Search results for: attack risk
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6562

Search results for: attack risk

4132 The Nutritional Status and the Kidney Function in Older Patients

Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

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Background: Obesity, particularly abdominal type, lead to accelerated progress of atherosclerosis and thus affects the functioning of various human organs. Non-HDL cholesterol includes residual risk of the cardiovascular diseases which persists in patients after achieved recommended level of LDL cholesterol. The maintenance of normal body mass index plays a particularly important role in both the prevention and treatment of chronic diseases. Materials and Methods: The study covered 96 patients (55 females, 42 males, age 66,9 +/-10,2 years). The nutritional status was determined with the Waist to Height Ratio (WHtR) and the Waist to Hip Ratio (WHR). A function of the kidney was evaluated by calculating the estimated glomerular filtration rate (eGFR) using the MDRD formula. Non-high-density lipoprotein cholesterol (non-HDL) is simply the difference between the total cholesterol concentration and the HDL cholesterol concentration. Results: The higher was level of non-HDL cholesterol, the lower eGFR had studied subjects (p<0.001). Significant correlation was found between higher WHtR and lower the eGFR (p=0.002). Also underweight (30% of patient) led to obtaining lower values of eGFR in subjects over 65 years old. The poorer nutrition the lower was glomerular filtration rate. Conclusions: Nutritional statuses of patients have a significant impact on the level of kidney function. Not only accumulated excess fat in the abdominal area, but also its deficiency affects the deterioration in renal filtration. Higher level of non-HDL not only raises the residual risk of the heart disease but also influences on kidney by worsening eGFR. Proper diet in connection with physical activity should lead to achieving good nutrition in these patients and protect their kidney function.

Keywords: nutrition, non-HDL cholesterol, glomerular filtration rate, lifestyle

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4131 Urine Neutrophil Gelatinase-Associated Lipocalin as an Early Marker of Acute Kidney Injury in Hematopoietic Stem Cell Transplantation Patients

Authors: Sara Ataei, Maryam Taghizadeh-Ghehi, Amir Sarayani, Asieh Ashouri, Amirhossein Moslehi, Molouk Hadjibabaie, Kheirollah Gholami

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Background: Acute kidney injury (AKI) is common in hematopoietic stem cell transplantation (HSCT) patients with an incidence of 21–73%. Prevention and early diagnosis reduces the frequency and severity of this complication. Predictive biomarkers are of major importance to timely diagnosis. Neutrophil gelatinase associated lipocalin (NGAL) is a widely investigated novel biomarker for early diagnosis of AKI. However, no study assessed NGAL for AKI diagnosis in HSCT patients. Methods: We performed further analyses on gathered data from our recent trial to evaluate the performance of urine NGAL (uNGAL) as an indicator of AKI in 72 allogeneic HSCT patients. AKI diagnosis and severity were assessed using Risk–Injury–Failure–Loss–End-stage renal disease and AKI Network criteria. We assessed uNGAL on days -6, -3, +3, +9 and +15. Results: Time-dependent Cox regression analysis revealed a statistically significant relationship between uNGAL and AKI occurrence. (HR=1.04 (1.008-1.07), P=0.01). There was a relation between uNGAL day +9 to baseline ratio and incidence of AKI (unadjusted HR=.1.047(1.012-1.083), P<0.01). The area under the receiver-operating characteristic curve for day +9 to baseline ratio was 0.86 (0.74-0.99, P<0.01) and a cut-off value of 2.62 was 85% sensitive and 83% specific in predicting AKI. Conclusions: Our results indicated that increase in uNGAL augmented the risk of AKI and the changes of day +9 uNGAL concentrations from baseline could be of value for predicting AKI in HSCT patients. Additionally uNGAL changes preceded serum creatinine rises by nearly 2 days.

Keywords: acute kidney injury, hemtopoietic stem cell transplantation, neutrophil gelatinase-associated lipocalin, Receiver-operating characteristic curve

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4130 Identify the Risks Factors and Problems of Waste Management in Developing Countries as Hurdles

Authors: Zubair Ahmad

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The aim of this study is to analyze the risks factors and issues with waste management in developing nations as barriers. Depending on their content and categorization, wastes are managed differently. Waste management strategies differ for liquid, solid, and organic wastes. The final stage of trash disposal entails procedures like burning, interment, recycling, and treatment. Due to the rising creation of solid waste, the growing urban population has a magnified impact on the environment and public health. All regions, but especially informal urban neighborhoods, tribal villages, and official rural settlements have a protracted backlog in waste services. Another significant impediment seen in the developing world is a lack of education and awareness of effective waste-management practices. Unauthorized dumpsites pose a serious risk to the environment since they could contain dangerous elements like radioactive, infectious, and toxic waste. Wealthier individuals are more inclined to think that their actions will have an impact on environmental problems and to act to address them. Waste managers need to take action to make sure the public is given information that is consistent with what they currently know. The results of the data analysis conducted with the aid of the various methodologies discussed in the preceding chapter are presented in this chapter by the researcher. Descriptive analysis has been used in research to determine whether or not there are relationships between variables and to determine the importance of the variables. According to a survey, there are no efforts being made to lessen the odor that garbage dump sites emit (in terms of treating or recycling the material placed at dumpsite) This might be the case since respondents only commented on the waste management conditions in their immediate surroundings and may not have fully understood the steps taken to resolve this issue.

Keywords: risk factor of waste material, lack of awareness, developing countries struggles, waste management

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4129 The Role of Moroccan Salafist Radicalism in Creating Threat to Spain’s Security

Authors: Stanislaw Kosmynka

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Although the genesis of the activity of fighting salafist radicalism in Spain dates back to the 80’s, the development of extremism of this kind manifested itself only in the next decade. Its first permanently functioning structures in this country in the second half of 90’s of 20th century came from Algieria and Syria. At the same time it should be emphasized that this distinction is in many dimensions conventional, the more so because they consisted also of immigrants from other coutries of Islam, particularly from Morocco. The paper seeks to understand the radical salafist challenge for Spain in the context of some terrorist networks consisted of immigrants from Morocco. On the eve of the new millennium Moroccan jihadists played an increasingly important role. Although the activity of these groups had for many years mainly logistical and propaganda character, the bomb attack carried out on 11 March 2004 in Madrid constituted an expression of open forms of terrorism, directed against the authorities and society of Spain and reflected the narration of representatives of the trend of the global jihad. The people involved in carrying out that act of violence were to a large extent Moroccan immigrants; also in the following years among the cells of radicals in Spain Moroccans stood out many times. That is why the forms and directions of activity of these extremists in Spain, also after 11th March 2004 and in the actual context of the impact of Islamic State, are worth presenting. The paper is focused on threats to the security of Spain and the region and remains connected with the issues of mutual relations of the society of a host country with immigrant communities which to a large degree come from this part of Maghreb.

