Search results for: curing days

Authors: Marcya Burden, Savonna Greer

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In the wake of social unrest around the world, protest movements have been captured like never before. As protest movements have evolved, so too have their visibility and sources of coverage. Long gone are the days of print media as our only glimpse into the action surrounding a protest. Now, with social networks such as Facebook, Instagram and Snapchat, we have access to real-time video footage of protest movements and human rights activism that can reach millions of people within seconds. This research paper investigated various social media network platforms’ statistical usage data in the areas of human rights activism and protest movements, paralleling with other past forms of media coverage. This research demonstrates that social networks are extremely important to protest movements and human rights activism. With over 2.9 billion users across social media networks globally, these platforms are the heart of most recent protests and human rights activism. This research shows the paradigm shift from the Selma March of 1965 to the more recent protests of Ferguson in 2014, Ni Una Menos in 2015, and End Sars in 2018. The research findings demonstrate that today, almost anyone may use their social networks to protest movement leaders and human rights activists. From a student to an 80-year-old professor, the possibility of reaching billions of people all over the world is limitless. Findings show that 82% of the world’s internet population is on social networks 1 in every 5 minutes. Over 65% of Americans believe social media highlights important issues. Thus, there is no need to have a formalized group of people or even be known online. A person simply needs to be engaged on their respective social media networks (Facebook, Twitter, Instagram, Snapchat) regarding any cause they are passionate about. Information may be exchanged in real time around the world and a successful protest can begin.

Keywords: activism, protests, human rights, networks

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Authors: S. M. M. Syairah, M. H. Rajikin, A. R. Sharaniza

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Several embryonic cellular mechanism including cell cycle, growth and apoptosis are regulated by phosphatidylinositol-3-kinase (PI3K)/Akt signaling pathway. The goal of present study is to determine the effects of annatto (Bixa orellana)-derived δ-tocotrienol (δ-TCT) on the regulations of PI3K/Akt genes in murine morula. Twenty four 6-8 week old (23-25g) female balb/c mice were randomly divided into four groups (G1-G4; n=6). Those groups were subjected to the following treatments for 7 consecutive days: G1 (control) received tocopherol stripped corn oil, G2 was given 60 mg/kg/day of δ-TCT mixture (contains 90% delta & 10% gamma isomers), G3 was given 60 mg/kg/day of pure δ-TCT (>98% purity) and G4 received 60 mg/kg/day α-TOC. On Day 8, females were superovulated with 5 IU Pregnant Mare’s Serum Gonadotropin (PMSG) for 48 hours followed with 5 IU human Chorionic Gonadotropin (hCG) before mated with males at the ratio of 1:1. Females were sacrificed by cervical dislocation for embryo collection 48 hours post-coitum. About fifty morula from each group were used in the gene expression analyses using Affymetrix QuantiGene Plex 2.0 Assay. Present data showed a significant increase (p<0.05) in the average number (mean + SEM) of morula produced in G2 (26.0 + 0.45), G3 (23.0 + 0.63) and G4 (25.0 + 0.73) compared to control group (G1 – 16.0 + 0.63). This is parallel with the high expression of PDK1 gene with increase of 2.75-fold (G2), 3.07-fold (G3) and 3.59-fold (G4) compared to G1 (1.78-fold). From the present data, it can be concluded that supplementation with δ-TCT(s) and α-TOC induced high expression of PDK1 in G2-G4 which enhanced the PI3K/Akt signaling activity, resulting in the increased number of morula.

Keywords: delta-tocotrienol, embryonic development, nicotine, vitamin E

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Authors: Elma C. Sultan

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The study concentrated on Vernacular Language Origin and Students’ Accent Neutralization of the College of Arts and Sciences fourth students in Samar State University, Catbalogan City answering respondent’s locale profile, vernacular language origin in terms of local dialect/s and domestic language/s used; the significant relationship between vernacular language origin and accent neutralization of the respondents; and the proposed activities to adopt in neutralizing students’ accent. It utilized the descriptive-correlational method of research determining the significant relationship between vernacular language origin and students’ accent neutralization. The researcher used: (1) questionnaire divided into three parts: the first part identified the students’ locale; the second part determined the respondents’ domestic language/s used while the third part identified their local language/s used, (2) validated accent neutralization assessment tool, (3) statistical treatments in the analysis of data: percentage to determine the profile of the students; chi-square test for independence to determine the significant relationship between vernacular language origin and students’ accent neutralization. Findings of the study showed that vowel and diphthong sound production, domestic and local languages in indigenous, and native dialects are significantly related to accent neutralization. While, slow reading speed has a higher possibility in affecting accent neutralization. These caused designing a 50-hour short-term program for accent neutralization focusing in the correct vowel and diphthong sounds production and appropriate reading speed in preparation for the respondents’ search for BPO employment. This short-term program ran for 5 hours in a day for five days in a week.

Keywords: accent neutralization, dialect, diphthongs, indigenous, language origin, language, native, reading speed, vernacular, vowels

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Authors: Kim Byeong-Gon, Lee Pureun-Haneul, Hong Jisu, Jang An-Soo

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Background: Diesel exhaust particles (DEPs) lead to trigger airway hyperresponsiveness (AHR) and airway dysfunction or inflammation in respiratory systems. Whether tight junction protein changes can contribute to development or exacerbations of airway diseases remain to be clarified. Objective: The aim of this study was to observe the effect of DEP on tight junction proteins in one airway both nose and lung in a mouse model. Methods: Mice were treated with saline (Sham) and exposed to 100 μg/m³ DEPs 1 hour a day for 5 days a week for 4 weeks and 8 weeks in a closed-system chamber attached to a ultrasonic nebulizer. Airway hyperresponsiveness (AHR) was measured and bronchoalveolar lavage (BAL) fluid, nasal lavage (NAL) fluid, lung and nasal tissue was collected. The effects of DEP on tight junction proteins were estimated using western blot, immunohistochemical in lung and nasal tissue. Results: Airway hyperresponsiveness and number of inflammatory cells were higher in DEP exposure group than in control group, and were higher in 4 and 8 weeks model than in control group. The expression of tight junction proteins CLND4, -5, and -17 in both lung and nasal tissue were significantly increased in DEP exposure group than in the control group. Conclusion: These results suggesting that CLDN4, -5 and -17 may be involved in the airway both nose and lung, suggesting that air pollutants cause to disruption of epithelial and endothelial cell barriers. Acknowledgment: This research was supported by Korea Ministry of Environment (MOE) as 'The Environmental Health Action Program' (2016001360009) and Soonchunhyang University Research Fund.

