Search results for: activity involvement
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7279

Search results for: activity involvement

4459 Diminishing Voices of Children in Mandatory Mediation Schemes

Authors: Yuliya Radanova, Agnė Tvaronavičienė

Abstract:

With the growing trend for mandating parties of family conflicts to out-of-court processes, the adopted statutory regulations often remain silent on the way the voice of the child is integrated into the procedure. Convention on the Rights of the Child (Art. 12) clearly states the obligation to assure to the child who can form his or her own views the right to express those views freely in all matters affecting him. This article seeks to explore the way children participate in the mandatory mediation schemes applicable to family disputes in the European Union. A review of scientific literature and empirical data has been conducted on those EU Member States that coerce parties to family mediation to establish that different models of practice are deployed, and there is a lack of synchronicity on how children’s role in mediation is viewed. Child-inclusive mediation processes are deemed to produce sustainable results over time but necessitate professional qualifications and skills for the purpose of mediators to accommodate that such discussions are aligned with the best interest of the child. However, there is no unanimous guidance, standards or protocols on the peculiar characteristics and manner through which children are involved in mediation. Herewith, it is suggested that the lack of such rigorous approaches and coherence in an ever-changing mediation setting transitioning towards mandatory mediation models jeopardizes the importance of children’s voices in the process. Thus, it is suggested that there is a need to consider the adoption of uniform guidelines on the specific role children have in mediation, particularly in its mandatory models.

Keywords: family mediation, child involvement, mandatory mediation, child-inclusive, child-focused

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4458 Problems concerning Legal Regulation of Electronic Governance in Georgia

Authors: Giga Phartenadze

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In the legal framework of regulation of electronic governance, those norms are considered which include measures for improvement of functions of public institutions and a complex of actions for raising their standard such as websites of public institutions, online services, some forms of internet interactions and higher level of internet services. An important legal basis for electronic governance in Georgia is Georgian Law about Electronic Communications which defines legal and economic basis for utilizing electronic communication systems in Georgia. As for single electronic basis for e-governance regulation, it can be said that it does not exist at all. The official websites of public institutions do not have standards for proactive spreading of information. At the same time, there is no common legal norm which would make all public institutions have an official website for public relations, accountability, publicity, and raising information quality. Electronic governance in Georgia needs comprehensive legal regulation. Public administration in electronic form is on the initial stage of development. Currently existing legal basis has a low quality for public institutions and officials as well as citizens and business. Services of e-involvement and e-consultation have also low quality. So far there is no established legal framework for e-governance. Therefore, a single legislative system of e-governance should be created which will help develop effective, comprehensive and multi component electronic systems in the country (central, regional, local levels). Such comprehensive legal framework will provide relevant technological, institutional, and informational conditions.

Keywords: law, e-government, public administration, Georgia

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4457 Extracting the Antioxidant Compounds of Medicinal Plant Limoniastrum guyonianum

Authors: Assia Belfar, Mohamed Hadjadj, Messaouda Dakmouche, Zineb Ghiaba, Mahdi Belguidoum

Abstract:

Introduction: This study aims to phytochemical screening; Extracting the active compounds and estimate the effectiveness of antioxidant in Medicinal plants desert Limoniastrum guyonianum (Zeïta) from South Algeria. Methods: Total phenolic content and total flavonoid content using Folin-Ciocalteu and aluminum chloride colorimetric methods, respectively. The total antioxidant capacity was estimated by the following methods: DPPH (1.1-diphenyl-2-picrylhydrazyl radical) and reducing power assay. Results: Phytochemical screening of the plant part reveals the presence of phenols, saponins, flavonoids and tannins. While alkaloids and Terpenoids were absent. The Methanolic extract of L. guyonianum was extracted successively with ethyl acetate and butanol. Extraction of yield varied widely in the L. guyonianum ranging from (1.315 % to 4.218%). butanol fraction had the highest yield. The higher content of phenols was recorded in butanol fraction (311.81 ± 0.02mg GAE/g DW), the higher content of flavonoids was found in butanol fraction (9.58 ± 0.33mg QE/g DW). IC50 of inhibition of radical DPPH in ethyl acetate fraction was (0.05 ± 0.01µg/ml) Equal effectiveness with BHT, All extracts showed good activity of ferric reducing power, the higher power was in butanol fraction (16.16 ± 0.05mM). Conclusions: Demonstrated this study that the Methanolic extract of L. guyonianum contain a considerable quantity of phenolic compounds and possess a good antioxidant activity. It can be used as an easily accessible source of Natural Antioxidants and as a possible food supplement and in pharmaceutical industry.

Keywords: flavonoid compound, l. guyonianum, medicinal plants, phenolic compounds, phytochemical screening

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4456 A Review of the Antecedents and Consequences of Employee Engagementc

Authors: Ibrahim Hamidu Magem

Abstract:

Employee engagement has continued to gain popularity among practitioners, consultants and academicians recent years. This is due to the fact that the engaged employees are central to organizational success in today’s highly competitive and rapidly changing business environment. Employee engagement depicts a situation whereby employee’s harnessed themselves to their work roles. The importance of employee engagement to organizations cannot be overemphasized in today’s rapidly changing business environment. Organizations both large and small are constantly striving to improve their performance, retain employees, reduce absenteeism, and create loyal customers among others. To be able to achieve these organizations need a team of highly engaged employees. In line with this, the study attempts to provide a valuable framework for understanding the antecedents and consequences of employee engagement in organizations. The paper categorizes the antecedents of employee engagement into individual and organizational factors which it is assumed that the existence of such factors could result into engaged employees that will be of benefit to organizations. Therefore, it is recommended that organizations should revisit and redesign its employee engagement system to enable them attain their organizational goals and objectives. In addition, organizations should note that engagement is personal but organizational engagement programmes should be about everyone in the organization. The findings from this paper adds to existing studies about employee engagement and also provide awareness to academics and practitioners about the importance of employee engagement to improve organizations efficiency and effectiveness, as well as to impact to overall firm performance.

