Search results for: estimated discharge date
Commenced in January 2007
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Edition: International
Paper Count: 4197

Search results for: estimated discharge date

1617 Changes in Expression of Galanin in the CSMG Neurons Supplying the Prepyloric Area of the Porcine Stomach Induced by Intragastric Infusion of Hydrochloric Acid

Authors: Katarzyna Palus, Jarosław Całka

Abstract:

Gastrointestinal disorders, especially acid-related diseases, including peptic and duodenal ulcers, gastroesophageal reflux disease, upper GI bleeding or stress-related mucosal disease, are currently serious health issues encountered very frequently in patients worldwide. However, to date, the response of sympathetic neurons to gastric mucosal injury and local inflammation following hyperacidity is unknown. Thus, the present study was designed to determine possible changes in expression of galanin (GAL) in the CSMG neurons supplying the prepyloric area of the porcine stomach in a physiological state and following experimentally-induced hyperacidity by using combined retrograde tracing and double-labelling immunohistochemistry. The choice of the domestic pig as an experimental model in the present study is not accidental and is justified by the high degree of physiological and anatomical similarity to human digestive system functions. In this experiment ten juvenile female pigs of the Large White Polish breed were used. The animals were divided into two groups: control and animals with hydrochloric acid infusion (HCl). The neuronal retrograde marker Fast Blue (FB) was injected into the anterior prepyloric wall of the stomach of all animals. After 23 days, animals of the HCl-group were reintroduced into a state of general anesthesia and intragastrically given 5 ml/kg of body weight of 0.25 M aqueous solution of hydrochloric acid. On the 28th day, all animals were euthanized. The CSMG complexes were then collected and the CSMG cryostat sections were stained immunocytochemically for GAL and TH (tyrosine hydroxylase). Immunohistochemistry revealed that in the control group 8.40 ± 0.53 % out of 200 FB-positive CSMG neurons contained GAL. In HCl group upregulation of the GAL-IR neurons to 22.52 ± 1.18 % were observed. All GAL-IR neurons in both groups showed the simultaneously TH immunoreactivity. Increase in the expression of GAL in FB-positive neurons of the HCL group may suggest its participation in the protective mechanisms of neurons in different pathological processes, such as gastric hyperacidity.

Keywords: coeliac-superior mesenteric ganglion complex, gastric innervation, hyperacidity, immunohistochemistry

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1616 Measuring Greenhouse Gas Exchange from Paddy Field Using Eddy Covariance Method in Mekong Delta, Vietnam

Authors: Vu H. N. Khue, Marian Pavelka, Georg Jocher, Jiří Dušek, Le T. Son, Bui T. An, Ho Q. Bang, Pham Q. Huong

Abstract:

Agriculture is an important economic sector of Vietnam, the most popular of which is wet rice cultivation. These activities are also known as the main contributor to the national greenhouse gas. In order to understand more about greenhouse gas exchange in these activities and to investigate the factors influencing carbon cycling and sequestration in these types of ecosystems, since 2019, the first eddy covariance station has been installed in a paddy field in Long An province, Mekong Delta. The station was equipped with state-of-the-art equipment for CO₂ and CH₄ gas exchange and micrometeorology measurements. In this study, data from the station was processed following the ICOS recommendations (Integrated Carbon Observation System) standards for CO₂, while CH₄ was manually processed and gap-filled using a random forest model from methane-gapfill-ml, a machine learning package, as there is no standard method for CH₄ flux gap-filling yet. Finally, the carbon equivalent (Ce) balance based on CO₂ and CH₄ fluxes was estimated. The results show that in 2020, even though a new water management practice - alternate wetting and drying - was applied to reduce methane emissions, the paddy field released 928 g Cₑ.m⁻².yr⁻¹, and in 2021, it was reduced to 707 g Cₑ.m⁻².yr⁻¹. On a provincial level, rice cultivation activities in Long An, with a total area of 498,293 ha, released 4.6 million tons of Cₑ in 2020 and 3.5 million tons of Cₑ in 2021.

Keywords: eddy covariance, greenhouse gas, methane, rice cultivation, Mekong Delta

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1615 Developing Pavement Maintenance Management System (PMMS) for Small Cities, Aswan City Case Study

Authors: Ayman Othman, Tallat Ali

Abstract:

A pavement maintenance management system (PMMS) was developed for the city of Aswan as a model of a small city to provide the road maintenance department in Aswan city with the capabilities for comprehensive planning of the maintenance activities needed to put the internal pavement network into desired physical condition in view of maintenance budget constraints. The developed system consists of three main stages. First is the inventory & condition survey stage where the internal pavement network of Aswan city was inventoried and its actual conditions were rated in segments of 100 meters length. Second is the analysis stage where pavement condition index (PCI) was calculated and the most appropriate maintenance actions were assigned for each segment. The total maintenance budget was also estimated and a parameter based ranking criteria were developed to prioritize maintenance activities when the available maintenance budget is not sufficient. Finally comes the packaging stage where approved maintenance budget is packed into maintenance projects for field implementation. System results indicate that, the system output maintenance budget is very reasonable and the system output maintenance programs agree to a great extent with the actual maintenance needs of the network. Condition survey of Aswan city road network showed that roughness is the most dominate distress. In general, the road network can be considered in a fairly reasonable condition, however, the developed PMMS needs to be officially adapted to maintain the road network in a desirable condition and to prevent further deterioration.

Keywords: pavement, maintenance, management, system, distresses, survey, ranking

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1614 Growing Evaluation Process in Chamaedorea Linearis with Humus from Biosolids of the Wastewater Treatment Plant, Nueva Granada Military University Cajica

Authors: J. Gonzalez, P. Jimenez, C. Isaza

Abstract:

Palms have different characteristics that make them vulnerable; that is the case of the Chamaedorea linearis, with the presence of solitary stems of small diameter and medium leaves, culturally harvested, and in religious festivities used. Additionally, they present a weak apical meristem as the only emergency point, slow development and growth, and an affectation due to the high rate of deforestation in Colombia. Propagation of this species can improve the pressure on wild populations and help their survival in the environment. In this study was used in 177 plants biosolids humus from the Wastewater Treatment Plant (WWTP), located at the UMNG Campus Cajica (Cundinamarca, Colombia). The experiment used a control and two treatments with 10% and 20% of humus. During the process, the variables evaluated were number of leaves, percentage of chlorophyll, stem length, and estimated leaf area. The data set were taking during 14 weeks before the reproductive maturity, evidencing that the most representative development of the palms was in the treatment of 20%, plants in this treatment presented major number of leaves, larger stems, a high quantity of chlorophyll, and was a first treatment that present pinnate leaves them represent an important point in maturity process. The research gives an opportunity to improve times of growth in another species of palms and plants (Product result from INV ING 2986 UMNG).