Keywords: diesel exhaust particles, air pollutant, tight junction, Claudin, Airway inflammation

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Authors: Juan Manuel Uriarte Lopez, Hector Raul Guemez Gaxiola, Javier Alonso Romo Rubio, Juan Manuel Romo Valdez

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The objective of this investigation was to determine the influence of the use of recycled vegetable oil from restaurants in the productive performance of sows in lactation. Twenty-four hybrids lactating sows (Landrace x Yorkshire) were divided into three treatments with eight sows per treatment. On day 107 of gestation, the sows were moved to the mesh floor maternity cages in an environment regulated by the environment regulated (2.4 × 0.6 m) contained an area (2.4 × 0.5 m) for newborn pigs on each side, all diets were provided as a dry powder, and the sows received free access to water throughout the experimental period. After farrowing, the sows were fasted for 12 hours, the daily feed ration gradually increased, and the sows had ad libitum access to feed on the fourth day. The diets used were corn-soybean meal-based, containing 0 (CONT), recycled vegetable oil 1.0 % (RVOL), or recycled vegetable oil 1.5 % (RVOH) for 30 days. The diets contained similar calculated levels of crude protein and metabolizable energy and contained vitamins and minerals that exceeded National Research Council (1998) recommendations; sows were fed three times daily. On day 30, piglets were weaned, and performances of lactating sows and nursery piglets were recorded. Results indicated that average daily feed intake (5.58, 5.55, and 5.49 kg for CONT, RVOL, and RVO, respectively) of sows were not affected (P > 0.05) by different dietary. There was no difference in the average body weight of piglets on the day of birth, with 1.33, 1.36, and 1.35 kg, respectively (P > 0.05). There was no difference in average body weight of piglets on day 30, with 6.91, 6.75, and 7.05 kg, respectively 0.05) between treatments numbers of weaned piglets per sow (9.95, 9.80, and 9.80) were not affected by treatments (P > 0.05).In conclusion, the substitution of virgin vegetable oil for recycled vegetable oil in the diet does not affect the productive performance of lactating sows.

Keywords: lactating, sow, vegetable, oil

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Authors: Muhammad Sajid Arshad, Sadaf Bashir

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In this study, the effects of pomegranate peel based edible coating were determined on safety and quality of chicken nuggets. Four treatment groups were prepared as control (without coating), coating with sodium alginate (SA) (1.5%), pomegranate peel powder (PPP) (1.5%), and combination of SA and PPP. There was a significant variation observed with respect to coating treatments and storage intervals. The chicken nuggets were subjected to refrigerated storage (40C) and were analyzed at regular intervals of 0, 7, 14 1 and 21 days. The microbiological quality was determined by total aerobic and coliform counts. Total aerobic (5.09±0.05 log CFU/g) and coliforms (3.91±0.06 log CFU/g) counts were higher in uncoated chicken nuggets whereas lower was observed in coated chicken nuggets having combination of SA and PPP. Likewise, antioxidants potential of chicken nuggets was observed by assessing total phenolic contents (TPC) and DPPH activity. Higher TPC (135.66 GAE/100g) and DPPH (64.65%) were found in combination with SA and PPP, whereas minimum TPC (91.38) and DPPH (41.48) was observed in uncoated chicken nuggets. Regarding the stability analysis of chicken nuggets, thiobarbituric acid reactive substances (TBARS) and peroxide value (POV) were determined. Higher TBARS (1.62±0.03 MDA/Kg) and POV (0.92±0.03 meq peroxide/kg) were found in uncoated chicken nuggets. Hunter color values were also observed in both uncoated and coated chicken nuggets. Sensorial attributes were also observed by the trained panelists. The higher sensory score for appearance, color, taste, texture and overall acceptability were observed in control (uncoated) while in coated treatments, it was found within acceptable limits. In nutshell, the combination of SA and PPP enhanced the overall quality, antioxidant potential, and stability of chicken nuggets.

Keywords: chicken nuggets, edible coatings, pomegranate peel powder, sodium alginate

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Authors: Mehieddine Bouatrous

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Recently bioactive ceramic materials have been applied in the biomedical field as bulk, granular, or coating materials for more than half a century. More recently, bone tissue engineering scaffolds made of highly porous bioactive ceramic, glass-ceramic, and composite materials have also been created. As a result, recent bioactive ceramic structures have a high bioactivity rate, an open pores network, and good mechanical characteristics simulating cortical bone. Cyclowollastonite frameworks are also suggested for use as a graft material. As a porogenous agent, various amounts of the polymethyl methacrylate (PMMA) powders were used in this study successfully to synthesize a highly interrelated, nanostructured porous cyclowollastonite with a large specific surface area where the morphology and porosity were investigated. Porous cyclowollastonite bioactive ceramics were synthesized with a cost-effective and eco-friendly wet chemical method. The synthesized biomaterial is bioactive according to in vitro tests and can be used for bone tissue engineering scaffolds where cyclowollastonite sintered dense discs were submerged in simulated body fluid (S.B.F.) for various periods of time (1-4 weeks), resulting in the formation of a dense and consistent layer of hydroxyapatite on the surface of the ceramics, indicating its good in vitro bioactivity. Therefore, the cyclowollastonite framework exhibits good in vitro bioactivity due to its highly interconnecting porous structure and open macropores. The results demonstrate that even after soaking for several days, the surface of cyclowollastonite ceramic can generate a dense and consistent layer of hydroxyapatite. The results showed that cyclowollastonite framework exhibits good in vitro bioactivity due to highly interconnecting porous structure and open macropores.

Keywords: porous, bioactive, biomaterials, S.B.F, cyclowollastonite, biodegradability

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Authors: Ho Seong Shin

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Introduction: A research in relation to wound healing also showed that platelet-rich plasma (PRP) was effective on normal tissue regeneration. Nonetheless, there is no evidence that when platelet-rich plasma was applied on diabetic wound, it normalize diabetic wound healing process. In this study, we have analyzed matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) expression to know the effect of PRP on diabetic wounds using Reverse transcription-polymerase chain reaction (RT-PCR) of MMP-2, MMP-9 mRNA. Materials and Methods: Platelet-rich plasma (PRP) was prepared from blood of 6 rats. The whole 120-mL was added immediately to an anticoagulant. Citrate phosphonate dextrose(CPD) buffer (0.15 mg CPDmL) in a ratio of 1 mL of CPD buffer to 5 mL of blood. The blood was then centrifuged at 220g for 20minutes. The supernatant was saved to produce fibrin glue. The participate containing PRP was used for second centrifugation at 480g for 20 minutes. The pellet from the second centrifugation was saved and diluted with supernatant until the platelet concentration became 900,000/μL. Twenty male, 4week-old OLETF rats were underwent operation; each rat had two wounds created on left and right sides. The each wound of left side was treated with PRP gel, the wound of right side was treated with physiologic saline gauze. Results: RT-PCR analysis; The levels of MMP-2 mRNA in PRP applied tissues were positively related to postwounding days, whereas MMP-2 mRNA expression in saline-applied tissues remained in 5day after treatment. MMP-9 mRNA was undetectable in saline-applied tissues for either tissue, except 3day after treatment. Following PRP-applied tissues, MMP-9 mRNA expression was detected, with maximal expression being seen at third day. The levels of MMP-9 mRNA in PRP applied tissues were reported high intensity of optical density related to saline applied tissues.

