Search results for: larvae/nymph mortality
1262 Jordan, Towards Eliminating Preventable Maternal Deaths
Authors: Abdelmanie Suleimat, Nagham Abu Shaqra, Sawsan Majali, Issam Adawi, Heba Abo Shindi, Anas Al Mohtaseb
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The Government of Jordan recognizes that maternal mortality constitutes a grave public health problem. Over the past two decades, there has been significant progress in improving the quality of maternal health services, resulting in improved maternal and child health outcomes. Despite these efforts, measurement and analysis of maternal mortality remained a challenge, with significant discrepancies from previous national surveys that inhibited accuracy. In response with support from USAID, the Jordan Maternal Mortality Surveillance Response (JMMSR) System was established to collect, analyze, and equip policymakers with data for decision-making guided by interdisciplinary multi-levelled advisory groups aiming to eliminate preventable maternal deaths, A 2016 Public Health Bylaw required the notification of deaths among women of reproductive age. The JMMSR system was launched in 2018 and continues annually, analyzing data received from health facilities, to guide policy to prevent avoidable deaths. To date, there have been four annual national maternal mortality reports (2018-2021). Data is collected, reviewed by advisory groups, and then consolidated in an annual report to inform and guide the Ministry of Health (MOH); JMMSR collects the necessary information to calculate an accurate maternal mortality ratio and assists in identifying leading causes and contributing factors for each maternal death. Based on this data, national response plans are created. A monitoring and evaluation plan was designed to define, track, and improve implementation through indicators. Over the past four years, one of these indicators, ‘percent of facilities notifying respective health directorates of all deaths of women of reproductive age,’ increased annually from 82.16%, 92.95%, and 92.50% to 97.02%, respectively. The Government of Jordan demonstrated commitment to the JMMSR system by designating the MOH to primarily host the system and lead the development and dissemination of policies and procedures to standardize implementation. The data was translated into practical and evidence-based recommendations. The successful impact of results deepened the understanding of maternal mortality in Jordan, which convinced the MOH to amend the Bylaw now mandating electronic reporting of all births and neonatal deaths from health facilities to empower the JMMSR system, by developing a stillbirths and neonatal mortality surveillance and response system.Keywords: maternal health, maternal mortality, preventable maternal deaths, maternal morbidity
Procedia PDF Downloads 281261 Full Mini Nutritional Assessment Questionnaire and the Risk of Malnutrition and Mortality in Elderly, Hospitalized Patients: A Cross-Sectional Study
Authors: Christos E. Lampropoulos, Maria Konsta, Tamta Sirbilatze, Ifigenia Apostolou, Vicky Dradaki, Konstantina Panouria, Irini Dri, Christina Kordali, Vaggelis Lambas, Georgios Mavras
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Objectives: Full Mini Nutritional Assessment (MNA) questionnaire is one of the most useful tools in diagnosis of malnutrition in hospitalized patients, which is related to increased morbidity and mortality. The purpose of our study was to assess the nutritional status of elderly, hospitalized patients and examine the hypothesis that MNA may predict mortality and extension of hospitalization. Methods: One hundred fifty patients (78 men, 72 women, mean age 80±8.2) were included in this cross-sectional study. The following data were taken into account in analysis: anthropometric and laboratory data, physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, dietary habits, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission. The latter was compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and extended hospitalization respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 20% per each unit increase of full MNA score (OR=0.8, 95% CI 0.74-0.89, p < 0.0001). Patients who admitted due to cancer were 23 times more likely to die, compared to those with infection (OR=23, 95% CI 3.8-141.6, p=0.001). Similarly, patients who admitted due to stroke were 7 times more likely to die (OR=7, 95% CI 1.4-34.5, p=0.02), while these with all other causes of admission were less likely (OR=0.2, 95% CI 0.06-0.8, p=0.03), compared to patients with infection. According to multivariate linear regression analysis, each increase of unit of full MNA, decreased the admission duration on average 0.3 days (b:-0.3, 95% CI -0.45 - -0.15, p < 0.0001). Patients admitted due to cancer had on average 6.8 days higher extension of hospitalization, compared to those admitted for infection (b:6.8, 95% CI 3.2-10.3, p < 0.0001). Conclusion: Mortality and extension of hospitalization is significantly increased in elderly, malnourished patients. Full MNA score is a useful diagnostic tool of malnutrition.Keywords: duration of admission, malnutrition, mini nutritional assessment score, prognostic factors for mortality
Procedia PDF Downloads 3061260 Assessing the Disability-Free Life Expectancy and Decomposition of Its Difference: A Gender Perspective on India over the Decade 2001-2011
Authors: Kajori Banerjee, Laxmi Kant Dwivedi
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“Health transition” is defined to be “a process through which high levels of mortality, morbidity and disability are reduced to low levels by influencing cultural, social and behavioural factors”. Life expectancy in India has been on the rise and parallel the burden of disease and disability has also risen noticeably. Borrowing data from Indian Census (2001, 2011), this study identifies the gender-wise burden of disability by calculating disability free life expectancy (DFLE) and life lived with disability (LWD). Sullivan’s method of calculating DFLE using proportion of disabled is used for this purpose. The change in person years lived with disability in the decade 2001-11 is further decomposed using Arriaga’s method into mortality and disability effects (ME and DE) to check the magnitude and direction of contribution of mortality and disability. Nationally, along with DFLE, LWD has amplified too. Despite having the highest life expectancy and DFLE, LWD in Kerala, was highest for both sexes in 2001. But in 2011, the LWD was highest among the males of Orissa and females of Rajasthan. For the overall population, DE is positive for the prime working age groups of 20-40years indicating that there has been an increase in the disability proportion holding mortality constant for 2001-2011. Females exhibit higher positive DE implying greater loss of healthy years due to disability than males. The findings call for an immediate attention to the causes of rising disability burden among the working population, especially females, as this might heavily effect the availability of quality labour force and its relative economic output in the Indian labour market. This also hints at the degrading quality of the elongated life and needs to be given the required attention to enhance the quality of life lead in the Nation.Keywords: disability-free life expectancy, disability effect, life expectancy, mortality effect
Procedia PDF Downloads 3861259 Evaluation of Risk and the Beneficial Effects of Synthesized Nano Silver-Based Disinfectant on Poultry Mortality and Health
Authors: Indrajeet Kumar, Jayanta Bhattacharya
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This study was evaluated for the potential use of nanosilver (nAg) as a disinfectant and antimicrobial growth promoter supplement for the poultry. The experiments were conducted in the Kangsabati river basin region, in West Medinipur district, West Bengal, India for six months. Two poultry farms were adopted for the experiment. The rural economy of this region from Jhargram to Barkola is heavily dependent on contract poultry farming. The water samples were collected from the water source of poultry farm which has been used for poultry drinking purpose. The bacteriological analysis of water sample revealed that the total bacterial count (total coliform and E. coli) were higher than the acceptable standards. The bacterial loads badly affected the growth performance and health of the poultry. For disinfection, a number of chemical compounds (like formaldehyde, calcium hypochloride, sodium hypochloride, and sodium bicarbonate) have been used in typical commercial formulations. However, the effects of all these chemical compounds have not been significant over time. As a part of our research-to-market initiative, we used nanosilver (nAg) formulation as a disinfectant. The nAg formulation was synthesized by hydrothermal technique and characterized by UV-visible, TEM, SEM, and EDX. The obtained results revealed that the mortality rate of poultry was reduced due to nAg formulation compared to the mortality rate of the negative control. Moreover, the income of the farmer family was increased by 10-20% due to less mortality and better health of the poultry.Keywords: farm water, nanosilver, field application, and poultry performance
