Search results for: muscle protection
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3083

Search results for: muscle protection

863 The Impact of Surface Roughness and PTFE/TiF3/FeF3 Additives in Plain ZDDP Oil on the Friction and Wear Behavior Using Thermal and Tribological Analysis under Extreme Pressure Condition

Authors: Gabi N. Nehme, Saeed Ghalambor

Abstract:

The use of titanium fluoride and iron fluoride (TiF3/FeF3) catalysts in combination with polutetrafluoroethylene (PTFE) in plain zinc dialkyldithiophosphate (ZDDP) oil is important for the study of engine tribocomponents and is increasingly a strategy to improve the formation of tribofilm and to provide low friction and excellent wear protection in reduced phosphorus plain ZDDP oil. The influence of surface roughness and the concentration of TiF3/FeF3/PTFE were investigated using bearing steel samples dipped in lubricant solution @100°C for two different heating time durations. This paper addresses the effects of water drop contact angle using different surface finishes after treating them with different lubricant combination. The calculated water drop contact angles were analyzed using Design of Experiment software (DOE) and it was determined that a 0.05 μm Ra surface roughness would provide an excellent TiF3/FeF3/PTFE coating for antiwear resistance as reflected in the scanning electron microscopy (SEM) images and the tribological testing under extreme pressure conditions. Both friction and wear performance depend greatly on the PTFE/and catalysts in plain ZDDP oil with 0.05% phosphorous and on the surface finish of bearing steel. The friction and wear reducing effects, which was observed in the tribological tests, indicated a better micro lubrication effect of the 0.05 μm Ra surface roughness treated at 100°C for 24 hours when compared to the 0.1 μm Ra surface roughness with the same treatment.

Keywords: scanning electron microscopy, ZDDP, catalysts, PTFE, friction, wear

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862 Al-Ti-W Metallic Glass Thin Films Deposited by Magnetron Sputtering Technology to Protect Steel Against Hydrogen Embrittlement

Authors: Issam Lakdhar, Akram Alhussein, Juan Creus

Abstract:

With the huge increase in world energy consumption, researchers are working to find other alternative sources of energy instead of fossil fuel one causing many environmental problems as the production of greenhouse effect gases. Hydrogen is considered a green energy source, which its combustion does not cause environmental pollution. The transport and the storage of the gas molecules or the other products containing this smallest chemical element in metallic structures (pipelines, tanks) are crucial issues. The dissolve and the permeation of hydrogen into the metal lattice lead to the formation of hydride phases and the embrittlement of structures. To protect the metallic structures, a surface treatment could be a good solution. Among the different techniques, magnetron sputtering is used to elaborate micrometric coatings capable of slowing down or stop hydrogen permeation. In the plasma environment, the deposition parameters of new thin-film metallic glasses Al-Ti-W were optimized and controlled in order to obtain, hydrogen barrier. Many characterizations were carried out (SEM, XRD and Nano-indentation…) to control the composition and understand the influence of film microstructure and chemical composition on the hydrogen permeation through the coatings. The coating performance was evaluated under two hydrogen production methods: chemical and electrochemical (cathodic protection) techniques. The hydrogen quantity absorbed was experimentally determined using the Thermal-Desorption Spectroscopy method (TDS)). An ideal ATW thin film was developed and showed excellent behavior against the diffusion of hydrogen.

Keywords: thin films, hydrogen, PVD, plasma technology, electrochemical properties

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861 Encapsulation of Probiotic Bacteria in Complex Coacervates

Authors: L. A. Bosnea, T. Moschakis, C. Biliaderis

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Two probiotic strains of Lactobacillus paracasei subsp. paracasei (E6) and Lactobacillus paraplantarum (B1), isolated from traditional Greek dairy products, were microencapsulated by complex coacervation using whey protein isolate (WPI, 3% w/v) and gum arabic (GA, 3% w/v) solutions mixed at different polymer ratio (1:1, 2:1 and 4:1). The effect of total biopolymer concentration on cell viability was assessed using WPI and GA solutions of 1, 3 and 6% w/v at a constant ratio of 2:1. Also, several parameters were examined for optimization of the microcapsule formation, such as inoculum concentration and the effect of ionic strength. The viability of the bacterial cells during heat treatment and under simulated gut conditions was also evaluated. Among the different WPI/GA weight ratios tested (1:1, 2:1, and 4:1), the highest survival rate was observed for the coacervate structures made with the ratio of 2:1. The protection efficiency at low pH values is influenced by both concentration and the ratio of the added biopolymers. Moreover, the inoculum concentration seems to affect the efficiency of microcapsules to entrap the bacterial cells since an optimum level was noted at less than 8 log cfu/ml. Generally, entrapment of lactobacilli in the complex coacervate structure enhanced the viability of the microorganisms when exposed to a low pH environment (pH 2.0). Both encapsulated strains retained high viability in simulated gastric juice (>73%), especially in comparison with non-encapsulated (free) cells (<19%). The encapsulated lactobacilli also exhibited enhanced viability after 10–30 min of heat treatment (65oC) as well as at different NaCl concentrations (pH 4.0). Overall, the results of this study suggest that complex coacervation with WPI/GA has a potential to deliver live probiotics in low pH food systems and fermented dairy products; the complexes can dissolve at pH 7.0 (gut environment), releasing the microbial cells.

Keywords: probiotic, complex coacervation, whey, encapsulation

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860 Effect of Miconazole Nitrate on Immunological Response and Its Preventive Efficacy in Labeo rohita Fingerlings against Oomycetes Saprolegnia parasitica

Authors: Mukta Singh, Ratan Kumar Saha, Himadri Saha, Paramveer Singh

Abstract:

The present study evaluated the effect of sub-lethal doses of antifungal drug miconazole nitrate (MCZ) on immunological responses including immune-related gene expression and its role as a prophylactic drug against S. parasitica in Labeo rohita fingerlings. Fish were fed with sub lethal doses of MCZ i.e., T1- 6.30 mg MCZ kgBW⁻¹, T2- 12.61 mg MCZ kgBW⁻¹ and T3- 25.22 mg MCZ kgBW⁻¹ and sampling was done at different time intervals for 240 h. Immunological parameters viz. lysozyme activity, oxygen radical production and plasma anti-protease activity showed significant enhancement (p < 0.05) in fish fed with T2 and T3 doses. Significant reduction in plasma protein content was observed in all the dietary groups as compared to control. Expression of immune-relevant genes like TLR-22 and β2-M showed significantly higher expression at six h and 24 h of sampling in both liver and head-kidney. However, these genes showed a down-regulation after 120 h of sampling in both the tissues. Preventive efficacy study showed that single dose of MCZ provides protection against oomycetes up to the fourth day of infection. Significantly higher mortality was observed in control diet-fed fish as compared to fish fed with MCZ medicated diet. Thus, from the study, it can be concluded that the MCZ can act as a potent antifungal agent for preventing oomycetes infection as well as to enhance the immune response.