Keywords: antecedents, employee engagement, job involvement, organization

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4455 Excess Body Fat as a Store Toxin Affecting the Glomerular Filtration and Excretory Function of the Liver in Patients after Renal Transplantation

Authors: Magdalena B. Kaziuk, Waldemar Kosiba, Marek J. Kuzniewski

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Introduction: Adipose tissue is a typical place for storage water-insoluble toxins in the body. It's connective tissue, where the intercellular substance consist of fat, which level in people with low physical activity should be 18-25% for women and 13-18% for men. Due to the fat distribution in the body we distinquish two types of obesity: android (visceral, abdominal) and gynoidal (gluteal-femoral, peripheral). Abdominal obesity increases the risk of complications of the cardiovascular system diseases, and impaired renal and liver function. Through the influence on disorders of metabolism, lipid metabolism, diabetes and hypertension, leading to emergence of the metabolic syndrome. So thus, obesity will especially overload kidney function in patients after transplantation. Aim: An attempt was made to estimate the impact of amount fat tissue on transplanted kidney function and excretory function of the liver in patients after Ktx. Material and Methods: The study included 108 patients (50 females, 58 male, age 46.5 +/- 12.9 years) with active kidney transplant after more than 3 months from the transplantation. An analysis of body composition was done by using electrical bioimpedance (BIA) and anthropometric measurements. Estimated basal metabolic rate (BMR), muscle mass, total body water content and the amount of body fat. Information about physical activity were obtained during clinical examination. Nutritional status, and type of obesity were determined by using indicators: Waist to Height Ratio (WHR) and Waist to Hip Ratio (WHR). Excretory functions of the transplanted kidney was rated by calculating the estimated renal glomerular filtration rate (eGFR) using the MDRD formula. Liver function was rated by total bilirubin and alanine aminotransferase levels ALT concentration in serum. In our patients haemolitic uremic syndrome (HUS) was excluded. Results: In 19.44% of patients had underweight, 22.37% of the respondents were with normal weight, 11.11% had overweight, and the rest were with obese (49.08%). People with android stature have a lower eGFR compared with those with the gynoidal stature (p = 0.004). All patients with obesity had higher amount of body fat from a few to several percent. The higher amount of body fat percentage, the lower eGFR had patients (p <0.001). Elevated ALT levels significantly correlated with a high fat content (p <0.02). Conclusion: Increased amount of body fat, particularly in the case of android obesity can be a predictor of kidney and liver damage. Due to that obese patients should have more frequent control of diagnostic functions of these organs and the intensive dietary proceedings, pharmacological and regular physical activity adapted to the current physical condition of patients after transplantation.

Keywords: obesity, body fat, kidney transplantation, glomerular filtration rate, liver function

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4454 The Effect of Colloidal Metals Nanoparticles on Quarantine Bacterium - Clavibacter michiganensis Ssp. sepedonicus

Authors: Włodzimierz Przewodowski, Agnieszka Przewodowska

Abstract:

Colloidal metal nanoparticles have drawn increasing attention in the field of phytopathology because of their unique properties and possibilities of applications. Their antibacterial activity, no induction of the development of pathogen resistance and the ability to penetrate most of biological barriers make them potentially useful in the fighting against dangerous pathogens. These properties are very important in the case of protection of strategic crops in the world, like potato - fourth crop in the world - which is host to numerous pathogenic microorganisms causing serious diseases, significantly affecting yield and causing the economic losses. One of the most important and difficult to reduce pathogen of potato plant is quarantine bacterium Clavibacter michiganensis ssp. sepedonicus (Cms) responsible for ring rot disease. Control and detection of these pathogens is very complicated. Application of healthy, certified seed material as well as hygiene in potato production and storage are the most efficient ways of preventing of ring rot disease. Currently used disinfectants and pesticides, have many disadvantages, such as toxicity, low efficiency, selectivity, corrosiveness, and the inability to eliminate the pathogens in potato tissue. In this situation, it becomes important to search for new formulations based on components harmful to health, yet efficient, stable during prolonged period of time and a with wide range of biocide activity. Such capabilities are offered by the latest generation of biocidal nanoparticles such as colloidal metals. Therefore the aim of the presented research was to develop newly antibacterial preparation based on colloidal metal nanoparticles and checking their influence on the Cms bacteria. Our preliminary results confirmed high efficacy of the nano-colloids in controlling the this selected pathogen.

Keywords: clavibacter michiganensis ssp. sepedonicus, colloidal metal nanoparticles, phytopathology, bacteria

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4453 Resveratrol Ameliorates Benzo(a)Pyrene Induced Testicular Dysfunction and Apoptosis: Involvement of p38 MAPK/ATF2/iNOS Signaling

Authors: Kuladip Jana, Bhaswati Banerjee, Parimal C. Sen

Abstract:

Benzo(a)pyrene [B(a)P] is an environmental toxicant present mostly in cigarette smoke and car exhaust, is an aryl hydrocarbon receptor (AhR) ligand that exerts its toxic effects on both male and female reproductive systems along with carcinogenesis in skin, prostate, ovary, lung and mammary glands. Our study was focused on elucidating the molecular mechanism of B(a)P induced male reproductive toxicity and its prevention with phytochemical like resveratrol. In this study, the effect of B(a)P at different doses (0.1, 0.25, 0.5, 1 and 5 mg /kg body weight) was studied on male reproductive system of Wistar rat. A significant decrease in cauda epididymal sperm count and motility along with the presence of sperm head abnormalities and altered epididymal and testicular histology were documented following B(a)P treatment. B(a)P treatment resulted apoptotic sperm cells as observed by TUNEL and Annexin V-PI assay with increased Reactive Oxygen Species (ROS), altered sperm mitochondrial membrane potential (ΔΨm) with a simultaneous decrease in the activity of antioxidant enzymes and GSH status. TUNEL positive apoptotic cells also observed in testis as well as isolated germ and Leydig cells following B(a)P exposure. Western Blot analysis revealed the activation of p38 mitogen activated protein kinase (p38MAPK), cytosolic translocation of cytochrome-c, upregulation of Bax and inducible nitric oxide synthase (iNOS) with cleavage of poly ADP ribose polymerase (PARP) and down regulation of BCl2 in testis upon B(a)P treatment. The protein and mRNA levels of testicular key steroidogenesis regulatory proteins like steroidogenic acute regulatory protein (StAR), cytochrome P450 IIA1 (CYPIIA1), 3β hydroxy steroid dehydrogenase (3β HSD), 17β hydroxy steroid dehydrogenase (17β HSD) showed a significant decrease in a dose dependent manner while an increase in the expression of cytochrome P450 1A1 (CYP1A1), Aryl hydrocarbon Receptor (AhR), active caspase- 9 and caspase- 3 following B(a)P exposure. We conclude that exposure of benzo(a)pyrene caused testicular gamatogenic and steroidogenic disorders by induction of oxidative stress, inhibition of StAR and other steroidogenic enzymes along with activation of p38MAPK and initiated caspase-3 mediated germ and Leydig cell apoptosis. Next we investigated the role of resveratrol on B(a)P induced male reproductive toxicity. Our study highlighted that resveratrol co-treatment with B(a)P maintained testicular redox potential, increased serum testosterone level and prevented steroidogenic dysfunction with enhanced expression of major testicular steroidogenic proteins (CYPIIA1, StAR, 3β HSD,17β HSD) relative to treatment with B(a)P only. Resveratrol suppressed B(a)P-induced testicular activation of p38 MAPK, ATF2, iNOS and ROS production; cytosolic translocation of Cytochome c and Caspase 3 activation thereby prevented oxidative stress of testis and inhibited apoptosis. Resveratrol co-treatment also decreased B(a)P-induced AhR protein level, its nuclear translocation and subsequent CYP1A1 promoter activation, thereby decreased protein and mRNA levels of testicular cytochrome P4501A1 (CYP1A1) and prevented BPDE-DNA adduct formation. Our findings cumulatively suggest that resveratrol prevents activation of B(a)P by modulating the transcriptional regulation of CYP1A1 and acting as an antioxidant thus prevents B(a)P-induced oxidative stress and testicular apoptosis.

