Search results for: disease incidence
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4580

Search results for: disease incidence

2210 Optimizing Rehabilitation Transitions: Delays, Determinants, and Outcomes in Hip Fracture Patients

Authors: David Maman, David E. Rothem, Merav Ben Natan, Yaron Berkovich

Abstract:

Introduction: Hip fractures are a major health concern due to their impact on disability, independence, and mortality. Timely rehabilitation is crucial for improving patient outcomes and reducing healthcare costs, yet delays in rehabilitation, often due to challenges in discharge processes, can lead to adverse events and increased healthcare burdens. Aim: The study aimed to investigate two primary aspects related to hip fracture older adults patients: firstly, identifying subgroups more prone to delayed discharge for further rehabilitation; and secondly, exploring the consequences of this delay on short-term outcomes and the incidence of adverse events. Methods: Conducting a retrospective analysis, we examined the medical records of 474 patients aged 65 and older, hospitalized for hip fractures between 2018 and 2022 in a major hospital in the north-central region of Israel. All patients were eligible for further rehabilitation, including options for in-patient or home-based care. Results: Of the studied patients, 61.4% experienced delayed discharge, with an average waiting period of 3.5 days. Factors such as older age, prolonged hospital stay, and the need for in-patient rehabilitation were associated with a higher likelihood of delayed discharge. Those promptly discharged demonstrated lower rates of infections, falls, and mortality. Furthermore, delayed discharge to further rehabilitation correlated with elevated hospitalization costs. Notably, no significant differences were observed in re-hospitalization or repeat surgery rates. Conclusion: This study underscores the pressing need for efficient strategies to ensure timely rehabilitation, particularly for older adults. Implementing such strategies can optimize outcomes, mitigate adverse events, and contribute to a reduction in healthcare costs.

Keywords: hip fracture rehabilitation, delayed discharge, older adults, healthcare coordination, adverse events

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2209 Frailty and Quality of Life among Older Adults: A Study of Six LMICs Using SAGE Data

Authors: Mamta Jat

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Background: The increased longevity has resulted in the increase in the percentage of the global population aged 60 years or over. With this “demographic transition” towards ageing, “epidemiologic transition” is also taking place characterised by growing share of non-communicable diseases in the overall disease burden. So, many of the older adults are ageing with chronic disease and high levels of frailty which often results in lower levels of quality of life. Although frailty may be increasingly common in older adults, prevention or, at least, delay the onset of late-life adverse health outcomes and disability is necessary to maintain the health and functional status of the ageing population. This is an effort using SAGE data to assess levels of frailty and its socio-demographic correlates and its relation with quality of life in LMICs of India, China, Ghana, Mexico, Russia and South Africa in a comparative perspective. Methods: The data comes from multi-country Study on Global AGEing and Adult Health (SAGE), consists of nationally representative samples of older adults in six low and middle-income countries (LMICs): China, Ghana, India, Mexico, the Russian Federation and South Africa. For our study purpose, we will consider only 50+ year’s respondents. The logistic regression model has been used to assess the correlates of frailty. Multinomial logistic regression has been used to study the effect of frailty on QOL (quality of life), controlling for the effect of socio-economic and demographic correlates. Results: Among all the countries India is having highest mean frailty in males (0.22) and females (0.26) and China with the lowest mean frailty in males (0.12) and females (0.14). The odds of being frail are more likely with the increase in age across all the countries. In India, China and Russia the chances of frailty are more among rural older adults; whereas, in Ghana, South Africa and Mexico rural residence is protecting against frailty. Among all countries china has high percentage (71.46) of frail people in low QOL; whereas Mexico has lowest percentage (36.13) of frail people in low QOL.s The risk of having low and middle QOL is significantly (p<0.001) higher among frail elderly as compared to non–frail elderly across all countries with controlling socio-demographic correlates. Conclusion: Women and older age groups are having higher frailty levels than men and younger aged adults in LMICs. The mean frailty scores demonstrated a strong inverse relationship with education and income gradients, while lower levels of education and wealth are showing higher levels of frailty. These patterns are consistent across all LMICs. These data support a significant role of frailty with all other influences controlled, in having low QOL as measured by WHOQOL index. Future research needs to be built on this evolving concept of frailty in an effort to improve quality of life for frail elderly population, in LMICs setting.

Keywords: Keywords: Ageing, elderly, frailty, quality of life

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2208 Exposure Assessment to Heavy Metals and Flame Retardants Among Moroccan Children and Their Impact on the Epigenetic Profile

Authors: Kaoutar Chbihi, Aziza Menouni, Emilie Hardy, Matteo Creta, Nathalie Grova, An Van Nieuwenhuyse, Lode Godderis, Samir El Jaafari, Radu-Corneliu Duca

Abstract:

Industrial products and materials are often treated with additional compounds like brominated flame retardants (BFRs) and heavy metals in order to prevent their ignition, increase their functionality and improve their performance like electrical conductivity. Consequently, this could potentially expose children to harmful chemicals through indoor dust and through hand-to-mouth or toy-chewing behaviors. The aim of this study was to assess the exposure of Moroccan children aged 5-11 years to BFRs and heavy metal elements and investigate their impacts on the epigenetic profile, namely through global DNA methylation modifications. First, parents were asked to answer a questionnaire on children’s lifestyle, then blood and urine samples were collected from (n= 93) children, following the ethical guidelines, for biomonitoring and DNA methylation analysis, using a set of solid phase extraction (SPE), LC-MS/MS, GC-MS/MS and ICP/MS techniques. BFRs were detected in 54.84% of samples with a median concentration of 0.01 nmol/mL (range: 0.004-0.051 nmol/mL), while metal elements were detected in more than 90% of samples. No association was found between BFRs and global DNA methylation, unlike metal element levels that showed significant variations with global DNA methylation biomarkers, namely 5-mdC, 5-OH-mdC and N⁶-mA levels. To conclude, Moroccan children could be significantly exposed to flame retardant compounds and heavy metal elements through several routes, such as dust or equipment usage and are therefore susceptible to the adverse health effects that could be linked with such chemicals. Further research is required to assess the exposure to environmental pollutants among the Moroccan population in order to protect Moroccan health and prevent the incidence of diseases.

Keywords: biomonitoring, children, DNA methylation, epigenetics, flame retardants, heavy metals, Morocco

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2207 Toxicity and Larvicidal Activity of Cholesta-β-D-Glucopyranoside Isolated from Combretum molle R.