Keywords: antifungal, immune gene, immunological, miconazole nitrate, prophylactic

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859 Application of Value Engineering Approach for Improving the Quality and Productivity of Ready-Mixed Concrete Used in Construction and Hydraulic Projects

Authors: Adel Mohamed El-Baghdady, Walid Sayed Abdulgalil, Ahmad Asran, Ibrahim Nosier

Abstract:

This paper studies the effectiveness of applying value engineering to actual concrete mixtures. The study was conducted in the State of Qatar on a number of strategic construction projects with international engineering specifications for the 2022 World Cup projects. The study examined the concrete mixtures of Doha Metro project and the development of KAHRAMAA’s (Qatar Electricity and Water Company) Abu Funtas Strategic Desalination Plant, in order to generally improve the quality and productivity of ready-mixed concrete used in construction and hydraulic projects. The application of value engineering to such concrete mixtures resulted in the following: i) improving the quality of concrete mixtures and increasing the durability of buildings in which they are used; ii) reducing the waste of excess materials of concrete mixture, optimizing the use of resources, and enhancing sustainability; iii) reducing the use of cement, thus reducing CO₂ emissions which ensures the protection of environment and public health; iv) reducing actual costs of concrete mixtures and, in turn, reducing the costs of construction projects; and v) increasing the market share and competitiveness of concrete producers. This research shows that applying the methodology of value engineering to ready-mixed concrete is an effective way to save around 5% of the total cost of concrete mixtures supplied to construction and hydraulic projects, improve the quality according to the technical requirements and as per the standards and specifications for ready-mixed concrete, improve the environmental impact, and promote sustainability.

Keywords: value management, cost of concrete, performance, optimization, sustainability, environmental impact

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858 The Effect of Aerobics and Yogic Exercise on Selected Physiological and Psychological Variables of Middle-Aged Women

Authors: A. Pallavi, N. Vijay Mohan

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A nation can be economically progressive only when the citizens have sufficient capacity to work efficiently to increase the productivity. So, good health must be regarded as a primary need of the community. This helps the growth and development of the body and the mind, which in turn leads to progress and prosperity of the nation. An optimum growth is a necessity for an efficient existence in a biologically adverse and economically competitive world. It is also necessary for the execution of daily routine work. Yoga is a method or a system for the complete development of the personality in a human being. It can be further elaborated as an all-around and complete development of the body, mind, morality, intellect and soul of a being. Sri Aurobindo defines yoga as 'a methodical effort towards self-perfection by the development of the potentialities in the individual.' Aerobic exercise as any activity that uses large muscle groups, can be maintained continuously, and is rhythmic I nature. It is a type of exercise that overloads the heart and lungs and causes them to work harder than at rest. The important idea behind aerobic exercise today, is to get up and get moving. There are more activities that ever to choose from, whether it is a new activity or an old one. Find something you enjoy doing that keeps our heart rate elevated for a continuous time period and get moving to a healthier life. Middle aged selected and served as the subjects for the purpose of this study. The selected subjects were in the age group of 30 to 40 years. By going through the literature and after consulting the experts in yoga and aerobic training, the investigator had chosen the variables which are specifically related to the middle-aged men. The selected physiological variables are pulse rate, diastolic blood pressure, systolic blood pressure; percent body fat and vital capacity. The selected psychological variables are job anxiety, occupational stress. The study was formulated as a random group design consisting of aerobic exercise and yogic exercises groups. The subjects (N=60) were at random divided into three equal groups of twenty middle-aged men each. The groups were assigned the names as follows: 1. Experimental group I- aerobic exercises group, 2. Experimental group II- yogic exercises, 3. Control group. All the groups were subjected to pre-test prior to the experimental treatment. The experimental groups participated in their respective duration of twenty-four weeks, six days in a week throughout the study. The various tests administered were: prior to training (pre-test), after twelfth week (second test) and twenty-fourth weeks (post-test) of the training schedule.

Keywords: pulse rate, diastolic blood pressure, systolic blood pressure; percent body fat and vital capacity, psychological variables, job anxiety, occupational stress, aerobic exercise, yogic exercise

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857 Economic Impact of Mediation: Analyzing the Strengths and Weaknesses of Portuguese Mediation System

Authors: M. L. Mesquita, V. H. Ferreira, C. M. Cebola

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Mediation is an increasingly important mechanism, particularly in the European context, as demonstrated, for example, by the publication by the European Union of the Directive 2008/52/EC on certain aspects of mediation in civil and mercantile matters. Developments in international trade and globalization in this new century have led to an increase of the number of litigations, often cross-border, and the courts have failed to respond adequately. From the economic point of view, competitive negotiation can generate negative external effects in social terms. Not always the solution found in court is the most efficient solution taking into account all elements of society. On the other hand, the administration of justice adds in economic terms transaction costs that can be mitigated by the application of other forms of conflict resolution, such as mediation. In this paper, the economic benefits of mediation will be analysed in the light of various studies on the functioning of justice. Several theoretical arguments will be confronted with empirical studies to demonstrate that mediation has significant positive economic effects. In the Portuguese legal system, legislative frameworks for mediation display a state committed to creating a new architecture for the administration of justice, based on the construction of a multi-faceted legal system for dispute resolution mechanisms. Understanding the way in which the system of mediation in Portugal was introduced, allows us to point out that our internal ordering is creating the legal instruments which can assist citizens in the effective protection of their rights. However, data on the use of mediation in concrete proceedings and the consequent effectiveness of mediation in settling disputes, reveal a mechanism that is still far from the ideal results that were initially sought.

Keywords: access to justice, alternative dispute resolution, mediation, litigation

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856 Supplier Selection Using Sustainable Criteria in Sustainable Supply Chain Management

Authors: Richa Grover, Rahul Grover, V. Balaji Rao, Kavish Kejriwal

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Selection of suppliers is a crucial problem in the supply chain management. On top of that, sustainable supplier selection is the biggest challenge for the organizations. Environment protection and social problems have been of concern to society in recent years, and the traditional supplier selection does not consider about this factor; therefore, this research work focuses on introducing sustainable criteria into the structure of supplier selection criteria. Sustainable Supply Chain Management (SSCM) is the management and administration of material, information, and money flows, as well as coordination among business along the supply chain. All three dimensions - economic, environmental, and social - of sustainable development needs to be taken care of. Purpose of this research is to maximize supply chain profitability, maximize social wellbeing of supply chain and minimize environmental impacts. Problem statement is selection of suppliers in a sustainable supply chain network by ranking the suppliers against sustainable criteria identified. The aim of this research is twofold: To find out what are the sustainable parameters that can be applied to the supply chain, and to determine how these parameters can effectively be used in supplier selection. Multicriteria decision making tools will be used to rank both criteria and suppliers. AHP Analysis will be used to find out ratings for the criteria identified. It is a technique used for efficient decision making. TOPSIS will be used to find out rating for suppliers and then ranking them. TOPSIS is a MCDM problem solving method which is based on the principle that the chosen option should have the maximum distance from the negative ideal solution (NIS) and the minimum distance from the ideal solution.

