Search results for: SOP for reporting and treatment of monitored abnormal events
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11837

Search results for: SOP for reporting and treatment of monitored abnormal events

9647 Efficacy of Biofeedback-Assisted Pelvic Floor Muscle Training on Postoperative Stress Urinary Incontinence

Authors: Asmaa M. El-Bandrawy, Afaf M. Botla, Ghada E. El-Refaye, Hassan O. Ghareeb

Abstract:

Background: Urinary incontinence is a common problem among adults. Its incidence increases with age and it is more frequent in women. Pelvic floor muscle training (PFMT) is the first-line therapy in the treatment of pelvic floor dysfunction (PFD) either alone or combined with biofeedback-assisted PFMT. The aim of the work: The purpose of this study is to evaluate the efficacy of biofeedback-assisted PFMT in postoperative stress urinary incontinence. Settings and Design: A single blind controlled trial design was. Methods and Material: This study was carried out in 30 volunteer patients diagnosed as severe degree of stress urinary incontinence and they were admitted to surgical treatment. They were divided randomly into two equal groups: (Group A) consisted of 15 patients who had been treated with post-operative biofeedback-assisted PFMT and home exercise program (Group B) consisted of 15 patients who had been treated with home exercise program only. Assessment of all patients in both groups (A) and (B) was carried out before and after the treatment program by measuring intra-vaginal pressure in addition to the visual analog scale. Results: At the end of the treatment program, there was a highly statistically significant difference between group (A) and group (B) in the intra-vaginal pressure and the visual analog scale favoring the group (A). Conclusion: biofeedback-assisted PFMT is an effective method for the symptomatic relief of post-operative female stress urinary incontinence.

Keywords: stress urinary incontinence, pelvic floor muscles, pelvic floor exercises, biofeedback

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9646 Production of Spherical Cementite within Bainitic Matrix Microstructures in High Carbon Powder Metallurgy Steels

Authors: O. Altuntaş, A. Güral

Abstract:

The hardness-microstructure relationships of spherical cementite in bainitic matrix obtained by a different heat treatment cycles carried out to high carbon powder metallurgy (P/M) steel were investigated. For this purpose, 1.5 wt.% natural graphite powder admixed in atomized iron powders and the mixed powders were compacted under 700 MPa at room temperature and then sintered at 1150 °C under a protective argon gas atmosphere. The densities of the green and sintered samples were measured via the Archimedes method. A density of 7.4 g/cm3 was obtained after sintering and a density of 94% was achieved. The sintered specimens having primary cementite plus lamellar pearlitic structures were fully quenched from 950 °C temperature and then over-tempered at 705 °C temperature for 60 minutes to produce spherical-fine cementite particles in the ferritic matrix. After by this treatment, these samples annealed at 735 °C temperature for 3 minutes were austempered at 300 °C salt bath for a period of 1 to 5 hours. As a result of this process, it could be able to produced spherical cementite particle in the bainitic matrix. This microstructure was designed to improve wear and toughness of P/M steels. The microstructures were characterized and analyzed by SEM and micro and macro hardness.

Keywords: powder metallurgy steel, bainite, cementite, austempering and spheroidization heat treatment

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9645 Effect of Modifiers (Sr/Sb) and Heat Treatment on the Microstructures and Wear Properties of Al-11Si-3Cu-0.5Mg Alloys

Authors: Sheng-Long Lee, Tse-An Pan

Abstract:

In this study, an optical microscope (OM), electron microscope (SEM), electrical conductivity meter (% IACS), hardness test, and wear test were subjected to analyze the microstructure of the wrought Al-11Si-3Cu-0.5Mg alloys. The effect of eutectic silicon morphology and alloy hardness on wear properties was investigated. The results showed that in the cast state, the morphology of eutectic silicon modified by strontium and antimony is lamellar and finer fibrous structure. After homogenization, the eutectic Si modified by Sr coarsened, and the eutectic Si modified by Sb refined due to fragmentation. The addition of modifiers, hot rolling, and solution aging treatment can control eutectic silicon morphology and hardness. The finer eutectic silicon and higher hardness have better wear resistance. During the wearing process, a protective oxide layer, also known as Mechanical Mixed Layer (MML), is formed on the surface of the alloy. The MML has higher stability and cracking resistance in Sr-modified alloys than in Sb-modified alloys. The study found that the wearing behavior of Al-11Si-3Cu-0.5Mg alloy was enhanced by the combination of adding Sr with lower solution time and T6 peak aging.

Keywords: Al-Si-Cu-Mg alloy, eutectic silicon, heat treatment, wear property

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9644 Impact of New Media Technologies to News, Social Interactions, and Traditional Media

Authors: Ademola Bamgbose

Abstract:

The new media revolution, which encompasses a wide variety of new media technologies like blogs, social networking, visual worlds, wikis, have had a great influence on communications, traditional media and across other disciplines. This paper gives a review of the impact of new media technologies on the news, social interactions and traditional media in developing and developed countries. The study points to the fact that there is a significant impact of new media technologies on the news, social interactions and the traditional media in developing and developed countries, albeit both positively and negatively. Social interactions have been significantly affected, as well as in news production and reporting. It is reiterated that despite the pervasiveness of new media technologies, it would not bring to a total decline of traditional media. This paper contributes to the theoretical framework on the new media and will help to assess the extent of the impact of the new media in different locations.

Keywords: communication, media, news, new media technologies, social interactions, traditional media

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9643 Application of the Critical Decision Method for Monitoring and Improving Safety in the Construction Industry

Authors: Juan Carlos Rubio Romero, Francico Salguero Caparros, Virginia Herrera-Pérez

Abstract:

No one is in the slightest doubt about the high levels of risk involved in work in the construction industry. They are even higher in structural construction work. The Critical Decision Method (CDM) is a semi-structured interview technique that uses cognitive tests to identify the different disturbances that workers have to deal with in their work activity. At present, the vision of safety focused on daily performance and things that go well for safety and health management is facing the new paradigm known as Resilience Engineering. The aim of this study has been to describe the variability in formwork labour on concrete structures in the construction industry and, from there, to find out the resilient attitude of workers to unexpected events that they have experienced during their working lives. For this purpose, a series of semi-structured interviews were carried out with construction employees with extensive experience in formwork labour in Spain by applying the Critical Decision Method. This work has been the first application of the Critical Decision Method in the field of construction and, more specifically, in the execution of structures. The results obtained show that situations categorised as unthought-of are identified to a greater extent than potentially unexpected situations. The identification during these interviews of both expected and unexpected events provides insight into the critical decisions made and actions taken to improve resilience in daily practice in this construction work. From this study, it is clear that it is essential to gain more knowledge about the nature of the human cognitive process in work situations within complex socio-technical systems such as construction sites. This could lead to a more effective design of workplaces in the search for improved human performance.

