Search results for: efficient SCADA based monitoring system
Commenced in January 2007
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Edition: International
Paper Count: 41326

Search results for: efficient SCADA based monitoring system

17296 Detection and Classification of Rubber Tree Leaf Diseases Using Machine Learning

Authors: Kavyadevi N., Kaviya G., Gowsalya P., Janani M., Mohanraj S.

Abstract:

Hevea brasiliensis, also known as the rubber tree, is one of the foremost assets of crops in the world. One of the most significant advantages of the Rubber Plant in terms of air oxygenation is its capacity to reduce the likelihood of an individual developing respiratory allergies like asthma. To construct such a system that can properly identify crop diseases and pests and then create a database of insecticides for each pest and disease, we must first give treatment for the illness that has been detected. We shall primarily examine three major leaf diseases since they are economically deficient in this article, which is Bird's eye spot, algal spot and powdery mildew. And the recommended work focuses on disease identification on rubber tree leaves. It will be accomplished by employing one of the superior algorithms. Input, Preprocessing, Image Segmentation, Extraction Feature, and Classification will be followed by the processing technique. We will use time-consuming procedures that they use to detect the sickness. As a consequence, the main ailments, underlying causes, and signs and symptoms of diseases that harm the rubber tree are covered in this study.

Keywords: image processing, python, convolution neural network (CNN), machine learning

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17295 Polymer Matrices Based on Natural Compounds: Synthesis and Characterization

Authors: Sonia Kudlacik-Kramarczyk, Anna Drabczyk, Dagmara Malina, Bozena Tyliszczak, Agnieszka Sobczak-Kupiec

Abstract:

Introduction: In the preparation of polymer materials, compounds of natural origin are currently gaining more and more interest. This is particularly noticeable in the case of synthesis of materials considered for biomedical use. Then, selected material has to meet many requirements. It should be characterized by non-toxicity, biodegradability and biocompatibility. Therefore special attention is directed to substances such as polysaccharides, proteins or substances that are the basic building components of proteins, i.e. amino acids. These compounds may be crosslinked with other reagents that leads to the preparation of polymer matrices. Such amino acids as e.g. cysteine or histidine. On the other hand, previously mentioned requirements may be met by polymers obtained as a result of biosynthesis, e.g. polyhydroxybutyrate. This polymer belongs to the group of aliphatic polyesters that is synthesized by microorganisms (selected strain of bacteria) under specific conditions. It is possible to modify matrices based on given polymer with substances of various origin. Such a modification may result in the change of their properties or/and in providing the material with new features desirable in viewpoint of specific application. Described materials are synthesized using UV radiation. Process of photopolymerization is fast, waste-free and enables to obtain final products with favorable properties. Methodology: Polymer matrices have been prepared by means of photopolymerization. First step involved the preparation of solutions of particular reagents and mixing them in the appropriate ratio. Next, crosslinking agent and photoinitiator have been added to the reaction mixture and the whole was poured into the Petri dish and treated with UV radiation. After the synthesis, polymer samples were dried at room temperature and subjected to the numerous analyses aimed at the determining their physicochemical properties. Firstly, sorption properties of obtained polymer matrices have been determined. Next, mechanical properties have been characterized, i.e. tensile strength. The ability to deformation under applied stress of all prepared polymer matrices has been checked. Such a property is important in viewpoint of the application of analyzed materials e.g. as wound dressings. Wound dressings have to be elastic because depending on the location of the wound and its mobility, such a dressing has to adhere properly to the wound. Furthermore, considering the use of the materials for biomedical purposes it is essential to determine its behavior in environments simulating these ones occurring in human body. Therefore incubation studies using selected liquids have also been conducted. Conclusions: As a result of photopolymerization process, polymer matrices based on natural compounds have been prepared. These exhibited favorable mechanical properties and swelling ability. Moreover, biocompatibility in relation to simulated body fluids has been stated. Therefore it can be concluded that analyzed polymer matrices constitute an interesting materials that may be considered for biomedical use and may be subjected to the further more advanced analyses using specific cell lines.

Keywords: photopolymerization, polymer matrices, simulated body fluids, swelling properties

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17294 Reduction of Fermentation Duration of Cassava to Remove Hydrogen Cyanide

Authors: Jean Paul Hategekimana, Josiane Irakoze, Eugene Niyonzima, Annick Ndekezi

Abstract:

Cassava (Manihot esculenta Crantz) is a root crop comprising an anti-nutritive factor known as cyanide. The compound can be removed by numerous processing methods such as boiling, fermentation, blanching, and sun drying to avoid the possibility of cyanide poisoning. Inappropriate processing mean can lead to disease and death. Cassava-based dishes are consumed in different ways, where cassava is cultivated according to their culture and preference. However, they have been shown to be unsafe based on high cyanide levels. The current study targeted to resolve the problem of high cyanide in cassava consumed in Rwanda. This study was conducted to determine the effect of slicing, blanching, and soaking time to reduce the fermentation duration of cassava for hydrogen cyanide (HCN) in mg/g removal. Cassava was sliced into three different portions (1cm, 2cm, and 5cm). The first portions were naturally fermented for seven days, where each portion was removed every 24 hours from soaking tanks and then oven dried at a temperature of 60°C and then milled to obtain naturally fermented cassava flours. Other portions of 1cm, 2cm, and 5cm were blanched for 2, 5, 10 min, respectively, and each similarly dried at 60°C and milled to produce blanched cassava flour. Other blanched portions were used to follow the previous fermentation steps. The last portions, which formed the control, were simply chopped. Cyanide content and starch content in mg/100g were investigated. According to the conducted analysis on different cassava treatments for detoxification, found that usual fermentation can be used, but for sliced portions aimed to size reduction for the easy hydrogen cyanide diffuse out and it takes four days to complete fermentation, which has reduced at 94.44% with significantly different (p<0.05)of total hydrogen cyanide contained in cassava to safe level of consumption, and what is recommended as more effective is to apply blanching combined with fermentation due to the fact that, it takes three days to complete hydrogen cyanide removal at 95.56% on significantly different (p<0.05) of reduction to the safe level of consumption.