Keywords: biosolids, humus, growth, palms, wastewater treatment plant, WWTP

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1613 Constructed Wetlands with Subsurface Flow for Nitrogen and Metazachlor Removal from Tile Drainage: First Year Results

Authors: P. Fucik, J. Vymazal, M. Seres

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Pollution from agricultural drainage is a severe issue for water quality, and it is a major reason for the failure in accomplishment of 'good chemical status' according to Water Framework Directive, especially due to high nitrogen and pesticide burden of receiving waters. Constructed wetlands were proposed as a suitable measure for removal of nitrogen from agricultural drainage in the early 1990s. Until now, the vast majority of constructed wetlands designed to treat tile drainage were free-surface constructed wetlands. In 2018, three small experimental constructed wetlands with horizontal subsurface flow were built in Czech Highlands to treat tile drainage from 15.73 ha watershed. The wetlands have a surface area of 79, 90 and 98 m² and were planted with Phalaris arundinacea and Glyceria maxima in parallel bands. The substrate in the first two wetlands is gravel (4-8 mm) mixed with birch woodchips (10:1 volume ratio). In one of those wetlands, the water level is kept 10 cm above the surface; in the second one, the water is kept below the surface. The third wetland has 20 cm layer of birch woodchips on top of gravel. The drainage outlet, as well as wetland outlets, are equipped with automatic discharge-gauging devices, temperature probes, as well as automatic water samplers (Teledyne ISCO). During the monitored period (2018-2019), the flows were unexpectedly low due to a drop of the shallow ground water level, being the main source of water for the monitored drainage system, as experienced at many areas of the Czech Republic. The mean water residence time was analyzed in the wetlands (KBr), which was 16, 9 and 27 days, respectively. The mean total nitrogen concentration eliminations during one-year period were 61.2%, 62.6%, and 70.9% for wetlands 1, 2, and 3, respectively. The average load removals amounted to 0.516, 0.323, and 0.399 g N m-2 d-1 or 1885, 1180 and 1457 kg ha-1 yr-1 in wetlands 1, 2 and 3, respectively. The plant uptake and nitrogen sequestration in aboveground biomass contributed only marginally to the overall nitrogen removal. Among the three variants, the one with shallow water on the surface was revealed to be the most effective for removal of nitrogen from drainage water. In August 2019, herbicide Metazachlor was experimentally poured in time of 2 hours at drainage outlet in a concentration of 250 ug/l to find out the removal rates of the aforementioned wetlands. Water samples were taken the first day every six hours, and for the next nine days, every day one water sample was taken. The removal rates were as follows 94, 69 and 99%; when the most effective wetland was the one with the longest water residence time and the birch woodchip-layer on top of gravel.

Keywords: constructed wetlands, metazachlor, nitrogen, tile drainage

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1612 Determinants of Economic Growth in Pakistan: A Structural Vector Auto Regression Approach

Authors: Muhammad Ajmair

Abstract:

This empirical study followed structural vector auto regression (SVAR) approach proposed by the so-called AB-model of Amisano and Giannini (1997) to check the impact of relevant macroeconomic determinants on economic growth in Pakistan. Before that auto regressive distributive lag (ARDL) bound testing technique and time varying parametric approach along with general to specific approach was employed to find out relevant significant determinants of economic growth. To our best knowledge, no author made such a study that employed auto regressive distributive lag (ARDL) bound testing and time varying parametric approach with general to specific approach in empirical literature, but current study will bridge this gap. Annual data was taken from World Development Indicators (2014) during period 1976-2014. The widely-used Schwarz information criterion and Akaike information criterion were considered for the lag length in each estimated equation. Main findings of the study are that remittances received, gross national expenditures and inflation are found to be the best relevant positive and significant determinants of economic growth. Based on these empirical findings, we conclude that government should focus on overall economic growth augmenting factors while formulating any policy relevant to the concerned sector.

Keywords: economic growth, gross national expenditures, inflation, remittances

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1611 Direct and Indirect Impacts of Predator Conflict in Kanha National Park, India

Authors: Diane H. Dotson, Shari L. Rodriguez

Abstract:

Habitat for predators is on the decline worldwide, which often brings humans and predators into conflict over remaining shared space and common resources. While the direct impacts of human predator conflict on humans (i.e., attacks on livestock or humans resulting in injury or death) are well documented, the indirect impacts of conflict on humans (i.e., downstream effects such as fear, stress, opportunity costs, PTSD) have not been addressed. We interviewed 437 people living in 54 villages on the periphery of Kanha National Park, India, to assess the amount and severity of direct and indirect impacts of predator conflict. ​While 58% of livestock owners believed that predator attacks on livestock guards occurred frequently and 62% of those who collect forest products believed that predator attacks on those collecting occurred frequently, less than 20% of all participants knew of someone who had experienced an attack. Data related to indirect impacts suggest that such impacts are common; 76% of participants indicated they were afraid a predator will physically injure them. Livestock owners reported that livestock guarding took time away from their primary job (61%) and getting enough sleep (73%), and believed that it increased their vulnerability to illnesses (80%). These results suggest that the perceptions of risk of predator attack are likely inflated, yet the costs of human predator impacts may be substantially higher than previously estimated, particularly related to human well-being, making the implementation of appropriate and effective conservation and conflict mitigation strategies and policies increasingly urgent.

Keywords: direct impacts, indirect impacts, human-predator conflict, India

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1610 Bringing the Confidence Intervals into Choropleth Mortality Map: An Example of Tainan, Taiwan

Authors: Tzu-Jung Tseng, Pei-Hsuen Han, Tsung-Hsueh Lu

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Background: Choropleth mortality map is commonly used to identify areas with higher mortality risk. However, the use of choropleth map alone might result in the misinterpretation of differences in mortality rates between areas. Two areas with different color shades might not actually have a significant difference in mortality rates. The mortality rates estimated for an area with a small population would be less stable. We suggest of bringing the 95% confidence intervals (CI) into the choropleth mortality map to help users interpret the areal mortality rate difference more properly. Method: In the first choropleth mortality map, we used only three color to indicate standardized mortality ratio (SMR) for each district in Tainan, Taiwan. The red color denotes that the SMR of that district was significantly higher than the Tainan average; on the contrary, the green color suggests that the SMR of that district was significantly lower than the Tainan average. The yellow color indicates that the SMR of that district was not statistically significantly different from the Tainan average. In the second choropleth mortality map, we used traditional sequential color scheme (color ramp) for different SMR in 37 districts in Tainan City with bar chart of each SMR with 95% CI in which the users could examine if the line of 95% CI of SMR of two districts overlapped (nonsignificant difference). Results: The all-causes SMR of each district in Tainan for 2008 to 2013 ranged from 0.77 (95% CI 0.75 to 0.80) in East District to 1.39 Beimen (95% CI 1.25 to 1.52). In the first choropleth mortality map, only 16 of 37 districts had red color and 8 districts had green color. For different causes of death, the number of districts with red color differed. In the first choropleth mortality map we added a bar chart with line of 95% CI of SMR in each district, in which the users could visualize the SMR differences between districts. Conclusion: Through the use of 95% CI the users could interpret the aral mortality differences more properly.

