Search results for: accessibility score
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2751

Search results for: accessibility score

561 The Effects of Nanoemulsions Based on Commercial Oils for the Quality of Vacuum-Packed Sea Bass at 2±2°C

Authors: Mustafa Durmuş, Yesim Ozogul, Esra Balıkcı, Saadet Gokdoğan, Fatih Ozogul, Ali Rıza Köşker, İlknur Yuvka

Abstract:

Food scientists and researchers have paid attention to develop new ways for improving the nutritional value of foods. The application of nanotechnology techniques to the food industry may allow the modification of food texture, taste, sensory attributes, coloring strength, processability, and stability during shelf life of products. In this research, the effects of nanoemulsions based on commercial oils for vacuum-packed sea bass fillets stored at 2±2°C were investigated in terms of the sensory, chemical (total volatile basic nitrogen (TVB-N), thiobarbituric acid (TBA), peroxide value (PV) and free fatty acids (FFA), pH, water holding capacity (WHC)) and microbiological qualities (total anaerobic bacteria and total lactic acid bacteria). Physical properties of emulsions (viscosity, the particle size of droplet, thermodynamic stability, refractive index, and surface tension) were determined. Nanoemulsion preparation method was based on high energy principle, with ultrasonic homojenizator. Sensory analyses of raw fish showed that the demerit points of the control group were found higher than those of treated groups. The sensory score (odour, taste and texture) of the cooked fillets decreased with storage time, especially in the control. Results obtained from chemical and microbiological analyses also showed that nanoemulsions significantly (p<0.05) decreased the values of biochemical parameters and growth of bacteria during storage period, thus improving quality of vacuum-packed sea bass.

Keywords: quality parameters, nanoemulsion, sea bass, shelf life, vacuum packing

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560 Attitudes and Knowledge of Dental Patients Towards Infection Control Measures in Kuwait University Dental Center

Authors: Fatima Taqi, Abrar Alanzi

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Objectives: The objective of this study is to determine and assess the level of knowledge and attitudes of dental patients attending Kuwait University Dental Clinics (KUDC) regarding the infection control protocols practiced in the clinic. The results would highlight the importance of conducting awareness campaigns in the community to promote good oral healthcare in Kuwait. Materials and Methods: A cross-sectional descriptive survey was carried out among dental patients attending KUDC. A structured questionnaire, in both Arabic and English languages, was used for data collection about the socio-demographic characteristics, knowledge about the dental cross-infection, and attitudes and self-reported practices regarding infection transmission and control in dentistry. Results: A response rate of 80% (202/250) was reported. 47% of respondents had poor knowledge about dental infection transmission, and only 19.8% had satisfactory knowledge. Female participants obtained a higher satisfactory score (14.3%) compared to males (5.5%). Patients with a university degree or higher education had a better level of knowledge compared to patients with a lower educational level (p < 0.05). The majority of participants agreed that the dentist should wear gloves (95.5%), masks (89.6%), safety glasses (70.3%), and gowns (84.7%). Many patients believed that the protection measures are mainly to stop the infection transmission from patient to patient via the dentist. Half of the participants would ask if the instruments are sterilized and might accept treatment from non-vaccinated dentists. Conclusions: Many dental patients attending KUDC have obtained poor knowledge scores regarding infection transmission in the dental clinic. The educational level was significantly associated with their level of knowledge. An overall positive attitude was reported regarding the infection control protocols practiced in the dental clinic. Raising awareness among dental patients about dental infection transmission and protective measures is of utmost importance.

Keywords: dental infection, knowledge, dental patients, infection control

Procedia PDF Downloads 138
559 Development and Validation of Work Movement Task Analysis: Part 1

Authors: Mohd Zubairy Bin Shamsudin

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Work-related Musculoskeletal Disorder (WMSDs) is one of the occupational health problems encountered by workers over the world. In Malaysia, there is increasing in trend over the years, particularly in the manufacturing sectors. Current method to observe workplace WMSDs is self-report questionnaire, observation and direct measurement. Observational method is most frequently used by the researcher and practitioner because of the simplified, quick and versatile when it applies to the worksite. However, there are some limitations identified e.g. some approach does not cover a wide spectrum of biomechanics activity and not sufficiently sensitive to assess the actual risks. This paper elucidates the development of Work Movement Task Analysis (WMTA), which is an observational tool for industrial practitioners’ especially untrained personnel to assess WMSDs risk factors and provide a basis for suitable intervention. First stage of the development protocol involved literature reviews, practitioner survey, tool validation and reliability. A total of six themes/comments were received in face validity stage. New revision of WMTA consisted of four sections of postural (neck, back, shoulder, arms, and legs) and associated risk factors; movement, load, coupling and basic environmental factors (lighting, noise, odorless, heat and slippery floor). For inter-rater reliability study shows substantial agreement among rater with K = 0.70. Meanwhile, WMTA validation shows significant association between WMTA score and self-reported pain or discomfort for the back, shoulder&arms and knee&legs with p<0.05. This tool is expected to provide new workplace ergonomic observational tool to assess WMSDs for the next stage of the case study.

Keywords: assessment, biomechanics, musculoskeletal disorders, observational tools

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558 Gc-ms Data Integrated Chemometrics for the Authentication of Vegetable Oil Brands in Minna, Niger State, Nigeria

Authors: Rasaq Bolakale Salau, Maimuna Muhammad Abubakar, Jonathan Yisa, Muhammad Tauheed Bisiriyu, Jimoh Oladejo Tijani, Alexander Ifeanyi Ajai

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Vegetables oils are widely consumed in Nigeria. This has led to competitive manufacture of various oil brands. This leads increasing tendencies for fraud, labelling misinformation and other unwholesome practices. A total of thirty samples including raw and corresponding branded samples of vegetable oils were collected. The Oils were extracted from raw ground nut, soya bean and oil palm fruits. The GC-MS data was subjected to chemometric techniques of PCA and HCA. The SOLO 8.7 version of the standalone chemometrics software developed by Eigenvector research incorporated and powered by PLS Toolbox was used. The GCMS fingerprint gave basis for discrimination as it reveals four predominant but unevenly distributed fatty acids: Hexadecanoic acid methyl ester (10.27- 45.21% PA), 9,12-octadecadienoic acid methyl ester (10.9 - 45.94% PA), 9-octadecenoic acid methyl ester (18.75 - 45.65%PA), and Eicosanoic acid methyl ester (1.19% - 6.29%PA). In PCA modelling, two PCs are retained at cumulative variance captured at 73.15%. The score plots indicated that palm oil brands are most aligned with raw palm oil. PCA loading plot reveals the signature retention times between 4.0 and 6.0 needed for quality assurance and authentication of the oils samples. They are of aromatic hydrocarbons, alcohols and aldehydes functional groups. HCA dendrogram which was modeled using Euclidian distance through Wards method, indicated co-equivalent samples. HCA revealed the pair of raw palm oil brand and palm oil brand in the closest neighbourhood (± 1.62 % A difference) based on variance weighted distance. It showed Palm olein brand to be most authentic. In conclusion, based on the GCMS data with chemometrics, the authenticity of the branded samples is ranked as: Palm oil > Soya oil > groundnut oil.

