Search results for: family medicine residents
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5074

Search results for: family medicine residents

2344 The Impact of E-Learning on Medication Administration of Nursing Students

Authors: Z. Karakus, Z. Ozer

Abstract:

Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement, or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery, and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.

Keywords: e-learning, medication administration, nursing, nursing students

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2343 Identification of a Cardiovirus in Feces of Wild Rats Through Viral Metagenomics

Authors: Shama Shama, Asif Mahmood, Wen Zhang

Abstract:

Cardiovirus is a genus of viruses belonging to the family Picornaviridae. Here, we used viral metagenomic techniques to detect the viral nucleic acid in the fecal samples from wild rats in Zhenjiang city in China. Fecal samples were collected from 20 wild rats and pooled into four sample pools and then subjected to library construction, which were then sequenced on the Illumina MiSeq platform. The sequenced reads were analyzed using a viral metagenomic analysis pipeline. A cardiovirus from the feces of a wild rat was identified, named amzj-2018, of which the complete genome was acquired. Phylogenetic analysis based on the complete amino acid sequence of polyprotein revealed that amzj-2018 formed a separate branch located between clusters of Saffold virus and Rat Theilovirus 1 (RTV-1). Phylogenetic analysis based on different regions of the polyproteins, including P1, P2, P3, and P2+P3, respectively, showed discordant trees, where the tree based on the P3 region indicated that amzj-2018 clustered separately between Theiler's murine encephalomyelitis virus and RTV-1. The complete genome of a cardiovirus was determined from the feces of wild rats, which belonged to a novel type of cardiovirus based on phylogenetic analysis. Whether it is associated with disease needs further investigation.

Keywords: viral metagenomics, viruses, cardiovirus, phylogenetic analysis

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2342 Motivating Factors of Couple Involvement in Copreneurship Businesses in Malaysia

Authors: Norasmah Othman, Suzana Mohamed, Salpiah Suradi

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Copreneurship is a term used to describe the business pattern of operations run by married couples who share commitment, goals, and responsibilities in handling a business. Research conducted overseas showed that copreneurship business activities grew quickly and played a role in elevating families’ and nations’ socio-economic standards. In Malaysia, copreneurship has long been cultivated by spouses. Thus, this study aimed to explore the factors that motivate married partners to start a copreneurship business, and who is the dominant partner in the management of this business. The study participants are four entrepreneurial couples who are SME business operators selected through purposive sampling. In-depth interviews and direct observation were used as methods of measurement for triangulation of qualitative data in this study. The findings of the interviews were administered using NVivo 8.0 software. The result shows that freedom is a key factor that drives entrepreneurs to set up copreneurship businesses, and that the husband dominates the management aspects of the business. The study gives an overview of the parties involved in entrepreneurship to provide understanding of the copreneurship concept as it is practiced. This study provides academic value by creating understanding of the importance of a harmonious family institution specifically for forming entrepreneurs in the familial environment in Malaysia.

Keywords: copreneurs, copreneurship, business management, enterprise

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2341 Stromal Vascular Fraction Regenerative Potential in a Muscle Ischemia/Reperfusion Injury Mouse Model

Authors: Anita Conti, Riccardo Ossanna, Lindsey A. Quintero, Giamaica Conti, Andrea Sbarbati

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Ischemia/reperfusion (IR) injury induces muscle fiber atrophy and skeletal muscle fiber death with subsequently functionality loss. The heterogeneous pool of cells, especially mesenchymal stem cells, contained in the stromal vascular fraction (SVF) of adipose tissue could promote muscle fiber regeneration. To prevent SVF dispersion, it has been proposed the use of injectable biopolymers that work as cells carrier. A significant element of the extracellular matrix is hyaluronic acid (HA), which has been widely used in regenerative medicine as a cell scaffold given its biocompatibility, degradability, and the possibility of chemical functionalization. Connective tissue micro-fragments enriched with SVF obtained from mechanical disaggregation of adipose tissue were evaluated for IR muscle injury regeneration using low molecular weight HA as a scaffold. IR induction. Hindlimb ischemia was induced in 9 athymic nude mice through the clamping of the right quadriceps using a plastic band. Reperfusion was induced by cutting the plastic band after 3 hours of ischemic period. Contralateral (left) muscular tissue was used as healthy control. Treatment. Twenty-four hours after the IR induction, animals (n=3) were intramuscularly injected with 100 µl of SVF mixed with HA (SVF-HA). Animals treated with 100 µl of HA (n=3) and 100 µl saline solution (n=3) were used as control. Treatment monitoring. All animals were in vivo monitored by magnetic resonance imaging (MRI) at 5, 7, 14 and 18 days post-injury (dpi). High-resolution morphological T2 weighed, quantitative T2 map and Dynamic Contrast-Enhanced (DCE) images were acquired in order to assess the regenerative potential of SVF-HA treatment. Ex vivo evaluation. After 18 days from IR induction, animals were sacrificed, and the muscles were harvested for histological examination. At 5 dpi T2 high-resolution MR images clearly reveal the presence of an extensive edematous area due to IR damage for all groups identifiable as an increase of signal intensity (SI) of muscular and surrounding tissue. At 7 dpi, animals of the SVF-HA group showed a reduction of SI, and the T2relaxation time of muscle tissue of the HA-SVF group was 29±0.5ms, comparable with the T2relaxation time of contralateral muscular tissue (30±0.7ms). These suggest a reduction of edematous overflow and swelling. The T2relaxation time at 7dpi of HA and saline groups were 84±2ms and 90±5ms, respectively, which remained elevated during the rest of the study. The evaluation of vascular regeneration showed similar results. Indeed, DCE-MRI analysis revealed a complete recovery of muscular tissue perfusion after 14 dpi for the SVF-HA group, while for the saline and HA group, controls remained in a damaged state. Finally, the histological examination of SVF-HA treated animals exhibited well-defined and organized fibers morphology with a lateralized nucleus, similar to contralateral healthy muscular tissue. On the contrary, HA and saline-treated animals presented inflammatory infiltrates, with HA slightly improving the diameter of the fibers and less degenerated tissue. Our findings show that connective tissue micro-fragments enriched with SVF induce higher muscle homeostasis and perfusion restoration in contrast to control groups.