Keywords: choropleth map, small area variation, standardized mortality ratio (SMR), Taiwan

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1609 Development of Self Emulsifying Drug Delivery Systems (SEDDS) of Anticancer Agents Used in AYUSH System of Medicine for Improved Oral Bioavailability Followed by Their Pharmacological Evaluation Using Biotechnological Techniques

Authors: Meenu Mehta, Munish Garg

Abstract:

The use of oral anticancer drugs from AYUSH system of medicine is widely increased among the society due to their low cost, enhanced efficacy, increased patient preference, lack of inconveniences related to infusion and they provide an opportunity to develop chronic treatment regimens. However, oral delivery of these drugs usually laid down by the limited bioavailability of the drug, which is associated with a wide variation. As most of the cytotoxic agents have a narrow therapeutic window and are dosed at or near the maximum tolerated dose, a wide variability in the bioavailability can negatively affect treatment result. It is estimated that 40% of active substances are poorly soluble in water. The improvement of bio-availability of drugs with such properties presents one of the greatest challenges in drug formulations. There are several techniques reported in literature. Among all these Self Emulsifying Drug Delivery System (SEDDS) has gained more attention due to enhanced oral bio-availability enabling a reduction in dose. Thus, SEDDS anticancer drugs will have the increased bioavailability and efficacy. These dosage form will provide societal benefit in a cost-effective manner as compared to other oral dosage forms. Present study reflects on the formulation strategies as SEDDS for oral anticancer agents of AYUSH system for enhanced bioavailability with proven efficacy by cancer cell lines.

Keywords: anticancer agents, AYUSH system, bioavailability, SEDDS

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1608 Life Table and Functional Response of Scolothrips takahashii (Thysanoptera: Thripidae) on Tetranychus urticae (Acari:Tetranychidae)

Authors: Kuang-Chi Pan, Shu-Jen Tuan

Abstract:

Scolothrips takahashii Priesner (Thysanoptera: Thripidae) is a common predatory thrips which feeds on spider mites; it is considered an important natural enemy and a potential biological control agent against spider mites. In order to evaluate the efficacy of S. takahashii against tetranychid mites, life table and functional response study were conducted at 25±1°C, with Tetranychus urticae Priesner as prey. The intrinsic rate of increase (r), finite rate of increase (λ), net reproduction rate (R₀), mean generation time (T) were 0.1674 d⁻¹, 1.1822d⁻¹, 62.26 offspring/individual, and 24.68d. The net consumption rate (C₀) was 846.15, mean daily consumption rate was 51.92 eggs for females and 19.28 eggs for males. S. takahashii exhibited type III functional response when offered T. urticae deutonymphs. Based on the random predator equation, the estimated maximum attack rate (a) and handling time (Th) were 0.1376h⁻¹ and 0.7883h. In addition, a life table experiment was conducted to evaluate the offspring sex allocation and population dynamic of Tetranychus ludeni Zacher under group-rearing conditions with different sex ratios. All bisexual groups produced offspring with similar sex allocation patterns, which started with the majority of females, then transited during the middle of the oviposition period and turned male-biased at the end of the oviposition period.

Keywords: Scolothrips takahashii, Tetranychus urticae, Tetranychus ludeni, two-sex life table, functional response, sex allocation

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1607 Antidepressant-Like Effects of EQC-34, a 5HT3 Receptor Antagonist in Neurobehavioral Mouse Model of Depression

Authors: D: Gupta, M. Radhakrishnan, Y. Kurhe, D. Thangaraj

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Depression is among the leading causes of death worldwide. The current pharmacotherapy is associated with poor compliance, resistance and relapse, which necessitate the development of novel compounds with better efficacy. The present study designed and synthesized EQC-34 (N-cyclohexyl-3-ethoxyquinoxalin-2-carboxamide) as novel serotonin type-3 (5HT3) antagonist and evaluated its antidepressant-like effects using neurobehavioral mouse model. 5HT3 antagonism (as pA2 value) was determined on the longitudinal smooth muscle of guinea-pig ileum against 2-methyl-5HT (a 5HT3 agonist). The doses were calculated by dose response of basal locomotor activity. Consequently, effects of EQC-34 on neurobehavioral parameters were measured in forced swim (FST) and tail suspension test (TST). The possible mechanism was estimated by interaction study with fluoxetine (a selective serotonin reuptake inhibitor) and mCPBG (1-(m-chlorophenyl)-biguanide, a selective 5HT3 agonist), and confirmed by potentiation of head twitch response by 5hydroxy-L-tryptophan (5HTP). EQC-34 (1-4 mg/kg, i.p.) produced significant decreased behavioral despair effects in FST and TST. It potentiated fluoxetine response, while mCPBG reduced EQC-34 activity in FST. Further, EQC-34 potentiated 5HTP induced head twitch response. EQC-34 revealed potential antidepressant-like effects, which may involve 5HT3 receptor mediated facilitation of 5HT neurotransmission, thereby reversing the pathological deficiency of monoamines (5HT) observed in depression. Thus, it may be further investigated as promising agent to improve therapeutics of depression.