Keywords: vegetable oil, authenticity, chemometrics, PCA, HCA, GC-MS

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557 Forest Degradation and Implications for Rural Livelihood in Kaimur Reserve Forest of Bihar, India

Authors: Shashi Bhushan, Sucharita Sen

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In India, forest and people are inextricably linked since millions of people live adjacent to or within protected areas and harvest forest products. Indian forest has their own legacy to sustain by its own climatic nature with several social, economic and cultural activities. People surrounding forest areas are not only dependent on this resource for their livelihoods but also for the other source, like religious ceremonies, social customs and herbal medicines, which are determined by the forest like agricultural land, groundwater level, and soil fertility. The assumption that fuelwood and fodder extraction, which is the part of local livelihood leads to deforestation, has so far been the dominant mainstream views in deforestation discourses. Given the occupational division across social groups in Kaimur reserve forest, the differential nature of dependence of forest resources is important to understand. This paper attempts to assess the nature of dependence and impact of forest degradation on rural households across various social groups. Also, an additional element that is added to the enquiry is the way degradation of forests leading to scarcity of forest-based resources impacts the patterns of dependence across various social groups. Change in forest area calculated through land use land cover analysis using remote sensing technique and examination of different economic activities carried out by the households that are forest-based was collected by primary survey in Kaimur reserve forest of state of Bihar in India. The general finding indicates that the Scheduled Tribe and Scheduled Caste communities, the most socially and economically deprived sections of the rural society are involved in a significant way in collection of fuelwood, fodder, and fruits, both for self-consumption and sale in the market while other groups of society uses fuelwood, fruit, and fodder for self-use only. Depending on the local forest resources for fuelwood consumption was the primary need for all social groups due to easy accessibility and lack of alternative energy source. In last four decades, degradation of forest made a direct impact on rural community mediated through the socio-economic structure, resulting in a shift from forest-based occupations to cultivation and manual labour in agricultural and non-agricultural activities. Thus there is a need to review the policies with respect to the ‘community forest management’ since this study clearly throws up the fact that engagement with and dependence on forest resources is socially differentiated. Thus tying the degree of dependence and forest management becomes extremely important from the view of ‘sustainable’ forest resource management. The statization of forest resources also has to keep in view the intrinsic way in which the forest-dependent population interacts with the forest.

Keywords: forest degradation, livelihood, social groups, tribal community

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556 The Invaluable Contributions of Radiography and Radiotherapy in Modern Medicine

Authors: Sahar Heidary

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Radiography and radiotherapy have emerged as crucial pillars of modern medical practice, revolutionizing diagnostics and treatment for a myriad of health conditions. This abstract highlights the pivotal role of radiography and radiotherapy in favor of healthcare and society. Radiography, a non-invasive imaging technique, has significantly advanced medical diagnostics by enabling the visualization of internal structures and abnormalities within the human body. With the advent of digital radiography, clinicians can obtain high-resolution images promptly, leading to faster diagnoses and informed treatment decisions. Radiography plays a pivotal role in detecting fractures, tumors, infections, and various other conditions, allowing for timely interventions and improved patient outcomes. Moreover, its widespread accessibility and cost-effectiveness make it an indispensable tool in healthcare settings worldwide. On the other hand, radiotherapy, a branch of medical science that utilizes high-energy radiation, has become an integral component of cancer treatment and management. By precisely targeting and damaging cancerous cells, radiotherapy offers a potent strategy to control tumor growth and, in many cases, leads to cancer eradication. Additionally, radiotherapy is often used in combination with surgery and chemotherapy, providing a multifaceted approach to combat cancer comprehensively. The continuous advancements in radiotherapy techniques, such as intensity-modulated radiotherapy and stereotactic radiosurgery, have further improved treatment precision while minimizing damage to surrounding healthy tissues. Furthermore, radiography and radiotherapy have demonstrated their worth beyond oncology. Radiography is instrumental in guiding various medical procedures, including catheter placement, joint injections, and dental evaluations, reducing complications and enhancing procedural accuracy. On the other hand, radiotherapy finds applications in non-cancerous conditions like benign tumors, vascular malformations, and certain neurological disorders, offering therapeutic options for patients who may not benefit from traditional surgical interventions. In conclusion, radiography and radiotherapy stand as indispensable tools in modern medicine, driving transformative improvements in patient care and treatment outcomes. Their ability to diagnose, treat, and manage a wide array of medical conditions underscores their favor in medical practice. As technology continues to advance, radiography and radiotherapy will undoubtedly play an ever more significant role in shaping the future of healthcare, ultimately saving lives and enhancing the quality of life for countless individuals worldwide.

Keywords: radiology, radiotherapy, medical imaging, cancer treatment

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555 Potential Ecological Risk Assessment of Selected Heavy Metals in Sediments of Tidal Flat Marsh, the Case Study: Shuangtai Estuary, China

Authors: Chang-Fa Liu, Yi-Ting Wang, Yuan Liu, Hai-Feng Wei, Lei Fang, Jin Li

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Heavy metals in sediments can cause adverse ecological effects while it exceeds a given criteria. The present study investigated sediment environmental quality, pollutant enrichment, ecological risk, and source identification for copper, cadmium, lead, zinc, mercury, and arsenic in the sediments collected from tidal flat marsh of Shuangtai estuary, China. The arithmetic mean integrated pollution index, geometric mean integrated pollution index, fuzzy integrated pollution index, and principal component score were used to characterize sediment environmental quality; fuzzy similarity and geo-accumulation Index were used to evaluate pollutant enrichment; correlation matrix, principal component analysis, and cluster analysis were used to identify source of pollution; environmental risk index and potential ecological risk index were used to assess ecological risk. The environmental qualities of sediment are classified to very low degree of contamination or low contamination. The similar order to element background of soil in the Liaohe plain is region of Sanjiaozhou, Honghaitan, Sandaogou, Xiaohe by pollutant enrichment analysis. The source identification indicates that correlations are significantly among metals except between copper and cadmium. Cadmium, lead, zinc, mercury, and arsenic will be clustered in the same clustering as the first principal component. Copper will be clustered as second principal component. The environmental risk assessment level will be scaled to no risk in the studied area. The order of potential ecological risk is As > Cd > Hg > Cu > Pb > Zn.