Keywords: resilience engineering, construction industry, unthought-of situations, critical decision method

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9642 Updating Stochastic Hosting Capacity Algorithm for Voltage Optimization Programs and Interconnect Standards

Authors: Nicholas Burica, Nina Selak

Abstract:

The ADHCAT (Automated Distribution Hosting Capacity Assessment Tool) was designed to run Hosting Capacity Analysis on the ComEd system via a stochastic DER (Distributed Energy Resource) placement on multiple power flow simulations against a set of violation criteria. The violation criteria in the initial version of the tool captured a limited amount of issues that individual departments design against for DER interconnections. Enhancements were made to the tool to further align with individual department violation and operation criteria, as well as the addition of new modules for use for future load profile analysis. A reporting engine was created for future analytical use based on the simulations and observations in the tool.

Keywords: distributed energy resources, hosting capacity, interconnect, voltage optimization

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9641 Oral Antibiotics in Trans-Rectal Prostate Biopsy and Its Efficacy to Reduce Infectious Complications: Systematic Review

Authors: Mohand Yaghi, O. Kehinde

Abstract:

Background: For the diagnosis of prostate cancer Trans-rectal prostate biopsy (TRPB) is used commonly, the procedure is associated with infective complications. There is evidence that antibiotics (ABx) decrease infective events after TRPB, but different regimens are used. Aim: To systematically review different regimens of prophylactic oral antibiotics in TRPB. Design: Medline, Embase, Clinical trials site, and Cochrane library were searched, experts were consulted about relevant studies. Randomized clinical trials (RCT) conducted in the last twenty years, which investigated different oral antibiotic regimens in TRPB, and compared their efficacy to reduce infectious complications were analyzed. Measurements: Primary outcomes were bacteriuria, urinary tract infection (UTI), fever, bacteremia, sepsis. Secondary outcomes were hospitalization rate, and the prevalence of ABx-resistant bacteria. Results: Nine trials were eligible with 3012 patients. Antibiotics prevented bacteriuria (3.5% vs. 9.88%), UTI (4.46% vs. 9.75%), and hospitalization (0.21% vs. 2.13%) significantly in comparison with placebo or no treatment. No significant difference was found in all outcomes of the review between the single dose regimen and the 3 days. The single dose regimen was as effective as the multiple dose except in Bacteriuria (6.75% vs. 3.25%), and the prevalence of ABx-resistant bacteria (1.57% vs. 0.27%). Quinolones reduced only UTI significantly in comparison with other antibiotics. Lastly, Ciprofloxacin is the best Quinolone to prevent UTI, and hospitalization. Conclusion: it is essential to prescribe prophylactic Antibiotics in TRPB. No conclusive evidence could be claimed about the superiority of the multiple or the 3 days regimens to the single dose regimen. Unexpectedly, ABx-resistant bacteria was identified more often in the single dose cohorts.

Keywords: infection, prostate cancer, sepsis, TRPB

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9640 The Evaluation of Costs and Greenhouse Gas Reduction by Using Technologies for Energy from Sewage Sludge

Authors: Futoshi Kakuta, Takashi Ishida

Abstract:

Sewage sludge is a biomass resource that can create a solid fuel and electricity. Utilizing sewage sludge as a renewable energy can contribute to the reduction of greenhouse gasses. In Japan, 'The National Plan for the Promotion of Biomass Utilization' and 'The Priority Plan for Social Infrastructure Development' were approved at cabinet meetings in December 2010 and August 2012, respectively, to promote the energy utilization of sewage sludge. This study investigated costs and greenhouse gas emission in different sewage sludge treatments with technologies for energy from sewage sludge. Costs were estimated on capital costs and O&M costs including energy consumption of solid fuel plants and biogas power generation plants for sewage sludge. Results showed that cost of sludge digestion treatment with solid fuel technologies was 8% lower than landfill disposal. Greenhouse gas emission of sludge digestion treatment with solid fuel technologies was also 6,390t as CO2 smaller than landfill disposal. Biogas power generation reduced the electricity of a wastewater treatment plant by 30% and the cost by 5%.

Keywords: global warming countermeasure, energy technology, solid fuel production, biogas

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9639 A Grid Synchronization Phase Locked Loop Method for Grid-Connected Inverters Systems

Authors: Naima Ikken, Abdelhadi Bouknadel, Nour-eddine Tariba Ahmed Haddou, Hafsa El Omari

Abstract:

The operation of grid-connected inverters necessity a single-phase phase locked loop (PLL) is proposed in this article to accurately and quickly estimate and detect the grid phase angle. This article presents the improvement of a method of phase-locked loop. The novelty is to generate a method (PLL) of synchronizing the grid with a Notch filter based on adaptive fuzzy logic for inverter systems connected to the grid. The performance of the proposed method was tested under normal and abnormal operating conditions (amplitude, frequency and phase shift variations). In addition, simulation results with ISPM software are developed to verify the effectiveness of the proposed method strategy. Finally, the experimental test will be used to extract the result and discuss the validity of the proposed algorithm.

Keywords: phase locked loop, PLL, notch filter, fuzzy logic control, grid connected inverters

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9638 Electrochemical Inactivation of Toxic Cyanobacteria and Degradation of Cyanotoxins

Authors: Belal Bakheet, John Beardall, Xiwang Zhang, David McCarthy

Abstract:

The potential risks associated with toxic cyanobacteria have raised growing environmental and public health concerns leading to an increasing effort into researching ways to bring about their removal from water, together with destruction of their associated cyanotoxins. A variety of toxins are synthesized by cyanobacteria and include hepatotoxins, neurotoxins, and cytotoxins which can cause a range of symptoms in humans from skin irritation to serious liver and nerve damage. Therefore drinking water treatment processes should ensure the consumers’ safety by removing both cyanobacterial cells, and cyanotoxins from the water. Cyanobacterial cells and cyanotoxins presented challenges to the conventional water treatment systems; their accumulation within drinking water treatment plants has been reported leading to plants shut down. Thus, innovative and effective water purification systems to tackle cyanobacterial pollution are required. In recent years there has been increasing attention to the electrochemical oxidation process as a feasible alternative disinfection method which is able to generate in situ a variety of oxidants that would achieve synergistic effects in the water disinfection process and toxin degradation. By utilizing only electric current, the electrochemical process through electrolysis can produce reactive oxygen species such as hydroxyl radicals from the water, or other oxidants such as chlorine from chloride ions present in the water. From extensive physiological and morphological investigation of cyanobacterial cells during electrolysis, our results show that these oxidants have significant impact on cell inactivation, simultaneously with cyanotoxins removal without the need for chemicals addition. Our research aimed to optimize existing electrochemical oxidation systems and develop new systems to treat water containing toxic cyanobacteria and cyanotoxins. The research covers detailed mechanism study on oxidants production and cell inactivation in the treatment under environmental conditions. Overall, our study suggests that the electrochemical treatment process e is an effective method for removal of toxic cyanobacteria and cyanotoxins.