Keywords: depression, forced swim test, 5HT3 receptor antagonist, serotonin

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1606 Green Fruit and Vegetables Have Favorable Effects on 3-Year Changes of Cardiometabolic Risk Factors: A Cohort Study

Authors: Parvin Mirmiran, Zahra Bahadoran, Nazanin Moslehi, Fereidoun Azizi

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Background and aim: We aimed to investigate the effects of green fruits and vegetables (green FV) consumption on the 3-year changes of cardiometabolic risk factors. Methods: This longitudinal study was conducted in the framework of Tehran Lipid and Glucose Study, between 2006-2008 and 2009-2011, on 1272 adults. Dietary intake of green FV, including green cabbage, broccoli, lettuce, celery, green beans, green peas, cucumber, leafy vegetables, zucchini, green chili and bell pepper, and kiwi fruit, has been assessed by a validated semi-quantitative food frequency questionnaire at baseline and second examination. Demographics, anthropometrics and biochemical measures were evaluated at baseline and 3 years later. The associations of cardiometabolic risk changes with mean intake of green FV were estimated. Results: The mean age of men and women at baseline was 39.8±12.7 and 37.3±12.1 years, respectively. Mean intake of green FV was 152±77 g/d. More intake from green FV was accompanied to more intake of vitamin A, α and β-carotene, lutein, β-criptoxanthine, potassium, magnesium and fiber. Consumption of green FV was inversely associated with 3-year change of waist circumference (β= -0.07, P=0.01), total cholesterol (β= -0.11, P=0.01) and triglycerides (β= -0.13, P=0.01). Each 25 g/d increase in consumption of green FV decreased the incidence of hyper-triglyceridemia by 12% (OR:0.88, 95%CI:0.71-0.99) in men. In women, no significant association was observed between consumption of green FV with cardiometabolic risk factors. Conclusion: Higher consumption of green FV could have preventive effects against abdominal fat gain and lipid disorders.

Keywords: cardiometabolic risk factors, abdominal obesity, lipid disorders, fruits, vegetables

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1605 Fungal Profile and Antifungal Susceptibility Patterns among Symptomatic Pediatrics Patients Attending Aboozar Children’s Hospital, Ahvaz, Iran

Authors: Nasrin Amirrajab, Yasaman Razavi Ghahfarokhi, Zahra Tootak, Maryam Hadian, Fatemeh Abooali Shamshiri

Abstract:

Urinary tract infections (UTIs) have been reported in children with nephrotic syndrome. However, the only causes for the infection reported to date are bacteria, but not many prior reported occurrences of fungi or yeast as causative organisms. Hence, the present study aimed to describe the epidemiology of urinary tract fungal infections in a tertiary care pediatric. A single-center cross-sectional study was conducted at the nephrology ward of Aboozar Pediatric Hospital between March 21, 2021, and April 28, 2022. Urine was collected aseptically from children, inoculated onto culture media, and incubated at 37 °C for 18–48 hours. Yeast was identified following standard procedures. Antifungal susceptibility testing was determined by the disk diffusion method according to the CLSI guideline. Descriptive statistics and logistical regressions were used to estimate the crude ratio with a 95% confidence interval. P-value < 0.05 was considered significant. Among 68 individuals referred to the mycology lab, the result of direct examination and culture of all patients approved for C.albicans. Of these, 38 individuals (55.8%) were male, and 30 (44.2%) were female. The patients' age ranges were between one month and an 18-year-old. In the study of infection intensity, the patients were classified into three levels such as few (73.5%), moderate (20.6%), and many (5.9%). In the present study, all the patients were sensitive to Posaconazole. Also, the eagle effect was found in Amphotericin B, Voriconazole, and Fluconazole with frequencies of 91.7%, 91.7%, and 83%, respectively. In addition, just 8.3% of isolates were resistant to Itraconazole. It has not shown resistance in other mentioned medicine. The patients showed an intermediate response to Itraconazole (91.7%), Fluconazole (17%), Voriconazole (8.3%), and Amphotericin B (8.3%). There is a high prevalence of yeast infections in children with suspected UTIs. Also, boys are more likely to get yeast infections, and the severity of the infection is higher than girls. The present study demonstrated the importance of diagnosing and selecting the appropriate drug for urinary tract fungal infections in hospitalized children.

Keywords: urinary tract infections, children, fungal infections, yeast, antifungal susceptibility

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1604 Controlling Cocoa Pod Borer, Conopomorpha cramerella (Snell.) and Cost Analysis Production at Cacao Plantation

Authors: Alam Anshary, Flora Pasaru, Shahabuddin

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The Cocoa Pod Borer (CPB), Conopomorpha cramerella (Snell.) is present on most of the larger cocoa producing islands in Indonesia. Various control measures CPB has been carried out by the farmers, but the results have not been effective. This study aims to determine the effect of application of Beauveria bassiana treatments and pruning technique to the control of CPB in the cocoa plantation people. Research using completely randomized design with 4 treatments and 3 replications, treatment consists of B.bassiana, Pruning, B. bassiana+pruning (Bb + Pr), as well as the control. The results showed that the percentage of PBK attack on cocoa pods in treatment (Bb + Pr) 3.50% the lowest compared to other treatments. CPB attack percentage in treatment B.bassiana 6.15%; pruning 8.75%, and 15.20% control. Results of the analysis of production estimates, the known treatments (Bb + Pr) have the highest production (1.95 tonnes / ha). The model results estimated production is Y= 0,20999 + 0,53968X1 + 0,34298X2+ 0,31410X3 + 0,35629X4 + 0,08345X5 + 0,29732X6. Farm production costs consist of fixed costs and variable costs, fixed costs are costs incurred by the farmer that the size does not affect the results, such as taxes and depreciation of production equipment. Variable costs are costs incurred by farmers who used up in one year cocoa farming activities. The cost of production in farming cocoa without integrated techniques control of CPB is Rp. 9.205.550 million/ha, while the cost of production with integrated techniques control is Rp. 6.666.050 million/ha.

Keywords: cacao, cocoa pod borer, pruning, Beauveria bassiana, production costs

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1603 Agriculture Water Quality Evaluation in Minig Basin

Authors: Ben Salah Nahla

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The problem of water in Tunisia affects the quality and quantity. Tunisia is in a situation of water shortage. It was estimated that 4.6 Mm3/an. Moreover, the quality of water in Tunisia is also mediocre. In fact, 50% of the water has a high salinity (> 1.5g/l). There are several parameters which affect water quality such as sodium, fluoride. An excess of this parameter may induce some human health. Furthermore, the mining basin area has a problem of industrial waste. This problem may affect the water quality of the groundwater. Therefore, the purpose of this work is to assess the water quality in Basin Mining and the impact of fluorine. For this research, some water samples were done in the field and specific water analysis was implemented in the laboratory. Sampling is carried out on eight drilling in the area of the mining region. In the following, we will look at water view composition, physical and chemical quality. A physical-chemical analysis of water from a survey of the Mining area of Tunisia was performed and showed an excess for the following items: fluorine, sodium, sulfate. So many chemicals may be present in water. However, only a small number of them immediately concern in terms of health in all circumstances. Fluorine (F) is one particular chemical that is considered both necessary for the human body, but an excess of the rate of this chemical causes serious diseases. Sodium fluoride and sodium silicofluoride are more soluble and may spread in animals and plants where their toxicity largest organizations. The more complex particles such as cryolite and fluorite, almost insoluble, are more stable and less toxic. Thereafter, we will study the problem of excess fluorine in the water. The latter intended for human consumption must always comply with the limits for microbiological quality parameters and physical-chemical parameters defined by European standards (1.5 mg/l) and Tunisian (2 mg/l).