Keywords: jihadi terrorism, Morocco, radical salafism, security, Spain, terrorist cells, threat

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4128 Prevalence of Metabolic Syndrome among Adult Obese Type 2 Diabetic Subjects

Authors: Mehwish Azam, Muhammad Imran, Humaira Jabeen, Sumreen Begum, Rashida Qasim

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Background: Metabolic syndrome is a cluster of metabolic risk factors including obesity, glucose intolerance, insulin resistance, dyslipidemia and hypertension. Metabolic syndrome in obese and type 2 diabetic subjects increases the risk of cardiovascular diseases (CVD). Globally, the prevalence of metabolic syndrome ranges from 10%-50% and in Pakistan ranges from 18%-46%. The objective of the present study is to estimate the prevalence of metabolic syndrome (MS) in obese type 2 diabetic subjects by using International Diabetes Federation (IDF) and National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) definitions. Methods: Obese type 2 diabetic subjects and normal healthy subjects of both genders were selected from diabetic clinics and hospitals of various localities of Karachi, Pakistan. The frequency of metabolic syndrome was estimated by the proposed definitions of IDF and NCEP-ATP III. Results: The prevalence of metabolic syndrome using International Diabetes Federation (IDF) definition in obese type 2 diabetic subjects was 85.7%. It is significantly higher (p<0.05) in females (47.1%) as compared to males (38.6%). While, using National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) definition the overall prevalence of metabolic syndrome in obese type 2 diabetic subjects was 75.7%, the prevalence is significantly higher (p<0.05) in females (45.7%) than males (30.0%). Conclusion: It is concluded that, the overall prevalence of metabolic syndrome is increasing significantly in obese type 2 diabetic subjects by using IDF and NCEP–ATP III definitions. Therefore, it is need to initiate the preventive measures by arranging public awareness programmes to highlight the significance of a healthy lifestyle and emphasis should be given to reduce weight, increase physical activity, and increase intake of healthy low-glycemic-index foods.

Keywords: metabolic syndrome, diabetes mellitus, obesity, IDF, NCEP-ATP III

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4127 Artificial Intelligence Techniques for Enhancing Supply Chain Resilience: A Systematic Literature Review, Holistic Framework, and Future Research

Authors: Adane Kassa Shikur

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Today’s supply chains (SC) have become vulnerable to unexpected and ever-intensifying disruptions from myriad sources. Consequently, the concept of supply chain resilience (SCRes) has become crucial to complement the conventional risk management paradigm, which has failed to cope with unexpected SC disruptions, resulting in severe consequences affecting SC performances and making business continuity questionable. Advancements in cutting-edge technologies like artificial intelligence (AI) and their potential to enhance SCRes by improving critical antecedents in the different phases have attracted the attention of scholars and practitioners. The research from academia and the practical interest of the industry have yielded significant publications at the nexus of AI and SCRes during the last two decades. However, the applications and examinations have been primarily conducted independently, and the extant literature is dispersed into research streams despite the complex nature of SCRes. To close this research gap, this study conducts a systematic literature review of 106 peer-reviewed articles by curating, synthesizing, and consolidating up-to-date literature and presents the state-of-the-art development from 2010 to 2022. Bayesian networks are the most topical ones among the 13 AI techniques evaluated. Concerning the critical antecedents, visibility is the first ranking to be realized by the techniques. The study revealed that AI techniques support only the first 3 phases of SCRes (readiness, response, and recovery), and readiness is the most popular one, while no evidence has been found for the growth phase. The study proposed an AI-SCRes framework to inform research and practice to approach SCRes holistically. It also provided implications for practice, policy, and theory as well as gaps for impactful future research.

Keywords: ANNs, risk, Bauesian networks, vulnerability, resilience

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4126 Alcohol-Containing versus Aqueous-Based Solutions for Skin Preparation in Abdominal Surgery: A Systematic Review and Meta-Analysis

Authors: Dimitra V. Peristeri, Hussameldin M. Nour, Amiya Ahsan, Sameh Abogabal, Krishna K. Singh, Muhammad Shafique Sajid

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Introduction: The use of optimal skin antiseptic agents for the prevention of surgical site infection (SSI) is of critical importance, especially during abdominal surgical procedures. Alcohol-based chlorhexidine gluconate (CHG) and aqueous-based povidone-iodine (PVI) are the two most common skin antiseptics used nowadays. The objective of this article is to evaluate the effectiveness of alcohol-based CHG versus aqueous-based PVI used for skin preparation before abdominal surgery to reduce SSIs. Methods: Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomised, controlled trials (RCTs) comparing alcohol-based CHG skin preparation versus aqueous-based PVI in patients undergoing abdominal surgery. The combined outcomes of SSIs were calculated using an odds ratio (OR) with 95% confidence intervals (95% CI). All data were analysed using Review Manager (RevMan) Software 5.4, and the meta-analysis was performed with a random effect model analysis. Results: A total of 11 studies, all RCTs, were included (n= 12072 participants), recruiting adult patients undergoing abdominal surgery. In the random effect model analysis, the use of alcohol-based CHG in patients undergoing abdominal surgery was associated with a reduced risk of SSI compared to aqueous-based PVI (OR: 0.84; 95% CI [0.74, 0.96], z= 2.61, p= 0.009). Conclusion: Alcohol-based CHG may be more effective for preventing the risk of SSI compared to aqueous-based PVI agents in abdominal surgery. The conclusion of this meta-analysis may add a guiding value to reinforce current clinical practice guidelines.

