Search results for: clinical residents
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4259

Search results for: clinical residents

1439 Assessment of Patient Cooperation and Compliance in Three Stages of Orthodontic Treatment in Adult Patients: A Cross-Sectional Study

Authors: Hafsa Qabool, Rashna Sukhia, Mubassar Fida

Abstract:

Introduction: Success of orthodontic mechanotherapy is highly dependent upon patient cooperation and compliance throughout the duration of treatment. This study was conducted to assess the cooperation and compliance of adult orthodontic patients during the leveling and alignment, space closure/molar correction, and finishing stages of tooth movement. Materials and Methods: Patient cooperation and compliance among three stages of orthodontic treatment were assessed using the Orthodontic Patient Cooperation Scale (OPCS) and Clinical Compliance Evaluation (CCE) form. A sample size of 38 was calculated for each stage of treatment; therefore, 114 subjects were included in the study. Shapiro-Wilk test identified that the data were normally distributed. One way ANOVA was used to evaluate the percentage cooperation and compliance among the three stages. Pair-wise comparisons between the three stages were performed using Post-hoc Tukey. Results: Statistically significant difference was seen for scores of patient compliance using CCE (p = 0.01); however, the results of the OPCS showed a non-significant difference for patient cooperation (p = 0.16) among the three stages of treatment. Post-hoc analysis showed significant differences (p = 0.01) in patient cooperation and compliance between space closure and the finishing stage. Highly significant (p < 0.001) decline in oral hygiene was found with the progression of orthodontic treatment. Conclusions: Improvement in the cooperation and compliance levels for adult orthodontic patients was observed during space closure & molar correction stage, which then showed a decline as treatment progressed. Oral hygiene was progressively compromised as orthodontic treatment progressed.

Keywords: patient compliance, adult orthodontics, orthodontic motivation, orthodontic patient adherence

Procedia PDF Downloads 144
1438 Combined Treatment of PARP-1 Inhibitor and Carbon Ion or Gamma Exposure Reduces the Metastatic Potential in Cultured Human Cells

Authors: Priyanka Chowdhury, Asitikantha Sarma, Utpal Ghosh

Abstract:

Hadron therapy using high Linear Energy Transfer (LET) ion beam is producing promising clinical results worldwide. The major advantages are its ability to kill radio-resistant tumor and its anti-metastatic activity. Poly(ADP-ribose) polymerase-1 (PARP-1) inhibitors have been widely used as radiosensitizer, but its role in metastasis is unknown. The purpose of our study was to investigate the effect of PARP-1 depletion in combination with either Carbon Ion Beam (CIB) or gamma irradiation on metastatic potential of cultured cancerous cells. A549 cells were irradiated with CIB (0-4Gy) or gamma (0, 2, 4, 6 and 10 Gy) with and without PARP-1 inhibition. The metastatic potential of the cells was determined by cell migratory assay, expression, and activity of MMP-2 and MMP-9, expression of Cadherin, Fibronectin, and Vimentin. CIB exposure reduced migratory property and activity of MMP-2 and MMP-9 significantly. CIB with PARP-1 inhibition reduced cell migration and Matrix Metalloproteinase (MMPs) activity in a synergistic manner. Expression of MMPs was also down-regulated in CIB and combined treatment. On the contrary, MMP- 2 and MMP-9 activity was significantly increased in gamma irradiated cells but decreased upon combined treatment of gamma and PARP-1 inhibitor. MMPs expression and migration was reduced when gamma irradiation was combined with PARP-1 inhibition. Thus, our study clearly demonstrates that PARP-1 inhibition in combination with either high or low LET can significantly suppress metastatic potential in cancer cells and thereby can be a promising tool in controlling metastatic cancers.

Keywords: high LET, low LET, matrix metalloproteinase (MMP), PARP-1

Procedia PDF Downloads 203
1437 Health Status among Government and Private Primary School Children in the Central of Thailand

Authors: Petcharat Kerdonfag, Supunnee Thrakul

Abstract:

School health services through regular screening of school students’ health status have been the main responsibility for community or school health nurses. The purposes of these retrospective study were to assess and compare health problems between government and private primary school students in the central region of Thailand. The data were collected from the school health records in October at the end of the first semester in the academic year 2018. Two thousand and fifty primary school health records from government and private primary schools were gathered to assess health problems regarding anthropometric measurements, physical examination/personal hygiene, and clinical findings for this study. Descriptive statistics and Chi-square were used to be analyzed. The results revealed that health problems of all the school students remained high magnitude. The five top ranks for prevalence rate of health problems were dental caries (36.6%), visual acuity problem (27.7%), over-nutrition (16.8%), head lice (12.8%), and under-nutrition (6.8%), respectively. However, when compared between government and private schools among five health problems; dental caries (55.0% vs 19.9%), visual acuity problem (23.1% vs 31.9%), over-nutrition (20.2% vs 13.8%), head lice (26.5% vs 0.3%), and under-nutrition (10.6% vs 3.4%) with Chi-square analysis, there were significantly different (p < .001). The problem of visual acuity seems to be more serious in private schools while other health problems tend to be more critical in government schools. The findings have suggested that parents who have children in the private primary schools should pay more attention to visual health defects whereas parents with children in the government school should pay more vigilance regards to hygiene and health behavior problems.

Keywords: community health nursing, school health service, health status, primary school children

Procedia PDF Downloads 105
1436 Examining the Relationship between Family Functioning and Perceived Self-Efficacy

Authors: Fenni Sim

Abstract:

Objectives: The purpose of the study is to examine the relationship between family functioning and level of self-efficacy: how family functioning can potentially affect self-efficacy which will eventually lead to better clinical outcomes. The hypothesis was ‘Patients on haemodialysis with perceived higher family functioning are more likely to have higher perceived level of self-efficacy’. Methods: The study was conducted with a mixed methodology of quantitative and qualitative data collection of survey and semi-structured interview respectively. The General Self-Efficacy scale and SCORE-15 were self-administered by participants. The data will be analysed with correlation analysis method using Microsoft Excel. 79 patients were recruited for the study through random sampling. 6 participants whose results did not reflect the hypothesis were then recruited for the qualitative study. Interpretive phemenological analysis was then used to analyse the qualitative data. Findings: The hypothesis was accepted that higher family functioning leads to higher perceived self-efficacy. The correlation coefficient of -0.21 suggested a mild correlation between the two variables. However, only 4.6% of the variation in perceived self-efficacy is accounted by the variation in family functioning. The qualitative study extrapolated three themes that might explain the variations in the outliers: (1) level of physical functioning affects perceived self-efficacy, (2) instrumental support from family influenced perceived level of family functioning, and self-efficacy, (3) acceptance of illness reflects higher level of self-efficacy. Conclusion: While family functioning does have an impact on perceived self-efficacy, there are many intrapersonal and physical factors that may affect self-efficacy. The concepts of family functioning and self-efficacy are more appropriately seen as complementing each other to help a patient in managing his illness. Healthcare social workers can look at how family functioning is supporting the individual needs of patients with different trajectory of ESRD and the support we can provide to improve one’s self-efficacy.