Keywords: cassava, cyanide, blanching, drying, fermentation

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17293 In-vitro Metabolic Fingerprinting Using Plasmonic Chips by Laser Desorption/Ionization Mass Spectrometry

Authors: Vadanasundari Vedarethinam, Kun Qian

Abstract:

The metabolic analysis is more distal over proteomics and genomics engaging in clinics and needs rationally distinct techniques, designed materials, and device for clinical diagnosis. Conventional techniques such as spectroscopic techniques, biochemical analyzers, and electrochemical have been used for metabolic diagnosis. Currently, there are four major challenges including (I) long-term process in sample pretreatment; (II) difficulties in direct metabolic analysis of biosamples due to complexity (III) low molecular weight metabolite detection with accuracy and (IV) construction of diagnostic tools by materials and device-based platforms for real case application in biomedical applications. Development of chips with nanomaterial is promising to address these critical issues. Mass spectroscopy (MS) has displayed high sensitivity and accuracy, throughput, reproducibility, and resolution for molecular analysis. Particularly laser desorption/ ionization mass spectrometry (LDI MS) combined with devices affords desirable speed for mass measurement in seconds and high sensitivity with low cost towards large scale uses. We developed a plasmonic chip for clinical metabolic fingerprinting as a hot carrier in LDI MS by series of chips with gold nanoshells on the surface through controlled particle synthesis, dip-coating, and gold sputtering for mass production. We integrated the optimized chip with microarrays for laboratory automation and nanoscaled experiments, which afforded direct high-performance metabolic fingerprinting by LDI MS using 500 nL of serum, urine, cerebrospinal fluids (CSF) and exosomes. Further, we demonstrated on-chip direct in-vitro metabolic diagnosis of early-stage lung cancer patients using serum and exosomes without any pretreatment or purifications. To our best knowledge, this work initiates a bionanotechnology based platform for advanced metabolic analysis toward large-scale diagnostic use.

Keywords: plasmonic chip, metabolic fingerprinting, LDI MS, in-vitro diagnostics

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17292 Influence of Inertial Forces of Large Bearings Utilized in Wind Energy Assemblies

Authors: S. Barabas, F. Sarbu, B. Barabas, A. Fota

Abstract:

Main objective of this paper is to establish a link between inertial forces of the bearings used in construction of wind power plant and its behavior. Using bearings with lower inertial forces has the immediate effect of decreasing inertia rotor system, with significant results in increased energy efficiency, due to decreased friction forces between rollers and raceways. The FEM analysis shows the appearance of uniform contact stress at the ends of the rollers, demonstrated the necessity of production of low mass bearings. Favorable results are expected in the economic field, by reducing material consumption and by increasing the durability of bearings. Using low mass bearings with hollow rollers instead of solid rollers has an impact on working temperature, on vibrations and noise which decrease. Implementation of types of hollow rollers of cylindrical tubular type, instead of expensive rollers with logarithmic profile, will bring significant inertial forces decrease with large benefits in behavior of wind power plant.

Keywords: inertial forces, Von Mises stress, hollow rollers, wind turbine

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17291 Embedding the Dimensions of Sustainability into City Information Modelling

Authors: Ali M. Al-Shaery

Abstract:

The purpose of this paper is to address the functions of sustainability dimensions in city information modelling and to present the required sustainability criteria that support establishing a sustainable planning framework for enhancing existing cities and developing future smart cities. The paper is divided into two sections. The first section is based on the examination of a wide and extensive array of cross-disciplinary literature in the last decade and a half to conceptualize the terms ‘sustainable’ and ‘smart city,' and map their associated criteria to city information modelling. The second section is based on analyzing two approaches relating to city information modelling, namely statistical and dynamic approaches, and their suitability in the development of cities’ action plans. The paper argues that the use of statistical approaches to embedding sustainability dimensions in city information modelling have limited value. Despite the popularity of such approaches in addressing other dimensions like utility and service management in development and action plans of the world cities, these approaches are unable to address the dynamics across various city sectors with regards to economic, environmental and social criteria. The paper suggests an integrative dynamic and cross-disciplinary planning approach to embedding sustainability dimensions in city information modelling frameworks. Such an approach will pave the way towards optimal planning and implementation of priority actions of projects and investments. The approach can be used to achieve three main goals: (1) better development and action plans for world cities (2) serve the development of an integrative dynamic and cross-disciplinary framework that incorporates economic, environmental and social sustainability criteria and (3) address areas that require further attention in the development of future sustainable and smart cities. The paper presents an innovative approach for city information modelling and a well-argued, balanced hierarchy of sustainability criteria that can contribute to an area of research which is still in its infancy in terms of development and management.

Keywords: information modelling, smart city, sustainable city, sustainability dimensions, sustainability criteria, city development planning

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17290 Implementation of Integrated Multi-Channel Analysis of Surface Waves and Waveform Inversion Techniques for Seismic Hazard Estimation with Emphasis on Associated Uncertainty: A Case Study at Zafarana Wind Turbine Towers Farm, Egypt

Authors: Abd El-Aziz Khairy Abd El-Aal, Yuji Yagi, Heba Kamal

Abstract:

In this study, an integrated multi-channel analysis of Surface Waves (MASW) technique is applied to explore the geotechnical parameters of subsurface layers at the Zafarana wind farm. Moreover, a seismic hazard procedure based on the extended deterministic technique is used to estimate the seismic hazard load for the investigated area. The study area includes many active fault systems along the Gulf of Suez that cause many moderate and large earthquakes. Overall, the seismic activity of the area has recently become better understood following the use of new waveform inversion methods and software to develop accurate focal mechanism solutions for recent recorded earthquakes around the studied area. These earthquakes resulted in major stress-drops in the Eastern desert and the Gulf of Suez area. These findings have helped to reshape the understanding of the seismotectonic environment of the Gulf of Suez area, which is a perplexing tectonic domain. Based on the collected new information and data, this study uses an extended deterministic approach to re-examine the seismic hazard for the Gulf of Suez region, particularly the wind turbine towers at Zafarana Wind Farm and its vicinity. Alternate seismic source and magnitude-frequency relationships were combined with various indigenous attenuation relationships, adapted within a logic tree formulation, to quantify and project the regional exposure on a set of hazard maps. We select two desired exceedance probabilities (10 and 20%) that any of the applied scenarios may exceed the largest median ground acceleration. The ground motion was calculated at 50th, 84th percentile levels.

