Search results for: trust recovery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2452

Search results for: trust recovery

682 Numerical Modelling of Skin Tumor Diagnostics through Dynamic Thermography

Authors: Luiz Carlos Wrobel, Matjaz Hribersek, Jure Marn, Jurij Iljaz

Abstract:

Dynamic thermography has been clinically proven to be a valuable diagnostic technique for skin tumor detection as well as for other medical applications such as breast cancer diagnostics, diagnostics of vascular diseases, fever screening, dermatological and other applications. Thermography for medical screening can be done in two different ways, observing the temperature response under steady-state conditions (passive or static thermography), and by inducing thermal stresses by cooling or heating the observed tissue and measuring the thermal response during the recovery phase (active or dynamic thermography). The numerical modelling of heat transfer phenomena in biological tissue during dynamic thermography can aid the technique by improving process parameters or by estimating unknown tissue parameters based on measured data. This paper presents a nonlinear numerical model of multilayer skin tissue containing a skin tumor, together with the thermoregulation response of the tissue during the cooling-rewarming processes of dynamic thermography. The model is based on the Pennes bioheat equation and solved numerically by using a subdomain boundary element method which treats the problem as axisymmetric. The paper includes computational tests and numerical results for Clark II and Clark IV tumors, comparing the models using constant and temperature-dependent thermophysical properties, which showed noticeable differences and highlighted the importance of using a local thermoregulation model.

Keywords: boundary element method, dynamic thermography, static thermography, skin tumor diagnostic

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681 The Role of the Coach in Elite Equestrian Sport

Authors: Victoria Lewis, L. Dumbell

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The British Equestrian Federation (BEF) aims to develop a holistic coach education and certification program, moving away from traditional autocratic instruction in line with the UK Coaching Framework. This framework is based on generic coaching science research where the coach is cited as a pivotal aspect in developing sporting success. Theoretic knowledge suggests that the role of the sports coach is to develop the physical, tactical, technical and psychological attributes of the athlete and is responsible for the planning, organization and delivery of the training plan and competition schedule. However, to the best of the author’s knowledge, there is no empirical evidence to suggest that is the role required in equestrian sport as the rider takes responsibility for many of these tasks. This research aimed to address the void in current knowledge by gaining an understanding of coaching in equestrian sport in order to improve coaching education system through awareness of the role of the coach. Objectives were to examine the relationship between coach and rider at elite level in equestrian sport providing empirical evidence to suggest that the rider is, in part, ‘self –coached’. To identify the elite equestrian coaches’ role in coaching these ‘self-coached riders. A qualitative method using semi-structured interviews was used. A sample of elite coaches (N=3) and elite riders (N=3) were interviewed. Analysis of the transcripts revealed a total of 534 meaning units that were further grouped into sub-themes and general themes from the coaches’ perspective and the riders’ perspective. This led to the development of a final thematic structure revealing major dimensions that characterized coaching in elite equestrian sport. It was found that the riders at the elite level coach themselves the majority of the time, therefore, can be considered as ‘self-coached’ athletes. However, they do use elite coaches in a mentoring and consultancy role, where they seek guidance from the coach on specific problems, to sound ideas off or to seek reassurance that what they are doing is correct. Findings from this research suggest that the rider-coach relationship at the elite level is a professional one, based on trust and respect, but not a close relationship as seen in other sports. The results show the imperative need for the BEF to educate coaches in coaching the self-coached rider at the elite level, particularly in terms of mentoring skills. As well as incorporating rider education aimed at developing the independent, self-coached riders.

Keywords: coaching, elite sport, equestrian, self coached

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680 Role of Social Workers in Mitigating the Effects of Climate Change in Makonde Communal Lands, Zimbabwe

Authors: Louis Nyahunda, Frans Koketso Matlakala, Jabulani Calvin Makhubele

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Climate change is among the most vital environmental aspects that the human community is endowed with. Climate as a factor of life is particularly strong to low income rural communities whose livelihoods heavily depend on rain-fed subsistence agriculture like Makonde communal lands. The purpose of social work within the context of climate change is to enhance community expertise and empower members for participation in the decision-making process through all stages of risk assessment, rescue, planning and intervention for recovery and preparedness. This paper sought to explore the role of social workers in mitigating the effects of climate change in Makonde communal lands of Zimbabwe. The objectives of the study were to identify what roles if any are social workers playing in mitigating the effects of climate change and if not, what are the impediments in that sphere. A qualitative research approach was followed within the traditional framework of descriptive and exploratory designs. Simple random, purposive and snowballing sampling techniques were used to gather twenty-five participants in the study. The Thematic Content Analysis was followed to analyse data inductively. The study found that Social Workers are not directly involved in climate change interventions in the Makonde area owing it to lack of training on climate change issues. The study recommends that climate change falls within the purview of the social work practice therefore social workers must take the lead in supporting families and communities affected by climate change following the values, knowledge base, skills and principles of the profession.

Keywords: role, social workers, mitigation, climate change, Makonde communal lands

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679 Pilot-free Image Transmission System of Joint Source Channel Based on Multi-Level Semantic Information

Authors: Linyu Wang, Liguo Qiao, Jianhong Xiang, Hao Xu

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In semantic communication, the existing joint Source Channel coding (JSCC) wireless communication system without pilot has unstable transmission performance and can not effectively capture the global information and location information of images. In this paper, a pilot-free image transmission system of joint source channel based on multi-level semantic information (Multi-level JSCC) is proposed. The transmitter of the system is composed of two networks. The feature extraction network is used to extract the high-level semantic features of the image, compress the information transmitted by the image, and improve the bandwidth utilization. Feature retention network is used to preserve low-level semantic features and image details to improve communication quality. The receiver also is composed of two networks. The received high-level semantic features are fused with the low-level semantic features after feature enhancement network in the same dimension, and then the image dimension is restored through feature recovery network, and the image location information is effectively used for image reconstruction. This paper verifies that the proposed multi-level JSCC algorithm can effectively transmit and recover image information in both AWGN channel and Rayleigh fading channel, and the peak signal-to-noise ratio (PSNR) is improved by 1~2dB compared with other algorithms under the same simulation conditions.