Keywords: diabetes, MMP-2, MMP-9, OLETF, PRP, wound healing MMP-9

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Authors: Pratap Sing, Chaman. K. Jadon, H. P. Meena, D. L.yadav, S. L. Yadav, Uditi Dhakad

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The experiment was conducted at Agricultural Research Station, Agriculture University, Kota, Rajasthan, India during kharif and rabi 2020-21 and 2021-22 to study the biofficacy of diclosulam and its residual effect on succeeding wheat crop. The treatments comprised of Diclosulam 84 % WDG viz. 6.25, 12.50, 25.00 and 37.50 g/ha as pre emergence (PE), Pendimethalin 30% EC 3.33 l/ha, Sulfentrazon 48% SC 750 g/ha, hand weeding at 30 and 45 DAS and weedy check, were evaluated in randomized block design in three replications. The experimental soil was clay in texture and non-calcareous. Experimental field was mainly dominated by grasses-Echinochloa colonum, E.crusgalli,Cynodon dactylon, Sedges-Cyperus rotundus and broad leaved weeds Celosia argentea and Digera arvensis.The result revealed that application of Diclosulam 84 % WDG 25 g/ha PE was found effective in controlling mostly weed species and registered higher weed control efficiency 81.2, 74.3, 69.6 per cent at 30, 45 days after sowing and at harvest. Diclosulam 84 % WDG (6.25-25.0 g/ha) was found selective to the soybean crop as no any phytotoxicity symptoms were observed. Among the herbicidal treatments, Diclosulam 84 % WDG 25 g/ha registered maximum and significantly higher soybean seed yield (1889 and 1431 kg/ha during kharif 2020 and 2021, respectively and was at par with Sulfentrazone 48% SC 750 g/ha and over weedy check( 1027 and 667 kg/ha).The wheat crop growth, yield attributes and seed yield were not influenced due to carry over effect of the Diclosulam 84 % WDG( 6.25-25.0 g/ha) and no any phytotoxicity symptoms were observed. Henceforth, the Diclosulam 84 % WDG 25.0 g/ha as pre emergence may be used in the soybean for effective weed control without carry over effect on succeeding wheat crop.

Keywords: Diclosulam, soybean, carry over effect, succeeding wheat

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Authors: Evgeny Pokushalov, Claire Garcia, Andrey Ponomarenko, John Smith, Michael Johnson, Inessa Pak, Evgenya Shrainer, Dmitry Kudlay, Leila Kasimova, Richard Miller

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This study evaluated the efficacy of an AI-guided dietary supplement regimen compared to a standard physician-guided regimen in managing Type 2 diabetes (T2D). A total of 160 patients were randomly assigned to either the AI-guided group (n=80) or the physician-guided group (n=80) and followed over 90 days. The AI-guided group received 5.3 ± 1.2 supplements per patient, while the physician-guided group received 2.7 ± 0.6 supplements per patient. The AI system personalized supplement types and dosages based on individual genetic and metabolic profiles. The AI-guided group showed a significant reduction in HbA1c levels from 7.5 ± 0.8% to 7.1 ± 0.7%, compared to a reduction from 7.6 ± 0.9% to 7.4 ± 0.8% in the physician-guided group (mean difference: -0.3%, 95% CI: -0.5% to -0.1%; p < 0.01). Secondary outcomes, including fasting plasma glucose, HOMA-IR, and insulin levels, also improved more in the AI-guided group. Subgroup analyses revealed that the AI-guided regimen was particularly effective in patients with specific genetic polymorphisms and elevated metabolic markers. Safety profiles were comparable between both groups, with no serious adverse events reported. In conclusion, the AI-guided dietary supplement regimen significantly improved glycemic control and metabolic health in T2D patients compared to the standard physician-guided approach, demonstrating the potential of personalized AI-driven interventions in diabetes management.

Keywords: Type 2 diabetes, AI-guided supplementation, personalized medicine, glycemic control, metabolic health, genetic polymorphisms, dietary supplements, HbA1c, fasting plasma glucose, HOMA-IR, personalized nutrition

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Authors: Leelavinothan Pari , Ayyasamy Rathinam

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Diabetes mellitus (DM) is a major and growing public health problem throughout the world. Pterocarpus marsupium (Roxb.) (Family: Fabaceae) is widely used as a traditional medicine to treat various diseases including diabetes. However, the molecular mechanism of Pterocarpus marsupium has not been investigated so far. Two fractions (2.5% and 5%) of extract from the medicinal plant, Pterocarpus marsupium (PME) were conducted in a dose dependent manner in streptozotocin (45 mg/kg b.w.) induced type 2 diabetic rats. Each fraction of PME was administered to diabetic rats intragastrically at a dose of 50, 100 and 200 mg/kg b.w for 45 days. The effective dose 200 mg/kg b.w of 5% fraction was more pronounced in reducing the levels of blood glucose (95.65 mg/dL) and glycosylated hemoglobin (HbA1c) (0.41 mg/g Hb), and increasing the plasma insulin (16.20 µU/mL) level. Moreover, PME (200 mg/kg b.w) significantly ameliorated lipid peroxidation products (thiobarbituric reactive substances, lipid hydroperoxides) enzymatic (superoxide dismutase, catalase and glutathione peroxidase) and non-enzymatic antioxidants (Vitamin C, Vitamin E and reduced glutathione) levels. The altered activities of the key enzymes of lipid metabolism along with the lipid profile in diabetic rats were significantly reverted to near normal levels by the administration of PME 5% 200 mg/kg b.w fraction. PME (200 mg/kg b.w) has the ability to reduce the inflammatory cytokines, such as TNF-α, IL-6 mRNA, as well as protein expression and apoptotic marker, such as caspase-3 enzyme in diabetic hepatic tissue. The above biochemical findings were also supported by histological studies such as improvement in pancreas and liver. Pterocarpus marsupium could effectively reduce the hyperglycemia, oxidative-stress, inflammation and hyperlipedimea in diabetic rats; hence it could be a useful drug in the management of diabetes without any side effects.