Keywords: benzo(a)pyrene, resveratrol, testis, apoptosis, cytochrome P450 1A1 (CYP1A1), aryl hydrocarbon receptor (AhR), p38 MAPK/ATF2/iNOS

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4452 Federal Bureau of Investigation Opposition to German Nationalist Organizations in the United States (1941-45)

Authors: Yaroslav Alexandrovich Levin

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In modern research on the history of the United States in World War II, it is quite popular to study the opposition of the American special services and, in particular, the Federal Bureau of Investigation (FBI) to various organizations of the German diasporas in new historical conditions. The appeal to traditional methods of historical research, comparative studies, and the principles of historicism will make it possible to more accurately trace the process of tightening the counterintelligence work of the Bureau and the close connection of concerns about the involvement of public organizations in the intelligence activities of the enemy. The broadcast of nationalist ideas by various communities of Germans under the auspices of their governments quickly attracted the attention of the FBI, which is in the process of consolidating its powers as the main US counterintelligence service. At the same time, the investigations and trials conducted by the John Edgar Hoover Department following these investigations often had an openly political color and increasingly consolidated the beginning of a political investigation in this service. This practice and its implementation ran into a tough contradiction between the legal norms of America, which proclaimed "democratic values," the right to freedom of speech, and the need to strengthen the internal security of the state and society in wartime. All these processes and the associated nuances and complexities are considered in specific examples of the work of federal agents against various pro-German organizations in the period 1941-45.

Keywords: World War II, internal security, countering extremism, counterintelligence, political investigation, FBI

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4451 Polymer Nanocomposite Containing Silver Nanoparticles for Wound Healing

Authors: Patrícia Severino, Luciana Nalone, Daniele Martins, Marco Chaud, Classius Ferreira, Cristiane Bani, Ricardo Albuquerque

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Hydrogels produced with polymers have been used in the development of dressings for wound treatment and tissue revitalization. Our study on polymer nanocomposites containing silver nanoparticles shows antimicrobial activity and applications in wound healing. The effects are linked with the slow oxidation and Ag⁺ liberation to the biological environment. Furthermore, bacterial cell membrane penetration and metabolic disruption through cell cycle disarrangement also contribute to microbial cell death. The silver antimicrobial activity has been known for many years, and previous reports show that low silver concentrations are safe for human use. This work aims to develop a hydrogel using natural polymers (sodium alginate and gelatin) combined with silver nanoparticles for wound healing and with antimicrobial properties in cutaneous lesions. The hydrogel development utilized different sodium alginate and gelatin proportions (20:80, 50:50 and 80:20). The silver nanoparticles incorporation was evaluated at the concentrations of 1.0, 2.0 and 4.0 mM. The physico-chemical properties of the formulation were evaluated using ultraviolet-visible (UV-Vis) absorption spectroscopy, Fourier transform infrared (FTIR) spectroscopy, differential scanning calorimetry (DSC), and thermogravimetric (TG) analysis. The morphological characterization was made using transmission electron microscopy (TEM). Human fibroblast (L2929) viability assay was performed with a minimum inhibitory concentration (MIC) assessment as well as an in vivo cicatrizant test. The results suggested that sodium alginate and gelatin in the (80:20) proportion with 4 mM of AgNO₃ in the (UV-Vis) exhibited a better hydrogel formulation. The nanoparticle absorption spectra of this analysis showed a maximum band around 430 - 450 nm, which suggests a spheroidal form. The TG curve exhibited two weight loss events. DSC indicated one endothermic peak at 230-250 °C, due to sample fusion. The polymers acted as stabilizers of a nanoparticle, defining their size and shape. Human fibroblast viability assay L929 gave 105 % cell viability with a negative control, while gelatin presented 96% viability, alginate: gelatin (80:20) 96.66 %, and alginate 100.33 % viability. The sodium alginate:gelatin (80:20) exhibited significant antimicrobial activity, with minimal bacterial growth at a ratio of 1.06 mg.mL⁻¹ in Pseudomonas aeruginosa and 0.53 mg.mL⁻¹ in Staphylococcus aureus. The in vivo results showed a significant reduction in wound surface area. On the seventh day, the hydrogel-nanoparticle formulation reduced the total area of injury by 81.14 %, while control reached a 45.66 % reduction. The results suggest that silver-hydrogel nanoformulation exhibits potential for wound dressing therapeutics.

Keywords: nanocomposite, wound healing, hydrogel, silver nanoparticle

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4450 Importance of Collegiality to Improve the Effectiveness of a Poorly Resourced School

Authors: Prakash Singh

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This study focused on the importance of collegiality to improve the effectiveness of a poorly resourced school (PRS). In an effective school that embraces collegiality as its culture, one can expect to find a teaching staff and a management team that shares responsibilities and accountabilities through the development of a common purpose and vision, regardless of whether the school is considered to be poorly resourced or not. Working together in collegial teams is a more effective way to accomplish tasks and to create a climate for effective learning, even for learners in PRSs from poor communities. The main aim of this study was therefore to determine whether collegiality as a leadership strategy could extract the best from people in a PRS, and consequently create the most effective and efficient educational climate possible. The responses received from the teachers and the principal at the PRS supports the notion that collegiality does have a positive influence on learning, as demonstrated by the improved academic achievement of the learners. The teachers were now more involved in the school. They agreed that this was a positive development. Their descriptions of increased involvement, shared accountability and shared decision-making identified important aspects of collegiality that transformed the school from being dysfunctional. Hence, it is abundantly clear that a collegial leadership style can help extract the best from people because the most effective and efficient educational climate can be created at a school when collegiality is employed. Collegial leadership demonstrates that even in PRSs, there are boundless opportunities to improve teaching and learning.

