Search results for: women in surgery
Commenced in January 2007
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Edition: International
Paper Count: 4014

Search results for: women in surgery

1524 Revival and Protection of Traditional Jewellery Motifs of Assam (India), over Eri Silk by Innovative Techniques

Authors: Ratna Sharma, Kaveri Dutta

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Assam (India), the gate way to the Northeast India is mainly known for its exquisite silks, the art and craft. The state has a rich collection of traditional jewellery which is unique and exclusive to the state. These jewelleries hold a special place in the heart of the Assamese women. Similarly handloom industry of Assam is basically silk oriented. Among the wild silk, Eri silk fabric has remained as “the poor man’s silk” but it is closely attached to the assamese society, dress for it's warm quality. In view of the changing market trends, fashion and consumer demands, Silk is emerging as a fashion fabric both in India and abroad. In case of Eri silk fabric it has limited use in clothing and accessories. Hence the restructured and redesigned traditional jewellery motifs of Assam (India) over Eri silk products will have greater potential in reviving the decline of art, generate revenue, self employment towards craftsmen and also recognition of the art. The information incorporated in the paper is primary and the data have been collected by purposive sampling method. This work of art was expressed on Eri silk fabric in the form of traditional hand embroidery as it is closely connected with the era of the individual in history of mankind and reflects the personal expression of an entity. For this study selected traditional motifs of Assamese ornaments was used. Some of the popular traditional Assamese jewellery include earrings with exquisite Lokaparo, Keru, Thuriya, Jangphai, etc. An array of necklaces including Golpata, Satsori, Jon biri, Bena, Gejera, Dhol biri, Doog doogi, Biri Moni, Mukuta Moni, Poalmoni, Silikha Moni and Magardana and diversified rings including Senpata, Horinsakua, Jethinejia, bakharpata and others. Selected two motifs each from necklace, earring and finger ring designs. Selected motifs were further developed into 3 categories- the border, the main motif and all over butta followed by placement of developed patterns on products. Products developed were stoles, scarf’s, purses, brooch pins, skirts for women and ties, handkerchief, jackets for men. The developed products were surveyed by selected respondents. From the present study it can be observed that the embellished traditional jewellery motifs resulted in fresh and colourful pattern on developed Eri silk products. Moreover the motifs which were gradually fading among the community itself showed a very good recognition towards art. The embroidered Eri silk fabric also created a huge change in a positive way among craftsman.

Keywords: Art and craft of Assam, eri silk, hand embroidery, traditional Assamese jewellery motifs

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1523 Investigation of FOXM1 Gene Expression in Breast Cancer and Its Relationship with Mir-216B-5P Expression Level

Authors: Ramin Mehdiabadi, Neda Menbari, Mohammad Nazir Menbari

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As a pressing public health concern, breast cancer stands as the predominant oncological diagnosis and principal cause of cancer-related mortality among women globally, accounting for 11.7% of new cancer incidences and 6.9% of cancer-related deaths. The annual figures indicate that approximately 230,480 women are diagnosed with breast cancer in the United States alone, with 39,520 succumbing to the disease. While developed economies have reported a deceleration in both incidence and mortality rates across various forms of cancer, including breast cancer, emerging and low-income economies manifest a contrary escalation, largely attributable to lifestyle-mediated risk factors such as tobacco usage, physical inactivity, and high caloric intake. Breast cancer is distinctly characterized by molecular heterogeneity, manifesting in specific subtypes delineated by biomarkers—Estrogen Receptors (ER), Progesterone Receptors (PR), and Human Epidermal Growth Factor Receptor 2 (HER2). These subtypes, comprising Luminal A, Luminal B, HER2-enriched, triple-negative/basal-like, and normal-like, necessitate nuanced, subtype-specific therapeutic regimens, thereby challenging the applicability of generalized treatment protocols. Within this molecular complexity, the transcription factor Forkhead Box M1 (FoxM1) has garnered attention as a significant driver of cellular proliferation, tumorigenesis, metastatic progression, and treatment resistance in a spectrum of human malignancies, including breast cancer. Concurrently, microRNAs (miRs), specifically miR-216b-5p, have been identified as post-transcriptional gene expression regulators and potential tumor suppressors. The overarching objective of this academic investigation is to explicate the multifaceted interrelationship between FoxM1 and miR-216b-5p across the disparate molecular subtypes of breast cancer. Employing a methodologically rigorous, interdisciplinary research design that incorporates cutting-edge molecular biology techniques, sophisticated bioinformatics analytics, and exhaustive meta-analyses of extant clinical data, this scholarly endeavor aims to unveil novel biomarker-specific therapeutic pathways. By doing so, this research is positioned to make a seminal contribution to the advancement of personalized, efficacious, and minimally toxic treatment paradigms, thus profoundly impacting the global efforts to ameliorate the burden of breast cancer.

Keywords: breast cancer, fox m1, microRNAs, mir-216b-5p, gene expression

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1522 A Flexible Piezoelectric - Polymer Composite for Non-Invasive Detection of Multiple Vital Signs of Human

Authors: Sarah Pasala, Elizabeth Zacharias

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Vital sign monitoring is crucial for both everyday health and medical diagnosis. A significant factor in assessing a human's health is their vital signs, which include heart rate, breathing rate, blood pressure, and electrocardiogram (ECG) readings. Vital sign monitoring has been the focus of many system and method innovations recently. Piezoelectrics are materials that convert mechanical energy into electrical energy and can be used for vital sign monitoring. Piezoelectric energy harvesters that are stretchable and flexible can detect very low frequencies like airflow, heartbeat, etc. Current advancements in piezoelectric materials and flexible sensors have made it possible to create wearable and implantable medical devices that can continuously monitor physiological signals in humans. But because of their non-biocompatible nature, they also produce a large amount of e-waste and require another surgery to remove the implant. This paper presents a biocompatible and flexible piezoelectric composite material for wearable and implantable devices that offers a high-performance platform for seamless and continuous monitoring of human physiological signals and tactile stimuli. It also addresses the issue of e-waste and secondary surgery. A Lead-free piezoelectric, SrBi4Ti4O15, is found to be suitable for this application because the properties can be tailored by suitable substitutions and also by varying the synthesis temperature protocols. In the present work, SrBi4Ti4O15 modified by rare-earth has been synthesized and studied. Coupling factors are calculated from resonant (fr) and anti-resonant frequencies (fa). It is observed that Samarium substitution in SBT has increased the Curie temperature, dielectric and piezoelectric properties. From impedance spectroscopy studies, relaxation, and non-Debye type behaviour are observed. The composite of bioresorbable poly(l-lactide) and Lead-free rare earth modified Bismuth Layered Ferroelectrics leads to a flexible piezoelectric device for non-invasive measurement of vital signs, such as heart rate, breathing rate, blood pressure, and electrocardiogram (ECG) readings and also artery pulse signals in near-surface arteries. These composites are suitable to detect slight movement of the muscles and joints. This Lead-free rare earth modified Bismuth Layered Ferroelectrics – polymer composite is synthesized using a ball mill and the solid-state double sintering method. XRD studies indicated the two phases in the composite. SEM studies revealed the grain size to be uniform and in the range of 100 nm. The electromechanical coupling factor is improved. The elastic constants are calculated and the mechanical flexibility is found to be improved as compared to the single-phase rare earth modified Bismuth Latered piezoelectric. The results indicate that this composite is suitable for the non-invasive detection of multiple vital signs of humans.