Keywords: ecological risk assessment, heavy metals, sediment, marsh, Shuangtai estuary

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554 The Effect of Spark Physical Program (Sports, Play and Active Recreation for Kids) on Quality of Life and Spirometry in 6-18-Year-Old Children with Cystic Fibrosis

Authors: Saeedeh Eshkil, Seyedeh Farnaz Mousavi, Hamid Reza Kianifar, Seyed Java Sayyedi, Mehdi Sohrabi, Elham Bakhtiari, Morteza Mashoughi, Ezzat Khodashenas

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Background: The effect of the SPARK physical education program on lung function in cystic fibrosis patients is not yet determined.).SPARK is Sports, play and active recreation for kids, including moving skills, aerobic games, jogging or walking, aerobic dance and jump rope. Regarding the high prevalence of cystic fibrosis and its destructive effects on the lungs, the aim of this study is to evaluate lung function and quality of life before and after undergoing the SPARK physical education program in children with cystic fibrosis. Method: In this quasi-experimental study, all patients with cystic fibrosis aged 6-18 years referred to the cystic fibrosis clinic of Dr. Sheikh Hospital were enrolled. The patients went under 12 weeks of SPARK training program (3 sessions per week, each session 45 minutes). The quality of life questionnaire ( Cystic Fibrosis Questionnaire includes self-examination, parental ) for patients with cystic fibrosis and spirometry indices (FEV1, FVC, FEV1/FVC, FEF25-75) was filled out before and after intervention for all patients. Results The mean and standard deviation of patients' age were 9.85±2.67 years, and 65% of patients were female. The FEV1 was significantly different before and after the SPARK physical education program (P=0.03), and the respiratory component of quality of life significantly increased after intervention (P=0.002). The overall score of quality of life from parents’ point of view was 2.87 ± 0.38, which increased to 2.99 ± 0.38 after the intervention. Conclusion: The SPARK training program may improve the spirometric parameters in children with cystic fibrosis. It also had a significant effect on improving the quality of life of patients, especially in the respiratory component.

Keywords: cystic fibrosis, pediatrics, SPARK motor program, spirometry

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553 Clinicoradiographic Evaluation of Polymer of Injectable Platelet-Rich Fibrin (i-PRF) and Hydroxyapatite as Bone Graft Substitute in Maxillomandibular Bony Defects: A Double-Blinded Randomized Control Trial

Authors: Naqoosh Haidry

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Objective & Goal: Enucleation of the maxillomandibular cysts will lead to the creation of post-surgical bone defects which may take more than a year for complete bone healing. The use of bone grafts is common to aid bone regeneration in large defects. The study aimed to evaluate the healing and bone formation capabilities of polymer of injectable platelet fibrin (i-PRF) and hydroxyapatite (HA) as bone graft substitute in maxilla-mandibular postsurgical defects compared to hydroxyapatite alone. The primary objective was to find out the clinical and radiological assessment of healing postoperatively and compare the outcome of both groups. Material and Methods: After surgical enucleation of 19 maxillomandibular cysts/tumors, either HA or HA+ i-PRF graft was adapted to the defect. Clinical outcome variables such as pain (VAS score), edema, and mucosal color were evaluated on postoperative days 01, 03, and 07 while radiological outcome variables such as volume of defect (cc), density of new bone (HU) on computed tomography were evaluated at 2nd and 4th month. The results obtained were tabulated and compared with the inferential analysis. Results: Clinical parameters seem to be better in the HA + i-PRF group, but the result was non-significant. Radiologically, the mean healing ratios were significantly greater in the HA + i-PRF group (63.5 ± 2.34 at 2nd month, 90.3 ± 7.32 at 4th month) compared to the HA group (57.2 ± 5.21at 2nd month, 80.8 ± 5.33 at 4th month). When comparing the mean density of new bone, there was a statistically significant difference with a mean difference of 95.2 HU more in the HA + i-PRF (623 HU ± 42.9) compared to the HA group (528 HU ± 96.5) in 2nd month. Conclusion: The polymer of i-PRF and HA prepared as the sticky bone yields faster and better bone healing in post-enucleation maxillomandibular bony defects as compared to hydroxyapatite alone based on radiological findings till four months.

Keywords: bone defect, density of new bone, hydroxyapatite, injectable platelet rich fibrin, maxillomandibular cysts, surgical defect

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552 Radiofrequency Ablation: A Technique in the Management of Low Anal Fistula

Authors: R. Suresh, C. B. Singh, A. K. Sarda

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Background: Over the decades, several surgical techniques have been developed to treat anal fistulas with variable success rates and complications. Large amount of work has been done in radiofrequency excision of the fistula for several years but no work has been done for ablating the tract. Therefore one can consider for obliteration ofanal fistula by Radiofrequency ablation (RFA). Material and Methods: A randomized controlled clinical trial was conducted at Lok Nayak Hospital, where a total of 40 patients were enrolled in the study and they were randomly assigned to Group I (fistulectomy)(n=20) and Group II (RFA) (n=20). Aim of the study was to compare the efficacy of RFA of fistula versus fistulectomy in the treatment of a low anal fistula and to evaluate RFA as an effective alternative to fistulectomy with respect to time taken for wound healing as primary outcome and post-operative pain, time taken to return to work as secondary outcomes. Patients with simple low anal fistulas, single internal and external opening, not more than two secondary tracts were included. Patients with high complex fistula, fistulas communicating with cavity, fistula due to condition like tuberculosis, Crohn's, malignancy were excluded from the study. Results: Both groups were comparable with respect to age, sex ratio, type of fistula. Themean healing time was significantly shorter in group II (41.02 days) than in group I(62.68 days).The mean operative time was significantly shorter in groupII (21.40 min) than in group I(28.50 min). The mean time taken to return to work was significantly shorter in group II(8.30 days)than in group I(12.01 days).There was no significant difference in the post operative hospital stay, mean postoperative pain score, wound infection and recurrence between the two groups. Conclusion: The patients who underwent RFA of fistula had shorter wound healing time, operative time and time taken to return to work when compared to those who underwent fistulectomy and therefore RFA shows outcome comparable to fistulectomy in the treatment of low anal fistula.