Procedia PDF Downloads 1521258 Helicoverpa armigera Hubner (Lepidoptera: Noctuidae) Susceptibility to Bacillus thuringiensis Crystal Toxins
Authors: Muhammad Jawad Saleem, Faisal Hafeez, Muhammad Arshad, Afifa Naeem, Ayesha Iftekhar
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Bacillus thuringiensis is a gram-positive spore-forming bacterium that belongs to the Bacillus cereus group of Bacilli and it produces ICP (insecticidal crystal protein) Cry toxins or Cysts toxins. Spores are produced as parasporal crystalline inclusions bodies (also known as endotoxins) at the onset of sporulation during the stationary growth phase. During vegetative growth that does not form crystals and is called vegetative insecticidal proteins (VIP) and secreted an insecticidal protein (SIP). Bacillus thuringiensis (Bt) is important for pest management either in the form of insecticides or through incorporated in the gene of the crop. Bioassays were conducted on the F2 generation of 1st instar larvae of H. armigera by the diet incorporation method to determine the susceptibility to Bt Cry toxins (Cry1Ac, Cry2Ab, Cry2A). The median lethal concentration (LC₅₀) of Cry1Ac, Cry2Ab, Cry2A ranged from 0.11 to 1.06 µg/ml and moult inhibitory concentration (MIC₅₀) of Cry1Ac, Cry2Ab, Cry2A ranged from 0.05 to 0.25 µg/ml. Cry1Ac was found most toxic to 1st instar larvae of H. armigera as compared to other Bt Cry toxins (Cry1Ac, Cry2Ab, Cry2A). The experimental results are important to policy-makers and technology providers to develop strategies for the exploitation of transgenic Bt cotton varieties as a component of integrated pest management.Keywords: Bt toxin, Cry1Ac, Cry2Ab, Cry2A, susceptibility, Helicoverpa armigera
Procedia PDF Downloads 1671257 Study on Biodeterioration of Proteinous Objects in Museums and Toxic Efficacy of Myristica Fragrans and Syzygium Aromaticum Oils against the Larvae of Anthrenus verbasci
Authors: Fatma Faheem, K. Abduraheem
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Museums are custodians of natural and cultural heritage. Objects like tribal dresses, headgears, weapons, musical instruments, manuscripts and other ethnocultural materials housed in museums are prized possessions of intellectual and cultural property of people. Tropical countries like India have a favorable climatic condition for biodeterioration. Organic materials such as leather and parchment objects which form a substantial part of natural history collections of museums across the world are promptly infested by insects like dermestid beetles, tenebrionides, silver fishes, cockroaches and other micro-organisms. The environmental problems caused due to the overuse of pesticides and other non-degradable chemicals have been the matter of serious concern for both the scientists and public in recent years. Synthetic pesticides are very expensive and also highly toxic for humans and its environment. Due to its high health risk factor government has taken severe initiatives on policy of banning it. In order to overcome the problems of biodeterioration, natural biocides should be applied. In this paper, comparative study has been done to investigate the toxic efficacy of Myristica fragrans and Syzygium aromaticum oil in variation with contact and stomach toxicity against larvae of Anthrenus verbasci.Keywords: biodeterioration, contact toxicity, cultural heritage, natural biocides, natural heritage, stomach toxicity
Procedia PDF Downloads 2311256 Prevalence and Clinical Significance of Antiphospholipid Antibodies in COVID-19 Patients Admitted to Intensive Care Units
Authors: Mostafa Najim, Alaa Rahhal, Fadi Khir, Safae Abu Yousef, Amer Aljundi, Feryal Ibrahim, Aliaa Amer, Ahmed Soliman Mohamed, Samira Saleh, Dekra Alfaridi, Ahmed Mahfouz, Sumaya Al-Yafei, Faraj Howady, Mohamad Yahya Khatib, Samar Alemadi
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Background: Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy among critically ill patients. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19 induced coagulopathy, their clinical significance among critically ill patients with COVID-19 remains uncertain. Methods: This prospective observational study included patients with COVID-19 admitted to intensive care units (ICU) to evaluate the prevalence and clinical significance of aPLs, including anticardiolipin IgG/IgM, anti-β2-glycoprotein IgG/IgM, and lupus anticoagulant. The study outcomes included the prevalence of aPLs, a primary composite outcome of all-cause mortality, and arterial or venous thrombosis among aPLs positive patients versus aPLs negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. Results: A total of 60 critically ill patients were enrolled. Of whom, 57 (95%) were male, with a mean age of 52.8 ± 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found to have positive aPLs; of whom 21 patients were positive for lupus anticoagulant, whereas one patient was positive for anti-β2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during ICU did not differ among patients with positive aPLs compared to those with negative aPLs (4 (18%) vs. 6 (16%), aOR= 0.98, 95% CI 0.1-6.7; p-value= 0.986). Likewise, the secondary outcomes, including all-cause mortality, venous thrombosis, arterial thrombosis, discharge from ICU, time to mortality, and time to discharge from ICU, did not differ between those with positive aPLs upon ICU admission in comparison to patients with negative aPLs. Conclusion: The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.Keywords: antiphospholipid antibodies, critically ill patients, coagulopathy, coronavirus
Procedia PDF Downloads 1551255 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
Procedia PDF Downloads 881254 Some Factors Affecting Reproductive Traits in Nigerian Indigenous Chickens under Intensive Management System
Authors: J. Aliyu, A. O. Raji, A. A. Ibrahim
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The study was carried out to assess the fertility, early and late embryonic mortalities as well as hatchability by strain, season and hen’s weight in Nigerian indigenous chickens reared on deep litter. Four strains (normal feathered, naked neck, frizzle and dwarf) of hens maintained at a mating ratio of 1 cock to 4 hens, fed breeders mash and water ad libitum were used in a three year experiment. The data generated were subjected to analysis of variance using the SAS package and the means, where significant, were separated using the least significant difference (LSD). There were significant effects (P < 0.05) of strain on all the traits studied. Fertility was generally high (84.29 %) in all the strains. Early embryonic mortality was significantly lowest (P < 0.01) in naked neck which had the highest late embryonic mortality (P < 0.001). Hatchability was significantly highest (P < 0.01) in normal feathered (80.23 %) and slightly depressed in frizzle (74.95 %) and dwarf (72.27 %) while naked neck had the lowest (60.80 %). Season of the year had significant effects on early embryonic mortality. Dry hot season significantly (P < 0.05) depressed fertility while early embryonic mortality was depressed in the wet season (15.33 %). Early and late embryonic mortalities significantly increased (P < 0.05) with increasing weight of hen. Dwarf, frizzle and normal feathered hens could be used to improve hatchability as well as reduce early and late embryonic mortalities in Nigerian indigenous chickens.Keywords: chicken, fertility, hatchability, indigenous, strain
Procedia PDF Downloads 4101253 Scoring System for the Prognosis of Sepsis Patients in Intensive Care Units
Authors: Javier E. García-Gallo, Nelson J. Fonseca-Ruiz, John F. Duitama-Munoz