Keywords: water, minier basin, fluorine, silicofluoride

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1602 Assessing the Impact of the Rome II Regulation's General Rule on Cross-Border Road Traffic Accidents: A Critique of Recent Case Law

Authors: Emma Roberts

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The Rome II Regulation has established a uniform regime of conflict of law rules across the European Union (except for Denmark) which determines the law applicable in non-contractual obligations disputes. It marks a significant development towards the Europeanization of private international law and aims to provide the most appropriate connecting factors to achieve both legal certainty and justice in individual cases. Many non-contractual obligations are recognised to present such distinct factors that, to achieve these aims, a special rule is provided for determining the applicable law in cases in respect of product liability and environmental torts, for example. Throughout the legislative process, the European Parliament sought to establish a separate rule for road traffic accidents, recognising that these cases too present such novel situations that a blanket application of a lex loci damni approach would not provide an appropriate answer. Such attempts were rejected and, as a result, cases arising out of road traffic accidents are subject to the Regulation’s general lex loci damni rule along with its escape clause and limited exception. This paper offers a critique of the Regulation’s response to cross-border road traffic accident cases. In England and Wales, there have been few cases that have applied the Regulation’s provisions to date, but significantly the majority of such cases are in respect of road traffic accidents. This paper examines the decisions in those cases and challenges the legislators’ decision not to provide a special rule for such incidences. Owing to the diversity in compensation systems globally, applying the Regulation’s general rule to cases of road traffic accidents – given the breadth of matters that are to be subject to the lex cause – cannot ensure an outcome that provides ‘justice in individual cases’ as is assured by the Regulation's recitals. Not only does this paper suggest that the absence of a special rule for road traffic accidents means that the Regulation fails to achieve one of its principal aims, but it further makes out a compelling case for the legislative body of the European Union to implement a corrective instrument.

Keywords: accidents abroad, applicable law, cross-border torts, non-contractual obligations, road traffic accidents

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1601 Prevalence of Selected Cardiovascular Risk Factors Obesity among University of Venda Staff

Authors: Avhasei Dorothy Rasifudi, Josephine Mandizha

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Cardiovascular risk factors continue to be the leading cause of death in the majority of developed and developing countries. In 2011, the World Health Organization reported that every year an estimated 17 million people globally die of CVD, representing 30% of all global deaths, particularly caused by heart attacks and strokes. The purpose of the study was to determine and describe the prevalence of selected cardiovascular risk factors among university of Venda staff. A cross-sectional study was conducted among 100 staff aged 20-65 years. The anthropometric measurements were conducted in accordance to and with standardized procedures advocated by the International Society for the Advanced Kinanthropometry. Weight, Height, waist circumference and hip circumference were measured for calculation of body mass index and waist-hip ratio. Blood pressure was measured using a Heine cuff and sphygmomanometer. Questionnaire was administered to gather demographic details and cardiovascular risk factors of hypertension and obesity. Data were analyzed using mean and standard deviation. The parameter t-test was applied to test significance level at p ≤ 0.05 between sexes. The statistical significance was set at p ≤ 0.05. The prevalence of hypertension was 23% with the highest prevalence amongst those aged 40 years and above. Factors found to be to be significantly associated with hypertension were gender, age, physical inactivity and family history. Prevalence of obesity was 43%, with the highest prevalence among those aged 40 years. The factors associated with obesity were diet, age and physical activity. The prevalence of hypertension and obesity in the study were high.

Keywords: cardiovascular, prevalence, risk factors, staff

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1600 Estimation of World Steel Production by Process

Authors: Reina Kawase

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World GHG emissions should be reduced 50% by 2050 compared with 1990 level. CO2 emission reduction from steel sector, an energy-intensive sector, is essential. To estimate CO2 emission from steel sector in the world, estimation of steel production is required. The world steel production by process is estimated during the period of 2005-2050. The world is divided into aggregated 35 regions. For a steel making process, two kinds of processes are considered; basic oxygen furnace (BOF) and electric arc furnace (EAF). Steel production by process in each region is decided based on a current production capacity, supply-demand balance of steel and scrap, technology innovation of steel making, steel consumption projection, and goods trade. World steel production under moderate countermeasure scenario in 2050 increases by 1.3 times compared with that in 2012. When domestic scrap recycling is promoted, steel production in developed regions increases about 1.5 times. The share in developed regions changes from 34 %(2012) to about 40%(2050). This is because developed regions are main suppliers of scrap. 48-57% of world steel production is produced by EAF. Under the scenario which thinks much of supply-demand balance of steel, steel production in developing regions increases is 1.4 times and is larger than that in developed regions. The share in developing regions, however, is not so different from current level. The increase in steel production by EAF is the largest under the scenario in which supply-demand balance of steel is an important factor. The share reaches 65%.

Keywords: global steel production, production distribution scenario, steel making process, supply-demand balance

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1599 PTOP Expression Correlates with Telomerase Activity and Grades of Malignancy in Human Glioma Tissues

Authors: F. Polito, M. Cucinotta, A. Conti, C. Lo Giudice, C. Tomasello, F. Angileri, D. La Torre, M. Aguennouz

Abstract:

Glioblastoma multiforme (GBM) is the most aggressive form of brain tumors, with an extremely poor prognosis. Telomeres lenght is associated with tumor progression in several type of human cancers and telomere elongation is a common molecular feature of advanced malignancies. Among the telomeric shelterin proteins PTOP is required for telomeric protein complex assembly, telomerase recruitment and activity, and telomere length regulation through a PTOP-telomerase interaction. Previous studies suggest that PTOP upregulation is involved in radioresistance and telomere lengthening in colorectal cancer cells. Moreover, in human osteosarcoma cells PTOP deletion led to telomere shortening, increased apoptosis and radiation sensitivity enhancement. However, to date, little is known about the role of PTOP in progression of glioma cancers. In light of this background aim of the study is to investigate the expression of PTOP in different grades of human glioma and its correlation with the pathological grade of gliomas, grades of malignancy, proliferative activity and apoptosis. Fifteen Low Grade Astrocytomas (LGA), 18 Anaplastic Astrocytomas (AA) and 26 Glioblastoma Multiforme (GBM) samples were analyzed. Three samples of normal brain tissue (NBT) were used as controls. The expression levels of PTOP, h-TERT, BIRC1 and cyclin D1 were determined by real time PCR and/or western blot. Results obtained shows that PTOP expression in glioma tissues is tightly correlated with clinical grade ( p < 0.01 ). No correlation was found between PTOP expression and other clinicopathologic parameters. The expression of PTOP was positively correlated with the expression of hTERT and TERF1. Furthermore PTOP positively correlates with cyclin D1 and negatively correlates with the expression of BIRC1. Our findings indicate that PTOP might play key role in the progression of glioma regulating telomerase activity and likely through regulation of cell cycle and apoptosis. In conclusion results obtained prompted us to speculate that PTOP might represents a potential molecular bio marker and a therapeutic target for the treatment of glioblastoma tumors.