Keywords: skin preparation, surgical site infection, chlorhexidine, skin antiseptics

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4125 The Development of Nursing Model for Pregnant Women to Prevention of Early Postpartum Hemorrhage

Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

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Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

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4124 Performance of Autoclaved Aerated Concrete Containing Recycled Ceramic and Gypsum Waste as Partial Replacement for Sand

Authors: Efil Yusrianto, Noraini Marsi, Noraniah Kassim, Izzati Abdul Manaf, Hafizuddin Hakim Shariff

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Today, municipal solid waste (MSW), noise pollution, and attack fire are three ongoing issues for inhabitants of urban including in Malaysia. To solve these issues, eco-friendly autoclaved aerated concrete (AAC) containing recycled ceramic and gypsum waste (CGW) as a partial replacement for sand with different ratios (0%, 5%, 10%, 15%, 20%, and 25% wt) has been prepared. The performance of samples, such as the physical, mechanical, sound absorption coefficient, and direct fire resistance, has been investigated. All samples showed normal color behavior, i.e., grey and free crack. The compressive strength was increased in the range of 6.10% to 29.88%. The maximum value of compressive strength was 2.13MPa for 15% wt of CGW. The positive effect of CGW on the compressive strength of AAC has also been confirmed by crystalline phase and microstructure analysis. The acoustic performances, such as sound absorption coefficients of samples at low frequencies (500Hz), are higher than the reference sample (RS). AAC-CGW samples are categorized as AAC material classes B and C. The fire resistance results showed the physical surface of the samples had a free crack and was not burned during the direct fire at 950ºC for 300s. The results showed that CGW succeeded in enhancing the performance of fresh AAC, such as compressive strength, crystalline phase, sound absorption coefficient, and fire resistance of samples.

Keywords: physical, mechanical, acoustic, direct fire resistance performance, autoclaved aerated concrete, recycled ceramic-gypsum waste

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4123 Aeroacoustics Investigations of Unsteady 3D Airfoil for Different Angle Using Computational Fluid Dynamics Software

Authors: Haydar Kepekçi, Baha Zafer, Hasan Rıza Güven

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Noise disturbance is one of the major factors considered in the fast development of aircraft technology. This paper reviews the flow field, which is examined on the 2D NACA0015 and 3D NACA0012 blade profile using SST k-ω turbulence model to compute the unsteady flow field. We inserted the time-dependent flow area variables in Ffowcs-Williams and Hawkings (FW-H) equations as an input and Sound Pressure Level (SPL) values will be computed for different angles of attack (AoA) from the microphone which is positioned in the computational domain to investigate effect of augmentation of unsteady 2D and 3D airfoil region noise level. The computed results will be compared with experimental data which are available in the open literature. As results; one of the calculated Cp is slightly lower than the experimental value. This difference could be due to the higher Reynolds number of the experimental data. The ANSYS Fluent software was used in this study. Fluent includes well-validated physical modeling capabilities to deliver fast, accurate results across the widest range of CFD and multiphysics applications. This paper includes a study which is on external flow over an airfoil. The case of 2D NACA0015 has approximately 7 million elements and solves compressible fluid flow with heat transfer using the SST turbulence model. The other case of 3D NACA0012 has approximately 3 million elements.

Keywords: 3D blade profile, noise disturbance, aeroacoustics, Ffowcs-Williams and Hawkings (FW-H) equations, k-ω-SST turbulence model

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4122 Design, Synthesis and Pharmacological Investigation of Novel 2-Phenazinamine Derivatives as a Mutant BCR-ABL (T315I) Inhibitor

Authors: Gajanan M. Sonwane

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Nowadays, the entire pharmaceutical industry is facing the challenge of increasing efficiency and innovation. The major hurdles are the growing cost of research and development and a concurrent stagnating number of new chemical entities (NCEs). Hence, the challenge is to select the most druggable targets and to search the equivalent drug-like compounds, which also possess specific pharmacokinetic and toxicological properties that allow them to be developed as drugs. The present research work includes the studies of developing new anticancer heterocycles by using molecular modeling techniques. The heterocycles synthesized through such methodology are much effective as various physicochemical parameters have been already studied and the structure has been optimized for its best fit in the receptor. Hence, on the basis of the literature survey and considering the need to develop newer anticancer agents, new phenazinamine derivatives were designed by subjecting the nucleus to molecular modeling, viz., GQSAR analysis and docking studies. Simultaneously, these designed derivatives were subjected to in silico prediction of biological activity through PASS studies and then in silico toxicity risk assessment studies. In PASS studies, it was found that all the derivatives exhibited a good spectrum of biological activities confirming its anticancer potential. The toxicity risk assessment studies revealed that all the derivatives obey Lipinski’s rule. Amongst these series, compounds 4c, 5b and 6c were found to possess logP and drug-likeness values comparable with the standard Imatinib (used for anticancer activity studies) and also with the standard drug methotrexate (used for antimitotic activity studies). One of the most notable mutations is the threonine to isoleucine mutation at codon 315 (T315I), which is known to be resistant to all currently available TKI. Enzyme assay planned for confirmation of target selective activity.

Keywords: drug design, tyrosine kinases, anticancer, Phenazinamine

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4121 Parent-Child Communication: Community Based HIV/AIDS Response Strategy among Young Persons

Authors: Vicent Lwanga

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Issue: Communication between parent and child is important and necessary. Poor parenting and lack of openness and communication between parents and their children contribute to the increasing rate of HIV infection among young persons between the ages of 10-25. The young person, when left on their own are at the risk of misinformation from peers and from other sources. Description: Parent-Child Communication (PCC) was designed as a key component of a community-based HIV and AIDS intervention focused on young persons by Elderly Widows Orphans Family Support Organisation. Findings from the preliminary community-level process indicated that the lack of parent-child communication militates against young persons adopting and maintaining healthier sexual behaviors. An integrated youth strategy consisting of youth Peer Education/Facilitation and PCC was used to bridge this gap. The process involved an interactive parent-child forum, which allowed parents and children to meet and have open and frank discussions on the needs of young persons and the role of parents. This forum addressed all emerging issues from all parties and created better cordiality amongst them. Lessons Learnt: When young people feel unconnected to their parents, family, or home, they may become involved in activities that put their health at risk. Equally, when parents affirm the value of their children through open interaction, children are more likely to develop positive and healthy attitudes about themselves. Creating the opportunity for this interactive forum is paramount in any intervention program focused on young persons. Conclusion: HIV and AIDS-related programmes, especially those focusing on youth, should have PCC as an integral, essential component. Parents should be vehicles for information dissemination and need to be equipped with the capacity and skills to take on the onerous task of talking sexual reproductive health and sexuality with their children and wards.