Keywords: ischemia/reperfusion injury, regenerative medicine, resonance imaging, stromal vascular fraction

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2340 School Choice and Institutional or Familial Habitus: Reciprocity in Parents-School Relationships

Authors: Fatemeh Yazdani

Abstract:

This paper explores the student intake policies in high-performing private schools in Iran by studying both sides involved in the school choice processes, parents and the school leaders. It is based on in-depth interviews with 27 parents and private schools’ staff and principals supplemented by ethnographic observation in two private schools in Tehran. From the Bourdieusian point of view, this paper argues that the school leadership engineers the composition of private schools’ students via different gatekeeping strategies, and these strategies represent and reconstruct the school’s institutional habitus. It further explores the ways that parents who look for quality education among non-state education providers deal with the school's institutional habitus based on their familial habitus and possessed economic, social, and cultural capital. The conclusion highlights that investigating school choice as a reciprocal process between family and school leadership can shed more light on the ways that an exclusive environment has been created in some high-performing private schools for certain class strata maintaining a distance that needs to be kept from ‘others.’ In a broader sense, this paper engages into an exploration of social inequality reproduction through private education.

Keywords: institutional habitus, private education, school choice, social inequality, student intake

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2339 Assessment of the Radiation Absorbed Dose Produced by Lu-177, Ra-223, AC-225 for Metastatic Prostate Cancer in a Bone Model

Authors: Maryam Tajadod

Abstract:

The treatment of cancer is one of the main challenges of nuclear medicine; while cancer begins in an organ, such as the breast or prostate, it spreads to the bone, resulting in metastatic bone. In the treatment of cancer with radiotherapy, the determination of the involved tissues’ dose is one of the important steps in the treatment protocol. Comparing absorbed doses for Lu-177 and Ra-223 and Ac-225 in the bone marrow and soft tissue of bone phantom with evaluating energetic emitted particles of these radionuclides is the important aim of this research. By the use of MCNPX computer code, a model for bone phantom was designed and the values of absorbed dose for Ra-223 and Ac-225, which are Alpha emitters & Lu-177, which is a beta emitter, were calculated. As a result of research, in comparing gamma radiation for three radionuclides, Lu-177 released the highest dose in the bone marrow and Ra-223 achieved the lowest level. On the other hand, the result showed that although the figures of absorbed dose for Ra and Ac in the bone marrow are near to each other, Ra spread more energy in cortical bone. Moreover, The alpha component of the Ra-223 and Ac-225 have very little effect on bone marrow and soft tissue than a beta component of the lu-177 and it leaves the highest absorbed dose in the bone where the source is located.

Keywords: bone metastases, lutetium-177, radium-223, actinium-225, absorbed dose

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2338 Reducing Flood Risk through Value Capture and Risk Communication: A Case Study in Cocody-Abidjan

Authors: Dedjo Yao Simon, Takahiro Saito, Norikazu Inuzuka, Ikuo Sugiyama

Abstract:

Abidjan city (Republic of Ivory Coast) is an emerging megacity and an urban coastal area where the number of floods reported is on a rapid increase due to climate change and unplanned urbanization. However, comprehensive disaster mitigation plans, policies, and financial resources are still lacking as the population ignores the extent and location of the flood zones; making them unprepared to mitigate the damages. Considering the existing condition, this paper aims to discuss an approach for flood risk reduction in Cocody Commune through value capture strategy and flood risk communication. Using geospatial techniques and hydrological simulation, we start our study by delineating flood zones and depths under several return periods in the study area. Then, through a questionnaire a field survey is conducted in order to validate the flood maps, to estimate the flood risk and to collect some sample of the opinion of residents on how the flood risk information disclosure could affect the values of property located inside and outside the flood zones. The results indicate that the study area is highly vulnerable to 5-year floods and more, which can cause serious harm to human lives and to properties as demonstrated by the extent of the 5-year flood of 2014. Also, it is revealed there is a high probability that the values of property located within flood zones could decline, and the values of surrounding property in the safe area could increase when risk information disclosure commences. However in order to raise public awareness of flood disaster and to prevent future housing promotion in high-risk prospective areas, flood risk information should be disseminated through the establishment of an early warning system. In order to reduce the effect of risk information disclosure and to protect the values of property within the high-risk zone, we propose that property tax increments in flood free zones should be captured and be utilized for infrastructure development and to maintain the early warning system that will benefit people living in flood prone areas. Through this case study, it is shown that combination of value capture strategy and risk communication could be an effective tool to educate citizen and to invest in flood risk reduction in emerging countries.

Keywords: Cocody-Abidjan, flood, geospatial techniques, risk communication, value capture

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2337 Skin Manifestations in Children With Inborn Errors of Immunity in a Tertiary Care Hospital in Iran

Authors: Zahra Salehi Shahrbabaki, Zahra Chavoshzadeh, Fahimeh Abdollahimajd, Samin Sharafian, Tolue Mahdavi, Mahnaz Jamee

Abstract:

Background: Inborn errors of immunity (IEIs) are monogenic diseases of the immune the system with broad clinical manifestations. Despite the increasing genetic advancements, the diagnosis of IEIs still leans on clinical diagnosis. Dermatologic manifestations are observed in a large number of IEI patients and can lead to proper approach, prompt intervention and improved prognosis. Methods: This cross-sectional study was carried out between 2018 and 2020 on IEIs at a Children's tertiary care center in Tehran, Iran. Demographic details (including age, sex, and parental consanguinity), age at onset of symptoms and family history of IEI with were recorded. Results :212 patients were included. Cutaneous findings were reported in (95 ,44.8%) patients. and 61 of 95 (64.2%) reported skin lesions as the first clinical presentation. Skin infection (69, 72.6%) was the most frequent cutaneous manifestation, followed by an eczematous rash (24, 25 %). Conclusions: Skin manifestations are common feature in IEI patients and can be readily recognizable by healthcare providers. This study tried to provide information on prognostic consequences.