Keywords: glioblastoma, PTOP, telomere, brain tumors

Procedia PDF Downloads 327
1598 Measuring Banking Systemic Risk Conditional Value-At-Risk and Conditional Coherent Expected Shortfall in Taiwan Using Vector Quantile GARCH Model

Authors: Ender Su, Kai Wen Wong, I-Ling Ju, Ya-Ling Wang

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In this study, the systemic risk change of Taiwan’s banking sector is analyzed during the financial crisis. The risk expose of each financial institutions to the whole Taiwan banking systemic risk or vice versa under financial distress are measured by conditional Value-at-Risk (CoVaR) and conditional coherent expected shortfall (CoES). The CoVaR and CoES are estimated by using vector quantile autoregression (MVMQ-CaViaR) with the daily stock returns of each banks included domestic and foreign banks in Taiwan. The daily in-sample data covered the period from 05/20/2002 to 07/31/2007 and the out-of-sample period until 12/31/2013 spanning the 2008 U.S. subprime crisis, 2010 Greek debt crisis, and post risk duration. All banks in Taiwan are categorised into several groups according to their size of market capital, leverage and domestic/foreign to find out what the extent of changes of the systemic risk as the risk changes between the individuals in the bank groups and vice versa. The final results can provide a guidance to financial supervisory commission of Taiwan to gauge the downside risk in the system of financial institutions and determine the minimum capital requirement hold by financial institutions due to the sensibility changes in CoVaR and CoES of each banks.

Keywords: bank financial distress, vector quantile autoregression, CoVaR, CoES

Procedia PDF Downloads 364
1597 Nutritive Value of Three-Stage Olive Cake (Olea europaea L.) for Growing Rabbit

Authors: Zahia Dorbane, Si Ammar Kadi, Dalila Boudouma, Thierry Gidenne

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In rabbits feeding, minimum fibre intake is essential to avoid digestive disorders. However, this concentration of fibre is not easy to obtain when formulating feeds, without reduction of nutritional value. Three stage olive cake, the residual material after oil extraction by centrifugation, including pulp and stones, can be used as a fibre source in rabbit diet. The incorporation of olive cake can allow a better balance between different fibre fractions and reduce health disorder. However, for practical use of any raw material, it is necessary to know its chemical and nutritive value. The aim of this study was to assess the nutritive value of three-stage olive cake (TSOC) for growing rabbits. Thus, 36 rabbits weaned at 35 days (702.8 ± 28.5) were divided into three groups of 12 receiving one of the following diets: control with 0% of TSOC, TSOC10 (10% of TSOC) and TSOC20 (20% TSOC). The rabbits were individually housed in digestibility cages and received ad libitum one of the three diets, fresh and clean water was provided ad libitum. After an adaptation period of 7d, feces were collected for 4d. Collected feces were frozen and stored for further analysis. The chemical composition of TSOC shows that it is a rich fiber raw material since it contains (%DM): 6% of CP; 7.4% of EE; 78.7% of NDF; 55.4% of ADF and 24.3% of ADL. The inclusion of TSOC at 20% of basal diet reduced the digestibility coefficient of organic matter, crude protein and NDF from 67.8 to 55.3%, 80.4 to 75.3% and from 31.5 to 18.4% (p < 0.001) respectively. The digestible energy and digestible protein content of the three-stage olive cake estimated by regression was 2.94 ± 0.52MJ DE/kg DM and 22.4 ± 6 g DP/kg DM respectively. In conclusion, based on the results of the present experiment, the three-stage olive cake can be used as a fibre source for rabbit.

Keywords: digestibility, nutritive value, olive cake, rabbit

Procedia PDF Downloads 143
1596 Efficient Estimation for the Cox Proportional Hazards Cure Model

Authors: Khandoker Akib Mohammad

Abstract:

While analyzing time-to-event data, it is possible that a certain fraction of subjects will never experience the event of interest, and they are said to be cured. When this feature of survival models is taken into account, the models are commonly referred to as cure models. In the presence of covariates, the conditional survival function of the population can be modelled by using the cure model, which depends on the probability of being uncured (incidence) and the conditional survival function of the uncured subjects (latency), and a combination of logistic regression and Cox proportional hazards (PH) regression is used to model the incidence and latency respectively. In this paper, we have shown the asymptotic normality of the profile likelihood estimator via asymptotic expansion of the profile likelihood and obtain the explicit form of the variance estimator with an implicit function in the profile likelihood. We have also shown the efficient score function based on projection theory and the profile likelihood score function are equal. Our contribution in this paper is that we have expressed the efficient information matrix as the variance of the profile likelihood score function. A simulation study suggests that the estimated standard errors from bootstrap samples (SMCURE package) and the profile likelihood score function (our approach) are providing similar and comparable results. The numerical result of our proposed method is also shown by using the melanoma data from SMCURE R-package, and we compare the results with the output obtained from the SMCURE package.

Keywords: Cox PH model, cure model, efficient score function, EM algorithm, implicit function, profile likelihood

Procedia PDF Downloads 126
1595 Wave Pressure Metering with the Specific Instrument and Measure Description Determined by the Shape and Surface of the Instrument including the Number of Sensors and Angle between Them

Authors: Branimir Jurun, Elza Jurun

Abstract:

Focus of this paper is description and functioning manner of the instrument for wave pressure metering. Moreover, an essential component of this paper is the proposal of a metering unit for the direct wave pressure measurement determined by the shape and surface of the instrument including the number of sensors and angle between them. Namely, far applied instruments by means of height, length, direction, wave time period and other components determine wave pressure on a particular area. This instrument, allows the direct measurement i.e. measurement without additional calculation, of the wave pressure expressed in a standardized unit of measure. That way the instrument has a standardized form, surface, number of sensors and the angle between them. In addition, it is made with the status that follows the wave and always is on the water surface. Database quality which is listed by the instrument is made possible by using the Arduino chip. This chip is programmed for receiving by two data from each of the sensors each second. From these data by a pre-defined manner a unique representative value is estimated. By this procedure all relevant wave pressure measurement results are directly and immediately registered. Final goal of establishing such a rich database is a comprehensive statistical analysis that ranges from multi-criteria analysis across different modeling and parameters testing to hypothesis accepting relating to the widest variety of man-made activities such as filling of beaches, security cages for aquaculture, bridges construction.