Authors: Abdu Zakari, Sai’d Jibril, Adoum A. Omar

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The leaves of Combretum molle was selected on the basis of its uses in folk medicine as insecticides. The leave extracts of Combretum molle was tested against the larvae of Artemia salina, i.e. Brine Shrimp Lethality Test (BST), Culex quinquefasciatus Say (Filaria disease vector) i.e. Larvicidal Test, using crude ethanol, n-hexane, chloroform, ethyl acetate, and methanol extracts. The methanolic extract proved to be the most effective in inducing complete lethality at minimum doses both in the BST and the Larvicidal activity test. The LC50¬ values obtained are 24.85 µg/ml and 0.4µg/ml respectively. The bioactivity-guided column chromatography afforded the pure compound ACM–3. ACM-3 was not active in the BST with LC50 value >1000µg/ml, but was active in the Larvicidal activity test with LC50 value 4.0µg/ml. ACM-3 was proposed to have the structure I, (Cholesta-β-D-Glucopyranoside).

Keywords: toxicity, larvicidal, Combretum molle, Artemia salina, Culex quinquefasciatus Say.

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2206 Nurse-Identified Barriers and Facilitators to Delivering End-of-Life Care in a Cardiac Intensive Care Unit: A Qualitative Study

Authors: Elena Ivany, Leanne Aitken

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Little is known about the delivery of end-of-life care in cardiac intensive care unit (CICU) settings. The aims of this study were to highlight the nurse-identified barriers and facilitators to delivering end-of-life care in the CICU, and to identify whether any of the barriers and/or facilitators are specific to the CICU setting. This was an exploratory qualitative study utilizing semi-structured individual interviews as the data collection method and inductive thematic analysis to structure the data. Six CICU nurses took part in the study. Five key themes were identified, each theme including both barriers and facilitators. The five key themes are as follows: patient-centered care, emotional challenges, reaching concordance, nursing contribution and the surgical intensive care unit.

Keywords: end-of-life, cardiovascular disease, cardiac surgery, critical care

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2205 Effect of Community Education and Early Intervention and Rehabilitation in Minimising the Impact on Mental Illness

Authors: Akanle Florence Foluso, Richard Oni, Ola Tolulo, Lani Ofie

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Health is a state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity. Society’s attitude to mental health and primary prevention is the key instrument in a better understanding of the mental illness. This paper attempted to investigate the effect of community education and early intervention and rehabilitation in minimizing the impact of mental illness. The study involved 50 adolescents who were randomly selected and assigned to two groups, the control and the experimental. Subjects in the experimental group were exposed to treatment, while those in the control group were not. The subject exposed to treatment had an increased understanding of what mental illness is. Those with mental illness were better understood, less feared, less discriminated against, and tertiary prevention strategies were reported to minimize the impact of mental illness when it occurs

Keywords: community, health, improve, status

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2204 A Kolmogorov-Smirnov Type Goodness-Of-Fit Test of Multinomial Logistic Regression Model in Case-Control Studies

Authors: Chen Li-Ching

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The multinomial logistic regression model is used popularly for inferring the relationship of risk factors and disease with multiple categories. This study based on the discrepancy between the nonparametric maximum likelihood estimator and semiparametric maximum likelihood estimator of the cumulative distribution function to propose a Kolmogorov-Smirnov type test statistic to assess adequacy of the multinomial logistic regression model for case-control data. A bootstrap procedure is presented to calculate the critical value of the proposed test statistic. Empirical type I error rates and powers of the test are performed by simulation studies. Some examples will be illustrated the implementation of the test.

Keywords: case-control studies, goodness-of-fit test, Kolmogorov-Smirnov test, multinomial logistic regression

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2203 The Survey of Sexual Health and Pornography among Divorce-Asking Women in West Azerbaijan-Iran: A Cross-Sectional Study

Authors: Soheila Rabiepoor, Elham Sadeghi

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Introduction: Divorce is both a personal and a social issue. Nowadays, due to various factors such as rapid social, economical, and cultural changes, the family structure has undergone many rough changes, out of 3 marriages 2 of them lead to divorce. One of the factors affecting the incidence of divorce and relationship problems between couples is the sexual and marital behaviors. There are several different reasons to suspect that pornography might affect divorce in either a positive or a negative way. Therefore this study evaluated the sexual health of divorce-asking in Urmia, Iran. Methods: This was a cross-sectional descriptive study and was conducted on 71 married women of Urmia, Iran in 2016. Participants were applicants of divorce (referred to divorce center) who were selected by using convenient sampling method. Data gathering tool included the scales for measuring demographic, sexual health (sexual satisfaction and function), and researcher made pornography questions. Data were analyzed based on the SPSS 16 software. P-values less than 0.05 were considered significant. Results: Investigation of demographic features showed that age average of studied samples was 28.98 ± 7.44, with a marriage duration average 8.12 ± 6.53 years (min 1 year/ max 28 years). Most of their education was at diploma (45.1%). 69 % of the women declared their income and expenditure as equal. Nearly 42% of women and 59% of their partner had watched sexual pornography clips. 45.5% of participants reported that they compared own sexual relationship with sexual pornography clips. In the other hand, sexual satisfaction total score was 51.50 ± 17.92. The mean total sexual function score was 16.62 ± 10.58. According to these findings, most of women were experienced sexual dissatisfaction and dysfunction. Conclusions: The results of the study indicated that who had low sexual satisfaction score, had higher rate of watching pornography clips. Based on current study, paying attention to family education and counseling programs especially in the sexual field will be more fruitful.

Keywords: divorce-asking, pornography, sexual satisfaction, sexual function, women

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2202 Scattering Operator and Spectral Clustering for Ultrasound Images: Application on Deep Venous Thrombi

Authors: Thibaud Berthomier, Ali Mansour, Luc Bressollette, Frédéric Le Roy, Dominique Mottier, Léo Fréchier, Barthélémy Hermenault

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Deep Venous Thrombosis (DVT) occurs when a thrombus is formed within a deep vein (most often in the legs). This disease can be deadly if a part or the whole thrombus reaches the lung and causes a Pulmonary Embolism (PE). This disorder, often asymptomatic, has multifactorial causes: immobilization, surgery, pregnancy, age, cancers, and genetic variations. Our project aims to relate the thrombus epidemiology (origins, patient predispositions, PE) to its structure using ultrasound images. Ultrasonography and elastography were collected using Toshiba Aplio 500 at Brest Hospital. This manuscript compares two classification approaches: spectral clustering and scattering operator. The former is based on the graph and matrix theories while the latter cascades wavelet convolutions with nonlinear modulus and averaging operators.