Keywords: diabetes mellitus, streptozotocin, Pterocarpus marsupium, lipid peroxidation, Antioxidants, inflammatory cytokines

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Authors: Kamel Abd Elaziz Mohamed

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Introduction: Drug related problems (DRPs) are of major concern, affecting patients of both sex. They impose considerable economic burden on the society and the health-care systems. Aim of the work: The aim of this work was to identify and categorize drug-related problems in adult intensive care unit. Patients and methods: The study was a prospective, observational study as eighty six patients were included. They were consecutively admitted to ICU through the emergency room or transferred from the general ward due to DRPs. Parameters included in the study as length of stay in ICU, need for cardiovascular support or mechanical ventilation, dialysis, as well as APACHE II score were recorded. Results: Drug related problems represent 3.6% of the total ICU admission. The median (range) of APACHE II score for 86 patients included in the study was 17 (10-23), and length of ICU stay was 2.4 (1.5-4.2) days. In 45 patients (52%), DRP was drug over dose (group 1), while other DRP was present in the other 41 patients (48%, group 11). Patients in group 1 were older (39 years versus 32 years in group 11), with significant impaired renal function. The need of inotropic drugs and mechanical ventilation as well as the length of stay (LOS) in ICU was significantly higher in group 1. There were no significant difference in GCS between both groups, however APACHE II score was significantly higher in group 1. Only four patients (4.6%) were admitted by suicidal attempt as well as three patients (3.4%) due to trauma drug-related admissions, all were in (group 1). Nineteen percent of the patients had drug related problem due to hypoglycaemic medication followed by tranquilizer (15%). Adverse drug effect followed by failure to receive medication were the most causes of drug problem in (group11).The total mortality rate was 4.6%, all of them were eventually non preventable. Conclusion: The critically ill patients admitted due to drug related problems represented a small proportion (3.6%) of admissions to the ICU. Hypoglycaemic medication was one of the most common causes of admission by drug related problems.

Keywords: drug related problems, ICU, cost, safety

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Authors: A. K. Srivastava, Sandeep K. Singh, A. K. Kulshetra

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Agriculture is the backbone of developing countries of Asian sub-continent like India. Uttar Pradesh is the most populous and fifth largest State of India. Total population of the state is 19.95 crore, which is 16.49% of the country that is more than that of many other countries of the world. Uttar Pradesh occupies only 7.36% of the total area of India. It is a well-established fact that agriculture has virtually been the lifeline of the State’s economy in the past for long and its predominance is likely to continue for a fairly long time in future. The total geographical area of the state is 242.01 lakh hectares, out of which 120.44 lakh hectares is facing various land degradation problems. This needs to be put under various conservation and reclamation measures at much faster pace in order to enhance agriculture productivity in the State. Keeping in view the above scenario Department of Agriculture, Government of Uttar Pradesh has formulated a multi-purpose project namely Bhoomi Sena for the entire state. The main objective of the project is to improve the land degradation using low cost technology available at village level. The total outlay of the project is Rs. 39643.75 Lakhs for an area of about 226000 ha included in the 12th Five Year Plan (2012-13 to 2016-17). It is expected that the total man days would be 310.60 lakh. An attempt has been made to use the space technology like remote sensing, geographical information system, at cadastral level for the overall management of agriculture engineering work which is required for the treatment of degradation of the land. After integration of thematic maps a proposed action plan map has been prepared for the future work.

Keywords: GPS, GIS, remote sensing, topographic survey, cadestral mapping

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Authors: Ya-Yi Yen

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The operating room is a medical environment full of high-risk, high-complexity and high-cost. In addition to assuring patient safety, the operating room should effort on the efficient and safe medical quality for the surgical patients of high risk, elders, and children. If the nursing staffs of operation room carry on the pre-operative visiting prior to surgery, the patient's anxiety and complications are expected to be alleviated, and the hospitalization days may also be shortened. Purpose: Applying the information system to enhance pre-operative visiting, case tracking, and effectiveness recording Method: (I) Application the information system to screen cases by integrating the operation scheduling, and linking the severe surgery codes, for to shorten the time to track cases of operative visiting. Through the improvement, the time required decreased to 1.5 minutes per day from 20 minutes per day, and nursing staffs’ satisfaction with satisfaction for tracking and visiting procedure of case increased to 86% from 54%. (II)The electronic establishment of the operative visiting record enhanced the integrity of the operative visiting record. The integrity rate was rise to 92% from 66%, while nursing staffs’ satisfaction with the visiting record increased to 82% from 61.3%. Since information technology continues evolving, the application of information technology is helpful to the integration of nursing information, simplification of processes, and saving of man-hours. This article introduces the application of information systems to simplify the processes and improve the effectiveness of operation visiting and tracking, including the saving of time, improving the integrity rate of record, and improving the satisfaction of nursing staffs.

Keywords: effectiveness, information system, perioperative nursing, pre-operative visiting

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Authors: Gokcen Akyurek, Hulya Kayihan, Deniz Yuce, Selen Yilmaz

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The stigma towards mental illness is still very rooted in our society, despite the number of studies, campaigns, and anti-stigma programs developed in recent years. Stigma represents a serious obstacle to recovery and social integration for people who experience a mental illness, affecting directly their well-being and quality of life. It implies that these persons have to deal with many other barriers apart from the disease symptoms (1-5). Convergent, recent literature suggests that less positive attitudes by mental health professionals interfere with the self-determination and recovery process (4-10).The aim of this study was to translate the Attribution Questionnaire-27 (AQ-27) to the Turkish language (AQ-27-T), and to examine the reliability and validity of this new Turkish version. Cultural adaptation was implemented according to the internationally suggested method. To determine the understandability and appropriateness of this measure for the Turkish culture, a pretest was administered and the final form was generated. Then, 424 randomly chosen people took part in the study. Participant’s mean age was 36.9±12.7 years and %52 of them female. Cronbach's alpha and intra-class coefficients were used to estimate instrument reliability. The AQ-27-T was assessed again 14 days later for test retest reliability. The AQ-27-T demonstrated acceptable internal consistency, with a Cronbach's alpha of 0.88 for the total scale and ranging between 0.86 and 0.89 for the items. The test-retest reliability was good, with Pearson correlation coefficients of 0.79 for the total scale and ranging between 0.35 and 0.77 for the items (p<0.05). Correlation between subscales was moderate-good, with Pearson correlation coefficients of 0.18-0.88 (p<0.05). Fit indices of the model supported the factor structure and paths. The AQ-27-T is a reliable measure to assess stigmatizing attitudes in Turkish.

