are included in this analysis. As an outcome of this research a map was drawn which shows the interrelation between locally available building materials, topography, climate and local building techniques? As a result of this study, which covers the last 300 years, one can see how the local population used natural resources very sensitively adapted to local environmental preconditions. In the case of clay, for example, changes of proportions of lime and particular minerals cause structural changes that differ from region to region. Based on material analyses in the field of clay mineralogy, on ethnographic research, literature and archive research, explanations for certain local structural developments will be given for the first time over the region of East Austria.

Keywords: European crafts, material culture, architectural history, earthen architecture, earth building history

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761 Development of Integrated Solid Waste Management Plan for Industrial Estates of Pakistan

Authors: Mehak Masood

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This paper aims to design an integrated solid waste management plan for industrial estates taking Sundar Industrial Estate as case model. The issue of solid waste management is on the rise in Pakistan especially in the industrial sector. In this regard, the concept of development and establishment of industrial estates is gaining popularity nowadays. Without proper solid waste management plan it is very difficult to manage day to day affairs of industrial estates. An industrial estate contains clusters of different types of industrial units. It is necessary to identify different types of solid waste streams from each industrial cluster within the estate. In this study, Sundar Industrial Estate was taken as a case model. Primary and secondary data collection, waste assessment, waste segregation and weighing and field surveys were essential elements of the study. Wastes from each industrial process were identified and quantified. Currently 130 industries are in production but after full colonization of industries this number would reach 385. Elaborated process flow diagrams were made to characterize the recyclable and non-recyclables waste. From the study it was calculated that about 12354.1 kg/captia/day of solid waste is being generated in Sundar Industrial Estate. After the full colonization of the industrial estate, the estimated quantity will be 4756328.5 kg/captia/day. Furthermore, solid waste generated from each industrial sector was estimated. Suggestions for collection and transportation are given. Environment friendly solid waste management practices are suggested. If an effective integrated waste management system is developed and implemented it will conserve resources, create jobs, reduce poverty, conserve natural resources, protect the environment, save collection, transportation and disposal costs and extend the life of disposal sites. A major outcome of this study is an integrated solid waste management plan for the Sundar Industrial Estate which requires immediate implementation.

Keywords: integrated solid waste management plan, industrial estates, Sundar Industrial Estate, Pakistan

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760 A Hybrid Block Multistep Method for Direct Numerical Integration of Fourth Order Initial Value Problems

Authors: Adamu S. Salawu, Ibrahim O. Isah

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Direct solution to several forms of fourth-order ordinary differential equations is not easily obtained without first reducing them to a system of first-order equations. Thus, numerical methods are being developed with the underlying techniques in the literature, which seeks to approximate some classes of fourth-order initial value problems with admissible error bounds. Multistep methods present a great advantage of the ease of implementation but with a setback of several functions evaluation for every stage of implementation. However, hybrid methods conventionally show a slightly higher order of truncation for any k-step linear multistep method, with the possibility of obtaining solutions at off mesh points within the interval of solution. In the light of the foregoing, we propose the continuous form of a hybrid multistep method with Chebyshev polynomial as a basis function for the numerical integration of fourth-order initial value problems of ordinary differential equations. The basis function is interpolated and collocated at some points on the interval [0, 2] to yield a system of equations, which is solved to obtain the unknowns of the approximating polynomial. The continuous form obtained, its first and second derivatives are evaluated at carefully chosen points to obtain the proposed block method needed to directly approximate fourth-order initial value problems. The method is analyzed for convergence. Implementation of the method is done by conducting numerical experiments on some test problems. The outcome of the implementation of the method suggests that the method performs well on problems with oscillatory or trigonometric terms since the approximations at several points on the solution domain did not deviate too far from the theoretical solutions. The method also shows better performance compared with an existing hybrid method when implemented on a larger interval of solution.

Keywords: Chebyshev polynomial, collocation, hybrid multistep method, initial value problems, interpolation

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759 Studying Growth as a Pursuit of Disseminating Social Impact: A Conceptual Study

Authors: Saila Tykkyläinen

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The purpose of this study is to pave the way for more focused accumulation of knowledge on social enterprise growth. The body of research touching upon the phenomenon is somewhat fragmented. In order to make an effort to create a solid common ground, this study draws from the theoretical starting points and guidelines developed within small firm growth research. By analyzing their use in social enterprise growth literature, the study offers insights on whether the proven theories and concepts from small firm context could be more systematically applied when investigating growth of social enterprises. Towards this end, the main findings from social enterprise growth research are classified under the three research streams on growth. One of them focuses on factors of growth, another investigates growth as a process and the third is interested in outcomes of growth. During the analysis, special attention is paid on exploring how social mission of the company and the pursuit of augmenting its social impact are dealt within those lines of research. The next step is to scrutinize and discuss some of the central building blocks of growth research, namely the unit of analysis, conceptualization of a firm and operationalizing growth, in relation to social enterprise studies. It appears that the social enterprise growth literature stresses the significance of 'social' both as a main driver and principle outcome of growth. As for the growth process, this emphasis is manifested by special interest in strategies and models tailored to disseminate social impact beyond organizational limits. Consequently, this study promotes more frequent use of business activity as a unit of analysis in the social enterprise context. Most of the times, it is their products, services or programs with which social enterprises and entrepreneurs aim to create the impact. Thus the focus should be placed on activities rather than on organizations. The study also seeks to contribute back to the small firm growth research. Even though the recommendation to think of business activities as an option for unit of analysis stems from there, it is all too rarely used. Social entrepreneurship makes a good case for testing and developing the approach further.