Keywords: deep learning, JSCC, pilot-free picture transmission, multilevel semantic information, robustness

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678 Examining Resilience, Social Supports, and Self-Esteem as Predictors of the Quality of Life of ODAPUS (Orang Dengan Lupus)

Authors: Yulmaida Amir, Fahrul Rozi, Insany C. Kamil, Fanny Aryani

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ODAPUS (Orang dengan Lupus) is an Indonesian term for people with Lupus, a chronic autoimmune disease in which immune system of the body becomes hyperactive and attacks normal tissue. The number of ODAPUS indicate an increase in Indonesia, thereby helping to improve their quality of life to be important to help their recovery. This study aims to examine the effect of resilience, self-esteem, and social support on the quality of life of women who had been diagnosed as having Lupus. Data were collected from 64 ODAPUS in Indonesia, using the World Health Organization Quality of Life (WHOQOL), Resilience Scale from Wagnil and Young (1993), self-esteem scale (developed from Coopersmith’s theory), and Social Support Questioner from Northouse (1988). Regression data analysis showed that resilience, social support, and self-esteem predict the quality of life of the ODAPUS simultaneously. If the variable was analysed individually, self-esteem did not significantly contribute to the quality of life. Resilience contributed most significantly to the quality of life, followed by social support. Of five sources of social supports included in the research, support from family members (parents and brother/sisters) has the most significant contribution to the quality of life, followed by support from spouse, and from friends. Interestingly, social support from medical personnel (medical doctors and nurses) had not a significant contribution to the quality of life of ODAPUS. As a conclusion, this research showed that the ability of ODAPUS to cope with difficulty in life, and support from family members, spouse, and friends were the significant predictors for their quality of life.

Keywords: quality of life, resilience, self-esteem, social supports

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677 Treating Global Trauma: Pandemic, Wars and Beyond. Somatically Based Psychotherapy Interventions as a “Bottom-Up” Approach to Improving the Effectiveness of PTSD Treatment While Preventing Clinicians’ Burnout

Authors: Nina Kaufmans

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Traditional therapies, utilizing spoken narratives as a primary source of intervention, are proven to be limited in effectively treating post traumatic stress disorder. Following the effects of the global pandemic of COVID-19, an increasing number of mental health consumers are beginning to experience somatically-based distress in addition to existing mental health symptoms. Moreover, the aftermath of the rapid increase in demand for mental health services has caused significant burnout in mental health professionals. This paper explores the ramifications of recent changes and challenges in the mental health demands and subsequent response and its consequences for mental health workers. We will begin by investigating the neurobiological mechanisms involved in traumatic experiences, then discuss the premises for "bottom-up" or somatically oriented psychotherapy approaches, and finally offer clinical skills and interventions for clients diagnosed with post traumatic stress disorder. In addition, we will discuss how somatically-based psychotherapy interventions implemented in sessions may decrease burnout and improve the well-being of clinicians. We will discuss how the integration of somatically-based interventions into counseling would increase the effectiveness of mental health recovery and sustain remission while simultaneously providing opportunities for self-care for mental health professionals.

Keywords: somatic psychotherapy interventions, trauma counseling, preventing and treating burnout, adults with PTSD, bottom-up skills, the effectiveness of trauma treatment

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676 Comparison of Soil Test Extractants for Determination of Available Soil Phosphorus

Authors: Violina Angelova, Stefan Krustev

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The aim of this work was to evaluate the effectiveness of different soil test extractants for the determination of available soil phosphorus in five internationally certified standard soils, sludge and clay (NCS DC 85104, NCS DC 85106, ISE 859, ISE 952, ISE 998). The certified samples were extracted with the following methods/extractants: CaCl₂, CaCl₂ and DTPA (CAT), double lactate (DL), ammonium lactate (AL), calcium acetate lactate (CAL), Olsen, Mehlich 3, Bray and Kurtz I, and Morgan, which are commonly used in soil testing laboratories. The phosphorus in soil extracts was measured colorimetrically using Spectroquant Pharo 100 spectrometer. The methods used in the study were evaluated according to the recovery of available phosphorus, facility of application and rapidity of performance. The relationships between methods are examined statistically. A good agreement of the results from different soil test was established for all certified samples. In general, the P values extracted by the nine extraction methods significantly correlated with each other. When grouping the soils according to pH, organic carbon content and clay content, weaker extraction methods showed analogous trends; also among the stronger extraction methods, common tendencies were found. Other factors influencing the extraction force of the different methods include soil: solution ratio, as well as the duration and power of shaking the samples. The mean extractable P in certified samples was found to be in the order of CaCl₂ < CAT < Morgan < Bray and Kurtz I < Olsen < CAL < DL < Mehlich 3 < AL. Although the nine methods extracted different amounts of P from the certified samples, values of P extracted by the different methods were strongly correlated among themselves. Acknowledgment: The financial support by the Bulgarian National Science Fund Projects DFNI Н04/9 and DFNI Н06/21 are greatly appreciated.

Keywords: available soil phosphorus, certified samples, determination, soil test extractants

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675 Digital Repository as a Service: Enhancing Access and Preservation of Cultural Heritage Artefacts

Authors: Lefteris Tsipis, Demosthenes Vouyioukas, George Loumos, Antonis Kargas, Dimitris Varoutas

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The employment of technology and digitization is crucial for cultural organizations to establish and sustain digital repositories for their cultural heritage artefacts. This utilization is also essential in facilitating the presentation of cultural works and exhibits to a broader audience. Consequently, in this work, we propose a digital repository that functions as Software as a Service (SaaS), primarily promoting the safe storage, display, and sharing of cultural materials, enhancing accessibility, and fostering a deeper understanding and appreciation of cultural heritage. Moreover, the proposed digital repository service is designed as a multitenant architecture, which enables organizations to expand their reach, enhance accessibility, foster collaboration, and ensure the preservation of their content. Specifically, this project aims to assist each cultural institution in organizing its digital cultural assets into collections and feeding other digital platforms, including educational, museum, pedagogical, and games, through appropriate interfaces. Moreover, the creation of this digital repository offers a cutting-edge and effective open-access laboratory solution. It allows organizations to have a significant influence on their audiences by fostering cultural understanding and appreciation. Additionally, it facilitates the connection between different digital repositories and national/European aggregators, promoting collaboration and information sharing. By embracing this solution, cultural institutions can benefit from shared resources and features, such as system updates, backup and recovery services, and data analytics tools, that are provided by the platform.