Keywords: fistulectomy, low anal fistula, radio frequency ablation, wound healing

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551 The Impact of Covid-19 on Anxiety Levels in the General Population of the United States: An Exploratory Survey

Authors: Amro Matyori, Fatimah Sherbeny, Askal Ali, Olayiwola Popoola

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Objectives: The study evaluated the impact of COVID-19 on anxiety levels in the general population in the United States. Methods: The study used an online questionnaire. It adopted the Generalized Anxiety Disorder Assessment (GAD-7) instrument. It is a self-administered scale with seven items used as a screening tool and severity measure for generalized anxiety disorder. The participants rated the frequency of anxiety symptoms in the last two weeks on a Likert scale, which ranges from 0-3. Then the item points are summed to provide the total score. Results: Thirty-two participants completed the questionnaire. Among them, 24 (83%) females and 5 (17%) males. The age range of 18-24-year-old represented the most respondents. Only one of the participants tested positive for the COVID-19, and 39% of them, one of their family members, friends, or colleagues, tested positive for the coronavirus. Moreover, 10% have lost a family member, a close friend, or a colleague because of COVID-19. Among the respondents, there were ten who scored approximately five points on the GAD-7 scale, which indicates mild anxiety. Furthermore, eight participants scored 10 to 14 points, which put them under the category of moderate anxiety, and one individual who was categorized under severe anxiety scored 15 points. Conclusions: It is identified that most of the respondents scored the points that put them under the mild anxiety category during the COVID-19 pandemic. It is also noticed that severe anxiety was the lowest among the participants, and people who tested positive and/or their family members, close friends, and colleagues were more likely to experience anxiety. Additionally, participants who lost friends or family members were also at high risk of anxiety. It is obvious the COVID-19 outcomes and too much thinking about the pandemic put people under stress which led to anxiety. Therefore, continuous assessment and monitoring of psychological outcomes during pandemics will help to establish early well-informed interventions.

Keywords: anxiety and covid-19, covid-19 and mental health outcomes, influence of covid-19 on anxiety, population and covid-19 impact on mental health

Procedia PDF Downloads 207
550 Hyponatremia in Community-Acquired Pneumonia

Authors: Emna Ketata, Wafa Farhat

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Introduction: Hyponatremia is defined by a blood sodium level of ≤ 136 mmol/L; it is associated with a high risk of morbidity and mortality in the emergency room. This was explained by transit disorders, including diarrhea and inappropriate antidiuretic hormone secretion (Syndrome of inappropriate antidiuretic hormone secretion). Pneumonia can cause dyspnea, stress-causing SIADH and digestive symptoms (diarrhea and vomiting). Aim: The purpose of this study was to determine the link between pneumonia and hyponatremia as a predictor of patient’s prognosis and intra-hospital mortality. Methodology: This is a prospective observational study over a period of 3 years in the emergency department. Inclusion :patients (age > 14 years), with clinical signs in favor of pneumonia. Natremia was measured. Natremia was classified as mild to moderate with a blood sodium level between 121 and 135 mmol/L and as severe with a blood sodium level ≤ 120 mmol/L. Results: This study showed an average serum sodium value of 135 mmol/L (range 114–159 mmol/L) in these patients. Hyponatremia was observed in 123 patients (43.6%), 115 patients (97,8%) had mild to moderate hyponatremia and 2,8% had severe hyponatremia. The mean age was 65±17 years with a sex ratio of 1.05. The main reason for consultation in patients with hyponatremia was cough in 58 patients (47.2%), and digestive symptoms were present in 25 patients (20.3. An altered state of consciousness was observed in 11 patients (3%). Patients with hyponatremia had greater heart rate (p=0.02),white blood cell count (p=0.009) , plasmatic lactate (p=0.002) and higher rate of pneumonia recurrence (p=0.001) .In addition, 80% of them have a positive CURB65 score (>=2). hyponatremia had higher rates of use of oxygen therapy compared to patients with normo-natremia (54% vs. 45%). The analytical study showed that hyponatremia is significantly associated with intra-hospital mortality with( p=0.01), severe hyponatremia p=0.04. Conclusion: Hyponatremia is a predictor of mortality and worse prognosis. Recognition of the pathophysiological mechanisms of hyponatremia in pneumonia will probably allow better management of it.

Keywords: oxygenotherapy, mortality, recurrence, positif curb65

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549 Context-Aware Recommender Systems Using User's Emotional State

Authors: Hoyeon Park, Kyoung-jae Kim

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The product recommendation is a field of research that has received much attention in the recent information overload phenomenon. The proliferation of the mobile environment and social media cannot help but affect the results of the recommendation depending on how the factors of the user's situation are reflected in the recommendation process. Recently, research has been spreading attention to the context-aware recommender system which is to reflect user's contextual information in the recommendation process. However, until now, most of the context-aware recommender system researches have been limited in that they reflect the passive context of users. It is expected that the user will be able to express his/her contextual information through his/her active behavior and the importance of the context-aware recommender system reflecting this information can be increased. The purpose of this study is to propose a context-aware recommender system that can reflect the user's emotional state as an active context information to recommendation process. The context-aware recommender system is a recommender system that can make more sophisticated recommendations by utilizing the user's contextual information and has an advantage that the user's emotional factor can be considered as compared with the existing recommender systems. In this study, we propose a method to infer the user's emotional state, which is one of the user's context information, by using the user's facial expression data and to reflect it on the recommendation process. This study collects the facial expression data of a user who is looking at a specific product and the user's product preference score. Then, we classify the facial expression data into several categories according to the previous research and construct a model that can predict them. Next, the predicted results are applied to existing collaborative filtering with contextual information. As a result of the study, it was shown that the recommended results of the context-aware recommender system including facial expression information show improved results in terms of recommendation performance. Based on the results of this study, it is expected that future research will be conducted on recommender system reflecting various contextual information.

Keywords: context-aware, emotional state, recommender systems, business analytics

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548 Validation of the Arabic Version of the InterSePT Scale for Suicidal Thinking (ISST) among the Arab Population in Qatar

Authors: S. Hammoudeh, S. Ghuloum, A. Abdelhakam, A. AlMujalli, M. Opler, Y. Hani, A. Yehya, S. Mari, R. Elsherbiny, Z. Mahfoud, H. Al-Amin

Abstract:

Introduction: Suicidal ideation and attempts are very common in patients with schizophrenia and still contributes to the high mortality in this population. The InterSePT Scale for Suicidal Thinking (ISST) is a validated tool used to assess suicidal ideation in patients with schizophrenia. This research aims to validate the Arabic version of the ISST among the Arabs residing in Qatar. Methods: Patients diagnosed with schizophrenia were recruited from the department of Psychiatry, Rumailah Hospital, Doha, Qatar. Healthy controls were recruited from the primary health care centers in Doha, Qatar. The validation procedures including professional and expert translation, pilot survey and back translation of the ISST were implemented. Diagnosis of schizophrenia was confirmed using the validated Arabic version of Mini International Neuropsychiatric Interview (MINI 6, module K) for schizophrenia. The gold standard was the module B on suicidality from MINI 6 also. This module was administered by a rater who was blinded to the results of ISST. Results: Our sample (n=199) was composed of 98 patients diagnosed with schizophrenia (age 36.03 ± 9.88 years; M/F is 2/1) and 101 healthy participants (age 35.01 ± 8.23 years; M/F is 1/2). Among patients with schizophrenia: 26.5% were married, 17.3% had a college degree, 28.6% were employed, 9% had committed suicide once, and 4.4% had more than 4 suicide attempts. Among the control group: 77.2% were married, 57.4% had a college degree, and 99% were employed. The mean score on the ISST was 2.36 ± 3.97 vs. 0.47 ± 1.44 for the schizophrenia and control groups, respectively. The overall Cronbach’s alpha was 0.91. Conclusions: This is the first study in the Arab world to validate the ISST in an Arabic-based population. The psychometric properties indicate that the Arabic version of the ISST is a valid tool to assess the severity of suicidal ideation in Arabic speaking patients diagnosed with schizophrenia.