Keywords: conceptual study, growth, scaling, social enterprise

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758 Burn/Traumatic Scar Maturation Using Autologous Fat Grafts + SVF

Authors: Ashok K. Gupta

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Over the past few decades, since the bio-engineering revolution, autologous cell therapy (ACT) has become a rapidly evolving field. Currently, this form of therapy has broad applications in modern medicine and plastic surgery, ranging from the treatment/improvement of wound healing to life-saving operations. A study was conducted on 50 patients having to disfigure, and deform post burn scars and was treated by injection of extracted, refined adipose tissue grafts with their unique stem cell properties. To compare the outcome, a control of 20 such patients was treated with conventional skin or soft-tissue flaps or skin grafting, and a control of 10 was treated with more advanced microsurgical techniques such as Pre-fabricated flaps/pre laminated flaps / free flaps. Assessment of fat volume and survival post- follow up period was done by radiological aid, using MRI and clinically (Survival of the autograft and objective parameters for scar elasticity were evaluated skin elasticity parameters 3 to 9 months postoperatively). Recently, an enzyme that is involved in collagen crosslinking in fibrotic tissue, lysyl hydroxylase (LH2), was identified. This enzyme is normally active in bone and cartilage but hardly in the skin. It has been found that this enzyme is highly expressed in scar tissue and subcutaneous fat; this is in contrast to the dermis, where the enzyme is hardly expressed. Adipose tissue-derived stem cell injections are an effective method in the treatment of various extensive post-burn scar deformities that makes it possible to re-create the lost sub-dermal tissue for improvement in the function of involved joint movements.

Keywords: adipose tissue-derived stem cell injections, treatment of various extensive post-burn scar deformities, re-create the lost sub-dermal tissue, improvement in function of involved joint movements

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757 A Comparative Study on Fish Raised with Feed Formulated with Various Organic Wastes and Commercial Feed

Authors: Charles Chijioke Dike, Hugh Clifford Chima Maduka, Chinwe A. Isibor

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Fish is among the products consumed at a very high rate. In most countries of the world, fish are used as part of the daily meal. The high cost of commercial fish feeds in Africa has made it necessary the development of an alternative source of fish feed processing from organic waste. The objective of this research is to investigate the efficacy of fish feeds processed from various animal wastes in order to know whether those feeds shall be alternatives to commercial feeds. This work shall be carried out at the Research Laboratory Unit of the Department of Human Biochemistry, Faculty of Basic Medical Sciences, College of Health Sciences, Nnamdi Azikiwe University (NAU), Nnewi Campus, Anambra State. The fingerlings to be used shall be gotten from the Agricultural Department of NAU, Awka, Anambra State, and allowed to acclimatize for 14 d. Animal and food wastes shall be gotten from Nnewi. The fish shall be grouped into 1-13 (Chicken manure only, cow dung only, pig manure only, chicken manure + yeast, cow dung + yeast, pig manure + yeast, chicken manure + other wastes + yeast, cow dung + other wastes + yeast, and pig manure + other wastes + yeast. Feed assessment shall be carried out by determining bulk density, feed water absorption, feed hardness, feed oil absorption, and feed water stability. The nutritional analysis shall be carried out on the feeds processed. The risk assessment shall be done on the fish by determining methylmercury (MeHg), polycyclic aromatic hydrocarbons (PAHs), and dichloro-diphenyl-trichloroethane (DDT) in the fish. The results from this study shall be analyzed statistically using SPSS statistical software, version 25. The hypothesis is that fish feeds processed from animal wastes are efficient in raising catfish. The outcome of this study shall provide the basis for the formulation of fish feeds from organic wastes.

Keywords: assessment, feeds, health risk, wastes

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756 Experience of Hydatid Disease of Liver at a Tertiary Care Center 7 Years Experience

Authors: Jibran Abbasy, Rizwan Sultan, Ammar Humayun, Tabish Chawla

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Background: Hydatid disease caused by Echinococcus Granulosus affects liver in 70-90% of cases. Dogs are the definitive host while humans are the accidental host. Modalities used for its treatment are especially important for our population as the disease is endemic in many Asian countries. The aim of the study was to perform an audit of the various modalities used for treatment of hydatid disease of liver and the response to each modality in tertiary care center of Pakistan. Materials and Methods: Retrospective audit of patients diagnosed and treated for Hydatid disease of the liver at Aga Khan University Hospital from 1st January 2007 to 31st December 2014 was completed. All patients aged 16 and above were included. Patients who had extra hepatic disease and missing records were excluded. Outcome measures were morbidity, mortality and recurrence of the disease. Results: During the study period 56 patients were treated for isolated hepatic hydatid disease and were included. Mean age was 39 years with 48% being females and 52% males. Most common presenting complaint was abdominal pain seen in 53% of patients(n=41). Duration of symptoms was less than 6 months in 74% (n=38). Mostly right lobe was involved in 69% (n=38).Most common treatment modality used was surgery in 34 patients followed by PAIR in 14 patients while 8 patients were treated medically. At a median follow up of 34 months recurrence was seen in 2 patients treated with PAIR while no patient treated with surgery had recurrence with the median follow up of 20 months. While no morbidity and mortality were observed in PAIR, but in surgery 5 patients had morbidity while 1 patient had mortality. Conclusion: Our data is comparative to other studies in terms of morbidity, mortality, and recurrence. We had adequate follow up. In our study PAIR and surgery both are effective and have less complications and recurrence rate. Surgery is still the gold standard in terms of recurrence.

Keywords: echinococcous granulosus, puncture aspiration irrigation reaspiration (PAIR), surgery, hydatid disease

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755 Tool for Maxillary Sinus Quantification in Computed Tomography Exams

Authors: Guilherme Giacomini, Ana Luiza Menegatti Pavan, Allan Felipe Fattori Alves, Marcela de Oliveira, Fernando Antonio Bacchim Neto, José Ricardo de Arruda Miranda, Seizo Yamashita, Diana Rodrigues de Pina

Abstract:

The maxillary sinus (MS), part of the paranasal sinus complex, is one of the most enigmatic structures in modern humans. The literature has suggested that MSs function as olfaction accessories, to heat or humidify inspired air, for thermoregulation, to impart resonance to the voice and others. Thus, the real function of the MS is still uncertain. Furthermore, the MS anatomy is complex and varies from person to person. Many diseases may affect the development process of sinuses. The incidence of rhinosinusitis and other pathoses in the MS is comparatively high, so, volume analysis has clinical value. Providing volume values for MS could be helpful in evaluating the presence of any abnormality and could be used for treatment planning and evaluation of the outcome. The computed tomography (CT) has allowed a more exact assessment of this structure, which enables a quantitative analysis. However, this is not always possible in the clinical routine, and if possible, it involves much effort and/or time. Therefore, it is necessary to have a convenient, robust, and practical tool correlated with the MS volume, allowing clinical applicability. Nowadays, the available methods for MS segmentation are manual or semi-automatic. Additionally, manual methods present inter and intraindividual variability. Thus, the aim of this study was to develop an automatic tool to quantity the MS volume in CT scans of paranasal sinuses. This study was developed with ethical approval from the authors’ institutions and national review panels. The research involved 30 retrospective exams of University Hospital, Botucatu Medical School, São Paulo State University, Brazil. The tool for automatic MS quantification, developed in Matlab®, uses a hybrid method, combining different image processing techniques. For MS detection, the algorithm uses a Support Vector Machine (SVM), by features such as pixel value, spatial distribution, shape and others. The detected pixels are used as seed point for a region growing (RG) segmentation. Then, morphological operators are applied to reduce false-positive pixels, improving the segmentation accuracy. These steps are applied in all slices of CT exam, obtaining the MS volume. To evaluate the accuracy of the developed tool, the automatic method was compared with manual segmentation realized by an experienced radiologist. For comparison, we used Bland-Altman statistics, linear regression, and Jaccard similarity coefficient. From the statistical analyses for the comparison between both methods, the linear regression showed a strong association and low dispersion between variables. The Bland–Altman analyses showed no significant differences between the analyzed methods. The Jaccard similarity coefficient was > 0.90 in all exams. In conclusion, the developed tool to quantify MS volume proved to be robust, fast, and efficient, when compared with manual segmentation. Furthermore, it avoids the intra and inter-observer variations caused by manual and semi-automatic methods. As future work, the tool will be applied in clinical practice. Thus, it may be useful in the diagnosis and treatment determination of MS diseases. Providing volume values for MS could be helpful in evaluating the presence of any abnormality and could be used for treatment planning and evaluation of the outcome. The computed tomography (CT) has allowed a more exact assessment of this structure which enables a quantitative analysis. However, this is not always possible in the clinical routine, and if possible, it involves much effort and/or time. Therefore, it is necessary to have a convenient, robust and practical tool correlated with the MS volume, allowing clinical applicability. Nowadays, the available methods for MS segmentation are manual or semi-automatic. Additionally, manual methods present inter and intraindividual variability. Thus, the aim of this study was to develop an automatic tool to quantity the MS volume in CT scans of paranasal sinuses. This study was developed with ethical approval from the authors’ institutions and national review panels. The research involved 30 retrospective exams of University Hospital, Botucatu Medical School, São Paulo State University, Brazil. The tool for automatic MS quantification, developed in Matlab®, uses a hybrid method, combining different image processing techniques. For MS detection, the algorithm uses a Support Vector Machine (SVM), by features such as pixel value, spatial distribution, shape and others. The detected pixels are used as seed point for a region growing (RG) segmentation. Then, morphological operators are applied to reduce false-positive pixels, improving the segmentation accuracy. These steps are applied in all slices of CT exam, obtaining the MS volume. To evaluate the accuracy of the developed tool, the automatic method was compared with manual segmentation realized by an experienced radiologist. For comparison, we used Bland-Altman statistics, linear regression and Jaccard similarity coefficient. From the statistical analyses for the comparison between both methods, the linear regression showed a strong association and low dispersion between variables. The Bland–Altman analyses showed no significant differences between the analyzed methods. The Jaccard similarity coefficient was > 0.90 in all exams. In conclusion, the developed tool to automatically quantify MS volume proved to be robust, fast and efficient, when compared with manual segmentation. Furthermore, it avoids the intra and inter-observer variations caused by manual and semi-automatic methods. As future work, the tool will be applied in clinical practice. Thus, it may be useful in the diagnosis and treatment determination of MS diseases.

Keywords: maxillary sinus, support vector machine, region growing, volume quantification

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754 A Case Study on the Effectiveness of the Physical Therapy Home Exercise Program for Pelvic Floor Muscle Training in a Middle-Aged Female Post- Surgical Repair of Stage III Pelvic Organ Prolapse

Authors: Iwona Kasior

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Purpose: Pelvic organ prolapse is the descent of pelvic organs into the vaginal opening. Currently, few trials have been conducted to determine the influence of pelvic floor muscle training in decreasing stage or symptoms associated with pelvic organ prolapse. The purpose of this case study is to determine whether pelvic floor muscle training can decrease the stage of pelvic organ prolapse and related symptoms. Case Presentation: This is the case of a 55-year-old female; recently diagnosed with midline cystocele, stage three. She has undergone corrective surgery that failed. She has now resorted to managing the condition with a home exercise regimen of voluntary pelvic floor muscle contractions, topical vaginal crème prescribed by her gynecologist, and slight lifestyle modifications. Methods: The patient was treated by a physical therapist for evaluation, vaginal exam, and educated in the ‘knack’ maneuver, lifestyle modifications, and proper technique of performing pelvic floor muscle contractions. The subject continued with a home exercise program with a specific regimen of pelvic floor muscle contractions and topical vaginal crème. Outcome: As determined by her physical therapist and the subject, her pelvic floor muscle strength had increased following the pelvic floor muscle training regimen and the use of the ‘knack’ maneuver. The subject reported a small decrease in the size of bulging prolapse and related symptoms of dryness, odor, vaginal discomfort, and the sensation of descent. Conclusion: Pelvic floor muscle training helped to lessen the degree of the prolapse, but not significantly enough to decrease the diagnosed stage.