Keywords: attribution questionnaire, validity, reliability, stigma

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Authors: Nasim Rasuli, Akram Ahmadi, Hossein Riahi, Zeinab Shariatmadari, Majid Ghorbani Nohooji, Pooyan Mehraban Joubani

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Cyanobacteria are one of the most promising sources of new biostimulants and have received much attention due to their diverse applications in biotechnology. These microorganisms enhance the growth and productivity of plants by producing plant growth stimulants and fixing atmospheric nitrogen. Thymus vulgaris L., a valuable medicinal plant from the Lamiaceae family, is widely distributed across the globe. essential oil of T. vulgaris is best characterized by the prominence of phenols, making them the key compounds in its composition. Lignin biosynthesis as a natural plant polyphenol plays a crucial role in promoting plant growth, strengthening cell walls, and increasing resistance to pathogens. In this study, the bioelicitor activity of five cyanobacterial suspensions including Anabaena torulosa ISB213, Nostoc calcicola ISB215, Nostoc ellipsosporum ISB217, Trichormus doliolum ISB214, and Oscillatoria sp. ISB2116 on the lignin content of the T. vulgaris L. was investigated. Pot experiments were performed by inoculation of a %2 algal extract to the soil of treated plants one week before planting and then every 20 days. After four months, the lignin content in the leaves of both treated and control plants was evaluated. The results demonstrated that the application of cyanobacteria significantly increased the lignin content in the leaves of treated plants compared to the control. The treatment with Oscillatoria sp. ISB216 and N. ellipsosporum ISB217 resulted in the highest lignin content, with an increase of 93.33% and 86.67%, respectively. These findings highlight the potential of cyanobacteria as bioelicitors, offering a viable alternative for enhancing the production of secondary metabolites in T. vulgaris. Consequently, this could contribute to the economic value of this medicinal plant.

Keywords: cyanobacteria, bioelicitor, thymus vulgaris, lignin

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Authors: Alfiah Hasanah, Silvia Mendolia, Oleg Yerokhin

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This paper explores the impacts of adult child migration on the health of elderly parents left behind. The maternal and children health are a priority of health-related policy in most low and middle-income country, and so there is lack of evidence on the health of older population particularly in Indonesia. With increasing life expectancy and limited access to social security and social services for the elderly in this country, the consequences of increasing number of out-migration of adult children to parent health are important to investigate. This study use Indonesia Family Life Survey (IFLS), the only large-scale continuing longitudinal socioeconomic and health survey that based on a sample of households representing about 83 percent of the Indonesian population in its first wave. Using four waves of IFLS including the recent wave of 2014, several indicators of the self-rated health status, interviewer-rated health status and days of illness are used to estimate the impact of labour out-migration of adult children on parent health status. Incorporate both individual fixed effects to control for unobservable factors in migrant and non-migrant households and the ordered response of self-rated health, this study apply the ordered logit of “Blow-up and Cluster” (BUC ) estimator. The result shows that labour out-migration of adult children significantly improves the self-rated health status of the elderly parent left behind. Findings of this study are consistent with the view that migration increases family resources and contribute to better health care and nutrition of the family left behind.

Keywords: aging, migration, panel data, self-rated health

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Authors: A. Alli-Oluwafuyi, A. Amin, S. M. Fii, S. O. Amusa, A. Imam, N. T. Asogwa, W. I. Abdulmajeed, F. Olaseinde, B. V. Owoyele

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Chronic stress or prolonged glucocorticoid administration impairs higher cognitive functions in rodents and humans. However, the mechanisms are not fully clear. Insulin and receptors are expressed in the brain and are involved in cognition. Insulin resistance accompanies Alzheimer’s disease and associated cognitive decline. The goal of this study was to evaluate the effects of sub-chronic administration of a glucocorticoid, dexamethasone (DEX) on behavior and biochemical changes in prefrontal cortex (PFC). Male Wistar rats were administered DEX (2, 4 & 8 mg/kg, IP) or saline for seven consecutive days and behavior was assessed in the following paradigms: “Y” maze, elevated plus maze, Morris’ water maze and novel object recognition (NOR) tests. Insulin, lactate dehydrogenase (LDH) and Superoxide Dismutase (SOD) activity were evaluated in homogenates of the prefrontal cortex. DEX-treated rats exhibited impaired prefrontal cortex function manifesting as reduced locomotion, impaired novel object exploration and impaired short- and long-term spatial memory compared to normal controls (p < 0.05). These effects were not consistently dose-dependent. These behavioral alterations were accompanied by a decrease in insulin concentration observed in PFC of 4 mg/kg DEX-treated rats compared to control (10μIU/mg vs. 50μIU/mg; p < 0.05) but not 2mg/kg. Furthermore, we report a modification of brain stress markers LDH and SOD (p > 0.05). These results indicate that prolonged activation of GCs disrupt prefrontal cortex function which may be related to insulin impairment. These effects may not be attributable to a non-specific elevation of oxidative stress in the brain. Future studies would evaluate mechanisms of GR-induced insulin loss.

Keywords: dexamethasone, insulin, memory, prefrontal cortex

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Authors: S. O. Obasa, J. A. Soaga, O. I. Afolabi, N. A. Bamidele, O. E. Babalola

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Attempt to improve the income of the rural population is a welcome development in Nigeria. Integrated fish-crop farming has been suggested as a means of raising farm income, reducing wastage and mitigating the risk component in production through the complementarity gain. A feeding trial was carried out to investigate the replacement of maize with fermented unripe plantain (Musa paradisiaca) peel meal in the diet of Nile tilapia, Oreochromis niloticus. The economics of the integrated enterprise was assessed using budgetary analysis techniques. The analysis incorporated the material and labour costs as well as the returns from sale of matured fish and plantain. A total of 60 fingerlings of Nile tilapia (1.70±0.1 g) were stocked at 10 per plastic tank. Two iso-nitrogenous diets containing 35% crude protein in which maize meal was replaced by fermented unripe plantain peel meal at 0% (FUP0/Control diet), and 100% (FUP100) were formulated and prepared. The fingerlings were fed at 5% body weight per day for 56 days. Lowest feed conversion ratio of 1.39 in fish fed diet FUP100 was not significantly different (P > 0.05) from the highest 1.42 of fish fed the Control diet. The highest percentage profit of 88.85% in fish fed diet FUP100 was significantly higher than 66.68% in fish fed diet FUP0, while the profit index of 1.89 in fish fed diet FUP100 was significantly different from 1.67 in fish fed diet FUP0. Therefore, fermented unripe plantain peel meal can completely replace maize in the diet of O. niloticus fingerlings. Profitability assessment shows that the net income from the integration was ₦ 463,000 per hectare and the integration resulted to an increase of ₦ 87,750.00 representing a 12.2% increase than in separate production.