Keywords: collegiality, collegial leadership, effective educational climate, poorly resourced school

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4449 Emerging Therapeutic Approach with Dandelion Phytochemicals in Breast Cancer Treatment

Authors: Angel Champion, Sadia Kanwal, Rafat Siddiqui

Abstract:

Harnessing phytochemicals from plant sources presents a novel opportunity to prevent or treat malignant diseases, including breast cancer. Chemotherapy lacks precision in targeting cancerous cells while sparing normal cells, but a phytopharmaceutical approach may offer a solution. Dandelion, a common weed plant, is rich in phytochemicals and provides a safer, more cost-effective alternative with lower toxicity than traditional pharmaceuticals for conditions such as breast cancer. In this study, an in-vitro experiment will be conducted using the ethanol extract of Dandelion on triple-negative MDA-231 breast cancer cell lines. The polyphenolic analysis revealed that the Dandelion extract, particularly from the root and leaf (both cut and sifted), had the most potent antioxidant properties and exhibited the most potent antioxidation activity from the powdered leaf extract. The extract exhibits prospective promising effects for inducing cell proliferation and apoptosis in breast cancer cells, highlighting its potential for targeted therapeutic interventions. Standardizing methods for Dandelion use is crucial for future clinical applications in cancer treatment. Combining plant-derived compounds with cancer nanotechnology holds the potential for effective strategies in battling malignant diseases. Utilizing liposomes as carriers for phytoconstituent anti-cancer agents offers improved solubility, bioavailability, immunoregulatory effects, advancing anticancer immune function, and reducing toxicity. This integrated approach of natural products and nanotechnology has significant potential to revolutionize healthcare globally, especially in underserved communities where herbal medicine is prevalent.

Keywords: apoptosis, antioxidant activity, cancer nanotechnology, phytopharmaceutical

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4448 Detection of Oral Mucosal Lesions in Cutaneous Psoriatic Patients

Authors: Rania A. R. Soudan, Easter Joury

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Introduction: Psoriasis is a common chronic dermatologic disease. It may affect the mucous membranes. The presence of oral mucosal lesions has been a subject of controversy. The aim: To determine possible association between oral mucosal lesions and psoriasis, and to correlate the same with different types of psoriasis and severity of the disease. Materials and Methods: The oral mucosa was clinically examined in 100 randomly selected Syrian psoriatic patients presented to the Dermatological Diseases Hospital in Damascus University, Syria (February 2009 - December 2010), and in 100 matched controls. PASI index was used to evaluate the disease severity. Chi-square and Student t-test were used to compare differences between groups. Results: Oral mucosal lesions were observed in 72% of the psoriasis cases, while 46% of the control group’s subjects had oral lesions. Fissured tongue, geographic tongue, and red lesions were detected in 36%, 25%, and 7% of the examined psoriatics, respectively. These lesions were significantly more frequent in the psoriatics than in the controls. A correlation was found between furred tongue and the age of the psoriasis patients. However, an association was observed for fissured tongue, furred tongue with the severity of the disease, and for fissured tongue, white lesions, cheilitis with nail involvement. However, no correlation with the psoriasis types was recorded. Conclusion: Some oral mucosal lesions were associated with psoriasis, so these lesions may be considered as oral manifestations of this disease, and should be taken into account in new studies as possible predictors or markers of this dermatitis. Further studies are recommended to confirm these oral manifestations.

Keywords: psoriasis, tongue, mucosa, lesions

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4447 Catalytic Production of Hydrogen and Carbon Nanotubes over Metal/SiO2 Core-Shell Catalyst from Plastic Wastes Gasification

Authors: Wei-Jing Li, Ren-Xuan Yang, Kui-Hao Chuang, Ming-Yen Wey

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Nowadays, plastic product and utilization are extensive and have greatly improved our life. Yet, plastic wastes are stable and non-biodegradable challenging issues to the environment. Waste-to-energy strategies emerge a promising way for waste management. This work investigated the co-production of hydrogen and carbon nanotubes from the syngas which was from the gasification of polypropylene. A nickel-silica core-shell catalyst was applied for syngas reaction from plastic waste gasification in a fixed-bed reactor. SiO2 were prepared through various synthesis solvents by Stöber process. Ni plays a role as modified SiO2 support, which were synthesized by deposition-precipitation method. Core-shell catalysts have strong interaction between active phase and support, in order to avoid catalyst sintering. Moreover, Fe or Co metal acts as promoter to enhance catalytic activity. The effects of calcined atmosphere, second metal addition, and reaction temperature on hydrogen production and carbon yield were examined. In this study, the catalytic activity and carbon yield results revealed that the Ni/SiO2 catalyst calcined under H2 atmosphere exhibited the best performance. Furthermore, Co promoted Ni/SiO2 catalyst produced 3 times more than Ni/SiO2 on carbon yield at long-term operation. The structure and morphological nature of the calcined and spent catalysts were examined using different characterization techniques including scanning electron microscopy, transmission electron microscopy, X-ray diffraction. In addition, the quality and thermal stability of the nano-carbon materials were also evaluated by Raman spectroscopy and thermogravimetric analysis.

Keywords: plastic wastes, hydrogen, carbon nanotube, core-shell catalysts

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4446 Process Development for the Conversion of Organic Waste into Valuable Products

Authors: Ife O. Bolaji

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Environmental concerns arising from the use of fossil fuels has increased the interest in the development of renewable and sustainable sources of energy. This would minimize the dependence on fossil fuels and serve as future alternatives. Organic wastes contain carbohydrates, proteins and lipids, which can be utilised as carbon sources for the production of bio-based products. Cellulose is the most abundant natural biopolymer, being the main structural component of lignocellulosic materials. The aim of this project is to develop a biological process for the hydrolysis and fermentation of organic wastes into ethanol and organic acids. The hydrolysis and fermentation processes are integrated in a single vessel using undefined mixed culture microorganisms. The anaerobic fermentation of microcrystalline cellulose was investigated in continuous and batch reactors at 25°C with an appropriate growth medium for cellulase formation, hydrolysis, and fermentation. The reactors were inoculated with soil (B1, C1, C3) or sludge from an anaerobic digester (B2, C2) and the breakdown of cellulose was monitored by measuring the production of ethanol, organic acids and the residual cellulose. The batch reactors B1 and B2 showed negligible microbial activity due to inhibition while the continuous reactors, C1, C2 and C3, exhibited little cellulose hydrolysis which was concealed by the cellulose accumulation in the reactor. At the end of the continuous operation, the reactors C1, C2 and C3 were operated under batch conditions. 48%, 34% and 42% cellulose had been fermented by day 88, 55 and 55 respectively of the batch fermentation. Acetic acid, ethanol, propionic acid and butyric acids were the main fermentation products in the reactors. A stable concentration of 0.6 g/l ethanol and 5 g/L acetic acid was maintained in C3 for several weeks due to reduced activity of methanogens caused by the decrease in pH. Thus far, the results have demonstrated that mixed microbial culture is capable of hydrolysing and fermenting cellulose under lenient conditions. The fermentation of cellulose has been found effective in a combination of continuous and batch processes.