Keywords: sustainable supply chain management, sustainable criteria, MCDM tools, AHP analysis, TOPSIS method

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855 Coral Reef Fishes in the Marine Protected Areas in Southern Cebu, Philippines

Authors: Christine M. Corrales, Gloria G. Delan, Rachel Luz V. Rica, Alfonso S. Piquero

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Marine protected areas (MPAs) in the study sites were established 8-13 years ago and are presently operational. This study was conducted to gather baseline information on the diversity, density and biomass of coral reef fishes inside and outside the four marine protected areas (MPAs) of Cawayan, Dalaguete; Daan-Lungsod Guiwang, Alcoy; North Granada, Boljoon and Sta. Cruz, Ronda. Coral reef fishes in the MPAs were identified using Fish Visual Census Method. Results of the t-test showed that the mean diversity (fish species/250m2) of target and non-target reef fish species found inside and outside the MPAs were significantly different. Density (ind./1,000m2) of target species inside and outside the MPAs showed no significant difference. Similarly, density of non-target species inside and outside the MPAs also showed no significant difference. This is an indication that fish density inside and outside the MPAs were more or less of the same condition. The mean biomass (kg/1,000m2) of target species inside and outside the MPAs showed a significant difference in contrast with non-target species inside and outside the MPAs which showed a no significant difference. Higher biomass of target fish species belonging to family Caesonidae (fusiliers) and Scaridae (parrotfishes) were commonly observed inside the MPAs. Results showed that fish species were more diverse with higher density and biomass inside the MPAs than the outside area. However, fish diversity and density were mostly contributed by non-target species. Hence, long term protection and management of MPAs is needed to effectively increase fish diversity, density and biomass specifically on target fish species.

Keywords: biomass, density, diversity, marine protected area, target fish species

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854 Health and Safety of Red Cross Workers in Long-Term Homes during Early Days of the COVID-19 Pandemic: A Human Performance Perspective

Authors: Douglas J. Kube

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At the beginning of the COVID-19 pandemic, the Canadian Red Cross deployed workers into long-term care homes across Canada to support our most vulnerable citizens. It began by recruiting and training small teams of workers to provide non-clinical services for facilities in outbreak. Deployed workers were trained on an approach based on successful Red Cross deployments used with Ebola in which zones were established, levels of protection used, and strict protocols followed to prevent exposure. This paper addresses aspects of human performance through a safety culture lens. The Red Cross deployments highlight valuable insights and are an excellent case study in the principles of human performance and organizational culture. This paper looks at human performance principles, including human fallibility, predictability of error-likely situations, avoiding events by understanding reasons mistakes occur, and the influence on behaviour by organizational factors. This study demonstrates how the Red Cross’s organizational culture and work design positively influenced performance to protect workers and residents/clients. Lastly, this paper shares lessons that can be applied in many workplaces to improve worker health and safety and safety culture. This critical examination is based on the author’s experience as a Senior Occupational Health and Safety Advisor with the Red Cross during the pandemic as part of the team responsible for developing and implementing biological safety practices in long-term care deployments.

Keywords: COVID, human performance, organizational culture, work design

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853 In-Situ Determination of Radioactivity Levels and Radiological Hazards in and around the Gold Mine Tailings of the West Rand Area, South Africa

Authors: Paballo M. Moshupya, Tamiru A. Abiye, Ian Korir

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Mining and processing of naturally occurring radioactive materials could result in elevated levels of natural radionuclides in the environment. The aim of this study was to evaluate the radioactivity levels on a large scale in the West Rand District in South Africa, which is dominated by abandoned gold mine tailings and the consequential radiological exposures to members of the public. The activity concentrations of ²³⁸U, ²³²Th and 40K in mine tailings, soil and rocks were assessed using the BGO Super-Spec (RS-230) gamma spectrometer. The measured activity concentrations for ²³⁸U, ²³²Th and 40K in the studied mine tailings were found to range from 209.95 to 2578.68 Bq/kg, 19.49 to 108.00 Bq/kg and 31.30 to 626.00 Bq/kg, respectively. In surface soils, the overall average activity concentrations were found to be 59.15 Bq/kg, 34.91 and 245.64 Bq/kg for 238U, ²³²Th and 40K, respectively. For the rock samples analyzed, the mean activity concentrations were 32.97 Bq/kg, 32.26 Bq/kg and 351.52 Bg/kg for ²³⁸U, ²³²Th and 40K, respectively. High radioactivity levels were found in mine tailings, with ²³⁸U contributing significantly to the overall activity concentration. The external gamma radiation received from surface soil in the area is generally low, with an average of 0.07 mSv/y. The highest annual effective doses were estimated from the tailings dams and the levels varied between 0.14 mSv/y and 1.09 mSv/y, with an average of 0.51 mSv/y. In certain locations, the recommended dose constraint of 0.25 mSv/y from a single source to the average member of the public within the exposed population was exceeded, indicating the need for further monitoring and regulatory control measures specific to these areas to ensure the protection of resident members of the public.

Keywords: activity concentration, gold mine tailings, in-situ gamma spectrometry, radiological exposures

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852 Heritage Impact Assessment Policy within Western Balkans, Albania

Authors: Anisa Duraj

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As usually acknowledged, cultural heritage is the weakest component in EIA studies. The role of heritage impact assessment (HIA) in development projects is not often accounted for, and in those cases where it is, HIA is considered as a reactive response and not as a solutions provider. Because of continuous development projects, in most cases, heritage is unconsidered and often put under threat. Cultural protection and development challenges ask for prudent legal regulation and appropriate policy implementation. The challenges become even more peculiar in underdeveloped countries or endangered areas, which are generally characterized by numerous legal constraints. Therefore, the need for strategic proposals for HIA is of high importance. In order to trigger HIA as a proactive operation in the IA process and make sure to cover cultural heritage in the whole EIA framework, an appropriate system of evaluation of impacts should be provided. To obtain the required results for HIA, this last must be part of a regional policy, which will address and guide development projects toward a proper evaluation of their impacts affecting heritage. In order to get a clearer picture of existing gabs but also new possibilities for HIA, this paper will focus on the Western Balkans region and the undergoing changes that it faces. Concerning continuous development pressure in the region and within the aspiration of the Western Balkans countries to join the European Union (EU) as member states, attention should be paid to new development policies under the EU directives for conducting EIAs, and accurate support is required for the restructuration of existing policies as well as for the implementation of the UN Agenda for SDGs. In the framework of new emerging needs, if HIA is taken into account, the outcome would be an inclusive regional program that would help to overcome marginality issues of spaces and people.