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Sepsis is a syndrome that occurs with physiological and biochemical abnormalities induced by severe infection and carries a high mortality and morbidity, therefore the severity of its condition must be interpreted quickly. After patient admission in an intensive care unit (ICU), it is necessary to synthesize the large volume of information that is collected from patients in a value that represents the severity of their condition. Traditional severity of illness scores seeks to be applicable to all patient populations, and usually assess in-hospital mortality. However, the use of machine learning techniques and the data of a population that shares a common characteristic could lead to the development of customized mortality prediction scores with better performance. This study presents the development of a score for the one-year mortality prediction of the patients that are admitted to an ICU with a sepsis diagnosis. 5650 ICU admissions extracted from the MIMICIII database were evaluated, divided into two groups: 70% to develop the score and 30% to validate it. Comorbidities, demographics and clinical information of the first 24 hours after the ICU admission were used to develop a mortality prediction score. LASSO (least absolute shrinkage and selection operator) and SGB (Stochastic Gradient Boosting) variable importance methodologies were used to select the set of variables that make up the developed score; each of this variables was dichotomized and a cut-off point that divides the population into two groups with different mean mortalities was found; if the patient is in the group that presents a higher mortality a one is assigned to the particular variable, otherwise a zero is assigned. These binary variables are used in a logistic regression (LR) model, and its coefficients were rounded to the nearest integer. The resulting integers are the point values that make up the score when multiplied with each binary variables and summed. The one-year mortality probability was estimated using the score as the only variable in a LR model. Predictive power of the score, was evaluated using the 1695 admissions of the validation subset obtaining an area under the receiver operating characteristic curve of 0.7528, which outperforms the results obtained with Sequential Organ Failure Assessment (SOFA), Oxford Acute Severity of Illness Score (OASIS) and Simplified Acute Physiology Score II (SAPSII) scores on the same validation subset. Observed and predicted mortality rates within estimated probabilities deciles were compared graphically and found to be similar, indicating that the risk estimate obtained with the score is close to the observed mortality, it is also observed that the number of events (deaths) is indeed increasing as the outcome go from the decile with the lowest probabilities to the decile with the highest probabilities. Sepsis is a syndrome that carries a high mortality, 43.3% for the patients included in this study; therefore, tools that help clinicians to quickly and accurately predict a worse prognosis are needed. This work demonstrates the importance of customization of mortality prediction scores since the developed score provides better performance than traditional scoring systems.Keywords: intensive care, logistic regression model, mortality prediction, sepsis, severity of illness, stochastic gradient boosting
Procedia PDF Downloads 2101252 Introduction of a New and Efficient Nematicide, Abamectin by Gyah Corporation, Iran, for Root-knot Nematodes Management Planning Programs
Authors: Shiva Mardani, Mehdi Nasr-Esfahani, Majid Olia, Hamid Molahosseini, Hamed Hassanzadeh Khankahdani
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Plant-parasitic nematodes cause serious diseases on plants and effectively reduce food production in quality and quantity worldwide, with at least 17 nematode species in the three important and major genera, including Meloidogyne, Heterodera, and Pratylenchus. Root-knot nematodes (RKN), Meloidogyne spp. with the dominant species, Meloidogynejavanica, are considered as the important plant pathogens of agricultural products globally. The hosts range can be vegetables, bedding plants, grasses, shrubs, numerous weeds, and trees, including forests. In this study, chemical management was carried out on RKN, M. javanica, to investigate the efficacy of Iranian Abamectin insecticide product [acaricide Abamectin (Vermectin® 2% EC, Gyah Corp., Iran)] verses imported normal Abamectin available in the Iran markets [acaricide Abamectin (Vermectin® 1.8% EC, Cropstar Chemical Industry Co., Ltd.)] each of which at the rate of 8 L./ha, on Tomatoes, Solanumlycopersicum L., (No. 29-41, Dutch company Siemens) as a test plant, and the controls (infested to RKN and without any chemical pesticides treatments); and (sterile soil without any RKN and chemical pesticides treatments) at the greenhouse in Isfahan, Iran. The trails were repeated thrice. The results indicated a highly significant reduction in RKN population and an increase in biomass parameters at 1% level of significance, respectively. Relatively similar results were obtained in all the three experiments conducted on tomato root-knot nematodes. The treatments of Gyah-Abamectin (51.6%) and external Abamectin (40.4%) had the highest to least effect on reducing the number of larvae in the soil compared to the infected controls, respectively. Gyah-Abamectin by 44.1% and then external one by 31.9% had the highest effect on reducing the number of larvae and eggs in the root and 31.4% and 24.1% reduction in the number of galls compared to the infected controls, respectively. Based on priority, Gyah-Abamectin (47.4 % ) and external Abamectin (31.1 %) treatments had the highest effect on reducing the number of egg- masses in the root compared to the infected controls, with no significant difference between Gyah-Abamectin and external Abamectin. The highest reproduction of larvae and egg in the root was observed in the infected controls (75.5%) and the lowest in the healthy controls (0.0%). The highest reduction in the larval and egg reproduction in the roots compared to the infected controls was observed in Gyah-Abamectin and the lowest in the external one. Based on preference, Gyah-Abamectin (37.6%) and external Abamectin (26.9%) had the highest effect on the reduction of the larvae and egg reproduction in the root compared to the infected controls, respectively. Regarding growth parameters factors, the lowest stem length was observed in external Abamectin (51.9 cm), with nosignificantly different from Gyah-Abamectin and healthy controls. The highest root fresh weight was recorded in the infected controls (19.81 gr.) and the lowest in the healthy ones (9.81 gr.); the highest root length in the healthy controls (22.4 cm), and the lowest in the infected controls and external Abamectin (12.6 and 11.9 cm), respectively. Conclusively, the results of these three tests on tomato plants revealed that Gyah-Abamectin 2% compared to external Abamectin 1.8% is competitive in the chemical management of the root nematodes of these types of products and is a suitable alternative in this regard.Keywords: solanum lycopersicum, vermectin, biomass, tomato
Procedia PDF Downloads 871251 Prognosis of Patients with COVID-19 and Hematologic Malignancies
Authors: Elizabeth Behrens, Anne Timmermann, Alexander Yerkan, Joshua Thomas, Deborah Katz, Agne Paner, Melissa Larson, Shivi Jain, Seo-Hyun Kim, Celalettin Ustun, Ankur Varma, Parameswaran Venugopal, Jamile Shammo
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Coronavirus Disease-2019 (COVID-19) causes persistent concern for poor outcomes in vulnerable populations. Patients with hematologic malignancies (HM) have been found to have higher COVID-19 case fatality rates compared to those without malignancy. While cytopenias are common in patients with HM, especially in those undergoing chemotherapy treatment, hemoglobin (Hgb) and platelet count have not yet been studied, to our best knowledge, as potential prognostic indicators for patients with HM and COVID-19. The goal of this study is to identify factors that may increase the risk of mortality in patients with HM and COVID-19. In this single-center, retrospective, observational study, 65 patients with HM and laboratory confirmed COVID-19 were identified between March 2020 and January 2021. Information on demographics, laboratory data the day of COVID-19 diagnosis, and prognosis was extracted from the electronic medical record (EMR), chart reviewed, and analyzed using the statistical software SAS version 9.4. Chi-square testing was used for categorical variable analyses. Risk factors associated with mortality were established by logistic regression models. Non-Hodgkin lymphoma (37%), chronic lymphocytic leukemia (20%), and plasma cell dyscrasia (15%) were the most common HM. Higher Hgb level upon COVID-19 diagnosis was related to decreased mortality, odd ratio=0.704 (95% confidence interval [CI]: 0.511-0.969; P = .0263). Platelet count the day of COVID-19 diagnosis was lower in patients who ultimately died (mean 127 ± 72K/uL, n=10) compared to patients who survived (mean 197 ±92K/uL, n=55) (P=.0258). Female sex was related to decreased mortality, odd ratio=0.143 (95% confidence interval [CI]: 0.026-0.785; P = .0353). There was no mortality difference between the patients who were on treatment for HM the day of COVID-19 diagnosis compared to those who were not (P=1.000). Lower Hgb and male sex are independent risk factors associated with increased mortality of HM patients with COVID-19. Clinicians should be especially attentive to patients with HM and COVID-19 who present with cytopenias. Larger multi-center studies are urgently needed to further investigate the impact of anemia, thrombocytopenia, and demographics on outcomes of patients with hematologic malignancies diagnosed with COVID-19.Keywords: anemia, COVID-19, hematologic malignancy, prognosis