Keywords: aids, communication, HIV, youth

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4120 Heavy Metal Contents in Vegetable Oils of Kazakhstan Origin and Life Risk Assessment

Authors: A. E. Mukhametov, M. T. Yerbulekova, D. R. Dautkanova, G. A. Tuyakova, G. Aitkhozhayeva

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The accumulation of heavy metals in food is a constant problem in many parts of the world. Vegetable oils are widely used, both for cooking and for processing in the food industry, meeting the main dietary requirements. One of the main chemical pollutants, heavy metals, is usually found in vegetable oils. These chemical pollutants are carcinogenic, teratogenic and immunotoxic, harmful to consumption and have a negative effect on human health even in trace amounts. Residues of these substances can easily accumulate in vegetable oil during cultivation, processing and storage. In this article, the content of the concentration of heavy metal ions in vegetable oils of Kazakhstan production is studied: sunflower, rapeseed, safflower and linseed oil. Heavy metals: arsenic, cadmium, lead and nickel, were determined in three repetitions by the method of flame atomic absorption. Analysis of vegetable oil samples revealed that the largest lead contamination (Pb) was determined to be 0.065 mg/kg in linseed oil. The content of cadmium (Cd) in the largest amount of 0.009 mg/kg was found in safflower oil. Arsenic (As) content was determined in rapeseed and safflower oils at 0.003 mg/kg, and arsenic (As) was not detected in linseed and sunflower oil. The nickel (Ni) content in the largest amount of 0.433 mg/kg was in linseed oil. The heavy metal contents in the test samples complied with the requirements of regulatory documents for vegetable oils. An assessment of the health risk of vegetable oils with a daily consumption of 36 g per day shows that all samples of vegetable oils produced in Kazakhstan are safe for consumption. But further monitoring is needed, since all these metals are toxic and their harmful effects become apparent only after several years of exposure.

Keywords: vegetable oil, sunflower oil, linseed oil, safflower oil, toxic metals, food safety, rape oil

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4119 Recurrent Neural Networks for Complex Survival Models

Authors: Pius Marthin, Nihal Ata Tutkun

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Survival analysis has become one of the paramount procedures in the modeling of time-to-event data. When we encounter complex survival problems, the traditional approach remains limited in accounting for the complex correlational structure between the covariates and the outcome due to the strong assumptions that limit the inference and prediction ability of the resulting models. Several studies exist on the deep learning approach to survival modeling; moreover, the application for the case of complex survival problems still needs to be improved. In addition, the existing models need to address the data structure's complexity fully and are subject to noise and redundant information. In this study, we design a deep learning technique (CmpXRnnSurv_AE) that obliterates the limitations imposed by traditional approaches and addresses the above issues to jointly predict the risk-specific probabilities and survival function for recurrent events with competing risks. We introduce the component termed Risks Information Weights (RIW) as an attention mechanism to compute the weighted cumulative incidence function (WCIF) and an external auto-encoder (ExternalAE) as a feature selector to extract complex characteristics among the set of covariates responsible for the cause-specific events. We train our model using synthetic and real data sets and employ the appropriate metrics for complex survival models for evaluation. As benchmarks, we selected both traditional and machine learning models and our model demonstrates better performance across all datasets.

Keywords: cumulative incidence function (CIF), risk information weight (RIW), autoencoders (AE), survival analysis, recurrent events with competing risks, recurrent neural networks (RNN), long short-term memory (LSTM), self-attention, multilayers perceptrons (MLPs)

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4118 The Relation between Physical Health and Mental Health in Women of Reproductive Age

Authors: Hannah Yael Ephraim

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During reproductive age (between 15 and 44), women are particularly susceptible to psychiatric illness. Depression and anxiety disorders are especially common for women during reproductive age. Women of reproductive age are also at greater risk for multiple physical conditions during this time. Existing literature focuses on the impact of mental health on physical health, showing that people with anxiety and depression repeatedly show greater physical health risk among those with developing chronic medical illness. However, there is limited research on the impact physical health has on mental health in women of reproductive age, a large and vulnerable population. For this reason, the current study seeks to ask the following questions: are women of reproductive age with a diagnosis of a chronic physical condition more likely to experience symptoms of mental illness than women without a diagnosis of a chronic physical condition? Does the type of physical illness relate to signs and symptoms of depression and anxiety? A quasi-experimental research design was implemented to compare the mental health outcomes of women with the diagnosis of chronic medical conditions and women without the diagnosis of a chronic medical condition. Quantitative data was collected through an anonymous ten-minute Qualtrics survey. The survey was sent out through multiple online platforms. The sample includes two groups of women: one group with the diagnosis of a chronic medical illness, and one group without a diagnosis and/or symptoms (N = 541). Participants identify as a woman and are between the ages of 15 and 44. A comparison of women with a diagnosis of a chronic physical condition and those without a diagnosis will be conducted to explore differences in depression and anxiety symptoms between women with and without a chronic medical diagnosis. The impact race, SES, and occupation will also be addressed in relation to anxiety and/or depression in women of reproductive age. This study will further the understanding of the relationship between mental illness in women of reproductive age with chronic medical conditions. The results of this study will have implications for the integration of mental health care in women’s health centers and perhaps training of clinicians and physicians providing psychological and medical care to women of reproductive age.

Keywords: mental health, physical health, reproductive age, women

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4117 Corporate Water Footprint Assessment: The Case of Tata Steel

Authors: Sujata Mukherjee, Arunavo Mukherjee

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Water covers 70 per cent of our planet; however, freshwater is incredibly rare, and scarce has been listed as the highest impact global risk. The problems related to freshwater scarcity multiplies with the human population having more than doubled coupled with climate change, changing water cycles leading to droughts and floods and a rise in water pollution. Businesses, governments, and local communities are constrained by water scarcity and are facing growing challenges to their growth and sustainability. Water foot printing as an indicator for water use was introduced in 2002. Business water footprint measures the total water consumed to produce the goods and services it provides. It is a combination of the water that goes into the production and manufacturing of a product or service and the water used throughout the supply chain, as well as during the use of the product. A case study approach was applied describing the efforts of Tata Steel. It is based on a series of semi-structured in-depth interviews with top executives of the company as well as observation and content analysis of internal and external documents about the company’s efforts in sustainable water management. Tata Steel draws water required for industrial use from surface water sources, primarily perennial rivers and streams, internal reservoirs and water from municipal sources. The focus of the present study was to explore Tata Steel’s engagement in sustainable water management focusing on water foot printing accounting as a tool to account for water use in the steel supply chain at its Jamshedpur plant. The findings enabled the researchers to conclude that no sources of water are adversely affected by the company’s production of steel at Jamshedpur.