Keywords: cultural heritage, impact assessment, SDGs, urban development, western Balkans, regional policy, HIA, EIA

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851 Design and Manufacture of a Hybrid Gearbox Reducer System

Authors: Ahmed Mozamel, Kemal Yildizli

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Due to mechanical energy losses and a competitive of minimizing these losses and increases the machine efficiency, the need for contactless gearing system has raised. In this work, one stage of mechanical planetary gear transmission system integrated with one stage of magnetic planetary gear system is designed as a two-stage hybrid gearbox system. The permanent magnets internal energy in the form of the magnetic field is used to create meshing between contactless magnetic rotors in order to provide self-system protection against overloading and decrease the mechanical loss of the transmission system by eliminating the friction losses. Classical methods, such as analytical, tabular method and the theory of elasticity are used to calculate the planetary gear design parameters. The finite element method (ANSYS Maxwell) is used to predict the behaviors of a magnetic gearing system. The concentric magnetic gearing system has been modeled and analyzed by using 2D finite element method (ANSYS Maxwell). In addition to that, design and manufacturing processes of prototype components (a planetary gear, concentric magnetic gear, shafts and the bearings selection) of a gearbox system are investigated. The output force, the output moment, the output power and efficiency of the hybrid gearbox system are experimentally evaluated. The viability of applying a magnetic force to transmit mechanical power through a non-contact gearing system is presented. The experimental test results show that the system is capable to operate continuously within the range of speed from 400 rpm to 3000 rpm with the reduction ratio of 2:1 and maximum efficiency of 91%.

Keywords: hybrid gearbox, mechanical gearboxes, magnetic gears, magnetic torque

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850 Ibrutinib and the Potential Risk of Cardiac Failure: A Review of Pharmacovigilance Data

Authors: Abdulaziz Alakeel, Roaa Alamri, Abdulrahman Alomair, Mohammed Fouda

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Introduction: Ibrutinib is a selective, potent, and irreversible small-molecule inhibitor of Bruton's tyrosine kinase (BTK). It forms a covalent bond with a cysteine residue (CYS-481) at the active site of Btk, leading to inhibition of Btk enzymatic activity. The drug is indicated to treat certain type of cancers such as mantle cell lymphoma (MCL), chronic lymphocytic leukaemia and Waldenström's macroglobulinaemia (WM). Cardiac failure is a condition referred to inability of heart muscle to pump adequate blood to human body organs. There are multiple types of cardiac failure including left and right-sided heart failure, systolic and diastolic heart failures. The aim of this review is to evaluate the risk of cardiac failure associated with the use of ibrutinib and to suggest regulatory recommendations if required. Methodology: Signal Detection team at the National Pharmacovigilance Center (NPC) of Saudi Food and Drug Authority (SFDA) performed a comprehensive signal review using its national database as well as the World Health Organization (WHO) database (VigiBase), to retrieve related information for assessing the causality between cardiac failure and ibrutinib. We used the WHO- Uppsala Monitoring Centre (UMC) criteria as standard for assessing the causality of the reported cases. Results: Case Review: The number of resulted cases for the combined drug/adverse drug reaction are 212 global ICSRs as of July 2020. The reviewers have selected and assessed the causality for the well-documented ICSRs with completeness scores of 0.9 and above (35 ICSRs); the value 1.0 presents the highest score for best-written ICSRs. Among the reviewed cases, more than half of them provides supportive association (four probable and 15 possible cases). Data Mining: The disproportionality of the observed and the expected reporting rate for drug/adverse drug reaction pair is estimated using information component (IC), a tool developed by WHO-UMC to measure the reporting ratio. Positive IC reflects higher statistical association while negative values indicates less statistical association, considering the null value equal to zero. The results of (IC=1.5) revealed a positive statistical association for the drug/ADR combination, which means “Ibrutinib” with “Cardiac Failure” have been observed more than expected when compared to other medications available in WHO database. Conclusion: Health regulators and health care professionals must be aware for the potential risk of cardiac failure associated with ibrutinib and the monitoring of any signs or symptoms in treated patients is essential. The weighted cumulative evidences identified from causality assessment of the reported cases and data mining are sufficient to support a causal association between ibrutinib and cardiac failure.

Keywords: cardiac failure, drug safety, ibrutinib, pharmacovigilance, signal detection

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849 Research on Strategies of Building a Child Friendly City in Wuhan

Authors: Tianyue Wan

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Building a child-friendly city (CFC) contributes to improving the quality of urbanization. It also forms a local system committed to fulfilling children's rights and development. Yet, the work related to CFC is still at the initial stage in China. Therefore, taking Wuhan, the most populous city in central China, as the pilot city would offer some reference for other cities. Based on the analysis of theories and practice examples, this study puts forward the challenges of building a child-friendly city under the particularity of China's national conditions. To handle these challenges, this study uses four methods to collect status data: literature research, site observation, research inquiry, and semantic differential (SD). And it adopts three data analysis methods: case analysis, geographic information system (GIS) analysis, and analytic hierarchy process (AHP) method. Through data analysis, this study identifies the evaluation system and appraises the current situation of Wuhan. According to the status of Wuhan's child-friendly city, this study proposes three strategies: 1) construct the evaluation system; 2) establish a child-friendly space system integrating 'point-line-surface'; 3) build a digitalized service platform. At the same time, this study suggests building a long-term mechanism for children's participation and multi-subject supervision from laws, medical treatment, education, safety protection, social welfare, and other aspects. Finally, some conclusions of strategies about CFC are tried to be drawn to promote the highest quality of life for all citizens in Wuhan.