Keywords: chronic kidney disease, coping of illness, family functioning, self efficacy

Procedia PDF Downloads 158
1435 Human Immune Response to Surgery: The Surrogate Prediction of Postoperative Outcomes

Authors: Husham Bayazed

Abstract:

Immune responses following surgical trauma play a pivotal role in predicting postoperative outcomes from healing and recovery to postoperative complications. Postoperative complications, including infections and protracted recovery, occur in a significant number of about 300 million surgeries performed annually worldwide. Complications cause personal suffering along with a significant economic burden on the healthcare system in any community. The accurate prediction of postoperative complications and patient-targeted interventions for their prevention remain major clinical provocations. Recent Findings: Recent studies are focusing on immune dysregulation mechanisms that occur in response to surgical trauma as a key determinant of postoperative complications. Antecedent studies mainly were plunging into the detection of inflammatory plasma markers, which facilitate in providing important clues regarding their pathogenesis. However, recent Single-cell technologies, such as mass cytometry or single-cell RNA sequencing, have markedly enhanced our ability to understand the immunological basis of postoperative immunological trauma complications and to identify their prognostic biological signatures. Summary: The advent of proteomic technologies has significantly advanced our ability to predict the risk of postoperative complications. Multiomic modeling of patients' immune states holds promise for the discovery of preoperative predictive biomarkers and providing patients and surgeons with information to improve surgical outcomes. However, more studies are required to accurately predict the risk of postoperative complications in individual patients.

Keywords: immune dysregulation, postoperative complications, surgical trauma, flow cytometry

Procedia PDF Downloads 73
1434 The Impact of Prior Cancer History on the Prognosis of Salivary Gland Cancer Patients: A Population-based Study from the Surveillance, Epidemiology, and End Results (SEER) Database

Authors: Junhong Li, Danni Cheng, Yaxin Luo, Xiaowei Yi, Ke Qiu, Wendu Pang, Minzi Mao, Yufang Rao, Yao Song, Jianjun Ren, Yu Zhao

Abstract:

Background: The number of multiple cancer patients was increasing, and the impact of prior cancer history on salivary gland cancer patients remains unclear. Methods: Clinical, demographic and pathological information on salivary gland cancer patients were retrospectively collected from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2017, and the characteristics and prognosis between patients with a prior cancer and those without prior caner were compared. Univariate and multivariate cox proportional regression models were used for the analysis of prognosis. A risk score model was established to exam the impact of treatment on patients with a prior cancer in different risk groups. Results: A total of 9098 salivary gland cancer patients were identified, and 1635 of them had a prior cancer history. Salivary gland cancer patients with prior cancer had worse survival compared with those without a prior cancer (p<0.001). Patients with a different type of first cancer had a distinct prognosis (p<0.001), and longer latent time was associated with better survival (p=0.006) in the univariate model, although both became nonsignificant in the multivariate model. Salivary gland cancer patients with a prior cancer were divided into low-risk (n= 321), intermediate-risk (n=223), and high-risk (n=62) groups and the results showed that patients at high risk could benefit from surgery, radiation therapy, and chemotherapy, and those at intermediate risk could benefit from surgery. Conclusion: Prior cancer history had an adverse impact on the survival of salivary gland cancer patients, and individualized treatment should be seriously considered for them.

Keywords: prior cancer history, prognosis, salivary gland cancer, SEER

Procedia PDF Downloads 132
1433 Investigation of Ezetimibe Administration on Cell Survival Markers in Kidney Ischemia

Authors: Zahra Heydari

Abstract:

Introduction: One of the major clinical issues is acute renal failure, which is caused by ischemia-reperfusion of the kidney and is associated with high mortality. Despite advances in this area, important issues such as tissue necrosis, cell apoptosis, and so on in damaged tissue are suggestive for more researches and study on this subject. Objective: Evaluation of the potential utility of Ezetimibe in reducing injuries and cell death induced by kidney ischemia/ reperfusion through inducing expression changes of different cellular pathways in adult Sprague-Dawley rats. Materials and methods: Forty rats weighing 180-200g were divided into 4 groups. For this purpose, the first right kidneys of the rats were removed during surgery. After 20 days, the left renal artery was closed with a soft clamp and reperfusion was performed. After 24 hours, blood samples were collected and sent to the laboratory with kidneys to measure bax and bcl-2 by Western blotting and histopathological tests. Results: Quantitative damage reviews of Kidney tissue indicates damage Acute and severe tubular lesions were observed in the ischemia group. Also, the amount of injury was significantly reduced in the treatment group. There was also a significant difference between the ischemia and sham groups. In general, the results show that a single dose of 1.2 mg/kg of ezetimibe can reduce the bax/ bcl-2 ratio compared to the ischemia group. In general, the results showed Ezetimibe is effective in reducing cell damage and death due to ischemia/ reperfusion after renal ischemia through changes in the expression of various cellular pathways in rats.

Keywords: acute renal failure, renal ischemia-reperfusion injury, ezetimibe, apoptosis

Procedia PDF Downloads 179
1432 Evaluation of Compressive Mechanical Properties of the Radial Bone Defect Treated with Selected Bone Graft Substitute Materials in Rabbit

Authors: Omid Gholipoor Bashiri, Ghafur Mosavi, Aliasghar Behnamghader, Seyed Mahmood Rabiee

Abstract:

Objective: To determine the effect of selected bone graft on the compression properties of radial bone in rabbit. Design-Experimental in vivo study. Animals: A total of 45 adult male New Zealand white rabbits. Procedures: The rabbits were anesthetized and a one-cm-full thickness piece of radial bone was removed using oscillating saw in the all rabbit. The rabbits were divided into 5 groups on the basis of the material used to fill the bone defect: group 1: the paste of bone cement calcium phosphate; group II: the paste of calcium phosphate mixture with type I collagen; group III: tricalcium phosphate mixed with hydroxyapatite (TCP & HP) with 5% porosity; group IV: the same scaffold as group III with 10% porosity; and group V: the same scaffold as group III and IV with 20% porosity, with 9 rabbits in each group. Subsequently subdivided into 3 subgroups of 3 rabbits each. Results: There was a significant increase in compression properties of radial bone in the group II and V in 2nd and 3rd months as compared with groups I, III and IV. The mean endurable crack-strength in group II and V were slightly higher than that of normal radius (P<0.05). Conclusion and clinical relevance: Application of calcium phosphate paste with type I collagen and scaffold of tricalcium phosphate with hydroxyapatite having 20% porosity indicated to have positive effect in integral formation of qualitative callus at the site of fracture and early re-organization of callus to regain mechanical strength too.