Keywords: primary immuno deficiency, inborn errror of metabolism, skin manifestation, skin infection

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2336 The Learning Process in Future Preparations: Middle-Aged and Older Adults' Experiences

Authors: Ya-Hui Lee, Ching-Yi Lu

Abstract:

Taiwan will become an aging society in 2018. The method to face the challenges related to the aging population has become an important topic. Purpose: This study aims to understand the future preparation of middle-age and older adults, and how they prepared themselves to face the problems of aging, and how they took actions to plan and cope with their future life. Moreover, how did they generate the process of learning action, so that they would be able to live a more active and meaningful life when they entered into their older age? Method: We conducted semi-structure interviews with 10 middle-aged and older adults who had taken actions to prepare for their future. We examined the interviewees’ consciousness and learning actions in their future preparation. Preliminary Results: 1. The triggering factors of the interviewees’ consciousness to prepare for the future included: family events, the desire to maintain active social lives after retirement, the continuation of the interviewees’ professional careers after retirement, and the aspiration for participation in volunteer services. 2. 'Health problems' and 'economic security' were issued of the utmost concern for the interviewees’ future. However, they would transform these worries to learning actions, comprising of active participation in learning, finding relevant information through learning; thus, accumulating more resources to cope with their future needs.

Keywords: middle-age and older adults, preparing for future, older adult learning

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2335 Medicinal Plants Used by Moroccan People in the Management of Diabetes and Hypertension

Authors: Alami Ilyass, Kharchoufa Loubna, Alachouri Mostafa

Abstract:

Cardiovascular disease (CDV) remains the major cause of morbidity; mortality and disability throughout the world. The ethnopharmcological and ethnobotanical studies are the paramount importance to set a high value on phytogenetic resources and to address health problems of some communities; especially poor peoples. Our work presents an analysis of published data from studies, that have been undertaken, in Morocco, by different seeker teams in separately areas during the last decades. Objectives: Evaluate and identify medicinal plants used for cardiovascular treatment by Moroccan people. Methodology: All these studies have the same approaches ; they were conducted by interviewing people suffering from diabetes. We use Factorial Analysis (FA) and principal Components analysis (PCA) to analyse the aggregated data from the different studies. Results: globally; 95 plants species were listed; all these plant were used empirically by Moroccan society for treating cardiovascular problems. These plants were divided in to 42 families and 87 genus. The lamiaceae; asteraceae; Apiaceae and poaceae are the botanical families with high number of plant species. Coclusion: Traditional medecine has been widely used for treatment of cardiovascular problems and it has been recognized as an interesting alternative to conventional medicine.

Keywords: cardiovascular, ethnobotanical, medicinal plants, Morocco

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2334 HPTLC Fingerprinting of steroidal glycoside of leaves and berries of Solanum nigrum L. (Inab-us-salab/makoh)

Authors: Karishma Chester, Sarvesh K. Paliwal, Sayeed Ahmad

Abstract:

Inab-us-salab also known as Solanum nigrum L. (Family: Solanaceae), is an important Indian medicinal plant and have been used in various unani traditional formulations for hepato-protection. It has been reported to contain significant amount of steroidal glycosides such as solamargine and solasonine as well as their aglycone part solasodine. Being important pharmacologically active metabolites of several members of solanaceae, these markers have been attempted various times for their extraction and quantification but separately for glycoside and aglycone part because of their opposite polarity. Here, we propose for the first time its fractionation and fingerprinting of aglycone (solasodine) and glycosides (solamargine and solasonine) in leaves and berries of S. nigrum using solvent extraction and fractionation followed by HPTLC analysis. The fingerprinting was done using silica gel 60F254 HPTLC plates as stationary phase and chloroform: methanol: acetone: 0.5% ammonia (7: 2.5: 1: 0.4 v/v/v/v) as mobile phase at 400 nm, after derivatization with antimony tri chloride reagent for identification of steroidal glycoside. The statistical data obtained can further be validated and can be used routinely for quality control of various solanaceous drugs reported for these markers as well as traditional formulations containing those plants as an ingredient.

Keywords: solanum nigrum, solasodine, solamargine, solasonine, quantification

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2333 The Role of Pulmonary Resection in Complicated Primary Pediatric Pulmonary Tuberculosis: An Evidence-Based Case Report

Authors: Hendra Wibowo, Suprayitno Wardoyo, Dhama Shinta

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Introduction: Pediatric pulmonary tuberculosis (TB) incidence was increasing, with many undetected cases. In complicated TB, treatment should consist of returning pulmonary function, preventing further complications, and eliminating bacteria. Complicated TB management was still controversial, and surgery was one of the treatments that should be evaluated in accordance with its role in the treatment of complicated TB. Method: This study was an evidence-based case report. The database used for the literature search were Cochrane, Medline, Proquest, and ScienceDirect. Keywords for the search were ‘primary pulmonary tuberculosis’, ‘surgery’, ‘lung resection’, and ‘children’. Inclusion criteria were studies in English or Indonesian, with children under 18 years old as subject, and full-text articles available. The assessment was done according to Oxford Centre for evidence-based medicine 2011. Results: Six cohort studies were analyzed. Surgery was indicated for patients with complicated TB that were unresponsive towards treatment. It should be noted that the experiments were done before the standard WHO antituberculosis therapy was applied; thus, the result may be different from the current application. Conclusion: Currently, there was no guideline on pulmonary resection. However, surgery yielded better mortality and morbidity in children with complicated pulmonary TB.