Keywords: deep venous thrombosis, ultrasonography, elastography, scattering operator, wavelet, spectral clustering

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2201 Health Ramifications of Workplace Bullying: Gender, Race and Sexual Orientation as Risk Factors

Authors: Kathleen Canul

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Bullying is on the rise according to several recent studies. Workplace bullying has garnered less attention than other forms yet incidence rates range from 35-45%. The consequences of being bullied at work are broad, ranging from physiological to psychological to occupational. As the bullying progresses, employees begin to exhibit physical and psychological symptoms. Blood pressure rises, along with other cardiac related concerns. For men, covert coping with job unfairness was associated with a four-fold risk of heart attack and death. Gastrointestinal distress, headaches, muscle tension, sleep disorders and exhaustion are also common. Workplace bullying appears to contribute to the risk of subsequent psychotropic medication, as well. Emotionally, anxiety and depression increase along with lowered self-esteem and problems concentrating on the duties of the job. In an attempt to cope, individuals may succumb to unhealthy practices involving food, alcohol and other drugs. Patterns of bullying vary by gender, race, and ethnicity, as well as sexual orientation, with women, ethnic minorities and LGBTQ employees reporting higher rates of bullying in the workplace. Not only is this an issue of inequity on the job, but also a problem of health disparities as there are few mental health professionals confident and competent in dealing with workplace bullying issues, and the lack of culturally competent clinicians exacerbates this inequality in receiving adequate care. Alone, the topic of workplace bullying is not unique; however, the diverse experiences of underrepresented groups who disproportionately are affected on the job and suffer untreated, health related concerns represent a significant and emerging problem requiring attention. Conference participants who have experienced, witnessed or help those bullied on the job would benefit most from this review of the literature on the consequences of bullying experienced by diverse and underrepresented groups in the workplace.

Keywords: bullying, ethnic minorities, health disparities, workplace conflict

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2200 Electroencephalogram Based Alzheimer Disease Classification using Machine and Deep Learning Methods

Authors: Carlos Roncero-Parra, Alfonso Parreño-Torres, Jorge Mateo Sotos, Alejandro L. Borja

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In this research, different methods based on machine/deep learning algorithms are presented for the classification and diagnosis of patients with mental disorders such as alzheimer. For this purpose, the signals obtained from 32 unipolar electrodes identified by non-invasive EEG were examined, and their basic properties were obtained. More specifically, different well-known machine learning based classifiers have been used, i.e., support vector machine (SVM), Bayesian linear discriminant analysis (BLDA), decision tree (DT), Gaussian Naïve Bayes (GNB), K-nearest neighbor (KNN) and Convolutional Neural Network (CNN). A total of 668 patients from five different hospitals have been studied in the period from 2011 to 2021. The best accuracy is obtained was around 93 % in both ADM and ADA classifications. It can be concluded that such a classification will enable the training of algorithms that can be used to identify and classify different mental disorders with high accuracy.

Keywords: alzheimer, machine learning, deep learning, EEG

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2199 Non-melanoma Nasal Skin Cancer: Literature Review

Authors: Geovanna dos Santos Romeiro, Polintia Rayza Brito da Silva, Luis Henrique Moura, Izadora Moreira Do Amaral, Marília Vitória Pinto Milhomem

Abstract:

Introduction: The nose is one of the most likely sites for the appearance of malignancy on the face. This can be associated with its unique position of exposure to environmental damage, lack of photoprotection and because it is an area susceptible to greater sun exposure. It is already known that the most common type of nasal tumor is basal cell carcinoma. Squamous cell carcinoma is less common but considerably more aggressive, with a tendency to grow rapidly and metastasize. Nasal skin cancer can have a good prognosis, regardless of the type of treatment chosen, i.e., surgery, radiotherapy or electrodissection. However, tumors that are not diagnosed and treated quickly can be harmful and have a greater chance of metastasizing. When curative surgery is performed, therapies and reconstructive surgical procedures are usually required. Objective: The objective is to review the literature on nasal skin tumors and their types and specific locations. Forty-four articles published in Pubmed related to the location of skin cancer in the specific nasal areas region were analyzed. Twelve were excluded for being prior to the year 2000, three with inconclusive results, and one with unbiased conclusions. Results and Conclusion: Regarding the prevalence of types of nasal tumors, basal cell carcinoma comprises the majority, occurring predominantly in the ala, tip and root; squamous cell carcinoma, on the other hand, is more common in the lateral borders and columella. Even so, 2 articles report that the prevalence of metastasis has a higher incidence in squamous cell carcinomas. All of this points to the importance of early location, including regions that are often overlooked in the examination if the patient is wearing glasses. This topic needs further investigation for a greater correlation between anatomy and clinical-surgical implications.

Keywords: skin cancer, melanoma, non-melanoma, surgery

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2198 Epidemiological, Clinical, Diagnostic Indicators and Treatment Efficiency of Patients with Immune Thrombocytopenic Purpura Diagnosed in Albania

Authors: Sara Grazhdani, Alma Cili, Arben Ivanaj

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Immune Thrombocytopenic Purpura is an autoimmune disease characterized by the destruction of platelets by immune mediators, their deficient production in the red bone marrow and increased splenic sequestration, leading to the appearance of thrombocytopenia and increased risk of hemorrhage. Treatment is indicated in patients with low platelet counts (<30 x 10 9 /L) who present clinically with hemorrhagic events or are at increased risk for hemorrhage. The goal of the treatment remains (I) prevention of hemorrhagic events and deaths resulting from them, (II) reaching an adequate level of the number of platelets, (III) treatment of patients with as few toxic effects as possible. Corticosteroid therapy remains the first choice in the treatment of patients with Primary Immune Thrombocytopenic Purpura. Rituximab (Mabthera) remains the first choice in the second line in the treatment of patients with Immune Thrombocytopenic Purpura, refractory to the use of cortisones.