Keywords: cultural technologies, gaming technologies, web sharing, digital repository

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674 Quality of Life Assessment across the Cancer Continuum: Understanding the Role of an Exercise Rehabilitation Programme

Authors: Bernat-Carles Serdà Ferrer, Arantza Del Valle Gómez

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The Quality of Life (QoL) paradigm is multidimensional, dynamic and modular and its definition differs across the cancer continuum. The challenge in the interpretation of QoL data in clinical research is that QoL is influenced by psychological phenomena such as adaptation to illness. This research aims to obtain a valid and sensitive assessment of QoL change over the continuum disease, and to evaluate a rehabilitation programme aimed at inverting the observed decrease in QoL when patients return to daily living activities. The sample comprised 66 men. Patients were first assessed to establish a baseline (P1-diagnosis). This was followed by a post-test (P2-discharge) and a then-test measurement (P3-retrospective evaluation) and after returning home patients were randomized in experimental and control groups. The experimental group attended a rehabilitation programme over 24 weeks (P4). Results show that from baseline to post-test, QoL decreased significantly. The recalibration then-test confirmed a low QoL in all periods evaluated. Significant differences between the experimental and control groups prove the positive effect of the Exercise Rehabilitation Programme (ERP) on QoL. Understanding the real dynamic of QoL over time would help to adapt rehabilitation programmes by improving sensitivity and efficacy and provide professionals with a more accurate perception of the impact of treatment and side effects on patients’ QoL. Our results underline the importance of changing the approach adopted by health professionals towards one of watchful waiting on patients’ QoL until their complete recovery in daily life.

Keywords: exercise, prostate cancer, quality of life, rehabilitation programme, response shift

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673 Optimization of Municipal Solid Waste Management in Peshawar Using Mathematical Modelling and GIS with Focus on Incineration

Authors: Usman Jilani, Ibad Khurram, Irshad Hussain

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Environmentally sustainable waste management is a challenging task as it involves multiple and diverse economic, environmental, technical and regulatory issues. Municipal Solid Waste Management (MSWM) is more challenging in developing countries like Pakistan due to lack of awareness, technology and human resources, insufficient funding, inefficient collection and transport mechanism resulting in the lack of a comprehensive waste management system. This work presents an overview of current MSWM practices in Peshawar, the provincial capital of Khyber Pakhtunkhwa, Pakistan and proposes a better and sustainable integrated solid waste management system with incineration (Waste to Energy) option. The diverted waste would otherwise generate revenue; minimize land fill requirement and negative impact on the environment. The proposed optimized solution utilizing scientific techniques (like mathematical modeling, optimization algorithms and GIS) as decision support tools enhances the technical & institutional efficiency leading towards a more sustainable waste management system through incorporating: - Improved collection mechanisms through optimized transportation / routing and, - Resource recovery through incineration and selection of most feasible sites for transfer stations, landfills and incineration plant. These proposed methods shift the linear waste management system towards a cyclic system and can also be used as a decision support tool by the WSSP (Water and Sanitation Services Peshawar), agency responsible for the MSWM in Peshawar.

Keywords: municipal solid waste management, incineration, mathematical modeling, optimization, GIS, Peshawar

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672 Developing a Health Promotion Program to Prevent and Solve Problem of the Frailty Elderly in the Community

Authors: Kunthida Kulprateepunya, Napat Boontiam, Bunthita Phuasa, Chatsuda Kankayant, Bantoeng Polsawat, Sumran Poontong

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Frailty is the thin line between good health and illness. The syndrome is more common in the elderly who transition from strong to weak. (Vulnerability). Fragility can prevent and promote healthy recovery before it goes into disability. This research and development aim to analyze the situation analysis of frailty of the elderly, develop a program, and evaluate the effect of a health promotion program to prevent and solve the problem of frailty among the elderly. The research consisted of 3 phases: 1) analysis of the frailty situation, 2) development of a model, 3) evaluation of the effectiveness of the model. Samples were 328, 122 elderlies using the multi-stage random sampling method. The research instrument was a frailty questionnaire use of the five symptoms, the main characteristics were muscle weakness, slow walking, low physical activity. Fatigue and unintentional weight loss, criteria frailty use more than or equal to three or more symptoms are frailty. Data were analyzed by descriptive and t-test dependent test statistics. The findings showed three parts. First, frailty in the elderly was 23.05 percentage and 56.70% pre-frailty. Second, it was development of a health promotion program to prevent and solve the problem of frailty the elderly with a combination of Nine-Square Exercise, Elastic Band Exercise, Elastic Coconut Shell. Third, evaluation of the effectiveness of the model by comparison of the elderly's get up and go test, the average time before using the program was 14.42 and after using the program was 8.57. It was statistically significant at the .05 level. In conclusion, the findings can used to develop guidelines to promote the health of the frailty elderly.

Keywords: elderly, fragile, nine-square exercise, elastic coconut shell

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671 Design and Construction of a Device to Facilitate the Stretching of a Plantiflexors Muscles in the Therapy of Rehabilitation for Patients with Spastic Hemiplegia

Authors: Nathalia Andrea Calderon Lesmes, Eduardo Barragan Parada, Diego Fernando Villegas Bermudez

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Spasticity in the plantiflexor muscles as a product of stroke (CVA-Cerebrovascular accident) restricts the mobility and independence of the affected people. Commonly, physiotherapists are in charge of manually performing the rehabilitation therapy known as Sustained Mechanical Stretching, rotating the affected foot of the patient in the sagittal plane. However, this causes a physical wear on the professional because it is a fatiguing movement. In this article, a mechanical device is developed to implement this rehabilitation therapy more efficiently. The device consists of a worm-crown mechanism that is driven by a crank to gradually rotate a platform in the sagittal plane of the affected foot, in order to achieve dorsiflexion. The device has a range of sagittal rotation up to 150° and has velcro located on the footplate that secures the foot. The design of this device was modeled by using CAD software and was checked structurally with a general purpose finite element software to be sure that the device is safe for human use. As a measurement system, a goniometer is used in the lateral part of the device and load cells are used to measure the force in order to determine the opposing torque exerted by the muscle. Load cells sensitivity is 1.8 ± 0.002 and has a repeatability of 0.03. Validation of the effectiveness of the device is measured by reducing the opposition torque and increasing mobility for a given patient. In this way, with a more efficient therapy, an improvement in the recovery of the patient's mobility and therefore in their quality of life can be achieved.

