Search results for: acute and chronic pancreatitis
453 Relatively High Heart-Rate Variability Predicts Greater Survival Chances in Patients with Covid-19
Authors: Yori Gidron, Maartje Mol, Norbert Foudraine, Frits Van Osch, Joop Van Den Bergh, Moshe Farchi, Maud Straus
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Background: The worldwide pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-COV2), which began in 2019, also known as Covid-19, has infected over 136 million people and tragically took the lives of over 2.9 million people worldwide. Many of the complications and deaths are predicted by the inflammatory “cytokine storm.” One way to progress in the prevention of death is by finding a predictive and protective factor that inhibits inflammation, on the one hand, and which also increases anti-viral immunity on the other hand. The vagal nerve does precisely both actions. This study examined whether vagal nerve activity, indexed by heart-rate variability (HRV), predicts survival in patients with Covid-19. Method: We performed a pseudo-prospective study, where we retroactively obtained ECGs of 271 Covid-19 patients arriving at a large regional hospital in The Netherlands. HRV was indexed by the standard deviation of the intervals between normal heartbeats (SDNN). We examined patients’ survival at 3 weeks and took into account multiple confounders and known prognostic factors (e.g., age, heart disease, diabetes, hypertension). Results: Patients’ mean age was 68 (range: 25-95) and nearly 22% of the patients had died by 3 weeks. Their mean SDNN (17.47msec) was far below the norm (50msec). Importantly, relatively higher HRV significantly predicted a higher chance of survival, after statistically controlling for patients’ age, cardiac diseases, hypertension and diabetes (relative risk, H.R, and 95% confidence interval (95%CI): H.R = 0.49, 95%CI: 0.26 – 0.95, p < 0.05). However, since HRV declines rapidly with age and since age is a profound predictor in Covid-19, we split the sample by median age (40). Subsequently, we found that higher HRV significantly predicted greater survival in patients older than 70 (H.R = 0.35, 95%CI: 0.16 – 0.78, p = 0.01), but HRV did not predict survival in patients below age 70 years (H.R = 1.11, 95%CI: 0.37 – 3.28, p > 0.05). Conclusions: To the best of our knowledge, this is the first study showing that higher vagal nerve activity, as indexed by HRV, is an independent predictor of higher chances for survival in Covid-19. The results are in line with the protective role of the vagal nerve in diseases and extend this to a severe infectious illness. Studies should replicate these findings and then test in controlled trials whether activating the vagus nerve may prevent mortality in Covid-19.Keywords: Covid-19, heart-rate Variability, prognosis, survival, vagal nerve
Procedia PDF Downloads 175452 Preparedness Level of European Cultural Institutions and Catering Establishments Within the Sanitary and Epidemiological Dimension During the COVID-19 Pandemic
Authors: Magdalena Barbara Kaziuk
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Introduction: In December 2019, the first case of an acute infectious disease of the respiratory system caused by the SARS-CoV-2 virus was recorded in Wuhan in Central China. On March 11, 2020, the World Health Organization restrictions, among others, in the travel industry. Aim: The aim of the study was the assessment of the preparedness of European cultural institutions and catering establishments within the sanitary and epidemiological dimension during the COVID-19 pandemic by Polish tourists and their sense of safety in selected destinations. Material and methods: The study involved 300 Polish tourists (125 females, 175 males, age 46.5+/-12.9 years) who traveled during the COVID-19 pandemic to Southern European countries. 5 most popular travel destinations were selected: Italy, Austria, Greece, Croatia, and Mediterranean islands. The tourists assessed cultural institutions and catering establishments with the use of a proprietary questionnaire which concerned the preparedness regarding the sanitary and epidemiological requirements and the tourists' sense of safety. The number of respondents was deliberate - 60 persons per each country. Results: The more stringent sanitary regimes, the higher the sense of safety in the study group of females aged 45-50 (p<0.005), while the more stringent sanitary and epidemiological issues are implemented, the shorter the stay (p<0.001). Less stringent restrictions resulted in increased sense of freedom and mental rest in the group of studied males (p<0.005). Conclusions: The respondents' opinions revealed that the highest level of safety with regard to sanitary and epidemiological requirements (masks covering mouth and nose worn by both personnel and society, the necessity to present the COVID passport, the possibility to disinfect hands) was observed in Austria and Italy, while shorter length of the stay in these countries resulted from high prices, particularly in catering establishments. According to the respondents, less stringent restrictions, among others lack of the necessity to own the COVID passport, were linked to Croatia and Mediterranean islands. The sense of safety was satisfying, while the sense of freedom and mental rest was high. declared a string of COVID-19 cases a pandemic. Most countries implemented numerous sanitary and epidemiologicalKeywords: sanitary and epidemiological regimes, tourist facilities, COVID-19 pandemic, sense of safety
Procedia PDF Downloads 125451 The h3r Antagonist E159 Alleviates Neuroinflammation and Autistic-Like Phenotypes in BTBR T+ tf/J Mouse Model of Autism
Authors: Shilu Deepa Thomas, P. Jayaprakash, Dorota Łazewska, Katarzyna Kieć-Kononowicz, B. Sadek
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A large body of evidence suggests the involvement of cognitive impairment, increased levels of inflammation and oxidative stress in the pathogenesis of autism spectrum disorder (ASD). ASD commonly coexists with psychiatric conditions like anxiety and cognitive challenges, and individuals with ASD exhibit significant levels of inflammation and immune system dysregulation. Previous Studies have identified elevated levels of pro-inflammatory markers such as IL-1β, IL-6, IL-2 and TNF-α, particularly in young children with ASD. The current therapeutic options for ASD show limited effectiveness, signifying the importance of exploring an efficient drugs to address the core symptoms. The role of histamine H3 receptors (H3Rs) in memory and the prospective role of H3R antagonists in pharmacological control of neurodegenerative disorders, e.g., ASD, is well-accepted. Hence, the effects of chronic systemic administration of H3R antagonist E159 on autistic-like repetitive behaviors, social deficits, memory and anxiety parameters, as well as neuroinflammation in Black and Tan BRachyury (BTBR) mice, were evaluated using Y maze, Barnes maze, self-grooming, open field and three chamber social test. E159 (2.5, 5 and 10 mg/kg, i.p.) dose-dependently ameliorated repetitive and compulsive behaviors by reducing the increased time spent in self-grooming and improved reduced spontaneous alternation in BTBR mice. Moreover, treatment with E159 attenuated disturbed anxiety levels and social deficits in tested male BTBR mice. Furthermore, E159 attenuated oxidative stress by significantly increasing GSH, CAT, and SOD and decreasing the increased levels of MDA in the cerebellum as well as the hippocampus. In addition, E159 decreased the elevated levels of proinflammatory cytokines (tumor necrosis factor (TNF-α), interleukin-1β (IL-1β), and IL-6). The observed results show that H3R antagonists like E159 may represent a promising novel pharmacological strategy for the future treatment of ASD.Keywords: histamine H3 receptors, antagonist E159, autism, behaviors, mice
Procedia PDF Downloads 66450 Prevention of Heart Failure Progression in Patients with Post-Infarction Cardiosclerosis After Coronavirus Infection
Authors: Sujayeva V. A., Karpova I. S., Koslataya O. V., Kolyadko M. G., Russkikh I. I., Vankovich E. A.