Keywords: cellulose, hydrolysis, mixed culture, organic waste

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4445 Toxicity, Analgesic, and Anti-Pyretic Activities of Methanolic Extract from Hyoscyamus albus’ Leaves in Albinos Rats

Authors: Yahia Massinissa, Afaf Benhouda, Mouloud Yahia

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Objective: The aim of this study was to investigate the toxicity; analgesic and anti-pyretic properties of standardized HA methanolic extract (HAMeOH) in vivo. Methods: The acute toxicity study was performed on rats while adopting the OECD-420 Guidelines (fixed dose procedure). Assessment of analgesic activity was performed in rats with two analgesic models. One was acetic acid induced writhing response and the other formalin-induced paw licking. The anti-pyretic effect was tested by Brewer’s yeast induced fever in rats. Results: For the acute toxicity test, the higher dose administration of 2000 mg/kg bw. of H.albus did not produce any toxic signs or deaths in rats. There were no significant differences (p>0.05) in the body and organ weights between control and treated groups. The (LD50) of 'H. albus' was higher than 2000 g/kg bw. In subacute toxicity study, no mortality and toxic signs were observed with the doses of 100 and 200 mg/kg bw. of extracts of for 28 consecutive days. These analgesic experimental results indicated that HAMeOH (100 mg/kg and 200 mg/kg) decreased the acetic acid-induced writhing responses and HAMeOH (100 mg/kg and 200 mg/kg) decreased the licking time in the second phase of the formalin test. Moreover, in the model of yeast-induced elevation of the body temperature HAMeOH showed dose-dependent lowering of the body temperature up to 3h at both the doses these results obtained, were comparable to that of paracetamol. Conclusion: The present findings indicate that the leaves of Hyoscyamus albus L. possess potent analgesic and antipyretic activity.

Keywords: Hyoscyamus albus, Umbilicus rupestris, secondary metabolites, NMR with protons, pharmacobiologic activities, methanolic extract

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4444 The Involvement of Visual and Verbal Representations Within a Quantitative and Qualitative Visual Change Detection Paradigm

Authors: Laura Jenkins, Tim Eschle, Joanne Ciafone, Colin Hamilton

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An original working memory model suggested the separation of visual and verbal systems in working memory architecture, in which only visual working memory components were used during visual working memory tasks. It was later suggested that the visuo spatial sketch pad was the only memory component at use during visual working memory tasks, and components such as the phonological loop were not considered. In more recent years, a contrasting approach has been developed with the use of an executive resource to incorporate both visual and verbal representations in visual working memory paradigms. This was supported using research demonstrating the use of verbal representations and an executive resource in a visual matrix patterns task. The aim of the current research is to investigate the working memory architecture during both a quantitative and a qualitative visual working memory task. A dual task method will be used. Three secondary tasks will be used which are designed to hit specific components within the working memory architecture – Dynamic Visual Noise (visual components), Visual Attention (spatial components) and Verbal Attention (verbal components). A comparison of the visual working memory tasks will be made to discover if verbal representations are at use, as the previous literature suggested. This direct comparison has not been made so far in the literature. Considerations will be made as to whether a domain specific approach should be employed when discussing visual working memory tasks, or whether a more domain general approach could be used instead.

Keywords: semantic organisation, visual memory, change detection

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4443 Peptidoglycan Vaccine-On-Chip against a Lipopolysaccharide-Induced Experimental Sepsis Model

Authors: Katerina Bakela, Ioanna Zerva, Irene Athanassakis

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Lipopolysaccharide (LPS) is commonly used in murine sepsis models, which are largely associated with immunosuppression (incretion of MDSCs cells and Tregs, imbalance of inflammatory/anti-inflammatory cytokines) and collapse of the immune system. After adapting the LPS treatment to the needs of locally bred BALB/c mice, the present study explored the protective role of Micrococcus luteus peptidoglycan (PG) pre-activated vaccine-on chip in endotoxemia. The established protocol consisted of five daily intraperitoneal injections of 0.2mg/g LPS. Such protocol allowed longer survival, necessary in the prospect of the therapeutic treatment application. The so-called vaccine-on-chip consists of a 3-dimensional laser micro-texture Si-scaffold loaded with BALB/c mouse macrophages and activated in vitro with 1μg/ml PG, which exert its action upon subcutaneous implantation. The LPS treatment significantly decreased CD4+, CD8+, CD3z+, and CD19+ cells, while increasing myeloid-derived suppressor cells (MDSCs), CD25+, and Foxp3+ cells. These results were accompanied by increased arginase-1 activity in spleen cell lysates and production of IL-6, TNF-a, and IL-18 while acquiring severe sepsis phenotype as defined by the murine sepsis scoring. The in vivo application of PG pre-activated vaccine-on chip significantly decreased the percent of CD11b+, Gr1+, CD25+, Foxp3+ cells, and arginase-1 activity in the spleen of LPS-treated animals, while decreasing IL-6 and TNF-a in the serum, allowing survival to all animals tested and rescuing the severity of sepsis phenotype. In conclusion, these results reveal a promising mode of action of PG pre-activated vaccine-on chip in LPS endotoxemia, strengthening; thus, the use of treatment is septic patients.

Keywords: myeloid-derived suppressor cells, peptidoglycan, sepsis, Si-scaffolds

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4442 Students With Special Educational Needs in Regular Classrooms and their Peer Effects on Learning Achievement

Authors: José María Renteria, Vania Salas

Abstract:

This study explores the impact of inclusive education on the educational outcomes of students without Special Educational Needs (non-SEN) in Peru, utilizing official Ministry of Education data and implementing cross-sectional regression analyses. Inclusive education is a complex issue that, without appropriate adaptations and comprehensive understanding, can present substantial challenges to the educational community. While prior research from developed nations offers diverse perspectives on the effects of inclusive education on non-SEN students, limited evidence exists regarding its impact in developing countries. Our study addresses this gap by examining inclusive education in Peru and its effects on non-SEN students, thereby contributing to the existing literature. the findings reveal that, on average, the presence of SEN students in regular classrooms does not significantly affect their non-SEN counterparts. However, we uncover heterogeneous effects contingent on the specific type of SEN and students’ academic placement. These results emphasize the importance of targeted resources, specialized teachers, and parental involvement in facilitating successful inclusive education, particularly for specific SEN types and students positioned at the lower end of the academic achievement spectrum. In summary, this study underscores the need for tailored strategies and additional resources to foster the success of inclusive education and calls for further research in this field to expand our understanding and enhance educational policy.