Keywords: sustainability, corporate responsibility water management, risk management, business engagement

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4116 Synthesis of Montmorillonite/CuxCd1-xS Nanocomposites and Their Application to the Photodegradation of Methylene Blue

Authors: H. Boukhatem, L. Djouadi, H. Khalaf, R. M. Navarro, F. V. Ganzalez

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Synthetic organic dyes are used in various industries, such as textile industry, leather tanning industry, paper production, hair dye production, etc. Wastewaters containing these dyes may be harmful to the environment and living organisms. Therefore, it is very important to remove or degrade these dyes before discharging them into the environment. In addition to standard technologies for the degradation and/or removal of dyes, several new specific technologies, the so-called advanced oxidation processes (AOPs), have been developed to eliminate dangerous compounds from polluted waters. AOPs are all characterized by the same chemical feature: production of radicals (•OH) through a multistep process, although different reaction systems are used. These radicals show little selectivity of attack and are able to oxidize various organic pollutants due to their high oxidative capacity (reduction potential of HO• Eo = 2.8 V). Heterogeneous photocatalysis, as one of the AOPs, could be effective in the oxidation/degradation of organic dyes. A major advantage of using heterogeneous photocatalysis for this purpose is the total mineralization of organic dyes, which results in CO2, H2O and corresponding mineral acids. In this study, nanomaterials based on montmorillonite and CuxCd1-xS with different Cu concentration (0.3 < x < 0.7) were utilized for the degradation of the commercial cationic textile dye Methylene blue (MB), used as a model pollutant. The synthesized nanomaterials were characterized by fourier transform infrared (FTIR) and thermogravimetric-differential thermal analysis (TG–DTA). Test results of photocatalysis of methylene blue under UV-Visible irradiation show that the photoactivity of nanomaterials montmorillonite/ CuxCd1-xS increases with the increasing of Cu concentration. The kinetics of the degradation of the MB dye was described with the Langmuir–Hinshelwood (L–H) kinetic model.

Keywords: heterogeneous photocatalysis, methylene blue, montmorillonite, nanomaterial

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4115 Geography Undergraduates 360⁰ Academic Peer Learning And Mentoring 2021 – 2023: A Pilot Study

Authors: N. Ayob, N. C. Nkosi, R. P. Burger, S. J. Piketh, F. Letlaila, O. Maphosa

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South African higher tertiary institution have been faced with high dropout rates. About 50 to 60% of first years drop out to due to various reasons one being inadequate academic support. Geography 111 (GEOG 111) module is historically known for having below 50% pass rate, high dropout rate and identified as a first year risk module. For the first time GEOG 111 (2021) on the Mahikeng Campus admitted 150 students pursuing more than 6 different qualifications (BA and BSc) from the Humanities Faculty and FNAS. First year students had difficulties transitioning from secondary to tertiary institutions as we shifted to remote learning while we navigate through the Covid-19 pandemic. The traditional method of teaching does not encourage students to help each other. With remote learning we do not have control over what the students share and perhaps this can be a learning opportunity to embrace peer learning and change the manner in which we assess the students. The purpose of this pilot study was to assist GEOG111 students with academic challenges whilst improving their University experience. This was a qualitative study open to all GEOG111, repeaters, students who are not confident in their Geographical knowledge and never did Geography at high school level. The selected 9 Golden Key International Honour Society Geography mentors attended an academic mentor training program with module lecturers. About 17.6% of the mentees did not have a geography background however, 94% of the mentees passed, 1 mentee had a mark of 38%. 11 of the participants had a mark >60% with one student that excelled 70%. It is evident that mentorship helped students reach their academic potential. Peer learning and mentoring are associated with improved academic performance and allows the students to take charge of their learning and academic experience. Thus an important element as we transform pedagogies at higher learning institutions.

Keywords: geography, risk module, peer mentoring, peer learning

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4114 Retrospective Study on the Prognosis of Patients with New-Onset Atrial Fibrillation to Evaluate the Risk of Developing Occult Cancer in Absence of Concurrent Chronic Inflammatory Disease

Authors: Helen Huang, Francisco Javier Quesada Ocet, Blanca Quesada Oce, Javier Jimenez Bello, Victor Palanca Gil, Alba Cervero Rubio, Ana Paya Chaume, Alejandro Herreros-Pomares, Fernando Vidal-Vanaclocha, Rafael Paya Serrano, Aurelio Quesada Dorador, Monica Soliman

Abstract:

Background: Cancer favors both the pro-inflammatory state and autonomic dysfunction, two important mechanisms in the genesis of AF. Atrial remodeling might be caused as a result of paraneoplastic conditions or the result of direct expression of neoplasia. Here, we hypothesize that cancer, through inflammatory mediators, may favor the appearance of AF and patients with the first episode of AF could have a higher risk of developing cancer. Method: Data was collected from patients who attended the emergency department of our hospital for the first episode of AF, diagnosed electrocardiographically, between 2010-2015 (n = 712). The minimum follow-up was 2 years, recording the appearance of cancer, total mortality, recurrences of AF and other events. Patients who developed cancer and those who did not during the 2 years after the onset of AF were compared, as well as with the incidence of cancer in Spain in 2012. Results: After 2 years, 35 patients (4.91%) were diagnosed with cancer, with an annual incidence of 2.45%. Hematological neoplasms were the most frequent (34.28%). The cancer group was older (76.68 +/-12.75 years vs 74.16 +/-12.71; p <0.05) and had fewer typical symptoms (palpitations) (33.38% vs 14.28% , p <0.05). The incidence of cancer in Spain during 2012 was 0.46%, much lower than our sample. When comparing the incidence by age, these differences were maintained both in those over 65 years of age and in those under 65 years of age (2.17% vs. 0.28%; 0.28% vs. 0.18% respectively). Discussion: Therefore, a high incidence of cancer in patients with the first episode of AF was observed (the annual incidence of 2.45% after the onset of AF is 6.1 times that of the general population). After the evaluation of patients with AF in their first detected episode, surveillance of the appearance of cancer should be considered in clinical practice.