Keywords: Kegel exercises, pelvic floor, pelvic organ prolapse, physical therapy

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753 Consequence of Multi-Templating of Closely Related Structural Analogues on a Chitosan-Methacryllic Acid Molecularly Imprinted Polymer Matrix-Thermal and Chromatographic Traits

Authors: O.Ofoegbu, S. Roongnapa, A.N. Eboatu

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Most polluted environments, most challengingly, aerosol types, contain a cocktail of different toxicants. Multi-templating of matrices have been the recent target by researchers in a bid to solving complex mixed-toxicant challenges using single or common remediation systems. This investigation looks at the effect of such multi-templated system vis-a-vis the synthesis by non-covalent interaction, of a molecularly imprinted polymer architecture using nicotine and its structural analogue Phenylalanine amide individually and, in the blend, (50:50), as template materials in a Chitosan-Methacrylic acid functional monomer matrix. The temperature for polymerization is 60OC and time for polymerization, 12hrs (water bath heating), 4mins for (microwave heating). The characteristic thermal properties of the molecularly imprinted materials are investigated using Simultaneous Thermal Analysis (STA) profiling, while the absorption and separation efficiencies based on the relative retention times and peak areas of templates were studied amongst other properties. Transmission Electron Microscopy (TEM) results obtained, show the creation of heterogeneous nanocavities, regardless, the introduction of Caffeine a close structural analogue presented near-zero perfusion. This confirms the selectivity and specificity of the templated polymers despite its dual-templated nature. The STA results presented the materials as having decomposition temperatures above 250OC and a relative loss in mass of less than19% over a period within 50mins of heating. Consequent to this outcome, multi-templated systems can be fabricated to sequester specifically and selectively targeted toxicants in a mixed toxicant populated system effectively.

Keywords: chitosan, dual-templated, methacrylic acid, mixed-toxicants, molecularly-imprinted-polymer

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752 Effect of Engineered Low Glycemic Foods on Cancer Progression and Healthy State

Authors: C. Panebianco, K. Adamberg, S. Adamberg, C. Saracino, M. Jaagura, K. Kolk, A. Di Chio, P. Graziano, R. Vilu, V. Pazienza

Abstract:

Background/Aims: Despite recent advances in treatment options, a modest impact on the outcome of the pancreatic cancer (PC) is observed so far. Short-term fasting cycles have the potential to improve the efficacy of chemotherapy against PC. However, diseased people may refuse to follow the fasting regimen and fasting may worsen the weight loss often occurring in cancer patients. Therefore, alternative approaches are needed. The aim of this study was to assess the effect of Engineered Low glycemic food ELGIF mimicking diet on growth of cancer cell lines in vitro and in an in vivo pancreatic cancer mouse xenograft model. Materials and Methods: BxPC-3, MiaPaca-2 and Panc-1 cells were cultured in control and ELGIF mimicking diet culturing condition to evaluate the tumor growth and proliferation pathways. Pancreatic cancer xenograft mice were subjected to ELGIF to assess the tumor volume and weight as compared to mice fed with control diet. Results: Pancreatic cancer cells cultured in ELGIF mimicking medium showed decreased levels of proliferation as compared to those cultured in the standard medium. Consistently, xenograft pancreatic cancer mice subjected to ELGIF diet displayed a significant decrease in tumor growth. Conclusion: A positive effect of ELGIF diet on proliferation in vitro is associated with the decrease of tumor progression in the in vivo PC xenograft mouse model. These results suggest that engineered dietary interventions could be supportive as synergistic approach to enhance the efficacy of existing cancer treatments in pancreatic cancer patients.

Keywords: functional food, microbiota, mouse model, pancreatic cancer

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751 Effect of Timing and Contributing Factors for Early Language Intervention in Toddlers with Repaired Cleft Lip and Palate

Authors: Pushpavathi M., Kavya V., Akshatha V.

Abstract:

Introduction: Cleft lip and palate (CLP) is a congenital condition which hinders effectual communication due to associated speech and language difficulties. Expressive language delay (ELD) is a feature seen in this population which is influenced by factors such as type and severity of CLP, age at surgical and linguistic intervention and also the type and intensity of speech and language therapy (SLT). Since CLP is the most common congenital abnormality seen in Indian children, early intervention is a necessity which plays a critical role in enhancing their speech and language skills. The interaction between the timing of intervention and factors which contribute to effective intervention by caregivers is an area which needs to be explored. Objectives: The present study attempts to determine the effect of timing of intervention on the contributing maternal factors for effective linguistic intervention in toddlers with repaired CLP with respect to the awareness, home training patterns, speech and non-speech behaviors of the mothers. Participants: Thirty six toddlers in the age range of 1 to 4 years diagnosed as ELD secondary to repaired CLP, along with their mothers served as participants. Group I (Early Intervention Group, EIG) included 19 mother-child pairs who came to seek SLT soon after corrective surgery and group II (Delayed Intervention Group, DIG) included 16 mother-child pairs who received SLT after the age of 3 years. Further, the groups were divided into group A, and group B. Group ‘A’ received SLT for 60 sessions by Speech Language Pathologist (SLP), while Group B received SLT for 30 sessions by SLP and 30 sessions only by mother without supervision of SLP. Method: The mothers were enrolled for the Early Language Intervention Program and following this, their awareness about CLP was assessed through the Parental awareness questionnaire. The quality of home training was assessed through Mohite’s Inventory. Subsequently, the speech and non-speech behaviors of the mothers were assessed using a Mother’s behavioral checklist. Detailed counseling and orientation was done to the mothers, and SLT was initiated for toddlers. After 60 sessions of intensive SLT, the questionnaire and checklists were re-administered to find out the changes in scores between the pre- and posttest measurements. Results: The scores obtained under different domains in the awareness questionnaire, Mohite’s inventory and Mothers behavior checklist were tabulated and subjected to statistical analysis. Since the data did not follow normal distribution (i.e. p > 0.05), Mann-Whitney U test was conducted which revealed that there was no significant difference between groups I and II as well as groups A and B. Further, Wilcoxon Signed Rank test revealed that mothers had better awareness regarding issues related to CLP and improved home-training abilities post-orientation (p ≤ 0.05). A statistically significant difference was also noted for speech and non-speech behaviors of the mothers (p ≤ 0.05). Conclusions: Extensive orientation and counseling helped mothers of both EI and DI groups to improve their knowledge about CLP. Intensive SLT using focused stimulation and a parent-implemented approach enabled them to carry out the intervention in an effectual manner.