Procedia PDF Downloads 1431250 Insecticide Resistance Detection on Filarial Vector, Simulium (Simulium) nobile (Diptera: Simuliidae) in Malaysia
Authors: Chee Dhang Chen, Hiroyuki Takaoka, Koon Weng Lau, Poh Ruey Tan, Ai Chdon Chin, Van Lun Low, Abdul Aziz Azidah, Mohd Sofian-Azirun
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Susceptibility status of Simulium (Simulium) nobile (Diptera: Simuliidae) adults obtained from Pahang, Malaysia was evaluated against 11 adulticides representing four major insecticide classes: organochlorines (DDT, dieldrin), organophosphates (malathion, fenitrothion), carbamates (bendiocarb, propoxur) and pyrethroids (etofenprox, deltamethrin, lambdacyhalothrin, permethrin, cyfluthrin). The adult bioassay was conducted according to WHO standard protocol to determine the insecticide susceptibility. Mortality at 24 h post treatment was used as indicator for susceptibility status. The results revealed that S. nobile obtained was susceptible to propoxur, cyfluthrin and bendiocarb with 100% mortality. S. nobile was resistant or exhibited some tolerant against lambdacyhalothrin and deltamethrin with mortality ranged ≥ 90% but < 98%. S. nobile populations in Pahang exhibited different level of resistant against 11 adulticides with mortality ranged from 60.00 ± 10.00 to 100.00 ± 0.00. In conclusion, S. nobile populations in Pahang were susceptible to propoxur, cyfluthrin and bendiocarb. The susceptibility status of S. nobile in descending order was propoxur, cyfluthrin > bendicarb > deltamethrin > lambdacyhalothrin > permethrin > etofenprox > DDT > malathion > fenitrothion > dieldrin. Regular surveys should be conducted to monitor the susceptibility status of this insect vector in order to prevent further development of resistance.Keywords: black fly, adult bioassay, insecticide resistance, Malaysia
Procedia PDF Downloads 2671249 Sensitivity of Steindachneridion parahybae Mature Oocytes versus Embryos at Low Temperature
Authors: Tais Silva Lopes, Danilo Caneppele, Elizabeth Romagosa
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Surubim-do-Paraíba, Steindachneridion parahybae is a species of South American fish in critical conditions of extinction. Researches have been developed with the objective of conserving the biological material of this species. We evaluated the cooling of mature oocytes in the cryoprotective solutions containing the following alcohols: methanol, Propylene glycol and DMSO, each at concentrations of 1M, 2M and 4M, totaling nine treatments. After being submitted to treatments, the oocytes were maintained for 120 minutes in cooling to -5.52±2.58⁰C. A sample of oocytes was submitted to negative control (NC), kept in 90% L-15 solution, and positive control (PC), fertilized and taken directly to the incubator. Fertilization and hatching rates were evaluated. In order to compare the sensitivity of oocytes to embryos of the same species, the embryos maintained as CP in the previous assay were used in the free-flow stage (about 22 hours post fertilization) and submitted to the same treatments (prepared in distilled water) and also cooled for 120 min. The evaluation was done by the hatch rate. There was no fertilization rate of the oocytes submitted to the cooling with propylene glycol; the other cryoprotectants presented values of at most 3.7% of fertilization (Methanol 1M), and no treatment completed development until hatching. The cooled embryos had a significant percentage of normal larvae in all treatments, but inversely proportional to the increase in the concentration of the alcohols. DMSO 1M was the most promising treatment for embryo cooling, with 41.7% ± 20.2 of normal larvae, while mature oocytes were highly sensitive to cold.Keywords: cryoconservation, cooling, embryos, freezing, oocytes, south American fish
Procedia PDF Downloads 2341248 Safety Evaluation of Intramuscular Administration of Zuprevo® Compared to Draxxin® in the Treatment of Swine Respiratory Disease at Weaning Age
Authors: Josine Beek, S. Agten, R. Del Pozo, B. Balis
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The objective of the present study was to compare the safety of intramuscular administration of Zuprevo® (tildipirosin, 40 mg/mL) with Draxxin® (tulathromycin, 100 mg/mL) in the treatment of swine respiratory disease at weaning age. The trial was carried out in two farrow-to-finish farms with 300 sows (farm A) and 500 sows (farm B) in a batch-production system. Farm A had no history of respiratory problems, whereas farm B had a history of respiratory outbreaks with increased mortality ( > 2%) in the nursery. Both farms were positive to Pasteurella multocida, Bordetella bronchiseptica, Actinobacillus pleuropneumoniae and Haemophilus parasuis. From each farm, one batch of piglets was included (farm A: 644 piglets; farm B: 963 piglets). One day before weaning (day 0; 18-21 days of age), piglets were identified by an individual ear tag and randomly assigned to a treatment group. At day 0, Group 1 was treated with a single intramuscular injection with Zuprevo® (tildipirosin, 40 mg/mL; 1 mL/10 kg) and group 2 with Draxxin® (tulathromycin, 100 mg/mL; 1 mL/40 kg). For practical reasons, dosage of the product was adjusted according to three weight categories: < 4 kg, 4-6 kg and > 6 kg. Within each farm, piglets of both groups were comingled at weaning and subsequently managed and located in the same facilities and with identical environmental conditions. Our study involved the period from day 0 until 10 weeks of age. Safety of treatment was evaluated by 1) visual examination for signs of discomfort directly after treatment and after 15 min, 1 h and 24 h and 2) mortality rate within 24 h after treatment. Efficacy of treatment was evaluated based on mortality rate from day 0 until 10 weeks of age. Each piglet that died during the study period was necropsied by the herd veterinarian to determine the probable cause of death. Data were analyzed using binary logistic regression and differences were considered significant if p < 0.05. The pig was the experimental unit. In total, 848 piglets were treated with tildipirosin and 759 piglets with tulathromycin. In farm A, one piglet with retarded growth ( < 1 kg at 18 days of age) showed an adverse reaction after injection of tildipirosin: lateral recumbence and dullness for ± 30 sec. The piglet recovered after 1-2 min. This adverse reaction was probably due to overdosing (12 mg/kg). No adverse effect of treatment was observed in any other piglet. There was no mortality within 24 h after treatment. No significant difference was found in mortality rate between both groups from day 0 until 10 weeks of age. In farm A, overall mortality rate was 0.3% (2/644). In farm B, mortality rate was 0.2% (1/502) in group 1 (tildipirosin) and 0.9% (4/461) in group 2 (tulathromycin)(p=0.60). The necropsy of piglets that died during the study period revealed no macroscopic lesions of the respiratory tract. In conclusion, Zuprevo® (tildipirosin, 40 mg/mL) was shown to be a safe and efficacious alternative to Draxxin® (tulathromycin, 100 mg/mL) for the early treatment of swine respiratory disease at weaning age.Keywords: antibiotic treatment, safety, swine respiratory disease, tildipirosin
Procedia PDF Downloads 3891247 Factors Contributing to Adverse Maternal and Fetal Outcome in Patients with Eclampsia
Authors: T. Pradhan, P. Rijal, M. C. Regmi
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Background: Eclampsia is a multisystem disorder that involves vital organs and failure of these may lead to deterioration of maternal condition and hypoxia and acidosis of fetus resulting in high maternal and perinatal mortality and morbidity. Thus, evaluation of the contributing factors for this condition and its complications leading to maternal deaths should be the priority. Formulating the plan and protocol to decrease these losses should be our goal. Aims and Objectives: To evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia and to correlate the risk factors associated with maternal and fetal morbidity and mortality. Methods: All patients with eclampsia admitted in Department of Obstetrics and Gynecology, B. P. Koirala Institute of Health Sciences were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to patients, and attendants like Antenatal clinic visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate and the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition like maternal Intensive Care Unit admission, neurological impairment and mortality were noted before discharge. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS 11). Mean and percentage were calculated for demographic variables. Pearson’s correlation test and chi-square test were applied to find the relation between the risk factors and the outcomes. P value less than 0.05 was considered significant. Results: There were 10,000 antenatal deliveries during the study period. Fifty-two patients with eclampsia were admitted. All of the patients were unbooked for our institute. Thirty-nine patients were antepartum eclampsia. Thirty-one patients required mechanical ventilator support. Twenty-four patients were delivered by emergency c-section and 21 babies were Low Birth Weight and there were 9 stillbirths. There was one maternal mortality and 45 patients were discharged with improvement but 3 patients had neurological impairment. Mortality was significantly related with number of seizure episodes and time interval between seizure onset and administration of magnesium sulphate. Conclusion: Early detection and management of hypertensive complicating pregnancy during antenatal clinic check up. Early hospitalization and management with magnesium sulphate for eclampsia can help to minimize the maternal and fetal adverse outcomes.Keywords: eclampsia, maternal mortality, perinatal mortality, risk factors