Keywords: calcium phosphate, tricalcium phosphate, hydroxyapatite, radial bone, compressive properties, porosity, type i collagen, rabbit

Procedia PDF Downloads 438
1431 Membrane-Localized Mutations as Predictors of Checkpoint Blockade Efficacy in Cancer

Authors: Zoe Goldberger, Priscilla S. Briquez, Jeffrey A. Hubbell

Abstract:

Tumor cells have mutations resulting from genetic instability that the immune system can actively recognize. Immune checkpoint immunotherapy (ICI) is commonly used in the clinic to re-activate immune reactions against mutated proteins, called neoantigens, resulting in tumor remission in cancer patients. However, only around 20% of patients show durable response to ICI. While tumor mutational burden (TMB) has been approved by the Food and Drug Administration (FDA) as a criterion for ICI therapy, the relevance of the subcellular localizations of the mutated proteins within the tumor cell has not been investigated. Here, we hypothesized that localization of mutations impacts the effect of immune responsiveness to ICI. We analyzed publicly available tumor mutation sequencing data of ICI treated patients from 3 independent datasets. We extracted the subcellular localization from the UniProtKB/Swiss-Prot database and quantified the proportion of membrane, cytoplasmic, nuclear, or secreted mutations per patient. We analyzed this information in relation to response to ICI treatment and overall survival of patients showing with 1722 ICI-treated patients that high mutational burden localized at the membrane (mTMB), correlate with ICI responsiveness, and improved overall survival in multiple cancer types. We anticipate that our results will ameliorate predictability of cancer patient response to ICI with potential implications in clinical guidelines to tailor ICI treatment. This would not only increase patient survival for those receiving ICI, but also patients’ quality of life by reducing the number of patients enduring non-effective ICI treatments.

Keywords: cancer, immunotherapy, membrane neoantigens, efficacy prediction, biomarkers

Procedia PDF Downloads 98
1430 Gellan Gum/Gamma-Polyglutamic Acid and Glycerol Composited Membrane for Guiding Bone Regeneration

Authors: Chi-Chang Lin, Jiun-Yan Chiu

Abstract:

Periodontal disease, oral cancer relating trauma is the prominent factor devastating bone tissue that is crucial to reestablishing in clinical. As we know, common symptom, osteoporosis, and infection limiting the ability of the bone tissue to recover cause difficulty before implantation therapy. Regeneration of bone tissue is the fundamental therapy before surgical processes. To promote the growth of bone tissue, many commercial products still have sophisticated problems that need to overcome. Regrettably, there is no available material which is apparently preferable for releasing and controlling of loading dosage, or mitigating inflammation. In our study, a hydrogel-based composite membrane has been prepared by using Gellan gum (GG), gamma-polyglutamic acid (γ-PGA) and glycerol with simple sol-gel method. GG is a natural material that is massively adopted in cartilage. Unfortunately, the strength of pure GG film is a manifest weakness especially under simulating body fluidic conditions. We utilize another biocompatible material, γ-PGA as cross-linker which can form tri-dimension structure that enhancing the strength. Our result indicated the strength of pure GG membrane can be obviously improved by cross-linked with γ-PGA (0.5, 0.6, 0.7, 0.8, 0.9, 1.0 w/v%). Besides, blending with glycerol (0, 1.0, 2.0, 3.0 w/v%) can significantly improve membrane toughness that corresponds to practical use. The innovative composited hydrogel made of GG, γ-PGA, and glycerol is attested with neat results including elongation and biocompatibility that take the advantage of extension covering major trauma. Recommendations are made for treatment to build up the foundation of bone tissue that would help patients to escape from the suffering and shorten the amount of time in recovery.

Keywords: bone tissue, gellan gum, regeneration, toughness

Procedia PDF Downloads 129
1429 Gastrointestinal Manifestations and Outcomes in Hospitalized COVID-19 Patients: A Retrospective Study

Authors: Jaylo Abalos, Sophia Zamora

Abstract:

BACKGROUND: Various gastrointestinal (GI) symptoms, including diarrhea, nausea/vomiting and abdominal pain, have been reported in patients with Coronavirus disease 2019 (COVID-19). In this context, the presence of GI symptoms is variably associated with poor clinical outcomes in COVID-19. We aim to determine the outcomes of hospitalized COVID-19 patients with gastrointestinal symptoms. METHODOLOGY: This is a retrospective cohort study that used medical records of admitted COVID-19 patients from March 2020- March 2021 in a tertiary hospital in Pangasinan. Data records were evaluated for the presence of gastrointestinal manifestations, including diarrhea, nausea, vomiting and abdominal pain at the time of admission. Comparison between cases or COVID-19 patients presenting with GI manifestations to controls or COVID-19 patients without GI manifestation was made. RESULTS: Four hundred three patients were included in the study. Of these, 22.3% presented with gastrointestinal symptoms, while 77.7% comprised the study controls. Diarrhea was the most common GI symptom (10.4%). No statistically significant difference was observed in comorbidities and laboratory findings. Mortality was the primary outcome of the study that did not reach statistical significance between cases and controls (13.33% vs. 16.30%, p =0.621). There were also no significant differences observed in the secondary outcomes, mean length of stay, (14 [12-18 days] in cases vs 14 [12- 17.5 days] in controls, p = 0.716) and need for mechanical ventilation (12.22% vs 16.93%, p = 0.329). CONCLUSION: The results of the study revealed no association of the GI symptoms to poor outcomes, including a high rate of mortality, prolonged length of stay and increased need for mechanical ventilation.

Keywords: gastrointestinal symptoms, COVID-19, outcomes, mortality, length of stay

Procedia PDF Downloads 124
1428 Knowledge and Attitude Towards Strabismus Among Adult Residents in Woreta Town, Northwest Ethiopia: A Community-Based Study

Authors: Henok Biruk Alemayehu, Kalkidan Berhane Tsegaye, Fozia Seid Ali, Nebiyat Feleke Adimassu, Getasew Alemu Mersha

Abstract:

Background: Strabismus is a visual disorder where the eyes are misaligned and point in different directions. Untreated strabismus can lead to amblyopia, loss of binocular vision, and social stigma due to its appearance. Since it is assumed that knowledge is pertinent for early screening and prevention of strabismus, the main objective of this study was to assess knowledge and attitudes toward strabismus in Woreta town, Northwest Ethiopia. Providing data in this area is important for planning health policies. Methods: A community-based cross-sectional study was done in Woreta town from April–May 2020. The sample size was determined using a single population proportion formula by taking a 50% proportion of good knowledge, 95% confidence level, 5% margin of errors, and 10% non- response rate. Accordingly, the final computed sample size was 424. All four kebeles were included in the study. There were 42,595 people in total, with 39,684 adults and 9229 house holds. A sample fraction ’’k’’ was obtained by dividing the number of the household by the calculated sample size of 424. Systematic random sampling with proportional allocation was used to select the participating households with a sampling fraction (K) of 21 i.e. each household was approached in every 21 households included in the study. One individual was selected ran- domly from each household with more than one adult, using the lottery method to obtain a final sample size. The data was collected through a face-to-face interview with a pretested and semi-structured questionnaire which was translated from English to Amharic and back to English to maintain its consistency. Data were entered using epi-data version 3.1, then processed and analyzed via SPSS version- 20. Descriptive and analytical statistics were employed to summarize the data. A p-value of less than 0.05 was used to declare statistical significance. Result: A total of 401 individuals aged over 18 years participated, with a response rate of 94.5%. Of those who responded, 56.6% were males. Of all the participants, 36.9% were illiterate. The proportion of people with poor knowledge of strabismus was 45.1%. It was shown that 53.9% of the respondents had a favorable attitude. Older age, higher educational level, having a history of eye examination, and a having a family history of strabismus were significantly associated with good knowledge of strabismus. A higher educational level, older age, and hearing about strabismus were significantly associated with a favorable attitude toward strabismus. Conclusion and recommendation: The proportion of good knowledge and favorable attitude towards strabismus were lower than previously reported in Gondar City, Northwest Ethiopia. There is a need to provide health education and promotion campaigns on strabismus to the community: what strabismus is, its’ possible treatments and the need to bring children to the eye care center for early diagnosis and treatment. it advocate for prospective research endeavors to employ qualitative study design.Additionally, it suggest the exploration of studies that investigate causal-effect relationship.