Keywords: fish-crop, income, Nile tilapia, waste management

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Authors: Nasim Hossein Hamzeh, Karim Shukurov, Abbas Ranjbar Saadat Abadi, Alaa Mhawish, Christian Opp

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Deserts are the main dust sources in the world. Also, recently driedLake beds have caused environmental problems inthe surrounding areas in the world. In this study, the Urmia Lake was the source of dustfromApril 24 to April 25, 2017.The local dust storm was combined with another large-scale dust storm that originated from Saudi Arabia and Iraq 1-2 days earlier. Synoptic investigation revealed that the severe dust storm was made by a strong Black Sea cyclone and a low-pressure system over the Middle East and Central Iraq in conjunction a high-pressure system and associated with a high gradient contour and a quasi-stationary long-wave trough over the east and south of the Mediterranean Sea. Based on HYSPLIT 72 hours backward and forward trajectories, the most probable dust transport routes to and from the Urmia Lake region are estimated. Using the concentration weighted trajectory (CWT) method based on 24 hours backward and 24 hours forward trajectories, the spatial distributions of potential sources of PM10 observed in the Urmia Lake region on April 23-26, 2017. Also, the vertical profile of dust particles using the WRF-Chem model with two dust schemes showed dust ascending up to 5 km from the lake. Also, the dust schemes outputs shows that the PM10 fluctuating changes are 12 hours earlier than the measured surface PM10 at five air pollution monitoring stations around the Urmia Lake in 23-26 April 2017.

Keywords: dust storm, synoptic investigation, WRF-chem model, urmia lake, lagrangian trajectory

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Authors: Alireza Arab, Morteza Elsa, Amirhossein Moghanian

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In this study, experiments were carried out to achieve a promising multifunctional and modified silicate based bioactive glass (BG). The main aim of the study was investigating the effect of lithium (Li) and magnesium (Mg) substitution, on in vitro bioactivity of substituted-58S BG. Moreover, it is noteworthy to state that modified BGs were synthesized in 60SiO₂–(36-x)CaO–4P₂O₅–(x)Li₂O and 60SiO₂–(36-x)CaO–4P₂O₅–(x)MgO (where x = 0, 5, 10 mol.%) quaternary systems, by sol-gel method. Their performance was investigated through different aspects such as biocompatibility, antibacterial activity as well as their effect on alkaline phosphatase (ALP) activity, and proliferation of MC3T3 cells. The antibacterial efficiency was evaluated against methicillin-resistant Staphylococcus aureus bacteria. To do so, CaO was substituted with Li₂O and MgO up to 10 mol % in 58S-BGs and then samples were immersed in simulated body fluid up to 14 days and then, characterized by X-ray diffraction, Fourier transform infrared spectroscopy, inductively coupled plasma atomic emission spectrometry, and scanning electron microscopy. Results indicated that this modification led to a retarding effect on in vitro hydroxyapatite (HA) formation due to the lower supersaturation degree for nucleation of HA compared with 58s-BG. Meanwhile, magnesium revealed further pronounced effect. The 3-(4,5 dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide (MTT) and ALP analysis illustrated that substitutions of both Li₂O and MgO, up to 5 mol %, had increasing effect on biocompatibility and stimulating proliferation of the pre-osteoblast MC3T3 cells in comparison to the control specimen. Regarding to bactericidal efficiency, the substitution of either Li or Mg for Ca in the 58s BG composition led to statistically significant difference in antibacterial behaviors of substituted-BGs. Meanwhile, the sample containing 5 mol % CaO/Li₂O substitution (BG-5L) was selected as a multifunctional biomaterial in bone repair/regeneration due to the improved biocompatibility, enhanced ALP activity and antibacterial efficiency among all of the synthesized L-BGs and M-BGs.

Keywords: alkaline, alkaline earth, bioactivity, biomedical applications, sol-gel processes

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Authors: Aminah Muchdar

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To increase the genetic diversity of soybean in order to adapt to agroecology in Indonesia conducted ways including introduction, cross, mutation and genetic transformation. The purpose of this research is to obtain early maturity soybean mutant lines, large seed tolerant to drought with high yield potential. This study consisted of two stages: the first is sensitivity of gamma rays carried out in the Laboratory BATAN. The genetic variety used is Anjasmoro. The method seeds irradiated with gamma rays at a rate of activity with the old ci 1046.16976 irradiation 0-71 minutes. Irradiation doses of 0, 100, 200, 300, 400, 500, 600, 700, 800, 900 and 1000gy. The results indicated all seeds irradiated with doses of 0 - 1000gy, just a dose of 200 and 300gy are able to show the percentage of germination, plant height, number of leaves, number of normal sprouts and green leaves of the best and can be continued for a second trial in order to assemble and to get mutants which is expected. The result of second stage of soybean M2 Population irradiated with diversity Gamma Irradiation performed that in the form of soybean planting, the seed planted is the first derivative of the M2 irradiated seeds. The result after the age of 30ADP has already showing growth and development of plants that vary when compared to its parent, both in terms of plant height, number of leaves, leaf shape and leaf forage level. In the generative phase, a plant that has been irradiated 200 and 300 gy seen some plants flower form packs, but not formed pods, there is also a form packs of flowers, but few pods produce soybean morphological characters such as plant height, number of branches, pods, days to flowering, harvesting, seed weight and seed number.

Keywords: gamma ray, genetic mutation, irradiation, soybean

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Authors: Sujeet Poudyal

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Introduction: After Holmium:yttrium-aluminum-garnet (Ho: YAG) laser has revolutionized the management of urolithiasis, the introduction of Thulium fibre laser (TFL) has already challenged Ho:YAG laser due to its multiple commendable properties. Nevertheless, there are only few studies comparing TFL and holmium laser in Retrograde Intrarenal Surgery(RIRS). Therefore, this study was carried out to compare the efficacy and safety of thulium fiber laser (TFL) and holmium laser in RIRS. Methods: This prospective comparative study, which included all patients undergoing laser lithotripsy (RIRS) for proximal ureteric calculus and nephrolithiasis from March 2022 to March 2023, consisted of 63 patients in Ho:YAG laser group and 65 patients in TFL group. Stone free rate, operative time, laser utilization time, energy used, and complications were analysed between the two groups. Results: Mean stone size was comparable in TFL (14.23±4.1 mm) and Ho:YAG (13.88±3.28 mm) group, p-0.48. Similarly, mean stone density in TFL (1269±262 HU) was comparable to Ho:YAG (1189±212 HU), p-0.48. There was significant difference in lasing time between TFL (12.69±7.41 mins) and Ho:YAG (20.44±14 mins), p-0.012). TFL group had operative time of 43.47± 16.8 mins which was shorter than Ho:YAG group (58±26.3 mins),p-0.005. Both TFL and Ho:YAG groups had comparable total energy used(11.4±6.2 vs 12±8 respectively, p-0.758). Stone free rate was 87%for TFL, whereas it was 79.5% for Ho:YAG, p-0.25). Two cases of sepsis and one ureteric stricture were encountered in TFL, whereas three cases suffered from sepsis apart from one ureteric stricture in Ho:YAG group, p-0.62). Conclusion: Thulium Fibre Laser has similar efficacy as Holmium: YAG Laser in terms of safety and stone free rate. However, due to better stone ablation rate in TFL, it can become the game changer in management of urolithiasis in the coming days.