Keywords: awareness, cleft lip and palate, early language intervention program, home training, orientation, timing of intervention

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750 Achievements of Healthcare Services Vis-À-Vis the Millennium Development Goals Targets: Evidence from Pakistan

Authors: Saeeda Batool, Ather Maqsood Ahmed

Abstract:

This study investigates the impact of public healthcare facilities and socio-economic circumstances on the status of child health in Pakistan. The complete analysis is carried out in correspondence with fourth and sixth millennium development goals. Further, the health variables chosen are also inherited from targeted indicators of the mentioned goals (MDGs). Trends in the Human Opportunity Index (HOI) for both health inequalities and coverage are analyzed using the Pakistan Social and Living Standards Measurement (PLSM) data set for 2001-02 to 2012-13 at the national and provincial level. To reveal the relative importance of each circumstance in achieving the targeted values for child health, Shorrocks decomposition is applied on HOI. The annual point average growth rate of HOI is used to simulate the time period for the achievement of target set by MDGs and universal access also. The results indicate an improvement in HOI for a reduction in child mortality rates from 52.1% in 2001-02 to 67.3% in 2012-13, which confirms the availability of healthcare opportunities to a larger segment of society. Similarly, immunization against measles and other diseases such as Diphtheria, Polio, Bacillus Calmette-Guerin (BCG), and Hepatitis has also registered an improvement from 51.6% to 69.9% during the period of study at the national level. On a positive note, no gender disparity has been found for child health indicators and that health outcome is mostly affected by the parental and geographical features and availability of health infrastructure. However, the study finds that this achievement has been uneven across provinces. Pakistan is not only lagging behind in achieving its health goals, disappointingly with the current rate of health care provision, but it will take many additional years to achieve its targets.

Keywords: socio-economic circumstances, unmet MDGs, public healthcare services, child and infant mortality

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749 Two-Way Reminder Systems to Support Activities of Daily Living for Adults with Cognitive Impairments: A Scoping Review

Authors: Julia Brudzinski, Ashley Croswell, Jade Mardin, Hannah Shilling, Jennifer Berg-Carnegie

Abstract:

Adults with brain injuries and mental illnesses commonly experience cognitive impairments that interfere with their participation in activities of daily living (ADLs). Prior research states that electronic reminder systems can support adults with cognitive impairments; however, previous studies focus primarily on one-way reminder systems. Research on adults with chronic diseases reported that two-way reminder systems yield better health outcomes and disease self-management compared to one-way reminder systems. Literature was identified through systematically searching 7 databases and hand-searching relevant reference lists. Retrieved studies were independently screened and reviewed by at least two members of the research team. Data was extracted on study design, participant characteristics, intervention details, study objectives, outcome measures, and important results. 574 articles were screened and reviewed. Nine articles met all inclusion criteria and were included. The literature focused on three main areas: system feasibility (n=8), stakeholder satisfaction (n=6), and efficacy of the two-way reminder systems (n=6). Participants in eight of the studies had brain injuries, with participants in only one study having a mental illness (i.e., schizophrenia). Two-way reminder systems were used to support participation in a wide range of ADLs. The current literature on two-way reminder systems to support ADLs for adults with cognitive impairments focuses on feasibility, stakeholder satisfaction, and system efficacy. Future research should focus on addressing the barriers to accessing and implementing two-way reminder systems and identifying specific client characteristics that would benefit most from using these systems.

Keywords: brain injury, digital health, occupational therapy, activities of daily living, two-way reminder systems

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748 Left Posterior Pericardiotomy in the Prevention of Post-Operative Atrial Fibrillation and Cardiac Tamponade: A Retrospective Study of 2118 Isolated Coronary Artery Bypass Graft Patients

Authors: Ayeshmanthe Rathnayake, Siew Goh, Carmel Fenton, Ashutosh Hardikar

Abstract:

Post-Operative Atrial Fibrillation (POAF) is the most frequent complication of cardiac surgery and is associated with reduced survival, increased rates of cognitive changes and cerebrovascular accident, heart failure, renal dysfunction, infection and length of stay, and hospital costs. Cardiac tamponade, although less common, carries high morbidity and mortality. Shed mediastinal blood in the pericardial space is a major source of intrapericardial oxidative stress and inflammation that triggers POAF. The utilisation of a left posterior pericardiotomy aims to shunt blood from the pericardium into the pleural space and have a role in the prevention of POAF as well as cardiac tamponade. 2118 patients had undergone isolated Coronary Artery Bypass Graft (CABG) at Royal Hobart Hospital from 2008-2021. They were divided into pericardiotomy vs control group. Patient baseline demographics, intraoperative data, and post-operative outcomes were reviewed retrospectively. Total incidence of new POAF and cardiac tamponade was 26.1% and 0.75%, respectively. Primary outcome of both the incidence of POAF(22.9% vs27.8%OR 0.77 p<0.05) and Cardiac Tamponade (0% vs 1.1% OR 0.85 p<0.05) were less in the pericardiotomy group.Increasing age, BMI, poor left ventricular function (EF <30%), and return to theatre were independent predictors of developing POAF. There were similar rates of return to theatre for bleeding however, no cases of tamponade in the pericardiotomy group. There were no complications attributable to left posterior pericardiotomy and the time added to the duration of surgery was minimal. Left posterior pericardiotomy is associated with a significant reduction in the incidence of POAFand cardiac tamponade and issafe and efficient.

Keywords: cardiac surgery, pericardiotomy, post-operative atrial fibrillation, cardiac tamponade

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747 Research Trends in Using Virtual Reality for the Analysis and Treatment of Lower-Limb Musculoskeletal Injury of Athletes: A Literature Review

Authors: Hannah K. M. Tang, Muhammad Ateeq, Mark J. Lake, Badr Abdullah, Frederic A. Bezombes

Abstract:

There is little research applying virtual reality (VR) to the treatment of musculoskeletal injury in athletes. This is despite their prevalence, and the implications for physical and psychological health. Nevertheless, developments of wireless VR headsets better facilitate dynamic movement in VR environments (VREs), and more research is expected in this emerging field. This systematic review identified publications that used VR interventions for the analysis or treatment of lower-limb musculoskeletal injury of athletes. It established a search protocol, and through narrative discussion, identified existing trends. Database searches encompassed four term sets: 1) VR systems; 2) musculoskeletal injuries; 3) sporting population; 4) movement outcome analysis. Overall, a total of 126 publications were identified through database searching, and twelve were included in the final analysis and discussion. Many of the studies were pilot and proof of concept work. Seven of the twelve publications were observational studies. However, this may provide preliminary data from which clinical trials will branch. If specified, the focus of the literature was very narrow, with very similar population demographics and injuries. The trends in the literature findings emphasised the role of VR and attentional focus, the strategic manipulation of movement outcomes, and the transfer of skill to the real-world. Causal inferences may have been undermined by flaws, as most studies were limited by the practicality of conducting a two-factor clinical-VR-based study. In conclusion, by assessing the exploratory studies, and combining this with the use of numerous developments, techniques, and tools, a novel application could be established to utilise VR with dynamic movement, for the effective treatment of specific musculoskeletal injuries of athletes.