Keywords: mental health, Qatar, schizophrenia, suicide

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547 Parallelization of Random Accessible Progressive Streaming of Compressed 3D Models over Web

Authors: Aayushi Somani, Siba P. Samal

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Three-dimensional (3D) meshes are data structures, which store geometric information of an object or scene, generally in the form of vertices and edges. Current technology in laser scanning and other geometric data acquisition technologies acquire high resolution sampling which leads to high resolution meshes. While high resolution meshes give better quality rendering and hence is used often, the processing, as well as storage of 3D meshes, is currently resource-intensive. At the same time, web applications for data processing have become ubiquitous owing to their accessibility. For 3D meshes, the advancement of 3D web technologies, such as WebGL, WebVR, has enabled high fidelity rendering of huge meshes. However, there exists a gap in ability to stream huge meshes to a native client and browser application due to high network latency. Also, there is an inherent delay of loading WebGL pages due to large and complex models. The focus of our work is to identify the challenges faced when such meshes are streamed into and processed on hand-held devices, owing to its limited resources. One of the solutions that are conventionally used in the graphics community to alleviate resource limitations is mesh compression. Our approach deals with a two-step approach for random accessible progressive compression and its parallel implementation. The first step includes partition of the original mesh to multiple sub-meshes, and then we invoke data parallelism on these sub-meshes for its compression. Subsequent threaded decompression logic is implemented inside the Web Browser Engine with modification of WebGL implementation in Chromium open source engine. This concept can be used to completely revolutionize the way e-commerce and Virtual Reality technology works for consumer electronic devices. These objects can be compressed in the server and can be transmitted over the network. The progressive decompression can be performed on the client device and rendered. Multiple views currently used in e-commerce sites for viewing the same product from different angles can be replaced by a single progressive model for better UX and smoother user experience. Can also be used in WebVR for commonly and most widely used activities like virtual reality shopping, watching movies and playing games. Our experiments and comparison with existing techniques show encouraging results in terms of latency (compressed size is ~10-15% of the original mesh), processing time (20-22% increase over serial implementation) and quality of user experience in web browser.

Keywords: 3D compression, 3D mesh, 3D web, chromium, client-server architecture, e-commerce, level of details, parallelization, progressive compression, WebGL, WebVR

Procedia PDF Downloads 170
546 Robotic Mini Gastric Bypass Surgery

Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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

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

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

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

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544 Factors Affecting Autistic Children's Development during the Early Years in Elementary School: A Longitudinal Study in Taiwan

Authors: Huang Ying

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The present study was to investigate factors affecting children's improvement through the first two years of elementary school on a population-based sample of children with autism in Taiwan. All the children were diagnosed with autism spectrum disorder (ASD) by clinical psychologists according to DSM-IV. Children's development was assessed by the Vineland Adaptive Behavior Scales-Chinese version (VABS-C) on the first and the third grade. Children's improvement was measured by the difference between the standardized total score of the third and the first year. In Taiwan, school-age children with special-education needs will be arranged into different classes, including normal classes (NC), resource classes (RC), and special classes (SC) by the government. Therefore, type of class was one of the independent variables. Moreover, as early intervention is considered to be crucial, the earliest age when intervention begins was collected from parents. Attention was also included in the analysis. Teachers were asked to evaluate children's attention with a 3-item Likert Scale. The frequency of paying attention to the class or the task was recorded and scores were summed up. Additionally, standardized scores of the VABS-C in the first grade were used as pretest scores representing children's developmental level at the beginning of elementary school. Multiple regression was conducted with improvement as the dependent variable. Results showed that children in special classes had smaller improvement compared to those in normal or resource classes. Attention positively predicted improvement yet the effect of earliest intervention age was not significant. Furthermore, scores in the first grade negatively predicted improvement, which indicated that children with higher developmental levels would make less progress in the following years. Results were to some degree consistent with previous findings through meta-analysis that the effectiveness of conventional intervention methods lacked sufficient evidence to support.

Keywords: attention, early intervention, elementary school, special education in Taiwan

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543 Changes in Textural Properties of Zucchini Slices Under Effects of Partial Predrying and Deep-Fat-Frying

Authors: E. Karacabey, Ş. G. Özçelik, M. S. Turan, C. Baltacıoğlu, E. Küçüköner

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Changes in textural properties of any food material during processing is significant for further consumer’s evaluation and directly affects their decisions. Thus any food material should be considered in terms of textural properties after any process. In the present study zucchini slices were partially predried to control and reduce the product’s final oil content. A conventional oven was used for partially dehydration of zucchini slices. Following frying was carried in an industrial fryer having temperature controller. This study was based on the effect of this predrying process on textural properties of fried zucchini slices. Texture profile analysis was performed. Hardness, elasticity, chewiness, cohesiveness were studied texture parameters of fried zucchini slices. Temperature and weight loss were monitored parameters of predrying process, whereas, in frying, oil temperature and process time were controlled. Optimization of two successive processes was done by response surface methodology being one of the common used statistical process optimization tools. Models developed for each texture parameters displayed high success to predict their values as a function of studied processes’ conditions. Process optimization was performed according to target values for each property determined for directly fried zucchini slices taking the highest score from sensory evaluation. Results indicated that textural properties of predried and then fried zucchini slices could be controlled by well-established equations. This is thought to be significant for fried stuff related food industry, where controlling of sensorial properties are crucial to lead consumer’s perception and texture related ones are leaders. This project (113R015) has been supported by TUBITAK.

Keywords: optimization, response surface methodology, texture profile analysis, conventional oven, modelling

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542 Increased Availability and Accessibility of Family Planning Services: An Approach Leading to Improved Contraceptive Uptake and Reproductive Behavior of Women Living in Pakistan

Authors: Lutaf Ali, Haris Ahmed, Hina Najmi

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Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.