Keywords: ITP, rituximab, prednisolone, relapse

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2197 Anisakidosis in Turkey: Serological Survey and Risk for Humans

Authors: E. Akdur Öztürk, F. İrvasa Bilgiç, A. Ludovisi , O. Gülbahar, D. Dirim Erdoğan, M. Korkmaz, M. Á. Gómez Morales

Abstract:

Anisakidosis is a zoonotic human fish-borne parasitic disease caused by accidental ingestion of anisakid third-stage larvae (L3) of members of the Anisakidae family present in infected marine fish or cephalopods. Infection with anisakid larvae can lead to gastric, intestinal, extra-gastrointestinal and gastroallergic forms of the disease. Anisakid parasites have been reported in almost all seas, particularly in the Mediterranean Sea. There is a remarkably high level of risk exposure to these zoonotic parasites as they are present in economically and ecologically important fish of Europe. Anisakid L3 larvae have been also detected in several fish species from the Aegean Sea. Turkey is a peninsular country surrounded by Black, Aegean and the Mediterranean Sea. In this country, fishing habit and fishery product consumption are highly common. In recent years, there was also an increase in the consumption of raw fish due to the increasing interest in the cuisine of the Far East countries. In different regions of Turkey, A. simplex (inMerluccius Merluccius Scomber japonicus, Trachurus mediterraneus, Sardina pilchardus, Engraulis encrasicolus, etc.), Anisakis spp., Contraceucum spp., Pseudoterronova spp. and, C. aduncum were identified as well. Although it is accepted both the presence of anisakid parasites in fish and fishery products in Turkey and the presence of Turkish people with allergic manifestations after fish consumption, there are no reports of human anisakiasis in this country. Given the high prevalence of anisakid parasites in the country, the absence of reports is likely not due to the absence of clinical cases rather to the unavailability of diagnostic tools and the low awareness of the presence of this infection. The aim of the study was to set up an IgE-Western Blot (WB) based test to detect the anisakidosis sensitization among Turkish people with a history of allergic manifestation related to fish consumption. To this end, crude worm antigens (CWA) and allergen enriched fraction (50-66% ) were prepared from L3 of A. simplex (s.l.) collected from Lepidopus caudatus fished in the Mediterranean Sea. These proteins were electrophoretically separated and transferred into the nitrocellulose membranes. By WB, specific proteins recognized by positive control serum samples from sensitized patients were visualized on nitrocellulose membranes by a colorimetric reaction. The CWA and 50–66% fraction showed specific bands, mainly due to Ani s 1 (20-22 kD) and Ani s 4 (9-10 kD). So far, a total of 7 serum samples from people with allergic manifestation and positive skin prick test (SPT) after fish consumption, have been tested and all of them resulted negative by WB, indicating the lack of sensitization to anisakids. This preliminary study allowed to set up a specific test and evidence the lack of correlation between both tests, SPT and WB. However, the sample size should be increased to estimate the anisakidosis burden in Turkish people.

Keywords: anisakidosis, fish parasite, serodiagnosis, Turkey

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2196 Bacterial Diversity in Human Intestinal Microbiota and Correlations with Nutritional Behavior, Physiology, Xenobiotics Intake and Antimicrobial Resistance in Obese, Overweight and Eutrophic Individuals

Authors: Thais O. de Paula, Marjorie R. A. Sarmiento, Francis M. Borges, Alessandra B. Ferreira-Machado, Juliana A. Resende, Dioneia E. Cesar, Vania L. Silva, Claudio G. Diniz

Abstract:

Obesity is currently a worldwide public health threat, being considered a pandemic multifactorial disease related to the human gut microbiota (GM). Add to that GM is considered an important reservoir of antimicrobial resistance genes (ARG) and little is known on GM and ARG in obesity, considering the altered physiology and xenobiotics intake. As regional and social behavior may play important roles in GM modulation, and most of the studies are based on small sample size and various methodological approaches resulting in difficulties for data comparisons, this study was focused on the investigation of GM bacterial diversity in obese (OB), overweight (OW) and eutrophic individuals (ET) considering their nutritional, clinical and social characteristics; and comparative screening of AGR related to their physiology and xenobiotics intake. Microbial community was accessed by FISH considering phyla as a taxonomic level, and PCR-DGGE followed by dendrograms evaluation (UPGMA method) from fecal metagenome of 72 volunteers classified according to their body mass index (BMI). Nutritional, clinical, social parameters and xenobiotics intake were recorded for correlation analysis. The fecal metagenome was also used as template for PCR targeting 59 different ARG. Overall, 62% of OB were hypertensive, and 12% or 4% were, regarding the OW and ET individuals. Most of the OB were rated as low income (80%). Lower relative bacterial densities were observed in the OB compared to ET for almost all studied taxa (p < 0.05) with Firmicutes/Bacteroidetes ratio increased in the OB group. OW individuals showed a bacterial density representative of GM more likely to the OB. All the participants were clustered in 3 different groups based on the PCR-DGGE fingerprint patterns (C1, C2, C3), being OB mostly grouped in C1 (83.3%) and ET mostly grouped in C3 (50%). The cluster C2 showed to be transitional. Among 27 ARG detected, a cluster of 17 was observed in all groups suggesting a common core. In general, ARG were observed mostly within OB individuals followed by OW and ET. The ratio between ARG and bacterial groups may suggest that AGR were more related to enterobacteria. Positive correlations were observed between ARG and BMI, calories and xenobiotics intake (especially use of sweeteners). As with nutritional and clinical characteristics, our data may suggest that GM of OW individuals behave in a heterogeneous pattern, occasionally more likely to the OB or to the ET. Regardless the regional and social behaviors of our population, the methodological approaches in this study were complementary and confirmatory. The imbalance of GM over the health-disease interface in obesity is a matter of fact, but its influence in host's physiology is still to be clearly elucidated to help understanding the multifactorial etiology of obesity. Although the results are in agreement with observations that GM is altered in obesity, the altered physiology in OB individuals seems to be also associated to the increased xenobiotics intake and may interfere with GM towards antimicrobial resistance, as observed by the fecal metagenome and ARG screening. Support: FAPEMIG, CNPQ, CAPES, PPGCBIO/UFJF.

Keywords: antimicrobial resistance, bacterial diversity, gut microbiota, obesity

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2195 Obsessive-Compulsive Disorder: Development of Demand-Controlled Deep Brain Stimulation with Methods from Stochastic Phase Resetting

Authors: Mahdi Akhbardeh

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Synchronization of neuronal firing is a hallmark of several neurological diseases. Recently, stimulation techniques have been developed which make it possible to desynchronize oscillatory neuronal activity in a mild and effective way, without suppressing the neurons' firing. As yet, these techniques are being used to establish demand-controlled deep brain stimulation (DBS) techniques for the therapy of movement disorders like severe Parkinson's disease or essential tremor. We here present a first conceptualization suggesting that the nucleus accumbens is a promising target for the standard, that is, permanent high-frequency, DBS in patients with severe and chronic obsessive-compulsive disorder (OCD). In addition, we explain how demand-controlled DBS techniques may be applied to the therapy of OCD in those cases that are refractory to behavioral therapies and pharmacological treatment.