Procedia PDF Downloads 1611246 Geographic Variation in the Baseline Susceptibility of Helicoverpa armigera (Hubner) (Noctuidae: Lepidoptera) Field Populations to Bacillus thuringiensis Cry Toxins for Resistance Monitoring
Authors: Muhammad Arshad, M. Sufian, Muhammad D. Gogi, A. Aslam
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The transgenic cotton expressing Bacillus thuringiensis (Bt) provides an effective control of Helicoverpa armigera, a most damaging pest of the cotton crop. However, Bt cotton may not be the optimal solution owing to the selection pressure of Cry toxins. As Bt cotton express the insecticidal proteins throughout the growing seasons, there are the chances of resistance development in the target pests. A regular monitoring and surveillance of target pest’s baseline susceptibility to Bt Cry toxins is crucial for early detection of any resistance development. The present study was conducted to monitor the changes in the baseline susceptibility of the field population of H. armigera to Bt Cry1Ac toxin. The field-collected larval populations were maintained in the laboratory on artificial diet and F1 generation larvae were used for diet incorporated diagnostic studies. The LC₅₀ and MIC₅₀ were calculated to measure the level of resistance of population as a ratio over susceptible population. The monitoring results indicated a significant difference in the susceptibility (LC₅₀) of H. armigera for first, second, third and fourth instar larval populations sampled from different cotton growing areas over the study period 2016-17. The variations in susceptibility among the tested insects depended on the age of the insect and susceptibility decreased with the age of larvae. The overall results show that the average resistant ratio (RR) of all field-collected populations (FSD, SWL, MLT, BWP and DGK) exposed to Bt toxin Cry1Ac ranged from 3.381-fold to 7.381-fold for 1st instar, 2.370-fold to 3.739-fold for 2nd instar, 1.115-fold to 1.762-fold for 3rd instar and 1.141-fold to 2.504-fold for 4th instar, depicting maximum RR from MLT population, whereas minimum RR for FSD and SWL population. The results regarding moult inhibitory concentration of H. armigera larvae (1-4th instars) exposed to different concentrations of Bt Cry1Ac toxin indicated that among all field populations, overall Multan (MLT) and Bahawalpur (BWP) populations showed higher MIC₅₀ values as compared to Faisalabad (FSD) and Sahiwal (SWL), whereas DG Khan (DGK) population showed an intermediate moult inhibitory concentrations. This information is important for the development of more effective resistance monitoring programs. The development of Bt Cry toxins baseline susceptibility data before the widespread commercial release of transgenic Bt cotton cultivars in Pakistan is important for the development of more effective resistance monitoring programs to identify the resistant H. armigera populations.Keywords: Bt cotton, baseline, Cry1Ac toxins, H. armigera
Procedia PDF Downloads 1301245 Mediterranean Diet, Duration of Admission and Mortality in Elderly, Hospitalized Patients: A Cross-Sectional Study
Authors: Christos Lampropoulos, Maria Konsta, Ifigenia Apostolou, Vicky Dradaki, Tamta Sirbilatze, Irini Dri, Christina Kordali, Vaggelis Lambas, Kostas Argyros, Georgios Mavras
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Objectives: Mediterranean diet has been associated with lower incidence of cardiovascular disease and cancer. The purpose of our study was to examine the hypothesis that Mediterranean diet may protect against mortality and reduce admission duration in elderly, hospitalized patients. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). The following data were taken into account in analysis: anthropometric and laboratory data, dietary habits (MedDiet score), patients’ nutritional status [Mini Nutritional Assessment (MNA) score], physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and admission duration difference respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 30% per each unit increase of MedDiet score (OR=0.7, 95% CI:0.6-0.8, p < 0.0001). Patients with cancer-related admission were 37.7 times more likely to die, compared to those with infection (OR=37.7, 95% CI:4.4-325, p=0.001). According to multivariate linear regression analysis, admission duration was inversely related to Mediterranean diet, since it is decreased 0.18 days on average for each unit increase of MedDiet score (b:-0.18, 95% CI:-0.33 - -0.035, p=0.02). Additionally, the duration of current admission increased on average 0.83 days for each previous hospital admission (b:0.83, 95% CI:0.5-1.16, p<0.0001). The admission duration of patients with cancer was on average 4.5 days higher than the patients who admitted due to infection (b:4.5, 95% CI:0.9-8, p=0.015). Conclusion: Mediterranean diet adequately protects elderly, hospitalized patients against mortality and reduces the duration of hospitalization.Keywords: Mediterranean diet, malnutrition, nutritional status, prognostic factors for mortality
Procedia PDF Downloads 3051244 Evaluation of the Spectrum of Cases of Perforation Peritonitis at Jawaharlal Nehru Medical College, Aligarh Muslim University
Authors: Mujahid Ali, Wasif Mohammed Ali, Meraj Ahmad
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Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well as in India. The etiology of perforation peritonitis in India continues to be different from its western counterparts. The aim of this study is to evaluate the spectrum of cases of perforation peritonitis at our hospital. Methods: A prospective study conducted includes three hundred thirtysix patients of perforation peritonitis at J. N. Medical College from October 2015 to July 2017. The patients were admitted, resuscitated and underwent emergency laparotomy. Data were collected in terms of demographic profile, clinical presentations, site of perforations, causes and surgical outcomes. Results: In this study, the most common cause of perforation peritonitis was peptic ulcer disease (43%), followed by enteric perforation (12.8%), tubercular perforation (12.5%), traumatic perforation (11.9%), appendicular perforation (9.8%), amoebic caecal perforation (3%), malignant perforation (1.5%), etc. The sites of perforations were stomach in majority (38.3%), ileum (31%), appendix (8%), duodenum (5.%), caecum (4.4%) ,colon (3%), jejunum (8.5%) and gall bladder (2%). The overall mortality was 21% in our study. Age >50 years (p= <0.0001, OR= 3.9260, CI= 2.2 to 6.9), organ failure (p= <0.0001, OR= 29.2, CI= 14.8 to 57.6), shock (p=<0.0001, OR=20.20, CI= 10.56 to 38.6), diffuse peritonitis (p<0.0015, OR= 6.8810, CI= 2.09 to 22.57) and faecal exudates (p<0.0001) were found to be significant factors affecting mortality. The most common complication associated was superficial wound infection (40%), followed by burst abdomen seen in 21% cases, intra-abdominal sepsis in 18% cases, electrolyte imbalances in 15% cases, anastomotic leak in 6% cases. Conclusion: In this study, stomach is the most common site of perforation with peptic ulcer disease being the most common etiology. Older age, presence of shock, organ failure and faecal peritonitis were the risk factors affecting the mortality of the patients. Early recognition, adequate resuscitation and referral of patients can influence outcome and reduces mortality as well as morbidity.Keywords: etiology, mortality, perforation, spectrum
Procedia PDF Downloads 2511243 Hospital Malnutrition and its Impact on 30-day Mortality in Hospitalized General Medicine Patients in a Tertiary Hospital in South India
Authors: Vineet Agrawal, Deepanjali S., Medha R., Subitha L.