Keywords: composites, flexible, non-invasive, piezoelectric

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1521 The Effects of Expanding the Generosity of the Statutory Sick Leave Insurance: The Case of a French Reform

Authors: Mohamed Ali Benhalima, Nathon Elbaz, Malik Koubi

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This paper evaluates an expansion of employer-mandated sick leave insurance in the French private sector. We use a difference-in-differences method in which control groups are defined according to the collective bargaining agreement (CBA) employees belong to. Indeed, thanks to complementary insurance provided by CBAs, employees were not affected the same way by the reform. We find significant effects of the reform on sick leave spells lasting at least 7 days, consistently with the reform target. The effects on spells’ duration and frequency are positive and more pronounced for women than for men, for whom the effect on frequency tends to be slightly negative. The effects are also more pronounced for executives and supervisors than less qualified categories.

Keywords: sickness absence, collective agreements, daily sickness benefits, labor economics

Procedia PDF Downloads 335
1520 Cystic Ganglionosis in Child: Rare Entity

Authors: Jatinder Pal Singh, Harpreet Singh, Gagandeep Singh Digra, Mandeep Kaur Sidhu, Pawan Kumar

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Introduction: Ganglion cyst is a benign condition in which there is a cystic lesion in relation to a joint or a tendon sheath arising from myxoid degeneration of fibrous connective tissue. These can be unilocular or multilocular. In rare cases, there may be multiple ganglion cysts, known as cystic ganglionosis. They can occur at any age but are commonly seen in adults. Clinically they may be asymptomatic or present as swelling or mass effect in adjacent structures. These are common in extremities such as hands and feet. Case Presentation: 11-year-old female child presented with slowly progressive painless swelling of her right hand since the age of 4. Antenatal and perinatal history was unremarkable. Her family history was negative. She denies fever, malaise, morning stiffness, weight loss, fatigue, restriction of joint movements, or any sensory and motor deficit. Lab parameters were negative for inflammatory or infectious etiology. No other joint or extremity involvement was present. On physical examination, the swelling was present on the dorsum and palmer aspect of the right hand and wrist. They were non-tender on palpation without any motor or sensory deficit. MRI hand revealed multiple well-defined fluid signal intensity cystic appearing lesions in periarticular/intraarticular locations in relation to distal radio-ulnar, radio-carpal, intercarpal, carpometacarpal, metacarpophalangeal and interphalangeal joints as well as peritendinous location around flexor tendons more so in the region of wrist, palm, 1st and 5th digit and along extensor tendons in the region of wrist, largest one noted along flexor pollicis longus tendon in thenar region and along 1st digit measuring approx. 4.6 x 1.2 x 1.2 centimeter. Pressure erosions and bone remodelling were noted in the bases of the 2nd to 5th metacarpals, capitate, trapezoid, the distal shaft of 1st metacarpal, and proximal phalanx of 1st digit. Marrow edema was noted in the base and proximal shaft of the 4th metacarpal and proximal shaft of the 3rd metacarpal – likely stress or pressure related. The patient was advised of aspiration, but the family refused the procedure. Therefore the patient was kept on conservative treatment. Conclusion: Cystic ganglionosis is a rare condition with very few cases reported in the medical literature. Its prevalence and association are not known because of the rarity of this condition. It should be considered as an important differential in patients presenting with soft tissue swelling in extremities. Treatment option includes conservative management, aspiration, and surgery. Aspiration has a high recurrence rate. Although surgery has a low recurrence rate, it carries a high rate of complications. Imaging with MRI is essential for confirmation of the cystic nature of lesions and their relation with the joint capsules or tendons. This helps in differentiating from other soft tissue lesions and presurgical planning.

Keywords: radiology, rare, cystic ganglionosis, child

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1519 Case Report on Anaesthesia for Ruptured Ectopic with Severe Pulmonary Hypertension in a Mute Patient

Authors: Pamela Chia, Tay Yoong Chuan

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Introduction: Severe pulmonary hypertension (PH) patients requiring non-cardiac surgery risk have increased mortality rates ranging. These patients are plagued with cardiorespiratory failure, dysrhythmias and anticoagulation potentially with concurrent sepsis and renal insufficiency, perioperative morbidity. We present a deaf-mute patient with severe idiopathic PH emergently prepared for ruptured ectopic laparotomy. Case Report: A 20 year-old female, 62kg (BMI 25 kg/m2) with severe idiopathic PH (2DE Ejection Fraction was 41%, Pulmonary Artery Systolic Pressure (PASP) 105 mmHg, Right ventricle strain and hypertrophy) and selective mutism was rushed in for emergency laparotomy after presenting to the emergency department for abdominal pain. The patient had an NYHA Class II with room air SpO2 93-95%. While awaiting lung transplant, the patient takes warfarin, Sildanefil, Macitentan and even Selexipag for rising PASP. At presentation, vital signs: BP 95/63, HR 119 SpO2 88% (room air). Despite decreasing haemoglobin 14 to 10g/dL, INR 2.59 was reversed with prothrombin concentrate, and Vitamin K. ECG revealed Right Bundle Branch Block with right ventricular strain and x-ray showed cardiomegaly, dilated Right Ventricle, Pulmonary Arteries, basal atelectasis. Arterial blood gas showed compensated metabolic acidosis pH 7.4 pCO2 32 pO2 53 HCO3 20 BE -4 SaO2 88%. The cardiothoracic surgeon concluded no role for Extracorporeal Membrane Oxygenation (ECMO). We inserted invasive arterial and central venous lines with blood transfusion via an 18G cannula before the patient underwent a midline laparotomy, haemostasis of ruptured ovarian cyst with 2.4L of clots under general anesthesia and FloTrac cardiac output monitoring. Rapid sequence induction was done with Midazolam/Propofol, remifentanil infusion, and rocuronium. The patient was maintained on Desflurane. Blood products and colloids were transfused for further 1.5L blood loss. Postoperatively, the patient was transferred to the intensive care unit and was extubated uneventfully 7hours later. The patient went home a week later. Discussion: Emergency hemostasis laparotomy in anticoagulated WHO Class I PH patient awaiting lung transplant with no ECMO backup poses tremendous stress on the deaf-mute patient and the anesthesiologist. Balancing hemodynamics avoiding hypotension while awaiting hemostasis in the presence of pulmonary arterial dilators and anticoagulation requires close titration of volatiles, which decreases RV contractility. We review the contraindicated anesthetic agents (ketamine, N2O), choice of vasopressors in hypotension to maintain Aortic-right ventricular pressure gradients and nitric oxide use perioperatively. Conclusion: Interdisciplinary communication with a deaf-mute moribund patient and anesthesia considerations pose many rare challenges worth sharing.