Keywords: strabismus, knowledge, attitude, Woreta

Procedia PDF Downloads 47
1427 The Determination of Stress Experienced by Nursing Undergraduate Students during Their Education

Authors: Gülden Küçükakça, Şefika Dilek Güven, Rahşan Kolutek, Seçil Taylan

Abstract:

Objective: Nursing students face with stress factors affecting academic performance and quality of life as from first moments of their educational life. Stress causes health problems in students such as physical, psycho-social, and behavioral disorders and might damage formation of professional identity by decreasing efficiency of education. In addition to determination of stress experienced by nursing students during their education, it was aimed to help review theoretical and clinical education settings for bringing stress of nursing students into positive level and to raise awareness of educators concerning their own professional behaviors. Methods: The study was conducted with 315 students studying at nursing department of Semra and Vefa Küçük Health High School, Nevşehir Hacı Bektaş Veli University in the academic year of 2015-2016 and agreed to participate in the study. “Personal Information Form” prepared by the researchers upon the literature review and “Nursing Education Stress Scale (NESS)” were used in this study. Data were assessed with analysis of variance and correlation analysis. Results: Mean NESS Scale score of the nursing students was estimated to be 66.46±16.08 points. Conclusions: As a result of this study, stress level experienced by nursing undergraduate students during their education was determined to be high. In accordance with this result, it can be recommended to determine sources of stress experienced by nursing undergraduate students during their education and to develop approaches to eliminate these stress sources.

Keywords: stress, nursing education, nursing student, nursing education stress

Procedia PDF Downloads 447
1426 Minimizing thought Communication Gap between Designer and Client Using the Projective Personality Tests

Authors: Hira, Nisar Bhatti, Ezza

Abstract:

Contemporary studies support the strong co-relation between psychology and design. This study elaborates how different psychological personality test can help a fashion designer to judge the needs of their clients with respect to the customized clothing. This study will also help the designer to improve the lacking in the personality and will enable him to put his effort in required areas for grooming the customer. The use of psychology test to support the choice of certain design strategies that how the right clothing can make client a better intellectual with enhanced self-esteem and confidence. Different projective personality test are being used to suggest to evaluate personality traits. The Rorschach Inkblot Test is projective mental comprising of 10 ink-blots synonymous with the clinical brain research. Lüsher Color Diagnostics measures a person’s psycho physical state, his or her ability to withstand stress to perform and communicate. HTP is a projective responsibility test measuring self-perception, attitudes. The TAT test intend to evaluate a person’s patterns of thoughts, attitudes, observation, capacity and emotional response to this ambiguous test materials. No doubt designers are already crucially redesigning the individuals by their attires, but to expose the behavioral mechanism of the customer, designers should be able to recognize the hidden complexity behind his client by using the above mentioned methods. The study positively finds the design and psychology need to become substantially contacted in order to create a new regime of norms to groom a personality under the concentration and services of a fashion designer in terms of clothing.

Keywords: projective personality tests, customized clothing, Rorschach Inkblot Test, TAT, HTP, Lüsher Color Diagnostics

Procedia PDF Downloads 537
1425 A Linear Regression Model for Estimating Anxiety Index Using Wide Area Frontal Lobe Brain Blood Volume

Authors: Takashi Kaburagi, Masashi Takenaka, Yosuke Kurihara, Takashi Matsumoto

Abstract:

Major depressive disorder (MDD) is one of the most common mental illnesses today. It is believed to be caused by a combination of several factors, including stress. Stress can be quantitatively evaluated using the State-Trait Anxiety Inventory (STAI), one of the best indices to evaluate anxiety. Although STAI scores are widely used in applications ranging from clinical diagnosis to basic research, the scores are calculated based on a self-reported questionnaire. An objective evaluation is required because the subject may intentionally change his/her answers if multiple tests are carried out. In this article, we present a modified index called the “multi-channel Laterality Index at Rest (mc-LIR)” by recording the brain activity from a wider area of the frontal lobe using multi-channel functional near-infrared spectroscopy (fNIRS). The presented index aims to measure multiple positions near the Fpz defined by the international 10-20 system positioning. Using 24 subjects, the dependencies on the number of measuring points used to calculate the mc-LIR and its correlation coefficients with the STAI scores are reported. Furthermore, a simple linear regression was performed to estimate the STAI scores from mc-LIR. The cross-validation error is also reported. The experimental results show that using multiple positions near the Fpz will improve the correlation coefficients and estimation than those using only two positions.

Keywords: frontal lobe, functional near-infrared spectroscopy, state-trait anxiety inventory score, stress

Procedia PDF Downloads 237
1424 Crude Extracts of Medicinal Plants Can Inhibit Some Bacteria of Clinical Importance in Minced Meat

Authors: Chika C. Ogueke, Ijeoma M. Agunwah

Abstract:

The antimicrobial activities and preservative potentials of crude extracts of Alstonia boonei stem bark and Euphorbia hirta leaves were studied. Soxhlet extraction and cold ethanol extraction methods were used for the extraction of the dried and ground plant samples. Well in agar diffusion method was used for the antimicrobial screening at different concentrations of 25mg/ml, 50mg/ml, 100mg/ml and 200mg/ml on E.coli and B.subtilis. The preservative effects of the extracts at 0.1%, 0.2% and 0.3% singly and in combination were determined in minced meat using E. coli and B. subtilis as test isolates. Phytochemical analysis was also conducted on the extracts using standard analytical methods. E.hirta cold and A.boonei cold extracts gave the highest zone of growth inhibition on E. coli and B.substilis with 20mm zone diameter at 200mg/ml concentration. Phytochemical analysis revealed the presence of alkaloids, flavonoids, tannins, saponins and cardiac glycosides. A.boonei at 0.1, 0.2 and 0.3% produced a log cycle reduction on the growth of E.coli. Mixture of A. boonei and E. hirta extracts (1:1) at 0.1% and 0.2% also produced a log cycle reduction on the growth of E.coli and B. subtilis, however the A. boonei extracts had more significant effect on the isolates. The observed antimicrobial activities are attributed to the phytochemicals identified in the extracts. The results reveal the potentials of plant extracts as natural antimicrobial preservatives in minced meat. Thus the crude extracts can act as inhibitors of bacteria in a food system. Upon further purification better results may be obtained.