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Objective: The goal of this study is to develop a method for the prevention of the progression of heart failure (HF) in patients with post-infarction cardiosclerosis who have suffered coronavirus infection. Methods: 135 patients with post-infarction cardiosclerosis were divided into 2 groups: Group I - patients who had suffered COVID-19 - 85 people, and Group II - patients who had not suffered COVID-19 - 50 people. Patients of group I, depending on the level of N-terminal fragment of natriuretic peptide (NTproBNP), were divided into 2 subgroups - subgroup A - with HF - 40 people, subgroup B - without HF - 45 people. All patients underwent a clinical examination, echocardiography, electrocardiotopography in 60 leads, computed angiography of the coronary arteries, heart magnetic resonance imaging, NTproBNP. Results: In the post-Covid period, in patients with post-infarction cardiosclerosis, remodeling of the left ventricle and right parts of the heart, deterioration of the systolic-diastolic function of both ventricles, increased pressure in the pulmonary artery, progression of coronary artery atherosclerosis, and an increase in the size of myocardial fibrosis were revealed. The consequence of these changes was the progression of heart failure. The developed method of medical prevention made it possible to improve the clinical course of coronary artery disease and prevent the progression of chronic heart failure in patients with post-infarction cardiosclerosis. Conclusions: In patients with post-infarction cardiosclerosis who initially had HF, after 1 year, according to laboratory and instrumental data, a slight decrease in its severity was revealed. In patients with post-infarction cardiosclerosis who did not have HF before COVID-19, HF developed 1 year after the coronavirus disease, which may be due to the identified process of myocardial fibrosis, which dictates the need to prevent the development of HF in patients with post-infarction cardiosclerosis, even those who did not initially have HF. The proposed method of medical prevention made it possible to improve the clinical course of coronary artery disease in patients with post-infarction cardiosclerosis after COVID-19, both in persons with and without HF, when included in the study. A method of medical prevention in people with post-infarction cardiosclerosis after COVID-19 infection, including spironolactone, loop diuretics, empagliflozin, sacubitril/valsartan, helped prevent the progression of HF.Keywords: elderly, myocardial infarction, COVID-19, prevention
Procedia PDF Downloads 25449 The Understanding of Biochemical and Molecular Analysis of Diabetic Rats Treated with Andrographis paniculata and Erythrina indica Methanol Extract
Authors: Chakrapani Pullagummi, Arun Jyothi Bheemagani, B. Chandra Sekhar Singh, Prem Kumar, A. Roja Rani
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Diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion and its action. The objective of present study was alloxan induced diabetes in S.D (Sprague Dawley) rats, treated with leaf extract of Andrographis paniculata and bark extract of Erythrina indica. Plant extract treated rats were analyzed biochemically and molecularly. on normal and diabetic rats. The changes in MDA (lipid peroxidation) and glucose (by GOD method) levels in blood of both normal and diabetic rat were analyzed. Diabetes induced rats were treated with methanolic extracts of Andrographis paniculata leaf and Erythrina indica bark which are of medicinal importance. Later after inducing diabetes the rats were treated with medicinal plant extracts, Andrographis paniculata leaf and Erythrina indica bark which are well known for their anti diabetic and antioxidative property in order to control the glucose and MDA levels. The blood plasma of diabetic and normal rats was analyzed for the levels of MDA (lipid peroxidation) and glucose levels. Results of this study suggested that the Andrographis paniculata leaf and Erythrina indica can be used as a potential natural antidiabetic agent for treating and postponing the appearance of complications that arise due to Diabetes. Molecular study deals with the analysis of binding mechanism of 2 selected natural compounds from Andrographis and Erythrina extracts against the novel target for type T2D namely PPAR-γ compared with Rosiglitazone (standard compound). The results revealed that most of the selected herbal lead compounds were effective targets against the receptors. These compounds showed favorable interactions with the amino acid residues thereby substantiating their proven efficacy as anti-diabetic compounds.Keywords: andrographis paniculata, erythrina indica, alloxan, lipid peroxidation, blood glucose level, PPAR-γ
Procedia PDF Downloads 477448 A Systematic Review of Pedometer-or Accelerometer-Based Interventions for Increasing Physical Activity in Low Socioeconomic Groups
Authors: Shaun G. Abbott, Rebecca C. Reynolds, James B. Etter, John B. F. de Wit
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The benefits of physical activity (PA) on health are well documented. Low socioeconomic status (SES) is associated with poor health, with PA a suggested mediator. Pedometers and accelerometers offer an effective behavior change tool to increase PA levels. While the role of pedometer and accelerometer use in increasing PA is recognized in many populations, little is known in low-SES groups. We are aiming to assess the effectiveness of pedometer- and accelerometer-based interventions for increasing PA step count and improving subsequent health outcomes among low-SES groups of high-income countries. Medline, Embase, PsycINFO, CENTRAL and SportDiscus databases were searched to identify articles published before 10th July, 2015; using search terms developed from previous systematic reviews. Inclusion criteria are: low-SES participants classified by income, geography, education, occupation or ethnicity; study duration minimum 4 weeks; an intervention and control group; wearing of an unsealed pedometer or accelerometer to objectively measure PA as step counts per day for the duration of the study. We retrieved 2,142 articles from our database searches, after removal of duplicates. Two investigators independently reviewed titles and abstracts of these articles (50% each) and a combined 20% sample were reviewed to account for inter-assessor variation. We are currently verifying the full texts of 430 articles. Included studies will be critically appraised for risk of bias using guidelines suggested by the Cochrane Public Health Group. Two investigators will extract data concerning the intervention; study design; comparators; steps per day; participants; context and presence or absence of obesity and/or chronic disease. Heterogeneity amongst studies is anticipated, thus a narrative synthesis of data will be conducted with the simplification of selected results into percentage increases from baseline to allow for between-study comparison. Results will be presented at the conference in December if selected.Keywords: accelerometer, pedometer, physical activity, socioeconomic, step count
Procedia PDF Downloads 332447 Cognitive Models of Health Marketing Communication in the Digital Era: Psychological Factors, Challenges, and Implications
Authors: Panas Gerasimos, Kotidou Varvara, Halkiopoulos Constantinos, Gkintoni Evgenia