Keywords: inclusive education, special educational needs, learning achievement, Peru, Basic education

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4441 Antioxidant and Cytotoxic Effects of Different Extracts of Fruit Peels Against Three Cancer Cell Lines

Authors: Emad A. Shalaby

Abstract:

Cancer is a disease that causes abnormal cell proliferation and invades nearby tissues. Lung cancer is the second most frequent cancer worldwide. Natural anti-cancer drugs have been developed with low side effects and toxicity. Citrus peels and extracts have been demonstrated to have significant pharmacological and physiological effects as a result of the high concentration of phenolic compounds found in citrus fruits, particularly peels. Tangerine peels can serve as an effective source of bioactive substances such as phenolics, flavonoids, and catechins, which have antioxidant, antibacterial, anticancer, and anti-inflammatory properties. Consequently, this work aims to determine the anticancer activity of ethanol extract of Tangerine peels against the A549 cell line and identify the phenolic compound profile (19 compounds) by using HPLC. Anticancer and antioxidant potentials of the extract were evaluated by MTT assay and TLC- TLC-bioautography sprayed with DPPH reagent, respectively. The obtained results revealed that tangerine peel extract showed significant activity against the A549 cell line with IC50 of 97.66 μg/mL. HPLC analysis proved that the highest concentration is naringenin 464.05 mg/g. More studies indicate that naringenin has significant anticancer potential on A549 cancer cells. The results showed that naringenin binds t0 EGFR protein in A549 with high binding affinity and thus may reduce lung cancer cell migration and enhance the apoptosis of cancer cells. From the obtained results it could be concluded that tangerine peel extract is an effective anti-cancer agent that may potentially serve as a natural therapeutic option for lung cancer treatment.

Keywords: tangerine peel, A549 cell line, anticancer, naringenin, HPLC analysis, naringenin, TLC bioautography

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4440 Embodied Spiritualities and Emerging Search for Social Transformation: An Embodied Ethnographic Study of Yoga Practices in Medellin, Colombia

Authors: Lina M. Vidal

Abstract:

This paper discusses yoga practices involvement in both self-transformation and social transformations by means of an embodied ethnographic approach to different initiatives for social change in Medellín. In the context of gradual popularization of embodied spiritualities, yoga practices have opened their way in calls for social change in a performative perspective which involves collective experiences, reflections and production of embodied knowledge. Through the reflection on bodily dimension and corporal experience, this ethnographic approach acknowledges inter-corporality and somatic modes of attention during observations and personal experiences. In social change initiatives that include yoga practices were identified transformations of common understanding on social issues such as it is produced by institutionalized education, health system and other fields of knowledge. This is clearly visible in yoga projects for children in vulnerable conditions, homeless people, prisoners, and young people recovering from drug addiction. These projects are often promoted by organizations and networks, which incorporate individual life stories into collective experiences. Dissemination of yoga is heading to a broad institutional and cultural legitimation of yoga and of spirituality that impact different fields of social work and everyday life in general. This way, yoga is becoming an embodied activist way of life and a legitimate field for social work.

Keywords: embodied ethnography, Medellin, social transformation, embodied spiritualities, yoga practices

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4439 In vitro Assessment of Bioactive Properties and Dose-Dependent Antioxidant Activities of Commercial Grape Cultivars in Taiwan

Authors: Kandi Sridhar, Charles Albert Linton

Abstract:

Grapes are excellent sources of bioactive compounds, which have been suggested to be responsible for lowering the risk of chronic diseases. Fresh and freeze-dried extracts of Kyoho and Jubilee, commercial grape varieties available in Taiwan and attractive for their quality berries, were investigated for their total phenolics and total flavonoids contents and related dose-dependent antioxidants properties using various in vitro assays. The efficiency of the extraction yield ranged from 7.10 % to 25.53 % (w/w), depending on solvent used. Fresh samples of Kyoho and Jubilee exhibited total polyphenolic contents (351.56 ± 23.08 and 328.67 ± 16.54 µg GAE/mL, respectively), whereas Kyoho freeze-dried methanol: water extracts contains the good levels of total flavonoids (4767.82 ± 22.20 µg QE/mL). Kyoho and Jubilee freeze-dried extracts exhibited the highest total flavonoid contents. There was a weak correlation between total phenolic and flavonoid assays (r= -0.05, R2 = 0.02, p > 0.05). Kyoho fresh and freeze-dried samples showed the DPPH (11.51 – 77.82 %), superoxide scavenging activity (33.61 – 81.95 %), and total antioxidant inhibition (92.01 – 99.28 %), respectively. Total flavonoids were statistically correlated with EC50 DPPH scavenging radicals (r =0.91, p < 0.01), EC50 nitric oxide (r = 0.25, p > 0.05), and EC50 lipid peroxidation radicals (r = 0.38, p > 0.05). These results suggested that the two commercial grape cultivars in Taiwan could be used as a good source of natural antioxidants. Thus, consumption of grapes as a source antioxidant might lower the risk of chronic diseases. Moreover, future studies will investigate and develop phenolic acid profile for the cultivars in Taiwan.

Keywords: antioxidants, EC50 radical scavenging activity, grape cultivars, total phenolics

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4438 Relationship between Learning Methods and Learning Outcomes: Focusing on Discussions in Learning

Authors: Jaeseo Lim, Jooyong Park

Abstract:

Although there is ample evidence that student involvement enhances learning, college education is still mainly centered on lectures. However, in recent years, the effectiveness of discussions and the use of collective intelligence have attracted considerable attention. This study intends to examine the empirical effects of discussions on learning outcomes in various conditions. Eighty eight college students participated in the study and were randomly assigned to three groups. Group 1 was told to review material after a lecture, as in a traditional lecture-centered class. Students were given time to review the material for themselves after watching the lecture in a video clip. Group 2 participated in a discussion in groups of three or four after watching the lecture. Group 3 participated in a discussion after studying on their own. Unlike the previous two groups, students in Group 3 did not watch the lecture. The participants in the three groups were tested after studying. The test questions consisted of memorization problems, comprehension problems, and application problems. The results showed that the groups where students participated in discussions had significantly higher test scores. Moreover, the group where students studied on their own did better than that where students watched a lecture. Thus discussions are shown to be effective for enhancing learning. In particular, discussions seem to play a role in preparing students to solve application problems. This is a preliminary study and other age groups and various academic subjects need to be examined in order to generalize these findings. We also plan to investigate what kind of support is needed to facilitate discussions.