Keywords: pediatric, pulmonary, surgery, therapy, tuberculosis

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2332 Effects of Inadequate Domestic Water Supply on Human Health in Selected Neighbourhoods of Lokoja, Kogi State

Authors: Folorunsho J. O., Umar M. A.

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Access to potable water supply in both the rural and urban regions of the world has been neglected, and this has severely affected man and the aesthetics of the natural environment of man. This has further worsened the issue of diseases prevalence. This study considered the effects of inadequate domestic water supply on human health in selected neighbourhoods of Lokoja. The study used descriptive statistics such as relative frequencies, percentages and inferential statistics to analyse the data obtained through the use of structured questionnaire. The results revealed that the females and male constituted 56% and 44% of the respondents respectively; 62% of the respondents married and 32% are unmarried; respondents between ages 31 and 40 years constitute majority of the study population, while respondents with tertiary education constituted 35%, and those with secondary education were 32% of the total respondents. Furthermore, civil servants constituted 40% and unemployed 16% of the total respondents. In terms of monthly income, 40% of the respondents was found to earn between ₦31,000 - 40,000 monthly. On the perception of households on the availability and adequacy of domestic water supply, the study revealed that 64.7% of the respondents have pipe-borne water as their main source of water supply, with only 28.5% out of the 64.7% have pipe-borne water supply daily. On the relationship between water supply characteristics and health status among households, the result shows that 76% of the respondents perceived a strong relationship between water supply and health status. Cumulatively, 67% of the respondents confirm that both the quality and quantity of water supplied play a critical role in determining health status of residents of the study area. The respondents also reported skin diseases (96%), diarrhoea (96%), malaria (91%), cholera (67%), dysentery (67%), and respiratory diseases (67%) as the most perceived and experienced in the area, the disease rate in the prevalence order of malaria (81%), diarrhoea (61%), skin diseases (58%), cholera (34%), dysentery (31%) and respiratory disease (14%) respectively. Finally, the results further showed how households cope with inadequate water supply with 52% of the respondents confirm that they regularly treat their water before it was deployed for domestic uses, while 35%, 26%, 25%, 10% and 4% of the 52% respectively, adopted boiling, addition of alums, filtering with fabrics, chlorination and bleaching as the preferred treatment methods. The study thus recommended policy options that will aggressively launch adequate potable water supply infrastructure in the study area.Keywords: Potable Water, Supply, Human Health, Perception, Chlorination

Keywords: potable water, human health, perception, chlorination

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2331 The Role of Financial Literacy and Personal Non-Cognitive Attributes in Household Financial Fragility

Authors: Ivana Bulog, Ana Rimac Smiljanić, Sandra Pepur

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The financial fragility of households has received increased attention following the recent health crisis, which has created uncertainty and caused increased levels of stress and consequently impaired individual and family well-being. Job losses and/or reduced wages and insecurity increased the number of people that were unable to meet unexpected expenses, which, in many cases, led to increased household debt levels. This presents a threat to the stability of the financial system and the whole economy; therefore, reducing financial fragility and improving financial literacy present challenges for academicians, practitioners, and policymakers. Concerning financial fragility, significant research attention has been devoted to financial knowledge and financial literacy. However, apart from specific knowledge, personal characteristics are of great importance in making financial decisions in the household. Self-efficacy is one of the personal non-cognitive attributes that is a valuable framework for understanding how household financial decisions are made. Thus, this research proposes that individual levels of financial literacy and self-efficacy are related to the indebtedness and financial instability of the household. The primary data were collected using a structured, self-administered online questionnaire, and a snowball sampling method was applied to reach the participants. Preliminary results confirm our assumptions on the influence of financial literacy and self-efficacy on household financial stability.

Keywords: financial literacy, self-efficacy, household financial fragility, well-being

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2330 Robotic Assistance in Nursing Care: Survey on Challenges and Scenarios

Authors: Pascal Gliesche, Kathrin Seibert, Christian Kowalski, Dominik Domhoff, Max Pfingsthorn, Karin Wolf-Ostermann, Andreas Hein

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Robotic assistance in nursing care is an increasingly important area of research and development. Facing a shortage of labor and an increasing number of people in need of care, the German Nursing Care Innovation Center (Pflegeinnovationszentrum, PIZ) aims to address these challenges from the side of technology. Little is known about nurses experiences with existing robotic assistance systems. Especially nurses perspectives on starting points for the development of robotic solutions, that target recurring burdensome tasks in everyday nursing care, are of interest. This paper presents findings focusing on robotics resulting from an explanatory mixed-methods study on nurses experiences with and their expectations for innovative technologies in nursing care in stationary and ambulant care facilities and hospitals in Germany. Based on the findings, eight scenarios for robotic assistance are identified based on the real needs of practitioners. An initial system addressing a single use-case is described to show perspectives for the use of robots in nursing care.

Keywords: robotics and automation, engineering management, engineering in medicine and biology, medical services, public health-care

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2329 Experiences of 529 Donor-Conceived Adults: Disclosure, Using a Donor, Donating

Authors: Wendy Kramer

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How and when a donor-conceived person (DCP) learns about their conception significantly affects their experiences and choices, including whether they'd consider using a donor or donating their own gametes. Objective: We sought to identify factors that positively and negatively impact the experience of being a DCP. We sought to determine if DCP would consider utilizing donor gametes themselves, if unable to conceive spontaneously and if DCP were likely to be donors themselves. Materials and Methods: A cross-sectional survey of adult DCP was disseminated to members of the Donor Sibling Registry. The survey consisted of 31 items, including whether experience as DCP was positive or negative, the willingness to use donor gametes if spontaneous conception was not an option, and questions regarding donating gametes. Results: 529 people (81.7% female) completed the survey, the median age was 28 years (range 18-77 years), and 94.7% were conceived via donor sperm. Most felt "neutral" (31.6%), "positive" (26.3%) or "very positive" (20.8%) about being a DCP regardless of donor type. While most found out about being a DCP after age 18 (63.4%), those with a positive experience were more likely to "have always known" (40.7%). Conclusions: People conceived by donor-assisted reproduction are more likely to have neutral to overall positive feelings surrounding their conception if they are told at a very young age about their donor-conceived origins by a family member. The majority of DCPs are willing to adopt but would not consider using donated gametes themselves if unable to conceive spontaneously. DCPs are not likely to become donors themselves despite the majority of DCP having a high positive feeling regarding being donor-conceived.