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As a result of growing technology and briefing by the internet, users resort to the internet and subsequently to the opinion of an expert. In many cases, they take control of their health in their hand and make a decision without the contribution of a doctor. According to that, this essay intends to analyze the confidence of searching health issues on the internet. For the fulfillment of this study, there has been a survey among doctors in order to find out the reasons a patient uses the internet about their health problems and the consequences that health information could lead by searching on the internet, as well. Specifically, the results regarding the research of the users demonstrate: a) the majority of users make use of the internet about health issues once or twice a month, b) individuals that possess chronic disease make health search on the internet more frequently, c) the most important topics that the majority of users usually search are pathological, dietary issues and the search of issues that are associated with doctors and hospitals. However, it observed that topic search varies depending on the users’ age, d) the most common sources of information concern the direct contact with doctors, as there is a huge preference from the majority of users over the use of the electronic form for their briefing and e) it has been observed that there is large lack of knowledge about e-health services. From the doctor's point of view, the following conclusions occur: a) almost all doctors use the internet as their main source of information, b) the internet has great influence over doctors’ relationship with the patients, c) in many cases a patient first makes a visit to the internet and then to the doctor, d) the internet significantly has a psychological impact on patients in order to for them to reach a decision, e) the most important reason users choose the internet instead of the health professional is economic, f) the negative consequence that emerges is inaccurate information, g) and the positive consequences are about the possibility of online contact with the doctor and contributes to the easy comprehension of the doctor, as well. Generally, it’s observed from both sides that the use of the internet in health issues is intense, which declares that the new means the doctors have at their disposal, produce the conditions for radical changes in the way of providing services and in the doctor-patient relationship.Keywords: cognitive models, health marketing, e-health, psychological factors, digital marketing, e-health services
Procedia PDF Downloads 206446 Towards Modern Approaches of Intelligence Measurement for Clinical and Educational Practices
Authors: Alena Kulikova, Tatjana Kanonire
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Intelligence research is one of the oldest fields of psychology. Many factors have made a research on intelligence, defined as reasoning and problem solving [1, 2], a very acute and urgent problem. Thus, it has been repeatedly shown that intelligence is a predictor of academic, professional, and social achievement in adulthood (for example, [3]); Moreover, intelligence predicts these achievements better than any other trait or ability [4]. The individual level, a comprehensive assessment of intelligence is a necessary criterion for the diagnosis of various mental conditions. For example, it is a necessary condition for psychological, medical and pedagogical commissions when deciding on educational needs and the most appropriate educational programs for school children. Assessment of intelligence is crucial in clinical psychodiagnostic and needs high-quality intelligence measurement tools. Therefore, it is not surprising that the development of intelligence tests is an essential part of psychological science and practice. Many modern intelligence tests have a long history and have been used for decades, for example, the Stanford-Binet test or the Wechsler test. However, the vast majority of these tests are based on the classic linear test structure, in which all respondents receive all tasks (see, for example, a critical review by [5]). This understanding of the testing procedure is a legacy of the pre-computer era, in which blank testing was the only diagnostic procedure available [6] and has some significant limitations that affect the reliability of the data obtained [7] and increased time costs. Another problem with measuring IQ is that classical line-structured tests do not fully allow to measure respondent's intellectual progress [8], which is undoubtedly a critical limitation. Advances in modern psychometrics allow for avoiding the limitations of existing tools. However, as in any rapidly developing industry, at the moment, psychometrics does not offer ready-made and straightforward solutions and requires additional research. In our presentation we would like to discuss the strengths and weaknesses of the current approaches to intelligence measurement and highlight “points of growth” for creating a test in accordance with modern psychometrics. Whether it is possible to create the instrument that will use all achievements of modern psychometric and remain valid and practically oriented. What would be the possible limitations for such an instrument? The theoretical framework and study design to create and validate the original Russian comprehensive computer test for measuring the intellectual development in school-age children will be presented.Keywords: Intelligence, psychometrics, psychological measurement, computerized adaptive testing, multistage testing
Procedia PDF Downloads 80445 The Relationship between Amplitude and Stability of Circadian Rhythm with Sleep Quality and Sleepiness: A Population Study, Kerman 2018
Authors: Akram Sadat Jafari Roodbandi, Farzaneh Akbari, Vafa Feyzi, Zahra Zare, Zohreh Foroozanfar
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Introduction: Circadian rhythm or sleep-awake cycle in 24 hours is one of the important factors affecting the physiological and psychological characteristics in humans that contribute to biochemical, physiological and behavioral processes and helps people to set up brain and body for sleep or active awakening during certain hours. The purpose of this study was to investigate the relationship between the characteristics of circadian rhythms on the sleep quality and sleepiness according to their demographic characteristics such as age. Methods: This cross-sectional descriptive-analytic study was carried out among the general population of Kerman, aged 15-84 years. After dividing the age groups into 10-year demographic characteristics questionnaire, the type of circadian questionnaire, Pittsburgh sleep quality questionnaire and Euporth sleepiness questionnaire were completed in equal numbers between men and women of that age group. Using cluster sampling with effect design equal 2, 1300 questionnaires were distributed during the various hours of 24 hours in public places in Kerman city. Data analysis was done using SPSS software and univariate tests and linear regressions at a significance level of 0.05. Results: In this study, 1147 subjects were included in the study, 584 (50.9%) were male and the rest were women. The mean age was 39.50 ± 15.38. 133 (11.60%) subjects from the study participants had sleepiness and 308 (26.90%) subjects had undesirable sleep quality. Using linear regression test, sleep quality was the significant correlation with sex, hours needed for sleep at 24 hours, chronic illness, sleepiness, and circadian rhythm amplitude. Sleepiness was the meaningful relationship with marital status, sleep-wake schedule of other family members and the stability of circadian rhythm. Both women and men, with age, decrease the quality of sleep and increase the rate of sleepiness. Conclusion: Age, sex, and type of circadian people, the need for sleep at 24 hours, marital status, sleep-wake schedule of other family members are significant factors related to the sleep quality and sleepiness and their adaptation to night shift work.Keywords: circadian type, sleep quality, sleepiness, age, shift work
Procedia PDF Downloads 157444 Prescription of Maintenance Fluids in the Emergency Department
Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall
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The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma
Procedia PDF Downloads 324443 Assessment of Genetic Variability of Potato Genotypes for Proline Under Salt Stress Conditions
Authors: Elchin Hajiyev, Afet Memmedova Dadash, Sabina Hajiyeva, Aynur Karimova, Ramiz Aliyev
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Although potatoes have a wide distribution range, the yield potential of varieties varies greatly depending on the region. Our country is made up of agricultural regions with very different environmental characteristics.In this case, we cannot expect the introduced varieties to show the same adaptation to the different conditions of our country. For this reason, in our country, varieties with high general adaptability should be used, rather than varieties with special adaptability in certain areas. Soil salinization has become a global problem.Increased salinity has a serious impact on food security by reducing plant productivity. Plants have protective mechanisms of adaptation to salt stress, such as the synthesis of physiologically active substances, resistance to antioxidant stress and oxidation of membrane lipids. One of these substances is free proline. Our study revealed genetic variation in proline accumulation among samples exposed to stress factors.Changes in proline content under stress conditions were studied in 50 samples. There was wide variation across all treatments.The amount of proline varied between 7.2–37.7 μM/g under salinity conditions.The lowest rate was in the SF33 genotype (1.5 times more than the control (2.5 μM/g)).The highest level of proline under the influence of salt stress was in the SF45 genotype (7.25 times higher than the control (32.5 μM/g)). Our studies have found that the protective system reacts differently to the influence of stress factors. According to the results obtained on the amount of proline, adaptation mechanisms must be more actively activated to maintain metabolism and ensure viability in sensitive forms under the influence of stress factors. At high doses of the salt stressor, a tenfold increase in proline compared to the control indicates significant damage to the plant organism as a result of stress.To prevent damage to the body, the antioxidant system needs to quickly mobilize and work at full capacity in adverse conditions. An increase in the dose of the stress factor salt in our study caused a greater increase in the amount of free proline in plant tissues. Considering the functions of proline as an osmoprotector and antioxidant, it was found that increasing its amount is aimed at protecting the plant from the acute effects of stressors.Keywords: genetic variability, potato, genotypes, proline, stress