Keywords: antimicrobial preservative, crude extracts, minced meat, test isolates

Procedia PDF Downloads 272
1423 High Prevalence of Multi-drug Resistant Diarrheagenic Escherichia coli among Hospitalised Diarrheal Patients in Kolkata, India

Authors: Debjani Ghosh, Goutam Chowdhury, Prosenjit Samanta, Asish Kumar Mukhopadhyay

Abstract:

Acute diarrhoea caused by diarrheagenic Escherichia coli (DEC) is one of the major public health problem in developing countries, mainly in Asia and Africa. DEC consists of six pathogroups, but the majority of the cases were associated with the three pathogropus, enterotoxigenic E. coli (ETEC), enteroaggregative E. coli (EAEC), and enteropathogenic E. coli (EPEC). Hence, we studied the prevalence and antimicrobial resistance of these three major DEC pathogroups in hospitalized diarrheal patients in Kolkata, India, during 2012-2019 with a large sample size. 8,891 stool samples were processed, and 7.8% of them was identified as DEC infection screened by multiplex PCR, in which ETEC was most common (47.7%) followed by EAEC (38.4%) and EPEC (13.9%). Clinical patient history suggested that children <5 years of age were mostly affected with ETEC and EAEC, whereas people within >5-14 years of age were significantly associated with EPEC and ETEC infections. Antibiogram profile showed a high prevalence of multidrug resistant (MDR) isolates among DEC (56.9%), in which 9% were resistant to antibiotics of six different antimicrobial classes. Screening of the antibiotic resistance conferring genes in DEC showed the presence of blaCTX-M (30.2%) in highest number followed by blaTEM (27.5%), tetB (18%), sul2 (12.6%), strA (11.8%), aadA1 (9.8%), blaOXA-1 (9%), dfrA1 (1.6%) and blaSHV (1.2%) which indicates the existence of mobile genetic elements in those isolates. Therefore, the presence of MDR DEC strains in higher number alarms the public health authorities to take preventive measures before the upsurge of the DEC caused diarrhea cases in near future.

Keywords: diarrheagenic escherichia coli, ETEC, EAEC, EPEC

Procedia PDF Downloads 144
1422 Multiple Variations of the Nerves of Gluteal Region and Their Clinical Implications, a Case Report

Authors: A. M. Prasad

Abstract:

Knowledge of variations of nerves of gluteal region is important for clinicians administering intramuscular injections, for orthopedic surgeons dealing with the hip surgeries, possibly for physiotherapists managing the painful conditions and paralysis of this region. Herein, we report multiple variations of the nerves of gluteal region. In the current case, the sciatic nerve was absent. The common peroneal and tibial nerves arose from sacral plexus and reached the gluteal region through greater sciatic foramen above and below piriformis respectively. The common peroneal nerve gave a muscular branch to the gluteus maximus. The inferior gluteal nerve and posterior cutaneous nerve of the thigh arose from a common trunk. The common trunk was formed by three roots. Upper and middle roots arose from sacral plexus and entered gluteal region through greater sciatic foramen respectively above and below piriformis. The lower root arose from the pudendal nerve and joined the common trunk. These variations were seen in the right gluteal region of an adult male cadaver aged approximately 70 years. Innervation of gluteus maximus by common peroneal nerve and presence of a common trunk of inferior gluteal nerve and posterior cutaneous nerve of the thigh make this case unique. The variant nerves may be subjected to iatrogenic injuries during surgical approach to the hip. They may also get compressed if there is a hypertrophy of the piriformis syndrome. Hence, the knowledge of these variations is of importance to clinicians, orthopedic surgeons and possibly for physiotherapists.

Keywords: gluteal region, multiple variations, nerve injury, sciatic nerve

Procedia PDF Downloads 335
1421 Correlations between Pushing Skills and Pushing Perceptions, Second-Stage Labor Duration, Postpartum Fatigue, and Birth Satisfaction

Authors: Yu-Ching Huang

Abstract:

Background: Delivery bridges the antepartum and postpartum period. Subsequent fatigue can affect indices, including postpartum recovery and life quality. Milk secretion, breastfeeding quality, and newborn participation may be compromised. Correspondingly, using proper pushing skills during the second stage of labor has the potential to effectively reduce postpartum fatigue and enhance birth satisfaction in new mothers. Purpose: To compare the effects of using different pushing skills on maternal pushing perception, postpartum fatigue, and birth satisfaction. Methodology: The present study used a descriptive research approach and recruited 382 participants from a medical center in northern Taiwan. Data were collected using a structured questionnaire, which included a demographic and obstetrics information datasheet, the Labor Pushing Experience Scale, a fatigue scale, and a birth satisfaction scale. Research Results: Using pushing skills (including upright position [t= 2.28, p < .05] and delayed pushing [t= -1.98, p < .05] during the second stage of labor was shown to enhance birth satisfaction in participants. Additionally, open glottis pushing ( t = 5.46, p < .001) resulted in a mean duration of second-stage labor that was 17.67 minutes less than that achieved using Valsalva pushing. Moreover, a better perceived pushing experience was associated with lower perceived postpartum fatigue (r = .46, p < .05) and higher birth satisfaction (r = -.16, p < .05). Finally, postpartum fatigue perception was negatively associated with birth satisfaction (r = -.16, p < .05). Conclusion and Clinical Application: The findings suggest that midwives should advocate that women adopt upright positions, delayed pushing, and open glottis pushing during the second stage of labor in order to enhance their birth satisfaction.

Keywords: second stage labor duration of pushing skill, pushing experience perception, postpartum fatigue, birth satisfaction

Procedia PDF Downloads 252
1420 Primary Analysis of a Randomized Controlled Trial of Topical Analgesia Post Haemorrhoidectomy

Authors: James Jin, Weisi Xia, Runzhe Gao, Alain Vandal, Darren Svirkis, Andrew Hill

Abstract:

Background: Post-haemorrhoidectomy pain is concerned by patients/clinicians. Minimizing the postoperation pain is highly interested clinically. Combinations of topical cream targeting three hypothesised post-haemorrhoidectomy pain mechanisms were developed and their effectiveness were evaluated. Specifically, a multi-centred double-blinded randomized clinical trial (RCT) was conducted in adults undergoing excisional haemorrhoidectomy. The primary analysis was conveyed on the data collected to evaluate the effectiveness of the combinations of topical cream targeting three hypothesized pain mechanisms after the operations. Methods: 192 patients were randomly allocated to 4 arms (each arm has 48 patients), and each arm was provided with pain cream 10% metronidazole (M), M and 2% diltiazem (MD), M with 4% lidocaine (ML), or MDL, respectively. Patients were instructed to apply topical treatments three times a day for 7 days, and record outcomes for 14 days after the operations. The primary outcome was VAS pain on day 4. Covariates and models were selected in the blind review stage. Multiple imputations were applied for the missingness. LMER, GLMER models together with natural splines were applied. Sandwich estimators and Wald statistics were used. P-values < 0.05 were considered as significant. Conclusions: The addition of topical lidocaine or diltiazem to metronidazole does not add any benefit. ML had significantly better pain and recovery scores than combination MDL. Multimodal topical analgesia with ML after haemorrhoidectomy could be considered for further evaluation. Further trials considering only 3 arms (M, ML, MD) might be worth exploring.