Keywords: cancer, cardiovascular outcomes, atrial fibrillation, inflammation

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4113 Night Shift Work as an Oxidative Stressor: A Systematic Review

Authors: Madeline Gibson

Abstract:

Night shift workers make up an essential part of the modern workforce. However, night shift workers have higher incidences of late in life diseases and earlier mortality. Night shift workers are exposed to constant light and experience circadian rhythm disruption. Sleep disruption is thought to increase oxidative stress, defined as an imbalance of excess pro-oxidative factors and reactive oxygen species over anti-oxidative activity. Oxidative stress can damage cells, proteins and DNA and can eventually lead to varied chronic diseases such as cancer, diabetes, cardiovascular disease, Alzheimer’s and dementia. This review aimed to understand whether night shift workers were at greater risk of oxidative stress and to contribute to a consensus on this relationship. Twelve studies published in 2001-2019 examining 2,081 workers were included in the review. Studies compared both the impact of working a single shift and in comparisons between those who regularly work night shifts and only day shifts. All studies had evidence to support this relationship across a range of oxidative stress indicators, including increased DNA damage, reduced DNA repair capacity, increased lipid peroxidation, higher levels of reactive oxygen species, and to a lesser extent, a reduction in antioxidant defense. This research supports the theory that melatonin and the sleep-wake cycle mediate the relationship between shift work and oxidative stress. It is concluded that night shift work increases the risk for oxidative stress and, therefore, future disease. Recommendations are made to promote the long-term health of shift workers considering these findings.

Keywords: night shift work, coxidative stress, circadian rhythm, melatonin, disease, circadian rhythm disruption

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4112 Sex Difference of the Incidence of Sudden Cardiac Arrest/Death in Athletes: A Systematic Review and Meta-analysis

Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

Abstract:

Background: The risk of sudden cardiac arret/death (SCA/D) in athletes is controversial. There is a lack of meta-analyses assessing the sex differences in the risk of SCA/D in competitive athletes. Purpose: The aim of the present study was to evaluate sex differences in the incidence of SCA/D in competitive athletes using meta-analyses. Methods: The systematic review was registered in the PROSPERO database (registration ID: CRD42023432022) and was conducted according to the PRISMA guidelines. PubMed, Embase, Scopus, SPORT Discus and Cochrane Library were searched up to July 2023. To avoid systematic bias in data pooling, only studies with data for both sexes were included. Results: From the 18 included studies, 2028 cases of SCA/D were observed (males 1821 (89.79%), females 207 (10.21%)). The age ranges from the adolescents (<26 years) to the elderly (>45 years). The incidence in male athletes was 1.32/100,000 AY (95% CI: [0.90, 1.93]) and in females was 0.26/100,000 AY (95% CI: [0.16, 0.43]), the incidence rate ratio (IRR) was 6.43 (95% CI: [4.22, 9.79]). The subgroup synthesis showed a higher incidence in males than in females in both age groups <25 years and ≤35 years, the IRR was 5.86 (95% CI: [4.69, 7.32]) and 5.79 (95% CI: [4.73, 7.09]), respectively. When considering the events, the IRR was 6.73 (95%CI: [3.06, 14.78]) among studies involving both SCA/D events and 7.16 (95% CI: [4.93, 10.40]) among studies including only cases of SCD. The available clinical evidence showed that cardiac events were most frequently seen in long-distance running races (26, 35.1%), marathon (16, 21.6%) and soccer (10, 13.5%). Coronary artery disease (14, 18.9%), hypertrophic cardiomyopathy (8, 10.8%), and arrhythmogenic right ventricular cardiomyopathy (7, 9.5%) are the most common causes of SCA/D in competitive athletes. Conclusion: The meta-analysis provides evidence of sex differences in the incidence of SCA/D in competitive athletes. The incidence of SCA/D in male athletes was 6 to 7 times higher than in females. Identifying the reasons for this difference may have implications for targeted the prevention of fatal evets in athletes.

Keywords: incidence, sudden cardiac arrest, sudden cardiac death, sex difference, athletes

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4111 The Effects of Alpha-Lipoic Acid Supplementation on Post-Stroke Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Hamid Abbasi, Neda Jourabchi, Ranasadat Abedi, Kiarash Tajernarenj, Mehdi Farhoudi, Sarvin Sanaie

Abstract:

Background: Alpha lipoic acid (ALA), fat- and water-soluble, coenzyme with sulfuret content, has received considerable attention for its potential therapeutic role in diabetes, cardiovascular diseases, cancers, and central nervous disease. This investigation aims to evaluate the probable protective effects of ALA in stroke patients. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, This meta-analysis was performed. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: stroke patients); Intervention (I: ALA); Comparison (C: control); Outcome (O: blood glucose, lipid profile, oxidative stress, inflammatory factors).In addition, Studies that were excluded from the analysis consisted of in vitro, in vivo, and ex vivo studies, case reports, quasi-experimental studies. Scopus, PubMed, Web of Science, EMBASE databases were searched until August 2023. Results: Of 496 records that were screened in the title/abstract stage, 9 studies were included in this meta-analysis. The sample sizes in the included studies vary between 28 and 90. The result of risk of bias was performed via risk of bias (RoB) in randomized-controlled trials (RCTs) based on the second version of the Cochrane RoB assessment tool. 8 studies had a definitely high risk of bias. Discussion: To the best of our knowledge, The present meta-analysis is the first study addressing the effectiveness of ALA supplementation in enhancing post-stroke metabolic markers, including lipid profile, oxidative stress, and inflammatory indices. It is imperative to acknowledge certain potential limitations inherent in this study. First of all, type of treatment (oral or intravenous infusion) could alter the bioavailability of ALA. Our study had restricted evidence regarding the impact of ALA supplementation on included outcomes. Therefore, further research is warranted to develop into the effects of ALA specifically on inflammation and oxidative stress. Funding: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 72825). Registration: This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CR42023461612).