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Background. Hospital malnutrition is a highly prevalent issue and is known to increase the morbidity, mortality, length of hospital stay, and cost of care. In India, studies on hospital malnutrition have been restricted to ICU, post-surgical, and cancer patients. We designed this study to assess the impact of hospital malnutrition on 30-day post-discharge and in-hospital mortality in patients admitted in the general medicine department, irrespective of diagnosis. Methodology. All patients aged above 18 years admitted in the medicine wards, excluding medico-legal cases, were enrolled in the study. Nutritional assessment was done within 72 h of admission, using Subjective Global Assessment (SGA), which classifies patients into three categories: Severely malnourished, Mildly/moderately malnourished, and Normal/well-nourished. Anthropometric measurements like Body Mass Index (BMI), Triceps skin-fold thickness (TSF), and Mid-upper arm circumference (MUAC) were also performed. Patients were followed-up during hospital stay and 30 days after discharge through telephonic interview, and their final diagnosis, comorbidities, and cause of death were noted. Multivariate logistic regression and cox regression model were used to determine if the nutritional status at admission independently impacted mortality at one month. Results. The prevalence of malnourishment by SGA in our study was 67.3% among 395 hospitalized patients, of which 155 patients (39.2%) were moderately malnourished, and 111 (28.1%) were severely malnourished. Of 395 patients, 61 patients (15.4%) expired, of which 30 died in the hospital, and 31 died within 1 month of discharge from hospital. On univariate analysis, malnourished patients had significantly higher morality (24.3% in 111 Cat C patients) than well-nourished patients (10.1% in 129 Cat A patients), with OR 9.17, p-value 0.007. On multivariate logistic regression, age and higher Charlson Comorbidity Index (CCI) were independently associated with mortality. Higher CCI indicates higher burden of comorbidities on admission, and the CCI in the expired patient group (mean=4.38) was significantly higher than that of the alive cohort (mean=2.85). Though malnutrition significantly contributed to higher mortality on univariate analysis, it was not an independent predictor of outcome on multivariate logistic regression. Length of hospitalisation was also longer in the malnourished group (mean= 9.4 d) compared to the well-nourished group (mean= 8.03 d) with a trend towards significance (p=0.061). None of the anthropometric measurements like BMI, MUAC, or TSF showed any association with mortality or length of hospitalisation. Inference. The results of our study highlight the issue of hospital malnutrition in medicine wards and reiterate that malnutrition contributes significantly to patient outcomes. We found that SGA performs better than anthropometric measurements in assessing under-nutrition. We are of the opinion that the heterogeneity of the study population by diagnosis was probably the primary reason why malnutrition by SGA was not found to be an independent risk factor for mortality. Strategies to identify high-risk patients at admission and treat malnutrition in the hospital and post-discharge are needed.Keywords: hospitalization outcome, length of hospital stay, mortality, malnutrition, subjective global assessment (SGA)
Procedia PDF Downloads 1461242 The Relationship between the Skill Mix Model and Patient Mortality: A Systematic Review
Authors: Yi-Fung Lin, Shiow-Ching Shun, Wen-Yu Hu
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Background: A skill mix model is regarded as one of the most effective methods of reducing nursing shortages, as well as easing nursing staff workloads and labor costs. Although this model shows several benefits for the health workforce, the relationship between the optimal model of skill mix and the patient mortality rate remains to be discovered. Objectives: This review aimed to explore the relationship between the skill mix model and patient mortality rate in acute care hospitals. Data Sources: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases and researchers retrieved studies published between January 1986 and March 2022. Review methods: Two independent reviewers screened the titles and abstracts based on selection criteria, extracted the data, and performed critical appraisals using the STROBE checklist of each included study. The studies focused on adult patients in acute care hospitals, and the skill mix model and patient mortality rate were included in the analysis. Results: Six included studies were conducted in the USA, Canada, Italy, Taiwan, and European countries (Belgium, England, Finland, Ireland, Spain, and Switzerland), including patients in medical, surgical, and intensive care units. There were both nurses and nursing assistants in their skill mix team. This main finding is that three studies (324,592 participants) show evidence of fewer mortality rates associated with hospitals with a higher percentage of registered nurse staff (range percentage of registered nurse staff 36.1%-100%), but three articles (1,122,270 participants) did not find the same result (range of percentage of registered nurse staff 46%-96%). However, based on appraisal findings, those showing a significant association all meet good quality standards, but only one-third of their counterparts. Conclusions: In light of the limited amount and quality of published research in this review, it is prudent to treat the findings with caution. Although the evidence is not insufficient certainty to draw conclusions about the relationship between nurse staffing level and patients' mortality, this review lights the direction of relevant studies in the future. The limitation of this article is the variation in skill mix models among countries and institutions, making it impossible to do a meta-analysis to compare them further.Keywords: nurse staffing level, nursing assistants, mortality, skill mix
Procedia PDF Downloads 1061241 Validation Pulmonary Embolus Severity Index Score Early Mortality Rate at 1, 3, 7 Days in Patients with a Diagnosis of Pulmonary Embolism
Authors: Nicholas Marinus Batt, Angus Radford, Khaled Saraya
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Pulmonary Embolus Severity Index (PESI) score is a well-validated decision-making score grading mortality rates (MR) in patients with a suspected or confirmed diagnosis of pulmonary embolism (PE) into 5 classes. Thirty and 90 days MR in class I and II are lower allowing the treatment of these patients as outpatients. In a London District General Hospital (DGH) with mixed ethnicity and high disease burden, we looked at MR at 1, 3, and 7 days of all PESI score classes. Our pilot study of 112 patients showed MR of 0% in class I, II, and III. The current study includes positive Computed Tomographic Scans (CT scans) for PE over the following three years (total of 555). MR was calculated for all PESI score classes at 1, 3 & 7 days. Thirty days MR was additionally calculated to validate the study. Our initial results so far are in line with our pilot studies. Further subgroup analysis accounting for the local co-morbidities and disease burden and its impact on the MR will be undertaken.Keywords: Pulmonary Embolism (PE), Pulmonary Embolism Severity Index (PESI) score, mortality rate (MR), CT pulmonary artery
Procedia PDF Downloads 2561240 Seasonal Short-Term Effect of Air Pollution on Cardiovascular Mortality in Belgium
Authors: Natalia Bustos Sierra, Katrien Tersago