Keywords: access, family planning, underserved population, socio-demographic facts

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541 Effects of Virtual Reality on the Upper Extremity Spasticity and Motor Function in Patients with Stroke: A Single Blinded Randomized Controlled Trial

Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini, Omid Seyed Esmaeili, Rouzbeh Kezemi, Noushin Mehrbod, Nazanin Vahed, Tahereh Hajiahmad, Noureddin Nakhostin Ansari

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Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of VR beside conventional rehabilitation versus conventional rehabilitation alone on spasticity and motor function in stroke patients. Materials and Methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran, in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were modified Ashworth scale, recovery stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in the combination group (P=0.003). Only wrist extension was varied between groups and was better in the combination group. The variables generally had a statistically significant difference (P < 0.05). Conclusion: Virtual reality plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: stroke, virtual therapy, rehabilitation, treatment

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540 Salon-Associated Infections: Customer’s Knowledge and Practice Measures

Authors: Esraa Elaraby, Dania Abu Zahra, Ghidaa Maswadah, Osama Amira, Mohamed Alshoura, Nihar Dash

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Background: Human being uses salon for a variety of purposes, from trimming of hair and shaving to a range of beauty treatments such as manicure and pedicure. Salon activities involve use of several instruments including scissors, scalpels and razors, materials such as soaps, solutions, creams and gels on human skin and body. Besides, salon customers also use chair, bed and many other common shared utensils and appliances. These salons related activities create a suitable environment for the transmission of several diseases and pathogens including hepatitis B and C, scabies, tuberculosis, staphylococcus and MRSA etc. The transmission of these pathogens can be prevented by maintenance of adequate hygiene and standard preventive measures. Aim: To assess the customer’s level of knowledge about salon-acquired infections and practices taken to prevent their transmission. Methods: A cross-sectional study was conducted among 500 participants across the Emirates. Moreover, self-administered questionnaires (in English and Arabic) were distributed through convenience sampling methods between February and April 2017. Results: The study included 500 participants of which 250 were females. The mean age of the study population was 33 years (SD=4.77). The participants were from several nationalities including 325 Arabs (Non-GCC) (66.2%), 108 Non-Arabs (22%), and 59 Arabs (GCC) (11.8%). The majority of the participants 421 (84.4%) had required knowledge about salon-associated infections with a mean knowledge score of 6/10 (60%). However, when it comes down to preventive practices, only 73 of the 500 participants (14.6%) did carry their own equipment. Thus, there was insufficient correlation between the level of knowledge and preventive practices (p=0.139) of salon-associated infections. Conclusion: People’s knowledge about the salon-associated infections among UAE residents was good, but only a small number practically took the required preventative measures towards this issue. Therefore, a public awareness program is recommended to enhance the deficiencies in knowledge and practices to prevent salon-acquired infections among the users. Up to our knowledge, this is the first study of this kind in the UAE targeting the salon customers about this important issue.

Keywords: awareness, knowledge, practices, salon-associated infections

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539 Role of Intralesional Tranexamic Acid in Comparison of Oral Tranexamic Acid in the Treatment of Melasma

Authors: Lubna Khondker

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Background: Melasma is a common pigmentary dermatosis, manifested by hyperpigmented macules or patches on the face, commonly occurring in females due to an acquired disorder in the melanogenesis process. Although several treatments are currently used, it remains a great challenge due to recurrence and refractory nature. It was recently reported that tranexamic acid (TA-plasmin inhibitor) is an effective treatment for melasma. Objective: This study aims to compare the efficacy and side effects of intralesional injection of Tranexamic acid with oral Tranexamic acid in the treatment of melasma. Methods: A clinical trial was done in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, for a period of 4 years. A total of 100 patients with melasma who did not respond to topical therapy were included in the study as group A and group B. Group A Patients were administered intralesional injection (10 mg/ml) of Tranexamic acid( TA) weekly for 6 weeks, and group B patients were treated with oral tranexamic acid 250 mg 12 hourly for 12 weeks after taking informed consent. The severity and extent of pigmentation were assessed by the modified melasma area severity index (MASI). The response to treatment was assessed by MASI at 4 weeks, 8 weeks, and 12 weeks after stopping treatment. Results: The study showed the MASI scores at the baseline, 4 weeks, 8 weeks, and 12 weeks in group A were 18.23±1.22, 6.14±3.26, 3.21±2.14 and 2.11±2.01 respectively, and in group B, 17.87±1.12, 11.21±6.25, 6.57±4.26 and 6.41±4.17 respectively. The mean MASI significantly reduced in group A compared to group B in the 4th, 8th, and 12th weeks. The present study showed that among group A patients, 56% rated excellent (>75% reduction) in outcome, 32% good (50-75% reduction), 8% moderate (25-50% reduction) and only 4% (<25% reduction) was unsatisfactory and among group B patients, 14% rated excellent in outcome, 28% good, 36% moderate and 22% was unsatisfactory. Overall improvement in our study in group A was 96% and in group B 78%. Side effects were negligible, and all the patients tolerated the treatment well. Conclusion: Based on our results, intralesional Tranexamic acid (10 mg/ml) is more effective and safer than oral Tranexamic acid in the treatment of melasma.

Keywords: intralesional tranexamic acid, melasma, oral tranexamic acid, MASI score

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538 Study on the Knowledge, Attitude and Practice (KAP) of Patients with Hypertension in Aseer Hospital, Asir Region, Saudi Arabia

Authors: Ayesha Siddiqua

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Background: Hypertension is a silent killer disease and a common risk factor for considerable morbidity and mortality. Its effects can be seen on the organs like Heart; Brain; Kidneys. In Saudi Arabia, hypertension affects a sizeable enough proportion of the population, with a prevalence of 27.9% in urban and 22.4 in rural population. Despite these features, the magnitude and epidemiological characteristics of this disease have been rarely studied in Saudi Arabia. To fill this gap, we conducted a survey in Abha to study the KAP of hypertension. KAP study shows what people know about certain things, their feelings and behavior towards the disease management. An improvement in the Knowledge and Attitudes towards disease management can reform the kinds of practices which are followed. Objectives: To assess the level of Knowledge, Attitude and Practice of patients who suffer from Hypertension. To improve the Quality of life of patients. Methods: A prospective cross-sectional survey was conducted on a sample size of 130 Hypertensive patients of both the genders enrolled by simple random sampling technique admitted in the Aseer Central Hospital of Abha during the period from October 2016 to December 2016. Results: Altogether 130 hypertensive patients were enrolled in this study with equal no. of Males and Females. Most of the respondents were aged between 18-40 years (45%). On assessing the KAP of the patients, we found that the Knowledge and Attitude score was good but the Practice scores were moderate in both the genders. Conclusion: Our study concludes that a significant proportion of hypertensive patients show less Practice towards the disease management which can lead to severe complications in time being and also result in damage of other vital organs. So there is a need of intense educational intervention for the patients which can be done by Patient counselling by the clinical pharmacist. Strategies to modify lifestyle which help in control of hypertension can include providing leaflets as well as direct educational programs.