Keywords: action plan, child friendly city, construction strategy, urban space

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848 The Hepatoprotective Effects of Aquatic Extract of Levesticum Officinale against Paraquat Toxicity of Hepatocytes

Authors: Hasan Afarnegan, Ali Shahraki, Jafar Shahraki

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Paraquat is widely used as a strong nitrogen-based herbicide for controlling of weeds in agriculture. This poison is extremely toxic for humans which induces several – organ failure by accumulation in cells and many instances of death occurred due to its poisoning. Paraquat metabolized primarily in the liver. The purpose of this study was to assess the effects of aquatic extract of levisticum officinale on oxidative status and biochemical factors in hepatocytes exposed to paraquat. Our results determined that hepatocytes destruction induced by paraquat is mediated by reactive oxygen species (ROS) production, lipid peroxidation and decrease of mitochondrial membrane potential were significantly (P<0.05) prevented by aquatic extract of Levisicum officinale (100, 200 and 300 µg/ml). These effects of paraquat also prevented via antioxidants and ROS scavengers (α-tocopherol, DMSO, manitol), mitochondrial permeability transition (MPT) pore sealing compound (carnitine).MPT pore sealing compound inhibited the hepatotoxicity, indicating that paraquat induced cell death via mithochondrial pathway. Pretreatment of hepatocytes with aquatic extracts of Levisticum officinale, antioxidants and ROS scavengers also blocked hepatic cell death caused by paraquat, suggesting that oxidative stress may be directly induced decline of mithochondrial membrane potential. In conclusion, paraquat hepatotoxicity can be attributed to oxidative stress and continued by mithochondrial membrane potential disruption. Levisticum officinale aquatic extract, presumably due to its strong antoxidant properties, could protect the destructive effects of paraquat on rat hepatocytes.

Keywords: hepatocyte protection, levisticum officinale, oxidative stress, paraquat

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847 Policy Brief/Note of Philippine Health Issues: Human Rights Violations Committed on Healthcare Workers

Authors: Trina Isabel Santiago, Daniel Chua, Jumee Tayaban, Joseph Daniel Timbol, Joshua Yanes

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Numerous instances of human rights violations on healthcare workers have been reported during the COVID-19 pandemic in the Philippines. This brief aims to explore these civil and political rights violations and propose recommendations to address these. Our review shows that a wide range of civic and political human rights violations have been committed by individual citizens and government agencies on individual healthcare workers and health worker groups. These violations include discrimination, red-tagging, evictions, illegal arrests, and acts of violence ranging from chemical attacks to homicide. If left unchecked, these issues, compounded by the pandemic, may lead to the exacerbations of the pre-existing problems of the Philippine healthcare system. Despite all pre-existing reports by human rights groups and public media articles, there still seems to be a lack of government action to condemn and prevent these violations. The existence of government agencies which directly contribute to these violations with the lack of condemnation from other agencies further propagate the problem. Given these issues, this policy brief recommends the establishment of an interagency task force for the protection of human rights of healthcare workers as well as the expedited passing of current legislative bills towards the same goal. For more immediate action, we call for the establishment of a dedicated hotline for these incidents with adequate appointment and training of point persons, construction of clear guidelines, and closer collaboration between government agencies in being united against these issues.

Keywords: human rights violations, healthcare workers, COVID-19 pandemic, Philippines

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846 Perception of Tactile Stimuli in Children with Autism Spectrum Disorder

Authors: Kseniya Gladun

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Tactile stimulation of a dorsal side of the wrist can have a strong impact on our attitude toward physical objects such as pleasant and unpleasant impact. This study explored different aspects of tactile perception to investigate atypical touch sensitivity in children with autism spectrum disorder (ASD). This study included 40 children with ASD and 40 healthy children aged 5 to 9 years. We recorded rsEEG (sampling rate of 250 Hz) during 20 min using EEG amplifier “Encephalan” (Medicom MTD, Taganrog, Russian Federation) with 19 AgCl electrodes placed according to the International 10–20 System. The electrodes placed on the left, and right mastoids served as joint references under unipolar montage. The registration of EEG v19 assignments was carried out: frontal (Fp1-Fp2; F3-F4), temporal anterior (T3-T4), temporal posterior (T5-T6), parietal (P3-P4), occipital (O1-O2). Subjects were passively touched by 4 types of tactile stimuli on the left wrist. Our stimuli were presented with a velocity of about 3–5 cm per sec. The stimuli materials and procedure were chosen for being the most "pleasant," "rough," "prickly" and "recognizable". Type of tactile stimulation: Soft cosmetic brush - "pleasant" , Rough shoe brush - "rough", Wartenberg pin wheel roller - "prickly", and the cognitive tactile stimulation included letters by finger (most of the patient’s name ) "recognizable". To designate the moments of the stimuli onset-offset, we marked the moment when the moment of the touch began and ended; the stimulation was manual, and synchronization was not precise enough for event-related measures. EEG epochs were cleaned from eye movements by ICA-based algorithm in EEGLAB plugin for MatLab 7.11.0 (Mathwork Inc.). Muscle artifacts were cut out by manual data inspection. The response to tactile stimuli was significantly different in the group of children with ASD and healthy children, which was also depended on type of tactile stimuli and the severity of ASD. Amplitude of Alpha rhythm increased in parietal region to response for only pleasant stimulus, for another type of stimulus ("rough," "thorny", "recognizable") distinction of amplitude was not observed. Correlation dimension D2 was higher in healthy children compared to children with ASD (main effect ANOVA). In ASD group D2 was lower for pleasant and unpleasant compared to the background in the right parietal area. Hilbert transform changes in the frequency of the theta rhythm found only for a rough tactile stimulation compared with healthy participants only in the right parietal area. Children with autism spectrum disorders and healthy children were responded to tactile stimulation differently with specific frequency distribution alpha and theta band in the right parietal area. Thus, our data supports the hypothesis that rsEEG may serve as a sensitive index of altered neural activity caused by ASD. Children with autism have difficulty in distinguishing the emotional stimuli ("pleasant," "rough," "prickly" and "recognizable").

Keywords: autism, tactile stimulation, Hilbert transform, pediatric electroencephalography

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845 Eco-Friendly Polymeric Corrosion Inhibitor for Sour Oilfield Environment

Authors: Alireza Rahimi, Abdolreza Farhadian, Arash Tajik, Elaheh Sadeh, Avni Berisha, Esmaeil Akbari Nezhad

Abstract:

Although natural polymers have been shown to have some inhibitory properties on sour corrosion, they are not considered very effective green corrosion inhibitors. Accordingly, effective corrosion inhibitors should be developed based on natural resources to mitigate sour corrosion in the oil and gas industry. Here, Arabic gum was employed as an eco-friendly precursor for the synthesis of innovative polyurethanes designed as highly efficient corrosion inhibitors for sour oilfield solutions. A comprehensive assessment, combining experimental and computational analyses, was conducted to evaluate the inhibitory performance of the inhibitor. Electrochemical measurements demonstrated that a concentration of 200 mM of the inhibitor offered substantial protection to mild steel against sour corrosion, yielding inhibition efficiencies of 98% and 95% at 25 ºC and 60 ºC, respectively. Additionally, the presence of the inhibitor led to a smoother steel surface, indicating the adsorption of polyurethane molecules onto the metal surface. X-ray photoelectron spectroscopy results further validated the chemical adsorption of the inhibitor on mild steel surfaces. Scanning Kelvin probe microscopy revealed a shift in the potential distribution of the steel surface towards negative values, indicating inhibitor adsorption and corrosion process inhibition. Molecular dynamic simulation indicated high adsorption energy values for the inhibitor, suggesting its spontaneous adsorption onto the Fe (110) surface. These findings underscore the potential of Arabic gum as a viable resource for the development of polyurethanes under mild conditions, serving as effective corrosion inhibitors for sour solutions.