Keywords: biomechanics, mechanical device, plantiflexor muscles, rehabilitation, spastic hemiplegia, sustained mechanical stretching

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670 Design and Evaluation of a Fully-Automated Fluidized Bed Dryer for Complete Drying of Paddy

Authors: R. J. Pontawe, R. C. Martinez, N. T. Asuncion, R. V. Villacorte

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Drying of high moisture paddy remains a major problem in the Philippines, especially during inclement weather condition. To alleviate the problem, mechanical dryers were used like a flat bed and recirculating batch-type dryers. However, drying to 14% (wet basis) final moisture content is long which takes 10-12 hours and tedious which is not the ideal for handling high moisture paddy. Fully-automated pilot-scale fluidized bed drying system with 500 kilograms per hour capacity was evaluated using a high moisture paddy. The developed fluidized bed dryer was evaluated using four drying temperatures and two variations in fluidization time at a constant airflow, static pressure and tempering period. Complete drying of paddy with ≥28% (w.b.) initial MC was attained after 2 passes of fluidized-bed drying at 2 minutes exposure to 70 °C drying temperature and 4.9 m/s superficial air velocity, followed by 60 min ambient air tempering period (30 min without ventilation and 30 min with air ventilation) for a total drying time of 2.07 h. Around 82% from normal mechanical drying time was saved at 70 °C drying temperature. The drying cost was calculated to be P0.63 per kilogram of wet paddy. Specific heat energy consumption was only 2.84 MJ/kg of water removed. The Head Rice Yield recovery of the dried paddy passed the Philippine Agricultural Engineering Standards. Sensory evaluation showed that the color and taste of the samples dried in the fluidized bed dryer were comparable to air dried paddy. The optimum drying parameters of using fluidized bed dryer is 70 oC drying temperature at 2 min fluidization time, 4.9 m/s superficial air velocity, 10.16 cm grain depth and 60 min ambient air tempering period.

Keywords: drying, fluidized bed dryer, head rice yield, paddy

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669 “Environmental-Friendly” and “People-Friendly” Project for a New North-East Italian Hospital

Authors: Emanuela Zilli, Antonella Ruffatto, Davide Bonaldo, Stefano Bevilacqua, Tommaso Caputo, Luisa Fontana, Carmelina Saraceno, Antonio Sturaroo, Teodoro Sava, Antonio Madia

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The new Hospital in Cittadella - ULSS 6 Euganea Health Trust, in the North-East of Italy (400 beds, project completion date in 2026), will partially take the place of the existing building. Interesting features have been suggested in order to project a modern, “environmental-friendly” and “people-friendly” building. Specific multidisciplinary meetings (involving stakeholders and professionals with different backgrounds) have been organized on a periodic basis in order to guarantee the appropriate implementation of logistic and organizational solutions related to eco-sustainability, integration with the context, and the concept of “design for all” and “humanization of care.” The resulting building will be composed of organic shapes determined by the external environment (sun movement, climate, landscape, pre-existing buildings, roads) and the needs of the internal environment (areas of care and diagnostic-treatment paths reorganized with experience gained during the pandemic), with extensive use of renewable energy, solar panels, a 4th-generation heating system, sanitised and maintainable surfaces. There is particular attention to the quality of the staff areas, which include areas dedicated to psycho-physical well-being (relax points, yoga gym), study rooms, and a centralized conference room. Outdoor recreational spaces and gardens for music and watercolour therapy will be included; atai-chi gym is dedicated to oncology patients. Integration in the urban and social context is emphasized through window placement toward the gardens (maternal-infant, mental health, and rehabilitation wards). Service areas such as dialysis, radiology, and labs have views of the medieval walls, the symbol of the city’s history. The new building has been designed to pursue the maximum level of eco-sustainability, harmony with the environment, and integration with the historical, urban, and social context; the concept of humanization of care has been considered in all the phases of the project management.

Keywords: environmental-friendly, humanization, eco-sustainability, new hospital

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668 Self-Healing Phenomenon Evaluation in Cementitious Matrix with Different Water/Cement Ratios and Crack Opening Age

Authors: V. G. Cappellesso, D. M. G. da Silva, J. A. Arndt, N. dos Santos Petry, A. B. Masuero, D. C. C. Dal Molin

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Concrete elements are subject to cracking, which can be an access point for deleterious agents that can trigger pathological manifestations reducing the service life of these structures. Finding ways to minimize or eliminate the effects of this aggressive agents’ penetration, such as the sealing of these cracks, is a manner of contributing to the durability of these structures. The cementitious self-healing phenomenon can be classified in two different processes. The autogenous self-healing that can be defined as a natural process in which the sealing of this cracks occurs without the stimulation of external agents, meaning, without different materials being added to the mixture, while on the other hand, the autonomous seal-healing phenomenon depends on the insertion of a specific engineered material added to the cement matrix in order to promote its recovery. This work aims to evaluate the autogenous self-healing of concretes produced with different water/cement ratios and exposed to wet/dry cycles, considering two ages of crack openings, 3 days and 28 days. The self-healing phenomenon was evaluated using two techniques: crack healing measurement using ultrasonic waves and image analysis performed with an optical microscope. It is possible to observe that by both methods, it possible to observe the self-healing phenomenon of the cracks. For young ages of crack openings and lower water/cement ratios, the self-healing capacity is higher when compared to advanced ages of crack openings and higher water/cement ratios. Regardless of the crack opening age, these concretes were found to stabilize the self-healing processes after 80 days or 90 days.

Keywords: sealf-healing, autogenous, water/cement ratio, curing cycles, test methods

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667 Single Protoplast of Murraya paniculata L. Jack Regenerated Into Plantlets