Procedia PDF Downloads 53442 Attributable Mortality of Nosocomial Infection: A Nested Case Control Study in Tunisia
Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said
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Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.Keywords: intensive care unit, mortality, nosocomial infection, risk factors
Procedia PDF Downloads 408441 Family and Community Care for the Elderly: An Implementation Research in Local Community, Thailand
Authors: Sumattana Glangkarn, Vorapoj Promasatayaprot
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Background: Proportion of population ageing in Thailand has been increased rapidly in the past decades according to living longer and the fertility rates have decreased. The most important challenge related to this situation is to consider how to improve quality and years of healthy of life. This study aimed to implement the older persons’ long term care (LTC) system for elderly care by family and community. Method: The Consolidated Framework for Implementation Research (CFIR) was employed for guiding and evaluating an implementation process in ageing care. The CFIR composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Results: most elderly participants were couples, educating primary school and living with children and grandchildren. More than half of them had chronic diseases such as diabetes mellitus and hypertension. Factor analysis revealed factors related to health care of older participants which consisted of exercise, diet, accidental prevention, relaxation, self-care capacity, joyfulness, family relationship, and personal hygiene. A pre-implementation phase showed intervention characteristics included facilities and services of the LTC policy from the Ministry of Public Health. The complexities of the LTC and relative advantages were explained. Community leaders, public health volunteers, care givers and health professionals had participated in the LTC activities. Outer and inner settings consisted of context of community, culture, and readiness. Characteristics of the individuals related to knowledge, self-efficacy, perceptions, and believes. The process consisted of planning, acting, observing, and reflecting. The implementation outcomes and service outcomes had been evaluated during-implementation phase. Conclusion: the participation of caregivers, community leaders, public health volunteers, and health professionals had supported the LTC services. Thus, family and community care could improve quality of life of the ageing.Keywords: ageing, CFIR, long term care, implementation
Procedia PDF Downloads 177440 Territorial Influence of Religious Based Armed Conflicts in Africa
Authors: Badru Hasan Segujja, Nassiwa Shamim
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This study “Territorial Influence of Religious Based Armed Conflicts in Africa” was in place to identify the influence of religious based armed conflicts, their parsistance and their impact on African societies. The study employed a qualitative research methodology, as data from respondents was descriptively recorded using random sampling technics. The study discovered that, the world is experiencing religious based armed violence where actors fight under the umbrella of freedom fighters where the African continent in particular has been at the pic of such armed violence almost since each countries independence to date. Because of this situation, the Continent is torn apart as families are traumatized by the memories of their dear ones who never survived in yesterdays’ faith based armed violence. The study disvovered that, some of these faith based armed conflicts are caused by factors ranging from undemocratic practices due to poor governance, poverty, Unemployment, religious extremism and radicalism which later turn into intractable violence. Religious armed groups such as, Holly Spirit Movement (HSM), Allied Democratic Forces (ADF) and Lords Resistance Army (LRA) in Uganda and now Eastern DRC and Central African Republic, ALSHABAB in East Africa, SELEKE and ANTI BALAKA in Central African Republic, BOKO HARAM in Nigeria, JANJAWEED in Sudan and Republic of Chad, Sudaneess Peoples Liberation Army (SPLA) in Southern Sudan, Alqaida Mission in Islamic Magreeb (AQIIM) in Mali coupled with acute racism of Hutu and Tutsi in Rwanda or Burundi and Xenophobic Nationalism in (South Africa). The study futher discovered that, the component of “freedom fighters” has strongly made these groups maintain the ground without fear of any repucation, which situation has resulted into children and women becoming disproportionally victims and the response of international communities to the violence is inadequate. The study concludes that, dialogue for peace is better than going for wars. The study recommends that, in order to restore peace on the African continent and elsewhere in the world, UN should recommend the teaching of peace values in schools, pre-conflict early warnings must be well attended, actors must refrain from using religious lebles, democracy, unemployment and poverty issues should as well be addressed to avoid unnessesary conflicts.Keywords: influence, religious, armed, conflicts
Procedia PDF Downloads 85439 Case Report on Sepsis by Alpha-Hemolytic Streptococcus and Mannheimia haemolytica in Neonate Dogs
Authors: Maria L. G. Lourenco, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado
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Neonatal sepsis is a systemic response of acute infection by bacteria that may lead to high mortality in a litter. This study aims to report a case of sepsis by alpha-hemolytic Streptococcus and Mannheimia haemolytica in neonate dogs. A pregnant, mixed-breed bitch at approximately the 60th day of pregnancy was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, and subjected to a c-section due to uterine atony and fetuses no heartbeats on the ultrasound examination. The mother presented leukopenia of 1.6 thousand leukocytes, and there was no other information regarding previous clinical history. Among the offspring, four were stillborn, and five were born alive. On clinical examination, neonates weighed between 312 and 384 grams. Reflexes were present, and the newborn's body temperature was between 89.9 ºF and 96.4 ºF. Neonates also presented clinical signs of neonatal infection: omphalitis, abdomen, and extremities with cyanotic color, hematuria, and diarrhea (meconium). Complementary tests revealed leukopenia. The presence of alpha hemolytic streptococcus and Mannheimia haemolytica was revealed in the bacterial culture. The bacteria were sensitive to cephalosporins and penicillin on the antibiogram. Treatment for sepsis was instituted with the drug ceftriaxone, at a dose of 50 mg per kilogram, administered intravenous (jugular vein). Subsequently administered subcutaneous, every 12 hours, for seven days. Heated fluid therapy was performed, with Ringer lactate, at a dose of 4 ml per 100 grams of weight, intravenous. Heating measures were instituted. Blood plasma was also administered, at a dose of 2 mL per 100 grams of weight, administered subcutaneous, as a source of passive immunity. A maternal milk substitute was instituted, and lactation was discontinued since the mother was unable to nurse due to the infection. The mother was neutered during the c-section and treated with ceftriaxone (50 mg/kg). After seven days, the newborns presented normal clinical signs and no alterations in the hemogram. Early diagnosis and intervention were essential for the survival of these patients.Keywords: neonatal infection, puppies, bacteria, newborn