Keywords: donor conception, sperm donation, oocyte donation, donor-conceived people, infertility

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2328 Small Community’s Proactive Thinking to Move from Zero to 100 Percent Water Reuse

Authors: Raj Chavan

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The City of Jal serves a population of approximately 3,500 people, including 2,100 permanent inhabitants and 1,400 oil and gas sector workers and RV park occupants. Over the past three years, Jal's population has increased by about 70 percent, mostly due to the oil and gas industry. The City anticipates that the population will exceed 4,200 by 2020, necessitating the construction of a new wastewater treatment plant (WWTP) because the old plant (aerated lagoon system) cannot accommodate such rapid population expansion without major renovations or replacement. Adhering to discharge permit restrictions has been challenging due to aging infrastructure and equipment replacement needs, as well as increasing nutrient loading to the wastewater collecting system from the additional oil and gas residents' recreational vehicles. The WWTP has not been able to maintain permit discharge standards for total nitrogen of less than 20 mg N/L and other characteristics in recent years. Based on discussions with the state's environmental department, it is likely that the future permit renewal would impose stricter conditions. Given its location in the dry, western part of the country, the City must rely on its meager groundwater supplies and scant annual precipitation. The city's groundwater supplies will be depleted sooner than predicted due to rising demand from the growing population for drinking, leisure, and other industrial uses (fracking). The sole type of reuse the city was engaging in (recreational reuse for a golf course) had to be put on hold because of an effluent water compliance issue. As of right now, all treated effluent is evaporated. The city's long-term goal is to become a zero-waste community that sends all of its treated wastewater effluent either to the golf course, Jal Lake, or the oil and gas industry for reuse. Hydraulic fracturing uses a lot of water, but if the oil and gas industry can use recycled water, it can reduce its impact on freshwater supplies. The City's goal of 100% reuse has been delayed by the difficulties of meeting the constraints of the regular discharge permit due to the large rise in influent loads and the aging infrastructure. The City of Jal plans to build a new WWTP that can keep up with the city's rapid population increase due to the oil and gas industry. Several treatment methods were considered in light of the City's needs and its long-term goals, but MBR was ultimately chosen recommended since it meets all of the permit's requirements while also providing 100 percent beneficial reuse. This talk will lay out the plan for the city to reach its goal of 100 percent reuse, as well as the various avenues for funding the small community that have been considered.

Keywords: membrane bioreactor, nitrogent, reuse, small community

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2327 Vaccination Coverage and Its Associated Factors in India: An ML Approach to Understand the Hierarchy and Inter-Connections

Authors: Anandita Mitro, Archana Srivastava, Bidisha Banerjee

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The present paper attempts to analyze the hierarchy and interconnection of factors responsible for the uptake of BCG vaccination in India. The study uses National Family Health Survey (NFHS-5) data which was conducted during 2019-21. The univariate logistic regression method is used to understand the univariate effects while the interconnection effects have been studied using the Categorical Inference Tree (CIT) which is a non-parametric Machine Learning (ML) model. The hierarchy of the factors is further established using Conditional Inference Forest which is an extension of the CIT approach. The results suggest that BCG vaccination coverage was influenced more by system-level factors and awareness than education or socio-economic status. Factors such as place of delivery, antenatal care, and postnatal care were crucial, with variations based on delivery location. Region-specific differences were also observed which could be explained by the factors. Awareness of the disease was less impactful along with the factor of wealth and urban or rural residence, although awareness did appear to substitute for inadequate ANC. Thus, from the policy point of view, it is revealed that certain subpopulations have less prevalence of vaccination which implies that there is a need for population-specific policy action to achieve a hundred percent coverage.

Keywords: vaccination, NFHS, machine learning, public health

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2326 Robustness Conditions for the Establishment of Stationary Patterns of Drosophila Segmentation Gene Expression

Authors: Ekaterina M. Myasnikova, Andrey A. Makashov, Alexander V. Spirov

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First manifestation of a segmentation pattern in the early Drosophila development is the formation of expression domains (along with the main embryo axis) of genes belonging to the trunk gene class. Highly variable expression of genes from gap family in early Drosophila embryo is strongly reduced by the start of gastrulation due to the gene cross-regulation. The dynamics of gene expression is described by a gene circuit model for a system of four gap genes. It is shown that for the formation of a steep and stationary border by the model it is necessary that there existed a nucleus (modeling point) in which the gene expression level is constant in time and hence is described by a stationary equation. All the rest genes expressed in this nucleus are in a dynamic equilibrium. The mechanism of border formation associated with the existence of a stationary nucleus is also confirmed by the experiment. An important advantage of this approach is that properties of the system in a stationary nucleus are described by algebraic equations and can be easily handled analytically. Thus we explicitly characterize the cross-regulation properties necessary for the robustness and formulate the conditions providing this effect through the properties of the initial input data. It is shown that our formally derived conditions are satisfied for the previously published model solutions.