Authors: Hasan Basri Jumin, Danil Endriand Basri

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Isolated protoplast from embryogenic callus of orange Jessamine (Murraya paniculata L. (Jack) cultured and maintained under growth chamber at the temperature +25oC. The parameter observed are the plating efficiency, the number of spherical embryos, heard-shaped embryos-like structure, shoot formation, and plantlets obtained. Treatment was arranged with 0.0, 0.001, 0.01, 0.1 or 1.0 mg 1-1 Naphthalene acetic acid (NAA), and 0, 300, 500 mg 1/l malt extract (ME) and 0.M sorbitol in the medium with 2.5 % sucrose. Interaction between 0.001 mg/l NAA and 500 mg/l was observed the higher percentage of planting efficiency. For embryo development from callus, the media was added to 0.0 mg/l, 0.001 mg/l, 0.01 ,mg/l, 0.1 mg/l, 1.0 mg/l NAA, and 1.0 %, 2.0 %, 3.0 %, 4.0 % sucrose. Media supplemented with 0.01mg/l NAA, and 1.0% sucrose was found to be a suitable medium for the development of spherical somatic embryos. A combination of 0.1 mg/ indole acetic acid (IAA) and 0.1 mg/l zeatin constituted the spherical somatic embryo became heart-shaped embryos-like structure. A combination between GA3 0.1 mg 1/l GA3 and 0.1 mg 1-1 zeatin is looking high, growing the heart-shaped embryos-like structure to form a shoot. Cells were developed into spherical embryos and grew into heart-shaped embryos, and then spherical somatic embryos developed into shoot formation. Sequence from single protoplast to plantlets was obtained by using a low concentration of plant growth regulator and sucrose; This recovery of single protoplast to be completed plantlets is a new technology in plant cell culture, and this could be used in genetic engineering in citrus.

Keywords: heart-shaped-embryos-like-structure, Muraya-paniculata, plant-growth-regulator, spherical- somatic-embryo, single protoplast, glucose

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666 New Off-Line SPE-GC-MS/MS Method for Determination of Mineral Oil Saturated Hydrocarbons/Mineral Oil Hydrocarbons in Animal Feed, Foods, Infant Formula and Vegetable Oils

Authors: Ovanes Chakoyan

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MOH (mineral oil hydrocarbons), which consist of mineral oil saturated hydrocarbons(MOSH) and mineral oil aromatic hydrocarbons(MOAH), are present in various products such as vegetable oils, animal feed, foods, and infant formula. Contamination of foods with mineral oil hydrocarbons, particularly mineral oil aromatic hydrocarbons(MOAH), exhibiting carcinogenic, mutagenic, and hormone-disruptive effects. Identifying toxic substances among the many thousands comprising mineral oils in food samples is a difficult analytical challenge. A method based on an offline-solid phase extraction approach coupled with gas chromatography-triple quadrupole(GC-MS/MS) was developed for the determination of MOSH/MOAH in various products such as vegetable oils, animal feed, foods, and infant formula. A glass solid phase extraction cartridge loaded with 7 g of activated silica gel impregnated with 10 % silver nitrate for removal of olefins and lipids. The MOSH/MOAH fractions were eluated with hexane and hexane: dichloromethane : toluene, respectively. Each eluate was concentrated to 50 µl in toluene and injected on splitless mode into GC-MS/MS. Accuracy of the method was estimated as measurement of recovery of spiked oil samples at 2.0, 15.0, and 30.0 mg kg -1, and recoveries varied from 85 to 105 %. The method was applied to the different types of samples (sunflower meal, chocolate ships, santa milk chocolate, biscuits, infant milk, cornflakes, refined sunflower oil, crude sunflower oil), detecting MOSH up to 56 mg/kg and MOAH up to 5 mg/kg. The limit of quantification(LOQ) of the proposed method was estimated at 0.5 mg/kg and 0.3 mg/kg for MOSH and MOAH, respectively.

Keywords: MOSH, MOAH, GC-MS/MS, foods, solid phase extraction

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665 Gonadal Maturation in Pen Shells Pinna Rudis and Pinna Nobilis Stimulated by Reproductive Neuropeptides

Authors: Ntalamagka N., Sanchis-Benlloch P. J., Mayoral-Serrano R., Tena-Medialdea J., García-March J. R.

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The pen shell Pinna nobilis population has declined dramatically since 2016 due to die-off events observed in the whole extent of the Mediterranean Sea associated with the protozoan Haplosporidium pinnae. As of 2019, it is considered a critically endangered species. Due to its ecological importance and its endangered status, several initiatives have been developed for its salvation and recovery. This research is an effort to understand and control its reproduction under captivity. As a limited number of Pinna nobilis individuals could be used for experimentation, the possibility of using the Pinna rudis as a model animal was explored. The molecular mechanism that regulates the reproduction of both species is unknown; consequently, transcriptomic analysis was performed to identify neuropeptides that are expressed in the key regulatory tissues of the visceral ganglia and gonads of both species. Neuropeptides form an important group of signaling peptides that regulate reproductive, behavioral and physiological functions in molluscs. In total, 17 neuropeptide precursors were identified in P. nobilis and 14 in P. rudis transcriptomes; 14 of them were identical in both species. This affinity verified the genetic similarity of these species at the reproduction level. APGWamide, buccalin, ELH and GnRH were tested in P. rudis and demonstrated their capacity to advance gonadal maturation and trigger spawning while spawning was recorded in P. nobilis after the usage of APGWamide and buccalin. The neuropeptides were administered using intramuscular injection and cholesterol implants following relative literature as well as a new method was developed for external administration without the use of anesthesia using a mathematical model. The know-how of this research will not only lead to the survival of the species but also will narrow the horizons of broodstock conditioning of other similar species.

Keywords: neuropeptides, Pinna nobilis, reproduction, transcriptomics

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664 Electrochemical Detection of the Chemotherapy Agent Methotrexate in vitro from Physiological Fluids Using Functionalized Carbon Nanotube past Electrodes

Authors: Shekher Kummari, V. Sunil Kumar, K. Vengatajalabathy Gobi

Abstract:

A simple, cost-effective, reusable and reagent-free electrochemical biosensor is developed with functionalized multiwall carbon nanotube paste electrode (f-CNTPE) for the sensitive and selective determination of the important chemotherapeutic drug methotrexate (MTX), which is widely used for the treatment of various cancer and autoimmune diseases. The electrochemical response of the fabricated electrode towards the detection of MTX is examined by cyclic voltammetry (CV), differential pulse voltammetry (DPV) and square wave voltammetry (SWV). CV studies have shown that f-CNTPE electrode system exhibited an excellent electrocatalytic activity towards the oxidation of MTX in phosphate buffer (0.2 M) compared with a conventional carbon paste electrode (CPE). The oxidation peak current is enhanced by nearly two times in magnitude. Applying the DPV method under optimized conditions, a linear calibration plot is achieved over a wide range of concentration from 4.0×10⁻⁷ M to 5.5×10⁻⁶ M with the detection limit 1.6×10⁻⁷ M. further, by applying the SWV method a parabolic calibration plot was achieved starting from a very low concentration of 1.0×10⁻⁸ M, and the sensor could detect as low as 2.9×10⁻⁹ M MTX in 10 s and 10 nM were detected in steady state current-time analysis. The f-CNTPE shows very good selectivity towards the specific recognition of MTX in the presence of important biological interference. The electrochemical biosensor detects MTX in-vitro directly from pharmaceutical sample, undiluted urine and human blood serum samples at a concentration range 5.0×10⁻⁷ M with good recovery limits.