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It is currently proven that both extremes of temperature are associated with increased mortality and that air pollution is associated with temperature. This relationship is complex, and in countries with important seasonal variations in weather such as Belgium, some effects can appear as non-significant when the analysis is done over the entire year. We, therefore, analyzed the effect of short-term outdoor air pollution exposure on cardiovascular mortality during the warmer and colder months separately. We used daily cardiovascular deaths from acute cardiovascular diagnostics according to the International Classification of Diseases, 10th Revision (ICD-10: I20-I24, I44-I49, I50, I60-I66) during the period 2008-2013. The environmental data were population-weighted concentrations of particulates with an aerodynamic diameter less than 10 µm (PM₁₀) and less than 2.5 µm (PM₂.₅) (daily average), nitrogen dioxide (NO₂) (daily maximum of the hourly average) and ozone (O₃) (daily maximum of the 8-hour running mean). A Generalized linear model was applied adjusting for the confounding effect of season, temperature, dew point temperature, the day of the week, public holidays and the incidence of influenza-like illness (ILI) per 100,000 inhabitants. The relative risks (RR) were calculated for an increase of one interquartile range (IQR) of the air pollutant (μg/m³). These were presented for the four hottest months (June, July, August, September) and coldest months (November, December, January, February) in Belgium. We applied both individual lag model and unconstrained distributed lag model methods. The cumulative effect of a four-day exposure (day of exposure and three consecutive days) was calculated from the unconstrained distributed lag model. The IQR for PM₁₀, PM₂.₅, NO₂, and O₃ were respectively 8.2, 6.9, 12.9 and 25.5 µg/m³ during warm months and 18.8, 17.6, 18.4 and 27.8 µg/m³ during cold months. The association with CV mortality was statistically significant for the four pollutants during warm months and only for NO₂ during cold months. During the warm months, the cumulative effect of an IQR increase of ozone for the age groups 25-64, 65-84 and 85+ was 1.066 (95%CI: 1.002-1.135), 1.041 (1.008-1.075) and 1.036 (1.013-1.058) respectively. The cumulative effect of an IQR increase of NO₂ for the age group 65-84 was 1.066 (1.020-1.114) during warm months and 1.096 (1.030-1.166) during cold months. The cumulative effect of an IQR increase of PM₁₀ during warm months reached 1.046 (1.011-1.082) and 1.038 (1.015-1.063) for the age groups 65-84 and 85+ respectively. Similar results were observed for PM₂.₅. The short-term effect of air pollution on cardiovascular mortality is greater during warm months for lower pollutant concentrations compared to cold months. Spending more time outside during warm months increases population exposure to air pollution and can, therefore, be a confounding factor for this association. Age can also affect the length of time spent outdoors and the type of physical activity exercised. This study supports the deleterious effect of air pollution on cardiovascular mortality (CV) which varies according to season and age groups in Belgium. Public health measures should, therefore, be adapted to seasonality.Keywords: air pollution, cardiovascular, mortality, season
Procedia PDF Downloads 1541239 Effect of Silicon on Tritrophic Interaction of Cotton, Whitefly and Chrysoperla carnea
Authors: Asim Abbasi, Muhammad Sufyan
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The present experiment was carried out to examine the effects of silicon dioxide on tritrophic interaction of cotton, whitefly, and the predator Chrysoperla carnea. Population of whitefly was maintained on silicon treated and non-treated cotton for two generations in greenhouse net cages exposed to outside temperature and luminosity. The cotton was treated with silicon dioxide twice after 15 days intervals with 200 ppm concentration. A stock rearing of the natural predator was developed in the laboratory conditions. In the bioassay eggs of the predator all at the same age were individualized in glass petri plates that will be pierced with a pin to allow aeration and maintained in an incubator at 28 ± 2°C, 70 ± 10% relative humidity and 12h photo phase. Population of whitefly stayed on silicon treated, and non-treated cotton were offered to newly hatched chrysopid larvae until the end of the larval stage, assuring a permanent supply. Feeding preference of C. carnea along with longevity, survival of each instar larvae, pupation, adult emergence, and fecundity was checked. The results revealed that there was no significant difference in the feeding preference of C. carnea among both treatments. Durations of 1st and 2nd larval instar were also at par in both treatments. However overall longevity and adult emergence were a bit lower in silicon treated whitefly treatment. This may be due to the fact that silicon reduces the nutritional quality of host because of reduced whitefly feeding on silicon treated cotton. No significant difference in 1st and 2nd larval instars and then increased larval duration in later instars suggested that the effect of silicon treated host should be checked on more than 1 generation of C. carnea to get better findings.Keywords: Chrysoperla carnea, silicon, tritrophic, whitefly
Procedia PDF Downloads 1741238 Utility of Thromboelastography to Reduce Coagulation-Related Mortality and Blood Component Rate in Neurosurgery ICU
Authors: Renu Saini, Deepak Agrawal
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Background: Patients with head and spinal cord injury frequently have deranged coagulation profiles and require blood products transfusion perioperatively. Thromboelastography (TEG) is a ‘bedside’ global test of coagulation which may have role in deciding the need of transfusion in such patients. Aim: To assess the usefulness of TEG in department of neurosurgery in decreasing transfusion rates and coagulation-related mortality in traumatic head and spinal cord injury. Method and Methodology: A retrospective comparative study was carried out in the department of neurosurgery over a period of 1 year. There are two groups in this study. ‘Control’ group constitutes the patients in whom data was collected over 6 months (1/6/2009-31/12/2009) prior to installation of TEG machine. ‘Test’ group includes patients in whom data was collected over 6months (1/1/2013-30/6/2013) post TEG installation. Total no. of platelet, FFP, and cryoprecipitate transfusions were noted in both groups along with in hospital mortality and length of stay. Result: Both groups were matched in age and sex of patients, number of head and spinal cord injury cases, number of patients with thrombocytopenia and number of patients who underwent operation. Total 178 patients (135 head injury and 43 spinal cord injury patents) were admitted in neurosurgery department during time period June 2009 to December 2009 i.e. prior to TEG installation and after TEG installation a total of 243 patients(197 head injury and 46 spinal cord injury patents) were admitted. After TEG introduction platelet transfusion significantly reduced (p=0.000) compare to control group (67 units to 34 units). Mortality rate was found significantly reduced after installation (77 patients to 57 patients, P=0.000). Length of stay was reduced significantly (Prior installation 1-211days and after installation 1-115days, p=0.02). Conclusion: Bedside TEG can dramatically reduce platelet transfusion components requirement in department of neurosurgery. TEG also lead to a drastic decrease in mortality rate and length of stay in patients with traumatic head and spinal cord injuries. We recommend its use as a standard of care in the patients with traumatic head and spinal cord injuries.Keywords: blood component transfusion, mortality, neurosurgery ICU, thromboelastography
Procedia PDF Downloads 3201237 The Impact of Hospital Strikes on Patient Care: Evidence from 135 Strikes in the Portuguese National Health System
Authors: Eduardo Costa
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Hospital strikes in the Portuguese National Health Service (NHS) are becoming increasingly frequent, raising concerns in what respects patient safety. In fact, data shows that mortality rates for patients admitted during strikes are up to 30% higher than for patients admitted in other days. This paper analyses the effects of hospital strikes on patients’ outcomes. Specifically, it analyzes the impact of different strikes (physicians, nurses and other health professionals), on in-hospital mortality rates, readmission rates and length of stay. The paper uses patient-level data containing all NHS hospital admissions in mainland Portugal from 2012 to 2017, together with a comprehensive strike dataset comprising over 250 strike days (19 physicians-strike days, 150 nurses-strike days and 50 other health professionals-strike days) from 135 different strikes. The paper uses a linear probability model and controls for hospital and regional characteristics, time trends, and changes in patients’ composition and diagnoses. Preliminary results suggest a 6-7% increase in in-hospital mortality rates for patients exposed to physicians’ strikes. The effect is smaller for patients exposed to nurses’ strikes (2-5%). Patients exposed to nurses strikes during their stay have, on average, higher 30-days urgent readmission rates (4%). Length of stay also seems to increase for patients exposed to any strike. Results – conditional on further testing, namely on non-linear models - suggest that hospital operations and service levels are partially disrupted during strikes.Keywords: health sector strikes, in-hospital mortality rate, length of stay, readmission rate