Keywords: alpha-lipoic acid, lipid profile, blood glucose, inflammatory factors, oxidative stress, meta-analysis, post-stroke

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4110 Acne Vulgaris Association with Smoking and Body Mass Index in Jordanian Young Adults

Authors: Almutazballlah Bassam Qablan, Jihan M. Muhaidat, bana Abu Rajab

Abstract:

Background: Acne vulgaris is considered one of the most common skin conditions encountered by dermatologists. It is a chronic inflammation affecting the pilosebaceous unit. Although acne vulgaris is not fatal, it leads to permanent scarring and disfigurement, and even without scarring, it has a huge effect on patients, causing negative health outcomes. Acne vulgaris patients experience psychological, and emotional ramifications as those with chronic health problems; they feel depressed, angry, anxious, and confused. Although acne is a popular disease, many thoughts and myths are still discussed about its origins and triggering factors. These myths can make you feel guilt as if you were somehow responsible for your acne. In this case control study, we want to define the relationship between two modifiable risk factors ;BMI and smoking, with acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Ramtha, Jordan in 2019/2020. A total number of 325 participants between 14 and 33 years of age were interviewed by the authors; including 163 acne vulgaris cases and 162 controls without acne vulgaris. Anthropometric measures and smoking for Acne patients and control participants were the independent variables used to assess acne. Univariate and multivariate analysis were used to compare the characteristics of people who reported acne with those with no acne. The collected data analyzed by using the Statistical Package for Social Sciences (SPSS). Results: Cigarette smoking was highly associated with controls; odds ratio 0.4 (95% CI: 0.2–0.9) , P-value = 0.018. BMI and waterpipe smoking were statistically insignificant with acne in the multivariate analysis. Conclusion: We found that cigarette smoking was protective against Acne. There was a statistically insignificant relation between BMI, waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, adolescents, BMI, smoking, case-control, risk factors

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4109 A Development of Practice Guidelines for Surgical Safety Management to Reduce Undesirable Incidents from Surgical Services in the Operating Room of Songkhla Hospital, Thailand

Authors: Thitima Plejai

Abstract:

The practice in the operating room has been continually performed according to standards of services; however, undesirable incidents from surgical services are found such as surgical complications in the operating room. This participation action research aimed to develop practice guidelines for surgical safety management to reduce undesirable incidents from surgical services in the operating room of Songkhla Hospital. The target population was all 84 members of the multidisciplinary team who were involved in surgical services in the operating room consisting of 28 surgeons from five branches of surgery, 27 anesthetists and nurse anesthetists, and 29 surgical nurses. The data were collected through in-depth interviews, and non-participatory observations. The research instrument was tested by three experts, and the steps of the development consisted of four cycles, each consisting of assessment, planning, practice, practice reflection, and improvement until every step is practicable. The data were validated through triangulation research method, analyzed through content analysis and statistical analysis with number and percentage. The results of the development of practice guidelines surgical safety management to reduce undesirable incidents from surgical services could be concluded as follows. 1) The multidisciplinary team in surgery participated in the needs assessment for development of practice guidelines for surgical patient safety, and agreed on adapting the WHO Surgical Safety Checklists for use. 2) The WHO Surgical Safety Checklists was implemented, and meetings were held for the multidisciplinary team in surgery and the organizational risk committee to improve the practice guidelines to make them more practicable. 3) The multidisciplinary team consisting of surgeons from five branches of surgery, anesthetists, nurse anesthetists, surgical nurses, and the organizational risk committee announced policy on safety for surgical patients; the organizational risk committee designated the Surgical Safety Checklist as an instrument for surgical patient safety. The results of the safety management found that the surgical team members who could follow 100 percent of the guidelines were: professional nurses who checked patient identity and information before taking the patient to the operating room and kept complete records of data on the patients; surgical nurses who checked readiness of the patient before surgery; nurse anesthetists who assessed readiness before administering anesthetic drugs, and confirmed correctness of the patient; and circulating perioperative nurses who gave confirmation to the surgical team after completion of the surgery. The rates of undesirable incidents (surgical complications rates) before and after the implementation of the surgical safety management were 1.60 percent and 0.66 percent, respectively. The satisfaction of the surgery-related teams towards the use of the guidelines was 89 percent. The practice guidelines for surgical safety management to reduce undesirable incidents were taken as guidelines for surgical safety that the multidisciplinary team involved in the surgical process implemented correctly and in the same direction and clearly reduced undesirable incidents in surgical patients.

Keywords: practice guidelines, surgical safety management, reduce undesirable incidents, operating Room

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4108 Considerations in Pregnancy Followed by Obesity Surgery

Authors: Maryam Nazari, Atefeh Ghanbari, Saghar Noorinia

Abstract:

Obesity, as an abnormal or excessive accumulation of fat, is caused by genetic, behavioral and environmental factors. Recently, obesity surgeries, such as bariatric surgery, as the last measure to control obesity, have attracted experts and society, especially women, attention, so knowing the possible complications of this major surgery and their control in reproductive age is of particular importance due to its effects on pregnancy outcomes. Bariatric surgery reduces the risk of diabetes and high blood pressure associated with pregnancy, premature birth, macrosomia, stillbirth and dumping syndrome. Although in the first months after surgery, nausea and vomiting caused by changes in intra-abdominal pressure are associated with an increased risk of malabsorption of micronutrients such as folic acid, iron, vitamin B1, D, calcium, selenium and phosphorus and finally, fetal growth disorder. Moreover, serum levels of micronutrients such as vitamin D, calcium, and iron in mothers who used to have bariatric surgery and their babies have been shown to be lower than in mothers without a history of bariatric surgery. Moreover, vitamin A deficiency is shown to be more widespread in pregnancies after bariatric surgery, which leads to visual problems in newborns and premature delivery. However, complications such as the duration of hospitalization of newborns in the NICU, disease rate in the first 28 days of life and congenital anomalies are not significantly different in babies born to mothers undergoing bariatric surgery compared to the control group. In spite of the vast advantages following obesity surgeries, due to the catabolic conditions and severe weight loss followed by such major intervention and the probability of nutrients malnutrition in a pregnant woman and her baby, after having surgery, at least 12 to 18 months should be considered to get pregnant as a recovery period. In addition, taking essential supplements before and at least 6 months after this approach is recommended.

Keywords: bariatric surgery, pregnancy, malnutrition, vitamin and mineral deficiency

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4107 Exploration of Influential Factors on First Year Architecture Students’ Productivity

Authors: Shima Nikanjam, Badiossadat Hassanpour, Adi Irfan Che Ani

Abstract:

The design process in architecture education is based upon the Learning-by-Doing method, which leads students to understand how to design by practicing rather than studying. First-year design studios, as starting educational stage, provide integrated knowledge and skills of design for newly jointed architecture students. Within the basic design studio environment, students are guided to transfer their abstract thoughts into visual concrete decisions under the supervision of design educators for the first time. Therefore, introductory design studios have predominant impacts on students’ operational thinking and designing. Architectural design thinking is quite different from students’ educational backgrounds and learning habits. This educational challenge at basic design studios creates a severe need to study the reality of design education at foundation year and define appropriate educational methods with convenient project types with the intention of enhancing architecture education quality. Material for this study has been gathered through long-term direct observation at a first year second semester design studio at the faculty of architecture at EMU (known as FARC 102), fall and spring academic semester 2014-15. Distribution of a questionnaire among case study students and interviews with third and fourth design studio students who passed through the same methods of education in the past 2 years and conducting interviews with instructors are other methodologies used in this research. The results of this study reveal a risk of a mismatch between the implemented teaching method, project type and scale in this particular level and students’ learning styles. Although the existence of such risk due to varieties in students’ profiles could be expected to some extent, recommendations can support educators to reach maximum compatibility.