Procedia PDF Downloads 121438 Review of the Safety of Discharge on the First Postoperative Day Following Carotid Surgery: A Retrospective Analysis
Authors: John Yahng, Hansraj Riteesh Bookun
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Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.Keywords: carotid, complication, discharge, surgery
Procedia PDF Downloads 166437 Effects of Robot-Assisted Hand Training on Upper Extremity Performance in Patients with Stroke: A Randomized Crossover Controlled, Assessor-Blinded Study
Authors: Hsin-Chieh Lee, Fen-Ling Kuo, Jui-Chi Lin
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Background: Upper extremity functional impairment that occurs after stroke includes hemiplegia, synergy movement, muscle hypertonicity, and somatosensory impairment, which result in inefficient and inaccurate movement. Robot-assisted rehabilitation is an intensive training approach that is effective in sensorimotor and hand function recovery. However, these systems mostly focused on the proximal part of the upper limb rather than the distal part. The device used in our study was Gloreha Sinfonia, which focuses on the distal part of the upper limb and uses a dynamic support system to facilitate the whole limb function. The objective of this study was to investigate the effects of robot-assisted therapy (RT) with Gloreha device on sensorimotor, and ADLs in patients with stroke. Method: Patients with stroke (N=25) participated AB or BA (A = 12 RT sessions and B = 12 conventional therapy (CT) sessions) for 6 weeks (60 min at each session, twice a week), with 1-month break for washout period. The performance of the patients was assessed by a blinded assessor at 4 time points (pretest 1, posttest 1, pretest 2, posttest 2) which including the Fugl–Meyer Assessment-upper extremity (FMA-UE), box and block test, electromyography of the extensor digitorum communis (EDC) and brachioradialis, a grip dynamometer for motor evaluation; Semmes–Weinstein hand monofilament and Revision of the Nottingham Sensory Assessment for sensory evaluation; and the Modified Barthel Index (MBI) for assessing the ADL ability. Result: RT group significantly improved FMA-UE proximal scores (p = 0.038), FMA-UE total scores (p = 0.046), and MBI (p = 0.030). The EDC exhibited higher efficiency during the small block grasping task in the RT group than in the CT group (p = 0.050). Conclusions: RT with the Gloreha device might lead to beneficial effects on arm motor function, ADL ability, and EDC muscle recruitment efficacy in patients with subacute to chronic stroke.Keywords: activities of daily living, hand function, robotic rehabilitation, stroke
Procedia PDF Downloads 118436 Hypolipidemic and Antioxidant Effects of Mycelial Polysaccharides from Calocybe indica in Hyperlipidemic Rats Induced by High-Fat Diet
Authors: Govindan Sudha, Mathumitha Subramaniam, Alamelu Govindasamy, Sasikala Gunasekaran
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The aim of this study was to investigate the protective effect of Hypsizygus ulmarius polysaccharides (HUP) on reducing oxidative stress, cognitive impairment and neurotoxicity in D-galactose induced aging mice. Mice were subcutaneously injected with D-galactose (150 mg/kg per day) for 6 weeks and were administered HUP simultaneously. Aged mice receiving vitamin E (100 mg/kg) served as positive control. Chronic administration of D-galactose significantly impaired cognitive performance oxidative defence and mitochondrial enzymes activities as compared to control group. The results showed that HUP (200 and 400 mg/kg) treatment significantly improved the learning and memory ability in Morris water maze test. Biochemical examination revealed that HUP significantly increased the decreased activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione-S-transferase (GST), mitochondrial enzymes-NADH dehydrogenase, malate dehydrogenase (MDH), isocitrate dehydrogenase (ICDH), Na+K+, Ca2+, Mg2+ATPase activities, elevated the lowered total anti-oxidation capability (TAOC), glutathione (GSH), vitamin C and decreased the raised acetylcholinesterase (AChE) activities, malondialdehyde (MDA), hydroperoxide (HPO), protein carbonyls (PCO), advanced oxidation protein products (AOPP) levels in brain of aging mice induced by D-gal in a dose-dependent manner. In conclusion, present study highlights the potential role of HUP against D-galactose induced cognitive impairment, biochemical and mitochondrial dysfunction in mice. In vitro studies on the effect of HUP on scavenging DPPH, ABTS, DMPD, OH radicals, reducing power, B-carotene bleaching and lipid peroxidation inhibition confirmed the free radical scavenging and antioxidant activity of HUP. The results suggest that HUP possesses anti-aging efficacy and may have potential in treatment of neurodegenerative diseases.Keywords: aging, antioxidants, mushroom, neurotoxicity
Procedia PDF Downloads 531435 Lessons Learned in Implementing Programs to Delay Diabetic Nephropathy Management in Primary Health Care: Case Study in Sakon Nakhon Province
Authors: Sasiwan Tassana-iem, Sumattana Glangkarn
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Diabetic nephropathy is a major complication in diabetic patients whom as the glomerular filtration rate falls. The affects their quality of life and results in loss of money for kidney replacement therapy costs. There is an existing intervention, but the prevalence remains high, thus this research aims to study lessons learned in implementing programs to delay diabetic nephropathy management in primary health care. Method: The target settings are, 24 sub-district health promoting hospital in Sakon Nakhon province. Participants included the health care professionals, head of the sub-district health promoting hospital and the person responsible for managing diabetic nephropathy in each hospital (n= 50). There are 400 patients with diabetes mellitus in an area. Data were collected using questionnaires, patient records data, interviews and focus groups and analyzed by statistics and content analysis. Result: Reflection of participants that the interventions to delay diabetic nephropathy management in each area, the Ministry of Public Health has a policy to screen and manage this disease. The implementing programs aimed to provide health education, innovative teaching media used in communication to educate. Patients and caregivers had misunderstanding about the actual causes and prevention of this disease and how to apply knowledge suitable for daily life. Conclusion: The obstacles to the success of the implementing programs to delay diabetic nephropathy management in primary health care were most importantly, the patient needs self-care and should be evaluated for health literacy. This is crucial to promote health literacy; to access and understand health information as well to decide their health-related choices based on health information which will promote and maintain a good health. This preliminary research confirms that situation of diabetic nephropathy still exists. The results of this study will lead to the development of delay in diabetic nephropathy implementation among patients in the province studied.Keywords: diabetic nephropathy, chronic kidney disease, primary health care, implementation
Procedia PDF Downloads 201434 Validation of an Impedance-Based Flow Cytometry Technique for High-Throughput Nanotoxicity Screening
Authors: Melanie Ostermann, Eivind Birkeland, Ying Xue, Alexander Sauter, Mihaela R. Cimpan