Keywords: drosophila, gap genes, reaction-diffusion model, robustness

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2325 The Epidemiology of Hospital Maternal Deaths, Haiti 2017-2020

Authors: Berger Saintius, Edna Ariste, Djeamsly Salomon

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Background: Maternal mortality is a preventable global health problem that affects developed, developing, and underdeveloped countries alike. Globally, maternal mortality rates have declined since 1990, but 830 women die every day from pregnancy and childbirth-related causes that are often preventable. Haiti, with a number of 529 maternal deaths per 100,000 live births, is one of the countries with the highest maternal mortality rate in the Caribbean. This study consists of analyzing maternal death surveillance data in Haiti from 2017-2020. Method : A descriptive study was conducted; data were extracted from the National Epidemiological Surveillance Network of maternal deaths from 2017 to 2020. Sociodemographic variables were analyzed. Excel and Epi Info 7.2 were used for data analysis. Frequency and proportion measurements were calculated. Results: 756 deaths were recorded for the study period: 42 (6%) in 2017, 168 (22%) in 2018, 265 (35%) in 2019, and 281 (37%) in 2020. The North Department recorded the highest number of deaths, 167 (22%). 83(11%) in Les Cayes. 96% of these deaths are people aged between 15 and 49. Conclusion. Maternal mortality is a major health problem in Haiti. Mobilization, participation, and involvement of communities, increase in obstetric care coverage and promotion of Family Planning are among the strategies to fight this problem.

Keywords: epidemiology, maternal death, hospital, Haiti

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2324 Botulinum A Toxin Injection in Two Filipino Brothers with X-linked Dystonia-Parkinsonism (XDP) in Cebu City, Philippines: A Case Report

Authors: Ana Katrina C. Longos, Jarungchai Anton S. Vatanagul

Abstract:

Objectives: To present a case of two Filipino male siblings initially seen with parkinsonism and eventually with dystonia and to present botulinum A toxin as part of the treatment for X-linked dystonia parkinsonism in Cebu City. Discussion: A 54 year old man presented initially with parkinsonian symptoms and later developed oromandibular and truncal dystonia. Further history revealed that he had an older brother who also presented with the same symptoms. Neuroimaging done on both patients revealed CVD infarcts in the pons and corona radiata respectively which where were not compatible with their symptoms. Family history revealed that their mother was originally from Panay and a diagnosis of X-linked dystonia parkinsonism (XDP) was made. Both patients were able to receive botulinum A toxin injections which provided temporary relief of symptoms. Conclusion: XDP was considered in 2 Filipino male siblings who presented with oromandibular dystonia, truncal dystonia, shuffling gait, resting tremors with ancestry from Panay on the maternal side. There is no cure for XDP, only symptomatic treatment. Until recently, only oral chemotherapy was available in Cebu. Botulinum A toxin injection done in both patients afforded temporary resolution of symptoms.

Keywords: XDP, dystonia of Panay, lubag, dystonia parkinsonism, botulinum a toxin

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2323 Serological Assay and Genotyping of Hepatitis C Virus in Infected Patients in Zanjan Province

Authors: Abdolreza Esmaeilzadeh, Maryam Erfanmanesh, Sousan Ghasemi, Farzaneh Mohammadi

Abstract:

Background: Hepatitis C Virus (HCV), a public health problem, is an enveloped, single-stranded RNA virus and a member of the Hepacivirus genus of the Flaviviridae family. Liver cancer, cirrhosis, and end-stage liver are the outcomes of chronic infection with HCV. HCV isolates show significant heterogeneity in genetics around the world. Therefore, determining HCV genotypes is a vital step in determining prognosis and planning therapeutic strategies. Materials and Methods: Serum samples of 136 patients were collected and analyzed for anti-HCV antibodies using ELISA (The enzyme-linked immunosorbent assay) method. Then, positive samples were exposed to RT-PCR, which was performed under standard condition. Afterwards, they investigated for genotyping using allele-specific PCR (AS-PCR), and HCV genotype 2.0 line probe assay (LiPA). Results: Samples indicated 216 bp bands on 2% agarose gel. Analyses of the results demonstrated that the most dominant subtype was 3a with frequency of 38.26% in Zanjan Province followed by subtypes of 1b, 1a, 2, and 4 with frequencies of 25.73%, 22.05%, 5.14%, and 4.41%, respectively. The frequency of unknown HCV genotypes was 4.41%. Conclusions: According to the results, it was found that HCV high prevalent genotype in Zanjan is subtype 3a. Analysis of the results provides identification of certain HCV genotypes, and these valuable findings could affect the type and duration of the treatment.

Keywords: anti-HCV antibody, Hepatitis C Virus (HCV), genotype, RT-PCR, AS-PCR

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2322 Analyzing the Impact of Local and International Artists in Creating Cultural Identity through Public Art: Case Study of Chicago Public Policies

Authors: Kaesha M. Freyaldenhoven

Abstract:

Chicago is a city in the United States whose cultural identity is largely shaped by public art pieces. Quintessential public works created by internationally renown artists – such as Anish Kapoor’s Cloud Gate in Millennium Park and 'The Picasso' in Daley Plaza – have historically contributed to developing a shared sense of community. In 2017, the city implemented a policy titled 50x50 Neighborhood Arts Project under the Chicago Public Art Plan. The policy promotes investments in contemporary public art to elevate neighborhood cultural assets and create a sense of place. Exclusively community-based artists were commissioned to accomplish the mission of the policy. Administrators felt only local artists would be capable of capturing the true essence of a neighborhood through art. This paper discusses the relationship between the public art and the culture of its respective neighborhood through close examination of aesthetic formal properties and social significance. Research compares the role of international artists with the role of local artists in cultivating the identity of a city through site-specific artworks in Chicago. Methodology unites theoretical research on understanding art and its function in the public space with empirical research on Chicago-based works. Theoretical frameworks provide an art historical foundation to explore the manner in which physical properties convey meaning through the work itself and its placement in an urban setting. Empirical research that examines policy documentation and press announcements released by the Department of Cultural Affairs and Special Events investigates project selection processes pertaining to the artists and neighborhoods. Ethnographies and interviews of individuals from diverse social segments in contemporary Chicago society measure impacts of the works on respective populations. Findings demonstrate works created by local artists activate neighborhoods and inculcate a sense of pride among community residents. Works created by international artists garner widespread media attention that frames the city’s cultural identity across temporal and geographic zones. This research can be utilized to inform future cultural policies pertaining to the commission of public art.