Keywords: environmental effect, Arabic gum, corrosion inhibitor, sour corrosion, molecular dynamics simulation

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844 Open Access in the Economic Sphere: A Framework Interpreting the Rise of the UK, US and China at Different Historical Times

Authors: Guanghua Yu

Abstract:

This article has examined the rise of the UK, US, and China at different historical times to explain the argument that it is open access in the economic sphere, as well as institutional building related to the protection of property rights, contract enforcement, financial market, the rule of law, and human resource accumulation that determine economic and human development. Both the UK, after the Glorious Revolution in the seventeenth century, and China, after its adoption of the open door policy at the end of the 1970s, follow such a path of development. The difference between the UK and China in moving toward that path is the different coordination of elites. While the coordination of elites in the UK through parliament played important roles in forcing the government to consider the wider encompassing interest in society after the Glorious Revolution, the coordination of elites in China has mainly been achieved by the Communist Party of China such that the Chinese Government has started to pay greater deal of attention to the wider encompassing interest in the country from 1978. The article has also examined the rise of the US following colonial settlement to independence and institutional building thereafter. The US case is similarly consistent with the argument that open access in the economic sphere and institutional building matter the most to economic development. More decentralized methods of the coordination of elites in the US among colonies (states), the federal governments, and other political groups similarly shaped the path towards open access in the economic sphere and institutional building. As such, open access in the political sphere plays an indirect role in development at best. If that is correct, there are possibilities that different political systems are able to achieve coordination of elites so that governments will turn their attention to development.

Keywords: open access, interconnected institutions, democracy, development

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843 European Union Health Policy and the Response to COVID-19 Pandemic: Building a European Health Union

Authors: Aikaterini Tsalampouni

Abstract:

The European Union has long been the most developed model of economic and political integration that has brought a common market, a common currency and a standardization of national policies in certain areas in consistent with EU values and principles. To this direction, there is a parallel process of social integration that effect public policy decisions of member states. Even though social policy, i.e. social protection and moreover healthcare policy, still remains in state's responsibility to develop, EU applies different mechanisms in order to influence health policy systems, since from a more federalist point of view, EU ought to expand its regulatory and legislative roles in as many policy areas as possible. Recently, the pandemic has become a turning point for health care provision and at the same time has also highlighted the need to strengthen the EU’s role in coordinating health care. This paper analyses the EU health policy in general, as well as the response to COVID-19 pandemic with an attempt to identify indications of interaction between EU policies and the promotion of sustainable and resilient health systems. More analytically, the paper investigates the EU binding legal instruments, non-binding legal instruments, monitoring and assessment instruments and instruments for co-financing concerning health care provision in member states and records the evolution of health policies before and during the COVID-19 pandemic. The paper concludes by articulating some remarks regarding the improvement of health policy in EU. Since the ability to deal with a pandemic depends on continuous and increased investment in health systems, the involvement of the EU can lead to a policy convergence, necessary for the resilience of the systems, maintaining at the same time, a strong health policy framework in Europe.

Keywords: EU health policy, EU response to COVID-19, European Health Union, health systems in Europe

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842 Providing a Proposed Framework for the Copyright of Library Resources in Iran: A Comparative Study of the Copyright Laws of Iran, Australia and U.S.

Authors: Zeinab Papi

Abstract:

This study was aimed at analyzing the copyright laws of Iran, Australia, the U.S., and library portals, thereby providing a proposed framework for the copyright of library resources for the NLAI and other Iranian libraries while considering the current situation and the internal Iranian laws. This is an applied study falling in the category of qualitative approach research. Documentary analysis method and comparative method were used to resolve the problem and answer the questions of the research. The two National Library of Australia (NLA) and Library of Congress (LC), together with the NLAI formed the research community. In addition, the Iranian Law for the Protection of Authors, Composers and Artists Rights (1970); the Australian Copyright Act (1968), and the U.S. Copyright Law (1976) were purposefully selected as three main resources among other documents and resources. Findings revealed that the dimensions of fair and non-profit use, duration of copyright, license, and agreement, copyright policy, moral rights, economic rights, and infringement of copyright were the main dimensions that, along with 49 main components, formed the proposed framework for the copyright of information resources for the NLAI and other Iranian libraries. It should be acknowledged that there are some differences in different copyright fields between countries' laws, and each country takes into account its internal conditions to compile and revise the laws. By following the laws of other countries, it is possible to effectively improve and develop copyright laws. The researcher hopes that this research can have its effects in creating awareness and ability among librarians, formulating a copyright policy in Iranian libraries, and helping legislators in revising copyright laws regarding library exceptions and exemptions.

Keywords: copyright, library resources, National Library and Archives of the I.R. of Iran, National Library of Australia, Library of Congress, copyright law

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841 Sound Absorbing and Thermal Insulating Properties of Natural Fibers (Coir/Jute) Hybrid Composite Materials for Automotive Textiles

Authors: Robel Legese Meko

Abstract:

Natural fibers have been used as end-of-life textiles and made into textile products which have become a well-proven and effective way of processing. Nowadays, resources to make primary synthetic fibers are becoming less and less as the world population is rising. Hence it is necessary to develop processes to fabricate textiles that are easily converted to composite materials. Acoustic comfort is closely related to the concept of sound absorption and includes protection against noise. This research paper presents an experimental study on sound absorption coefficients, for natural fiber composite materials: a natural fiber (Coir/Jute) with different blend proportions of raw materials mixed with rigid polyurethane foam as a binder. The natural fiber composite materials were characterized both acoustically (sound absorption coefficient SAC) and also in terms of heat transfer (thermal conductivity). The acoustic absorption coefficient was determined using the impedance tube method according to the ASTM Standard (ASTM E 1050). The influence of the structure of these materials on the sound-absorbing properties was analyzed. The experimental results signify that the porous natural coir/jute composites possess excellent performance in the absorption of high-frequency sound waves, especially above 2000 Hz, and didn’t induce a significant change in the thermal conductivity of the composites. Thus, the sound absorption performances of natural fiber composites based on coir/jute fiber materials promote environmentally friendly solutions.