Keywords: toxic cyanobacteria, cyanotoxins, electrochemical process, oxidants

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9637 Effect of Selenium Source on Meat Quality of Bonsmara Bull Calves

Authors: J. van Soest, B. Bruneel, J. Smit, N. Williams, P. Swiegers

Abstract:

Selenium (Se) is an essential trace mineral involved in reducing oxidative stress, enhancing immune status, improving reproduction, and regulating growth. During finishing period, selenium supplementation can be applied to improve meat quality. Dietary selenium can be provided in inorganic or organic forms. Specifically, L-selenomethionine (organic selenium) allows for selenium storage in animal protein which supports the animal during periods of high oxidative stress. The objective of this study was to investigate the effects of synthetically produced, single amino acid, L-selenomethionine (Excential Selenium 4000, Orffa Additives BV) on production parameters, health status, and meat quality of Bonsmara bull calves. 24 calves, 7 months of age, completed a 60-day initial growing period at a commercial feedlot, after which they were transported to research station Rumen-8 (Bethlehem, South-Africa). After a ten-day adaptation period, the bulls were allocated to a control (n=12) or treatment (n=12) group. Each group was divided over 3 pens based on weight. Both groups received Total Mixed Ration supplemented with 5.25 mg Se/head per day. The control group was supplemented with sodium selenite as Se source, whilst the treatment group was supplemented with L-selenomethionine (Excential Selenium 4000, Orffa Additives BV). Animals were limited to 10 kg feed intake per head per day to ensure similar Se intake. Treatment period lasted 1.5 months. A beta-adrenergic agonist was included in the feed for the last 30 days. During the treatment period, average daily gain, average daily feed intake, and feed conversion ratio were recorded. Blood parameters were measured at day 1, day 25, and before slaughter (day 47). After slaughter, carcass weight, dressing percentage, grading, and meat quality (pH, tenderness, colour, odour, purge, proximate analyses, acid detergent fibre, and neutral detergent fibre) were determined. No differences between groups were found in performance. A higher number of animals with cortisol levels below detection limit (27.6 nmol/l) was recorded for the treatment group. Other blood parameters showed no differences. No differences were found regarding carcass weight and dressing percentage. Important parameters of meat quality were significantly improved in the treatment group: instrumental tenderness at 14 days ageing was 2.8 and 3.4 for treatment and control respectively (P=0.010), and a 0.5% decrease in purge (of fresh samples) was shown, 1.5% and 2.0% for treatment group and control respectively (p=0.029). Besides, pH was shown to be numerically reduced in the treatment group. In summary, supplementation with L-selenomethionine as selenium source improved meat quality compared to sodium selenite. Lower instrumental tenderness (Warner Bratzler Shear Force, WBSF) was recorded for the treatment group. This indicates less tough meat and highest consumer satisfaction. Regarding purge, control was just below 2.0%, an important threshold for consumer acceptation. Treatment group scored 0.5% lower for purge than control, indicating higher consumer satisfaction. The lower pH in the treatment group could be an indication of higher glycogen reserves in muscle which could contribute to a reduced risk of Dark Firm Dry carcasses. More animals showed cortisol levels below detection limit in the treatment group, indicating lower levels of stress when animals receive L-selenomethionine.

Keywords: calves, meat quality, nutrition, selenium

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9636 Comparative Study Between Oral and Intralesional Injection of Beta Blocker in the Treatment of Infantile Capillary Hemangioma

Authors: Nadeen Eltoukhy, Sahar S. Sheta, Walaa Elnaggar, Karim Bakr

Abstract:

Purpose: The aim of this study is to compare the clinical efficacy and side effects of oral versus intralesional propranolol treatment of infantile capillary hemangiomas in infants. Methods: The study enrolled 40 infants diagnosed with infantile capillary hemangiomas. Patients were divided into 2 groups: Group A (Non-invasive group) included 20 infants who received oral propranolol hydrochloride starting at a dose of 1 mg/kg/day BID, then increased to a max of 2 mg/kg/day BID gradually over 2 weeks for 3 months. Group B (Invasive group) included 20 infants who received intralesional propranolol injection at a dose of 1 mg/mL; the volume of the injected drug depended on the size of the lesion (0.2 mL injected per cm of lesion diameter), with a maximum volume of 1 mL for a lesion of 5 cm diameter under complete aseptic conditions in the operating theater. Results: At three months after initiating treatment, the circumferential size of the hemangioma showed a statistically significant decrease in both groups; in Group A from 3.66±2.89 cm to 1.56±1.26 cm with p-value <0.05 and in Group B from 2.99±2.73 cm to 1.32±1.18 cm with p-value <0.05. There is no statistically significant comparative difference between the two groups (p-value = 0.538 = insignificant). Regarding the complications of oral propranolol, one patient (5%) had bradycardia, and one patient (5%) had diarrhea. In the injection group, 20 patients (100%) had local edema, and one patient (5%) had a local infection. Conclusions: Both oral non-invasive and intralesional invasive propranolol are safely used to successfully treat and decrease the size of infantile hemangioma while showing no statistically comparative difference between both treatment techniques.

Keywords: hemangioma, oral beta blocker, intralesional beta blocker, infants

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9635 Increased Envy and Schadenfreude in Parents of Newborns

Authors: Ana-María Gómez-Carvajal, Hernando Santamaría-García, Mateo Bernal, Mario Valderrama, Daniela Lizarazo, Juliana Restrepo, María Fernanda Barreto, Angélica Parra, Paula Torres, Diana Matallana, Jaime Silva, José Santamaría-García, Sandra Baez

Abstract:

Higher levels of oxytocin are associated with better performance on social cognition tasks. However, higher levels of oxytocin have also been associated with increased levels of envy and schadenfreude. Considering these antecedents, this study aims to explore social emotions (i.e., envy and schadenfreude) and other components of social cognition (i.e. ToM and empathy), in women in the puerperal period and their respective partners, compared to a control group of men and women without children or partners. Control women should be in the luteal phase of the menstrual cycle or taking oral contraceptives as they allow oxytocin levels to remain stable. We selected this population since increased levels of oxytocin are present in both mothers and fathers of newborn babies. Both groups were matched by age, sex, and education level. Twenty-two parents of newborns (11 women, 11 men) and 15 controls (8 women, 7 men) performed an experimental task designed to trigger schadenfreude and envy. In this task, each participant was shown a real-life photograph and a description of two target characters matched in age and gender with the participant. The task comprised two experimental blocks. In the first block, participants read 15 sentences describing fortunate events involving either character. After reading each sentence, participants rated the event in terms of how much envy they felt for the character (1=no envy, 9=extreme envy). In the second block, participants read and reported the intensity of their pleasure (schadenfreude, 1=no pleasure, 9=extreme pleasure) in response to 15 unfortunate events happening to the characters. Five neutral events were included in each block. Moreover, participants were assessed with ToM and empathy tests. Potential confounding variables such as general cognitive functioning, stress levels, hours of sleep and depression symptoms were also measured. Results showed that parents of newborns showed increased levels of envy and schadenfreude. These effects are not explained by any confounding factor. Moreover, no significant differences were found in ToM or empathy tests. Our results offer unprecedented evidence of specific differences in envy and schadenfreude levels in parents of newborns. Our findings support previous studies showing a negative relationship between oxytocin levels and negative social emotions. Further studies should assess the direct relationship between oxytocin levels in parents of newborns and the performance in social emotions tasks.

Keywords: envy, empathy, oxytocin, schadenfreude, social emotions, theory of mind

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9634 Pattern of Deliberate Self-Harm Repetition in Rural Sri Lanka

Authors: P. H. G. J. Pushpakumara, Andrew Dawson

Abstract:

Introduction: Deliberate self harm (DSH) is a major public health problem globally. Suicide rates of Sri Lanka are being among the highest national rates in the world, since 1950. Previous DSH is the most important independent predictor of repetition. The estimated 1 year non-fatal repeat self-harm rate was 16.3%. Asian countries had considerably lower rate, 10.0%. Objectives: To calculate incidence of deliberate self-poisoning (DSP) and suicides, repetition rate of DSP in Kurunegala District (KD). To determine the pattern of repeated DSP in KD. Methods: Study had two components. In the first component, demographic and event related details of, DSP admission in 46 hospitals and suicides in 28 police stations of KD were collected for 3 years from January 2011. Demographic details of cohort of DSP patients admitted to above hospitals in 2011 were linked with hospital admissions and police records of next two years period from the index admission. Records were screened for links with high sensitivity using the computer then did manual matching which would have been much more specific. In the second component, randomly selected DSP patients (n=438), who admitted to main referral centre which receives 60% of DSP cases of the district, were interviewed to assess life-time repetition. Results: There were 16,993 DSP admissions and 1078 suicides for the three year period. Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011, 2012 and 2013. Average male to female ratio for suicide incidences was 5.5. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population. Male incidences were slightly greater than the female incidences, male: female ratio was 1.1:1. Highest age standardized male and female incidence was reported in 20-24 years age group, 769.6/100,000, and 15-19 years age group 1304.0/100,000. Male to female ratio of the incidence increased with the age. There were 318 (179 male and 139 female) patients attempted DSH within two years. Female repetitive patients were ounger compared to the males, p < 0.0001, median age: males 28 and females 19 years. 290 (91.2%) had only one repetitive attempt, 24 (7.5%) had two, 3 (0.9%) had three and one (0.3%) had four in that period. One year repetition rate was 5.6 and two year repetition rate was 7.9%. Average intervals between indexed events and first repetitive DSP events were 246.8 (SD:223.4) and 238.5 (SD:207.0) days among males and females. One fifth of first repetitive events occurred within first two weeks in both males and females. Around 50% of males and females had the second event within 28 weeks. Within the first year of the indexed event, around 70% had the second event. First repetitive event was fatal for 28 (8.8%) individuals. Ages of those who died, mean 49.7 years (SD:15.3), were significantly higher compared to those who had non-fatal outcome, p<0.0001. 9.5% had life time history of DSH attempts. Conclusions: Both, DSP and suicide incidences were very high in KD. However, repetition rates were lesser compared regional values. Prevention of repetition alone may not produce significant impact on prevention of DSH.

Keywords: deliberate self-harm, incidence, repetition, Sri Lanka, suicide

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9633 Differences in Patient Satisfaction Observed between Female Japanese Breast Cancer Patients Who Receive Breast-Conserving Surgery or Total Mastectomy

Authors: Keiko Yamauchi, Motoyuki Nakao, Yoko Ishihara

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The increase in the number of women with breast cancer in Japan has required hospitals to provide a higher quality of medicine so that patients are satisfied with the treatment they receive. However, patients’ satisfaction following breast cancer treatment has not been sufficiently studied. Hence, we investigated the factors influencing patient satisfaction following breast cancer treatment among Japanese women. These women underwent either breast-conserving surgery (BCS) (n = 380) or total mastectomy (TM) (n = 247). In March 2016, we conducted a cross-sectional internet survey of Japanese women with breast cancer in Japan. We assessed the following factors: socioeconomic status, cancer-related information, the role of medical decision-making, the degree of satisfaction regarding the treatments received, and the regret arising from the medical decision-making processes. We performed logistic regression analyses with the following dependent variables: extreme satisfaction with the treatments received, and regret regarding the medical decision-making process. For both types of surgery, the odds ratio (OR) of being extremely satisfied with the cancer treatment was significantly higher among patients who did not have any regrets compared to patients who had. Also, the OR tended to be higher among patients who chose to play a wanted role in the medical decision-making process, compared with patients who did not. In the BCS group, the OR of being extremely satisfied with the treatment was higher if, at diagnosis, the patient’s youngest child was older than 19 years, compared with patients with no children. The OR was also higher if patient considered the stage and characteristics of their cancer significant. The OR of being extremely satisfied with the treatments was lower among patients who were not employed on full-time basis, and among patients who considered the second medical opinions and medical expenses to be significant. These associations were not observed in the TM group. The OR of having regrets regarding the medical decision-making process was higher among patients who chose to play a role in the decision-making process as they preferred, and was also higher in patients who were employed on either a part-time or contractual basis. For both types of surgery, the OR was higher among patients who considered a second medical opinion to be significant. Regardless of surgical type, regret regarding the medical decision-making process decreases treatment satisfaction. Patients who received breast-conserving surgery were more likely to have regrets concerning the medical decision-making process if they could not play a role in the process as they preferred. In addition, factors associated with the satisfaction with treatment in BCS group but not TM group included the second medical opinion, medical expenses, employment status, and age of the youngest child at diagnosis.