Keywords: Chicago, cultural policy, public art, urban art

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2321 Acute Intraperitoneal Toxicity of Sesbania grandiflora (Katuray) Methanolic Flower Extract in Swiss Albino Mice

Authors: Levylee Bautista, Dawn Grace Santos, Aishwarya Veluchamy, Jesusa Santos, Ghafoor Haque, Jr. I, Rodolfo Rafael

Abstract:

Sesbania grandiflora is widely used in traditional medicine to treat a wide range of ailments. Assessment of its toxic properties is hence crucial when considering public health protection because exposure to plant extracts may pose adverse effects on consumers. This study aimed to investigate the acute intraperitoneal toxicity of S. grandiflora flower methanolic extract (SGFME) in Swiss albino mice. Four different concentrations (11.25, 22.5, 40, and 90 mg/kg) of SGFME were administered intraperitoneally and immediate behavioral and clinical signs were observed. All concentrations of SGFME-treated mice exhibited gasping and faster respiratory rate, writhing, reddening and fanning of the ears, paralysis of the hind leg, and mortality. Such reactions may be attributed to the histamine and saponin content of S. grandiflora. Results of this study suggests that intraperitoneal administration of SGFME produced significant adverse effect in mice, therefore, caution should be exercised in using it as herbal remedy since there is little control over its quality.

Keywords: acute toxicity test, histamine, medicinal plants, Sesbania grandiflora

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2320 Demographic Determinants of Spatial Patterns of Urban Crime

Authors: Natalia Sypion-Dutkowska

Abstract:

Abstract — The main research objective of the paper is to discover the relationship between the age groups of residents and crime in particular districts of a large city. The basic analytical tool is specific crime rates, calculated not in relation to the total population, but for age groups in a different social situation - property, housing, work, and representing different generations with different behavior patterns. They are the communities from which criminals and victims of crimes come. The analysis of literature and national police reports gives rise to hypotheses about the ability of a given age group to generate crime as a source of offenders and as a group of victims. These specific indicators are spatially differentiated, which makes it possible to detect socio-demographic determinants of spatial patterns of urban crime. A multi-feature classification of districts was also carried out, in which specific crime rates are the diagnostic features. In this way, areas with a similar structure of socio-demographic determinants of spatial patterns on urban crime were designated. The case study is the city of Szczecin in Poland. It has about 400,000 inhabitants and its area is about 300 sq km. Szczecin is located in the immediate vicinity of Germany and is the economic, academic and cultural capital of the region. It also has a seaport and an airport. Moreover, according to ESPON 2007, Szczecin is the Transnational and National Functional Urban Area. Szczecin is divided into 37 districts - auxiliary administrative units of the municipal government. The population of each of them in 2015-17 was divided into 8 age groups: babes (0-2 yrs.), children (3-11 yrs.), teens (12-17 yrs.), younger adults (18-30 yrs.), middle-age adults (31-45 yrs.), older adults (46-65 yrs.), early older (66-80) and late older (from 81 yrs.). The crimes reported in 2015-17 in each of the districts were divided into 10 groups: fights and beatings, other theft, car theft, robbery offenses, burglary into an apartment, break-in into a commercial facility, car break-in, break-in into other facilities, drug offenses, property damage. In total, 80 specific crime rates have been calculated for each of the districts. The analysis was carried out on an intra-city scale, this is a novel approach as this type of analysis is usually carried out at the national or regional level. Another innovative research approach is the use of specific crime rates in relation to age groups instead of standard crime rates. Acknowledgments: This research was funded by the National Science Centre, Poland, registration number 2019/35/D/HS4/02942.

Keywords: age groups, determinants of crime, spatial crime pattern, urban crime

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2319 Comparison of Rumen Microbial Analysis Pipelines Based on 16s rRNA Gene Sequencing

Authors: Xiaoxing Ye

Abstract:

To investigate complex rumen microbial communities, 16S ribosomal RNA (rRNA) sequencing is widely used. Here, we evaluated the impact of bioinformatics pipelines on the observation of OTUs and taxonomic classification of 750 cattle rumen microbial samples by comparing three commonly used pipelines (LotuS, UPARSE, and QIIME) with Usearch. In LotuS-based analyses, 189 archaeal and 3894 bacterial OTUs were observed. The observed OTUs for the Usearch analysis were significantly larger than the LotuS results. We discovered 1495 OTUs for archaea and 92665 OTUs for bacteria using Usearch analysis. In addition, taxonomic assignments were made for the rumen microbial samples. All pipelines had consistent taxonomic annotations from the phylum to the genus level. A difference in relative abundance was calculated for all microbial levels, including Bacteroidetes (QIIME: 72.2%, Usearch: 74.09%), Firmicutes (QIIME: 18.3%, Usearch: 20.20%) for the bacterial phylum, Methanobacteriales (QIIME: 64.2%, Usearch: 45.7%) for the archaeal class, Methanobacteriaceae (QIIME: 35%, Usearch: 45.7%) and Methanomassiliicoccaceae (QIIME: 35%, Usearch: 31.13%) for archaeal family. However, the most prevalent archaeal class varied between these two annotation pipelines. The Thermoplasmata was the top class according to the QIIME annotation, whereas Methanobacteria was the top class according to Usearch.