Keywords: MASW, seismic hazard, wind turbine towers, Zafarana wind farm

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17289 Perceptions of Corporate Governance and Business Ethics Practices in Kuwaiti Islamic and Conventional Banks

Authors: Khaled Alotaibi, Salah Alhamadi, Ibraheem Almubarak

Abstract:

The study attempts to explore both corporate governance (GC) and business ethics (BE) practices in Kuwaiti banks and the relationship between CG and BE, using an accountability framework. By examining the perceptions of key stakeholder groups, this study investigates the practices of BE and CG in Islamic banks (IBs) compared to conventional banks (CBs). We contribute to the scarce studies concerned with relations between CG and BE. We have employed a questionnaire survey method for a random sample of crucial relevant stakeholder groups. The empirical analysis of the participants’ perceptions highlights the importance of applying CG regulations and BE for Kuwaiti banks and the clear link between the two concepts. We find that the main concern is not the absence of CG and BE codes, but the lack of consistent enforcement of the regulations. Such a system needs to be strictly and effectively implemented in Kuwaiti banks to protect all stakeholders’ wealth, not only that of stockholders. There are significant patterns in the CG and BE expectations among different stakeholder groups. Most interestingly, banks’ client groups illustrate high expectations concerning CG and BE practices.

Keywords: corporate governance, GC, business ethics, BE, Islamic banks, IBs, conventional banks, CBs, accountability

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17288 Metal Layer Based Vertical Hall Device in a Complementary Metal Oxide Semiconductor Process

Authors: Se-Mi Lim, Won-Jae Jung, Jin-Sup Kim, Jun-Seok Park, Hyung-Il Chae

Abstract:

This paper presents a current-mode vertical hall device (VHD) structure using metal layers in a CMOS process. The proposed metal layer based vertical hall device (MLVHD) utilizes vertical connection among metal layers (from M1 to the top metal) to facilitate hall effect. The vertical metal structure unit flows a bias current Ibias from top to bottom, and an external magnetic field changes the current distribution by Lorentz force. The asymmetric current distribution can be detected by two differential-mode current outputs on each side at the bottom (M1), and each output sinks Ibias/2 ± Ihall. A single vertical metal structure generates only a small amount of hall effect of Ihall due to the short length from M1 to the top metal as well as the low conductivity of the metal, and a series connection between thousands of vertical structure units can solve the problem by providing NxIhall. The series connection between two units is another vertical metal structure flowing current in the opposite direction, and generates negative hall effect. To mitigate the negative hall effect from the series connection, the differential current outputs at the bottom (M1) from one unit merges on the top metal level of the other unit. The proposed MLVHD is simulated in a 3-dimensional model simulator in COMSOL Multiphysics, with 0.35 μm CMOS process parameters. The simulated MLVHD unit size is (W) 10 μm × (L) 6 μm × (D) 10 μm. In this paper, we use an MLVHD with 10 units; the overall hall device size is (W) 10 μm × (L)78 μm × (D) 10 μm. The COMSOL simulation result is as following: the maximum hall current is approximately 2 μA with a 12 μA bias current and 100mT magnetic field; This work was supported by Institute for Information & communications Technology Promotion(IITP) grant funded by the Korea government(MSIP) (No.R7117-16-0165, Development of Hall Effect Semiconductor for Smart Car and Device).

Keywords: CMOS, vertical hall device, current mode, COMSOL

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17287 Authentication and Traceability of Meat Products from South Indian Market by Species-Specific Polymerase Chain Reaction

Authors: J. U. Santhosh Kumar, V. Krishna, Sebin Sebastian, G. S. Seethapathy, G. Ravikanth, R. Uma Shaanker

Abstract:

Food is one of the basic needs of human beings. It requires the normal function of the body part and a healthy growth. Recently, food adulteration increases day by day to increase the quantity and make more benefit. Animal source foods can provide a variety of micronutrients that are difficult to obtain in adequate quantities from plant source foods alone. Particularly in the meat industry, products from animals are susceptible targets for fraudulent labeling due to the economic profit that results from selling cheaper meat as meat from more profitable and desirable species. This work presents an overview of the main PCR-based techniques applied to date to verify the authenticity of beef meat and meat products from beef species. We were analyzed 25 market beef samples in South India. We examined PCR methods based on the sequence of the cytochrome b gene for source species identification. We found all sample were sold as beef meat as Bos Taurus. However, interestingly Male meats are more valuable high price compare to female meat, due to this reason most of the markets samples are susceptible. We were used sex determination gene of cattle like TSPY(Y-encoded, testis-specific protein TSPY is a Y-specific gene). TSPY homologs exist in several mammalian species, including humans, horses, and cattle. This gene is Y coded testis protein genes, which only amplify the male. We used multiple PCR products form species-specific “fingerprints” on gel electrophoresis, which may be useful for meat authentication. Amplicons were obtained only by the Cattle -specific PCR. We found 13 market meat samples sold as female beef samples. These results suggest that the species-specific PCR methods established in this study would be useful for simple and easy detection of adulteration of meat products.

Keywords: authentication, meat products, species-specific, TSPY

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17286 EEG and DC-Potential Level Сhanges in the Elderly

Authors: Irina Deputat, Anatoly Gribanov, Yuliya Dzhos, Alexandra Nekhoroshkova, Tatyana Yemelianova, Irina Bolshevidtseva, Irina Deryabina, Yana Kereush, Larisa Startseva, Tatyana Bagretsova, Irina Ikonnikova

Abstract:

In the modern world the number of elderly people increases. Preservation of functionality of an organism in the elderly becomes very important now. During aging the higher cortical functions such as feelings, perception, attention, memory, and ideation are gradual decrease. It is expressed in the rate of information processing reduction, volume of random access memory loss, ability to training and storing of new information decrease. Perspective directions in studying of aging neurophysiological parameters are brain imaging: computer electroencephalography, neuroenergy mapping of a brain, and also methods of studying of a neurodynamic brain processes. Research aim – to study features of a brain aging in elderly people by electroencephalogram (EEG) and the DC-potential level. We examined 130 people aged 55 - 74 years that did not have psychiatric disorders and chronic states in a decompensation stage. EEG was recorded with a 128-channel GES-300 system (USA). EEG recordings are collected while the participant sits at rest with their eyes closed for 3 minutes. For a quantitative assessment of EEG we used the spectral analysis. The range was analyzed on delta (0,5–3,5 Hz), a theta - (3,5–7,0 Hz), an alpha 1-(7,0–11,0 Hz) an alpha 2-(11–13,0 Hz), beta1-(13–16,5 Hz) and beta2-(16,5–20 Hz) ranges. In each frequency range spectral power was estimated. The 12-channel hardware-software diagnostic ‘Neuroenergometr-KM’ complex was applied for registration, processing and the analysis of a brain constant potentials level. The DC-potential level registered in monopolar leads. It is revealed that the EEG of elderly people differ in higher rates of spectral power in the range delta (р < 0,01) and a theta - (р < 0,05) rhythms, especially in frontal areas in aging. By results of the comparative analysis it is noted that elderly people 60-64 aged differ in higher values of spectral power alfa-2 range in the left frontal and central areas (р < 0,05) and also higher values beta-1 range in frontal and parieto-occipital areas (р < 0,05). Study of a brain constant potential level distribution revealed increase of total energy consumption on the main areas of a brain. In frontal leads we registered the lowest values of constant potential level. Perhaps it indicates decrease in an energy metabolism in this area and difficulties of executive functions. The comparative analysis of a potential difference on the main assignments testifies to unevenness of a lateralization of a brain functions at elderly people. The results of a potential difference between right and left hemispheres testify to prevalence of the left hemisphere activity. Thus, higher rates of functional activity of a cerebral cortex are peculiar to people of early advanced age (60-64 years) that points to higher reserve opportunities of central nervous system. By 70 years there are age changes of a cerebral power exchange and level of electrogenesis of a brain which reflect deterioration of a condition of homeostatic mechanisms of self-control and the program of processing of the perceptual data current flow.

Keywords: brain, DC-potential level, EEG, elderly people

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17285 Applications of Polyvagal Theory for Trauma in Clinical Practice: Auricular Acupuncture and Herbology

Authors: Aurora Sheehy, Caitlin Prince

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Within current orthodox medical protocols, trauma and mental health issues are deemed to reside within the realm of cognitive or psychological therapists and are marginalised in these areas, in part due to limited drugs option available, mostly manipulating neurotransmitters or sedating patients to reduce symptoms. By contrast, this research presents examples from the clinical practice of how trauma can be assessed and treated physiologically. Adverse Childhood Experiences (ACEs) are a tally of different types of abuse and neglect. It has been used as a measurable and reliable predictor of the likelihood of the development of autoimmune disease. It is a direct way to demonstrate reliably the health impact of traumatic life experiences. A second assessment tool is Allostatic Load, which refers to the cumulative effects that chronic stress has on mental and physical health. It records the decline of an individual’s physiological capacity to cope with their experience. It uses a specific grouping of serum testing and physical measures. It includes an assessment of neuroendocrine, cardiovascular, immune and metabolic systems. Allostatic load demonstrates the health impact that trauma has throughout the body. It forms part of an initial intake assessment in clinical practice and could also be used in research to evaluate treatment. Examining medicinal plants for their physiological, neurological and somatic effects through the lens of Polyvagal theory offers new opportunities for trauma treatments. In situations where Polyvagal theory recommends activities and exercises to enable parasympathetic activation, many herbs that affect Effector Memory T (TEM) cells also enact these responses. Traditional or Indigenous European herbs show the potential to support the polyvagal tone, through multiple mechanisms. As the ventral vagal nerve reaches almost every major organ, plants that have actions on these tissues can be understood via their polyvagal actions, such as monoterpenes as agents to improve respiratory vagal tone, cyanogenic glycosides to reset polyvagal tone, volatile oils rich in phenyl methyl esters improve both sympathetic and parasympathetic tone, bitters activate gut function and can strongly promote parasympathetic regulation. Auricular Acupuncture uses a system of somatotopic mapping of the auricular surface overlaid with an image of an inverted foetus with each body organ and system featured. Given that the concha of the auricle is the only place on the body where the Vagus Nerve neurons reach the surface of the skin, several investigators have evaluated non-invasive, transcutaneous electrical nerve stimulation (TENS) at auricular points. Drawn from an interdisciplinary evidence base and developed through clinical practice, these assessment and treatment tools are examples of practitioners in the field innovating out of necessity for the best outcomes for patients. This paper draws on case studies to direct future research.

Keywords: polyvagal, auricular acupuncture, trauma, herbs

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17284 The Effects of a Thin Liquid Layer on the Hydrodynamic Machine Rotor

Authors: Jaroslav Krutil, František Pochylý, Simona Fialová, Vladimír Habán

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A mathematical model of the additional effects of the liquid in the hydrodynamic gap is presented in the paper. An in-compressible viscous fluid is considered. Based on computational modeling are determined the matrices of mass, stiffness and damping. The mathematical model is experimentally verified.

Keywords: computational modeling, mathematical model, hydrodynamic gap, matrices of mass, stiffness and damping

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17283 Investigation of Soil Slopes Stability

Authors: Nima Farshidfar, Navid Daryasafar

Abstract:

In this paper, the seismic stability of reinforced soil slopes is studied using pseudo-dynamic analysis. Equilibrium equations that are applicable to the every kind of failure surface are written using Horizontal Slices Method. In written equations, the balance of the vertical and horizontal forces and moment equilibrium is fully satisfied. Failure surface is assumed to be log-spiral, and non-linear equilibrium equations obtained for the system are solved using Newton-Raphson Method. Earthquake effects are applied as horizontal and vertical pseudo-static coefficients to the problem. To solve this problem, a code was developed in MATLAB, and the critical failure surface is calculated using genetic algorithm. At the end, comparing the results obtained in this paper, effects of various parameters and the effect of using pseudo - dynamic analysis in seismic forces modeling is presented.