Keywords: instrument, metering, water, waves

Procedia PDF Downloads 250
1594 A Framework Based on Dempster-Shafer Theory of Evidence Algorithm for the Analysis of the TV-Viewers’ Behaviors

Authors: Hamdi Amroun, Yacine Benziani, Mehdi Ammi

Abstract:

In this paper, we propose an approach of detecting the behavior of the viewers of a TV program in a non-controlled environment. The experiment we propose is based on the use of three types of connected objects (smartphone, smart watch, and a connected remote control). 23 participants were observed while watching their TV programs during three phases: before, during and after watching a TV program. Their behaviors were detected using an approach based on The Dempster Shafer Theory (DST) in two phases. The first phase is to approximate dynamically the mass functions using an approach based on the correlation coefficient. The second phase is to calculate the approximate mass functions. To approximate the mass functions, two approaches have been tested: the first approach was to divide each features data space into cells; each one has a specific probability distribution over the behaviors. The probability distributions were computed statistically (estimated by empirical distribution). The second approach was to predict the TV-viewing behaviors through the use of classifiers algorithms and add uncertainty to the prediction based on the uncertainty of the model. Results showed that mixing the fusion rule with the computation of the initial approximate mass functions using a classifier led to an overall of 96%, 95% and 96% success rate for the first, second and third TV-viewing phase respectively. The results were also compared to those found in the literature. This study aims to anticipate certain actions in order to maintain the attention of TV viewers towards the proposed TV programs with usual connected objects, taking into account the various uncertainties that can be generated.

Keywords: Iot, TV-viewing behaviors identification, automatic classification, unconstrained environment

Procedia PDF Downloads 217
1593 Globalisation, Growth and Sustainability in Sub-Saharan Africa

Authors: Ourvashi Bissoon

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Sub-Saharan Africa in addition to being resource rich is increasingly being seen as having a huge growth potential and as a result, is increasingly attracting MNEs on its soil. To empirically assess the effectiveness of GDP in tracking sustainable resource use and the role played by MNEs in Sub-Saharan Africa, a panel data analysis has been undertaken for 32 countries over thirty-five years. The time horizon spans the period 1980-2014 to reflect the evolution from before the publication of the pioneering Brundtland report on sustainable development to date. Multinationals’ presence is proxied by the level of FDI stocks. The empirical investigation first focuses on the impact of trade openness and MNE presence on the traditional measure of economic growth namely the GDP growth rate, and then on the genuine savings (GS) rate, a measure of weak sustainability developed by the World Bank, which assumes the substitutability between different forms of capital and finally, the impact on the adjusted Net National Income (aNNI), a measure of green growth which caters for the depletion of natural resources is examined. For countries with significant exhaustible natural resources and important foreign investor presence, the adjusted net national income (aNNI) can be a better indicator of economic performance than GDP growth (World Bank, 2010). The issue of potential endogeneity and reverse causality is also addressed in addition to robustness tests. The findings indicate that FDI and openness contribute significantly and positively to the GDP growth of the countries in the sample; however there is a threshold level of institutional quality below which FDI has a negative impact on growth. When the GDP growth rate is substituted for the GS rate, a natural resource curse becomes evident. The rents being generated from the exploitation of natural resources are not being re-invested into other forms of capital namely human and physical capital. FDI and trade patterns may be setting the economies in the sample on a unsustainable path of resource depletion. The resource curse is confirmed when utilising the aNNI as well, thus implying that GDP growth measure may not be a reliable to capture sustainable development.

Keywords: FDI, sustainable development, genuine savings, sub-Saharan Africa

Procedia PDF Downloads 202
1592 Comparative Evaluation of Pharmacologically Guided Approaches (PGA) to Determine Maximum Recommended Starting Dose (MRSD) of Monoclonal Antibodies for First Clinical Trial

Authors: Ibraheem Husain, Abul Kalam Najmi, Karishma Chester

Abstract:

First-in-human (FIH) studies are a critical step in clinical development of any molecule that has shown therapeutic promise in preclinical evaluations, since preclinical research and safety studies into clinical development is a crucial step for successful development of monoclonal antibodies for guidance in pharmaceutical industry for the treatment of human diseases. Therefore, comparison between USFDA and nine pharmacologically guided approaches (PGA) (simple allometry, maximum life span potential, brain weight, rule of exponent (ROE), two species methods and one species methods) were made to determine maximum recommended starting dose (MRSD) for first in human clinical trials using four drugs namely Denosumab, Bevacizumab, Anakinra and Omalizumab. In our study, the predicted pharmacokinetic (pk) parameters and the estimated first-in-human dose of antibodies were compared with the observed human values. The study indicated that the clearance and volume of distribution of antibodies can be predicted with reasonable accuracy in human and a good estimate of first human dose can be obtained from the predicted human clearance and volume of distribution. A pictorial method evaluation chart was also developed based on fold errors for simultaneous evaluation of various methods.

Keywords: clinical pharmacology (CPH), clinical research (CRE), clinical trials (CTR), maximum recommended starting dose (MRSD), clearance and volume of distribution

Procedia PDF Downloads 361
1591 Effect of Post and Pre Induced Treatment with Hesperidin in N-Methyl N-Nitrosourea Induced Mammary Gland Cancer in Female Sprague-Dawley Rats

Authors: Vinay Kumar Theendra

Abstract:

The main objective of the study is to evaluate the effectiveness of hesperidin in the treatment of breast cancer and causing less (or) no bone marrow depression which is the major side effect of the present anticancer drugs treating breast cancer, also to evaluate the mechanisms through which these compounds are exerting their effect. Breast cancer is induced by administering N-methyl N-Nitrosourea (MNU) at a dose of 50mg/kg body weight. Upon the termination of the experiment, the animals were sacrificed by the method of cervical dislocation. The animals were dissected along the ventral midline and were grossly examined for the presence of tumors. Then the tumours were removed along with the stroma. Vascular endothelial growth factor (VEGF) levels were estimated by using ELISA method. The first occurrence of palpable tumors was eight weeks after carcinogen treatment and the final tumour incidence was 100% in the MNU alone and topical treated rats. Whereas in rats of other treatment groups there is decreased tumour incidence which might be due to their antitumour activity. Hesperidin therapy inhibited angiogenesis which can be evident from the significant reduction in serum as well as tumour VEGF concentrations in comparison to the untreated mammary carcinoma bearing rats. Hesperidin is promising agents that exert direct antitumor and also antiangiogenic, antiproliferative and anti-inflammatory activities. Even though the potency is little lesser than standard drug vincristine, it has been proved to be safe without effecting haematological count.