Keywords: retrograde intrarenal surgery, thulium fibre laser, holmium:yttrium-aluminum-garnet (ho:yag) laser, nephrolithiasis

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Authors: Deependra Prasad Sarraf, Ashish Shrestha, Mehul Rajesh Jaisani, Gajendra Prasad Rauniar

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Background: Honey is the worlds’ oldest known wound dressing. Its wound healing properties are not fully established till today. Concerns about antibiotic resistance, and a renewed interest in natural remedies have prompted the resurgence in the antimicrobial and wound healing properties of Honey. Evidence from animal studies and some trials has suggested that honey may accelerate wound healing in burns, infected wounds and open wounds. None of these reports have documented the effect of honey on the healing of socket after tooth extraction. Therefore, the present experimental study was planned to evaluate the efficacy of honey on the healing of socket after tooth extraction in rabbits. Materials and Methods: An experimental study was conducted in six New Zealand White rabbits. Extraction of first premolar tooth on both sides of the lower jaw was done under anesthesia produced by Ketamine and Xylazine followed by application of honey on one socket (test group) and normal saline (control group) in the opposite socket. The intervention was continued for two more days. On the 7th day, the biopsy was taken from the extraction site, and histopathological examination was done. Student’s t-test was used for comparison between the groups and differences were considered to be statistically significant at p-value less than 0.05. Results: There was a significant difference between control group and test group in terms of fibroblast proliferation (p = 0.0019) and bony trabeculae formation (p=0.0003). Inflammatory cells were also observed in both groups, and it was not significant (p=1.0). Overlying epithelium was hyperplastic in both the groups. Conclusion: The study showed that local application of honey promoted the rapid healing process particularly by increasing fibroblast proliferation and bony trabeculae.

Keywords: honey, extraction wound, Nepal, healing

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Authors: Farid Rezaei, Zahra Reza Soltani, Behrouz Tavana, Afsaneh Dadarkhah, Masoume Bahrami Asl, S. Alireza Mirghasemi

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Introduction: Fibromyalgia is a syndrome comprised of a group of symptoms. The primary symptom of fibromyalgia is pain propagation is associated by Secondary symptoms include fatigue, cognitive disorders, sleep disorders and hypersensitivity to painful stimuli. Recent studies have shown that there is a direct relationship between fibromyalgia and certain changes in brain activity. Aim: The aim of this study is determining the effect of tDCS in pain and quality of life in patients with fibromyalgia. Method: 68 patients with fibromyalgia who had inclusion criterias were randomly divided into two groups of case and control. Groups were matched in terms of gender, age, education, duration of pain and PMS. Patient groups treated with tDCS device manufacture by Enraf company made in Netherlands (M1 anodal stimulation, 2 mA constant current, 20 minutes, for 10 sessions (3 days a week)). Also the protocol was done for control group, in sham mode of tDCS device that had no current, for 10 sessions of 20 minutes. Before treatment, immediately after the end of 10 sessions treatment (short-term) and 10 week later (long-term effect), pain intensity questionnaires (VAS) and quality of life in fibromyalgia patients questionnaire was completed by the patient. Results: Pain intensity were significantly lower in the treatment group than the sham group 2 weeks and 10 weeks after treatment than before treatment (P < 0.001). Although the quality of life of patients 2 weeks after treatment showed no significant change, but ten weeks after treatment were more than sham group (P < 0.0001). Conclusion: Our results suggest that tDCS is a safe and effective in treating fibromyalgia patients and an important effect in reducing pain and increasing quality of their life.

Keywords: fibromyalgia, tDCS, quality of life, VAS score

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Authors: Ali Taheri Mirghaed, Sara Ahani, Ashkan Zargar, Seyyed Morteza Hoseini

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Diseases are the major challenges in intensive aquaculture that cause significant annual losses. Antibiotic-therapy is a common way to control bacterial disease in fish, and oxytetracycline (OTC) is the only oral antibiotic in aquaculture approved FDA. OTC has been found to have negative effects on fish, such as oxidative stress and immune-suppression, thus, it is necessary to mitigate such effects. Medicinal herbs have various benefits on fish, including antioxidant, immunostimulant, and anti-microbial effects. Therefore, we hypothesized if dietary ginger meal (GM) interacts with dietary OTC by monitoring plasma protein fractions in rainbow trout. The study was conducted as a 2 × 2 factorial design, including diets containing 0 and 1% GM and 0 and 1.66 % OTC (corresponding to 100 mg/kg fish biomass per day). After ten days treating the fish (60 g individual weight) with these feeds, blood samples were taken from al treatments (n =3). Plasma was separated by centrifugation, and protein fractions were determined by electrophoresis. The results showed that OTC and GM had interaction effects on total protein (P<0.001), albumin (P<0.001), alpha-1 fraction (P=0.010), alpha-2 fraction (P=0.001), beta-2 fraction (P=0.014), and gamma fraction (P<0.001). Beta-1 fraction was significantly (P=0.030) affected by dietary GM. GM decreased plasma total protein, albumin, and beta-2 but increased beta-1 fraction. OTC significantly decreased total protein (P<0.001), albumin (P=0.001), alpha-2 fraction (P<0.001), beta-2 fraction (P=0.004), and gamma fraction (P<0.001) but had no significant effects on alpha-1 and beta-1 fractions. Dietary GM inhibited/suppressed the effects of dietary OTC on the plasma total protein and protein fractions. In conclusion, adding 1% GM to diet can mitigate the negative effects of dietary OTC on plasma proteins. Thus, GM may boost health of rainbow trout during the period of medication with OTC.