Keywords: pulmonary hypertension, case report, warfarin reversal, emergency surgery

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1518 Study of the Optical Illusion Effects of Color Contrasts on Body Image Perception

Authors: A. Hadj Taieb, H. Ennouri

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The current study aimed to investigate the effect that optical illusion garments have on a woman’s self-perception of her own body shape. First, we created different optical illusion garment by using color contrasts. Second, a short survey based on visual perception is addressed to women in order to compare the different optical illusion garments to determine if they met the established 'ideal' body shape. A ‘visual analysis method’ was used to investigate the clothing models with optical illusions. The theories in relation with the optical illusion were used through this method. The effects of the optical illusion of color contrast on body shape in the fashion sector were tried to be revealed.

Keywords: optical illusion, color contrasts, body image perception, self-esteem

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1517 Influence of Coenzyme as a Corrosion Barrier for Biodegradable Magnesium

Authors: Minjung Park, Jimin Park, Youngwoon Kim, Hyungseop Han, Myoungryul Ok, Hojeong Jeon, Hyunkwang Seok, Yuchan Kim

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Magnesium is an essential element in human body and has unique characteristics such as bioabsorbable and biodegradable properties. Therefore, there has been much attention on studies on the implants based on magnesium to avoid subsequent surgery. However, high amount of hydrogen gas is generated by relatively severe corrosion of magnesium especially in aqueous condition with chloride ions. And it contributes to the causes of swelling of skin and causes consequent inflammation of soft tissue where is directly in contact with implants. Therefore, there is still concern about the safety of the using biodegradable magnesium alloys, which is limited to various applications. In this study, we analyzed the influence of coenzyme on corrosion behavior of magnesium. The analysis of corrosion rate was held by using Hanks’ balanced salt solution (HBSS) as a body stimulated fluid and in condition of 37°C. Thus, with deferring the concentration of the coenzyme used in this study, corrosion rates from 0.0654ml/ cm² to 0.0438ml/cm² were observed in immersion tests. Also, comparable results were obtained in electrochemical tests. Results showed that hydrogen gas produced from corrosion of magnesium can be controlled.

Keywords: biodegradable magnesium, biomaterials, coenzyme, corrosion

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1516 Ambivalence in Embracing Artificial Intelligence in the Units of a Public Hospital in South Africa

Authors: Sanele E. Nene L., Lia M. Hewitt

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Background: Artificial intelligence (AI) has a high value in healthcare, various applications have been developed for the efficiency of clinical operations, such as appointment/surgery scheduling, diagnostic image analysis, prognosis, prediction and management of specific ailments. Purpose: The purpose of this study was to explore, describe, contrast, evaluate, and develop the various leadership strategies as a conceptual framework, applied by public health Operational Managers (OMs) to embrace AI benefits, with the aim to improve the healthcare system in a public hospital. Design and Method: A qualitative, exploratory, descriptive and contextual research design was followed and a descriptive phenomenological approach. Five phases were followed to conduct this study. Phenomenological individual interviews and focus groups were used to collect data and a phenomenological thematic data analysis method was used. Findings and conclusion: Three themes surfaced as the experiences of AI by the OMs; Positive experiences related to AI, Management and leadership processes in AI facilitation, and Challenges related to AI.

Keywords: ambivalence, embracing, Artificial intelligence, public hospital

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1515 Social Enterprises in India: Conceptualization and Challenges

Authors: Prajakta Khare

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There is a huge number of social enterprises operating in India, across all enterprise sizes and forms addressing diverse social issues. Some cases such as such as Aravind eye care, Narayana Hridalaya, SEWA have been studied extensively in management literature and are known cases in social entrepreneurship. But there are several smaller social enterprises in India that are not called so per se due to the lack of understanding of the concept. There is a lack of academic research on social entrepreneurship in India and the term ‘social entrepreneurship’ is not yet widely known in the country, even by people working in this field as was found by this study. The present study aims to identify the most prominent form of social enterprises in India, the profile of the entrepreneurs, challenges faced, the lessons (theory and practices) emerging from their functioning and finally the factors contributing to the enterprises’ success. This is a preliminary exploratory study using primary data from 30 social enterprises in India. The study used snow ball sampling and a qualitative analysis. Data was collected from founders of social enterprises through written structured questionnaires, open-ended interviews and field visits to enterprises. The sample covered enterprises across sectors such as environment, affordable education, children’s rights, rain water harvesting, women empowerment etc. The interview questions focused on founder’s background and motivation, qualifications, funding, challenges, founder’s understanding and perspectives on social entrepreneurship, government support, linkages with other organizations etc. apart from several others. The interviews were conducted across 3 languages - Hindi, Marathi, English and were then translated and transcribed. 50% of founders were women and 65% of the total founders were highly qualified with a MBA, PhD or MBBS. The most important challenge faced by these entrepreneurs is recruiting skilled people. When asked about their understanding of the term, founders had diverse perspectives. Also, their understandings about the term social enterprise and social entrepreneur were extremely varied. Some founders identified the terms with doing something good for the society, some thought that every business can be called a social enterprise. 35% of the founders were not aware of the term social entrepreneur/ social entrepreneurship. They said that they could identify themselves as social entrepreneurs after discussions with the researcher. The general perception in India is that ‘NGOs are corrupt’- fighting against this perception to secure funds is also another problem as pointed out by some founders. There are unique challenges that social entrepreneurs in India face, as the political, social, economic environment around them is rapidly changing; and getting adequate support from the government is a problem. The research in its subsequent stages aims to clarify existing, missing and new definitions of the term to provide deeper insights in the terminology and issues relating to Social Entrepreneurship in India.