Keywords: hesperidin, VEGF, COX 2, N-methyl N-nitrosourea

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1590 The Relationship between Caregiver Burden and Life Satisfaction of Caregivers of Elderly Individuals

Authors: Guler Duru Asiret, Cemile Kutmec Yilmaz, Gulcan Bagcivan, Tugce Turten Kaymaz

Abstract:

This descriptive study was conducted to determine the relationship between caregiver burden and life satisfaction who give home care to elderly individuals. The sample was recruited from the internal medicine unit and palliative unit of a state hospital located in Turkey on June 2016-2017. The study sample consisted of 231 primary caregiver family member, who met the eligibility criteria and agreed to participate in the study. The inclusion criteria were as follows: inpatient’s caregiver, primary caregiver for at least 3 months, at least 18 years of age, no communication problem or mental disorder. Data were gathered using an Information Form prepared by the researchers based on previous literature, the Zarit Burden Interview (ZBI), and the Satisfaction with Life Scale (SWLS). The data were analyzed using IBM SPSS Statistics software version 20.0 (SPSS, Chicago, IL). The descriptive characteristics of the participant were analyzed using number, percentage, mean and standard deviation. The suitability of normal distribution of scale scores was analyzed using Kolmogorov-Smirnov and Shapiro-Wilk test. Relationships between scales were analyzed using Spearman’s rank-correlation coefficient. P values less than 0.05 were considered to be significant. The average age of the caregivers was 50.11±13.46 (mean±SD) years. Of the caregivers, 76.2% were women, 45% were primary school graduates, 89.2% were married, 38.1% were the daughters of their patients. Among these, 52.4% evaluated their income level to be good. Of them, 53.6% had been giving care less than 2 years. The patients’ average age was 77.1±8.0 years. Of the patients, 55.8% were women, 56.3% were illeterate, 70.6% were married, and 97.4% had at least one chronic disease. The mean Zarit Burden Interview score was 35.4±1.5 and the Satisfaction with Life Scale score was 20.6±6.8. A negative relationship was found between the patients’ score average on the ZBI, and on the SWLS (r= -0.438, p=0.000). The present study determined that the caregivers have a moderate caregiver burden and the life satisfaction. And the life satisfaction of caregivers decreased as their caregiver burden increase. In line with the results obtained from the research, it is recommended that to increase the effectiveness of discharge training, to arrange training and counseling programs for caregivers to cope with the problems they experienced, to monitor the caregivers at regular intervals and to provide necessary institutional support.

Keywords: caregiver burden, family caregivers, nurses, satisfaction

Procedia PDF Downloads 157
1589 Association of Transmission Risk Factors Among HCV-infected Bangladeshi Patients With Different Genotypes

Authors: Nahida Sultana

Abstract:

Globally, an estimated 58 million people have chronic hepatitis C virus infection, with about 1.5 million new infections occurring per year. The hepatitis C virus is a blood-borne virus, and most infections occur through exposure to blood from unsafe injection practices, unsafe health care, unscreened blood transfusion, injection drug use, and sexual practices that lead to exposure to blood. Hepatitis C virus (HCV) causes chronic infections that mainly affect the liver leading to liver diseases. This study aimed to determine whether there is any significant association between HCV transmission risk factors in relation to genotypes in HCV-infected Bangladeshi patients. After quantification of HCV viral load, 36 samples were randomly selected for HCV genotyping and risk factor measurement. A greater proportion of genotype 1 (p > 0.05) patients (40%) underwent blood transfusion compared to patients (22.6%) with genotype 3 infections. More genotype 1 patient underwent surgery and invasive procedures (20%), and rather than those with genotype 3 patients (16.1%). The history of IDUs (25.8%) and sexual exposure (3.2%) are only prevalent in genotype 3 patients and absent in patients with genotype 1 (p >0.05). There was no significant statistical difference found in HCV transmission risk factors (blood transfusion, IDUs, Surgery& interventions, sexual transmission) between patients infected with genotypes 1 and 3. In HCV infection, genotype may have no relation to transmission risk factors among Bangladeshi patients.

Keywords: HCV genotype, alanine aminotransferase (ALT), HCV viral load, IDUs

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1588 Increasing Access to Upper Limb Reconstruction in Cervical Spinal Cord Injury

Authors: Michelle Jennett, Jana Dengler, Maytal Perlman

Abstract:

Background: Cervical spinal cord injury (SCI) is a devastating event that results in upper limb paralysis, loss of independence, and disability. People living with cervical SCI have identified improvement of upper limb function as a top priority. Nerve and tendon transfer surgery has successfully restored upper limb function in cervical SCI but is not universally used or available to all eligible individuals. This exploratory mixed-methods study used an implementation science approach to better understand these factors that influence access to upper limb reconstruction in the Canadian context and design an intervention to increase access to care. Methods: Data from the Canadian Institute for Health Information’s Discharge Abstracts Database (CIHI-DAD) and the National Ambulatory Care Reporting System (NACRS) were used to determine the annual rate of nerve transfer and tendon transfer surgeries performed in cervical SCI in Canada over the last 15 years. Semi-structured interviews informed by the consolidated framework for implementation research (CFIR) were used to explore Ontario healthcare provider knowledge and practices around upper limb reconstruction. An inductive, iterative constant comparative process involving descriptive and interpretive analyses was used to identify themes that emerged from the data. Results: Healthcare providers (n = 10 upper extremity surgeons, n = 10 SCI physiatrists, n = 12 physical and occupational therapists working with individuals with SCI) were interviewed about their knowledge and perceptions of upper limb reconstruction and their current practices and discussions around upper limb reconstruction. Data analysis is currently underway and will be presented. Regional variation in rates of upper limb reconstruction and trends over time are also currently being analyzed. Conclusions: Utilization of nerve and tendon transfer surgery to improve upper limb reconstruction in Canada remains low. There are a complex array of interrelated individual-, provider- and system-level barriers that prevent individuals with cervical SCI from accessing upper limb reconstruction. In order to offer equitable access to care, a multi-modal approach addressing current barriers is required.

Keywords: cervical spinal cord injury, nerve and tendon transfer surgery, spinal cord injury, upper extremity reconstruction

Procedia PDF Downloads 86