Keywords: soil slopes, pseudo-dynamic, genetic algorithm, optimization, limit equilibrium method, log-spiral failure surface

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17282 Drug Therapy Problems and Associated Factors among Patients with Heart Failure in the Medical Ward of Arba Minch General Hospital, Ethiopia

Authors: Debalke Dale, Bezabh Geneta, Yohannes Amene, Yordanos Bergene, Mohammed Yimam

Abstract:

Background: A drug therapy problem (DTP) is an event or circumstance that involves drug therapies that actually or potentially interfere with the desired outcome and requires professional judgment to resolve. Heart failure is an emerging worldwide threat whose prevalence and health loss burden constantly increase, especially in the young and in low-to-middle-income countries. There is a lack of population-based incidence and prevalence of heart failure (HF) studies in sub-Saharan African countries, including Ethiopia. Objective: The aim of this study was designed to assess drug therapy problems and associated factors among patients with HF in the medical ward of Arba Minch General Hospital(AGH), Ethiopia, from June 5 to August 20, 2022. Methods: A retrospective cross-sectional study was conducted among 180 patients with HF who were admitted to the medical ward of AGH. Data were collected from patients' cards by using questionnaires. The data were categorized and analyzed by using SPSS version 25.0 software, and data were presented in tables and words based on the nature of the data. Result: Out of the total, 85 (57.6%) were females, and 113 (75.3%) patients were aged over fifty years. Of the 150 study participants, 86 (57.3%) patients had at least one DTP identified, and a total of 116 DTPs were identified, which is 0.77 DTPs per patient. The most common types of DTP were unnecessary drug therapy (32%), followed by the need for additional drug therapy (36%), and dose too low (15%). Patients who used polypharmacy were 5.86 (AOR) times more likely to develop DTPs than those who did not (95% CI = 1.625–16.536, P = 0.005), and patients with more co-morbid conditions developed 3.68 (AOR) times more DTPs than those who had fewer co-morbidities (95% CI = 1.28–10.5, P = 0.015). Conclusion: The results of this study indicated that drug therapy problems were common among medical ward patients with heart failure. These problems are adversely affecting the treatment outcomes of patients, so it requires the special attention of healthcare professionals to optimize them.

Keywords: heart failure, drug therapy problems, Arba Minch general hospital, Ethiopia

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17281 Common Misconceptions around Human Immunodeficiency Virus in Rural Uganda: Establishing the Role for Patient Education Leaflets Using Patient and Staff Surveys

Authors: Sara Qandil, Harriet Bothwell, Lowri Evans, Kevin Jones, Simon Collin

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Background: Uganda suffers from high rates of HIV. Misconceptions around HIV are known to be prevalent in Sub-Saharan Africa (SSA). Two of the most common misconceptions in Uganda are that HIV can be transmitted by mosquito bites or from sharing food. The aim of this project was to establish the local misconceptions around HIV in a Central Ugandan population, and identify if there is a role for patient education leaflets. This project was undertaken as a student selected component (SSC) offered by Swindon Academy, based at the Great Western Hospital, to medical students in their fourth year of the undergraduate programme. Methods: The study was conducted at Villa Maria Hospital; a private, rural hospital in Kalungu District, Central Uganda. 36 patients, 23 from the hospital clinic and 13 from the community were interviewed regarding their understanding of HIV and by what channels they had obtained this understanding. Interviews were conducted using local student nurses as translators. Verbal responses were translated and then transcribed by the researcher. The same 36 patients then undertook a 'misconception' test consisting of 35 questions. Quantitative data was analysed using descriptive statistics and results were scored based on three components of 'transmission knowledge', 'prevention knowledge' and 'misconception rejection'. Each correct response to a question was scored one point, otherwise zero e.g. correctly rejecting a misconception scored one point, but answering ‘yes’ or ‘don’t know’ scored zero. Scores ≤ 27 (the average score) were classified as having ‘poor understanding’. Mean scores were compared between participants seen at the HIV clinic and in the community, and p-values (including Fisher’s exact test) were calculated using Stata 2015. Level of significance was set at 0.05. Interviews with 7 members of staff working in the HIV clinic were undertaken to establish what methods of communication are used to educate patients. Interviews were transcribed and thematic analysis undertaken. Results: The commonest misconceptions which failed to be rejected included transmission of HIV by kissing (78%), mosquitoes (69%) and touching (36%). 33% believed HIV may be prevented by praying. The overall mean scores for transmission knowledge (87.5%) and prevention knowledge (81.1%) were better than misconception rejection scores (69.3%). HIV clinic respondents did tend to have higher scores, i.e. fewer misconceptions, although there was statistical evidence of a significant difference only for prevention knowledge (p=0.03). Analysis of the qualitative data is ongoing but several patients expressed concerns about not being able to read and therefore leaflets not having a helpful role. Conclusions: Results from this paper identified that a high proportion of the population studied held misconceptions about HIV. Qualitative data suggests that there may be a role for patient education leaflets, if pictorial-based and suitable for those with low literacy skill.

Keywords: HIV, human immunodeficiency virus, misconceptions, patient education, Sub-Saharan Africa, Uganda

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17280 The Electrophysiology Study Results in Patients with Guillain Barre Syndrome (GBS): A Retrospective Study in a TertiaryHospital in Cebu City, Philippines

Authors: Dyna Ann C. Sevilles, Noel J. Belonguel, Jarungchai Anton S. Vatanagul, Mary Jeanne O. Flordelis, Grace G. Anota

Abstract:

Guillain Barre syndrome is an acute inflammatory polyradiculoneuropathy causing progressive symmetrical weakness which can be debilitating to the patient. Early diagnosis is important especially in the acute phase when treatment favors good outcome and reduces the incidence of the need for mechanical ventilation. Electrodiagnostic studies aid in the evaluation of patients suspected with GBS. However, the characteristic electrical changes may not be evident until after several weeks. Thus, studies performed early in the course may give unclear results. The aim of this study is to associate the symptom onset of patients diagnosed with Guillain Barre syndrome with the EMG NCV results and determine the earliest time when there is evident findings supporting the diagnosis. This is a retrospective descriptive chart review study involving patients of >/= 18 years of age with GBS written on their charts in a Tertiaty hospital in Cebu City, Philippines from January 2000 to July 2014. Twenty patients showed electrodiagnostic findings suggestive of GBS. The mean day of illness when EMG NCV was carried out was 7 days. The earliest with suggestive findings was done on day 2 (10%) of illness. Moreover, the highest frequency with positive results was done on day 3 (20%) of illness. Based on the Dutch Guillain Barre Study group criteria, the most frequent variables noted were: prolonged distal motor latency in both median and ulnar nerves(65%) and both peroneal and tibial nerves (71%); and reduced CMAP in both median and ulnar nerves (65%) and both tibial and peroneal nerves (71%). The EMG NCV findings showed majority of demyelinating type (59%). Electrodiagnostic studies are helpful in aiding the physician in the diagnosis and treatment of the disease in the early stage. Based on this study, neurophysiologic evidence of GBS can be seen in as early as day 2 of clinical illness.