Keywords: ginger, plasma protein electrophoresis, dietary additive, rainbow trout

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Authors: Sharjeel Abid, Tanveer Hussain, Ahsan Nazir, Abdul Zahir, Nabyl Khenoussi

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Localized application of drug has various advantages and fewer side effects as compared with other methods. Burn patients suffer from swear pain and the major aspects that are considered for burn victims include pain and infection management. Nano-fibers (NFs) loaded with drug, applied on local wound area, can solve these problems. Therefore, this study dealt with the fabrication of drug loaded NFs for better pain management. Two layers of NFs were fabricated with different drugs. Contact layer was loaded with Gabapentin (a nerve painkiller) and the second layer with acetaminophen. The fabricated dressing was characterized using scanning electron microscope, Fourier Transform Infrared Spectroscopy, X-Ray Diffraction and UV-Vis Spectroscopy. The double layered based NFs dressing was designed to have both initial burst release followed by slow release to cope with pain for two days. The fabricated nanofibers showed diameter < 300 nm. The liquid absorption capacity of the NFs was also checked to deal with the exudate. The fabricated double layered dressing with dual drug loading and release showed promising results that could be used for dealing pain in burn victims. It was observed that by the addition of drug, the size of nanofibers was reduced, on the other hand, the crystallinity %age was increased, and liquid absorption decreased. The combination of fast nerve pain killer release followed by slow release of non-steroidal anti-inflammatory drug could be a good tool to reduce pain in a more secure manner with fewer side effects.

Keywords: pain management, burn wounds, nano-fibers, controlled drug release

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Authors: Gopika Rajagopal, Sudheesh Thiyyakkandi

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Back-to-back reinforced earth (RE) walls are extensively used in these days as bridge abutments and highway ramps, owing to their cost efficiency and ease of construction. High quality select fill is the most suitable backfill material due to its excellent engineering properties and constructability. However, industries are compelled to use low quality, locally available soil because of its ample availability on site. However, several failure cases of such walls are reported, especially subsequent to rainfall events. The stiffness of reinforcement is one of the major factors affecting the performance of RE walls. The present study focused on analyzing the effect of reinforcement stiffness on the performance of complete select fill, complete marginal fill, and hybrid-fill (i.e., combination of select and marginal fills) back-to-back RE walls, immediately after construction and upon rainwater infiltration through finite element modelling. A constant width to height (W/H) ratio of 3 and height (H) of 6 m was considered for the numerical analysis and the stiffness of reinforcement layers was varied from 500 kN/m to 10000 kN/m. Results showed that reinforcement stiffness had a noticeable influence on the response of RE wall, subsequent to construction as well as rainwater infiltration. Facing displacement was found to decrease and maximum reinforcement tension and factor of safety were observed to increase with increasing the stiffness of reinforcement. However, beyond a stiffness of 5000 kN/m, no significant reduction in facing displacement was observed. The behavior of fully marginal fill wall considered in this study was found to be reasonable even after rainwater infiltration when the high stiffness reinforcement layers are used.

Keywords: back-to-back reinforced earth wall, finite element modelling, rainwater infiltration, reinforcement stiffness

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Authors: Ni Luh Putu Harta Wedari

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Background: Clostridium difficile has two main virulence factors, namely TcdA and TcdB. TcdA encoded by the tcdA gene acts as an enterotoxin, pro-inflammatory and fluid accumulation, while TcdB encoded by the tcdB gene is cytotoxic, causes disruption of the actin cytoskeleton, and causes disruption of tight junctions in colon cells. This study aims to explore the relationship between the tcdA and tcdB genes and the duration of diarrhea in elderly patients. Method: This research was an observational analytic with a prospective cross-sectional with samples of elderly diarrhea patients who met the inclusion criteria in Denpasar City health service facilities from 1 December 2022 until 30 June 2023, and then their feces were analyzed using the real-time PCR method. Results: In this study, 40 elderly diarrhea patients met the inclusion criteria and in accordance with the minimum sample size, 28 (70%) men and 12 (30%) women. 5 patients (12.5%) had a history of azithromycin, 4 (10%) levofloxacin, 17 (42.5%) ciprofloxacin, 8 (20%) metronidazole, 1 (2.5%) cefoperazone, 5 (12, 5%) doxycycline. Comorbids, namely 13 (32.5%) type II diabetes mellitus, 4 (10%) chronic kidney disease, 10 (25%) malignancies, 7 (17.5%) urinary tract infections, 3 (7.5%) %) immunocompromised, 2 (5%) cardiac heart failure, and 1 (2.5%) acute on chronic kidney disease. The overall diarrhea duration average was 5 days. 8 samples (20%) were positive for 16s rRNA, and there was no significant difference in diarrhea duration with negative samples (p=0.166). The relationship between the tcdA gene and the duration of diarrhea could not be performed because all samples were negative. Likewise, relationship analysis between the coexistence of tcdA and tcdB could not be performed. There was no significant difference between tcdB positive 3 (7.5%) and negative with diarrhea duration (p=0.739). Conclusion: There is no significant relationship between the presence of the 16s rRNA and tcdB C. difficile genes with the duration of diarrhea in elderly patients.

Keywords: clostridium, difficile, diarrhea, elderly, tcdA, tcdB

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Authors: Fergus Wade, Jasmine Makker, Matthew Jankinson, Aminah Qamar, Gemma Morrelli, Shayan Shah

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Background: Ambulance offload delays (AODs) affect patient outcomes. At baseline, the average AOD at Princess Royal University Hospital (PRUH) was 41 minutes, in breach of the 15-minute target. Aims: By February 2023, we aimed to reduce: the average AOD to 30 minutes percentage of AOD >30 minutes (PA30) to 25% and >60 minutes (PA60) to 10% Methods: Following a root-cause analysis, we implemented 2 Plan, Do, Study, Act (PDSA) cycles. PDSA-1 ‘Drop-and-run’: ambulances waiting >15 minutes for a handover left the patients in the Emergency Department (ED) and returned to the community. PDSA-2: Booking in the patients before the handover, allowing direct updates to online records, eliminating the need for handwritten notes. Outcome measures: AOD, PA30, and PA60, and process measures: total ambulances and patients in the ED were recorded for 16 weeks. Results: In PDSA-1, all parameters increased slightly despite unvarying ED crowding. In PDSA-2, two shifts in data were seen: initially, a sharp increase in the outcome measures consistent with increased ED crowding, followed by a downward shift when crowding returned to baseline (p<0.01). Within this interval, the AOD reduced to 29.9 minutes, and PA30 and PA60 were 31.2% and 9.2% respectively. Discussion/conclusion: PDSA-1 didn’t result in any significant changes; lack of compliance was a key cause. The initial upward shift in PDSA-2 is likely associated with NHS staff strikes. However, during the second interval, the AOD and the PA60 met our targets of 30 minutes and 10%, respectively, improving patient flow in the ED. This was sustained without further input and if maintained, saves 2 paramedic shifts every 3 days.

Keywords: ambulance offload, district general hospital, handover, quality improvement

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