Keywords: amperometry, electrochemical detection, human blood serum, methotrexate, MWCNT, SWV

Procedia PDF Downloads 295
663 Biocellulose Template for 3D Mineral Scaffolds

Authors: C. Busuioc, G. Voicu, S. I. Jinga

Abstract:

The field of tissue engineering brings new challenges in terms of proposing original solutions for ongoing medical issues, improving the biological performances of existing clinical systems and speeding the healing process for a faster recovery and a more comfortable life as patient. In this context, we propose the obtaining of 3D porous scaffolds of mineral nature, dedicated to bone repairing and regeneration purposes or employed as bioactive filler for bone cements. Thus, bacterial cellulose - calcium phosphates composite materials have been synthesized by successive immersing of the polymeric membranes in the precursor solution containing Ca2+ and [PO4]3- ions. The mineral phase deposited on the surface of biocellulose fibers was varied as amount through the number of immersing cycles. The intermediary composites were subjected to thermal treatments at different temperatures in order to remove the organic part and provide the formation of a self-sustained 3D architecture. The resulting phase composition consists of common phosphates, while the morphology largely depends on the preparation parameters. Thus, the aspect of the 3D mineral scaffolds can be tuned from a loose microstructure composed of large grains connected via monocrystalline nanorods to a trabecular pattern crossed by parallel internal channels, just like the natural bone. The bioactivity and biocompatibility of the obtained materials have been also assessed, with encouraging results in the clinical use direction. In conclusion, the compositional, structural, morphological and biological characterizations sustain the suitability of the reported biostructures for integration in hard tissue engineering applications.

Keywords: bacterial cellulose, bone reconstruction, calcium phosphates, mineral scaffolds

Procedia PDF Downloads 178
662 Development of a Direct Immunoassay for Human Ferritin Using Diffraction-Based Sensing Method

Authors: Joel Ballesteros, Harriet Jane Caleja, Florian Del Mundo, Cherrie Pascual

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Diffraction-based sensing was utilized in the quantification of human ferritin in blood serum to provide an alternative to label-based immunoassays currently used in clinical diagnostics and researches. The diffraction intensity was measured by the diffractive optics technology or dotLab™ system. Two methods were evaluated in this study: direct immunoassay and direct sandwich immunoassay. In the direct immunoassay, human ferritin was captured by human ferritin antibodies immobilized on an avidin-coated sensor while the direct sandwich immunoassay had an additional step for the binding of a detector human ferritin antibody on the analyte complex. Both methods were repeatable with coefficient of variation values below 15%. The direct sandwich immunoassay had a linear response from 10 to 500 ng/mL which is wider than the 100-500 ng/mL of the direct immunoassay. The direct sandwich immunoassay also has a higher calibration sensitivity with value 0.002 Diffractive Intensity (ng mL-1)-1) compared to the 0.004 Diffractive Intensity (ng mL-1)-1 of the direct immunoassay. The limit of detection and limit of quantification values of the direct immunoassay were found to be 29 ng/mL and 98 ng/mL, respectively, while the direct sandwich immunoassay has a limit of detection (LOD) of 2.5 ng/mL and a limit of quantification (LOQ) of 8.2 ng/mL. In terms of accuracy, the direct immunoassay had a percent recovery of 88.8-93.0% in PBS while the direct sandwich immunoassay had 94.1 to 97.2%. Based on the results, the direct sandwich immunoassay is a better diffraction-based immunoassay in terms of accuracy, LOD, LOQ, linear range, and sensitivity. The direct sandwich immunoassay was utilized in the determination of human ferritin in blood serum and the results are validated by Chemiluminescent Magnetic Immunoassay (CMIA). The calculated Pearson correlation coefficient was 0.995 and the p-values of the paired-sample t-test were less than 0.5 which show that the results of the direct sandwich immunoassay was comparable to that of CMIA and could be utilized as an alternative analytical method.

Keywords: biosensor, diffraction, ferritin, immunoassay

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661 Corticomotor Excitability after Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Ischemic Stroke Patients

Authors: Asrarul Fikri Abu Hassan, Muhammad Hafiz bin Hanafi, Jafri Malin Abdullah

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This study is to compare the motor evoked potential (MEP) changes using different settings of repetitive transcranial magnetic stimulation (rTMS) in the post-haemorrhagic stroke patient which treated conservatively. The goal of the study is to determine changes in corticomotor excitability and functional outcome after repetitive transcranial magnetic stimulation (rTMS) therapy regime. 20 post-stroke patients with upper limb hemiparesis were studied due to haemorrhagic stroke. One of the three settings; (I) Inhibitory setting, or (II) facilitatory setting, or (III) control group, no excitatory or inhibitory setting have been applied randomly during the first meeting. The motor evoked potential (MEP) were recorded before and after application of the rTMS setting. Functional outcomes were evaluated using the Barthel index score. We found pre-treatment MEP values of the lesional side were lower compared to post-treatment values in both settings. In contrast, we found that the pre-treatment MEP values of the non-lesional side were higher compared to post-treatment values in both settings. Interestingly, patients with treatment, either facilitatory setting and inhibitory setting have faster motor recovery compared to the control group. Our data showed both settings might improve the MEP of the upper extremity and functional outcomes in the haemorrhagic stroke patient.