Keywords: RCT, primary analysis, multiple imputation, pain scores, haemorrhoidectomy, analgesia, lmer

Procedia PDF Downloads 93
1419 Revisiting Politics of Religion in Muslim Republics of Former Soviet Union and Rise of Extremism, Global Jihadi Terrorism

Authors: Etibar Guliyev

Abstract:

The breakdown of the Soviet Union in 1991 has led to a considerable rise in the religious self-consciousness of Muslim population of the Central Asia. Additionally, huge amount of money spent by various states further facilitated the spread of religious ideas. According to some sources, Saudi Arabia spent 87 billion dollars to propagate Wahhabism abroad during two decades, whereas the Communist Party of the Soviet Union spent just over 7 billion dollars to spread its ideology worldwide between 1921 and 1991. As the result, today once a remote area from international politics has turned into third major source of recruitment of fighters for global terrorist organizations. In order to illustrate to scope of the involvement of the Central Asian residents in international terrorist networks it is enough to mention the name of Colonel Gulmorod Khalimov, the former head of the Tajik special police forces who served as ISIS war minister between 2016 and 2017. The importance of the topic stems from the fact that the above-mentioned republics with a territory of 4 million square km and the population of around 80 million people borders Russia, Iran Afghanistan and China. Moreover, the fact that political and military activities motivated with religious feelings in those countries have implications not only for domestic but also for regional and global political relations and all of them has root in politics of religions adds value to the research. This research aims to provide an in-depth analyses of the marked features of the state policies to regulate religious activities and approach this question both from individual, domestic, regional and global levels of analyses. The research will enable us to better understand what implications have the state of religious freedom in post-Soviet Muslim republics for international relations and the rise of global jihadi terrorism. The paper tries to find a linkage between the mentioned terror attacks and underground rise of religious extremism in Central Asia. This research is based on multiple research methods, mainly on qualitative one. The process tracing method is also employed to review religious policies implemented from 1918-1991 and after the collapse of the Soviet Union in a chronological way. In terms of the quantitative method, it chiefly will be used in a bid to process various statistics disseminated in academic and official sources. The research mostly explored constructivist, securitization and social movement theories. Findings of the research suggests that the endemic problems peculiar to authoritarian regimes of Central Asia such as crackdown on the expression of religious believe and any kind of opposition, economic decline, instrumental use of religion and corruption and tribalism further accelerated the recruitment problem. Paper also concludes that the Central Asian states in some cases misused counter-terrorism campaign as a pretext to further restrict freedom of faith in their respective countries.

Keywords: identity, political Islam, religious extremism, security, terrorism

Procedia PDF Downloads 251
1418 Synthesis and in vitro Characterization of a Gel-Derived SiO2-CaO-P2O5-SrO-Li2O Bioactive Glass

Authors: Mehrnaz Aminitabar, Moghan Amirhosseinian, Morteza Elsa

Abstract:

Bioactive glasses (BGs) are a group of surface-reactive biomaterials used in clinical applications as implants or filler materials in the human body to repair and replace diseased or damaged bone. Sol-gel technique was employed to prepare a SiO2-CaO-P2O5 glass with nominal composition of 58S BG with the addition of Sr and Li modifiers which imparts special properties to the BG. The effect of simultaneous addition of Sr and Li on bioactivity and biocompatibility, proliferation, alkaline phosphatase (ALP) activity of osteoblast cell line MC3T3-E1 and antibacterial property against methicillin-resistant Staphylococcus aureus (MRSA) bacteria were examined. BGs were characterized by X-ray diffraction, Fourier transform infrared spectroscopy, scanning electron microscopy before and after soaking the samples in the simulated body fluid (SBF) for different time intervals to characterize the formation of hydroxyapatite (HA) formed on the surface of BGs. Structural characterization indicated that the simultaneous presence of 5% Sr and 5% Li in 58S-BG composition not only did not retard HA formation because of opposite effect of Sr and Li of the dissolution of BG in the SBF but also, stimulated the differentiation and proliferation of MC3T3-E1s. Moreover, the presence of Sr and Li on dissolution of the ions resulted in an increase in the mean number of DAPI-labeled nuclei which was in good agreement with live/dead assay. The result of antibacterial tests revealed that Sr and Li-substituted 58S BG exhibited a potential antibacterial effect against MRSA bacteria. Because of optimal proliferation and ALP activity of MC3T3-E1cells, proper bioactivity and high antibacterial potential against MRSA, BG-5/5 is suggested as a multifunctional candidate for bone tissue engineering.

Keywords: antibacterial activity, bioactive glass, sol-gel, strontium

Procedia PDF Downloads 103
1417 Border Between the Violation of Dental Ethics and the Occurrence of Dental Malpractice

Authors: Saimir Heta, Rialda Xhizdari, Kers Kapaj, Ilma Robo

Abstract:

Background: The interests of both individuals involved, both the dentist with his professionalism, and the patient who claims and expects the proper professional dental service, are determined in cases of dental malpractice. The latter is a phenomenon that is also wearing the "cloak" of bilateral manipulations, which in themselves require strong legal control to regulate the relations between the involved parties. The two individuals are involved both individually and even professionally and emotionally, with support in the "ultimate" interests of the two people, which in the case of conflicts or grievances, which as a result are transported to the family or society of the affected individual. Main text: The reason for malpractice is the most difficult part to find and then to interpret. It can be professional in the view of "so much I know how to do, so much done", or in the view of the impossibility of individual health conditions to achieve high professional expectations. But, the reason can also be individual with the intention of doing bad without reason or with the source of an unhealthy mind and the source of malicious thinking. The professional himself is a human being and as such may be under the effect of individual treatments or vices, therefore causing misuse, a case that must be distinguished from intentional misuse and which must be judged for the results or damages caused by the professional based on criminal law. Conclusions: Malpractice in some cases may be unavoidable, beyond the good intention of the dental intervention, which should be well understood by both parties involved in this relationship. Malpractice is not necessarily related only to difficult clinical cases, but sometimes also appears as a random deviation of a dental treatment with a welldefined professional protocol. The legal support in the interpretation of malpractice cases should be much more specific according to previous cases, this practice specifically, perhaps also according to different religious states.