Keywords: Acute Inflammatory Demyelinating Polyneuropathy, electrophysiologic study, EMG NCV, Guillain Barre Syndrome

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17279 Expression of ACSS2 Genes in Peripheral Blood Mononuclear Cells of Patients with Alzheimer’s Disease

Authors: Ali Bayram, Burak Uz, Remzi Yiğiter

Abstract:

The impairment of lipid metabolism in the central nervous system has been suggested as a critical factor of Alzheimer’s disease (AD) pathogenesis. Homo sapiens acyl-coenyme A synthetase short-chain family member 2 (ACSS2) gene encodes the enzyme acetyl-Coenzyme A synthetase (AMP forming; AceCS) providing acetyl-coenzyme A (Ac-CoA) for various physiological processes, such as cholesterol and fatty acid synthesis, as well as the citric acid cycle. We investigated ACSS2, transcript variant 1 (ACSS2*1), mRNA levels in the peripheral blood mononuclear cells (PBMC) of patients with AD and compared them with the controls. The study group comprised 50 patients with the diagnosis of AD who have applied to Gaziantep University Faculty of Medicine, and Department of Neurology. 49 healthy individuals without any neurodegenerative disease are included as controls. ACSS2 mRNA expression in PBMC of AD/control patients was 0.495 (95% confidence interval: 0.410-0.598), p= .000000001902). Further studies are needed to better clarify this association.

Keywords: Alzheimer’s disease, ACSS2 Genes, mRNA expression, RT-PCR

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17278 Evaluating Robustness of Conceptual Rainfall-runoff Models under Climate Variability in Northern Tunisia

Authors: H. Dakhlaoui, D. Ruelland, Y. Tramblay, Z. Bargaoui

Abstract:

To evaluate the impact of climate change on water resources at the catchment scale, not only future projections of climate are necessary but also robust rainfall-runoff models that are able to be fairly reliable under changing climate conditions. This study aims at assessing the robustness of three conceptual rainfall-runoff models (GR4j, HBV and IHACRES) on five basins in Northern Tunisia under long-term climate variability. Their robustness was evaluated according to a differential split sample test based on a climate classification of the observation period regarding simultaneously precipitation and temperature conditions. The studied catchments are situated in a region where climate change is likely to have significant impacts on runoff and they already suffer from scarcity of water resources. They cover the main hydrographical basins of Northern Tunisia (High Medjerda, Zouaraâ, Ichkeul and Cap bon), which produce the majority of surface water resources in Tunisia. The streamflow regime of the basins can be considered as natural since these basins are located upstream from storage-dams and in areas where withdrawals are negligible. A 30-year common period (1970‒2000) was considered to capture a large spread of hydro-climatic conditions. The calibration was based on the Kling-Gupta Efficiency (KGE) criterion, while the evaluation of model transferability is performed according to the Nash-Suttfliff efficiency criterion and volume error. The three hydrological models were shown to have similar behaviour under climate variability. Models prove a better ability to simulate the runoff pattern when transferred toward wetter periods compared to the case when transferred to drier periods. The limits of transferability are beyond -20% of precipitation and +1.5 °C of temperature in comparison with the calibration period. The deterioration of model robustness could in part be explained by the climate dependency of some parameters.

Keywords: rainfall-runoff modelling, hydro-climate variability, model robustness, uncertainty, Tunisia

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17277 Coupled Space and Time Homogenization of Viscoelastic-Viscoplastic Composites

Authors: Sarra Haouala, Issam Doghri

Abstract:

In this work, a multiscale computational strategy is proposed for the analysis of structures, which are described at a refined level both in space and in time. The proposal is applied to two-phase viscoelastic-viscoplastic (VE-VP) reinforced thermoplastics subjected to large numbers of cycles. The main aim is to predict the effective long time response while reducing the computational cost considerably. The proposed computational framework is a combination of the mean-field space homogenization based on the generalized incrementally affine formulation for VE-VP composites, and the asymptotic time homogenization approach for coupled isotropic VE-VP homogeneous solids under large numbers of cycles. The time homogenization method is based on the definition of micro and macro-chronological time scales, and on asymptotic expansions of the unknown variables. First, the original anisotropic VE-VP initial-boundary value problem of the composite material is decomposed into coupled micro-chronological (fast time scale) and macro-chronological (slow time-scale) problems. The former is purely VE, and solved once for each macro time step, whereas the latter problem is nonlinear and solved iteratively using fully implicit time integration. Second, mean-field space homogenization is used for both micro and macro-chronological problems to determine the micro and macro-chronological effective behavior of the composite material. The response of the matrix material is VE-VP with J2 flow theory assuming small strains. The formulation exploits the return-mapping algorithm for the J2 model, with its two steps: viscoelastic predictor and plastic corrections. The proposal is implemented for an extended Mori-Tanaka scheme, and verified against finite element simulations of representative volume elements, for a number of polymer composite materials subjected to large numbers of cycles.

Keywords: asymptotic expansions, cyclic loadings, inclusion-reinforced thermoplastics, mean-field homogenization, time homogenization

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17276 Intracellular Strategies for Gene Delivery into Mammalian Cells Using Bacteria as a Vector

Authors: Kumaran Narayanan, Andrew N. Osahor

Abstract:

E. coli has been engineered by our group and by others as a vector to deliver DNA into cultured human and animal cells. However, so far conditions to improve gene delivery using this vector have not been investigated, resulting in a major gap in our understanding of the requirements for this vector to function optimally. Our group recently published novel data showing that simple addition of the DNA transfection reagent Lipofectamine increased the efficiency of the E. coli vector by almost 3-fold, providing the first strong evidence that further optimization of bactofection is possible. This presentation will discuss advances that demonstrate the effects of several intracellular strategies that improve the efficiency of this vector. Conditions that promote endosomal escape of internalized bacteria to evade lysosomal destruction after entry in the cell, a known obstacle limiting this vector, are elucidated. Further, treatments that increase bacterial lysis so that the vector can release its transgene into the mammalian environment for expression will be discussed. These experiments will provide valuable new insight to advance this E. coli system as an important class of vector technology for genetic correction of human disease models in cells and whole animals.