Keywords: challenges, India, social entrepreneurship, social entrepreneurs

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1514 Human Rights on Digital Platforms

Authors: Niina Meriläinen

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Digital platforms are arenas for dialogue, various kinds of political debates, information and news gathering, policymaking, and social change processes. Human rights serve as examples of social and political issues that are universally noted as principles and yet often violated on digital platforms as well as in the analog world. Digital platforms in this study are different Internet sites, blogs, discussion platforms, social media apps, and gaming. Various actors, from human rights activists and non-governmental organizations to individual people, governments, and corporations, use digital platforms along with analog arenas to discuss and defend human rights, while violators can find new victims and continue violating rights on the same platforms. Digital platforms create opportunities for various women and minorities to empower themselves and others and to be active in various arenas of society and policymaking. At the same time, digital platforms pose threats to human rights globally, especially to women, girls, and minorities. The results of this meta-study of n=120 academic case studies indicate that more research is needed to determine the framework of human rights and human rights on digital platforms. A broad discussion must be had on what human rights require in the digital realm and how ICTs may enhance or threaten our ability to respect, protect, and fulfill a wide variety of human rights while various digital platforms pose multiple threats to human rights. This relates to the willingness of political decision-makers to act upon various crimes committed on and with online platforms. More research is needed to determine the framework of digital human rights and human rights on digital platforms in relation to political communication and decision-making. It is important to develop a framework in which these are defined. It must be discussed who participates in this process: those whose rights are violated, companies that profit by selling our personal data, activists, governments, and some unknown actors. In the end, the question comes back to who has the power to define what we talk about, when, and where. This use of power plays a big role. Digital platforms illustrate the darker side of technological progress, which, on the one hand, has given various people the possibility to engage in society, empower themselves, and take ownership of their rights globally. At the same time, the platforms enable others to use the same platforms to find victims, abuse them, and exploit them. Bullying, harassment, and violence are rampant on various digital platforms, where minorities and people with limited support are victims. There is indeed a need for a discussion of normative values in the era of fake news, the power of influencers, Trumpism, and institutionalized disregard for human rights, gender equality, and the elimination of gender-based violence online. Attention and obligations must be placed on politicians and internet architecture, such as corporations, and their roles in human rights and their violations online.

Keywords: human rights, digital platforms, violations, internet, social media

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1513 Effects of Polyvictimization in Suicidal Ideation among Children and Adolescents in Chile

Authors: Oscar E. Cariceo

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In Chile, there is a lack of evidence about the impact of polyvictimization on the emergence of suicidal thoughts among children and young people. Thus, this study aims to explore the association between the episodes of polyvictimization suffered by Chilean children and young people and the manifestation of signs related to suicidal tendencies. To achieve this purpose, secondary data from the First Polyvictimization Survey on Children and Adolescents of 2017 were analyzed, and a binomial logistic regression model was applied to establish the probability that young people are experiencing suicidal ideation episodes. The main findings show that women between the ages of 13 and 15 years, who are in seventh grade and second in subsidized schools, are more likely to express suicidal ideas, which increases if they have suffered different types of victimization, particularly physical violence, psychological aggression, and sexual abuse.

Keywords: Chile, polyvictimization, suicidal ideation, youth

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1512 Men of Congress in Today’s Brazil: Ethnographic Notes on Neoliberal Masculinities in Support of Bolsonaro

Authors: Joao Vicente Pereira Fernandez

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In the context of a democratic crisis, a new wave of authoritarianism prompts domineering male figures to leadership posts worldwide. Although the gendered aspect of this phenomenon has been reasonably documented, recent studies have focused on high-level commanding posts, such as those of president and prime-minister, leaving other positions of political power with limited attention. This natural focus of investigation, however powerful, seems to have restricted our understanding of the phenomenon by precluding a more thorough inquiry of its gendered aspects and its consequences for political representation as a whole. Trying to fill this gap, in recent research, we examined the election results of Jair Bolsonaro’s party for the Legislative Branch in 2018. We found that the party's proportion of non-male representatives was on average, showing it provided reasonable access of women to the legislature in a comparative perspective. However, and perhaps more intuitively, we also found that the elected members of Bolsonaro’s party performed very gendered roles, which allowed us to draw the first lines of the representative profiles gathered around the new-right in Brazil. These results unveiled new horizons for further research, addressing topics that range from the role of women for the new-right on Brazilian institutional politics to the relations between these profiles of representatives, their agendas, and political and electoral strategies. This article aims to deepen the understanding of some of these profiles in order to lay the groundwork for the development of the second research agenda mentioned above. More specifically, it focuses on two out of the three profiles that were grasped predominantly, if not entirely, from masculine subjects during our last research, with the objective of portraying the masculinity standards mobilized and promoted by them. These profiles –the entrepreneur and the army man – were chosen to be developed due to their proximity to both liberal and authoritarian views, and, moreover, because they can possibly represent two facets of the new-right that were integrated in a certain way around Bolsonaro in 2018, but that can be reworked in the future. After a brief introduction of the literature on masculinity and politics in times of democratic crisis, we succinctly present the relevant results of our previous research and then describe these two profiles and their masculinities in detail. We adopt a combination of ethnography and discourse analysis, methods that allow us to make sense of the data we collected on our previous research as well as of the data gathered for this article: social media posts and interactions between the elected members that inspired these profiles and their supporters. Finally, we discuss our results, presenting our main argument on how these descriptions provide a further understanding of the gendered aspect of liberal authoritarianism, from where to better apprehend its political implications in Brazil.

Keywords: Brazilian politics, gendered politics, masculinities, new-right

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1511 A Nanofi Brous PHBV Tube with Schwann Cell as Artificial Nerve Graft Contributing to Rat Sciatic Nerve Regeneration across a 30-Mm Defect Bridge

Authors: Esmaeil Biazar

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A nanofibrous PHBV nerve conduit has been used to evaluate its efficiency based on the promotion of nerve regeneration in rats. The designed conduits were investigated by physical, mechanical and microscopic analyses. The conduits were implanted into a 30-mm gap in the sciatic nerves of the rats. Four months after surgery, the regenerated nerves were evaluated by macroscopic assessments and histology. This polymeric conduit had sufficiently high mechanical properties to serve as a nerve guide. The results demonstrated that in the nanofibrous graft with cells, the sciatic nerve trunk had been reconstructed with restoration of nerve continuity and formatted nerve fibers with myelination. For the grafts especially the nanofibrous conduits with cells, muscle cells of gastrocnemius on the operated side were uniform in their size and structures. This study proves the feasibility of artificial conduit with Schwann cells for nerve regeneration by bridging a longer defect in a rat model.