Keywords: architecture education, basic design studio, educational method, forms creation skill

Procedia PDF Downloads 375
4106 Review of the Road Crash Data Availability in Iraq

Authors: Abeer K. Jameel, Harry Evdorides

Abstract:

Iraq is a middle income country where the road safety issue is considered one of the leading causes of deaths. To control the road risk issue, the Iraqi Ministry of Planning, General Statistical Organization started to organise a collection system of traffic accidents data with details related to their causes and severity. These data are published as an annual report. In this paper, a review of the available crash data in Iraq will be presented. The available data represent the rate of accidents in aggregated level and classified according to their types, road users’ details, and crash severity, type of vehicles, causes and number of causalities. The review is according to the types of models used in road safety studies and research, and according to the required road safety data in the road constructions tasks. The available data are also compared with the road safety dataset published in the United Kingdom as an example of developed country. It is concluded that the data in Iraq are suitable for descriptive and exploratory models, aggregated level comparison analysis, and evaluation and monitoring the progress of the overall traffic safety performance. However, important traffic safety studies require disaggregated level of data and details related to the factors of the likelihood of traffic crashes. Some studies require spatial geographic details such as the location of the accidents which is essential in ranking the roads according to their level of safety, and name the most dangerous roads in Iraq which requires tactic plan to control this issue. Global Road safety agencies interested in solve this problem in low and middle-income countries have designed road safety assessment methodologies which are basing on the road attributes data only. Therefore, in this research it is recommended to use one of these methodologies.

Keywords: road safety, Iraq, crash data, road risk assessment, The International Road Assessment Program (iRAP)

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4105 Lateral Retroperitoneal Transpsoas Approach: A Practical Minimal Invasive Surgery Option for Treating Pyogenic Spondylitis of the Lumbar Vertebra

Authors: Sundaresan Soundararajan, Chor Ngee Tan

Abstract:

Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

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4104 Novel Oral Anticoagulants (NOACS) Adherence and Bleeding Events in Atrial Fibrillation Patients: A Systematic Review and Meta-Analysis

Authors: Tadesse Melaku Abegaz, Akshaya Srikanth Bahagavathula, Abdulla Shehab Sheab, Asim Hassen

Abstract:

Objectives: Non-adherence and discontinuation of anticoagulant therapy lead to increased ischemic stroke risk and contributes to suboptimal outcomes of the anticoagulant treatment. This systematic review and meta-analysis were aimed to investigate the adherence to NOACs and adverse events in patients with AF. Methods: Original research articles conducted on patients with AF and using any NOACs (dabigatran, rivoraxaban and apixaban) reporting adherence for at least 35 days were included. Scientific databases including PubMed, Web of Science, and Google Scholar were searched using MeSH keywords to obtaining literature researched between 2008 to till June, 2016. Study characteristics, patient’s sociodemographic and clinical characteristics, medication adherence levels and bleeding events reported were recorded. Results: The overall sample size of the six studies is 1,640,157, with CHADS2 scores < 2 in 551 patients, CHADS2-VASc ≥ 2 in 62,232 AF patients. Three-forth [75.6% (95%CI= 66.5-84.8), p < 0.001] are adherent to NOACs. However, a higher rate [72.7% (62.5-82.9), p < 0.001] of adherence was observed with Dabigatran than Apixaban [59.9% (3.2-123.1), p=0.063] and Rivaroxaban [59.3% (38.7-80.0), p<0.001]. Sub-group analysis revealed that nearly 57% of the AF patients on NOACs have CHADS2 scores < 2 and 20% of these patients were non-adherent to NOACs. Overall bleeding events rate associated with NOACs non-adherent AF patients was found to be 7.5% (0.2-14.8), p=0.045. However, nearly 11.2% of AF patients experienced bleeding events were non-adherent to NOAC medications. A higher proportion of bleeding events were noticed with Dabigatran (14.7%). Conclusions: Adherence rates, while uniformly suboptimal, nevertheless varied considerably, lowest at 59.3% for rivaroxaban and 59.9% for apixaban, followed by dabigatran (75.6%). Overall bleeding events associated with NOACs rates were 7.5%. However, lower adherence to NOACs was associated with worse outcomes among patients with greater stroke risk.

Keywords: atrial fibrillation, bleeding events, meta-analysis, novel oral anticoagulants

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4103 Opinion Mining to Extract Community Emotions on Covid-19 Immunization Possible Side Effects

Authors: Yahya Almurtadha, Mukhtar Ghaleb, Ahmed M. Shamsan Saleh

Abstract:

The world witnessed a fierce attack from the Covid-19 virus, which affected public life socially, economically, healthily and psychologically. The world's governments tried to confront the pandemic by imposing a number of precautionary measures such as general closure, curfews and social distancing. Scientists have also made strenuous efforts to develop an effective vaccine to train the immune system to develop antibodies to combat the virus, thus reducing its symptoms and limiting its spread. Artificial intelligence, along with researchers and medical authorities, has accelerated the vaccine development process through big data processing and simulation. On the other hand, one of the most important negatives of the impact of Covid 19 was the state of anxiety and fear due to the blowout of rumors through social media, which prompted governments to try to reassure the public with the available means. This study aims to proposed using Sentiment Analysis (AKA Opinion Mining) and deep learning as efficient artificial intelligence techniques to work on retrieving the tweets of the public from Twitter and then analyze it automatically to extract their opinions, expression and feelings, negatively or positively, about the symptoms they may feel after vaccination. Sentiment analysis is characterized by its ability to access what the public post in social media within a record time and at a lower cost than traditional means such as questionnaires and interviews, not to mention the accuracy of the information as it comes from what the public expresses voluntarily.

Keywords: deep learning, opinion mining, natural language processing, sentiment analysis

Procedia PDF Downloads 171