Keywords: Attitude, hypertension, Knowledge, practices

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537 Fostering Diversity, Equity, and Inclusion: Case of Higher Education Institutions in Kazakhstan

Authors: Gainiya Tazhina

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Higher education systems of many countries have increased diversity and ensured equal rights and opportunities for inclusive students in the last decades. Issues of diversity-equity-inclusion (DEI) in Kazakhstani higher education began to be considered in legislation in 2021-2023. The adoption of the Road Map of the Ministry of Education and Science for universities’ inclusivity indicated strategies for change. The paper traces how this government initiative is being implemented in universities across the country. Content analysis of legislative documents, media publications, surveys of students, staff and interviews with leaders have demonstrated the inconsistency of these strategic decisions. Thus, the Road Map required that by 2023 conditions for promoting and ensuring inclusive education and barrier-free environments should be created in 60% -100% of Kazakhstani universities, including spaces inside academic buildings and dormitories in a short period of time. (March 2023-August 2025). Educational programs and curricula have not been adapted to the needs of students with special education needs (SEN); teachers do not have the skills and methods to work with students with SEN, students from minority groups, and international students. 60% of universities have not created a barrier-free environment on campuses due to the high cost of elevators, tactile tiles and assistive devices. Only 1% of school-disabled graduates enter universities due to the unwillingness of universities to educate people with disabilities. At the same time, universities do not adapt their educational programs and services to the needs of inclusive students; their needs are not identified; they study under the same conditions as regular students. Accordingly, teaching staff does not have the knowledge and skills to teach inclusive students; university lecturers misunderstand or oversimplify the social phenomena of ‘inclusion’ and ‘diversity’. The situation is more acute with the creation of a barrier-free architectural environment on university campuses. Recent reports indicate that these reforms have not been implemented to date, proven controversial in practice due to the inconsistency of national research on inclusion in higher education. Widely announced reforms have not produced the expected results leading to distortions at the local level. Inconsistent policies, contradictory legislative acts without expertise of needs and developing specific implementation criteria, without training specialists and indicators for achieving reforms are doomed to failure and mistrust of society. Based on the results of this research, recommendations have been developed: (1) to overcome inconsistencies in legislation regarding DEI in higher education; (2) to encourage initiatives in universities' inclusive environments; (3) to develop projects that will promote public awareness of DEI.

Keywords: diversity-equity-inclusion, Kazakhstani universities, reforms, legislation, accessibility

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536 Clinical Audit of Selected Nephrology Nursing Procedures Performed in Nephrology Unit of AIIMS with a View to Develop Nephrology Nursing Procedure Protocol

Authors: Mamta Thakur, Dr. Shashi Mawar, Ms. Levis Murry, Dr. D.k.sharma

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Aim: The aim of this study is to develop nephrology nursing procedure protocol after clinical audit of current nephrology nursing practices. Materials and methods: This descriptive observational study was conducted on 40 nurses who were working in Nephrology Department of AIIMS, New Delhi to observe their current practices to assess the existing gaps in the practice. The nurses were enrolled through total enumerative sampling. Sociodemographic profile of nurses and clinical profile for site of procedure was collected. Observation checklist was formed on the basis of standard nursing practices, which included 7 dimensions for hemodialysis procedure and 3 dimensions for procedure of assisting renal biopsy. Based on the gaps identified, nephrology nursing procedure protocol will be developed. Nurses were observed during two shifts, and each nurse was observed once. Scoring of items were done in each dimension, and for acceptable practices, nurses have to score ≥80% in each dimension. Results: Data was analyzed using descriptive statistics. Majority of nurses (73.7%) in nephrology ward and (80.9%) in hemodialysis unit have not undergone any special training in nephrology. Most of nurses (80.9%) followed the acceptable nursing practices for procedure of connection for hemodialysis. None of nurses followed the acceptable level (≥80%) of nursing practices for the procedure of predialysis assessment, the procedure for site preparation, during dialysis assessment and post dialysis assessment. None (100%) showed the acceptable level of nursing practices for all the dimensions of assisting renal biopsy procedure. Nephrology nursing procedure protocol was developed by researcher following a rigorous process, and this will reduce the gaps in the nursing practice. Conclusion: Clinical audit found that there were gaps in the existing nursing practices compared to the standardised nursing practices for procedure of hemodialysis and assisting renal biopsy, and these gaps have been addressed by the development of the protocol.

Keywords: nursing practice, nephrology nursing procedure, nursing protocol, renal biopsy, hemodialysis

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535 Educational Infrastructure a Barrier for Teaching and Learning Architecture

Authors: Alejandra Torres-Landa López

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Introduction: Can architecture students be creative in spaces conformed by an educational infrastructure build with paradigms of the past?, this question and others related are answered in this paper as it presents the PhD research: An anthropic conflict in Mexican Higher Education Institutes, problems and challenges of the educational infrastructure in teaching and learning History of Architecture. This research was finished in 2013 and is one of the first studies conducted nationwide in Mexico that analysis the educational infrastructure impact in learning architecture; its objective was to identify which elements of the educational infrastructure of Mexican Higher Education Institutes where architects are formed, hinder or contribute to the teaching and learning of History of Architecture; how and why it happens. The methodology: A mixed methodology was used combining quantitative and qualitative analysis. Different resources and strategies for data collection were used, such as questionnaires for students and teachers, interviews to architecture research experts, direct observations in Architecture classes, among others; the data collected was analyses using SPSS and MAXQDA. The veracity of the quantitative data was supported by the Cronbach’s Alpha Coefficient, obtaining a 0.86, figure that gives the data enough support. All the above enabled to certify the anthropic conflict in which Mexican Universities are. Major findings of the study: Although some of findings were probably not unknown, they haven’t been systematized and analyzed with the depth to which it’s done in this research. So, it can be said, that the educational infrastructure of most of the Higher Education Institutes studied, is a barrier to the educational process, some of the reasons are: the little morphological variation of space, the inadequate control of lighting, noise, temperature, equipment and furniture, the poor or none accessibility for disable people; as well as the absence, obsolescence and / or insufficiency of information technologies are some of the issues that generate an anthropic conflict understanding it as the trouble that teachers and students have to relate between them, in order to achieve significant learning). It is clear that most of the educational infrastructure of Mexican Higher Education Institutes is anchored to paradigms of the past; it seems that they respond to the previous era of industrialization. The results confirm that the educational infrastructure of Mexican Higher Education Institutes where architects are formed, is perceived as a "closed container" of people and data; infrastructure that becomes a barrier to teaching and learning process. Conclusion: The research results show it's time to change the paradigm in which we conceive the educational infrastructure, it’s time to stop seen it just only as classrooms, workshops, laboratories and libraries, as it must be seen from a constructive, urban, architectural and human point of view, taking into account their different dimensions: physical, technological, documental, social, among others; so the educational infrastructure can become a set of elements that organize and create spaces where ideas and thoughts can be shared; to be a social catalyst where people can interact between each other and with the space itself.