Keywords: cattle rumen, rumen microbial, 16S rRNA gene sequencing, bioinformatics pipeline

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2318 Integrating Multi-Sectoral Approaches to Address Gender-Based Violence in Lagos State: Prevalence, Perceptions, and Policy Recommendations

Authors: Lola Vivour-Adeniyi, Oluwatoyosi Abikoye

Abstract:

Gender-based violence (GBV) is a pervasive issue that demands a nuanced understanding to foster effective solutions. This study, conducted by the Lagos State Domestic and Sexual Violence Agency (DSVA), delves into the heart of Lagos State to uncover the realities of GBV, from the perceptions of its residents to the efficacy of support systems in place. Covering ten local government areas (LGAs) and drawing from a diverse range of demographics—gender, age, marital status, literacy levels, religion, and ethnicity—this research paints a comprehensive picture of GBV's impact. The narrative begins with the voices of the community, revealing a widespread awareness of GBV's multifaceted nature—physical, emotional, psychological, and structural. Through their stories, key drivers such as poverty, low education levels, and substance abuse emerge, illustrating the interconnected factors that sustain GBV. Despite a high level of awareness, there is a significant gap in knowledge about reporting mechanisms, highlighting an urgent need for improved accessibility and information dissemination on support services. Notably, inter-agency collaboration and public awareness campaigns play crucial roles in the community's fight against GBV. This study evaluates these efforts by the Lagos State Government, shedding light on successful educational interventions that have transformed community attitudes. Case studies of these initiatives provide examples of success, demonstrating the power of coordinated action and informed advocacy. In conclusion, the study calls for a robust, multi-sectoral approach—engaging government agencies, civil society organizations, and community stakeholders—to address GBV comprehensively. Recommendations include scaling successful models to other urban centers, enhancing reporting mechanisms for greater accessibility and confidentiality, and investing in ongoing research to refine our understanding of GBV's dynamics with the aim to foster a safer and more inclusive society, tackling the root causes of GBV and improving support for survivors.

Keywords: gender based violence, policy recommendations, public awareness, Iinter agency collaboration

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2317 Demographic Characteristics as a Determinant of the use of Health Care Services: Case of Nsukka, Southwest Nigeria

Authors: Beatrice Adeoye

Abstract:

Studies have associated social and demographic characteristics as strong determinants of utilization of health care services; however, not much has been done to explore the dynamics of these variables in Nigeria. This empirical study explores the link between demographic factors and the future use of health care services in Nsukka, southeast Nigeria. A total of 543 respondents were selected using multi-stage sampling technique. The findings of the study showed that majority (56.9%) of the respondents were female while 43.1% were male. More of the respondents were married (50.3%) while 41.80/0 of the respondents were between ages 26-35. Testing the demographic characteristics regarding where people will prefer to go first for treatment with multiple regression, It is only Sex as a demographic variable that indicates positive association for future occurrence to where people will prefer to go first for treatment with 0.08 significance. Age and education indicates no association considering their level of significance. This result shows that sex is one of the determinant factors of where and when people will go for treatment. This is pointing out the realities regarding African society where in the family setting, it is the father that dictates the cause of action. Also to buttress these findings, cross tabulating age with who determines where and when to go for treatment, findings show that majority (58.9%) within age 26-35 said their spouses decide on where and when to go for treatment. Findings showed that patriarchy still plays an important role in the utilization of health care delivery among the people studied.

Keywords: Demographic characters, Determinant, Health Care, treatment, self-medication, symptom,

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2316 Human Trafficking in Your Backyard: Know the Signs and How to Help

Authors: Jessie Fazel, Kristen Smith

Abstract:

Human trafficking is a multi-billion-dollar criminal industry that affects 24.9 million people around the world. There are several different types of trafficking, the most common being sex trafficking, labor trafficking, and domestic servitude. Survival sex is common in the pediatric population, as they engage in sex for food, a place to sleep, or other basic needs. Statistics show that health care workers are at a unique advantage to help identify victims and get them the help they need, as 88% of trafficked victims encounter a health care worker while being trafficked. Unfortunately, victims don’t usually self-identify that they are being trafficked and the situations they face can vary dramatically. It is imperative to remember that traditional red flags are not always present in the pediatric population. Risk factors and red flags with their history and physical exam are one of the best indicators that health care providers need to be vigilant in looking at. There are numerous barriers for disclosure in the healthcare setting. Periods of time before and after disclosure are often emotionally difficult and could be dangerous for the victim. It is extremely important to have a plan in place for intervention if the victim does disclose trafficking. A trauma informed approach to medical and mental health interventions, that focus on safety, are vital in this population. This is happening where you live and you can make a difference in their lives.

Keywords: human trafficking, public health, emergency medicine, sexual health

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2315 Change in Food Choice Behavior: Trend and Challenges

Authors: Gargi S. Kumar, Mrinmoyi Kulkarni

Abstract:

Food choice behavior is complex and determined by biological, psychological, socio-cultural, and economic factors. The past two decades, have seen dramatic changes in food consumption patterns among urban Indian consumers. The objective of the current study was to evaluate perceptions about changes with respect to food choice behavior. Ten participants [urban men and women] ranging in age from 40 to 65 were selected and in-depth interviews were conducted with a set of open ended questions. The recorded interviews were transcribed and thematically analyzed using inductive, open and axial coding. The results identified themes that act as drivers and consequences of change in food choice behavior. Drivers such as globalization [sub themes of urbanization, education, income, and work environment], media and advertising, changing gender roles, women in the workforce, and change in family structure have influenced food choice, both at an individual and national level. The consequences of changes in food choice were health implications, processed food consumption, food decisions driven by children and eating out among others. The study reveals that, over time, food choices change and evolve. However it is interesting to note how market forces and culture interact to influence individual behavior and the overall food environment which subsequently affects food choice and the health of the people.

Keywords: change, consequences, drivers, food choice, globalization

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