Keywords: sciatic regeneration, Schwann cell, artificial conduit, nanofibrous PHBV, histological assessments

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1510 Aerobic Training Combined with Nutritional Guidance as an Effective Strategy for Improving Aerobic Fitness and Reducing BMI in Inactive Adults

Authors: Leif Inge Tjelta, Gerd Lise Nordbotten, Cathrine Nyhus Hagum, Merete Hagen Helland

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Overweight and obesity can lead to numerous health problems, and inactive people are more often overweight and obese compared to physically active people. Even a moderate weight loss can improve cardiovascular and endocrine disease risk factors. The aim of the study was to examine to what extent overweight and obese adults starting up with two weekly intensive running sessions had an increase in aerobic capacity, reduction in BMI and waist circumference and changes in body composition after 33 weeks of training. An additional aim was to see if there were differences between participants who, in addition to training, also received lifestyle modification education, including practical cooking (nutritional guidance and training group (NTG =32)) compared to those who were not given any nutritional guidance (training group (TG=40)). 72 participants (49 women), mean age of 46.1 ( ± 10.4) were included. Inclusion Criteria: Previous untrained and inactive adults in all age groups, BMI ≥ 25, desire to become fitter and reduce their BMI. The two weekly supervised training sessions consisted of 10 min warm up followed by 20 to 21 min effective interval running where the participants’ heart rate were between 82 and 92% of hearth rate maximum. The sessions were completed with ten minutes whole body strength training. Measures of BMI, waist circumference (WC) and 3000m running time were performed at the start of the project (T1), after 15 weeks (T2) and at the end of the project (T3). Measurements of fat percentage, muscle mass, and visceral fat were performed at T1 and T3. Twelve participants (9 women) from both groups, who all scored around average on the 3000 m pre-test, were chosen to do a VO₂max test at T1 and T3. The NTG were given ten theoretical sessions (80 minutes each) and eight practical cooking sessions (140 minutes each). There was a significant reduction in bout groups for WC and BMI from T1 to T2. There was not found any further reduction from T2 to T3. Although not significant, NTG reduced their WC more than TG. For both groups, the percentage reduction in WC was similar to the reduction in BMI. There was a decrease in fat percentage in both groups from pre-test to post-test, whereas, for muscle mass, a small, but insignificant increase was observed for both groups. There was a decrease in 3000m running time for both groups from T1 to T2 as well as from T2 to T3. The difference between T2 and T3 was not statistically significant. The 12 participants who tested VO₂max had an increase of 2.86 ( ± 3.84) mlkg⁻¹ min⁻¹ in VO₂max and 3:02 min (± 2:01 min) reduction in running time over 3000 m from T1 until T3. There was a strong, negative correlation between the two variables. The study shows that two intensive running session in 33 weeks can increase aerobic fitness and reduce BMI, WC and fat percent in inactive adults. Cost guidance in addition to training will give additional effect.

Keywords: interval training, nutritional guidance, fitness, BMI

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1509 Influence of Ligature Tightening on Bone Fracture Risk in Interspinous Process Surgery

Authors: Dae Kyung Choi, Won Man Park, Kyungsoo Kim, Yoon Hyuk Kim

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The interspinous process devices have been recently used due to its advantages such as minimal invasiveness and less subsidence of the implant to the osteoporotic bone. In this paper, we have analyzed the influences of ligature tightening of several interspinous process devices using finite element analysis. Four types of interspinous process implants were inserted to the L3-4 spinal motion segment based on their surgical protocols. Inferior plane of L4 vertebra was fixed and 7.5 Nm of extension moment were applied on superior plane of L3 vertebra with 400N of compressive load along follower load direction and pretension of the ligature. The stability of the spinal unit was high enough than that of intact model. The higher value of pretension in the ligature led the decrease of dynamic stabilization effect in cases of the WallisTM, DiamTM, Viking, and Spear®. The results of present study could be used to evaluate surgical option and validate the biomechanical characteristics of the spinal implants.

Keywords: interspinous process device, bone fracture risk, lumbar spine, finite element analysis

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1508 A Prospective Study on the Efficacy of Mesenchymal Stem Cells in Intervertebral Disc Regeneration

Authors: Prabhu Thangaraju, Manoj Deepak, A. Sivakumar

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Removal of inter vertebral disc along with spinal fusion has many disadvantages such as causing stress fractures. If it is possible regenerate the spine it would be possible avoid the complications of the surgery and achieve better results. Our study involves the use of mesenchymal stem cells in regenerating the discs. Our study involved 10 patients who presented with degenerative disc disease between 2008-2011 in our hospital. After adequate pre-operative check prepared mesenchymal stem cells were injected into the disc spaces. These patients were subjected to conservative therapy for a minimum of six weeks before they were accepted into the study. They were followed up regularly for a minimum of 2years with serial radiographs and MRI. 8 out of the 10 patients had completed reduction in the pain. The T2 weighted MRI images in 9 out of the 10 patients showed a bright signal compared the previous Images which indicated that there was improvement in the hydration levels. From the case study of 10 patients who were subjected to mesenchymal cell therapy in our hospital, we can conclude that the use of mesenchymal cells in treatment of intervertebral disc degeneration in a safe and effective option.

Keywords: mesenchymal stem cells, intervertebral disc, the spine, disc degeneration

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1507 Palliation of Pain in Pyomyositis: A Case Series and Literature Review

Authors: Katie Jerram, Jacqui Nevols, Rebecca Howes, Hayley Richardson, Debbie Suso, Thomas Batten, Reny Mathai

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Pyomyositis is an uncommon acute purulent skeletal muscle infection, usually caused by Staphylococcus aureus, occurring either spontaneously or following local trauma. Immunocompromise is a risk factor. It presents with pyrexia, pain, and tenderness of the affected muscle, which may have a firm ‘woody’ feel. Management usually involves surgery and prolonged courses of antibiotics, but alongside these active treatments, palliation of symptoms such as pain is also a priority. A short case series of diabetic inpatients under the care of the Renal Medicine team with pyomyositis is presented, demonstrating that Hospital Palliative Care Teams may be well placed to provide symptom management advice by working jointly with the patient’s medical or surgical team. A review of the literature on the management of pain in pyomyositis is also presented, and there was no clear consensus on the best strategy. It may be that a combination of analgesics and adjuncts is the most effective strategy, perhaps combined with the holistic approach used within palliative care.