Keywords: medical decision making, breast-conserving surgery, total mastectomy, Japanese

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9632 Investigation of Alfa Fibers Reinforced Epoxy-Amine Composites Properties

Authors: Amar Boukerrou, Ouerdia Belhadj, Dalila Hammiche, Jean Francois Gerard, Jannick Rumeau

Abstract:

The main goal of this study is the investigation of alfa fiber content, treated with alkali treatment, on the thermal and mechanical properties of epoxy-amine matrix-based composites. The fibers were treated with 5% of sodium hydroxide solution and varied between 10% to 30% weight fractions. The tensile, flexural, and hardness tests are carried out to investigate the mechanical properties of composites. The results show those composites’ mechanical properties are higher than the neat epoxy-amine. It was noticed that the alkali treatment is more effective in the case of the tensile and flexural modulus than the tensile and flexural strength. The decline of both the tensile and flexural behavior of all composites with the increasing of the filler content was due probably to the random dispersion of the fibers in the epoxy resin The Fourier transform infrared (FTIR) was employed to analyze the chemical structure of epoxy resin before and after curing with amine hardener. FTIR and DSC analysis confirmed that epoxy resin was completely cured with amine hardener at room temperature. SEM analysis has highlighted the microstructure of epoxy matrix and its composites.

Keywords: alfa fiber, epoxy resin, alkali treatment, mechanical properties

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9631 Surveying Energy Dissipation in Stepped Spillway Using Finite Element Modeling

Authors: Mehdi Fuladipanah

Abstract:

Stepped spillway includes several steps from the crest to the toe. The steps of stepped spillway could cause to decrease the energy with making energy distribution in the longitude mode and also to reduce the outcome speed. The aim of this study was to stimulate the stepped spillway combined with stilling basin-step using Fluent model and the turbulent superficial flow using RNG, K-ε. The free surface of the flow was monitored by VOF model. The velocity and the depth of the flow were measured by tail water depth by the numerical model and then the dissipated energy was calculated along the spillway. The results indicated that the stilling basin-step complex may cause energy dissipation increment in the stepped spillway. Also, the numerical model was suggested as an effective method to predict the circular and complicated flows in the stepped spillways.

Keywords: stepped spillway, fluent model, VOF model, K-ε model, energy distribution

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9630 Obtaining High Purity Hydroxyapatite from Bovine Bone: Effect of Chemical and Thermal Treatments

Authors: Hernandez Pardo Diego F., Guiza Arguello Viviana R., Coy Echeverria Ana, Viejo Abrante Fernando

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The biological hydroxyapatite obtained from bovine bone arouses great interest in its application as a material for bone regeneration due to its better bioactive behavior in comparison with synthetic hydroxyapatite. For this reason, the objective of the present investigation was to determine the effect of chemical and thermal treatments in obtaining biological bovine hydroxyapatite of high purity and crystallinity. Two different chemical reagents were evaluated (NaOH and HCl) with the aim to remove the organic matrix of the bovine cortical bone. On the other hand, for analyzing the effect of thermal treatment temperature was ranged between 500 and 1000°C for a holding time of 4 hours. To accomplish the above, the materials before and after the chemical and thermal treatments were characterized by elemental compositional analysis (CHN), infrared spectroscopy by Fourier transform (FTIR), RAMAN spectroscopy, scanning electron microscopy (SEM), thermogravimetric analysis (TGA) and X-ray diffraction (XRD) and energy dispersion X-ray spectroscopy (EDS). The results allowed to establish that NaOH is more effective in the removal of the organic matrix of the bone when compared to HCl, whereas a thermal treatment at 700ºC for 4 hours was enough to obtain biological hydroxyapatite of high purity and crystallinity.

Keywords: bovine bone, hydroxyapatite, biomaterials, thermal treatment

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9629 Moderate Electric Field Influence on Carotenoids Extraction Time from Heterochlorella luteoviridis

Authors: Débora P. Jaeschke, Eduardo A. Merlo, Rosane Rech, Giovana D. Mercali, Ligia D. F. Marczak

Abstract:

Carotenoids are high value added pigments that can be alternatively extracted from some microalgae species. However, the application of carotenoids synthetized by microalgae is still limited due to the utilization of organic toxic solvents. In this context, studies involving alternative extraction methods have been conducted with more sustainable solvents to replace and reduce the solvent volume and the extraction time. The aim of the present work was to evaluate the extraction time of carotenoids from the microalgae Heterochlorella luteoviridis using moderate electric field (MEF) as a pre-treatment to the extraction. The extraction methodology consisted of a pre-treatment in the presence of MEF (180 V) and ethanol (25 %, v/v) for 10 min, followed by a diffusive step performed for 50 min using a higher ethanol concentration (75 %, v/v). The extraction experiments were conducted at 30 °C and, to keep the temperature at this value, it was used an extraction cell with a water jacket that was connected to a water bath. Also, to enable the evaluation of MEF effect on the extraction, control experiments were performed using the same cell and conditions without voltage application. During the extraction experiments, samples were withdrawn at 1, 5 and 10 min of the pre-treatment and at 1, 5, 30, 40 and 50 min of the diffusive step. Samples were, then, centrifuged and carotenoids analyses were performed in the supernatant. Furthermore, an exhaustive extraction with ethyl acetate and methanol was performed, and the carotenoids content found for this analyses was considered as the total carotenoids content of the microalgae. The results showed that the application of MEF as a pre-treatment to the extraction influenced the extraction yield and the extraction time during the diffusive step; after the MEF pre-treatment and 50 min of the diffusive step, it was possible to extract up to 60 % of the total carotenoids content. Also, results found for carotenoids concentration of the extracts withdrawn at 5 and 30 min of the diffusive step did not presented statistical difference, meaning that carotenoids diffusion occurs mainly in the very beginning of the extraction. On the other hand, the results for control experiments showed that carotenoids diffusion occurs mostly during 30 min of the diffusive step, which evidenced MEF effect on the extraction time. Moreover, carotenoids concentration on samples withdrawn during the pre-treatment (1, 5 and 10 min) were below the quantification limit of the analyses, indicating that the extraction occurred in the diffusive step, when ethanol (75 %, v/v) was added to the medium. It is possible that MEF promoted cell membrane permeabilization and, when ethanol (75 %) was added, carotenoids interacted with the solvent and the diffusion occurred easily. Based on the results, it is possible to infer that MEF promoted the decrease of carotenoids extraction time due to the increasing of the permeability of the cell membrane which facilitates the diffusion from the cell to the medium.