Keywords: athletes, lower-limb musculoskeletal injury, rehabilitation, return-to-sport, virtual reality

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746 Role of Energy Storage in Renewable Electricity Systems in The Gird of Ethiopia

Authors: Dawit Abay Tesfamariam

Abstract:

Ethiopia’s Climate- Resilient Green Economy (ECRGE) strategy focuses mainly on generating and proper utilization of renewable energy (RE). Nonetheless, the current electricity generation of the country is dominated by hydropower. The data collected in 2016 by Ethiopian Electric Power (EEP) indicates that the intermittent RE sources from solar and wind energy were only 8 %. On the other hand, the EEP electricity generation plan in 2030 indicates that 36.1 % of the energy generation share will be covered by solar and wind sources. Thus, a case study was initiated to model and compute the balance and consumption of electricity in three different scenarios: 2016, 2025, and 2030 using the EnergyPLAN Model (EPM). Initially, the model was validated using the 2016 annual power-generated data to conduct the EnergyPLAN (EP) analysis for two predictive scenarios. The EP simulation analysis using EPM for 2016 showed that there was no significant excess power generated. Thus, the EPM was applied to analyze the role of energy storage in RE in Ethiopian grid systems. The results of the EP simulation analysis showed there will be excess production of 402 /7963 MW average and maximum, respectively, in 2025. The excess power was in the three rainy months of the year (June, July, and August). The outcome of the model also showed that in the dry seasons of the year, there would be excess power production in the country. Consequently, based on the validated outcomes of EP indicates, there is a good reason to think about other alternatives for the utilization of excess energy and storage of RE. Thus, from the scenarios and model results obtained, it is realistic to infer that if the excess power is utilized with a storage system, it can stabilize the grid system and be exported to support the economy. Therefore, researchers must continue to upgrade the current and upcoming storage system to synchronize with potentials that can be generated from renewable energy.

Keywords: renewable energy, power, storage, wind, energy plan

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745 The Effectiveness of Incidental Physical Activity Interventions Compared to Other Interventions in the Management of People with Low Back Pain: A Systematic Review and Meta-Analysis

Authors: Hosam Alzahrani, Martin Mackey, Emmanuel Stamatakis, Marina B. Pinheiro, Manuela Wicks, Debra Shirley

Abstract:

Objective: To investigate the effectiveness of incidental (non-structured) physical activity interventions compared with other commonly prescribed interventions for the management of people with low back pain (LBP). Methods: We performed a systematic review with meta-analyses of eligible randomized controlled trials obtained by searching Medline, Scopus, CINAHL, EMBASE, and CENTRAL. This review considered trials investigating the effect of incidental physical activity interventions compared to other interventions in people aged 18 years or over, diagnosed with non-specific LBP. Analyses were conducted separately for short-term (≤3 months), intermediate-term (> 3 and < 12 months), and long-term (≥ 12 months), for each outcome. The analyses were conducted using the weighted mean difference (WMD). The overall quality of evidence was assessed using the GRADE system. Meta-analyses were only performed for pain and disability outcomes as there was insufficient data on the other outcomes. Results: For pain, the pooled results did not show any significant effects between the incidental physical activity intervention and other interventions at any time point. For disability, incidental physical activity was not statistically more effective than other interventions at short-term; however, the pooled results favored incidental physical activity at intermediate-term (WMD= -6.05, 95% CI: -10.39 to -1.71, p=0.006) and long-term (WMD= -6.40 95% CI: -11.68 to -1.12, p=0.02) follow-ups among participants with chronic LBP. The overall quality of evidence was rated “moderate quality” based on the GRADE system. Conclusion: The incidental physical activity intervention provided intermediate and long disability relief for people with chronic LBP, although this improvement was small and not likely to be clinically important.

Keywords: physical activity, incidental, low back pain, systematic review, meta-analysis

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744 The Joy of Painless Maternity: The Reproductive Policy of the Bolsheviks in the 1930s

Authors: Almira Sharafeeva

Abstract:

In the Soviet Union of the 1930s, motherhood was seen as a natural need of women. The masculine Bolshevik state did not see the emancipated woman as free from her maternal burden. In order to support the idea of "joyful motherhood," a medical discourse on the anesthesia of childbirth emerges. In March 1935 at the IX Congress of obstetricians and gynecologists the People's Commissar of Public Health of the RSFSR G.N. Kaminsky raised the issue of anesthesia of childbirth. It was also from that year that medical, literary and artistic editions with enviable frequency began to publish articles, studies devoted to the issue, the goal - to anesthetize all childbirths in the USSR - was proclaimed. These publications were often filled with anti-German and anti-capitalist propaganda, through which the advantages of socialism over Capitalism and Nazism were demonstrated. At congresses, in journals, and at institute meetings, doctors' discussions around obstetric anesthesia were accompanied by discussions of shortening the duration of the childbirth process, the prevention and prevention of disease, the admission of nurses to the procedure, and the proper behavior of women during the childbirth process. With the help of articles from medical periodicals of the 1930s., brochures, as well as documents from the funds of the Institute of Obstetrics and Gynecology of the Academy of Medical Sciences of the USSR (TsGANTD SPb) and the Department of Obstetrics and Gynecology of the NKZ USSR (GARF) in this paper we will show, how the advantages of the Soviet system and the socialist way of life were constructed through the problem of childbirth pain relief, and we will also show how childbirth pain relief in the USSR was related to the foreign policy situation and how projects of labor pain relief were related to the anti-abortion policy of the state. This study also attempts to answer the question of why anesthesia of childbirth in the USSR did not become widespread and how, through this medical procedure, the Soviet authorities tried to take control of a female function (childbirth) that was not available to men. Considering this subject from the perspective of gender studies and the social history of medicine, it is productive to use the term "biopolitics. Michel Foucault and Antonio Negri, wrote that biopolitics takes under its wing the control and management of hygiene, nutrition, fertility, sexuality, contraception. The central issue of biopolitics is population reproduction. It includes strategies for intervening in collective existence in the name of life and health, ways of subjectivation by which individuals are forced to work on themselves. The Soviet state, through intervention in the reproductive lives of its citizens, sought to realize its goals of population growth, which was necessary to demonstrate the benefits of living in the Soviet Union and to train a pool of builders of socialism. The woman's body was seen as the object over which the socialist experiment of reproductive policy was being conducted.