Keywords: pyomyositis, pain, palliation, analgesia

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1506 Chronic Hypertension, Aquaporin and Hydraulic Conductivity: A Perspective on Pathological Connections

Authors: Chirag Raval, Jimmy Toussaint, Tieuvi Nguyen, Hadi Fadaifard, George Wolberg, Steven Quarfordt, Kung-ming Jan, David S. Rumschitzki

Abstract:

Numerous studies examine aquaporins’ role in osmotic water transport in various systems but virtually none focus on aquaporins’ role in hydrostatically-driven water transport involving mammalian cells save for our laboratory’s recent study of aortic endothelial cells. Here we investigate aquaporin-1 expression and function in the aortic endothelium in two high-renin rat models of hypertension, the spontaneously hypertensive genomically altered Wystar-Kyoto rat variant and Sprague-Dawley rats made hypertensive by two kidney, one clip Goldblatt surgery. We measured aquaporin-1 expression in aortic endothelial cells from whole rat aortas by quantitative immunohistochemistry, and function by measuring the pressure driven hydraulic conductivities of excised rat aortas with both intact and denuded endothelia on the same vessel. We use them to calculate the effective intimal hydraulic conductivity, which is a combination of endothelial and subendothelial components. We observed well-correlated enhancements in aquaporin-1 expression and function in both hypertensive rat models as well as in aortas from normotensive rats whose expression was upregulated by 2h forskolin treatment. Upregulated aquaporin-1 expression and function may be a response to hypertension that critically determines conduit artery vessel wall viability and long-term susceptibility to atherosclerosis. Numerous studies examine aquaporins’ role in osmotic water transport in various systems but virtually none focus on aquaporins’ role in hydrostatically-driven water transport involving mammalian cells save for our laboratory’s recent study of aortic endothelial cells. Here we investigate aquaporin-1 expression and function in the aortic endothelium in two high-renin rat models of hypertension, the spontaneously hypertensive genomically altered Wystar-Kyoto rat variant and Sprague-Dawley rats made hypertensive by two kidney, one clip Goldblatt surgery. We measured aquaporin-1 expression in aortic endothelial cells from whole rat aortas by quantitative immunohistochemistry, and function by measuring the pressure driven hydraulic conductivities of excised rat aortas with both intact and denuded endothelia on the same vessel. We use them to calculate the effective intimal hydraulic conductivity, which is a combination of endothelial and subendothelial components. We observed well-correlated enhancements in aquaporin-1 expression and function in both hypertensive rat models as well as in aortas from normotensive rats whose expression was upregulated by 2h forskolin treatment. Upregulated aquaporin-1 expression and function may be a response to hypertension that critically determines conduit artery vessel wall viability and long-term susceptibility to atherosclerosis.

Keywords: acute hypertension, aquaporin-1, hydraulic conductivity, hydrostatic pressure, aortic endothelial cells, transcellular flow

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1505 Ocular Biometry: Common Etiologies of Difference More Than 0.33mm between Axial Lengths of the 2 Eyes

Authors: Ghandehari Motlagh, Mohammad

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Purpose: We tried to find the most common etiologies for anisometropia in pre-op cataract cases: axial or refractive. Methods: In this cross-sectional study ,41 pre-op cataract eyes with more than 0.33 difference between axial lengths of 2 eyes were enrolled.Considered for each 1mm difference between axial lengths in long eyes( AXL more than 25):1.75-2.00 D of anisometropia, for normal eyes(AXL: 22- 25):2.50D and for short eyes (AXL less than 22):3.50-3.75 D as axial anisometropia. If there are more or lesser anisometropia, we recorded as refractive anisometropia. Results: Average of anisometropia :4.24 D, prevalence of PK or LK :1 (2.38%), kc:1(2.38%), glaucoma surgery: 1(2.38%), and pseudophakic status of the opposite eye 8(19.04%). Prevalence of axial anisometropia:21 (52.4%) and refractive anisometropia 20(47.6%).Then on basis of this study we can rely on the patient’s refraction exactly before phaco for evaluation of axial length differences between the 2 eyes, because most of the anisometropias are axial. Conclusion: In most cases, cataract does not induce significant change in refractive error (secondary myopia) and AXL difference between the 2 eyes are correlated with anisometropia.so it can be used for cataract patient’s ocular biometry evaluation. Pre-cataract refraction is a valuable variable should be measured and recorded in routin eye examination.

Keywords: ocular axial length, anisometropia, cataract, ophthalmology and optometry

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1504 Flow as a Positive Intervention for Post-Traumatic Stress Disorder

Authors: Sonal Khosla

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A research is proposed in the present paper to explore the role of flow in coping with traumatic experiences and attaining post-traumatic growth. A grounded theory research is proposed to be carried by analyzing memoirs of people who have been through trauma. A pilot study was carried out on two memoirs of women who were held captive for over ten years and were sexually assaulted repeatedly. The role of flow in their coping experiences was explored by analyzing the books. Some of the flow activities that were used by them were- drawing and daydreaming. Their narratives show the evidence for flow as having cathartic and healing effects on them. Applicability of the findings can take two forms: 1. Flow can be applied as a preventive technique to help the people who are going through trauma, 2. Flow can be adopted into a positive intervention to help people suffering from PTSD.

Keywords: flow, positive intervention, PTSD, PTG

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1503 Attachment as a Predictor for Cognitive Rigidity

Authors: Barbara Gawda

Abstract:

Attachment model formed in childhood has an important impact on emotional development, personality, and social relationships. Attachment is also thought to have an impact on construction of affective-cognitive schemas and cognitive functioning. The aim of the current study was to verify whether there is an association between attachment and cognitive rigidity defined as dogmatism and intolerance of ambiguity. The analysis of 180 participants (persons of a similar age and education level, number of men and women was equal) was conducted. To test the attachment styles, the Revised Experiences in Close Relationships Inventory (ECR-R) was used. To examine cognitive rigidity, the Rokeach and Budner questionnaires were used. A multiple regression model was employed to examine whether attachment styles are predictors for dogmatism. The results confirmed that fearful-ambivalent attachment is the main predictor for dogmatism but not for intolerance of ambiguity.

Keywords: attachment styles, cognitive rigidity, dogmatism, intolerance of ambiguity

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1502 Examining Smallholder Farmers’ Perceptions of Climate Change and Barriers to Strategic Adaptation in Todee District, Liberia

Authors: Joe Dorbor Wuokolo

Abstract:

Thousands of smallholder farmers in Todee District, Montserrado county, are currently vulnerable to the negative impact of climate change. The district, which is the agricultural hot spot for the county, is faced with unfavorable changes in the daily temperature due to climate change. Farmers in the district have observed a dramatic change in the ratio of rainfall to sunshine, which has caused a chilling effect on their crop yields. However, there is a lack of documentation regarding how farmers perceive and respond to these changes and challenges. A study was conducted in the region to examine the perceptions of smallholder farmers regarding the negative impact of climate change, the adaptation strategies practice, and the barriers that hinder the process of advancing adaptation strategy. On purpose, a sample of 41 respondents from five towns was selected, including five town chiefs, five youth leaders, five women leaders, and sixteen community members. Women and youth leaders were specifically chosen to provide gender balance and enhance the quality of the investigation. Additionally, to validate the barriers farmers face during adaptation to climate change, this study interviewed eight experts from local and international organizations and government ministries and agencies involved in climate change and agricultural programs on what they perceived as the major barrier in both local and national level that impede farmers adaptation to climate change impact. SPSS was used to code the data, and descriptive statistics were used to analyze the data. The weighted average index (WAI) was used to rank adaptation strategies and the perceived importance of adaptation practices among farmers. On a scale from 0 to 3, 0 indicates the least important technique, and 3 indicates the most effective technique. In addition, the Problem Confrontation Index (PCI) was used to rank the barriers that prevented farmers from implementing adaptation measures. According to the findings, approximately 60% of all respondents considered the use of irrigation systems to be the most effective adaptation strategy, with drought-resistant varieties making up 30% of the total. Additionally, 80% of respondents placed a high value on drought-resistant varieties, while 63% percent placed it on irrigation practices. In addition, 78% of farmers ranked and indicated that unpredictability of the weather is the most significant barrier to their adaptation strategies, followed by the high cost of farm inputs and lack of access to financing facilities. 80% of respondents believe that the long-term changes in precipitation (rainfall) and temperature (hotness) are accelerating. This suggests that decision-makers should adopt policies and increase the capacity of smallholder farmers to adapt to the negative impact of climate change in order to ensure sustainable food production.

Keywords: adaptation strategies, climate change, farmers’ perception, smallholder farmers

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1501 Learning from Long COVID: How Healthcare Needs to Change for Contested Illnesses

Authors: David Tennison

Abstract:

In the wake of the Covid-19 pandemic, a new chronic illness emerged onto the global stage: Long Covid. Long Covid presents with several symptoms commonly seen in other poorly-understood illnesses, such as fibromyalgia (FM) and myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). However, while Long Covid has swiftly become a recognised illness, FM and ME/CFS are still seen as contested, which impacts patient care and healthcare experiences. This study aims to examine what the differences are between Long Covid and FM; and if the Long Covid case can provide guidance for how to address the healthcare challenge of contested illnesses. To address this question, this study performed comprehensive research into the history of FM; our current biomedical understanding of it; and available healthcare interventions (within the context of the UK NHS). Analysis was undertaken of the stigma and stereotypes around FM, and a comparison made between FM and the emerging Long Covid literature, along with the healthcare response to Long Covid. This study finds that healthcare for chronic contested illnesses in the UK is vastly insufficient - in terms of pharmaceutical and holistic interventions, and the provision of secondary care options. Interestingly, for Long Covid, many of the treatment suggestions are pulled directly from those used for contested illnesses. The key difference is in terms of funding and momentum – Long Covid has generated exponentially more interest and research in a short time than there has been in the last few decades of contested illness research. This stands to help people with FM and ME/CFS – for example, research has recently been funded into “brain fog”, a previously elusive and misunderstood symptom. FM is culturally regarded as a “women’s disease” and FM stigma stems from notions of “hysteria”. A key finding is that the idea of FM affecting women disproportionally is not reflected in modern population studies. Emerging data on Long Covid also suggests a slight leaning towards more female patients, however it is less feminised, potentially due to it emerging in the global historical moment of the pandemic. Another key difference is that FM is rated as an extremely low-prestige illness by healthcare professionals, while it was in large part due to the advocacy of affected healthcare professionals that Long Covid was so quickly recognised by science and medicine. In conclusion, Long Covid (and the risk of future pandemics and post-viral illnesses) highlight a crucial need for implementing new, and reinforcing existing, care networks for chronic illnesses. The difference in how contested illnesses like FM, and new ones like Long Covid are treated have a lot to do with the historical moment in which they emerge – but cultural stereotypes, from within and without medicine, need updating. Particularly as they contribute to disease stigma that causes genuine harm to patients. However, widespread understanding and acceptance of Long Covid could help fight contested illness stigma, and the attention, funding and research into Long Covid may actually help raise the profile of contested illnesses and uncover answers about their symptomatology.

Keywords: long COVID, fibromyalgia, myalgic encephalomyelitis, chronic fatigue syndrome, NHS, healthcare, contested illnesses, chronic illnesses, COVID-19 pandemic

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1500 Maternal Death Review and Contextualization of Maternal Death in West Bengal

Authors: M. Illias Kanchan

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The death of a woman during pregnancy and childbirth is not only a health issue, but also a matter of social injustice. This study makes an attempt to explore the association between maternal death and associated factors in West Bengal using the approaches of facility-based and community-based maternal death review. Bivariate and binary logistic regression analysis have been performed to understand the causes and circumstances of maternal deaths in West Bengal. Delay in seeking care was the major contributor in maternal deaths, near about one-third women died due to this factor. The most common cause of maternal death is found to be hypertensive disorders of pregnancy or eclampsia. We believe that these deaths can be averted by reducing hypertensive disorders of pregnancy or eclampsia.

Keywords: maternal death, facility-based, community-based, review, west Bengal, eclampsia

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1499 Youth Participation in Peace Building and Development in Northern Uganda

Authors: Eric Awich Ochen

Abstract:

The end of the conflict in Northern Uganda in 2006 brought about an opportunity for the youth to return to their original home and contribute to the peace building and development process of their communities. Post-conflict is used here to refer to the post-armed conflict situation and activities of rebels of Joseph Kony in northern Uganda. While the rebels remain very much active in the Sudan and Central African Republic, in Uganda the last confrontations occurred around 2006 or earlier, and communities have returned to their homes and began the process of rebuilding their lives. It is argued that socio-economic reconstruction is at the heart of peacebuilding and sustenance of positive peace in the aftermath of conflict, as it has a bearing on post-conflict stability and good governance. We recognize that several post-conflict interventions within Northern Uganda have targeted women and children with a strong emphasis on family socio-economic empowerment and capacity building, including access to micro finance. The aim of this study was to examine the participation of the youth in post-conflict peace building and development in Northern Uganda by assessing the breadth and width of their engagement and the stages of programming cycle that they are involved in, interrogating the space for participation and how they are facilitating or constraining participation. It was further aimed at examining the various dimensions of participation at play in Northern Uganda and where this fits within the conceptual debates on peace building and development in the region. Supporting young people emerging out of protracted conflict to re-establish meaningful socio-economic engagements and livelihoods is fundamental to their participation in the affairs of the community. The study suggests that in the post-conflict development context of Northern Uganda, participation has rarely been disaggregated or differentiated by sectors or groups. Where some disaggregation occurs, then the main emphasis has always been on either women or children. It appears therefore that little meaningful space has thus been created for young people to engage and participate in peace building initiatives within the region. In other cases where some space is created for youth participation, this has been in pre-conceived programs or interventions conceived by the development organizations with the youth or young people only invited to participate at particular stages of the project implementation cycle. Still within the implementation of the intervention, the extent to which young people participate is bounded, with little power to influence the course of the interventions or make major decisions. It is thus visible that even here young people mainly validate and legitimize what are predetermined processes only act as pawns in the major chess games played by development actors (dominant peace building partners). This paper, therefore, concludes that the engagement of the youth in post-conflict peace building has been quite problematic and tokenistic and has not given the adequate youth space within which they could ably participate and express themselves in the ensuing interventions.