Keywords: discussions, education, learning, lecture, test

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4437 Ajmer Dargah: Sustaining the Identity of a Religious Precinct

Authors: Vinod Chovvayil Panengal

Abstract:

The idea of secularism in India has taken a different direction after independence when religion became a reason for a great divide in, otherwise harmonious society. Since then the religious spaces became protected and more sacred and not shared. However, there is a larger threat on beliefs, rituals, and the spirituality of these religions in the form of technology, tourism and globalization. In a way, they weaken the importance of religion from our society over a period of time. The importance of religion to a sense of place has been overlooked or diminished. Religion provides symbolic meaning to places which distinguishes certain physical environments from otherwise similar ones. The rapid transformation of urban spaces, eliminating the territorial differences of sense, spirit and identity have started creating urban centers rooting out this genre of unique urban spaces from our cities. Indian cities, with a strong identity created by rich and colorful overlays of culture through its evolution, have been threatened by this de-territorialization. This paper enquires the relationship of the symbol of the identity and religiosity of a place, through spatial form, rituals and activity, and accommodating the technology and the changing social structure within the bounds of that relationship. The subjects for this enquiry are Sufism and the Sufi city- Ajmer. The internal transformations in the ideologies of Islam and Sufism and the changes in the society surround it triggered the phenomena of de- territorialization. The need for establishing a symbiotic relationship between the spiritual content and the social life, through the manifestation of space, time and activity derived from this concern on abated territory of Sufism inside the city. Redirecting transformation catalyst such as tourism, technology, etc, towards the improvement of physical and social conditions, preservation of the heritage and the expansion of the notional idea of religion over the city will help to re- territorialize city as a Sufi city.

Keywords: sense of place, religion, Islam, identity

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4436 Activity Antidiarrheal Extract Kedondong Leaf in Balb/C Strain Male Mice Invivo

Authors: Johanrik, Arini Aprilliani, Fikri Haikal, Diyas Yuca, Muhammad A. Latif, Edijanti Goenarwo, Nurita P. Sari

Abstract:

Diarrhea is one of the leading causes of morbidity and mortality in many countries, as well as responsible for the deaths of millions of people each year. Previous research showed that the leaves, bark, and root bark of kedondong contains saponins, tannins, and flavonoids. Tannins have anti-diarrheal effects that work as the freeze of protein / astrigen, and may inhibit the secretion of chloride over the tannate bonding between protein in the intestines. Chemical compounds of flavonoids also have an effect as anti-diarrheal block receptors Cl ˉ in intestinal thus reducing the secretion of Cl ˉ to the intestinal lume. This research aims to know the anti-diarrheal activity of extracts kedondong leaf in mice Balb/C strain males in vivo. This research also proves kedondong leaves as an anti-diarrhea through trial efficacy of kedondong leaves as antisekretori and antimotilitas. This research using post-test only controlled group design. Analysis of statistical data normality and homogenity were tested by Kolmogorov Smirnov. If the data obtained homogenous then using ANOVA test. This research using ethanolic extracts kedondong leaf 200, 400 and 800 mg/kgBW to prove there is anti-diarrhea it makes into six treatment groups, for anti-secretory it makes into five treatment groups and anti-motility became five treatment groups. The result showed dose of ethanolic extracts kedondong leaf 800 mg/kgBW have significant value (p < 0.005). The conclusion from this extracts kedondong leaf research 800 mg/kgBW have pharmacological effects as antidiarrhea on Balb/C strain male mice with a mechanism of action as antisecretory and antimotility.

Keywords: anti-diarrhea, anti-secretory, anti-motility, kedondong leaf

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4435 Understanding of Corporate Social Responsibility and Non-Governmental Organizations

Authors: Abdul Ghafar, Malini Nair

Abstract:

Non-governmental organizations have been seemed to struggle the battle of balancing many concerns with corporates which may impact on their financial solvency. Some of these concerns relates to uphold the relationship where weighing up the impacts of their involvement with corporates takes priority over the main purpose of creating valuable impacts for communities. To some extent, it can be argued that NGOs are influenced by corporates’ power to tackle contemporary issues rather than eradicating the root causes of such issues and transform the results into more sustainable manner. NGOs spend massive amount of energy, time and resources in order to move some corporates to embrace their social responsibilities. It has become a norm, where an active NGO that is becoming more successful on building partnerships with corporates is perceived to be more socially responsible. In contrast to this, as some researchers argue that the social responsibility for NGOs is not a voluntary act; they must exhibit the core values in all their practices require much attention to address. This article stresses the need of understanding ‘Social Responsibility’ of NGOs that stem from an argument that NGOs tend to act on narrow mandate rather than considering broader outcomes of their CSR initiatives. This paper argues that NGOs must focus on building capabilities of the recipients from CSR initiatives which should serve as a core value of partnerships mandate between NGOs, Corporates and Governments. We argue that SEN’s Capabilities Approach can further enhance the mainstream CSR agenda of NGOs which seems to incline more towards providing palliative solutions to social issues.

Keywords: non-profit organization, corporate social responsibility, partnerships, capabilities approach

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4434 Determinants of Quality of Life and Mental Health in Medical Students During Two Years Observation

Authors: Szymon Szemik, Małgorzata Kowalska

Abstract:

Objective: Medical students experience numerous demands during the education process, determining their quality of life (QoL) and health status. POLLEK (POLski LEKarz, eng. Polish Physician) study aims to identify and evaluate the quality of life, mental health status, and ever-recognized chronic diseases by simultaneously assessing their determinants in Polish medical students during long-term observation. Material and Methods: The POLLEK is the follow-up cohort study conducted among medical students at the Medical University of Silesia in Katowice. Students were followed during two observation periods: in their first year of studies, the academic year 2021/2022 (T1), and in their second year, the academic year 2022/2023 (T2). Results: The total number of participants in the first year of observation (T1) was 427 while in the second year (T2) was 335. Obtained results confirmed that the QoL score significantly decreased in their second year of studies mainly in the somatic and psychological domains. Moreover, we observed a significant increase in self-declared scoring of somatic symptoms year by year (from M=4.75 at T1 to M=8.06 at T2, p<0.001) in the GHQ-28 questionnaire survey. The determinants of QoL domains common to T1 and T2 remained self-declared health status, frequency of physical activity, and current financial situation. In the first year of evaluation, 56 students (13.10%) were overweight or obese, and 52 (15.8%) in the second. Regardless of the academic year, the increased risk of being overweight or obese was significantly associated with dissatisfaction with personal health, financial deficiencies, and a diet abundant in meat consumption. Conclusions: The QoL in medical students and selected determinants of their health status deteriorated during the observation period. Our findings suggest that medical schools should actively promote the activity needed to achieve a balance between schoolwork and the personal life of medical students from the beginning of university study.