Keywords: moderate electric field (MEF), pigments, microalgae, ethanol

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9628 Cognitive Effects of Repetitive Transcranial Magnetic Stimulation in Patients with Parkinson's Disease

Authors: Ana Munguia, Gerardo Ortiz, Guadalupe Gonzalez, Fiacro Jimenez

Abstract:

Parkinson's disease (PD) is a neurodegenerative disorder that causes motor and cognitive symptoms. The first-choice treatment for these patients is pharmacological, but this generates several side effects. Because of that new treatments were introduced such as Repetitive Transcranial Magnetic Stimulation (rTMS) in order to improve the life quality of the patients. Several studies suggest significant changes in motor symptoms. However, there is a great diversity in the number of pulses, amplitude, frequency and stimulation targets, which results in inconsistent data. In addition, these studies do not have an analysis of the neuropsychological effects of the treatment. The main purpose of this study is to evaluate the impact of rTMS on the cognitive performance of 6 patients with H&Y III and IV (45-65 years, 3 men and 3 women). An initial neuropsychological and neurological evaluation was performed. Patients were randomized into two groups; in the first phase one received rTMS in the supplementary motor area, the other group in the dorsolateral prefrontal cortex contralateral to the most affected hemibody. In the second phase, each group received the stimulation in the area that he had not been stimulated previously. Reassessments were carried out at the beginning, at the end of each phase and a follow-up was carried out 6 months after the conclusion of the stimulation. In these preliminary results, it is reported that there's no statistically significant difference before and after receiving rTMS in the neuropsychological test scores of the patients, which suggests that the cognitive performance of patients is not detrimental. There are even tendencies towards an improvement in executive functioning after the treatment. What added to motor improvement, showed positive effects in the activities of the patients' daily life. In a later and more detailed analysis, will be evaluated the effects in each of the patients separately in relation to the functionality of the patients in their daily lives.

Keywords: Parkinson's disease, rTMS, cognitive, treatment

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9627 The Influence of Aerobic Physical Exercise with Different Frequency to Concentration of Vascular Endothelial Growth Factor in Brain Tissue of Wistar Rat

Authors: Rostika Flora, Muhammad Zulkarnain, Syokumawena

Abstract:

Background: Aerobic physical exercises are recommended to keep body fit and healthy although physical exercises themselves can increase body metabolism and oxygen and can lead into tissue hypoxia. Oxygen pressure can serve as Vascular Endhothelial Growth Factor (VEGF) regulator. Hypoxia increases gene expression of VEGF through ascendant regulation of HIF-1. VEGF is involved in regulating angiogenesis process. Aerobic physical exercises can increase the concentration of VEGF in brain and enables angiogenesis process. We have investigated the influence of aerobic physical exercise to the VGEF concentration of wistar rat’s brain. Methods: This was experimental study using post test only control group design. Independent t-test was used as statistical test. The samples were twenty four wistar rat (Rattus Norvegicus) which were divided into four groups: group P1 (control group), group P2 (treatment group with once-a-week exercise), group P3 (treatment group with three time-a-week exercise), and group P4 (treatment group with seven time-a-week exercise). Group P2, P3, and P4 were treated with treadmil with speed of 20 m/minute for 30 minutes. The concentration of VEGF was determined by ELISA. Results: There was a significant increase of VEGF in treatment group compared with control one (<0.05). The maximum increase was found in group P2 (129.02±64.49) and the minimum increase was in group P4 (96.98±11.20). Conclusion: The frequency of aerobic physical exercises influenced the concentration of Vascular Endhothelial Growth Factor (VEGF) of brain tissue of Rattus Norvegicus.

Keywords: brain tissue, hypoxia, physical exercises, vascular endhothelial growth factor

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9626 A Culture-Contrastive Analysis Of The Communication Between Discourse Participants In European Editorials

Authors: Melanie Kerschner

Abstract:

Language is our main means of social interaction. News journalism, especially opinion discourse, holds a powerful position in this context. Editorials can be regarded as encounters of different, partially contradictory relationships between discourse participants constructed through the editorial voice. Their primary goal is to shape public opinion by commenting on events already addressed by other journalistic genres in the given newspaper. In doing so, the author tries to establish a consensus over the negotiated matter (i.e. the news event) with the reader. At the same time, he/she claims authority over the “correct” description and evaluation of an event. Yet, how can the relationship and the interaction between the discourse participants, i.e. the journalist, the reader and the news actors represented in the editorial, be best visualized and studied from a cross-cultural perspective? The present research project attempts to give insights into the role of (media) culture in British, Italian and German editorials. For this purpose the presenter will propose a basic framework: the so called “pyramid of discourse participants”, comprising the author, the reader, two types of news actors and the semantic macro-structure (as meta-level of analysis). Based on this framework, the following questions will be addressed: • Which strategies does the author employ to persuade the reader and to prompt him to give his opinion (in the comment section)? • In which ways (and with which linguistic tools) is editorial opinion expressed? • Does the author use adjectives, adverbials and modal verbs to evaluate news actors, their actions and the current state of affairs or does he/she prefer nominal labels? • Which influence do language choice and the related media culture have on the representation of news events in editorials? • In how far does the social context of a given media culture influence the amount of criticism and the way it is mediated so that it is still culturally-acceptable? The following culture-contrastive study shall examine 45 editorials (i.e. 15 per media culture) from six national quality papers that are similar in distribution, importance and the kind of envisaged readership to make valuable conclusions about culturally-motivated similarities and differences in the coverage and assessment of news events. The thematic orientation of the editorials will be the NSA scandal and the reactions of various countries, as this topic was and still is relevant to each of the three media cultures. Starting out from the “pyramid of discourse participants” as underlying framework, eight different criteria will be assigned to the individual discourse participants in the micro-analysis of the editorials. For the purpose of illustration, a single criterion, referring to the salience of authorial opinion, will be selected to demonstrate how the pyramid of discourse participants can be applied as a basis for empirical analysis. Extracts from the corpus shall furthermore enhance the understanding.

Keywords: Micro-analysis of editorials, culture-contrastive research, media culture, interaction between discourse participants, evaluation

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9625 Computational Approach to the Interaction of Neurotoxins and Kv1.3 Channel

Authors: Janneth González, George Barreto, Ludis Morales, Angélica Sabogal

Abstract:

Sea anemone neurotoxins are peptides that interact with Na+ and K+ channels, resulting in specific alterations on their functions. Some of these neurotoxins (1ROO, 1BGK, 2K9E, 1BEI) are important for the treatment of nearly eighty autoimmune disorders due to their specificity for Kv1.3 channel. The aim of this study was to identify the common residues among these neurotoxins by computational methods, and establish whether there is a pattern useful for the future generation of a treatment for autoimmune diseases. Our results showed eight new key common residues between the studied neurotoxins interacting with a histidine ring and the selectivity filter of the receptor, thus showing a possible pattern of interaction. This knowledge may serve as an input for the design of more promising drugs for autoimmune treatments.