Keywords: stereotactic neurosurgery, deep brain stimulation, obsessive-compulsive disorder, phase resetting

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2194 Appraisal of Road Transport Infrastructure and Commercial Activities in Ede, Osun State Nigeria

Authors: Rafiu Babatunde Ibrahim, Richard Oluseyi Taiwo, Abiodun Toheeb Akintunde

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The relationship between road transport infrastructure and commercial activities in Nigeria has been a topical issue and identified as one of the crucial components for economic development in the country. This study examines road transport infrastructure and commercial activities along selected roads in Ede, Nigeria. The study assesses the characteristics of the selected roads, the condition of road infrastructure, the degree of road network connectivity, maintenance culture for the road infrastructure as well as commercial activities along identified roads in the study area. Stratified Sampling Techniques were used to partition the study area into core, Intermediate and Suburb Township zones. Roads were also classified into Major, Distributor and Access Roads. Field observation and measurement, as well as a questionnaire, were used to obtain primary data from 246 systematically sampled respondents along the roads selected, and they were analyzed using descriptive and inferential statistics. The study revealed that most of the roads were characterized by an incidence of potholes. A total of 448 potholes were observed, where Olowoibida Road accounted for (19.0%), Federal Polytechnic Road (17.4%), and Back to Land Road (16.3%). The majority of the selected roads have no street lights and are of open drainage systems. Also, the condition of road surfaces was observed to be deteriorating. Road network connectivity of the study area was found to be poorly connected with 11% using the alpha index and 40% of Gamma index. It was found that the tailoring business (39) is predominant on major roads and Distributor Roads, while petty trading (35) is dominant on the access road. Results of correlation analysis (r = 0.242) show that there is a low positive correlation between road infrastructure and commercial activities; the significant relationships have indeed explained how important it is in influencing commercial activities across the study area. The study concluded by emphasizing the need for the provision of more roads and proper maintenance of the existing ones. This will no doubt improve the commercial activities along the roads in the study area.

Keywords: road transport, infrastructure, commercial activities, maintenance culture

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2193 A Review on Assessment on the Level of Development of Macedonia and Iran Organic Agriculture as Compared to Nigeria

Authors: Yusuf Ahmad Sani, Adamu Alhaji Yakubu, Alhaji Abdullahi Jamilu, Joel Omeke, Ibrahim Jumare Sambo

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With the rising global threat of food security, cancer, and related diseases (carcinogenic) because of increased usage of inorganic substances in agricultural food production, the Ministry of Food Agriculture and Livestock of the Republic of Turkey organized an International Workshop on Organic Agriculture between 8 – 12th December 2014 at the International Agricultural Research and Training Center, Izmir. About 21 countries, including Nigeria, were invited to attend the training workshop. Several topics on organic agriculture were presented by renowned scholars, ranging from regulation, certification, crop, animal, seed production, pest and disease management, soil composting, and marketing of organic agricultural products, among others. This paper purposely selected two countries (Macedonia and Iran) out of the 21 countries to assess their level of development in terms of organic agriculture as compared to Nigeria. Macedonia, with a population of only 2.1 million people as of 2014, started organic agriculture in 2005 with only 266ha of land and has grown significantly to over 5,000ha in 2010, covering such crops as cereals (62%), forage (20%) fruit orchard (7%), vineyards (5%), vegetables (4%), oil seed and industrial crops (1%) each. Others are organic beekeeping from 110 hives to over 15,000 certified colonies. As part of government commitment, the level of government subsidy for organic products was 30% compared to the direct support for conventional agricultural products. About 19 by-laws were introduced on organic agricultural production that was fully consistent with European Union regulations. The republic of Iran, on the other hand, embarked on organic agriculture for the fact, that the country recorded the highest rate of cancer disease in the world, with over 30,000 people dying every year and 297 people diagnosed every day. However, the host country, Turkey, is well advanced in organic agricultural production and now being the largest exporter of organic products to Europe and other parts of the globe. A technical trip to one of the villages that are under the government scheme on organic agriculture reveals that organic agriculture was based on market-demand-driven and the support of the government was very visible, linking the farmers with private companies that provide inputs to them while the companies purchase the products at harvest with high premium price. However, in Nigeria, research on organic agriculture was very recent, and there was very scanty information on organic agriculture due to poor documentation and very low awareness, even among the elites. The paper, therefore, recommends that the government should provide funds to NARIs to conduct research on organic agriculture and to establish clear government policy and good pre-conditions for sustainable organic agricultural production in the country.

Keywords: organic agriculture, food security, food safety, food nutrition

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2192 Monitoring and Analysis of Bridge Crossing Ground Fissures

Authors: Zhiqing Zhang, Xiangong Zhou, Zihan Zhou

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Ground fissures can be seen in some cities all over the world. As a special urban geological disaster, ground fissures in Xi'an have caused great harm to infrastructure. Chang'an Road Interchange in Xi'an City is a bridge across ground fissures. The damage to Chang'an Road interchange is the most serious and typical. To study the influence of ground fissures on the bridge, we established a bridge monitoring system. The main monitoring items include elevation monitoring, structural displacement monitoring, etc. The monitoring results show that the typical failure is mainly reflected in the bridge deck damage caused by horizontal tension and vertical dislocation. For the construction of urban interchange spanning ground fissures, the interchange should be divided reasonably, a simple support structure with less restriction should be adopted, and the monitoring of supports should be strengthened to prevent the occurrence of beam falling.

Keywords: bridge monitoring, ground fissures, typical disease, structural displacement

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2191 Alterations of Malondialdehyde and Heat Shock Protein-27 in Sheep with Naturally Infected Liver Cystic Echinococcosis

Authors: K. Azimzadeh, S. Rasouli

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The present study investigates whether malondialdehyde (MDA) and heat shock protein-27 (HSP-27) are altered in sheep with cystic echinococcosis (CE). For this purpose, forty parasitized and thirty healthy sheep were selected based on severe cystic form observation in liver and lack of blood parasite along with no cystic conformation in carcass respectively. The results revealed a significant decrease (p<0.01) in albumin (Alb) and total plasma protein (TPP) and a significant increase (p<0.01) in HSP-27, MDA, total bilirubin and unconjugated bilirubin in the infected group compared with healthy ones.The results indicate low levels of TPP and Alb reveal liver damage in suffered sheep and MDA elevation demonstrates oxidative stress in infected group. In addition, HSP-27 enhancement may attribute to disease-induced stress conditions.