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Background: New reliable and robust techniques to assess biological effects of nanomaterials (NMs) in vitro are needed to speed up safety analysis and to identify key physicochemical parameters of NMs, which are responsible for their acute cytotoxicity. The central aim of this study was to validate and evaluate the applicability and reliability of an impedance-based flow cytometry (IFC) technique for the high-throughput screening of NMs. Methods: Eight inorganic NMs from the European Commission Joint Research Centre Repository were used: NM-302 and NM-300k (Ag: 200 nm rods and 16.7 nm spheres, respectively), NM-200 and NM- 203 (SiO₂: 18.3 nm and 24.7 nm amorphous, respectively), NM-100 and NM-101 (TiO₂: 100 nm and 6 nm anatase, respectively), and NM-110 and NM-111 (ZnO: 147 nm and 141 nm, respectively). The aim was to assess the biological effects of these materials on human monoblastoid (U937) cells. Dispersions of NMs were prepared as described in the NANOGENOTOX dispersion protocol and cells were exposed to NMs at relevant concentrations (2, 10, 20, 50, and 100 µg/mL) for 24 hrs. The change in electrical impedance was measured at 0.5, 2, 6, and 12 MHz using the IFC AmphaZ30 (Amphasys AG, Switzerland). A traditional toxicity assay, Trypan Blue Dye Exclusion assay, and dark-field microscopy were used to validate the IFC method. Results: Spherical Ag particles (NM-300K) showed the highest toxic effect on U937 cells followed by ZnO (NM-111 ≥ NM-110) particles. Silica particles were moderate to non-toxic at all used concentrations under these conditions. A higher toxic effect was seen with smaller sized TiO2 particles (NM-101) compared to their larger analogues (NM-100). No interferences between the IFC and the used NMs were seen. Uptake and internalization of NMs were observed after 24 hours exposure, confirming actual NM-cell interactions. Conclusion: Results collected with the IFC demonstrate the applicability of this method for rapid nanotoxicity assessment, which proved to be less prone to nano-related interference issues compared to some traditional toxicity assays. Furthermore, this label-free and novel technique shows good potential for up-scaling in directions of an automated high-throughput screening and for future NM toxicity assessment. This work was supported by the EC FP7 NANoREG (Grant Agreement NMP4-LA-2013-310584), the Research Council of Norway, project NorNANoREG (239199/O70), the EuroNanoMed II 'GEMN' project (246672), and the UH-Nett Vest project.Keywords: cytotoxicity, high-throughput, impedance, nanomaterials
Procedia PDF Downloads 362433 Enhanced Cytotoxic Effect of Expanded NK Cells with IL12 and IL15 from Leukoreduction Filter on K562 Cell Line Exhibits Comparable Cytotoxicity to Whole Blood
Authors: Abdulbaset Mazarzaei
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Natural killer (NK) cells are innate immune effectors that play a pivotal role in combating tumors and infected cells. In recent years, the therapeutic potential of NK cells has gained significant attention due to their remarkable cytotoxic ability. This study focuses on investigating the cytotoxic effect of expanded NK cells enriched with interleukin 12 (IL12) and interleukin 15 (IL15), derived from the leukoreduction filter, on the K562 cell line. Firstly, NK cells were isolated from whole blood samples obtained from healthy volunteers. These cells were subsequently expanded ex vivo using a combination of feeder cells, IL12, and IL15. The expanded NK cells were then harvested and assessed for their cytotoxicity against K562, a well-established human chronic myelogenous leukemia cell line. The cytotoxicity was evaluated using flow cytometry assay. Results demonstrate that the expanded NK cells significantly exhibited enhanced cytotoxicity against K562 cells compared to non-expanded NK cells. Interestingly, the expanded NK cells derived specifically from IL12 and IL15-enriched leukoreduction filters showed a robust cytotoxic effect similar to the whole blood-derived NK cells. These findings suggest that IL12 and IL15 in the leukoreduction filter are crucial in promoting NK cell cytotoxicity. Furthermore, the expanded NK cells displayed relatively similar cytotoxicity profiles to whole blood-derived NK cells, indicating their comparable capability in targeting and eliminating tumor cells. This observation is of significant relevance as expanded NK cells from the leukoreduction filter could potentially serve as a readily accessible and efficient source for adoptive immunotherapy. In conclusion, this study highlights the significant cytotoxic effect of expanded NK cells enriched with IL12 and IL15 obtained from the leukoreduction filter on the K562 cell line. Moreover, it emphasizes that these expanded NK cells exhibit comparable cytotoxicity to whole blood-derived NK cells. These findings reinforce the potential clinical utility of using expanded NK cells from the leukoreduction filter as an effective strategy in adoptive immunotherapy for the treatment of cancer. Further studies are warranted to explore the broader implications of this approach in clinical settings.Keywords: natural killer (NK) cells, Cytotoxicity, Leukoreduction filter, IL-12 and IL-15 Cytokines
Procedia PDF Downloads 67432 The Short-Term Stress Indicators in Home and Experimental Dogs
Authors: Madara Nikolajenko, Jevgenija Kondratjeva
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Stress is a response of the body to physical or psychological environmental stressors. Cortisol level in blood serum is determined as the main indicator of stress, but the blood collection, the animal preparation and other activities can cause unpleasant conditions and induce increase of these hormones. Therefore, less invasive methods are searched to determine stress hormone levels, for example, by measuring the cortisol level saliva. The aim of the study is to find out the changes of stress hormones in blood and saliva in home and experimental dogs in simulated short-term stress conditions. The study included clinically healthy experimental beagle dogs (n=6) and clinically healthy home American Staffordshire terriers (n=6). The animals were let into a fenced area to adapt. Loud drum sounds (in cooperation with 'Andžeja Grauda drum school') were used as a stressor. Blood serum samples were taken for sodium, potassium, glucose and cortisol level determination and saliva samples for cortisol determination only. Control parameters were taken immediately before the start of the stressor, and next samples were taken immediately after the stress. The last measurements were taken two hours after the stress. Electrolyte levels in blood serum were determined using direction selective electrode method (ILab Aries analyzer) and cortisol in blood serum and saliva using electrochemical luminescence method (Roche Diagnostics). Blood glucose level was measured with glucometer (ACCU-CHECK Active test strips). Cortisol level in the blood increased immediately after the stress in all home dogs (P < 0,05), but only in 33% (P < 0,05) of the experimental dogs. After two hours the measurement decreased in 83% (P < 0,05) of home dogs (in 50% returning to the control point) and in 83% (P < 0,05) of the experimental dogs. Cortisol in saliva immediately after the stress increased in 50% (P > 0,05) of home dogs and in 33% (P > 0,05) of the experimental dogs. After two hours in 83% (P > 0,05) of the home animals, the measurements decreased, only in 17% of the experimental dogs it decreased as well, while in 49% measurement was undetectable due to the lack of material. Blood sodium, potassium, and glucose measurements did not show any significant changes. The combination of short-term stress indicators, when, after the stressor, all indicators should immediately increase and decrease after two hours, confirmed in none of the animals. Therefore the authors can conclude that each animal responds to a stressful situation with different physiological mechanisms and hormonal activity. Cortisol level in saliva and blood is released with the different speed and is not an objective indicator of acute stress.Keywords: animal behaivor, cortisol, short-term stress, stress indicators
Procedia PDF Downloads 270431 Developing Wearable EMG Sensor Designed for Parkinson's Disease (PD) Monitoring, and Treatment
Authors: Bulcha Belay Etana
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Electromyography is used to measure the electrical activity of muscles for various health monitoring applications using surface electrodes or needle electrodes. Recent developments in electromyogram signal acquisition using textile electrodes open the door for wearable health monitoring which enables patients to monitor and control their health issues outside of traditional healthcare facilities. The aim of this research is therefore to develop and analyze wearable textile electrodes for the acquisition of electromyography signals for Parkinson’s patients and apply an appropriate thermal stimulus to relieve muscle cramping. In order to achieve this, textile electrodes are sewn with a silver-coated thread in an overlapping zigzag pattern into an inextensible fabric, and stainless steel knitted textile electrodes attached to a sleeve were prepared and its electrical characteristics including signal to noise ratio were compared with traditional electrodes. To relieve muscle cramping, a heating element using stainless steel conductive yarn Sewn onto a cotton fabric, coupled with a vibration system were developed. The system was integrated using a microcontroller and a Myoware muscle sensor so that when muscle cramping occurs, measured by the system activates the heating elements and vibration motors. The optimum temperature considered for treatment was 35.50c, so a Temperature measurement system was incorporated to deactivate the heating system when the temperature reaches this threshold, and the signals indicating muscle cramping have subsided. The textile electrode exhibited a signal to noise ratio of 6.38dB while the signal to noise ratio of the traditional electrode was 7.05dB. The rise time of the developed heating element was about 6 minutes to reach the optimum temperature using a 9volt power supply. The treatment of muscle cramping in Parkinson's patients using heat and muscle vibration simultaneously with a wearable electromyography signal acquisition system will improve patients’ livelihoods and enable better chronic pain management.Keywords: electromyography, heating textile, vibration therapy, parkinson’s disease, wearable electronic textile