Keywords: coir/jute fiber, sound absorption coefficients, compression molding, impedance tube, thermal insulating properties, SEM analysis

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840 Study of the Allelopathic Effects of Certain Aromatic Plants on Grapevines

Authors: Tinatin Shengelia, Mzia Beruashvili

Abstract:

In organic farming, including organic viticulture, biodiversity plays a crucial role. Properly selected ‘companion’ and helper plants create favorable conditions for the growth and development of the main crop. Additionally, they can provide protection from pests and diseases, suppress weeds, improve the crop’s visual and taste characteristics, enhance nutrient absorption from the soil, and, as a result of all these factors, increase yields. The use of companion plants is particularly relevant for organic farms, where the range of pesticides and fertilizers is significantly restricted by organic regulations, and they must be replaced with alternative, environmentally safe methods. Therefore, the aim of this research was to study the allelopathic effects of companion aromatic plants on grapevines. The research employed methods used in organic farming and the biological control of harmful organisms. The experiments were conducted in control and experimental plots, each with three replications on equal areas (50 m²). The allelopathic potential of medicinal hyssop (Hyssopus officinalis), basil (Ocimum basilicum), marigold or Imeretian saffron (Tagetes patula), and lavender (Lavandula angustifolia L.) was studied in vineyards located in the Mtskheta-Mtianeti and Kakheti regions. The impact of these plants on grapevines (Vitis vinifera L.) (variety Muscat petitgrain), their growth and development according to the BBCH scale, yields, and diseases caused by certain pathogenic microorganisms (downy mildew, powdery mildew, anthracnose) were determined. Additionally, the biological, agricultural, and economic efficiency of using these companion plants was assessed.

Keywords: organic farming, biodiversity, allelopathy, aromatic plants

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839 Studies on Efficacy of Some Acaricidal Molecules against Mites in Polyhouse Capsicum

Authors: P. N. Guru, C. S. Patil

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The experiment was conducted during Kharif 2016 at Hingoni, Ahmednagar (dist.), Maharashtra (India) to evaluate the novel molecules of acaricides against mites in polyhouse capsicum. The study was planned with randomized block design (RBD) and included nine treatments replicated thrice with 30 m² each plot size. The crop (var. Bachata) was raised according to the standard package of practices except plant protection measures. The molecules viz., spiromesifen 22.9SC (95 gm a.i. ha⁻¹), fenpyroximate 5EC (15 gm a.i. ha⁻¹), hexythiazox 5.45EC (15 gm a.i. ha⁻¹), diafenthiuron 50WP (300 gm a.i. ha⁻¹), chlorfenapyr 10SC (75 gm a.i. ha⁻¹) were compared with a standard acaricide, dicofol 18.5EC (500 gm a.i. ha⁻¹) and biopesticides like Verticillium lecanii (2 g/l), Metarhizium anisopliae (2 g/l) and Neem oil 10,000ppm (2ml/l). In total three sprays were given after 30, 50 and 70 days after transplanting (DAT) at an interval of 20 days. The insecticidal solutions were prepared in water by diluting required concentration of chemical and applied using knapsack sprayer with hollow cone nozzle @ 500L of solution per hectare. The mites were counted per 4 cm² in three leaves from randomly selected five plants in each plot at 1 day before treatment (precount) and 1, 3, 5, 7, 10 and 15 days after treatment. The results revealed that fenpyroximate 5EC found best by recording significantly least mite population (2.72/4 cm² leaf area) followed by hexythiazox 5.45EC and spiromesifen 22.9SC (3.78 and 3.82 per 4 cm² leaf area, respectively) and followed by remaining treatments chlorfenapyr 10SC (4.13/4 cm² leaf area), diafenthiuron 50WP (4.32/4 cm² leaf area), and dicofol 18.5EC (4.48/4 cm² leaf area). Among the biopesticides tested Neem oil and Verticillium lecanii were found to be superior to Metarhizium anisopliae. Overall, newer molecules like fenpyroximate, hexythiazox, spiromesifen, diafenthiuron, and Chlorfenapyr can be used for the effective management of mites under polyhouse capsicum.

Keywords: acaricides, capsicum, mites, spiromesifen

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838 Assessment of in vitro Antioxidant and Anti-Inflammatory Potentials of Methanol Extract of Chrysophyllum albidum Cotyledon

Authors: Christianah Adebimpe Dare, Nelson Oghenebrorhie Elvis

Abstract:

This study was aimed at analysing the phytochemicals in Chrysophyllum albidum cotyledon extract and their in vitro antioxidant and anti-inflammatory effects. The star apple fruit was bought at Igbona market Osogbo, Osun State, Nigeria. The seed from the fruit was removed and defatted. The residue was exhaustively extracted with methanol. The Chrysophyllum albidum cotyledon methanol extract (CCME) was phytochemically screened, flavonoids and phenol contents, antioxidant and anti-inflammatory assays were carried out on the extract using standard procedures. Phytochemicals analysis revealed the presence of steroids, tannins, flavonoid, saponin, triterpenes, and xanthoproteins. The phenolic concentration, total flavonoids concentration, and total sugar concentration were found to be 26.72 ± 0.048 µgTAE/mg, 23.12 ± 1.92µg of Rutin equivalent (RTE)/mg (10.49 ± 1.12µg of Quercetin equivalent (QE/mg) and 778.38 ± 12.82 µg of glucose/ml, respectively. The extract demonstrated significant inhibitory effect compared with the standards as potent antioxidant with percentage inhibition of DPPH as 38.10 %-39.51 %, lipid peroxidation as 45.85 %-65.85 %; ferric reducing power showed linear correlation to the standard and the anti-inflammatory potential with 22.06 %-26.37 % protection of the human red blood membrane and the percentage inhibition of denaturation of albumin 3.42 %-7.32 %. The study showed that C. albidum cotyledon methanol extract is a potent antioxidant and anti-inflammatory agent to combat oxidative stress and pathological diseases caused by reactive species.

Keywords: albumin denaturation, free radicals, lipid peroxidation, reactive species

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837 The Applicability of Just Satisfaction in Inter-State Cases: A Case Study of Cyprus versus Turkey

Authors: Congrui Chen

Abstract:

The European Court of Human Rights (hereinafter ECtHR) delivered its judgment of just satisfaction on the case of Cyprus v. Turkey, ordering a lump sum of 9,000,000 euros as the just compensation. It is the first time that the ECtHR applied the Article 41 of just compensation in an inter-state case, and it stands as the highest amount of just compensation awarded in the history of the ECtHR. The Cyprus v. Turkey case, which represents the most crucial contribution to European peace in the history of the court. This thesis uses the methodologies of textual research, comparison analysis, and case law study to go further on the following two questions specifically:(i) whether the just compensation is applicable in an inter-state case; (ii) whether such just compensation is of punitive nature. From the point of view of general international law, the essence of the case is the state's responsibility for the violation of individual rights. In other words, the state takes a similar diplomatic protection approach to seek relief. In the course of the development of international law today, especially with the development of international human rights law, States that have a duty to protect human rights should bear corresponding responsibilities for their violations of international human rights law. Under the specific system of the European Court of Human Rights, the just compensation for article 41 is one of the specific ways of assuming responsibility. At the regulatory level, the European Court of Human Rights makes it clear that the just satisfaction of article 41 of the Convention does not include punitive damages, as it relates to the issue of national sovereignty. Nevertheless, it is undeniable that the relief to the victim and the punishment to the responsible State are two closely integrated aspects of responsibility. In other words, compensatory compensation has inherent "punitive".