Keywords: DNA, E. coli, gene expression, vector

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17275 Multi-Modality Brain Stimulation: A Treatment Protocol for Tinnitus

Authors: Prajakta Patil, Yash Huzurbazar, Abhijeet Shinde

Abstract:

Aim: To develop a treatment protocol for the management of tinnitus through multi-modality brain stimulation. Methodology: Present study included 33 adults with unilateral (31 subjects) and bilateral (2 subjects) chronic tinnitus with and/or without hearing loss independent of their etiology. The Treatment protocol included 5 consecutive sessions with follow-up of 6 months. Each session was divided into 3 parts: • Pre-treatment: a) Informed consent b) Pitch and loudness matching. • Treatment: Bimanual paper pen task with tinnitus masking for 30 minutes. • Post-treatment: a) Pitch and loudness matching b) Directive counseling and obtaining feedback. Paper-pen task is to be performed bimanually that included carrying out two different writing activities in different context. The level of difficulty of the activities was increased in successive sessions. Narrowband noise of a frequency same as that of tinnitus was presented at 10 dBSL of tinnitus for 30 minutes simultaneously in the ear with tinnitus. Result: The perception of tinnitus was no longer present in 4 subjects while in remaining subjects it reduced to an intensity that its perception no longer troubled them without causing residual facilitation. In all subjects, the intensity of tinnitus decreased by an extent of 45 dB at an average. However, in few subjects, the intensity of tinnitus also decreased by more than 45 dB. The approach resulted in statistically significant reductions in Tinnitus Functional Index and Tinnitus Handicap Inventory scores. The results correlate with pre and post treatment score of Tinnitus Handicap Inventory that dropped from 90% to 0%. Discussion: Brain mapping(qEEG) Studies report that there is multiple parallel overlapping of neural subnetworks in the non-auditory areas of the brain which exhibits abnormal, constant and spontaneous neural activity involved in the perception of tinnitus with each subnetwork and area reflecting a specific aspect of tinnitus percept. The paper pen task and directive counseling are designed and delivered respectively in a way that is assumed to induce normal, rhythmically constant and premeditated neural activity and mask the abnormal, constant and spontaneous neural activity in the above-mentioned subnetworks and the specific non-auditory area. Counseling was focused on breaking the vicious cycle causing and maintaining the presence of tinnitus. Diverting auditory attention alone is insufficient to reduce the perception of tinnitus. Conscious awareness of tinnitus can be suppressed when individuals engage in cognitively demanding tasks of non-auditory nature as the paper pen task used in the present study. To carry out this task selective, divided, sustained, simultaneous and split attention act cumulatively. Bimanual paper pen task represents a top-down activity which underlies brain’s ability to selectively attend to the bimanual written activity as a relevant stimulus and to ignore tinnitus that is the irrelevant stimuli in the present study. Conclusion: The study suggests that this novel treatment approach is cost effective, time saving and efficient to vanish the tinnitus or to reduce the intensity of tinnitus to a negligible level and thereby eliminating the negative reactions towards tinnitus.

Keywords: multi-modality brain stimulation, neural subnetworks, non-auditory areas, paper-pen task, top-down activity

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17274 Modelling of Heat Transfer during Controlled Cooling of Thermo-Mechanically Treated Rebars Using Computational Fluid Dynamics Approach

Authors: Rohit Agarwal, Mrityunjay K. Singh, Soma Ghosh, Ramesh Shankar, Biswajit Ghosh, Vinay V. Mahashabde

Abstract:

Thermo-mechanical treatment (TMT) of rebars is a critical process to impart sufficient strength and ductility to rebar. TMT rebars are produced by the Tempcore process, involves an 'in-line' heat treatment in which hot rolled bar (temperature is around 1080°C) is passed through water boxes where it is quenched under high pressure water jets (temperature is around 25°C). The quenching rate dictates composite structure consisting (four non-homogenously distributed phases of rebar microstructure) pearlite-ferrite, bainite, and tempered martensite (from core to rim). The ferrite and pearlite phases present at core induce ductility to rebar while martensitic rim induces appropriate strength. The TMT process is difficult to model as it brings multitude of complex physics such as heat transfer, highly turbulent fluid flow, multicomponent and multiphase flow present in the control volume. Additionally the presence of film boiling regime (above Leidenfrost point) due to steam formation adds complexity to domain. A coupled heat transfer and fluid flow model based on computational fluid dynamics (CFD) has been developed at product technology division of Tata Steel, India which efficiently predicts temperature profile and percentage martensite rim thickness of rebar during quenching process. The model has been validated with 16 mm rolling of New Bar mill (NBM) plant of Tata Steel Limited, India. Furthermore, based on the scenario analyses, optimal configuration of nozzles was found which helped in subsequent increase in rolling speed.

Keywords: boiling, critical heat flux, nozzles, thermo-mechanical treatment

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17273 Women with Invisible Wounds: A Qualitative Exploration of Emotional Abuse

Authors: Mehar Pruthi, Manjula V.

Abstract:

For the longest time, Indian households have been hosts to a variety of domestic evils such as intimate partner violence, physical abuse, sexual assaults, and more commonly gender-based violence. The prevalence of such heinous acts against women is often swept under the carpet of patriarchy and leaves women scarred. Many times, these wounds are caused by more insidious and subtle acts of violence. For this study, the choice of term for these acts is Emotional Abuse. The ill effects of emotional abuse on the victim’s sense of self and psychological health have been widely established. The current study takes a qualitative approach to explore women’s experiences at the brunt of emotional abuse. To this end, six participants (N=6) were identified using purposive and snowball sampling which was followed by a pre-screening form to assess for the presence of emotional abuse. A semi-structured interview guide was employed to investigate the victim’s perception of emotional abuse, the manifestation of emotional abuse in a patriarchal society, and the reasons women remain in abusive relationships. Each interview lasted about 50-60 mins and was accompanied by extensive note-making. A preliminary analysis of the interviews was done using the Interpretative Phenomenological Approach. Initial findings reveal the emergence of themes such as feelings of loneliness, intergenerational transmission of violence, denial, justifying the partner’s behavior, staying because of children, hoping things would change, and faith in God. The study is instrumental in conceptualizing the patterns of emotional abuse keeping in mind the patriarchal context of the Indian society. It has implications for professionals in the mental health field who work with this population so they can better understand their plight. Future research could focus on rebuilding relationships for those partners who decide to sustain such relationships and focus on various coping mechanisms with special emphasis on religious beliefs.