Procedia PDF Downloads 136430 Therapeutic Effects of Guar Gum Nanoparticles in Oxazolone-Induced Atopic Dermatitis
Authors: Nandita Ghosh, Shinjini Mitra, Ena Ray Banerjee
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Atopic dermatitis (AD) is a chronic disease of the skin, involving itchy, reddish, and scaly lesions. It mainly affects children and has a high prevalence in developing countries. The AD may occur due to environmental or genetic factors. There is no permanent cure for the AD. Currently, all therapeutic strategies involve methods to simply alleviate the symptoms, and include lotions and corticosteroids, which have adverse effects. Use of phytochemicals and natural products has not yet been exploited fully. The particle used in this study is derived from Cyamopsis tetragonoloba, an edible polysaccharide with a galactomannan component. The mannose component mainly increases its specificity towards cellular uptake by mannose receptors, highly expressed by the macrophage. The aim of this study was to determine the therapeutic effect of guar gum nanoparticles (GN) in vitro and in vivo in the AD. To assess the wound healing capacity of the guar gum nanoparticle (GN), we first treated adherent NIH3T3 cells, with a scratch injury, with GN. GN successfully healed the wound caused by the scratch. In the in vivo experiment, Balb/c mice ear were topically treated with oxazolone (oxa) to induce AD and then were topically treated with GN. The ear thickness was increased significantly till day 28 on the treatment of Oxa. The GN application showed a significant decrease in the thickness as assessed on day 28. The total cell count of skin cells showed fold increase when treated with oxa, was again decreased on topical application of GN on the affected skin. The eosinophil count, as assessed by Giemsa staining was also increased when treated with oxa, GN application led to a significant decrease. The IgE level was assessed in the serum samples which showed that GN helped in restoring the alleviated IgE level. The T helper cells and the macrophage population showed increased percentage when treated with oxa, the GN application. This was examined by flow cytometry. The H&E staining of the ear tissue showed epidermal thickness in the oxa treated mice, GN application showed reduced cellular filtration followed by epidermal thickness. Thus our assays showed that GN was successful in alleviating the disease caused by Oxa when administered topically.Keywords: allergen, inflammation, nanodrug, wound
Procedia PDF Downloads 243429 Tuberculosis in Humans and Animals in the Eastern Part of the Sudan
Authors: Yassir Adam Shuaib, Stefan Niemann, Eltahir Awad Khalil, Ulrich Schaible, Lothar Heinz Wieler, Mohammed Ahmed Bakhiet, Abbashar Osman Mohammed, Mohamed Abdelsalam Abdalla, Elvira Richter
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Tuberculosis (TB) is a chronic bacterial disease of humans and animals and it is characterized by the progressive development of specific granulomatous tubercle lesions in affected tissues. In a six-month study, from June to November 2014, a total of 2,304 carcasses of cattle, camel, sheep, and goats slaughtered at East and West Gaash slaughterhouses, Kassala, were investigated during postmortem, in parallel, 101 sputum samples from TB suspected patients at Kassala and El-Gadarif Teaching Hospitals were collected in order to investigate tuberculosis in animals and humans. Only 0.1% carcasses were found with suspected TB lesions in the liver and lung and peritoneal cavity of two sheep and no tuberculous lesions were found in the carcasses of cattle, goats or camels. All samples, tissue lesions and sputum, were decontaminated by the NALC-NaOH method and cultured for mycobacterial growth at the NRZ for Mycobacteria, Research Center Borstel, Germany. Genotyping and molecular characterization of the grown strains were done by line probe assay (GenoType CM and MTBC) and 16S rDNA, rpoB gene, and ITS sequencing, spoligotyping, MIRU-VNTR typing and next generation sequencing (NGS). Culture of the specimens revealed growth of organisms from 81.6% of all samples. Mycobacterium tuberculosis (76.2%), M. intracellulare (14.2%), mixed infection with M. tuberculosis and M. intracellulare (6.0%) and mixed infection with M. tuberculosis and M. fortuitum and with M. intracellulare and unknown species (1.2%) were detected in the sputum samples and unknown species (1.2%) were detected in the samples of one of the animals tissues. From the 69 M. tuberculosis strains, 25 (36.2%) were showing either mono-drug-resistant or multi-drug-resistant or poly-drug-resistant but none was extensively drug-resistant. In conclusion, the prevalence of TB in animals was very low while in humans M. tuberculosis-Delhi/CAS lineage was responsible for most cases and there was an evidence of MDR transmission and acquisition.Keywords: animal, human, slaughterhouse, Sudan, tuberculosis
Procedia PDF Downloads 369428 Determinants of Post-Psychotic Depression in Schizophrenia Patients in ACSH and Mekellle Hospital Tigray, Ethiopia, 2019
Authors: Ashenafi Ayele, Shewit Haftu, Tesfalem Araya
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Background: “Post-psychotic depression”, “post schizophrenic depression”, and “secondary depression” have been used to describe the occurrence of depressive symptoms during the chronic phase of schizophrenia. Post-psychotic depression is the most common cause of death due to suicide in schizophrenia patients. Overall lifetime risk for patients with schizophrenia is 50% for suicide attempts and 9-13% lifetime risk for completed suicide and also it is associated with poor prognosis and poor quality of life. Objective: To assess determinant of post psychotic depression in schizophrenia patients ACSH and Mekelle General Hospital, Tigray Ethiopia 2019. Methods: An institutional based unmatched case control study was conducted among 69 cases and 138 controls with the ratio of case to control 1 ratio 2. The sample is calculated using epi-info 3.1 to assess the determinant factors of post-psychotic depression in schizophrenia patients. The cases were schizophrenia patients who have been diagnosed at least for more than one-year stable for two months, and the controls are any patients who are diagnosed as schizophrenia patients. Study subjects were selected using a consecutive sampling technique. The Calgary depression scale for schizophrenia self-administered questionnaire was used. Before the interview, it was assessed the client’s capacity to give intended information using a scale called the University of California, San Diego Brief Assessment of Capacity to Consent (UBACC). Bivariant and multiple Logistic regression analysis was performed to determine between the independent and dependent variables. The significant independent predictor was declared at 95% confidence interval and P-value of less than 0.05. Result: Females were affected by post psychotic depression with the (AOR=2.01, 95%CI: 1.003- 4.012, P= 0.49).Patients who have mild form of positive symptom of schizophrenia affected by post psychotic depression with (AOR =4.05, 95%CI: 1.888- 8.7.8, P=0001).Patients who have minimal form of negative symptom of schizophrenia are affected by post psychotic depression with (AOR =4.23, 95%CI: 1.081-17.092, P=.038). Conclusion: In this study, sex (female) and presence of positive and negative symptoms of schizophrenia were significantly associated. It is recommended that the post psychotic depression should be assessed in every schizophrenia patient to decrease the severity of illness, and to improve patient’s quality of life.Keywords: determinants, post-psychotic depression, Mekelle city
Procedia PDF Downloads 124427 Investigation of Subsurface Structures within Bosso Local Government for Groundwater Exploration Using Magnetic and Resistivity Data
Authors: Adetona Abbassa, Aliyu Shakirat B.