Keywords: youth, conflict, peace building, participation

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1498 Trabecular Texture Analysis Using Fractal Metrics for Bone Fragility Assessment

Authors: Khaled Harrar, Rachid Jennane

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The purpose of this study is the discrimination of 28 postmenopausal with osteoporotic femoral fractures from an age-matched control group of 28 women using texture analysis based on fractals. Two pre-processing approaches are applied on radiographic images; these techniques are compared to highlight the choice of the pre-processing method. Furthermore, the values of the fractal dimension are compared to those of the fractal signature in terms of the classification of the two populations. In a second analysis, the BMD measure at proximal femur was compared to the fractal analysis, the latter, which is a non-invasive technique, allowed a better discrimination; the results confirm that the fractal analysis of texture on calcaneus radiographs is able to discriminate osteoporotic patients with femoral fracture from controls. This discrimination was efficient compared to that obtained by BMD alone. It was also present in comparing subgroups with overlapping values of BMD.

Keywords: osteoporosis, fractal dimension, fractal signature, bone mineral density

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1497 Current Cosmetic Treatments in Pregnancy

Authors: Daniela F. Maluf, Fernanda Roters, Luma C. F. Silva

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The goal of this work is to report the main dermatological alterations occurring during pregnancy and actual cosmetic protocols available and recommended for safe use. Throughout pregnancy, woman's body undergoes many transformations such as hormonal changes and weight gain. These alterations can result in undesirable skin aspects that end up affecting the future mother's life. The main complaints of pregnant women involve melasma advent, varicose veins, edema, and natural skin aging. Even if most of the time is recommended to wait for the birth to use cosmetics, there are some alternatives to prevent and to treat these alterations during pregnancy. For all these cases, there is a need to update information about safety and efficacy of new actives and technologies in cosmetic products. The purpose of this study was to conduct a literature review about the main skin alterations during pregnancy and actual recommended treatments, according to the current legislation.

Keywords: pregnancy, cosmetic, treatment, physiological changes

Procedia PDF Downloads 351
1496 Quick off the Mark with Achilles Tendon Rupture

Authors: Emily Moore, Andrew Gaukroger, Matthew Solan, Lucy Bailey, Alexandra Boxall, Andrew Carne, Chintu Gadamsetty, Charlotte Morley, Katy Western, Iwona Kolodziejczyk

Abstract:

Introduction: Rupture of the Achilles tendon is common and has a long recovery period. Most cases are managed non-operatively. Foot and Ankle Surgeons advise an ultrasound scan to check the gap between the torn ends. A large gap (with the ankle in equinus) is a relative indication for surgery. The definitive decision regarding surgical versus non-operative management can only be made once an ultrasound scan is undertaken and the patient is subsequently reviewed by a Foot and Ankle surgeon. To get to this point, the patient journey involves several hospital departments. In nearby trusts, patients reattend for a scan and go to the plaster room both before and after the ultrasound for removal and re-application of the cast. At a third visit to the hospital, the surgeon and patient discuss options for definitive treatment. It may take 2-3 weeks from the initial Emergency Department visit before the final treatment decision is made. This “wasted time” is ultimately added to the recovery period for the patient. In this hospital, Achilles rupture patients are seen in a weekly multidisciplinary OneStop Heel Pain clinic. This pathway was already efficient but subject to occasional frustrating delays if a key staff member was absent. A new pathway was introduced with the goal to reduce delays to a definitive treatment plan. Method: A retrospective series of Achilles tendon ruptures managed according to the 2019 protocol was identified. Time taken from the Emergency Department to have both an ultrasound scan and specialist Foot and Ankle surgical review were calculated. 30 consecutive patients were treated with our new pathway and prospectively followed. The time taken for a scan and for specialist review were compared to the 30 consecutive cases from the 2019 (pre-COVID) cohort. The new pathway includes 1. A new contoured splint applied to the front of the injured limb held with a bandage. This can be removed and replaced (unlike a plaster cast) in the ultrasound department, removing the need for plaster room visits. 2. Urgent triage to a Foot and Ankle specialist. 3. Ultrasound scan for assessment of rupture gap and deep vein thrombosis check. 4. Early decision regarding surgery. Transfer to weight bearing in a prosthetic boot in equinuswithout waiting for the once-a-week clinic. 5. Extended oral VTE prophylaxis. Results: The time taken for a patient to have both an ultrasound scan and specialist review fell > 50%. All patients in the new pathway reached a definitive treatment decision within one week. There were no significant differences in patient demographics or rates of surgical vs non-operative treatment. The mean time from Emergency Department visit to specialist review and ultrasound scan fell from 8.7 days (old protocol) to 2.9 days (new pathway). The maximum time for this fell from 23 days (old protocol) to 6 days (new pathway). Conclusion: Teamwork and innovation have improved the experience for patients with an Achilles tendon rupture. The new pathway brings many advantages - reduced time in the Emergency Department, fewer hospital visits, less time using crutches and reduced overall recovery time.

Keywords: orthopaedics, achilles rupture, ultrasound, innovation

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1495 The Effectiveness and Accuracy of the Schulte Holt IOL Toric Calculator Processor in Comparison to Manually Input Data into the Barrett Toric IOL Calculator

Authors: Gabrielle Holt

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This paper is looking to prove the efficacy of the Schulte Holt IOL Toric Calculator Processor (Schulte Holt ITCP). It has been completed using manually inputted data into the Barrett Toric Calculator and comparing the number of minutes taken to complete the Toric calculations, the number of errors identified during completion, and distractions during completion. It will then compare that data to the number of minutes taken for the Schulte Holt ITCP to complete also, using the Barrett method, as well as the number of errors identified in the Schulte Holt ITCP. The data clearly demonstrate a momentous advantage to the Schulte Holt ITCP and notably reduces time spent doing Toric Calculations, as well as reducing the number of errors. With the ever-growing number of cataract surgeries taking place around the world and the waitlists increasing -the Schulte Holt IOL Toric Calculator Processor may well demonstrate a way forward to increase the availability of ophthalmologists and ophthalmic staff while maintaining patient safety.

Keywords: Toric, toric lenses, ophthalmology, cataract surgery, toric calculations, Barrett

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