Keywords: Barthel index, corticomotor excitability, motor evoked potential, repetitive transcranial magnetic stimulation, stroke

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660 Use of Acid Mine Drainage as a Source of Iron to Initiate the Solar Photo-Fenton Treatment of Municipal Wastewater: Circular Economy Effect

Authors: Tooba Aslam, Efthalia Chatzisymeon

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Untreated Municipal Wastewater (MWW) is renowned as the utmost harmful pollution caused to environmental water due to the high presence of nutrients and organic contaminants. Removal of Chemical Oxygen Demand (COD) from synthetic as well as municipal wastewater is investigated by using acid mine drainage as a source of iron to initiate the solar photo-Fenton treatment of municipal wastewater. In this study, Acid Mine Drainage (AMD) and different minerals enriched in iron, such as goethite, hematite, magnetite, and magnesite, have been used as the source of iron to initiate the photo-Fenton process. Co-treatment of real municipal wastewater and acid mine drainage /minerals is widely examined. The effects of different parameters such as minerals recovery from AMD, AMD as a source of iron, H₂O₂ concentration, and COD concentrations on the COD percentage removal of the process are studied. The results show that, out of all the four minerals, only hematite (1g/L) could remove 30% of the pollutants at about 100 minutes and 1000 ppm of H₂O₂. The addition of AMD as a source of iron is performed and compared with both synthetic as well as real wastewater from South Africa under the same conditions, i.e., 1000 ppm of H₂O₂, ambient temperature, 2.8 pH, and solar simulator. In the case of synthetic wastewater, the maximum removal (56%) is achieved with 50 ppm of iron (AMD source) at 160 minutes. On the other hand, in real wastewater, the removal efficiency is 99% with 30 ppm of iron at 90 minutes and 96% with 50 ppm of iron at 120 minutes. In conclusion, overall, the co-treatment of AMD and MWW by solar photo-Fenton treatment appears to be an effective and promising method to remove organic materials from Municipal wastewater.

Keywords: municipal wastewater treatment, acid mine drainage, co-treatment, COD removal, solar photo-Fenton, circular economy

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659 Relationship between Wave Velocities and Geo-Pressures in Shallow Libyan Carbonate Reservoir

Authors: Tarek Sabri Duzan

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Knowledge of the magnitude of Geo-pressures (Pore, Fracture & Over-burden pressures) is vital especially during drilling, completions, stimulations, Enhance Oil Recovery. Many times problems, like lost circulation could have been avoided if techniques for calculating Geo-pressures had been employed in the well planning, mud weight plan, and casing design. In this paper, we focused on the relationships between Geo-pressures and wave velocities (P-Wave (Vp) and S-wave (Vs)) in shallow Libyan carbonate reservoir in the western part of the Sirte Basin (Dahra F-Area). The data used in this report was collected from four new wells recently drilled. Those wells were scattered throughout the interested reservoir as shown in figure-1. The data used in this work are bulk density, Formation Mult -Tester (FMT) results and Acoustic wave velocities. Furthermore, Eaton Method is the most common equation used in the world, therefore this equation has been used to calculate Fracture pressure for all wells using dynamic Poisson ratio calculated by using acoustic wave velocities, FMT results for pore pressure, Overburden pressure estimated by using bulk density. Upon data analysis, it has been found that there is a linear relationship between Geo-pressures (Pore, Fracture & Over-Burden pressures) and wave velocities ratio (Vp/Vs). However, the relationship was not clear in the high-pressure area, as shown in figure-10. Therefore, it is recommended to use the output relationship utilizing the new seismic data for shallow carbonate reservoir to predict the Geo-pressures for future oil operations. More data can be collected from the high-pressure zone to investigate more about this area.

Keywords: bulk density, formation mult-tester (FMT) results, acoustic wave, carbonate shalow reservoir, d/jfield velocities

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658 Evaluation of Australian Open Banking Regulation: Balancing Customer Data Privacy and Innovation

Authors: Suman Podder

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As Australian ‘Open Banking’ allows customers to share their financial data with accredited Third-Party Providers (‘TPPs’), it is necessary to evaluate whether the regulators have achieved the balance between protecting customer data privacy and promoting data-related innovation. Recognising the need to increase customers’ influence on their own data, and the benefits of data-related innovation, the Australian Government introduced ‘Consumer Data Right’ (‘CDR’) to the banking sector through Open Banking regulation. Under Open Banking, TPPs can access customers’ banking data that allows the TPPs to tailor their products and services to meet customer needs at a more competitive price. This facilitated access and use of customer data will promote innovation by providing opportunities for new products and business models to emerge and grow. However, the success of Open Banking depends on the willingness of the customers to share their data, so the regulators have augmented the protection of data by introducing new privacy safeguards to instill confidence and trust in the system. The dilemma in policymaking is that, on the one hand, lenient data privacy laws will help the flow of information, but at the risk of individuals’ loss of privacy, on the other hand, stringent laws that adequately protect privacy may dissuade innovation. Using theoretical and doctrinal methods, this paper examines whether the privacy safeguards under Open Banking will add to the compliance burden of the participating financial institutions, resulting in the undesirable effect of stifling other policy objectives such as innovation. The contribution of this research is three-fold. In the emerging field of customer data sharing, this research is one of the few academic studies on the objectives and impact of Open Banking in the Australian context. Additionally, Open Banking is still in the early stages of implementation, so this research traces the evolution of Open Banking through policy debates regarding the desirability of customer data-sharing. Finally, the research focuses not only on the customers’ data privacy and juxtaposes it with another important objective of promoting innovation, but it also highlights the critical issues facing the data-sharing regime. This paper argues that while it is challenging to develop a regulatory framework for protecting data privacy without impeding innovation and jeopardising yet unknown opportunities, data privacy and innovation promote different aspects of customer welfare. This paper concludes that if a regulation is appropriately designed and implemented, the benefits of data-sharing will outweigh the cost of compliance with the CDR.

Keywords: consumer data right, innovation, open banking, privacy safeguards

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657 Analgesic Efficacy of IPACK Block in Primary Total Knee Arthroplasty (90 CASES)

Authors: Fedili Benamar, Beloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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 Background and aims: Peripheral regional anesthesia has been integrated into most analgesia protocols for total knee arthroplasty which considered among the most painful surgeries with a huge potential for chronicization. The adductor canal block (ACB) has gained popularity. Similarly, the IPACK block has been described to provide analgesia of the posterior knee capsule. This study aimed to evaluate the analgesic efficacy of this block in patients undergoing primary PTG. Methods: 90 patients were randomized to receive either an IPACK, an anterior sciatic block, or a sham block (30 patients in each group + multimodal analgesia and a catheter in the KCA adductor canal). GROUP 1 KCA GROUP 2 KCA+BSA GROUP 3 KCA+IPACK The analgesic blocks were done under echo-guidance preoperatively respecting the safety rules, the dose administered was 20 cc of ropivacaine 0.25% was used. We were to assess posterior knee pain 6 hours after surgery. Other endpoints included quality of recovery after surgery, pain scores, opioid requirements (PCA morphine)(EPI info 7.2 analysis). Results: -groups were matched -A predominance of women (4F/1H). -average age: 68 +/-7 years -the average BMI =31.75 kg/m2 +/- 4. -70% of patients ASA2 ,20% ASA3. -The average duration of the intervention: 89 +/- 19 minutes. -Morphine consumption (PCA) significantly higher in group 1 (16mg) & group 2 (8mg) group 3 (4mg) - The groups were matched . -There was a correlation between the use of the ipack block and postoperative pain Conclusions :In a multimodal analgesic protocol, the addition of IPACK block decreased pain scores and morphine consumption ,