Keywords: dental ethics, malpractice, professional dental service, legal support

Procedia PDF Downloads 84
1416 The Factors Affecting on Promoting Productivity from Nurses' View

Authors: Mahnaz Sanjari, Sedigheh Salemi, Mohammad Mirzabeigi

Abstract:

Nowadays, the world is facing a crisis of workforce and one of the most striking examples is the shortage of nurses. Nursing workforce productivity is related by various factors such as absenteeism, professional effectiveness and quality care. This cross-sectional study was conducted in 700 nurses who work in government hospitals from 35 hospitals of 9 provinces in Iran. The study was approved by the Nursing Council and was carried out with the authorization of the Research Ethics Committee. The questionnaire included 33 questions and 4 sub categories such as human resource, education and management. The reliability was evaluated by Cronbach's alpha (α=0/85). Statistical analyzes were performed, using SPSS version 16. The result showed that nurses emphasized on "respect to nurse-to-bed ratio" and less importance item was "using less experienced nurse". In addition, another important factor in clinical productivity is "Proper physical structure and amenities","good communication with colleagues" and "having good facilities". Also, "human resources at all levels of standard", "promoting on merit" and "well defined relationship in health system" are another important factors in productivity from nurse` view. The main managerial factor is "justice between employees" and the main educational component of productivity is “updating nursing knowledge”. The results show that more than half of the participants emphasized on the management and educational factors. Productivity as one of the main part of the health care quality leads to appropriate use of human and organizational resources, reduce cost services, and organizational development.

Keywords: productivity, nursing services, workforce, cost services

Procedia PDF Downloads 335
1415 Common Causes of Eye Removal Surgery in Turkish Patients: A Review of 226 Cases

Authors: Titap Yazicioglu

Abstract:

Purpose: To determine the etiological factors responsible for the eye removal surgery and to evaluate our surgical results. Material and Methods: Medical records of 226 patients, who underwent eye removal surgery, were analyzed retrospectively. Demographic information, clinical history, surgical procedure, and histopathological data were all collected. Evisceration surgery was performed under general anesthesia in all patients except tumor cases and one patient with rhino-orbital mucormycosis. The patients were followed for an average of 16.46±10.78 months and checked for the possible complications, cosmesis, and functional results.Results: 144 men, and 82 women,with a mean age of 41.78±22.6 years, were underwent enucleation (n=15) or evisceration (n=211) due to traumatic (n=169) and non-traumatic (n=57) causes. In the traumatic group, 79.8% of 169 patients were injured by penetrating and 14.2% by blunt trauma.3.6% of the patients were injured in a traffic accident, and 2.4% of them were injured by explosives. In the non-traumatic group, 40% of 25 patients had post-traumatic endophthalmitis, 32% had endophthalmitis due to corneal ulceration and melting, and 24% had endophthalmitis after cataract surgery. One patient had panophthalmitis due to rhino-orbital mucormycosis. Another cause in the non-traumatic group was glaucoma, of which 92.3% had neovascular glaucoma, and 8.7% had congenital glaucoma. Of the 14 patients who were enucleated for tumor, 35.7% had retinoblastoma, 14.3% had medulloepithelioma, 42.9% had uveal melanoma, and 7.1% had metastatic tumor from paranasal sinuses.The most common complaint in the follow-up period was discharging, seen in all prosthesis-wearing patients. 13.3% of the patients had itching due to ocular prosthesis. 4.4% of the patients were complaining about deep superior sulcus. 4.4% had pyogenic granuloma, and 17.8% had implant exposure. Conclusion: Etiological factors should be carefully evaluated, and precautions should be taken in order to reduce the devastating effect of the physical loss of the eye.

Keywords: enucleation, evisceration, ocular injury, etiology, frequency

Procedia PDF Downloads 101
1414 A Comprehensive Characterization of Cell-free RNA in Spent Blastocyst Medium and Quality Prediction for Blastocyst

Authors: Huajuan Shi

Abstract:

Background: The biopsy of the preimplantation embryo may increase the potential risk and concern of embryo viability. Clinically discarded spent embryo medium (SEM) has entered the view of researchers, sparking an interest in noninvasive embryo screening. However, one of the major restrictions is the extremelty low quantity of cf-RNA, which is difficult to efficiently and unbiased amplify cf-RNA using traditional methods. Hence, there is urgently need to an efficient and low bias amplification method which can comprehensively and accurately obtain cf-RNA information to truly reveal the state of SEM cf-RNA. Result: In this present study, we established an agarose PCR amplification system, and has significantly improved the amplification sensitivity and efficiency by ~90 fold and 9.29 %, respectively. We applied agarose to sequencing library preparation (named AG-seq) to quantify and characterize cf-RNA in SEM. The number of detected cf-RNAs (3533 vs 598) and coverage of 3' end were significantly increased, and the noise of low abundance gene detection was reduced. The increasing percentage 5' end adenine and alternative splicing (AS) events of short fragments (< 400 bp) were discovered by AG-seq. Further, the profiles and characterizations of cf-RNA in spent cleavage medium (SCM) and spent blastocyst medium (SBM) indicated that 4‐mer end motifs of cf-RNA fragments could remarkably differentiate different embryo development stages. Significance: This study established an efficient and low-cost SEM amplification and library preparation method. Not only that, we successfully described the characterizations of SEM cf-RNA of preimplantation embryo by using AG-seq, including abundance features fragment lengths. AG-seq facilitates the study of cf-RNA as a noninvasive embryo screening biomarker and opens up potential clinical utilities of trace samples.

Keywords: cell-free RNA, agarose, spent embryo medium, RNA sequencing, non-invasive detection

Procedia PDF Downloads 47
1413 Eco-City Planning and Urban Design in Lagos, Nigeria: Recent Innovations, Trends, Concerns, Challenges, and Solutions

Authors: Dahunsi Michael Oluseyi

Abstract:

This paper aims to extensively examine eco-city planning and urban design in Lagos, Nigeria. It will delve into the city's developments, challenges, and potential solutions to offer insights for sustainable urban growth within the rapidly expanding urban landscape. The research will scrutinize recent innovations, emerging trends, and practical remedies to promote ecological sustainability within an urban framework. It will encompass a more in-depth review of current literature, case studies, and qualitative analyses, thereby augmenting the depth and breadth of the research. The objectives are to assess the current eco-city planning initiatives and urban design trends in Lagos, Nigeria, considering the city's unique characteristics and challenges. To identify and analyze the challenges encountered during the implementation of eco-friendly urban developments in Lagos, to explore and evaluate the innovative and practical solutions that are implemented to promote sustainability within the city, to provide comprehensive insights and actionable recommendations for policymakers, urban planners, and other stakeholders involved in sustainable urban development in Lagos, the rapid urbanization of Lagos has brought forth a myriad of challenges, including a burgeoning population, inadequate infrastructure, waste management issues, and environmental pollution. Eco-city planning has emerged as a promising approach to addressing these obstacles, striving to create urban spaces that are more habitable, resource-efficient, and environmentally friendly. This research holds substantial importance in exploring the application of eco-city planning principles within a megacity like Lagos. Analyzing recent innovations, trends, concerns, challenges, and solutions provides invaluable insights for policymakers, urban planners, and stakeholders dedicated to fostering sustainable urban development. The methodologies employed in this research are structured to embrace a multifaceted and intricate approach, aiming to facilitate a comprehensive understanding of the complexities inherent in eco-city planning and urban design in Lagos, Nigeria. This methodological framework is designed to encompass various diverse strategies and analytical tools to effectively capture the multidimensional aspects of sustainable urban development. It involves an in-depth analysis of academic publications, governmental reports, and urban planning documents to highlight global eco-city planning trends and gather Lagos-specific insights through a detailed exploration of eco-friendly initiatives and projects in Lagos to evaluate successes, challenges, and strategies for addressing environmental concerns by engaging key stakeholders, including urban planners, policymakers, environmental experts, and residents, to collect firsthand perspectives, concerns, and insights. Also, a thorough analysis will be carried out on data collected from literature reviews, case studies, interviews, and surveys used to extract prevalent patterns, challenges, and innovative solutions from diverse sources. This study aims to contribute to the discourse on sustainable urban development by offering a comprehensive analysis of eco-city planning in Lagos and providing practical recommendations for a more sustainable urban future.