Keywords: malondialdehyde, heat shock protein-27, Echinococcosis, blood parasites

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2190 Determinants of Risk Perceptions and Risk Attitude among Flue-Cured Virginia Tobacco Growers: A Case Study of Pakistan

Authors: Wencong Lu, Abdul Latif, Raza Ullah, Subhan Ullah

Abstract:

Agricultural production is subject to risk and the attitudes of producers toward risk, in turn, may be affected by certain socioeconomic characteristics of producers. Although, it is important to assess the risk attitude of farmers and their perception towards different calamitous risk sources for better understanding of their risk management adoption decisions, to the best of our knowledge no studies have been carried out to analyze the risk attitude and risk perceptions in the context of tobacco production in Pakistan. Therefore the study in hand is conducted with an attempt to overcome the gap in existing literature by analyzing different catastrophic risk sources faced by tobacco growers, their attitude towards risk and the effect of socioeconomic and demographic characteristics, farmers’ participation in contract farming and off-farm diversification on their risk attitude and risk perception. Around 78% of Pakistan’s entire tobacco crop and nearly all of the country’s Flue-Cured Virginia (FCV) tobacco is produced in Khyber Pakhtunkhwa (KPK) province alone. The yield/hectare of tobacco produced in KPK province is 14% higher than the global average and 22 % higher than national average. Khyber Pakhtunkhwa province was selected as main study area as nearly all of the country’s Flue-Cured Virginia (FCV) tobacco is produced in Khyber Pakhtunkhwa (KPK) province alone. Six districts were purposely selected based on their contribution in overall production for the last five years which accounts for more than 94.84% of the tobacco production in KPK province. Specific objectives taken into considerations for this study are the risk attitude of the farmers for growing FCV tobacco crop, farmers’ risk perception for different risk sources related to tobacco production (as far as the incidence and severity of each risk source is concerned) and the effect of socioeconomic characteristics, contract farming participation and off-farm diversification (income) on the risk attitude and risk perception of FCV tobacco growers.

Keywords: risk attitude, risk perception, contract farming, off-farm diversification, probit model

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2189 DNA Polymorphism Studies of β-Lactoglobulin Gene in Native Saudi Goat Breeds

Authors: Amr A. El Hanafy, Muhammad I. Qureshi, Jamal Sabir, Mohamed Mutawakil, Mohamed M. Ahmed, Hassan El Ashmaoui, Hassan Ramadan, Mohamed Abou-Alsoud, Mahmoud Abdel Sadek

Abstract:

β-Lactoglobulin (β-LG) is the dominant non-casein whey protein found in bovine milk and of most ruminants. The amino acid sequence of β-LG along with its 3-dimensional structure illustrates linkage with the lipocalin superfamily. Preliminary studies in goats indicated that milk yield can be influenced by polymorphism in genes coding for whey proteins. The aim of this study is to identify and evaluate the incidence of functional polymorphisms in the exonic and intronic portions of β-LG gene in native Saudi goat breeds (Ardi, Habsi, and Harri). Blood samples were collected from 300 animals (100 for each breed) and genomic DNA was extracted using QIAamp DNA extraction Kit. A fragment of the β-LG gene from exon 7 to 3’ flanking region was amplified with pairs of specific primers. Subsequent digestion with Sac II restriction endonuclease revealed two alleles (A and B) and three different banding patterns or genotypes i.e. AA, AB and BB. The statistical analysis showed that β-LG AA genotype had higher milk yield than β-LG AB and β-LG BB genotypes. Nucleotide sequencing of the selected β-LG fragments was done and submitted to GenBank NCBI (Accession No. KJ544248, KJ588275, KJ588276, KJ783455, KJ783456 and KJ874959). Two already established SNPs in exon 7 (+4601 and +4603) and one fresh SNP in the 3’ UTR region were detected in the β-LG fragments with designated AA genotype. The polymorphisms in exon 7 did not produce any amino acid change. Phylogenetic analysis on the basis of nucleotide sequences of native Saudi goats indicated evolutional similarity with the GenBank reference sequences of goat, Bubalus bubalis and Bos taurus.

Keywords: β-Lactoglobulin, Saudi goats, PCR-RFLP, functional polymorphism, nucleotide sequencing, phylogenetic analysis

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2188 AMF activates PDH 45 and G-proteins Genes to Alleviate Abiotic Stress in Tomato Plants

Authors: Deepak Bhardwaj, Narendra Tuteja

Abstract:

Global climate change is impacting large agrarian societies, especially those in countries located near the equator. Agriculture, and consequently, plant-based food, is the hardest hit in tropical and sub-tropical countries such as India due to an increased incidence of drought as well as an increase in soil salinity. One method that holds promise is AMF-rich biofertilizers which assist in activating proteins which in turn help alleviate abiotic stress in plants. In the present study, we identified two important species of (arbuscular mycorrhizal fungus) AMF belonging to Glomus and Gigaspora from the rhizosphere of the important medicinal plant Justicia adathoda. These two species have been found to be responsible for the abundance of Justicia adathoda in the semi-arid areas of the Jammu valley located in northern India, namely, the Union Territory of Jammu and Kashmir. We isolated the species of Glomus and Gigaspora from the rhizosphere of Justicia adathoda and used them as biofertilizers for the tomato plant. Significant improvements in the growth parameters were observed in the tomato plants inoculated with Glomus sp. and Gigaspora sp. in comparison with the tomato plants that were grown without AMF treatments. Tomato plants grown along with Glomus sp. and Gigaspora sp. have been observed to withstand 200 mM of salinity and 25% PEG stress. AMF also resulted in an increased concentration of proline and antioxidant enzymes in tomato plants. We also examined the expression levels of salinity and drought stress-inducible genes such as pea DNA helicase 45 (PDH 45) and genes of G-protein subunits of the tomato plants inoculated with and without AMF under stress and normal conditions. All the stress-inducible genes showed a significant increase in their gene expression under stress and AMF inoculation, while their levels were found to be normal under AMF inoculation without stress. We propose a model of abiotic stress alleviation in tomato plants with the help of external factors such as AMF and internally with the help of proteins like PDH 45 and G-proteins.

Keywords: AMF, abiotic stress, g-proteins, PDH-45

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2187 A Rare Entity: Case Report on Anaesthetic Management in Robinow Syndrome

Authors: Vidhi Chandra, Arshpreet Singh Grewal

Abstract:

A five-year-old male child born from non-consanguineous marriage, who presented with complaints of growth retardation and no appreciable increase in the penile size since birth and he was posted for de-gloving of penis with dissection of corpora under anaesthesia. After thorough preoperative evaluation it was revealed that patient had peculiar facial dysmorphism that of Robinow Syndrome, high arched palate, Mallampati grade III, mesomelic limbs, scoliotic spine and short stature. All routine investigation were within normal limit, electrocardiography (ECG) and 2D-Echocardiography (ECHO) were normal. In antero-posterior roentgenogram chest showed butterfly and hemivertebrae at multiple levels. The patient was considered to be ASA II. On the day of surgery after ensuring fasting of 6 hours, patient was taken in operation theatre, all standard ASA monitoring was done with ECG, non-invasive blood pressure, peripheral oxygen saturation (SpO2) and body temperature. The patient was pre-oxygenated with 100% oxygen with anatomical face mask. General anaesthesia was induced with Sevoflurane 1-8%, and airway was secured with an appropriate size supraglottic airway and anaesthesia was maintained with nitrous oxide and oxygen in 1:1 ratio along with sevoflurane 2%. An ultrasound guided caudal block was given owing to the skeletal deformities making it difficult even under USG guidance. Post operatively patient was given supportive care with proper hydration, antibiotics, anti-inflammatory and analgesics. He was discharged the next day and followed up weekly for a month. DISCUSSION Robinow syndrome is genetically inherited as autosomal dominant, autosomal recessive or heterogenous disorder involving tyrosine kinase ROR2 gene located on chromosome 9. It has low incidence with no preponderance for any gender. Though intelligence is normal but developmental delay and mental retardation occurs in 20%cases

Keywords: Robinow Syndrome, dwarfism, paediatric, anaesthesia

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2186 Giant Filiform Polyposis in a Patient with Ulcerative Colitis Mimicking Colorectal Cancer

Authors: Godwin Dennison, Edwin Cooper, George Theobald, Richard Dalton

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We report an unusual case of giant filiform polyposis in a patient with ulcerative colitis, causing a large stricture in the colon. A 62-year-old man was referred to the Bowel Cancer Screening Programme with a positive Faecal Immunochemical Test (FIT). He was known to have UC for 30 years. A CT scan showed a 9 cm stricture in the transverse colon suspicious of malignancy. A colonoscopy was attempted three times, and biopsies confirmed features of ulcerative colitis. A laparoscopic assisted transverse colectomy (Left hemicolectomy) was performed, and the histology revealed giant filiform polyposis. This should be considered in a UC patient presenting with signs of obstruction mimicking a carcinoma. Whilst it is a benign condition, because of the size of the lesion, it often causes obstruction, and surgery is indicated to relieve symptoms.

Keywords: giant inflammatory polyposis, filiform polyposis, ulcerative colitis, inflammatory bowel disease

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2185 Early Hypothyroidism after Radiotherapy for Nasopharyngeal Carcinoma

Authors: Nejla Fourati, Zied Fessi, Fatma Dhouib, Wicem Siala, Leila Farhat, Afef Khanfir, Wafa Mnejja, Jamel Daoud

Abstract:

Purpose: Radiation induced hypothyroidism in nasopharyngeal cancer (NPC) ranged from 15% to 55%. In reported data, it is considered as a common late complication of definitive radiation and is mainly observed 2 years after the end of treatment. The aim of this study was to evaluate the incidence of early hypothyroidism within 6 months after radiotherapy. Patients and methods: From June 2017 to February 2020, 35 patients treated with concurrent chemo-radiotherapy (CCR) for NPC were included in this prospective study. Median age was 49 years [23-68] with a sex ratio of 2.88. All patients received intensity modulated radiotherapy (IMRT) at a dose of 69.96 Gy in 33 daily fractions with weekly cisplatin (40mg/m²) chemotherapy. Thyroid stimulating hormone (TSH) and Free Thyroxine 4 (FT4) dosage was performed before the start of radiotherapy and 6 months after. Different dosimetric parameters for the thyroid gland were reported: the volume (cc); the mean dose (Dmean) and the %age of volume receiving more than 45 Gy (V45Gy). Wilcoxon Test was used to compare these different parameters between patients with or without hypothyroidism. Results: At baseline, 5 patients (14.3%) had hypothyroidism and were excluded from the analysis. For the remaining 30 patients, 9 patients (30%) developed a hypothyroidism 6 months after the end of radiotherapy. The median thyroid volume was 10.3 cc [4.6-23]. The median Dmean and V45Gy were 48.3 Gy [43.15-55.4] and 74.8 [38.2-97.9] respectively. No significant difference was noted for all studied parameters. Conclusion: Early hypothyroidism occurring within 6 months after CCR for NPC seems to be a common complication (30%) that should be screened. Good patient monitoring with regular dosage of TSH and FT4 makes it possible to treat hypothyroidism in asymptomatic phase. This would be correlated with an improvement in the quality of life of these patients. The results of our study do not show a correlation between the thyroid doses and the occurrence of hypothyroidism. This is probably related to the high doses received by the thyroid in our series. These findings encourage more optimization to limit thyroid doses and then the risk of radiation-induced hypothyroidism

Keywords: nasopharyngeal carcinoma, hypothyroidism, early complication, thyroid dose

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2184 Indigenous Understandings of Climate Vulnerability in Chile: A Qualitative Approach

Authors: Rosario Carmona

Abstract:

This article aims to discuss the importance of indigenous people participation in climate change mitigation and adaptation. Specifically, it analyses different understandings of climate vulnerability among diverse actors involved in climate change policies in Chile: indigenous people, state officials, and academics. These data were collected through participant observation and interviews conducted during October 2017 and January 2019 in Chile. Following Karen O’Brien, there are two types of vulnerability, outcome vulnerability and contextual vulnerability. How vulnerability to climate change is understood determines the approach, which actors are involved and which knowledge is considered to address it. Because climate change is a very complex phenomenon, it is necessary to transform the institutions and their responses. To do so, it is fundamental to consider these two perspectives and different types of knowledge, particularly those of the most vulnerable, such as indigenous people. For centuries and thanks to a long coexistence with the environment, indigenous societies have elaborated coping strategies, and some of them are already adapting to climate change. Indigenous people from Chile are not an exception. But, indigenous people tend to be excluded from decision-making processes. And indigenous knowledge is frequently seen as subjective and arbitrary in relation to science. Nevertheless, last years indigenous knowledge has gained particular relevance in the academic world, and indigenous actors are getting prominence in international negotiations. There are some mechanisms that promote their participation (e.g., Cancun safeguards, World Bank operational policies, REDD+), which are not absent from difficulties. And since 2016 parties are working on a Local Communities and Indigenous Peoples Platform. This paper also explores the incidence of this process in Chile. Although there is progress in the participation of indigenous people, this participation responds to the operational policies of the funding agencies and not to a real commitment of the state with this sector. The State of Chile omits a review of the structure that promotes inequality and the exclusion of indigenous people. In this way, climate change policies could be configured as a new mechanism of coloniality that validates a single type of knowledge and leads to new territorial control strategies, which increases vulnerability.