Keywords: regional anesthesia, analgesia, total knee arthroplasty, the adductor canal block (acb), the ipack block, pain

Procedia PDF Downloads 52
656 Adoption of Green Supply Chain Practices and Their Impact on a Firm's Economic and Environmental Performance

Authors: Qingyu Zhang, Helin Ma, Lili Weng, Mei Cao

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Green supply chain management has been an important organizational strategy to reduce environmental risks and improve financial performance. Firms have to adopt green supply chain practices to meet the official regulations and reduce peer pressure in China. This paper exhibits an empirical study of the drivers of green supply chain management practices and the environmental and economic performance of green supply chain management implementation in Chinese firms. While China is the fastest-growing emerging economy, it has paid a high ecological price. It is reported that China hosts 7 of the world’s 10 most polluted cities. The continued environmental deterioration and the resultant heightened regulatory control and public scrutiny have posed new operating challenges to firms conducting business in China. These challenges make the country an ideal setting to conduct the present study. A research questionnaire was developed to gather data in China. The questionnaire targeted managers and employees in Chinese companies. The data were collected in the last quarter of 2015, involving industries such as electronic & communicational equipment, textile & clothing, pharmaceutical & healthcare, and so on. This study confirms and validates that (1) both internal and external drivers play a significant role in the implementation of green supply chain management practices; (2) green purchase and investment recovery have a significant impact on firms’ environmental and economic performance; (3) with the improvement of the firms’ environmental performance, their economic performance will improve.

Keywords: economic performance, environmental performance, external driver, green supply chain management

Procedia PDF Downloads 357
655 Challenging Shariah-Compliant Contract: A Latest Insight into the Malaysian Court Cases

Authors: Noor Suhaida Kasri

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In the last three decades, Malaysia has developed fundamental legal and regulatory structures that aim to accommodate and facilitate the growth of Islamic banking and finance industry. Important building blocks have been put in place, to cite a few, the elevation of the position of the Malaysian Central Bank Shariah Advisory Council (SAC) as the apex advisory body and the empowerment of their Shariah resolutions through the Central Bank Act 1958; the promulgation of the Islamic Financial Services Act 2013 that regulate and govern Islamic finance market with a robust statutory requirement of Shariah governance and Shariah compliance. Notwithstanding these achievements, enforceability of Shariah-compliant contract remains a contentious subject. The validity of Al Bai Bithaman Ajil concept that was commonly used by the Islamic financial institutions in their financing facilities structures and documentation has been unabatedly challenged by the customers in courts. The challenge was due to the manner in which the Al Bai Bithaman Ajil transactions were carried out. Due to this legal challenge, Al Bai Bithaman Ajil financing structure seems to no longer be the practitioners’ favourite in Malaysia, though its substitute tawarruq and commodity murabahah financing structure may potentially face similar legal challenges. This paper examines the legal challenges affecting the enforceability of these underlying Shariah contracts. The examination of these cases highlights the manner in which these contracts were being implemented and applied by the Malaysian Islamic financial institutions that triggered Shariah and legal concern. The analysis also highlights the approach adopted by the Malaysian courts in determining the Shariah issues as well as the SAC in ascertaining the rulings on the Shariah issues referred to it by the courts. The paper adopts a qualitative research methodology by using textual and documentary analysis approach. The outcome of this study underlines factors that require consideration by industry stakeholder in order to ameliorate the efficacy of the existing building blocks that would eventually strengthens the validity and enforceability of Shariah-compliant contracts. This, in the long run, will further reinforce financial stability and trust into the Islamic banking and finance industry in Malaysia.

Keywords: enforceability of Shariah compliant contract, legal challenge, legal and regulatory framework, Shariah Advisory Council

Procedia PDF Downloads 219
654 Enhanced Anti-Dermatophytic Effect of Nanoparticles Stimulated by Laser and Cold Plasma Techniques

Authors: Salama A. Ouf, Amera A. El-Adly, Abdelaleam H. Mohamed

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Dermatophytosis is the infection of keratinized tissues such as hair, nail and the stratum corneum of the skin by dermatophytic fungi. Infection is generally cutaneous and restricted to the non-living cornified layers because of the inability of the fungi to penetrate the deeper tissues or organs of immunocompetent hosts. In Saudi Arabia, Onychomycosis is the most frequent infection (40.3%), followed by tinea capitis (21.9%), tinea pedis (16%), tinea cruris (15.1%), and tinea corporis (6.7%). Several azole compounds have been tried to control dermatophytic infection, however, the azole-containing medicines may interfere with the activity of hepatic microsomal enzymes, sex and thyroid hormones, and testosterone biosynthesis. In this research, antibody-conjugated nanoparticles stimulated by cold plasma and laser were evaluated in vitro against some dermatophytes isolated from the common types of tinea. Different types of nanomaterials were tested but silver nanoparticles (AgNPs) were proved to be most effective against the dermatophytes under test. The use of cold plasma coupled with antibody-conjugated nano-particles has severe impact on dermatophytes where the inhibition of growth, spore germination keratinase activity was more than 88% in the case of Trichophyton rubrum, T. violaceum, Microsprum canis and M. gypseum. Complete inhibition of growth for all dermatophytes was brought about by the interaction of conjugated nanoparticles, with cold plasma and laser treatment. The in vivo test with inoculated guinea pigs achieved promising results where the recovery from the infection reached 95% in the case of M. canis –inoculated pigs treated with AgNPs pretreated with cold plasma and laser.

Keywords: cold plasma, dermatophytes, laser, silver nanoparticles

Procedia PDF Downloads 351
653 A Systematic Review and Meta-Analysis in Slow Gait Speed and Its Association with Worse Postoperative Outcomes in Cardiac Surgery

Authors: Vignesh Ratnaraj, Jaewon Chang

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Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

Procedia PDF Downloads 58