Keywords: eco-friendly, innovation, sustainability, stakeholders

Procedia PDF Downloads 48
1412 Establishment of a Nomogram Prediction Model for Postpartum Hemorrhage during Vaginal Delivery

Authors: Yinglisong, Jingge Chen, Jingxuan Chen, Yan Wang, Hui Huang, Jing Zhnag, Qianqian Zhang, Zhenzhen Zhang, Ji Zhang

Abstract:

Purpose: The study aims to establish a nomogram prediction model for postpartum hemorrhage (PPH) in vaginal delivery. Patients and Methods: Clinical data were retrospectively collected from vaginal delivery patients admitted to a hospital in Zhengzhou, China, from June 1, 2022 - October 31, 2022. Univariate and multivariate logistic regression were used to filter out independent risk factors. A nomogram model was established for PPH in vaginal delivery based on the risk factors coefficient. Bootstrapping was used for internal validation. To assess discrimination and calibration, receiver operator characteristics (ROC) and calibration curves were generated in the derivation and validation groups. Results: A total of 1340 cases of vaginal delivery were enrolled, with 81 (6.04%) having PPH. Logistic regression indicated that history of uterine surgery, induction of labor, duration of first labor, neonatal weight, WBC value (during the first stage of labor), and cervical lacerations were all independent risk factors of hemorrhage (P <0.05). The area-under-curve (AUC) of ROC curves of the derivation group and the validation group were 0.817 and 0.821, respectively, indicating good discrimination. Two calibration curves showed that nomogram prediction and practical results were highly consistent (P = 0.105, P = 0.113). Conclusion: The developed individualized risk prediction nomogram model can assist midwives in recognizing and diagnosing high-risk groups of PPH and initiating early warning to reduce PPH incidence.

Keywords: vaginal delivery, postpartum hemorrhage, risk factor, nomogram

Procedia PDF Downloads 57
1411 Multi-Criteria Geographic Information System Analysis of the Costs and Environmental Impacts of Improved Overland Tourist Access to Kaieteur National Park, Guyana

Authors: Mark R. Leipnik, Dahlia Durga, Linda Johnson-Bhola

Abstract:

Kaieteur is the most iconic National Park in the rainforest-clad nation of Guyana in South America. However, the magnificent 226-meter-high waterfall at its center is virtually inaccessible by surface transportation, and the occasional charter flights to the small airstrip in the park are too expensive for many tourists and residents. Thus, the largest waterfall in all of Amazonia, where the Potaro River plunges over a single free drop twice as high as Victoria Falls, remains preserved in splendid isolation inside a 57,000-hectare National Park established by the British in 1929, in the deepest recesses of a remote jungle canyon. Kaieteur Falls are largely unseen firsthand, but images of the falls are depicted on the Guyanese twenty dollar note, in every Guyanese tourist promotion, and on many items in the national capital of Georgetown. Georgetown is only 223-241 kilometers away from the falls. The lack of a single mileage figure demonstrates there is no single overland route. Any journey, except by air, involves changes of vehicles, a ferry ride, and a boat ride up a jungle river. It also entails hiking for many hours to view the falls. Surface access from Georgetown (or any city) is thus a 3-5 day-long adventure; even in the dry season, during the two wet seasons, travel is a particularly sticky proposition. This journey was made overland by the paper's co-author Dahlia Durga. This paper focuses on potential ways to improve overland tourist access to Kaieteur National Park from Georgetown. This is primarily a GIS-based analysis, using multiple criteria to determine the least cost means of creating all-weather road access to the area near the base of the falls while minimizing distance and elevation changes. Critically, it also involves minimizing the number of new bridges required to be built while utilizing the one existing ferry crossings of a major river. Cost estimates are based on data from road and bridge construction engineers operating currently in the interior of Guyana. The paper contains original maps generated with ArcGIS of the potential routes for such an overland connection, including the one deemed optimal. Other factors, such as the impact on endangered species habitats and Indigenous populations, are considered. This proposed infrastructure development is taking place at a time when Guyana is undergoing the largest boom in its history due to revenues from offshore oil and gas development. Thus, better access to the most important tourist attraction in the country is likely to happen eventually in some manner. But the questions of the most environmentally sustainable and least costly alternatives for such access remain. This paper addresses those questions and others related to access to this magnificent natural treasure and the tradeoffs such access will have on the preservation of the currently pristine natural environment of Kaieteur Falls.

Keywords: nature tourism, GIS, Amazonia, national parks

Procedia PDF Downloads 136
1410 The Differences and Similarities in Neurocognitive Deficits in Mild Traumatic Brain Injury and Depression

Authors: Boris Ershov

Abstract:

Depression is the most common mood disorder experienced by patients who have sustained a traumatic brain injury (TBI) and is associated with poorer cognitive functional outcomes. However, in some cases, similar cognitive impairments can also be observed in depression. There is not enough information about the features of the cognitive deficit in patients with TBI in relation to patients with depression. TBI patients without depressive symptoms (TBInD, n25), TBI patients with depressive symptoms (TBID, n31), and 28 patients with bipolar II disorder (BP) were included in the study. There were no significant differences in participants in respect to age, handedness and educational level. The patients clinical status was determined by using Montgomery–Asberg Depression Rating Scale (MADRS). All participants completed a cognitive battery (The Brief Assessment of Cognition in Affective Disorders (BAC-A)). Additionally, the Rey–Osterrieth Complex Figure (ROCF) was used to assess visuospatial construction abilities and visual memory, as well as planning and organizational skills. Compared to BP, TBInD and TBID showed a significant impairments in visuomotor abilities, verbal and visual memory. There were no significant differences between BP and TBID groups in working memory, speed of information processing, problem solving. Interference effect (cognitive inhibition) was significantly greater in TBInD and TBID compared to BP. Memory bias towards mood-related information in BP and TBID was greater in comparison with TBInD. These results suggest that depressive symptoms are associated with impairments some executive functions in combination at decrease of speed of information processing.

Keywords: bipolar II disorder, depression, neurocognitive deficits, traumatic brain injury

Procedia PDF Downloads 334