Keywords: labor anesthesia, biopolitics of stalinism, childbirth pain relief, reproductive policy

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743 The Causality between Corruption and Economic Growth in MENA Countries: A Dynamic Panel-Data Analysis

Authors: Nour Mohamad Fayad

Abstract:

Complex and extensively researched, the impact of corruption on economic growth seems to be intricate. Many experts believe that corruption reduces economic development. However, counterarguments have suggested that corruption either promotes growth and development or has no significant impact on economic performance. Clearly, there is no consensus in the economics literature regarding the possible relationship between corruption and economic development. Corruption's complex and clandestine nature, which makes it difficult to define and measure, is one of the obstacles that must be overcome when investigating its effect on an economy. In an attempt to contribute to the ongoing debate, this study examines the impact of corruption on economic growth in the Middle East and North Africa (MENA) region between 2000 and 2021 using a Customized Corruption Index-CCI and panel data on MENA countries. These countries were selected because they are understudied in the economic literature, and despite the World Bank's recent emphasis on corruption in the developing world, the MENA countries have received little attention. The researcher used Cobb-Douglas functional form to test corruption in MENA using a customized index known as Customized Corruption Index-CCI to track corruption over almost 20 years, then used the dynamic panel data. The findings indicate that there is a positive correlation between corruption and economic growth, but this is not consistent across all MENA nations. First, the relatively recent lack of data from MENA nations. This issue is related to the inaccessibility of data for many MENA countries, particularly regarding the returns on resources, private malfeasance, and other variables in Gulf countries. In addition, the researcher encountered several restrictions, such as electricity and internet outages, due to the fact that he is from Lebanon, a country whose citizens have endured difficult living conditions since the Lebanese crisis began in 2019. Demonstrating a customized index known as Customized Corruption Index-CCI that suits the characteristics of MENA countries to peculiarly measure corruption in this region, the outcome of the Customized Corruption Index-CCI is then compared to the Corruption Perception Index-CPI and Control of Corruption from World Governance Indicator-CC from WGI.

Keywords: corruption, economic growth, corruption measurements, empirical review, impact of corruption

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742 Clinical Relevance of TMPRSS2-ERG Fusion Marker for Prostate Cancer

Authors: Shalu Jain, Anju Bansal, Anup Kumar, Sunita Saxena

Abstract:

Objectives: The novel TMPRSS2:ERG gene fusion is a common somatic event in prostate cancer that in some studies is linked with a more aggressive disease phenotype. Thus, this study aims to determine whether clinical variables are associated with the presence of TMPRSS2:ERG-fusion gene transcript in Indian patients of prostate cancer. Methods: We evaluated the clinical variables with presence and absence of TMPRSS2:ERG gene fusion in prostate cancer and BPH association of clinical patients. Patients referred for prostate biopsy because of abnormal DRE or/and elevated sPSA were enrolled for this prospective clinical study. TMPRSS2:ERG mRNA copies in samples were quantified using a Taqman chemistry by real time PCR assay in prostate biopsy samples (N=42). The T2:ERG assay detects the gene fusion mRNA isoform TMPRSS2 exon1 to ERG exon4. Results: Histopathology report has confirmed 25 cases as prostate cancer adenocarcinoma (PCa) and 17 patients as benign prostate hyperplasia (BPH). Out of 25 PCa cases, 16 (64%) were T2: ERG fusion positive. All 17 BPH controls were fusion negative. The T2:ERG fusion transcript was exclusively specific for prostate cancer as no case of BPH was detected having T2:ERG fusion, showing 100% specificity. The positive predictive value of fusion marker for prostate cancer is thus 100% and the negative predictive value is 65.3%. The T2:ERG fusion marker is significantly associated with clinical variables like no. of positive cores in prostate biopsy, Gleason score, serum PSA, perineural invasion, perivascular invasion and periprostatic fat involvement. Conclusions: Prostate cancer is a heterogeneous disease that may be defined by molecular subtypes such as the TMPRSS2:ERG fusion. In the present prospective study, the T2:ERG quantitative assay demonstrated high specificity for predicting biopsy outcome; sensitivity was similar to the prevalence of T2:ERG gene fusions in prostate tumors. These data suggest that further improvement in diagnostic accuracy could be achieved using a nomogram that combines T2:ERG with other markers and risk factors for prostate cancer.

Keywords: prostate cancer, genetic rearrangement, TMPRSS2:ERG fusion, clinical variables

Procedia PDF Downloads 441
741 Extending Theory of Planned Behavior to Modelling Chronic Patients’ Acceptance of Health Information: An Information Overload Perspective

Authors: Shu-Lien Chou, Chung-Feng Liu

Abstract:

Self-health management of chronic illnesses plays an important part in chronic illness treatments. However, various kinds of health information (health education materials) which government or healthcare institutions provide for patients may not achieve the expected outcome. One of the critical reasons affecting patients’ use intention could be patients’ perceived Information overload regarding the health information. This study proposed an extended model of Theory of Planned Behavior, which integrating perceived information overload as another construct to explore patients’ use intention of the health information for self-health management. The independent variables are attitude, subject norm, perceived behavior control and perceived information overload while the dependent variable is behavior intention to use the health information. The cross-sectional study used a structured questionnaire for data collection, focusing on the chronic patients with coronary artery disease (CAD), who are the potential users of the health information, in a medical center in Taiwan. Data were analyzed using descriptive statistics of the basic information distribution of the questionnaire respondents, and the Partial Least Squares (PLS) structural equation model to study the reliability and construct validity for testing our hypotheses. A total of 110 patients were enrolled in this study and 106 valid questionnaires were collected. The PLS analysis result indicates that the patients’ perceived information overload of health information contributes the most critical factor influencing the behavioral intention. Subjective norm and perceived behavioral control of TPB constructs had significant effects on patients’ intentions to use health information also, whereas the attitude construct did not. This study demonstrated a comprehensive framework, which extending perceived information overload into TPB model to predict patients’ behavioral intention of using heath information. We expect that the results of this study will provide useful insights for studying health information from the perspectives of academia, governments, and healthcare providers.