Keywords: indigenous knowledge, climate change, vulnerability, Chile

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2183 Colonization of Candida Albicans on 3D Printed CAD/CAM Complete Denture Versus Conventional Complete Denture: Randomized Controlled Clinical Study

Authors: Eman Helal, Ahmed M. Esmat

Abstract:

Statement of problem: The development of computer-aided design/computer-aided manufacturing (CAD/CAM) resin dentures has simplified complete denture production. Most of the studies evaluated the mechanical properties of the material, but the hygienic performance of the CAD /CAM denture and their ability to maintain clean surfaces and minimize bacterial accumulation is still lacking. Purpose evaluation of the antibacterial characteristics of the 3D printed CAD/CAM denture and to compare it with the conventional heat polymerized acrylic denture base material. Methodology a total of thirty completely edentulous patients grouped randomly into two groups (Group I: Control group) received conventional heat polymerized acrylic resin complete dentures, (Group II: Test group) received 3D printed (CAD/CAM) dentures (stereolithographic PMMA), Samples of Candida albicans culture swabs were taken after 1 month and 3 months of dentures` insertion. A culture swab was obtained by scrubbing the fitting surface of the upper denture. At each time interval, three swab samples were collected from each patient and were inoculated in three individual culture media. Results: there was a significant difference in the colonization of Candida albicans to the fitting surface of the dentures between both groups (Group I: Conventional denture cases) exhibited more adhesion of Candida Albicans to the fitting surface than did (Group II: CAD/CAM cases) (P<0.05). Conclusion: 3D printed CAD/CAM complete denture showed minimal Candida adherence upon upper denture fitting compared to conventional heat-polymerized acrylic resin, which contributes to decreasing the incidence of denture stomatitis which is considered one of the most common problems among complete denture wearers.

Keywords: CAD/CAM denture, completely edentulous, elderly patients, 3D printing, antimicrobial efficiency, conventional denture, PMMA, Candida Albicans, denture stomatitis

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2182 Positron Emission Tomography Parameters as Predictors of Pathologic Response and Nodal Clearance in Patients with Stage IIIA NSCLC Receiving Trimodality Therapy

Authors: Andrea L. Arnett, Ann T. Packard, Yolanda I. Garces, Kenneth W. Merrell

Abstract:

Objective: Pathologic response following neoadjuvant chemoradiation (CRT) has been associated with improved overall survival (OS). Conflicting results have been reported regarding the pathologic predictive value of positron emission tomography (PET) response in patients with stage III lung cancer. The aim of this study was to evaluate the correlation between post-treatment PET response and pathologic response utilizing novel FDG-PET parameters. Methods: This retrospective study included patients with non-metastatic, stage IIIA (N2) NSCLC cancer treated with CRT followed by resection. All patients underwent PET prior to and after neoadjuvant CRT. Univariate analysis was utilized to assess correlations between PET response, nodal clearance, pCR, and near-complete pathologic response (defined as the microscopic residual disease or less). Maximal standard uptake value (SUV), standard uptake ratio (SUR) [normalized independently to the liver (SUR-L) and blood pool (SUR-BP)], metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured pre- and post-chemoradiation. Results: A total of 44 patients were included for review. Median age was 61.9 years, and median follow-up was 2.6 years. Histologic subtypes included adenocarcinoma (72.2%) and squamous cell carcinoma (22.7%), and the majority of patients had the T2 disease (59.1%). The rate of pCR and near-complete pathologic response within the primary lesion was 28.9% and 44.4%, respectively. The average reduction in SUVmₐₓ was 9.2 units (range -1.9-32.8), and the majority of patients demonstrated some degree of favorable treatment response. SUR-BP and SUR-L showed a mean reduction of 4.7 units (range -0.1-17.3) and 3.5 units (range –1.7-12.6), respectively. Variation in PET response was not significantly associated with histologic subtype, concurrent chemotherapy type, stage, or radiation dose. No significant correlation was found between pathologic response and absolute change in MTV or TLG. Reduction in SUVmₐₓ and SUR were associated with increased rate of pathologic response (p ≤ 0.02). This correlation was not impacted by normalization of SUR to liver versus mediastinal blood pool. A threshold of > 75% decrease in SUR-L correlated with near-complete response, with a sensitivity of 57.9% and specificity of 85.7%, as well as positive and negative predictive values of 78.6% and 69.2%, respectively (diagnostic odds ratio [DOR]: 5.6, p=0.02). A threshold of >50% decrease in SUR was also significantly associated pathologic response (DOR 12.9, p=0.2), but specificity was substantially lower when utilizing this threshold value. No significant association was found between nodal PET parameters and pathologic nodal clearance. Conclusions: Our results suggest that treatment response to neoadjuvant therapy as assessed on PET imaging can be a predictor of pathologic response when evaluated via SUV and SUR. SUR parameters were associated with higher diagnostic odds ratios, suggesting improved predictive utility compared to SUVmₐₓ. MTV and TLG did not prove to be significant predictors of pathologic response but may warrant further investigation in a larger cohort of patients.

Keywords: lung cancer, positron emission tomography (PET), standard uptake ratio (SUR), standard uptake value (SUV)

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2181 Improvement of the Geometric of Dental Bridge Framework through Automatic Program

Authors: Rong-Yang Lai, Jia-Yu Wu, Chih-Han Chang, Yung-Chung Chen

Abstract:

The dental bridge is one of the clinical methods of the treatment for missing teeth. The dental bridge is generally designed for two layers, containing the inner layer of the framework(zirconia) and the outer layer of the porcelain-fused to framework restorations. The design of a conventional bridge is generally based on the antagonist tooth profile so that the framework evenly indented by an equal thickness from outer contour. All-ceramic dental bridge made of zirconia have well demonstrated remarkable potential to withstand a higher physiological occlusal load in posterior region, but it was found that there is still the risk of all-ceramic bridge failure in five years. Thus, how to reduce the incidence of failure is still a problem to be solved. Therefore, the objective of this study is to develop mechanical designs for all-ceramic dental bridges framework by reducing the stress and enhancing fracture resistance under given loading conditions by finite element method. In this study, dental design software is used to design dental bridge based on tooth CT images. After building model, Bi-directional Evolutionary Structural Optimization (BESO) Method algorithm implemented in finite element software was employed to analyze results of finite element software and determine the distribution of the materials in dental bridge; BESO searches the optimum distribution of two different materials, namely porcelain and zirconia. According to the previous calculation of the stress value of each element, when the element stress value is higher than the threshold value, the element would be replaced by the framework material; besides, the difference of maximum stress peak value is less than 0.1%, calculation is complete. After completing the design of dental bridge, the stress distribution of the whole structure is changed. BESO reduces the peak values of principle stress of 10% in outer-layer porcelain and avoids producing tensile stress failure.

Keywords: dental bridge, finite element analysis, framework, automatic program

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