Keywords: quality of life, mental health, medical students, follow-up study

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4433 Exploring Management Strategies Used by Grade 1 Educators in the Classroom Working with Learners Presenting with ADHD Symptoms in the Western Cape

Authors: Athena Pedro, Gina Stockingt

Abstract:

This study aimed to explore current management strategies used by Grade 1 educators working with learners presenting with Attention Deficit Hyperactivity Disorder (ADHD) symptoms in mainstream schools in the Western Cape. A sample of grade 1 educators were selected for the study. The sample comprised of twelve grades 1 educators from four local schools in the Western Cape. All twelve educators were individually interviewed and discussed the management strategies used in the classroom when working with learner presenting with ADHD symptoms. The data was analysed qualitatively with a focus in identifying, sorting and analyse meaning according to the subjective perception, understanding and behaviour of the grade 1 educators within their context. Furthermore, the social, cultural, political and physical environment of the participants were taken into consideration to explore and interpret the link between these elements. The findings were as follows: many educators felt that they did not receive enough training on Attention Deficit Hyperactivity Disorder, therefore lacking knowledge on how to apply management strategies to address this. Managing a diverse range of learners, lack of resources, lack of parental involvement, lack of assistance in the classroom, as well as distracted and disorganised children posed as challenges for educators working with learners presenting with Attention Deficit Hyperactivity Disorder symptoms.

Keywords: ADHD, Grade 1 educators, Learners, Management strategies

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4432 Polish Catholic Discourse on Gender Equality in the Face of Social and Cultural Changes in Poland

Authors: Anna Jagielska

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Five years ago, the word ‘gender’ was discussed in Poland exclusively in academic contexts. One year later, it was chosen as the word of the year and omnipresent in the Polish media. The rapid career of this word is due to the involvement of the Polish church hierarchy who strategically brought this term into relation with abortion, pornography and paedophilia. ‘Gender’ is more than a political slogan. It is a symbol of social anxiety and moral panic in Poland which need to be historically considered. The aim of this paper is to present selected rhetorical strategies used by the Polish Catholic clergy who strive to have an impact on the current gender discourse in Poland. In particular, the gender debate, culminated in the pastoral letter of the Bishops' Conference of Poland, will be discussed. The church’s protest against the Council of Europe’s Convention on Preventing and Combating Violence against Women and Domestic Violence will be analyzed and the recent heated debates in Poland on contraception, abortion, in vitro fertilization, and sex education will be mentioned. To provide explanations on the specificity of Polish gender debates the role of the Catholic Church in the fall of communism in Poland as well as the charismatisation of Polish society by Pope John Paul II will be explained. The social constructions of communism and feminism which are manifested in both written and symbolic contracts on gender equality between the Church and the State will be demonstrated. At the end of the paper, theories about the changing role of religion in society will be applied.

Keywords: gender, Poland, religion, catholicism, feminism

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4431 Domain-Specific Languages Evaluation: A Literature Review and Experience Report

Authors: Sofia Meacham

Abstract:

In this abstract paper, the Domain-Specific Languages (DSL) evaluation will be presented based on existing literature and years of experience developing DSLs for several domains. The domains we worked on ranged from AI, business applications, and finances/accounting to health. In general, DSLs have been utilised in many domains to provide tailored and efficient solutions to address specific problems. Although they are a reputable method among highly technical circles and have also been used by non-technical experts with success, according to our knowledge, there isn’t a commonly accepted method for evaluating them. There are some methods that define criteria that are adaptations from the general software engineering quality criteria. Other literature focuses on the DSL usability aspect of evaluation and applies methods such as Human-Computer Interaction (HCI) and goal modeling. All these approaches are either hard to introduce, such as the goal modeling, or seem to ignore the domain-specific focus of the DSLs. From our experience, the DSLs have domain-specificity in their core, and consequently, the methods to evaluate them should also include domain-specific criteria in their core. The domain-specific criteria would require synergy between the domain experts and the DSL developers in the same way that DSLs cannot be developed without domain-experts involvement. Methods from agile and other software engineering practices, such as co-creation workshops, should be further emphasised and explored to facilitate this direction. Concluding, our latest experience and plans for DSLs evaluation will be presented and open for discussion.

Keywords: domain-specific languages, DSL evaluation, DSL usability, DSL quality metrics

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4430 Predictors of Survival of Therapeutic Hypothermia Based on Analysis of a Consecutive American Inner City Population over 4 Years

Authors: Jorge Martinez, Brandon Roberts, Holly Payton Toca

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Background: Therapeutic hypothermia (TH) is the international standard of care for all comatose patients after cardiac arrest, but criticism focuses on poor outcomes. We sought to develop criteria to identify American urban patients more likely to benefit from TH. Methods: Retrospective chart review of 107 consecutive adults undergoing TH in downtown New Orleans from 2010-2014 yielded records for 99 patients with all 44 survivors or families contacted up to four years. Results: 69 males and 38 females with a mean age of 60.2 showed 63 dead (58%) and 44 survivors (42%). Presenting cardiac rhythm was divided into shockable (Pulseless Ventricular Tachycardia, Ventricular Fibrillation) and non-shockable (Pulseless Electrical Activity, Asystole). Presenting in shockable rhythms with ROSC <20 minutes were 21 patients with 15 (71%) survivors (p=.001). Time >20 minutes until ROSC in shockable rhythms had 5 patients with 3 survivors (78%, p=0.001). Presenting in non-shockable rhythms with ROSC <20 minutes were 54 patients with 18 survivors (33%, p=.001). ROSC >20 minutes in non-shockable rhythms had 19 patients with 2 survivors (8%, p=.001). Survivors of shockable rhythms showed 19 (100%) living post TH. 15 survivors (79%, n=19, p=.001) had CPC score 1 or 2 with 4 survivors (21%, n=19) having a CPC score of 3. A total of 25 survived non-shockable rhythm. Acute survival of patients with non-shockable rhythm showed 18 expired <72 hours (72%, n=25) with long-term survival of 4 patients (5%, n=74) and CPC scores of 1 or 2 (p=.001). Interestingly, patients with time to ROSC <20 minutes exhibiting more than one loss of sustained ROSC showed 100% mortality (p=.001). Patients presenting with shockable >20 minutes ROSC had overall survival of 70% (p=.001), but those undergoing >3 cardiac rhythm changes had 100% mortality (p=.001). Conclusion: Patients presenting with shockable rhythms undergoing TH had overall acute survival of 70% followed by long-term survival of 100% after 4 years. In contrast, patients presenting with non-shockable rhythm had long-term survival of 5%. TH is not recommended for patients presenting with non-shockable rhythm and requiring greater than 20 minutes for restoration of ROSC.

Keywords: cardiac rhythm changes, Pulseless Electrical Activity (PEA), Therapeutic Hypothermia (TH)

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