Procedia PDF Downloads 1291236 Defense Priming from Egg to Larvae in Litopenaeus vannamei with Non-Pathogenic and Pathogenic Bacteria Strains
Authors: Angelica Alvarez-Lee, Sergio Martinez-Diaz, Jose Luis Garcia-Corona, Humberto Lanz-Mendoza
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World aquaculture is always looking for improvements to achieve productions with high yields avoiding the infection by pathogenic agents. The best way to achieve this is to know the biological model to create alternative treatments that could be applied in the hatcheries, which results in greater economic gains and improvements in human public health. In the last decade, immunomodulation in shrimp culture with probiotics, organic acids and different carbon sources has gained great interest, mainly in larval and juvenile stages. Immune priming is associated with a strong protective effect against a later pathogen challenge. This work provides another perspective about immunostimulation from spawning until hatching. The stimulation happens during development embryos and generates resistance to infection by pathogenic bacteria. Massive spawnings of white shrimp L. vannamei were obtained and placed in experimental units with 700 mL of sterile seawater at 30 °C, salinity of 28 ppm and continuous aeration at a density of 8 embryos.mL⁻¹. The immunostimulating effect of three death strains of non-pathogenic bacterial (Escherichia coli, Staphylococcus aureus and Bacillus subtilis) and a pathogenic strain for white shrimp (Vibrio parahaemolyticus) was evaluated. The strains killed by heat were adjusted to O.D. 0.5, at A 600 nm, and directly added to the seawater of each unit at a ratio of 1/100 (v/v). A control group of embryos without inoculum of dead bacteria was kept under the same physicochemical conditions as the rest of the treatments throughout the experiment and used as reference. The duration of the stimulus was 12 hours, then, the larvae that hatched were collected, counted and transferred to a new experimental unit (same physicochemical conditions but at a salinity of 28 ppm) to carry out a challenge of infection against the pathogen V. parahaemolyticus, adding directly to seawater an amount 1/100 (v/v) of the live strain adjusted to an OD 0.5; at A 600 nm. Subsequently, 24 hrs after infection, nauplii survival was evaluated. The results of this work shows that, after 24 hrs, the hatching rates of immunostimulated shrimp embryos with the dead strains of B. subtillis and V. parahaemolyticus are significantly higher compared to the rest of the treatments and the control. Furthermore, survival of L. vanammei after a challenge of infection of 24 hrs against the live strain of V. parahaemolyticus is greater (P < 0.05) in the larvae immunostimulated during the embryonic development with the dead strains B. subtillis and V. parahaemolyticus, followed by those that were treated with E. coli. In summary superficial antigens can stimulate the development cells to promote hatching and can have normal development in agreeing with the optical observations, plus exist a differential response effect between each treatment post-infection. This research provides evidence of the immunostimulant effect of death pathogenic and non-pathogenic bacterial strains in the rate of hatching and oversight of shrimp L. vannamei during embryonic and larval development. This research continues evaluating the effect of these death strains on the expression of genes related to the defense priming in larvae of L. vannamei that come from massive spawning in hatcheries before and after the infection challenge against V. parahaemolyticus.Keywords: immunostimulation, L. vannamei, hatching, survival
Procedia PDF Downloads 1341235 Impact of Coccidia on Mortality and Weight Growth in Japanese Quail Coturnix japonica (Aves, Phasianidae) in Algeria
Authors: Amina Smai, Fairouz Haddadj, Habiba Saadi-Idouhar, Meriem Aissi, Safia Zenia, Salaheddine Doumandji
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Coccidiosis is a very common intestinal parasitic disease caused by a worldwide distributed protozoan of the genus Eimeria. This disease is very common in young birds beyond the second week of life, especially in land-based breeding. The study was carried out in a hunting center of Zeralda located in the north-east of Algiers. The objective of our work is to study the evolution of coccidiosis in quails from 1 to 35 days old by collecting their droppings daily. These are analyzed in the laboratory using the flotation method and the Mac Master one to count coccidia. Weight changes are taken into account as well as mortality in parallel with certain zootechnical parameters such as density. The species of coccidia recovered is Eimeria coturnicis. The results showed that there is an average evolution of mortality of individuals with a rate of 13.33% due to the presence of coccidia with a significant regression (p=0.031). The weight of the quails increases with the age of the animal with a rapid growth rate from the 3rd week onwards. Indeed, the statistical analysis reveals that the evolution of the number did not affect the evolution of the weight (p=0.70) and the GMQ (R=0.52).Keywords: coccidiosis, Coturnix japonica, daily average gain, weight
Procedia PDF Downloads 1741234 Neonatal Sepsis in Dogs Attend in Veterinary Hospital of the Sao Paulo State University, Botucatu, Brazil – Incidence, Clinical Aspects and Mortality
Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Vivane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado
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Neonatal sepsis is a systemic response to the acute generalized infection caused by one or more bacterial agents, representing the main infectious cause of neonatal mortality in dogs during the first three weeks of life. This study aims to describe the incidence of sepsis in neonate dogs, as well as the main clinical signs and mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. Seven hundred thirty-five neonates, 14% (98/703) presented neonatal sepsis. The main sources of infection for the neonates were intrauterine (72.5%, 71/98), lactogenic (13.2%, 13/98), umbilical (5.1%, 5/98) and unidentified sources (9.2%, 9/98). The main non-specific clinical signs observed in the newborns were weakness, depression, impaired or absent reflexes, hypothermia, hypoglycemia, dehydration, reduced muscle tonus and diarrhea. The newborns also manifested clinical signs of severe infection, such as hyperemia in the abdominal and anal regions, omphalitis, hematuria, abdomen and extremities with purplish-blue coloration necrosing injuries in the pads, bradycardia, dyspnea, epistaxis, hypotension and evolution to septic shock. Infections acquired during intrauterine life led to the onset of the clinical signs at the time of birth, with fast evolution during the first hours of life. On the other hand, infections acquired via milk or umbilical cord presented clinical signs later. The total mortality rate was 5.4% (38/703) and the mortality rate among the neonates with sepsis was 38.7% (38/98). The early mortality rate (0 to 2 days) accounted for 86.9% (33/38) and the late mortality rate (3 to 30 days) for 13.1% (5/38) of the deaths among the newborns with sepsis. The main bacterial agents observed were Staphylococcus spp., Streptococcus spp., Proteus spp. Mannheimia spp. and Escherichia coli. Neonatal sepsis evolves quickly and may lead to high mortality in a litter. The prognosis is usually favorable if the diagnosis is reached early and the antibiotic therapy instituted as soon as possible, even before the results of blood cultures and antibiograms. The therapeutic recommendations should meet the special physiological conditions of a neonate in terms of metabolism and excretion of medication. Therefore, it is of utmost importance that the veterinarian is knowledgeable regarding neonatology to provide effective intervention and improve the survival rates of these patients.Keywords: Neonatal infection , bacteria, puppies, newborn
Procedia PDF Downloads 1071233 Assessment of Delirium, It's Possible Risk Factors and Outcome in Patient Admitted in Medical Intensive Care Unit
Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda
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Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.Keywords: delirium, risk factors, outcome, intervention
Procedia PDF Downloads 158