Keywords: European Court of Human Right, inter-state cases, just satisfaction, punitive damages

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836 Effects of Adding Gypsum in Agricultural Land on Mitigating Splash Erosion on Sandy Loam and Loam Soil Textures, Afghanistan

Authors: Abdul Malik Dawlatzai, Shafiqullah Rahmani

Abstract:

Splash erosion in field has affected by factors; slope, rain intensity, soil properties, and plant cover. And also, soil erosion affects not only farmland productivity but also water quality downstream. There are a number of potential soil conservation practices, but many of these are complicated and relatively expensive, such as buffer strips, agro-forestry, counter banking, catchment canal, terracing, surface mulching, reduced tillage, etc. However, mitigation soil and water loss in agricultural land, particularly in arid and semi-arid climatic conditions, is indispensable for environmental protection and agricultural production. The objective of this study is to evaluate the effects of adding gypsum mineral on mitigating splash erosion caused by rain drop. The research was conducted in soil laboratory Badam Bagh Agricultural Researching Farm, Kabul, Afghanistan. The stainless steel cores were used, and constant water pressure was controlled by a Mariotte’s bottle with kinetic energy of raindrops 2.36 x 10⁻⁵J. Gypsum mineral was applied at a rate of 5 and 10 t ha⁻¹ and using a sandy loam and loam soil textures. The result was showed an average soil loss from sandy loam soil texture; control was 8.22%, 4.31% and 4.06% similar from loam soil texture, control was 7.26%, 2.89%, and 2.72% respectively. The application of gypsum mineral significantly (P < 0.05) reduced dispersion of soil particles caused by the impact of raindrops compared to control. Therefore, it was concluded that the addition of gypsum was effective as a measure for mitigating splash erosion.

Keywords: gypsum, soil loss, splash erosion, Afghanistan

Procedia PDF Downloads 132
835 Increasing National Health Insurance Scheme Enrolment in Ghana: Pro-Rata Insurance Premium Payment with Mobile Phone as the Answer

Authors: Joseph Marfo Boaheng, Daniel Ansong, Eugenia Amporfo

Abstract:

Health Insurance is proposed to provide financial protection against catastrophic health care cost arising from disease. Ghana has had a National Health Insurance Scheme (NHIS) since 2003 with the current enrolment/retention rate of 36%. The main goal of the scheme is to provide equity in the health sector as well as ensuring affordable health care for the poor. However, the current payment system is not flexible to attract significant proportion of the poor informal sector onto the scheme. Looking at the extensive use of mobiles in the Ghana where about 29,220,602.00 registered mobile phone lines are actively in used as of June 2014, paying health insurance premium through mobile phone could be feasible to attract larger proportion of the informal sector onto the scheme. Methodology: The quantitative cross-sectional survey was used to solicit the required information from 877 respondents living in Kumasi, the second capital city of Ghana. The magnitude of the effect of Pro-rata system (flexible payment terms) on NHIS enrollment rate was estimated with binary logistic regression model. Results: The odds for an individual to enroll onto NHIS with mobile phone increases about 2 times more when payment of insurance premium is on pro-rata basis ie. flexible payment terms (p=0.008, CI=1.212-3.565). Conclusion: The study advocates the National Health Insurance Authority consider this alternative payment system that has the potential of attracting a greater proportion of the informal sector to be enrolled or retained onto the scheme.

Keywords: enrollment, health insurance, mobile phone, pro-rata

Procedia PDF Downloads 394
834 Good Functional Outcome after Late Surgical Treatment for Traumatic Rotator Cuff Tear, a Retrospective Cohort Study

Authors: Soheila Zhaeentan, Anders Von Heijne, Elisabet Hagert, André Stark, Björn Salomonsson

Abstract:

Recommended treatment for traumatic rotator cuff tear (TRCT) is surgery within a few weeks after injury if the diagnosis is made early, especially if a functional impairment of the shoulder exists. This may lead to the assumption that a poor outcome then can be expected in delayed surgical treatment, when the patient is diagnosed at a later stage. The aim of this study was to investigate if a surgical repair later than three months after injury may result in successful outcomes and patient satisfaction. There is evidence in literature that good results of treatment can be expected up to three months after the injury, but little is known of later treatment with cuff repair. 73 patients (75 shoulders), 58 males/17 females, mean age 59 (range 34-­‐72), who had undergone surgical intervention for TRCT between January 1999 to December 2011 at our clinic, were included in this study. Patients were assessed by MRI investigation, clinical examination, Western Ontario Rotator Cuff index (WORC), Oxford Shoulder Score, Constant-­‐Murley Score, EQ-­‐5D and patient subjective satisfaction at follow-­‐up. The patients treated surgically within three months ( < 12 weeks) after injury (39 cases) were compared with patients treated more than three months ( ≥ 12 weeks) after injury (36 cases). WORC was used as the primary outcome measure and the other variables as secondary. A senior consultant radiologist, blinded to patient category and clinical outcome, evaluated all MRI-­‐images. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy was evaluated in all cases. The average follow-­‐up time was 56 months (range 14-­‐149) and the average time from injury to repair was 16 weeks (range 3-­‐104). No statistically significant differences were found for any of the assessed parameters or scores between the two groups. The mean WORC score was 77 (early group, range 25-­‐ 100 and late group, range 27-­‐100) for both groups (p= 0.86), Constant-­‐Murley Score (p= 0.91), Oxford Shoulder Score (p= 0.79), EQ-­‐5D index (p= 0.86). Re-­‐tear frequency was 24% for both groups, and the patients with re-­‐tear reported less satisfaction with outcome. Discussion and conclusion: This study shows that surgical repair of TRCT performed later than three months after injury may result in good functional outcomes and patient satisfaction. However, this does not motivate an intentional delay in surgery when there is an indication for surgical repair as that delay may adversely affect the possibility to perform a repair. Our results show that surgeons may safely consider surgical repair even if a delay in diagnosis has occurred. A retrospective cohort study on 75 shoulders shows good functional result after traumatic rotator cuff tear (TRCT) treated surgically up to one year after the injury.

Keywords: traumatic rotator cuff injury, time to surgery, surgical outcome, retrospective cohort study

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