Keywords: chronic patients, health information, information overload, theory of planned behavior

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740 Physiological Response of Water-Restricted Xhosa Goats Supplemented with Vitamin C

Authors: O.F. Akinmoladun, F.N. Fon, C.T. Mpendulo, O. Okoh

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The sustainability of livestock production is under threat as a result of water scarcity, fluctuating precipitation, and high environmental temperature. These combined stressors have impacted negatively on general animal production and welfare, necessitating a very reliable and cost-effective management practices, especially in arid and water-limited regions of the world. Instead of the above, this study was designed to investigate the growth performance and physiological response of water-restricted Xhosa ear-lobe goats fed diets supplemented with single or multiple vitamin C (VC) during summer. The total forty-eight goats used for the experiment were balanced for body weight and randomly assigned to the seven treatment groups (seven goats/treatment): GI (W100%); GII (W70%); GIII (W50%); GIV (W70%+3g/day VC); GV ((W50% +3g/day VC); GVI (W70%+3g/d VC+extra 5g on every eight-day); GVII (W50%+3g/d VC+extra 5g on every eight-day). The design was a complete randomized design and VC was administered per os. At the end of the 75-day feeding trial, GIII (W50%) animals were the most affected (P<0.05) and the effect was more pronounced in their body condition scores (BCs). Weight loss and depression in feed intake due to water restriction (P<0.05) were attenuated by VC treated groups (GIV-GVII). Changes in body thermal gradient (BTG) and rectal temperature (RcT) were similar (P>0.05) across the various experimental groups. The attenuation effect of VC was significant in responses to respiratory rate (RR) and cortisol. Supplementation of VC (either single or multiple) did not significantly (P>0.05) improve water restriction effect on body condition scores (BCs) and FAMACHA©. The current study found out that Xhosa ear lobe goats can adapt to the prevailing bioclimatic changes and limited water intake. However, supplementation of vitamin C can be beneficial at modulating these stressful stimuli. Continuous consistencies in the outcome of vitamin C on water-stressed animals can help validate recommendations especially to farmers in the arid and water-limited regions across the globe.

Keywords: vitamin C, Xhosa ear-lobe, thermotolerance, water stress

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739 Nurturing of Children with Results from Their Nature (DNA) Using DNA-MILE

Authors: Tan Lay Cheng (Cheryl), Low Huiqi

Abstract:

Background: All children learn at different pace. Individualized learning is an approach that tailors to the individual learning needs of each child. When implementing this approach, educators have to base their lessons on the understanding that all students learn differently and that what works for one student may not work for another. In the current early childhood environment, individualized learning is for children with diverse needs. However, a typical developing child is also able to benefit from individualized learning. This research abstract explores the concept of utilizing DNA-MILE, a patented (in Singapore) DNA-based assessment tool that can be used to measure a variety of factors that can impact learning. The assessment report includes the dominant intelligence of the user or, in this case, the child. From the result, a personalized learning plan that is tailored to each individual student's needs. Methods: A study will be conducted to investigate the effectiveness of DNA-MILE in supporting individualized learning. The study will involve a group of 20 preschoolers who were randomly assigned to either a DNA-MILE-assessed group (experimental group) or a control group. 10 children in each group. The experimental group will receive DNA Mile assessments and personalized learning plans, while the control group will not. The children in the experimental group will be taught using the dominant intelligence (as shown in the DNA-MILE report) to enhance their learning in other domains. The children in the control group will be taught using the curriculum and lesson plan set by their teacher for the whole class. Parents’ and teachers’ interviews will be conducted to provide information about the children before the study and after the study. Results: The results of the study will show the difference in the outcome of the learning, which received DNA Mile assessments and personalized learning plans, significantly outperformed the control group on a variety of measures, including standardized tests, grades, and motivation. Conclusion: The results of this study suggest that DNA Mile can be an effective tool for supporting individualized learning. By providing personalized learning plans, DNA Mile can help to improve learning outcomes for all students.

Keywords: individualized, DNA-MILE, learning, preschool, DNA, multiple intelligence

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738 The Effect of Second Victim-Related Distress on Work-Related Outcomes in Tertiary Care, Kelantan, Malaysia

Authors: Ahmad Zulfahmi Mohd Kamaruzaman, Mohd Ismail Ibrahim, Ariffin Marzuki Mokhtar, Maizun Mohd Zain, Saiful Nazri Satiman, Mohd Najib Majdi Yaacob

Abstract:

Background: Aftermath any patient safety incidents, the involved healthcare providers possibly sustained second victim-related distress (second victim distress and reduced their professional efficacy), with subsequent negative work-related outcomes or vice versa cultivating resilience. This study aimed to investigate the factors affecting negative work-related outcomes and resilience, with the triad of support; colleague, supervisor, and institutional support as the hypothetical mediators. Methods: This was a cross sectional study recruiting a total of 733 healthcare providers from three tertiary care in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for each outcome; negative work-related outcomes and resilience. Then, four multiple mediator models of support triad were analyzed. Results: Second victim distress, professional efficacy, and the support triad contributed significantly for each regression model. In the pathway of professional efficacy on each negative work-related outcomes and resilience, colleague support partially mediated the relationship. As for second victim distress on negative work related outcomes, colleague and supervisor support were the partial mediator, and on resilience; all support triad also produced a similar effect. Conclusion: Second victim distress, professional efficacy, and the support triad influenced the relationship with the negative work-related outcomes and resilience. Support triad as the mediators ameliorated the effect in between and explained the urgency of having good support for recovery post encountering patient safety incidents.

Keywords: second victims, patient safety incidents, hierarchical linear regression, mediation, support

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