Keywords: educational infrastructure, impact of space in learning architecture outcomes, learning environments, teaching architecture, learning architecture

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534 Bio-Medical Equipment Technicians: Crucial Workforce to Improve Quality of Health Services in Rural Remote Hospitals in Nepal

Authors: C. M. Sapkota, B. P. Sapkota

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Background: Continuous developments in science and technology are increasing the availability of thousands of medical devices – all of which should be of good quality and used appropriately to address global health challenges. It is obvious that bio medical devices are becoming ever more indispensable in health service delivery and among the key workforce responsible for their design, development, regulation, evaluation and training in their use: biomedical technician (BMET) is the crucial. As a pivotal member of health workforce, biomedical technicians are an essential component of the quality health service delivery mechanism supporting the attainment of the Sustainable Development Goals. Methods: The study was based on cross sectional descriptive design. Indicators measuring the quality of health services were assessed in Mechi Zonal Hospital (MZH) and Sagarmatha Zonal Hospital (SZH). Indicators were calculated based on the data about hospital utilization and performance of 2018 available in Medical record section of both hospitals. MZH had employed the BMET during 2018 but SZH had no BMET in 2018.Focus Group Discussion with health workers in both hospitals was conducted to validate the hospital records. Client exit interview was conducted to assess the level of client satisfaction in both the hospitals. Results: In MZH there was round the clock availability and utilization of Radio diagnostics equipment, Laboratory equipment. Operation Theater was functional throughout the year. Bed Occupancy rate in MZH was 97% but in SZH it was only 63%.In SZH, OT was functional only 54% of the days in 2018. CT scan machine was just installed but not functional. Computerized X-Ray in SZH was functional only in 72% of the days. Level of client satisfaction was 87% in MZH but was just 43% in SZH. MZH performed all (256) the Caesarean Sections but SZH performed only 36% of 210 Caesarean Sections in 2018. In annual performance ranking of Government Hospitals, MZH was placed in 1st rank while as SZH was placed in 19th rank out of 32 referral hospitals nationwide in 2018. Conclusion: Biomedical technicians are the crucial member of the human resource for health team with the pivotal role. Trained and qualified BMET professionals are required within health-care systems in order to design, evaluate, regulate, acquire, maintain, manage and train on safe medical technologies. Applying knowledge of engineering and technology to health-care systems to ensure availability, affordability, accessibility, acceptability and utilization of the safer, higher quality, effective, appropriate and socially acceptable bio medical technology to populations for preventive, promotive, curative, rehabilitative and palliative care across all levels of the health service delivery.

Keywords: biomedical equipment technicians, BMET, human resources for health, HRH, quality health service, rural hospitals

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533 Parent’s Expectations and School Achievement: Longitudinal Perspective among Chilean Pupils

Authors: Marine Hascoet, Valentina Giaconi, Ludivine Jamain

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The aim of our study is to examine if the family socio-economic status (SES) has an influence on students’ academic achievement. We first make the hypothesis that the more their families have financial and social resources, the more students succeed at school. We second make the hypothesis that this family SES has also an impact on parents’ expectations about their children educational outcomes. Moreover, we want to study if that parents’ expectations play the role of mediator between parents’ socio-economic status and the student’ self-concept and academic outcome. We test this model with a longitudinal design thanks to the census-based assessment from the System of Measurement of the Quality of Education (SIMCE). The SIMCE tests aim to assess all the students attending to regular education in a defined level. The sample used in this study came from the SIMCE assessments done three times: in 4th, 8th and 11th grade during the years 2007, 2011 and 2014 respectively. It includes 156.619 students (75.084 boys and 81.535 girls) that had valid responses for the three years. The family socio-economic status was measured at the first assessment (in 4th grade). The parents’ educational expectations and the students’ self-concept were measured at the second assessment (in 8th grade). The achievement score was measured twice; once when children were in 4th grade and a second time when they were in 11th grade. To test our hypothesis, we have defined a structural equation model. We found that our model fit well the data (CFI = 0.96, TLI = 0.95, RMSEA = 0.05, SRMR = 0.05). Both family SES and prior achievements predict parents’ educational expectations and effect of SES is important in comparison to the other coefficients. These expectations predict students’ achievement three years later (with prior achievement controlled) but not their self-concept. Our model explains 51.9% of the achievement in the 11th grade. Our results confirm the importance of the parents’ expectations and the significant role of socio-economic status in students’ academic achievement in Chile.

Keywords: Chilean context, parent’s expectations, school achievement, self-concept, socio-economic status

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532 The Role Previous Cytomegalovirus Infection in Subsequent Lymphoma Develompment

Authors: Amalia Ardeljan, Lexi Frankel, Divesh Manjani, Gabriela Santizo, Maximillian Guerra, Omar Rashid

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Introduction: Cytomegalovirus (CMV) infection is a widespread infection affecting between 60-70% of people in industrialized countries. CMV has been previously correlated with a higher incidence of Hodgkin Lymphoma compared to noninfected persons. Research regarding prior CMV infection and subsequent lymphoma development is still controversial. With limited evidence, further research is needed in order to understand the relationship between previous CMV infection and subsequent lymphoma development. This study assessed the effect of CMV infection and the incidence of lymphoma afterward. Methods: A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th,10th codes, and Current Procedural Terminology (CPT) codes. These were used to identify lymphoma diagnosis in a previously CMV infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). A chi-squared test was used to assess statistical significance. Results: A total number of 14,303 patients was obtained in the CMV infected group as well as in the control population (matched by age range and CCI score). Subsequent lymphoma development was seen at a rate of 11.44% (1,637) in the CMV group and 5.74% (822) in the control group, respectively. The difference was statistically significant by p= 2.2x10-16, odds ratio = 2.696 (95% CI 2.483- 2.927). In an attempt to stratify the population by antiviral medication exposure, the outcomes were limited by the decreased number of members exposed to antiviral medication in the control population. Conclusion: This study shows a statistically significant correlation between prior CMV infection and an increased incidence of lymphoma afterward. Further exploration is needed to identify the potential carcinogenic mechanism of CMV and whether the results are attributed to a confounding bias.

Keywords: cytomegalovirus, lymphoma, cancer, microbiology

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