Keywords: neurotoxins, potassium channel, Kv1.3, computational methods, autoimmune diseases

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9624 Synthesis of New Anti-Tuberculosis Drugs

Authors: M. S. Deshpande, Snehal D. Bomble

Abstract:

Tuberculosis (TB) is a deadly contagious disease that is caused by a bacterium called Mycobacterium tuberculosis. More than sixty years ago, the introduction of the first anti-TB drugs for the treatment of TB (streptomycin (STR), p-aminosalcylic acid (PAS), isoniazid (INH), and then later ethambutol (EMB) and rifampicin (RIF)) gave optimism to the medical community, and it was believed that the disease would be completely eradicated soon. Worldwide, the number of TB cases has continued to increase, but the incidence rate has decreased since 2003. Recently, highly drug-resistant forms of TB have emerged worldwide. The prolonged use of classical drugs developed a growing resistance and these drugs have gradually become less effective and incapable to meet the challenges, especially those of multi drug resistant (MDR)-TB, extensively drug resistant (XDR)-TB, and HIV-TB co-infections. There is an unmet medical need to discover newer synthetic molecules and new generation of potent drugs for the treatment of tuberculosis which will shorten the time of treatment, be potent and safe while effective facing resistant strains and non-replicative, latent forms, reduce adverse side effect and not interfere in the antiretroviral therapy. This paper attempts to bring out the review of anti-TB drugs, and presents a novel method of synthesizing new anti-tuberculosis drugs and potential compounds to overcome the bacterial resistance and combat the re-emergence of tuberculosis.

Keywords: tuberculosis, mycobacterium, multi-drug resistant (MDR)-TB, extensively drug resistant (XDR)-TB

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9623 Ultrasonic Assisted Growth of ZnO Nanorods at Low Temperature

Authors: Khairul Anuar, Wai Yee Lee, Daniel C. S. Bien, Hing Wah Lee, Ishak Azid

Abstract:

This paper investigates the effect of ultrasonic treatment on ZnO nutrient solution prior to the growth of ZnO nanorods, where the seed layer is annealed at 50 and 100°C. The results show that the ZnO nanorods are successfully grown on the sample annealed at 50°C in the sonicated ZnO nutrient solution with a length and a diameter of approximately 8.025 µm and 92 nm, respectively. However, no ZnO nanorods structures are observed for the sample annealed at 50°C and grown in unsonicated ZnO nutrient solution. Meanwhile, the ZnO nanorods for the sample annealed at 100°C are successfully grown in both sonicated and unsonicated ZnO nutrient solutions. The length and diameter of the nanorods for the sample grown in the sonicated solution are 8.681 µm and 1.033 nm, whereas those for the sample grown in the unsonicated solution are 7.613 µm and 1.040 nm. This result shows that with ultrasonic treatment, the length of the ZnO nanorods increases by 14%, whereas their diameter is reduced by 0.7%, resulting in an increase of aspect ratio from 7:1 to 8:1. Electroconductivity and pH sensors are used to measure the conductivity and acidity level of the sonicated and unsonicated solutions, respectively. The result shows that the conductivity increases from 87 mS/cm to 10.4 mS/cm, whereas the solution pH decreases from 6.52 to 6.13 for the sonicated and unsonicated solutions, respectively. The increase in solution conductivity and acidity level elucidates the higher amount of zinc nutrient in the sonicated solution than in the unsonicated solution.

Keywords: ultrasonic treatment, low annealing temperature, ZnO nanostructure, nanorods

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9622 Surfactant Free Synthesis of Magnetite/Hydroxyapatite Composites for Hyperthermia Treatment

Authors: M. Sneha, N. Meenakshi Sundaram

Abstract:

In recent times, magnetic hyperthermia is used for cancer treatment as a tool for active targeting of delivering drugs to the targeted site. It has a potential advantage over other heat treatment because there is no systemic buildup in organs and large doses are possible. The aim of this study is to develop a suitable magnetic biomaterial that can destroy the cancer cells as well as induce bone regeneration. In this work, the composite material was synthesized in two-steps. First, porous iron oxide nano needles were synthesized by hydrothermal process. Second, the hydroxyapatite, were synthesized from natural calcium (i.e., egg shell) and inorganic phosphorous source using wet chemical method. The crystalline nature is confirmed by powder X-ray diffraction analysis (XRD). Thermal analysis and the surface area of the material is studied by Thermo Gravimetric Analysis (TGA), Brunauer-Emmett and Teller (BET) technique. Scanning electron microscope (SEM) images show that the particles have nanoneedle-like morphology. The magnetic property is studied by vibrating sample magnetometer (VSM) technique which confirms the superparamagnetic behavior. This paper presents a simple and easy method for synthesis of magnetite/hydroxyapatite composites materials.

Keywords: iron oxide nano needles, hydroxyapatite, superparamagnetic, hyperthermia

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9621 An Institutional Analysis of IFRS Adoption in Poor Jurisdictions

Authors: Catalina Florentina Pricope

Abstract:

The last two decades witnessed a movement towards harmonization of international financial reporting standards (IFRS) throughout the global economy. This investigation seeks to identify the factors that could explain the adoption of IFRS by poor jurisdictions. While there has been a considerable amount, of literature published on the effects and key drivers of IFRS adoption in both developed and developing countries, little attention has been paid to jurisdictions with less developed capital markets and low-income levels exclusively. Drawing upon the Institutional Isomorphism theory and analyzing a sample of 45 poor jurisdictions between 2008 and 2013, the study empirically shows that poor jurisdictions are driven by legitimacy concerns rather than by economic reasoning to adopt an international accounting perspective. This in turn has implications for the IASB, as it should seek to influence institutional pressures within a particular jurisdiction in order to promote IFRS adoption.

Keywords: IFRS adoption, isomorphism, poor jurisdictions, accounting harmonization

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9620 OnabotulinumtoxinA Injection for Glabellar Frown Lines as an Adjunctive Treatment for Depression

Authors: I. Witbooi, J. De Smidt, A. Oelofse

Abstract:

Negative emotions that are common in depression are coupled with the activation of the corrugator supercilli and procerus muscles in the glabellar region of the face. This research investigated the impact of OnabotulinumtoxinA (BOTOX) in the improvement of emotional states in depressed subjects by relaxing the mentioned muscles. The aim of the study was to investigate the effectiveness of BOTOX treatment for glabellar frown lines as an adjunctive therapy for Major Depressive Disorder (MDD) and to improve the quality of life and self-esteem of the subjects. It is hypothesized that BOTOX treatment for glabellar frown lines reduces depressive symptoms significantly and therefore augment conventional antidepressant medication. Forty-five (45) subjects diagnosed with MDD were assigned to a treatment (n = 15), placebo (n = 15), and control (n = 15) group. The treatment group received BOTOX injection, while the placebo group received saline injection into the Procerus and Corrugator supercilli muscles with follow-up visits every 3 weeks (weeks 3, 6 and 12 respectively). The control group received neither BOTOX nor saline injections and were only interviewed again on the 12th week. To evaluate the effect of BOTOX treatment in the glabellar region on depressive symptoms, the Montgomery-Asberg Depression Rating (MADRS) scale and the Beck Depression Inventory (BDI) were used. The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) and Rosenberg Self-Esteem Scale (RSES) were used in the assessment of self-esteem and quality of life. Participants were followed up for a 12 week period. The expected primary outcome measure is the response to treatment, and it is defined as a ≥ 50% reduction in MADRS score from baseline. Other outcome measures include a clinically significant decrease in BDI scores and the increase in quality of life and self-esteem respectively. Initial results show a clear trend towards such differences. Results showed trends towards expected differences. Patients in the Botox group had a mean MADRS score of 14.0 at 3 weeks compared to 20.3 of the placebo group. This trend was still visible at 6 weeks with the Botox and placebo group scoring an average of 10 vs. 18 respectively. The mean difference in MDRS scores from baseline to 3 weeks were 9.3 and 2.0 for the Botox and placebo group respectively. Similarly, the BDI scores were lower in the Botox group (17.25) compared to the placebo group (19.43). The two self-esteem questionnaires showed expected results at this stage with the RSES 19.1 in the Botox group compared to 18.6 in the placebo group. Similarly, the Botox patients had a higher score for the Q-LES-Q-SF of 49.2 compared to 46.1 for the placebo group. Conclusions: Initial results clearly demonstrated that the use of Botox had positive effects on both scores of depressions and that of self-esteem when compared to a placebo group.

Keywords: adjunctive therapy, depression, glabellar area, OnabotulinumtoxinA

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9619 Navigating Rapids And Collecting Medical Insights: A Data Collection Of Athletes Presenting To The Medical Team At The International Canoe Federation Canoe Slalom World Championships 2023

Authors: Grace Scaplehorn, Muhammad Adeel Akhtar, Jane Gibson

Abstract:

Background: Canoe Slalom entails the skilful navigation of a carbon composite canoe or kayak through a series of 18-25 hanging gates, strategically positioned along the course, either upstream or downstream, amidst currents of whitewater rapids in natural and man-made river settings. Athletes compete individually in timed trials, competing for the fastest course time, typically around 80 to 120 seconds. In the new discipline of Kayak Cross, descents of the course are initiated by groups of four athletes freefalling simultaneously from a starting platform situated 3m above the river. Kayak Cross athletes, in contrast to Canoe Slalom, can make physical contact with suspended gates without incurring time penalties and are required to perform a kayak roll half way down the course. The Canoe Slalom World Championships were held at Lee Valley Whitewater Centre, London, from 19th to 24th September 2023. The event comprised 299 international athletes competing for 10 World Championship titles in Canoe/Kayak Slalom events (Olympic Debut Munich 1972), and the new Kayak Cross discipline (Olympic Debut Paris 2024). The inaugural appearance of Kayak Cross at the World Championships occurred in 2017, in Pau, France. There is limited literature surrounding Kayak Cross and the incidence of athlete injuries compared to traditional Canoe Slalom, hence it was felt important to undertake this review to address the perception that the event is dangerous. Aim: The study aimed to quantify and collate data collected from athletes presenting to the event medical centre. Methods: Athletes’ details were collected at initial assessments from the start of the practice period (16th–18th September) and throughout the event. Demographics such as age, sex and nationality were recorded along with presenting complaints, treatment, medication administered and outcome. Specifically, injuries were then sub-classified into body regions. The data does not include athletes who sought medical attention from their own governing body’s medical team. Results: During the 8-day period, there were 11 individual presentations to the medical centre, 3.7% of the athlete population (n=299). The mean age was 23.9 years (n=7), 6 were male (n=10). The most common presentation was minor injury (n=9), with 6 being musculoskeletal and 3 comprising skin damage, followed by insect sting/allergy (n=1) and pain relief requests (n=1). Five presentations were event-related, all being musculoskeletal injuries; 2 shoulder/arm, 1 head/neck, 1 hand/wrist and 1 other (data was not recorded). Of these injuries, the only intervention was 2 cases of 400mg Ibuprofen, which was given to both shoulder/arm injuries. Four of the 11 presentations were pre-existing injuries, which had been exacerbated due to increased intensity of practice. Two patients were advised to return for review, with 100% compliance. There were no unplanned re-presentations, and no emergency transfers to secondary care. Both the Kayak Cross and Canoe Slalom competitions resulted in 1 new event-related athlete presentation each. Conclusion: The event resulted in a negligible incidence of presentations at the medical centre, for both Kayak Cross and Canoe Slalom. This data holds significance in informing risk assessments and medical protocols necessary for the organisation of canoe slalom events.

Keywords: canoe slalom, kayak cross, athlete injuries, event injuries

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9618 Creating a Digital Map to Monitor the Care of People Living with HIV/Aids in Porto Alegre, Brazil: An Experience Report

Authors: Tiago Sigal Linhares, Ana Amélia Nascimento da Silva Bones, Juliana Miola, McArthur Alexander Barrow, Airton Tetelbom Stein

Abstract:

Introduction: As a result of increased globalization and changing migration trends, it is expected that a significant portion of People Living with HIV/AIDS (PLWHA) will change their place of residence over time. In order to provide better health care, monitor the HIV epidemic and plan urban public health care and policies, there is a growing need to formulate a strategy for monitoring PLWHA care, location and migration patterns. The Porto Alegre District is characterized by a high prevalence of PLWHA and is considered one of the epicenters of HIV epidemic in Latin America. Objectives: The aim of this study is to create a digital and easily editable map in order to create a visual representation of the location of PLWHA and to monitor their migration within the city and the country in an effort to promote longitudinal care. Methods: This Experience Report used Google Maps Map Creator to generate an active digital map showing the location and changes in residence of 165 PLWHA who received care at two Primary Health Care (PHC) clinics, which attended an estimated population of five thousand patients, in downtown Porto Alegre over the last four years. Their current addresses were discovered in the unified Brazilian health care system digital records (e-SUS) and updated on the map. Results: A digital map with PLWHA current residence location was created. It was possible to demonstrate visually areas with a large concentration of PLWHA and the migration of the population within the city as wells as other cities, regions and states. Conclusions: An easily reproducible and free map could aid in PLWHA monitoring, urban public health planning, target interventions and situational diagnosis. Moreover, a visual representation of PLWHA location and migration could help bring more attention and investments to areas with geographic inequities or higher prevalence of PLWHA. It also enables notification of local PHC units of monitored patients inside their area, which are in clinical risk or with treatment abandonment through active case findings, improving the care of PLWHA.

Keywords: health care, medical public health, theoretical and conceptual innovations, urban public health

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