Keywords: emotional abuse, gender-based violence, intimate partner violence, marriage, patriarchy

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17272 Integration of LCA and BIM for Sustainable Construction

Authors: Laura Álvarez Antón, Joaquín Díaz

Abstract:

The construction industry is turning towards sustainability. It is a well-known fact that sustainability is based on a balance between environmental, social and economic aspects. In order to achieve sustainability efficiently, these three criteria should be taken into account in the initial project phases, since that is when a project can be influenced most effectively. Thus the aim must be to integrate important tools like BIM and LCA at an early stage in order to make full use of their potential. With the synergies resulting from the integration of BIM and LCA, a wider approach to sustainability becomes possible, covering the three pillars of sustainability.

Keywords: building information modeling (BIM), construction industry, design phase, life cycle assessment (LCA), sustainability

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17271 Vibration Mitigation in Partially Liquid-Filled Vessel Using Passive Energy Absorbers

Authors: Maor Farid, Oleg Gendelman

Abstract:

The following study deals with fluid vibration of a liquid in a partially filled vessel under periodic ground excitation. This external excitation might lead to hidraulic impact applied on the vessel inner walls. In order to model these sloshing dynamic regimes, several equivalent mechanical models were suggested in the literature, such as series of pendula or mass-spring systems that are able to impact the inner tank walls. In the following study, we use the latter methodology, use parameter values documented in literature corresponding to cylindrical tanks and consider structural elasticity of the tank. The hydraulic impulses are modeled by the high-exponent potential function. Additional system parameters are found with the help of Finite-Element (FE) analysis. Model-driven stress assessment method is developed. Finally, vibration mitigation performances of both tuned mass damper (TMD) and nonlinear energy sink (NES) are examined.

Keywords: nonlinear energy sink (NES), reduced-order modelling, liquid sloshing, vibration mitigation, vibro-impact dynamics

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17270 The Need for Selective Credit Policy Implementation: Case of Croatia

Authors: Drago Jakovcevic, Mihovil Andelinovic, Igor Husak

Abstract:

The aim of this paper is to explore the economic circumstances in which the selective credit policy, the least used instrument of four types of instruments on disposal to central banks, should be used. The most significant example includes the use of selective credit policies in response to the emergence of the global financial crisis by the FED. Specifics of the potential use of selective credit policies as the instigator of economic growth in Croatia, a small open economy, are determined by high euroization of financial system, fixed exchange rate and long-term trend growth of external debt that is related to the need to maintain high levels of foreign reserves. In such conditions, the classic forms of selective credit policies are unsuitable for the introduction. Several alternative approaches to implement selective credit policies are examined in this paper. Also, thorough analysis of distribution of selective monetary policy loans among economic sectors in Croatia is conducted in order to minimize the risk of investing funds and maximize the return, in order to influence the GDP growth.

Keywords: global crisis, selective credit policy, small open economy, Croatia

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17269 Development of Green Cement, Based on Partial Replacement of Clinker with Limestone Powder

Authors: Yaniv Knop, Alva Peled

Abstract:

Over the past few years there has been a growing interest in the development of Portland Composite Cement, by partial replacement of the clinker with mineral additives. The motivations to reduce the clinker content are threefold: (1) Ecological - due to lower emission of CO2 to the atmosphere; (2) Economical - due to cost reduction; and (3) Scientific\Technology – improvement of performances. Among the mineral additives being used and investigated, limestone is one of the most attractive, as it is considered natural, available, and with low cost. The goal of the research is to develop green cement, by partial replacement of the clinker with limestone powder while improving the performances of the cement paste. This work studied blended cements with three limestone powder particle diameters: smaller than, larger than, and similarly sized to the clinker particle. Blended cement with limestone consisting of one particle size distribution and limestone consisting of a combination of several particle sizes were studied and compared in terms of hydration rate, hydration degree, and water demand to achieve normal consistency. The performances of these systems were also compared with that of the original cement (without added limestone). It was found that the ability to replace an active material with an inert additive, while achieving improved performances, can be obtained by increasing the packing density of the cement-based particles. This may be achieved by replacing the clinker with limestone powders having a combination of several different particle size distributions. Mathematical and physical models were developed to simulate the setting history from initial to final setting time and to predict the packing density of blended cement with limestone having different sizes and various contents. Besides the effect of limestone, as inert additive, on the packing density of the blended cement, the influence of the limestone particle size on three different chemical reactions were studied; hydration of the cement, carbonation of the calcium hydroxide and the reactivity of the limestone with the hydration reaction products. The main results and developments will be presented.

Keywords: packing density, hydration degree, limestone, blended cement

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17268 Impact Analysis of a School-Based Oral Health Program in Brazil

Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

Abstract:

Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

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17267 Coronary Artery Calcium Score and Statin Treatment Effect on Myocardial Infarction and Major Adverse Cardiovascular Event of Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analysis

Authors: Yusra Pintaningrum, Ilma Fahira Basyir, Sony Hilal Wicaksono, Vito A. Damay

Abstract:

Background: Coronary artery calcium (CAC) scores play an important role in improving prognostic accuracy and can be selectively used to guide the allocation of statin therapy for atherosclerotic cardiovascular disease outcomes and potentially associated with the occurrence of MACE (Major Adverse Cardiovascular Event) and MI (Myocardial Infarction). Objective: This systematic review and meta-analysis aim to analyze the findings of a study about CAC Score and statin treatment effect on MI and MACE risk. Methods: Search for published scientific articles using the PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta-Analysis) method conducted on PubMed, Cochrane Library, and Medline databases published in the last 20 years on “coronary artery calcium” AND “statin” AND “cardiovascular disease” Further systematic review and meta-analysis using RevMan version 5.4 were performed based on the included published scientific articles. Results: Based on 11 studies included with a total of 1055 participants, we performed a meta-analysis and found that individuals with CAC score > 0 increased risk ratio of MI 8.48 (RR = 9.48: 95% CI: 6.22 – 14.45) times and MACE 2.48 (RR = 3.48: 95% CI: 2.98 – 4.05) times higher than CAC score 0 individual. Statin compared against non-statin treatment showed a statistically insignificant overall effect on the risk of MI (P = 0.81) and MACE (P = 0.89) in an individual with elevated CAC score 1 – 100 (P = 0.65) and > 100 (P = 0.11). Conclusions: This study found that an elevated CAC scores individual has a higher risk of MI and MACE than a non-elevated CAC score individual. There is no significant effect of statin compared against non-statin treatment to reduce MI and MACE in elevated CAC score individuals of 1 – 100 or > 100.

Keywords: coronary artery calcium, statin, cardiovascular disease, myocardial infarction, MACE

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