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The study area is part of Bosso local Government, enclosed within Longitude 6.25’ to 6.31’ and Latitude 9.35’ to 9.45’, an area of 16x8 km², within the basement region of central Nigeria. The region is a host to Nigerian Airforce base 12 (NAF 12quick response) and its staff quarters, the headquarters of Bosso local government, the Independent National Electoral Commission’s two offices, four government secondary schools, six primary schools and Minna international airport. The area suffers an acute shortage of water from November when rains stop to June when rains commence within North Central Nigeria. A way of addressing this problem is a reconnaissance method to delineate possible fractures and fault lines that exists within the region by sampling the Aeromagnetic data and using an appropriate analytical algorithm to delineate these fractures. This is followed by an appropriate ground truthing method that will confirm if the fracture is connected to underground water movement. The first vertical derivative for structural analysis, reveals a set of lineaments labeled AA’, BB’, CC’, DD’, EE’ and FF’ all trending in the Northeast – Southwest directions. AA’ is just below latitude 9.45’ above Maikunkele village, cutting off the upper part of the field, it runs through Kangwo, Nini, Lawo and other communities. BB’ is at Latitude 9.43’ it truncated at about 2Km before Maikunkele and Kuyi. CC’ is around 9.40’ sitting below Maikunkele runs down through Nanaum. DD’ is from Latitude 9.38’; interestingly no community within this region where the fault passes through. A result from the three sites where Vertical Electrical Sounding was carried out reveals three layers comprised of topsoil, intermediate Clay formation and weathered/fractured or fresh basement. The depth to basement map was also produced, depth to the basement from the ground surface with VES A₂, B5, D₂ and E₁ to be relatively deeper with depth values range between 25 to 35 m while the shallower region of the area has a depth range value between 10 to 20 m. Hence, VES A₂, A₅, B₄, B₅, C₂, C₄, D₄, D₅, E₁, E₃, and F₄ are high conductivity zone that are prolific for groundwater potential. The depth range of the aquifer potential zones is between 22.7 m to 50.4 m. The result from site C is quite unique though the 3 layers were detected in the majority of the VES points, the maximum depth to the basement in 90% of the VES points is below 8 km, only three VES points shows considerably viability, which are C₆, E₂ and F₂ with depths of 35.2 m and 38 m respectively but lack of connectivity will be a big challenge of chargeability.Keywords: lithology, aeromagnetic, aquifer, geoelectric, iso-resistivity, basement, vertical electrical sounding(VES)
Procedia PDF Downloads 139426 Comprehensive Longitudinal Multi-omic Profiling in Weight Gain and Insulin Resistance
Authors: Christine Y. Yeh, Brian D. Piening, Sarah M. Totten, Kimberly Kukurba, Wenyu Zhou, Kevin P. F. Contrepois, Gucci J. Gu, Sharon Pitteri, Michael Snyder
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Three million deaths worldwide are attributed to obesity. However, the biomolecular mechanisms that describe the link between adiposity and subsequent disease states are poorly understood. Insulin resistance characterizes approximately half of obese individuals and is a major cause of obesity-mediated diseases such as Type II diabetes, hypertension and other cardiovascular diseases. This study makes use of longitudinal quantitative and high-throughput multi-omics (genomics, epigenomics, transcriptomics, glycoproteomics etc.) methodologies on blood samples to develop multigenic and multi-analyte signatures associated with weight gain and insulin resistance. Participants of this study underwent a 30-day period of weight gain via excessive caloric intake followed by a 60-day period of restricted dieting and return to baseline weight. Blood samples were taken at three different time points per patient: baseline, peak-weight and post weight loss. Patients were characterized as either insulin resistant (IR) or insulin sensitive (IS) before having their samples processed via longitudinal multi-omic technologies. This comparative study revealed a wealth of biomolecular changes associated with weight gain after using methods in machine learning, clustering, network analysis etc. Pathways of interest included those involved in lipid remodeling, acute inflammatory response and glucose metabolism. Some of these biomolecules returned to baseline levels as the patient returned to normal weight whilst some remained elevated. IR patients exhibited key differences in inflammatory response regulation in comparison to IS patients at all time points. These signatures suggest differential metabolism and inflammatory pathways between IR and IS patients. Biomolecular differences associated with weight gain and insulin resistance were identified on various levels: in gene expression, epigenetic change, transcriptional regulation and glycosylation. This study was not only able to contribute to new biology that could be of use in preventing or predicting obesity-mediated diseases, but also matured novel biomedical informatics technologies to produce and process data on many comprehensive omics levels.Keywords: insulin resistance, multi-omics, next generation sequencing, proteogenomics, type ii diabetes
Procedia PDF Downloads 429425 Inhibitory Effect of Coumaroyl Lupendioic Acid on Inflammation Mediator Generation in Complete Freund’s Adjuvant-Induced Arthritis
Authors: Rayhana Begum, Manju Sharma
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Careya arborea Roxb. belongs to the Lecythidaceae family, is traditionally used in tumors, anthelmintic, bronchitis, epileptic fits, astringents, inflammation, an antidote to snake-venom, skin disease, diarrhea, dysentery with bloody stools, dyspepsia, ulcer, toothache, and ear pain. The present study was focused on investigating the anti-arthritic effect of coumaroyl lupendioic acid, a new lupane-type triterpene from Careya arborea stem bark in the chronic inflammatory model and further assessing its possible mechanism on the modulation of inflammatory biomarkers. Arthritis was induced by injecting 0.1 ml of Complete Freund’s Adjuvant (5 mg/ml of heat killed Mycobacterium tuberculosis) into the subplantar region of the left hind paw. Treatment with coumaroyl lupendioic acid (10 and 20 mg/kg, p.o.) and reference drugs (indomethacin and dexamethasone at the dose of 5 mg/kg, p.o.) were started on the day of induction and continued up to 28 days. The progression of arthritis was evaluated by measuring paw volume, tibio tarsal joint diameters, and arthritic index. The effect of coumaroyl lupendioic acid (CLA) on the production PGE₂, NO, MPO, NF-κB, TNF-α, IL-1β, and IL-6 on serum level as well as inflamed paw tissue were also assessed. In addition, ankle joints and spleen were collected and prepared for histological examination. CLA in inflamed rats resulted in significant amelioration of paw edema, tibio-tarsal joint swelling and arthritic score as compared to CFA control group. The results indicated that CLA treated groups markedly decreased the levels of inflammatory mediators (PGE₂, NO, MPO and NF-κB levels) and down-regulated the production of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) in paw tissue homogenates as well as in serum. However, the more pronounced effect was observed in the inflamed paw tissue homogenates. CLA also revealed a protective effect to the tibio-tarsal joint cartilage and spleen. These results suggest that coumaroyl lupendioic acid inhibits inflammation may be through the suppression of the cascade of proinflammatory mediators via the down-regulation of NF-ҡB.Keywords: complete Freund’s adjuvant , Coumaroyl lupendioic acid, pro-inflammatory cytokines, prostaglandin E2
Procedia PDF Downloads 143424 Coping Strategies Used by Persons with Spinal Cord Injury: A Rehabilitation Hospital Based Qualitative Study
Authors: P. W. G. D. P. Samarasekara, S. M. K. S. Seneviratne, D. Munidasa, S. S. Williams
Abstract:
Sustaining a spinal cord injury (SCI) causes severe disruption of all aspects of a person’s life, resulting in the difficult process of coping with the distressing effects of paralysis affecting their ability to lead a meaningful life. These persons are hospitalized in the acute stage of injury and subsequently for rehabilitation and the treatment of complications. The purpose of this study was to explore coping strategies used by persons with SCI during their rehabilitation period. A qualitative study was conducted among persons with SCI, undergoing rehabilitation at the Rheumatology and Rehabilitation Hospitals, Ragama and Digana Sri Lanka. Twelve participants were selected purposively to represent both males and females, with cervical, thoracic or lumbar levels of injuries due to traumatic and non-traumatic causes as well as from different socioeconomic backgrounds. Informed consent was taken from the participants. In-depth interviews were conducted using an interview guide to collect data. Probes were used to get more information and to encourage participants. Interviews were audio taped and transcribed verbatim. Qualitative content analysis was conducted. Ethical approval for this study was obtained from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya. Five themes were identified in the content analysis: social support, religious beliefs, determination, acceptance and making comparisons. Participants indicated that the support from their family members had been an essential factor in coping, after sustaining an SCI and they expressed the importance of emotional support from family members during their rehabilitation. Many participants had a strong belief towards the God, who had a personal interest in their lives, played an important role in their ability to cope with the injury. They believed that what happens to them in this life results from their actions in previous lives. They expressed that determination was essential as a factor that helps them cope with their injury. They indicated their focus on the positive aspects of the life and accepted the disability. They made comparisons to other persons who were worse off than them to help lift them out of unpleasant experience. Even some of the most severely injured and disabled participants presented evidence of using this coping strategy. Identification of coping strategies used by persons with SCI will help nurses and other health-care professionals in reinforcing the most effective coping strategies among persons with SCI. The findings recommend that engagement coping positively influences psychosocial adaptation.Keywords: content analysis, coping strategies, rehabilitation, spinal cord injury
Procedia PDF Downloads 185